The Intake of Vitamin B6 and Folate and the Risk of Migraine in Adults

by | Dec 12, 2023 | 2023, Brain Health, Folic Acid & Folate, Vitamin B6

Written by Harold Oster, MD. Results suggest that B6 and folate consumption may lower the risk of migraine in adults.

Migraine is a disabling headache syndrome affecting more than one billion people worldwide. For the prevention of migraines, patients are often prescribed medications that may have undesirable side effects1. Vitamin B6, found in both animal and plant food sources, is necessary for numerous biochemical reactions, including the brain2. Folate, present in high quantities in fruits, vegetables, and eggs, is an essential vitamin and is involved in the proper development and function of the nervous system3. These vitamins may play a role in the pathogenesis of migraine4, and their intake may aid in migraine prevention5.

Sheng Tian et al. studied the association between migraine and the intake of vitamin B6 and folate in adults over 20 years old. The authors analyzed data collected between 1999 and 2004 for the National Health and Nutrition Examination Survey (NHANES), a population-based cross-sectional study conducted by the National Center for Health Statistics at the Centers for Disease Control and Prevention. The incidence of migraine was determined by asking participants whether they had a migraine or severe headache in the preceding three months. Intake of vitamin B6 and folate was ascertained through a 24-hour dietary recall interview, and the participants were divided into quartiles based on their intake of foods that contained the vitamins. The data was analyzed for possible covariables, and the association between the intake of vitamin B6 and folate and the incidence of migraine was determined. The relationship of the interaction between the intake of vitamin B6 and the intake of folate was determined by standard statistical methods: the relative excess risk due to interaction (RERI), the attributable proportion of interaction (AP), and the synergy index (S)6.

The authors noted the following:

  • Based on exclusion criteria, data from 7017 adults was used in the study, of whom 1350 had experienced migraine in the preceding three months.
  • The intake of vitamin B6 was lower in those experiencing migraines than in those without migraines.
  • After adjustment for covariables, the risk of migraine in the participants in the highest quartile of vitamin B6 intake was lower than those in the lowest quartile. (odds ratio 0.66)
  • The odds ratio for having a migraine was 0.72, comparing the highest quartile of vitamin B6 intake to the lower three quartiles combined.
  • The intake of folate was lower in those experiencing migraines than in those without migraines.
  • After adjustment for covariables, the risk of migraine in the participants in the highest quartile of folate intake was lower than those in the lowest quartile. (odds ratio 0.57)
  • The odds ratio for having a migraine was 0.62, comparing the highest quartile of intake to the lower three quartiles combined.
  • Results of the statistical tests, RERI, AP, and S, showed a synergistic interaction between a high intake of vitamin B6 and a high intake of folate on a lower risk of migraine.

The authors concluded that higher intakes of vitamin B6 and folate are associated with a lower risk of migraine in adults and that the effect of the vitamins is synergistic. Limitations of the study include the lack of assessment of supplement intake, the use of a questionnaire to determine whether patients had a migraine in the preceding three months, and the possibility of residual confounding variables.

Source:  Tian, Sheng, Xinping Yu, Lanxiang Wu, Heqing Zheng, Xianhui Zhong, Yonggang Xie, and Wei Wu. “Vitamin B6 and folate intake are associated with lower risk of severe headache or migraine in adults: an analysis based on NHANES 1999-2004.” Nutrition Research (2023).

© 2023 Published by Elsevier Inc.

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Posted December 12, 2023.

Harold Oster, MD graduated from medical school in Miami, Florida in 1992 and moved to Minnesota in 2004. After more than 25 years of practicing Internal Medicine, he recently retired. Dr. Oster is especially interested in nutrition, weight management, and disease prevention. Visit his website at haroldoster.com.

References:

  1. Eigenbrodt AK, Ashina H, Khan S, et al. Diagnosis and management of migraine in ten steps. Nature reviews Neurology. Aug 2021;17(8):501-514. doi:10.1038/s41582-021-00509-5
  2. Parra M, Stahl S, Hellmann H. Vitamin B₆ and Its Role in Cell Metabolism and Physiology. Cells. Jul 22 2018;7(7)doi:10.3390/cells7070084
  3. Shulpekova Y, Nechaev V, Kardasheva S, et al. The Concept of Folic Acid in Health and Disease. Molecules. Jun 18 2021;26(12)doi:10.3390/molecules26123731
  4. Shaik MM, Tan HL, Kamal MA, Gan SH. Do folate, vitamins B₆ and B₁₂ play a role in the pathogenesis of migraine? The role of pharmacoepigenomics. CNS Neurol Disord Drug Targets. 2014;13(5):828-35. doi:10.2174/18715273113129990112
  5. Nematgorgani S, Razeghi-Jahromi S, Jafari E, et al. B vitamins and their combination could reduce migraine headaches: A randomized double-blind controlled trial. Curr J Neurol. Apr 4 2022;21(2):105-118. doi:10.18502/cjn.v21i2.10494
  6. Knol MJ, VanderWeele TJ, Groenwold RH, Klungel OH, Rovers MM, Grobbee DE. Estimating measures of interaction on an additive scale for preventive exposures. Eur J Epidemiol. Jun 2011;26(6):433-8. doi:10.1007/s10654-011-9554-9