Migraine

Why it works: Magnesium is involved in many brain and vascular processes that are implicated in migraine: it modulates neuronal excitability (including NMDA/glutamate pathways), stabilizes volta...

Instructions: a. Prevention (oral magnesium). • Typical doses used in prevention trials: ~400 mg elemental magnesium daily, with many sources recommending 400–600 mg/day (commonly magnesium oxid...

Warnings: Main side effects:. • Gastrointestinal: oral magnesium commonly causes diarrhoea, abdominal cramping...

Studies: Guidelines / evidence grading: The American Academy of Neuro...

Why it works: Parthenolide and related sesquiterpene lactones — the most studied active constituents — appear to reduce inflammation and inhibit mediators involved in migraine pathways (for exam...

Instructions: Common whole-leaf / powdered doses used in trials: 50–150 mg/day of dried feverfew leaf (often split doses or once daily). Many older positive trials used freeze-dried whole-leaf p...

Warnings: Pregnancy & breastfeeding: Avoid. Feverfew may stimulate uterine contractions and is not recommended...

Studies: Lancet randomized double-blind crossover trial (Murphy et al...

Why it works: Mitochondrial energy support (riboflavin/B2). Many migraine researchers theorize that migraine susceptibility is related to impaired brain energy metabolism. Riboflavin is a precur...

Instructions: Riboflavin (Vitamin B2) — adult prophylaxis (most evidence). • Typical trial dose: 400 mg per day (given orally, once daily or split), most RCTs ran for ~3 months. Some meta-analys...

Warnings: General safety. • Riboflavin is usually well tolerated even at trial doses (400 mg/day). The most co...

Studies: Riboflavin (B2) — trials & reviewsMDPI review: Experimen...

Why it works: The main active component is menthol. Menthol activates the cold receptor TRPM8 on sensory nerves, producing a cooling/counter-irritant effect that reduces pain signalling and can...

Instructions: (A) Evidence-based topical protocol used in trials (most-studied):. • Product / formulation used in trials: 10% peppermint oil in ethanol (i.e., 10 g peppermint oil + ethanol to 10...

Warnings: (A) Evidence-based topical protocol used in trials (most-studied):. • Product / formulation used in...

Studies: Göbel et al., Der Nervenarzt (1996) — randomized, double-bli...

Why it works: The active constituents in butterbur—petasins (sesquiterpene esters)—have anti-inflammatory and neuromodulatory actions. They reduce neurogenic inflammation, inhibit inflammatory m...

Instructions: Dose used in the pivotal trials: commonly 50 mg twice daily (100 mg/day) or 75 mg twice daily (150 mg/day). The 75 mg twice-daily dose (150 mg/day) produced larger and statisticall...

Warnings: Pyrrolizidine alkaloids (PAs) — the big safety issue: Raw butterbur contains PAs, which are hepatoto...

Studies: Randomized controlled trials: A key randomized, double-blind...

Why it works: Chuanxiong Cha­tiao San (川芎茶調散, CXS / CXCT) — a classic 9-herb TCM formula built around Ligusticum chuanxiong (Chuanxiong) — is widely used in China for wind-type headaches an...

Instructions: Formula composition (typical): CXS is a 9-ingredient formula. Common ingredients include Ligusticum chuanxiong (Chuanxiong), Angelica dahurica (Bai Zhi), Notopterygium (Qiang Huo),...

Warnings: Bleeding risk / anticoagulants: Chuanxiong exhibits antiplatelet/anticoagulant activity in some phar...

Studies: Systematic review & meta-analysis (Hindawi, 2019). A sys...

Why it works: Traditional TCM rationale. • In TCM the formula is used for “blood stasis in the head/face” causing headache, vertigo and related signs. The formula’s actions are described as “act...

Instructions: Traditional decoction (classical instructions). • The classic recipe (from Yi Lin Gai Cuo, Wang Qingren) lists: Chi Shao (3 g), Chuan Xiong (3 g), Tao Ren (9 g), Hong Hua (9 g), Co...

Warnings: Bleeding risk & drug interactions: key herbs in TQHXT (Hong Hua / safflower and Tao Ren / peach kern...

Studies: What exists specifically for migraineThere are relatively fe...

Why it works: Wuzhuyu (WZYD / Wuzhuyu decoction, also called Goshuyuto in Japanese) is a classical 4-herb traditional East-Asian formula used for headache with nausea/vomiting and “cold” pattern...

Instructions: Traditional formula composition (classical prescription):. • Wu Zhu Yu (Evodia / Euodiae Fructus) — principal herb. • Ren Shen (Ginseng radix). • Sheng Jiang (fresh ginger). • Da Z...

Warnings: 1. Potential hepatotoxicity (liver injury) linked to Evodia (Wu Zhu Yu) / evodiamine:. • Several ana...

Studies: Key randomized controlled trial (human):Efficacy of Modified...

Why it works: White willow bark (Salix spp.) contains salicin, which the body converts to salicylic acid (an aspirin-like compound). That explains why it can relieve pain — but high-quality clin...

Instructions: Forms commonly used. • Standardized willow-bark extracts (capsules/tablets) that specify salicin content.. • Tinctures (alcohol extracts).. • Teas / decoctions from dried bark (les...

Warnings: Major cautions. • Bleeding risk / antiplatelet effects: Because salicylates reduce platelet function...

Studies: What the trials show (summary)Low-back pain: A randomized, d...

Why it works: There is biological plausibility (antioxidant + anti-inflammatory + neuroprotective effects) and several animal studies showing pain/neuropathic-pain benefits, but there are no hig...

Instructions: There are no standard, evidence-based dosing recommendations for migraine because there are no migraine RCTs. However, clinical studies in other conditions (eye strain, cognition,...

Warnings: Warfarin / anticoagulant interaction (case signal): there is at least one case report and subsequent...

Studies: What exists:Mechanistic & review papers summarizing anti...

Why it works: Active compounds in butterbur extracts are petasins (petasin, isopetasin) which have anti-inflammatory and neuromodulatory activity. They appear to reduce neurogenic inflammation b...

Instructions: Typical trial dose: the most common, evidence-backed dosing used in the randomized trials is 75 mg twice daily (total 150 mg/day) of a standardized butterbur root extract (e.g., Pe...

Warnings: Pyrrolizidine alkaloids (PAs) — the big safety issue. Raw butterbur contains PAs, which are known he...

Studies: Lipton RB et al., Neurology 2004 — randomized, three-arm tri...