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

Abstract

Some studies have suggested a link between vitamin D and headache; however, the underlying physiological mechanisms are unclear. We aimed to summarize the available evidence on the relationship between vitamin D and the various subtypes of primary headaches, including migraines and tension-type headaches. All articles concerning the association between primary headache and vitamin D published up to October 2019 were retrieved by searching clinical databases, including: EMBASE, MEDLINE, PubMed, Google scholar, and the Cochrane library. All types of studies (i.e., observational, cross-sectional, case-control, and clinical trials) were included. We identified 22 studies investigating serum vitamin D levels in association with headaches. Eight studies also evaluated the effect of vitamin D supplementation on the various headache parameters. Among them, 18 studies showed a link between serum vitamin D levels and headaches, with the strongest connection reported between serum vitamin D levels and migraine. Overall, there is not enough evidence to recommend vitamin D supplementation to all headache patients, but the current literature indicates that it may be beneficial in some patients suffering headaches, mainly migraineurs, to reduce the frequency of headaches, especially in those with vitamin D deficiency.

The Relationship Between Serum Vitamin D Levels and Pain Severity in Children with Migraine

“…In another study, it has been reported that serum levels of both vitamin D and vitamin D receptors were lower in subjects with migraine than that of controls (8) . In addition, some studies reported no correlations between the levels of serum vitamin D and some parameters of headache such as aura, severity, and duration (28) . In a few studies, the authors found an increase in migraine attacks in the autumn and winter months and a decrease in vitamin D levels in the same period.…”

Vitamin D status in children with migraine: a case-control study

“…These studies have been suggested the possible role of hypercalcemia in migraine headaches and proposed that genetically elevated serum calcium over lifetime appears to increase risk for migraine [36]. Moreover, investigators have had attempted to explain a number of pathophysiologic mechanisms of vitamin D and its deficiency in patients with migraine [8]. Among these mechanisms, anti-inflammatory effects of calcitriol, controlling T helper cells, acting as a neuroactive steroid, inhibiting nitric oxide, and suppressing prostaglandin E2 are the most proposed mechanisms [8].…”

“…Moreover, investigators have had attempted to explain a number of pathophysiologic mechanisms of vitamin D and its deficiency in patients with migraine [8]. Among these mechanisms, anti-inflammatory effects of calcitriol, controlling T helper cells, acting as a neuroactive steroid, inhibiting nitric oxide, and suppressing prostaglandin E2 are the most proposed mechanisms [8]. In addition, clinical trials of supplemental vitamin D in patients with migraine headaches have shown controversial results, and supplementing with vitamin D is not indicated in all patients with migraine.…”

“…They also assessed the therapeutic use of exogenous melatonin in migraine [5]. Among the different vitamins, one of the most noted is vitamin D [4,8].…”

“…Vitamin D has a wide range of effects on different systems of the human body including the nervous system [8]. Some observational studies and a few clinical trials tried to show the role of this vitamin in migraine headaches [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24], however, the results are controversial and prescribing vitamin D in every patient with migraine is not indicated [8]. Vitamin D may influence migraine headaches in a number of ways.…”