Do you know that approximately 42% of people with chronic migraine are considered lacking enough serum Vitamin D? Let’s take a deep dive into the often overlooked relationship between Vitamin D and migraine.
As a registered dietitian with migraine, I am especially interested in keeping you updated with published research as well as my own experience and observations. What about Vitamin D and headache? We all know migraine is more than a headache, but millions suffer from headaches. And, many of us also get headaches that are not associated with our full migraine attacks. We’re all looking for pieces to our personal “migraine puzzle” and I’m confident that for some of you, Vitamin D will bring about some relief while also bringing about other healthful benefits.
In this article I will endeavor to answer common questions like -Can Vitamin D deficiency cause headaches? Can low Vitamin D cause migraine? Are there other benefits to taking Vitamin D like pain relief? Do I need to supplement with Vitamin D? If so, how much?
While I am a licensed health professional, this article is for education purposes only. It is not medical advice nor a substitute for medical advice. It is written from the patient and patient-advocate perspective.
What Is Vitamin D?
Vitamin D is not really a vitamin. It’s a hormone. I’ll continue to refer to it as a vitamin, but it’s a critically important hormone like thyroid hormones, insulin and fertility hormones. Your body makes Vitamin D when sunlight penetrates your skin. Depending on the time of year, your skin type and the amount of protection from the sun you wear (sunscreen and clothing), your body makes different amounts.
When you take supplements or consume Vitamin D in foods, your body converts that to the active, hormone form. Vitamin D plays an important role with about 3 dozen types of tissues in your body.
Vitamin D deficiency headaches
Based on the available published literature, there seems to be an association of Vitamin D deficiency and headaches. In this study, tension-type headache was strongly linked to those people who were deficient in serum Vitamin D compared to people who had normal levels.
To answer the question of can Vitamin D deficiency actually cause headaches more studies would need to be done. It’s possible that other factors are at play and the biochemical association was not causative of a disorder just periods of symptoms. Also, it sure would be helpful if there were studies showing that correcting the deficiency brought about relief. Really, folks. Let’s do this!
“What about Vitamin D and migraines?”
This is the most frequent question we get about this topic in our private Facebook group. Fortunately, published reviews of the literature on this topic are stronger than the literature for Vitamin D deficiency and headache. Vitamin D and migraine attacks are likely even more connected. In this review of the literature on Vitamin D and migraine.
Three possible mechanisms for why Vitamin D deficiency causes headache and migraine
In my own review of the literature, the three mechanisms below came up most frequently. As we all know, migraine is complex. Effective treatment is highly variable. This is likely due to the many genes involved in migraine disease, our unique bodies and highly variable lifestyles and environments. So, there may be more than one mechanism involved.
- Neurotransmitters Dopamine and serotonin– the roles of these 2 super-important neurotransmitters in migraine has been studied. Vitamin D may be involved in the release of these chemical messengers.
- Magnesium – This vital mineral’s role is well-recognized in migraine. Vitamin D is directly involved in intestinal absorption of magnesium. Having inadequate Vitamin D may explain how being deficient in Vitamin D can cause headaches and migraine. One of our most popular articles will help you understand all you need to know about magnesium and migraine.
- Inflammation and pain– Vitamin D is a known substance that reduces inflammation. Since part of the cascade of events that leads to migraine attacks is inflammation, perhaps that explains Vitamin D deficiency and migraine.
Dr. Stasha Gominak – the theory about sleep and headache and migraine
If you ask most headache specialists, they will emphatically tell you that sleep plays a critical role in migraine. Dr. Stasha Gominak is a neurologist and sleep disorder specialist. She is passionate about her work and believes that she has a big part of migraine figured out. She knows that many of us have poor sleep, sleep disorders, inadequate Vitamin B12 levels and inadequate Vitamin D levels.
If you listen to this one-hour lecture about headache and migraine from Dr. Gominak, you will come away with an amazing amount of knowledge about the relationship between sleep, headache and migraine. The video isn’t for everyone as it’s a lecture with slides given to other health professionals. But, if you are into it, you will get jazzed about fixing your sleep issues. Unfortunately, lousy sleep is a common among those of us with migraine.
According to Dr. Gominak, attaining and maintaining a Vitamin D level of 60ng/mL-80 ng/mL will help restorative sleep and therefore help migraine. She says that below 60ng/mL and above 80ng/mL, sleep and migraine are likely to be worse. As a dietitian very involved in migraine-related social media, I am struck by how many people with migraine have very low levels of Vitamin D. I know plenty of people who have been in the teens! Yikes!
Here is a link to the Dr. Stasha Gominak’s website so you can see what other practical info she has to share. In addition, we have 2 wonderful articles from Jenn Bragdon focused on quality slumber. This article promises to help people with migraine sleep. There are unique challenges of sleeping with vestibular migraine that are addressed in this other helpful piece by our resident expert.
The Vitamin D – BPPV link
BPPV (Benign paroxysmal positional vertigo) is one of the most common causes of vertigo. Understanding the Vitamin D-BPPV link might be very helpful for many people.
Briefly, BPPV happens when crystals that are normally housed in gelatinous matter in the utricle of the ear get dislodged and move into semicircular canals. This can disrupt the normal flow of fluid in the ear especially with certain head movements. False and confusing signals get sent to the brain and cause the brain to bring on frightening spinning sensations.
While there were only a small number of published studies on the Vitamin D-BPPV link, all three showed a clear benefit from supplementing those with deficient Vitamin D compared to those who were not supplemented. The recurrence rate for those treated with Vitamin D was significantly lower than those not treated in both studies.
In another study, supplementation of both Vitamin D and calcium also showed significant improvement measured by the recurrence rate of symptoms.
In all three studies, only those who were deficient in Vitamin D were studied. I think it would be very interesting to see if there is improvement when people are treated with Vitamin D before they are considered deficient. Dr. Stasha Gominak would likely agree that it would be interesting to see if bringing people to the optimized range (60ng/mL-80 ng/mL) would help even more and show an even stronger Vitamin D-BPPV link. We need studies!
For more info on BPPV along with personal and practical tips of dealing with the dizziness and other vestibular symptoms, read, no devour all of Jennifer Bragdon’s articles here. She is passionate about educating and inspiring those with debilitating vestibular symptoms. This is a good one to start with.
Vitamin D and pain
Based on the research, it certainly seems that the Vitamin D works directly on the actual mechanism of migraine. Other studies on pain management show that Vitamin D also has a role in controlling pain.
This is especially helpful to our community as many people with migraine also have comorbidities like fibromyalgia and/or joint pain. Vitamin D has also been studied to see its value in a number of other inflammatory diseases like asthma, heart disease, liver disease and multiple sclerosis.
What Is The Recommended Daily Allowance?
When the Institute of Medicine came up with the recommended daily allowance for Vitamin D, it based the recommendation on how much they believed was safe and supportive of bone health. Their work did not include considerations for what the safe, or optimal, amount would be for supporting Vitamin D’s role for its many other important functions in the body. The recommended daily allowance for Vitamin D for an adult under 70 years old is 600 IU/day. They did not address the optimal amount.
For emphasis, I am mentioning again that the government’s recommendations were based on bone health and not the many other critical roles that Vitamin D plays. If you recall, in a previous paragraph I identified 3 possible mechanisms that Vitamin D and headache and migraine are connected – neurotransmitters, magnesium status and inflammation. One must wonder what the recommendations would be if the Institute of Medicine looked beyond bone health.
Determining an optimal amount is difficult due to the fact that your body makes varying amounts. Also, a number of factors impact an individual’s need. For example, people with dark skin have more melanin in their skin and do not make as much from the sun. People who are obese tend to store vitamin D in fat rather than allow it to be used in circulation. Both of these groups may need more Vitamin D than the average person who is not obese and has light skin.
Testing your Vitamin D level
So, what to do? First, know your vitamin D level. Ask your doctor to specifically order a 25(OH)D blood test as this is the best measure of your vitamin D status.
Vitamin D is a fat-soluble vitamin. Unlike most other vitamins that we eat and/or supplement with, much of the excess that isn’t used is stored in our body. This can lead to an accumulation of toxic amounts if supplementation is too high for too long. Know your Vitamin D level and get it rechecked as you work on bringing the level up. Get your doctor’s opinion and do your own research so you can make an informed decision about your next steps.
There is a detail that can be confusing to many of us as some countries report levels in nanomoles per liter (nmol/L) and some use nanograms per milliliter (ng/mL). It’s important that you notice that important detail when you are reading through the literature and doing your own homework. The Vitamin D Society is an excellent resource and provides a conversion tool to help you. The Vitamin D society has a plethora of reliable information on the many benefits of this nutrient and hormone.
What amount of Vitamin D should you take?
As stated above, there is no definitive answer based on the a high degree of individual variation and seasonal exposure to the sun. As a Floridian, I can tell you that there are plenty of people who regularly get sun exposure throughout the year and eat good sources of Vitamin D yet are unable to keep from being low. Getting into the optimal range (60ng/mL-80 ng/mL) for helping sleep and migraine would be out of the question for them without supplementation.
“My doctor prescribed big weekly doses.”
It’s not uncommon for people to get a prescription for 50,000 IUs of weekly Vitamin D for several weeks. The strategy is to quickly give a loading dose to get the serum level of Vitamin D to a healthy range. The jury is out as to whether or not the large boluses are optimal metabolically, but studies show that the boluses are safe.
Unless specified, these bolus doses are typically dispensed by the pharmacy in the Vitamin D2 form instead of the Vitamin D3 form. This article discusses why Vitamin D3 is preferable and may be worth requesting.
This article from Dr. Gominak has excellent info to read and discuss with your doctor.
Personally, I think it’s a good idea to get a good loading dose and also have a plan to transition to a daily dose to maintain the levels daily.
Preferred types for migraine
Since some of us with migraine have significant sensitivities to the inactive ingredients in supplements like gelatin, it can be hard to find a good Vitamin D3 supplement. My personal preference in to take formulations that are pharmaceutical grade and combine Vitamin D3 with Vitamin K. I like Vitamin D Supreme from Designs for Health as it has both Vitamins. The dose of Vitamin D3 is 5000IUs and it was the only supplement that helped get my stubborn D level into the optimized range. You can find this supplement and other favorites in the Migraine Strong Dispensary.
A very nice aspect of Vitamin D3 is that is is available in pleasant or neutral tasting liquid forms. The liquid droplets are quite concentrated so you can get as much or as little as you’d like. The drops are nice as we often take so many tablets and capsules. Giving kids Vitamin D is even easier when it comes from a dropper!
As stated above, please get your level of Vitamin D tested, do your own research and discuss a plan with your doctor to optimize and maintain your Vitamin D level to help your head and your overall wellness.