Let’s first talk about what migraines are. Migraine is a type of headache that can be quite disabling and can last from hours to several days. It is typically associated with nausea and vomiting, light and/or sound sensitivity, and tends to be characterized by throbbing pain on one side of the scalp. Other features may include vision disturbances, numbness or weakness of one part of the body or even vertigo. Migraines can occur several times per week, or once or twice per year.

Migraine headaches affect 12% of the US population and are up to 3 times more common in women than in men (up to 6% of men and up to 17% of women have them. The prevalence of migraines increases up until the age of 39. In a group of women aged 30-39, close to 1 in 4 may have a migraine.

Mechanisms leading to migraines are complex and not fully understood. Scientists believe that migraines result from a malfunction of neurons (nerve cells) that leads to a sequence of changes that lead to migraine symptoms described above. Both genetic and environmental factors are involved in migraines.

When it comes to migraine headaches, there are 2 basic approaches in conventional medicine when it comes to treating the symptoms.

A class of drugs known as triptans (e.g., sumatriptan (Imitrex), rizatriptan (Maxalt), or naratriptan (Amerge)), may be used to abort the symptoms once they start. Non-steroidal anti- inflammatory medications such as ibuprofen (Advil) or naproxen (Aleve) may also be used.

Those who have frequent migraines may be on medications for migraine prevention, or even have Botox to help prevent migraines. Some of the oral medications that help prevent migraines include anti-seizure medications such as topiramate (Topamax), beta-blocker medications such as propranolol (Inderal), and anti-depressants such as amitriptyline (Elavil). In 2018, the FDA approved drugs that are calcitonin gene-related peptide (CGRP) antagonists for migraine prevention. More data are needed to know the long term safety of these medications.

While it is important to get migraine symptoms under control, it is just as important to understand the root cause of migraines and identify any possible triggers. Many of my patients’ migraines are triggered by certain foods, by skipping meals or by alcohol.

Many of my patients find that their migraine frequency increases when they don’t sleep well and their stress levels are high. Working with your qualified healthcare practitioner is key in both adequately addressing your symptoms but also identifying triggers, so that you reduce these symptoms and their frequency, or even completely eliminate them.

Prevention is key. Although it may take considerable detective work to understand what triggers your migraines, it is generally easier to prevent a migraine than it is to have to endure the symptoms and treat it.

Here are my top tips:

  1. Watch what you eat. Keep a food diary and a record of your symptoms. Identify what triggers your migraines. Common offenders include foods high in histamine, MSG, chocolate, cheese, artificial sweeteners such as aspartame, and others.
  2. Stay hydrated.
  3. Avoid alcohol.
  4. Stay well rested. I generally recommend aiming for at least 8 hours of sleep to my patients.
  5. Master stress and engage in mindfulness, meditation, breath work, yoga, EFT tapping, acupuncture, therapy, vibroacoustics, taking baths or whichever modality works to help you channel stress effectively.
  6. Consider acupuncture. I have witnessed a friend’s migraines that she struggled with for years go away completely with acupuncture.
  7. If you are considering using supplements, work with a qualified healthcare professional to determine the appropriate supplements and doses for you. Know that supplements are not the current standard of care, however there are studies and plenty of anecdotal clinical evidence that supplements can be effective for reducing the frequency of migraines.

Here is a list of supplements you may want to ask your provider about, that can help reduce the frequency of migraines:

  1. Butterbur root has been found effective in studies, although there have been recent safety concerns that were brought up. These were addressed on the American Academy of Neurology website.
  2. Magnesium has been found to reduce migraine frequency by almost 42% by weeks 9-12 of a clinical trial.
  3. Although some evidence for feverfew exists for reducing migraine frequency, the authors of this review concluded that more research was needed.
  4. A French study found that a supplement containing coenzyme Q 10, along with feverfew and magnesium, was found to reduce migraine frequency, improve quality of life and reduce symptoms of anxiety and depression.
  5. Vitamin B2, or riboflavin is thought to address dysfunction of mitochondria, which is thought to occur in individuals with migraines. Mitochondria are power factories of the cells. This review found that riboflavin is safe and can be an effective treatment. Further research is needed to determine who may benefit from this.
  6. Magnesium oxide and L-carnitine have been found to be efficacious when used together and can reduce migraine frequency.

*Sublingual ginger and feverfew have been found to relieve migraine attacks.

None of the information in this article is a representation or warranty that any particular drug or treatment is safe, appropriate or effective for you, or that any particular healthcare provider is appropriate for you.  Never disregard professional medical advice or delay seeking help from a health care provider due to something you have read or seen in this article.  Your reading/use of this article does not create in any way a physician-patient relationship, any sort of confidential, fiduciary or professional relationship, or any other special relationship that would give rise to any duties.  This article does not recommend or endorse any specific tests, healthcare providers, procedures, or treatments, and if you rely on any of the information provided by this article, you do so solely at your own risk.


  • Bojana Jankovic Weatherly, MD, MSc

    Board Certified Physician in Internal and Integrative Medicine

    Bojana Jankovic Weatherly, MD PLLC

    Dr. Bojana Jankovic Weatherly is an award-winning physician, double board certified in internal and integrative medicine. After completing internal medicine residency, she did a fellowship in integrative medicine trained in functional medicine, nutrition and mindfulness. Her approach is rooted in evidence-based medicine that is personalized to each individual she works with. She partners with her patients to discover and address the root causes of their conditions and develops individualized plans to support and empower each unique individual to achieve her or his health goals. As part of her mission to deliver accessible, evidence-based health and wellness information, she created her website, drbojana.com, that features her videos, articles and recipes.   Dr. Bojana is the recipient of several patient satisfaction awards at Cedars-Sinai and was recognized as the Southern California Top Doctors’ Rising Star in 2016 and 2017 and awarded the Top Doctor recognition in 2018 and 2019 in New York.   Prior to starting her integrative and functional medicine practice, she worked as a primary care physician at Cedars-Sinai Medical Group and Crossover Health, provided executive healthcare at EHE and worked at Dr. Frank Lipman’s Eleven Eleven Wellness. She was the Co-Founder of and served as the Chief Medical Officer of WellStart Health, a digital therapeutics start up for chronic disease prevention and reversal. She currently serves as their Medical Advisor.   A lifelong learner, she completed a fellowship in Integrative Medicine established by Dr. Andrew Weil at the University of Arizona and continues to train in functional medicine at The Institute for Functional Medicine. She completed her Internal Medicine residency at Cedars-Sinai Medical Center and West LA Veterans Affairs in Los Angeles. She completed medical school, Master of Science (Experimental medicine) and Bachelor of Science (Biophysics Honors) degrees at University of British Columbia in Vancouver, Canada. Throughout her academic career, Dr. Bojana Jankovic Weatherly performed research in endocrinology and oncology, published papers in peer-reviewed journals and presented her work at academic conferences. She is the recipient of numerous honors and awards. She has also established herself as an educator and speaker, teaching medical students and residents, and speaking on health and wellness in academic and corporate settings, podcasts, and wellness events. She has also shared her medical expertise on Today Show and Rachael Ray.   In addition to serving on the Board of EWG, she serves on the Board of Directors and has been honored for her contribution by Lifeline New York, a nonprofit organization that provides support to Serbian hospitals and children in need, and is on the Board of Tryall Fund, a non-profit organization that promotes health and education in Jamaica.   Dr. Bojana loves spending time with her two children and husband in nature, experimenting in the kitchen, doing ballet barre and practicing mindfulness and yoga. Her not guilty pleasure: Reishi mushroom coffee in the morning. Guilty pleasure: anything with chocolate.   Dr. Bojana Jankovic Weatherly practices at 245 5th Avenue, 3rd Floor, NY, NY 10016.