The beneficial effect of Alpha-lipoic acid supplementation as a potential adjunct treatment in episodic migraines

Abstract

The current study was performed to evaluate the effects of alpha-lipoic acid (ALA) supplementation on lactate, nitric oxide (NO), vascular cell adhesion molecule-1 (VCAM-1) levels, and clinical symptoms in women with episodic migraines. Considering the inclusion and exclusion criteria, ninety-two women with episodic migraines participated in this randomized, double-blind, placebo-controlled, parallel-design trial. The participants were randomly assigned to receive either 300 mg/day ALA or placebo, twice per day for 12 weeks. The primary outcomes included headache severity, headache frequency per month, and duration of attacks and the secondary outcomes included lactate (a marker of mitochondrial function), NO, and VCAM-1 serum levels were measured at baseline and the end of the intervention. At the end of the study, there was a significant decrease in lactate serum levels (− 6.45 ± 0.82 mg/dl vs − 2.27 ± 1.17 mg/dl; P = 0.039) and VCAM-1 (− 2.02 ± 0.30 ng/ml vs − 1.21 ± 0.36 ng/ml; P = 0.025) in the ALA as compared to the placebo group. In addition, the severity (P < 0.001), frequency (P = 0.001), headache impact test (HIT-6) (P < 0.001), headache dairy results (HDR) (P = 0.003), and migraine headache index score (MHIS) (P < 0.001) had significantly decreased in the intervention as compared to the control group. No significant changes were observed for NO levels and duration of migraine pains. ALA supplementation can be considered a potential adjunct treatment in patients with migraine due to its improving mitochondrial and endothelial functions and clinical symptoms.

The effect of selenium supplementation on oxidative stress, clinical and physiological symptoms in patients with migraine: a double-blinded randomized clinical trial

“…Moreover, the current study indicated that selenium supplementation has a favorable effect on patients’ quality of life. A number of previous studies have investigated the effect of various antioxidants on migraine symptoms, of which, the results of a study by Kelishadi et al showed that alpha-lipoic acid supplementation for 12 weeks had a reducing effect on the frequency and severity of headaches in women with episodic migraine ( 34 ). Another RCT revealed that curcumin and Q10 co-supplementation for 8 weeks improved the frequency, duration, and severity of headaches as well as quality of life in patients with episodic migraine ( 35 ).…”

“…In the current study, unlike the frequency and severity of headaches, selenium had no effect on headache duration. Previous studies have shown that headache duration has a late response to interventions designed for patients with migraine ( 16 , 34 ). Therefore, a longer duration of selenium treatment and intervention with higher doses may affect the duration of headaches in migraineurs.…”

Sex differences in clinical characteristics of migraine and its burden: a population‐based study

“…The median migraine disease burden (MDB) was based on the Migraine Headache Index Score (MHIS). The MHIS has been described in detail elsewhere [22,23] and is calculated by multiplying the migraine frequency within the last 3 months (days per month) by the pain intensity (scaled from 0 to 10) and migraine attack duration (fraction of 24 h). The MDB was calculated by multiplying the median MHIS by the 3-month prevalence of migraine.…”

Current perspectives on mitochondrial dysfunction in migraine

“…A plasma concentration of as low as 0.13 μg/L of ALA is shown to correlate with migraine; thus, it is speculated as a potential biomarker in migraine (Gross et al, 2021). Recent findings have suggested that supplementation of ALA 600 mg/day as adjunct treatment in patients with migraine has imparted improvement in mitochondrial and endothelial functions, thereby alleviating the clinical symptoms (Kelishadi et al, 2022). Similarly, thiols, the sulphur containing organic compounds, readily react with ROS to form disulfides, which decreases oxidative stress (Banne et al, 2003).…”