Riboflavin (Vitamin B2)
Summary:
Riboflavin is a B vitamin that plays a critical role in mitochondrial energy production. It may reduce migraine frequency by enhancing ATP synthesis and reducing oxidative stress.
Biological Plausibility
Migraine is associated with mitochondrial dysfunction and low brain energy reserves. Riboflavin is essential for the electron transport chain and oxidative metabolism, and may stabilize neuronal energy balance.
Evidence
RCTs show that high-dose riboflavin (400 mg/day) reduces migraine frequency and severity, especially in adults. Pediatric data are mixed but suggest benefit.
Effect Size
About 2 fewer migraine days/month. Responder rates of 40–60% in high-dose trials over 3 months.
⚠️ Risk
Minimal. May cause bright yellow urine (harmless). Very rarely may cause nausea or increased urination.
Cost
$
Scores
- Benefit: 3
- Burden: 2
- Ratio: 1.5
Clinical Takeaways
- Safe, low-cost option with strong plausibility and decent evidence.
- Typical dose is 400 mg/day for at least 3 months.
- Can be combined with magnesium and CoQ10.
Key References
- Schoenen J, et al. *Effectiveness of high-dose riboflavin in migraine prophylaxis: A randomized controlled trial.* Neurology. 1998.
- Boehnke C, et al. *High-dose riboflavin treatment is efficacious in migraine prophylaxis: an open study in a tertiary care centre.* Eur J Neurol. 2004.