Yet another chronic and debilitating condition may turn out to have a surprisingly cheap, widely available, and safe solution. Namely, vitamin D. In pharma research, a new drug that demonstrates effectiveness for a specific condition of just 20% over a placebo group is considered a very solid “hit”. In cases, where a new drug demonstrates 20% effectiveness over an already established drug, that is considered a blockbuster result. Well, the study below is an example of the latter. The “placebo” group was given the drug topiramate, which is already approved for migraines. The active group was given topiramate plus 5,000 IU of vitamin D3 daily. Treatment lasted four (4) months. The results were a response rate of 76% in the active and 53.5 in the “placebo” group. That is an effectiveness rate of 22.5% over an established drug – a truly blockbuster result. Even better – subsequent data analysis revealed that vitamin D was more effective than “placebo” (topiramate) for migraine frequency, severity, duration, and disability. In other words, no need to reach for the topiramate (or other migraine drugs) at all, as vitamin D can provide at least as much benefit at a fraction of the costs and risks. Now, the study was with children, so the adult vitamin D3 dosage would probably have to be 2-3 times higher, but that is still within the limits of what most studies consider safe.
Finally, IMO the likely mechanism of action of vitamin D for migraines is reduction of serotonin synthesis since some of the oldest and effective anti-migraine drugs on the market (e.g. methysergide) work by blocking/reducing serotonin. A post I did almost a decade ago discussed a study, which found that vitamin D reduces activity/expression of the serotonin-producing enzyme tryptophan hydroxylase (TPH), thus lowering serotonin levels in the brain.
https://doi.org/10.1177/08830738221092882
https://www.contemporarypediatrics.com/view/vitamin-d-supplementation-may-aid-in-preventing-migraine
“…In children who are subject to migraine attacks, vitamin D supplementation may be an effective and safe adjunctive prophylactic therapy to topiramate, results of a study in Saudi Arabia showed. The 56 children (34 girls and 22 boys), who ranged in age from 5 to 14 years had 2 or more headache attacks each week, were not receiving any migraine preventive therapies other than topiramate, and had not taken vitamin D3 supplements within the past 3 months. The patients were divided into 2 groups. The intervention group received topiramate tablets (2mg per kg of body weight) in 2 daily divided doses along with 5,000 IU of vitamin D3 for 4 consecutive months. The placebo group received only the topiramate along with a placebo. Investigators observed a good response to treatment in both groups: 76.13% of patients in the intervention group and 53.5% of those in the placebo group. However, a comparison of migraine characteristics in the 2 groups at the conclusion of the trial showed that D3 supplementation was more effective than “placebo” (topiramate) in reducing migraine frequency, severity, duration, and disability.”
