Vitamin D

Does it work? Maybe - lower vitamin D levels are associated with more migraine symptoms, but results are mixed when it comes to supplementation.

How do I use it? Dosage depends on how deficient you are - 50,000 IU/week is a common repletion dose, while 1,000-2,000 IU/day is a common maintenance dose.

The Basics

Vitamin D, also called "the sunshine vitamin", is a unique nutrient in that the most widely available form of it is not food, but the sun. Vitamin D is essential for a slew of functions in the body, including keeping inflammation in check and supporting your immune system. 

With the realization that many, many people are deficient in this vitamin due to our largely indoor lives, research has started examining how vitamin D supplementation may improve our health - including the role deficiency may play in migraine severity and frequency.

The recommended daily amount of vitamin D for adults is 600 IU (international units), but you may need much more if your levels are low. Getting blood work done before starting supplementation is your best bet.

The Science: Vitamin D and Migraine

The active form of vitamin D used by your body is unique among the vitamins because it's known as a hormone. Hormones are one of your body's messengers that send signals to other areas of your body via your blood. Vitamin D, like other hormones, is produced with the help of cholesterol.

Vitamin D even has a link to another one of our favorite migraine supplements - in order for your body to use vitamin D from the sun, food, or supplements, you need plenty of magnesium!

Vitamin D is now being recognized for its role in normal brain function. This vitamin can influence the action of neurotransmitters like serotonin, act as an antioxidant, reduce inflammation, and encourage the recycling system your body uses to get rid of damaged/mutated cells (called apoptosis).

There is an impressive amount of research being done on the relationship between Vitamin D and migraine. Several observational studies have found a correlation between low vitamin D levels and migraine. Interestingly, a 2010 study showed that headache frequency tends to increase in the fall and winter months, when days are shorter and less sunlight is available.

A 2013 found that higher vitamin D levels were associated with shorter frequency and duration of migraine headaches, but not severity.

A 2015 study looked at the effect of vitamin D supplementation on migraine over the course of 10 weeks. Participants taking vitamin D had a greater improvement in migraine symptoms compared with the group taking a placebo (sugar pill). This study also looked at the effect of vitamin D on CRP levels, an indicator of inflammation in the body, but found it had no effect. 

There are also several studies looking at chronic pain in general that show higher vitamin D levels are associated with lower pain. 

While much of the evidence so far is showing associations (which can't tell us that taking vitamin D will actually reduce pain), there seems to be enough evidence to consider vitamin D as a complementary treatment for migraine.

Signs of Deficiency

The ideal blood levels of vitamin D are most likely above 30 ng/mL for adults. Below this level, symptoms of vitamin D deficiency have been seen such as those below.

Signs of a Vitamin D deficiency include:

• Fatigue
• Chronic low back pain
• Depression
• Low immunity (wounds take a long time to heal and you get sick often)
• Softening of the bones (Rickets in children, osteomalacia in adults)

Vitamin D From Sun and Food

The best way to get Vitamin D is by consistently exposing large parts of your skin to the sun. Using sunscreen or getting sun through a window will not allow your body to absorb the UV light necessary to create vitamin D. 

This alone is the main reason why so many of us are deficient - much of our time is spent indoors, and when we do go outside we use sunscreen. Many people recommend spending your first ten minutes outside with no sunscreen and applying it after that to allow your skin to be exposed to the sun.

Few foods naturally contain vitamin D, but the ones that do contain high amounts. These include:

• Cod liver oil
• Trout
• Salmon
• Mushrooms
• Sardines
• Eggs

Vitamin D can be found added to some foods like milk and milk alternatives. 

Vitamin D Supplements

Vitamin D supplements can be found in two forms - vitamin D2 (known as ergocalciferol), and vitamin D3 (cholecalciferol).

Vitamin D3 is found in animal products like eggs and fish, while Vitamin D2 can be found in plant products like mushrooms. D3 is also what your skin produces when it's exposed to sunlight.

Research suggests that vitamin D3 is much better at raising blood levels than vitamin D2. This is because while they are both absorbed equally, D3 is able to be better converted to the form tested for in your blood (calcifediol) than D2.

It's important to remember that getting vitamin D from the sun is by far the best way to reap the benefits of this important vitamin. While using supplementation to raise your blood levels is typically recommended, getting regular sun exposure should also be incorporated as possible.

Common Usage

Many studies use high doses of 50,000 IU per week as a treatment dose. While this is appropriate if you are trying to correct a deficiency, this is likely too high of a dose to continue long term. 

For daily maintenance, The Mayo Clinic suggests 1,000-2,000 IU per day as a safe amount to take. Unlike some other supplements used for migraine (like magnesium and riboflavin), the idea is not to take mega doses - it's to make sure your body has enough without getting too much. 

This is where testing your vitamin D levels comes in handy. Normal levels (above 30 ng/mL but below 50 ng/mL) can ensure you're not taking too much, and low levels can tell you to increase your dose temporarily.

Side Effects and Warnings

Vitamin D is a fat soluble vitamin, and like other fat soluble vitamins, getting too much of it can be toxic. 

It's really not possible to get too much vitamin D from the sun, but it's certainly possible to take too high of a dose from supplements. Long term, this can create serious issues.

Potential side effects of taking too much Vitamin D include:

• nausea
• pain
• vomiting
• loss of appetite
• dehydration
• kidney stones

These side effects are a result of too much calcium in your blood, a condition called hypercalcemia. This happens when you take too much vitamin D long term because this vitamin increases how much calcium you absorb - usually a good thing, but not when the calcium builds up in your blood!

This is why it's important to have your vitamin D levels checked regularly when you're taking a supplement. You may need a high dose at first to correct a deficiency, but once your levels are normal you can likely switch to a lower, maintenance dose.

Bottom Line

Vitamin D is an important vitamin for everyone, including people with migraine. While spending time in the sun is most beneficial, taking a supplement has been shown in some studies to improve migraine symptoms at doses of 50,000 IU per week, although long term doses of 1,000 to 2,000 IU is more widely recommended.

References

Vitamin D: Fact Sheet for Professionals

The Role of Vitamin D in Primary Headache–from Potential Mechanism to Treatment 

The relationship between serum levels of vitamin D and migraine

Vitamin D: Is it a primary hormone targeting the migraine headache or just as adjunct therapy?

Effect of Vitamin D supplementation on symptoms and C-reactive protein in migraine patients

Effect of Vitamin D Deficiency on the Frequency of Headaches in Migraine