CoEnzyme Q10 for Migraine Prevention

Coenzyme Q10, also known as CoQ10, is one of a number of non-drug nutritional supplements found to be effective in preventing migraines. As with other "natural" migraine preventives (such as riboflavin), CoQ10 is considerably less likely to cause side effects than prescription drugs. That is one of the reasons for its growing popularity among people with frequent migraine headaches.

CoQ10 has not been approved by the Food and Drug Administration (FDA) for migraine prevention. However, the American Headache Society (AHS), the American Academy of Neurology (AAN), and the Canadian Headache Society feel confident enough in its safety and potential efficacy to offer specific recommendations for its use in prophylactic migraine therapy.

This article discusses CoQ10, its effectiveness for migraines, as well as potential side effects and precautions to consider.

What Is CoQ10?

Coenzyme Q10 is a compound that is found in mitochondria—the tiny organelles that exist in nearly every cell from which food combines with oxygen to create energy. In fact, mitochondria are often referred to as "the powerhouses of cells."

When these tiny structures don't function properly, nearly every system in the body can be affected. Mitochondrial problems are linked to a variety of diseases and conditions.

Because these metabolic imbalances take place not only during migraine attacks but also may exist in between them, supplementation with CoQ10 may stabilize imbalances, potentially preventing migraines.

Can CoQ10 Prevent Migraines?

Only a few studies have looked at coenzyme Q10 as a migraine prophylactic (preventive measure).

• A small 2017 study looked at eighty people diagnosed with migraine headaches based on International Headache Society criteria. The participants were allocated to receiving only their current preventive drugs or their current preventive drugs plus 100 mg CoQ10 daily. The results showed the number of attacks per month dropped significantly in the CoQ10 group, as well as the severity of headaches.
• A 2020 meta-analysis of four randomized clinical trials with 221 participants concluded coenzyme Q10 supplementation significantly reduced the frequency of migraine attacks per month.
• A 2022 randomized clinical trial of 72 children aged 5–15 years old with a diagnosis of migraine concluded that co-enzyme Q10, with fewer side effects and comparable therapeutic effects, could be a good drug for prophylactic treatment of migraine headaches.

However, another systematic review and meta-analysis concluded there is insufficient evidence to determine if coenzyme Q10 is effective for migraine prophylaxis in adults. It stated that high-quality, large randomized control trials are needed to fully evaluate the efficacy and safety.

Several studies suggest CoQ10 may be beneficial in preventing episodic migraines (occurring in fewer than 15 days per month).

• In a small study, 84 women received either 400 mg of CoQ10 or a placebo daily. The results showed a significant improvement in the frequency, severity, and duration of migraine attacks in the CoQ10 group compared to the placebo group. 
• A 2019 review analyzed five studies involving 346 participants (120 children and 226 adults). According to the researchers, CoQ10 reduced the number of attacks per month along with their duration. However, CoQ10 didn't reduce the severity of the symptoms.
• A 2021 meta-analysis found similar results: CoQ10 has beneficial effects in reducing the duration and frequency of migraine attacks, but not in reducing the severity of migraine headaches.

Side Effects of CoQ10

One thing that makes CoQ10 supplementation attractive to people with migraines is that reported side effects have been mild.

People may experience one or more of these side effects:

• Stomach upset
• Loss of appetite
• Nausea
• Vomiting
• Diarrhea
• Sensitivity to light
• Skin rash
• Dizziness
• Insomnia
• Fatigue
• Irritability

Talk to your healthcare provider if symptoms continue or are bothersome.

What Dosage of CoQ10 Should You Take

Per the AHS/AAN guidelines for the prevention of migraines, the recommended dosage of CoQ10 is 100 mg taken three times per day.

As a nutritional supplement, coenzyme Q10 is sold as a pill, capsule, or gelcap to be taken by mouth.

Coenzyme Q10 can also be derived from food sources, including oily fish (such as salmon and tuna), organ meats (such as liver), and whole grains. However, it would be difficult to get the recommended therapeutic amounts from food sources alone.

Warnings and Interactions

There are few medications known to potentially interact with coenzyme Q10 supplements. They include:

• Blood thinners: CoQ10 may make blood thinners such as Jantoven (warfarin) less effective. 
• Insulin: CoQ10 may lower blood sugar. While potentially beneficial to people with diabetes, CoQ10 may lead to hypoglycemia (abnormally low blood sugar) in people on anti-diabetes drugs.
• Certain drugs that are used to lower cholesterol and blood pressure levels may decrease the effects of CoQ10. 
• Cancer treatments: The use of CoQ10 before or during chemotherapy or radiation may interfere with cancer treatment.

Advise your healthcare provider if you take these or any other medications before trying coenzyme Q10 to prevent migraine headaches.

Coenzyme Q10 has not been established as safe during pregnancy or breastfeeding. So if you are pregnant, planning to conceive, or are breastfeeding, it is best not to take this supplement just to be safe.

Summary

If you have episodic migraine headaches, taking coenzyme Q10 supplements might be a natural and effective way to reduce the frequency of headaches, and possibly prevent them. Side effects are minimal, especially compared to drugs. Before taking CoQ10 or any supplements, talk to your healthcare provider to ensure you can take them safely based on your health needs.