Serum Vitamin D Levels and Risk for Migraine
Immune dysfunction and inflammation have been proposed as playing key roles in the pathogenesis of migraine headaches.
Higher levels of serum 25-hydroxyvitamin D, 25(OH) D, may be associated with lower risk for migraine headaches, according to a study published in Headache.
Immune dysfunction and inflammation have been proposed as playing key roles in the pathogenesis of migraine headaches. There is evidence that vitamin D has a beneficial role on the regulation of oxidative stress and inflammation, leading the researchers to hypothesize that its levels may have an effect on migraine.
A total of 70 patients with migraine (36 with episodic migraine and 34 with chronic migraine; mean age, 37 years; 77.14% women) and 70 age- and sex-matched healthy control individuals (72.85% women) with similar body mass indexes (BMI) were enrolled between April and September 2017 in this prospective case-control study. At baseline, participants with migraine were evaluated for headache intensity with a visual analogue scale and for disability using the Migraine Disability Assessment Scale, and then given a 30-day headache diary to complete.
Serum 25(OH)D concentrations were measured at baseline in control participants and at 30-day follow-up in those with migraine, with levels <20 ng/mL, 20 to 29 ng/mL, and 30 to 100 ng/mL indicating deficient, insufficient, and sufficient vitamin D, respectively. Multivariable regression analyses were performed to calculate odds ratios (OR) and to examine migraine risk factors.
Patients with migraine had mean 25(OH) D levels that were lower than healthy control participants (30 vs 43 ng/mL; P < .001). A greater percentage of participants with vs without migraine had vitamin D deficiency or insufficiency (ie, serum levels <30 ng/mL; 53.7% vs 26.1%, respectively; P < .0001). Serum vitamin D levels were comparable in participants with chronic or episodic migraine.
After adjusting for age, sex, BMI and anticonvulsant medications, the risk for migraine was found to decrease with increasing vitamin D: for each additional quartile of serum vitamin D level, the risk was reduced by 37%, 81%, and 83% (first vs second quartile, OR=0.63 [95% CI, 0.22-1.77]; first vs third quartile: OR=0.19 [95% CI, 0.06-0.56]; lowest vs highest quartile: OR=0.17 [95% CI, 0.04-0.64]; P =.003 for trend). For each increase of 5 ng/mL in serum vitamin D, the risk for migraine was reduced by 22% (OR=0.78; 95% CI, 0.68-0.90; P = 001). These results corresponded with an 80% to 83% reduction in migraine risk for participants with 25(OH)D concentrations between 50 and 100 ng/mL compared with those with levels <20 ng/mL.
Study strengths include expert diagnosis of migraine and the use of age-, sex-, and BMI-matched healthy control patients. Study limitations include a small sample size, lack of measurement of vitamin D concentration in the cerebrospinal fluid, and the lack of assessment of abortive and prophylactic medication dosages used by patients during the study.
"Our results show that the prevalence of vitamin D deficiency and insufficiency among migraine patients was about 53.7%, which raises awareness of the need for screening marginal vitamin D status when the diagnosis of migraine is confirmed in patients," concluded the study authors.
Togha M, Jahromi SR, Ghorbani Z, Martami F, Seifishahpar M. Serum vitamin D status in a group of migraine patients compared with healthy controls: a case-control study [published online October 20, 2018]. Headache. doi: 10.1111/head.13423