Writing in the journal BMC Medicine, Iranian researchers reported that co-supplementation for 12 weeks could result in a significant reduction in migraine headache frequency and slight decreases in migraine headache duration and severity.
“Although several medications are available to alleviate pain and clinical symptoms of migraine, acute treatment with most of them might not lead to favorable clinical outcomes,” the researchers wrote. “Suboptimal treatment can lead to medication overuse, which, in turn, increases the chronicity of the disease and the risk of depression and anxiety.”
They noted that migraines also result in a substantial burden to society because of the disease's direct and indirect medical costs related to unemployment and lost work time.
One billion affected
A migraine is defined as a headache that is unilateral, pulsating, moderate to severe and aggravated by physical activity. Symptoms include nausea and/or vomiting, phonophobia and photophobia during an attack. Some migraine patients experience aura, reversible focal neurological symptoms that occur five to 60 minutes before the headache develops.
There are sometimes psychiatric comorbidities, such as depression, anxiety and sleep disorders that occur in migraine patients compared to the general population, impacting quality of life and clinical outcomes. More than one billion people suffer from migraines globally.
Probiotics may relieve migraine headaches by improving the function of gut-brain axis, and Vitamin D supplementation has also shown positive effects on the number and severity of migraine attacks, the researchers noted.
“It seems that one of the mechanisms through which vitamin D improves migraine attacks might be through its effect on the brain-intestinal axis,” they added. “We hypothesized that probiotic and vitamin D supplementation might be synergistically effective on the brain-gut axis and migraine symptoms.”
Study details
The study was a randomized, triple-blinded, placebo-controlled trial, including 68 participants between the ages of 18 and 55 years diagnosed with migraine. Scientists collected blood samples after 12 hours of fasting at baseline and at the end of the intervention.
Participants received either vitamin D (50,000 IU every two weeks) plus probiotic (4.5 × 1011 CFU per day) or placebo for 12 weeks. After the study period, patients completed the Headache Impact Test (HIT-6) and Depression, Anxiety, and Stress Scale (DASS) questionnaires, although there was no significant difference in migraine headache duration and HIT-6 score changes between the two groups
Participants also assessed the frequency, duration and severity of migraine headaches by using a self-administered 30-day headache diary at baseline and the end of the intervention.
Only migraine headache frequency and severity substantially decreased in the intervention group. Probiotic and vitamin D co-supplementation had no effect on daily functioning, mental health outcomes and serum levels of hs-CRP in adult patients with migraine.
“Previous findings have shown that gut microbiota dysbiosis and increased gut permeability stimulate the release of proinflammatory cytokines which lead to migraine headache initiation by inducing nociceptive responses in the trigeminal pathway,” the researchers wrote. “Thus, it seems that treatment options affecting gut microbiota such as vitamin D and probiotic supplementation can alleviate migraine headache symptoms by improving gut microbiota dysbiosis and consequent related inflammatory and immune responses.”
Source: BMC Medicine
doi: 10.1186/s12916-024-03684-6
“Effects of probiotic and vitamin D co-supplementation on clinical symptoms, mental health, and inflammation in adult patients with migraine headache: a randomized, triple-blinded, placebo-controlled trial”
Authors: Shahnaz Amani Tirani et al.