Migraine headaches are recognised as the first contributor to disability in adults under 50 years,1 with 4.9 million Australians suffering from migraine headaches and 7.6% of suffers experiencing chronic episodes (i.e. ≥ 15 migraine days per month).2 While there is a marked decline in frequency with increasing age, migraines are three times more prevalent in women.
The pathogenesis of migraine is not entirely understood. Several underlying mechanisms including vascular dysfunction, neurogenic inflammation and activation of the trigeminovascular system have been proposed.3 While there have been significant advances in the knowledge around the drivers for migraine, there remains an unmet need for effective treatment for the condition.
There exists a large body of research for vitamin D. At present, there is clinical evidence that it protects against a variety of vascular and inflammatory disorders, and has been demonstrated to potentially play a role in blocking cellular proliferation, angiogenesis, regulating the production of pro/anti-inflammatory factors, antioxidant agents, prostaglandin E2 and nitric oxide synthase.4
Some research exists suggesting that lower vitamin D levels were associated with risk of migraine.5 Further to this, it has been suggested that vitamin D acts as a neuroactive steroid, therefore may alleviate pain in such conditions as headache and migraine. As such, the authors of a recent clinical trial sought to investigate the effect of vitamin D3 supplementation on migraine characteristics, as well as serum levels of pro/anti-inflammatory markers.4
Employing a randomised, double blind, placebo controlled model, 74 episodic migraineurs received either 2000IU of vitamin D3 daily for 12 weeks or placebo. Following the intervention, those in the vitamin D3 treatment group experienced significantly less headache days, reduced frequency and duration of attacks, as well as reduced migraine severity scores. Furthermore, those in the treatment group reportedly reduced their analgesic medication intake by 50%. While serum levels of IL-10 and Cox-2 did not differ between the groups, IL-6 and iNOS were significantly reduced in the treatment group post intervention.4
One of the underlying mechanisms for migraine is the activation of the trigeminovascular and nociceptive systems, which may initiate a neuro-inflammatory response via the release of various inflammatory peptides, pro-inflammatory cytokines and mast cells.6,7 Elevated IL-6 is considered an indicator of a transition from acute into chronic inflammation,8 while iNOS is considered a marker of neuro-inflammation and macrophage activation.4
The results of this study indicate that vitamin D may have anti-inflammatory and antioxidant actions via its suppression of these pro-inflammatory mediators thus attenuating migraine presentation.
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References are available by request .