CoEnzyme Q10 for Migraine Prevention

Coenzyme Q10, also known as CoQ10 or, less frequently, ubiquinone, is one of a number of non-drug nutritional supplements found to be effective in preventing migraines. As with other "natural" migraine prophylactics, such as riboflavin, CoQ10 is considerably less likely than prescription medications to cause side effects. That is one reason it is growing in popularity among people who suffer from frequent migraine headaches.

It's important to note that CoQ10 has not been approved by the U.S. Food and Drug Administration (FDA) for migraine prevention. However, based on existing studies, the American Headache Society (AHS), the American Academy of Neurology (AAN), and the Canadian Headache Society feel confident enough in the safety and potential effectiveness of CoQ10 to have created specific recommendations for using it as a prophylactic migraine therapy.

Coenzyme Q10 is a compound that's found in mitochondria—the tiny structures called organelles that exist in nearly every cell in which nutrients from food combine with oxygen to create energy. In fact, mitochondria often are referred to as "the powerhouses of cells."

When these tiny structures don't function properly, nearly every system in the body can be affected. Mitochondrial problems are linked to a variety of diseases and conditions.

With migraines, it's thought that antioxidant properties present in CoQ10 may thwart oxidative stress that occurs in the brains of some people who get these headaches—especially those who suffer from severe variants such as hemiplegic migraine and who are prone to metabolic abnormalities that make them especially vulnerable to migraine triggers.

Because these metabolic imbalances take place not only during migraine attacks but also may exist in between them, supplementation with CoQ10 may improve them and the overall energy metabolism in cells, potentially preventing migraines.

Only a few studies have looked at coenzyme Q10 as a migraine prophylactic, but the supplement has repeatedly worked well for preventing episodic migraines (headaches that occur fewer than 15 days per month).

For instance, in a 2005 study published in the journal Neurology, 43 patients who had episodic migraines received either 100 milligrams (mg) of CoQ10 or a placebo three times a day for three months. Throughout this time, the participants were asked to record specific details about their headaches, including how severe the pain was; whether they experienced nausea and/or vomiting; which, if any, medications they took to alleviate symptoms; and how long each episode lasted.

At the end of the study, the participants who received CoQ10 had at least 50 percent fewer migraine attacks than those who took the placebo.

Similarly, in a four-month trial in 2002, more than 61 percent of participants who took coenzymeQ10 had the same reduction in headache frequency. In that study, the dose was 150 mg per day. According to the researchers, CoQ10 is well-tolerated at doses as high as 600 mg.

One thing that makes CoQ10 supplementation attractive to migraine patients is that it has few side effects, and those that have been documented have been mild. In the aforementioned 2002 study, for example, all of the participants tolerated taking the supplements well, with the exception of one person who developed a skin allergy.

That being said, the most commonly reported side effects of coenzymeQ10 include:

• Nausea
• Diarrhea
• Abdominal pain
• Heartburn
• Appetite loss
• Headache
• Dizziness
• Fatigue
• Insomnia and other sleep problems
• Irritability
• Sensitivity to light
• Skin rash
• Elevated liver enzymes

There are few medications known to potentially interact with coenzyme Q10 supplements. They include:

• Blood thinners such as Coumadin or Jantoven (warfarin), which often are prescribed for heart patients to prevent blood clots. (CoQ10 may make these drugs less effective.)
• Insulin
• Some types of cancer treatment

Even if you don't take these medications (or any prescriptions or over-the-counter drugs at all), talk to your doctor before trying coenzymeQ10 to help ward off migraine headaches.

CoenzymeQ10 has not been established as safe during pregnancy or breastfeeding, so if you're planning to conceive, are already expecting, or are nursing a baby, it's best not to take this supplement.

As a nutritional supplement, coenzymeQ10 is sold as a pill or capsule to be taken by mouth. It's also available as a gel cap, which some experts believe is preferable because the gel caps contain a liquid form of CoQ10 that's thought to be better absorbed than powdered forms.

Before trying coenzymeQ10 to help prevent migraine headaches, it's important to talk to your doctor to make sure it's right for you and also to determine how much of it you should take and how often.

Although there have been variations in the doses of coenzyme Q10 used in studies, the recommended dosage in the AHS/AAN Guidelines for Prevention of Episodic Migraines is 100 mg taken three times a day.

If you have episodic migraine headaches, taking coenzyme Q10 supplements might be a natural and effective way to prevent them. You may be especially interested in talking to your doctor about CoQ10 if you're unhappy with any migraine preventive drugs you're currently taking or have tried. Once you start taking this supplement, be patient: It can take several weeks for it to become effective, but once it does, you may enjoy fewer headache days each month.