Researchers in Iran investigated the effects of probiotic and vitamin D co-supplementation on adult patients suffering from migraine headaches and found that they had reduced symptoms after 12 weeks.
“Our findings showed that probiotic and vitamin D co-supplementation for 12 weeks could result in a significant reduction in migraine headache frequency and slight decreases in migraine headache duration and severity,” wrote researchers in BMC Medicine.
However, there were no other significant changes to mental health and the inflammatory marker hs-CRP.
“Probiotic and vitamin D co-supplementation had no effects on daily functioning, mental health outcomes, and serum levels of hs-CRP in adult patients with migraine,” said researchers.
This contrasts with recent data which shows that migraines could be due to microbiota dysbiosis in the gut, and that increased levels of pro-inflammatory cytokines like hs-CRP have been observed during migraine attacks. It was based on these findings that researchers decided to explore therapeutic strategies affecting the intestinal microbiota, which can be useful in the treatment of migraine.
Probiotics could probably relieve migraine headaches through improving the function of gut-brain axis while vitamin D supplementation has also shown beneficial effects on the frequency and severity of migraine attacks.
“It seems that one of the mechanisms through which vitamin D improves migraine attacks might be through its effect on the brain-intestinal axis. We [therefore] hypothesised that probiotic and vitamin D supplementation might be synergistically effective on the brain-gut axis and migraine symptoms,” said researchers.
The objective was to explore a potential treatment alternative to routine medications for migraine treatment, which are not useful in treating all patients and may have some side effects.
The present study therefore investigated the effect of vitamin D and probiotic co-supplementation on clinical characteristics of migraine, daily functioning, mental health outcomes, and serum levels of hs-CRP.
Effects of probiotics and vitamin D on migraine and mental health
The 12-week study was a randomised, triple-blinded, placebo-controlled trial.
Seventy-two patients diagnosed with migraine were recruited for this RCT. They were aged 18–55 years old.
Participants were randomly assigned to two groups.
In the intervention group, each of the 36 participants took 4.5 × 1011 CFU probiotics per day, and vitamin D at a dosage of 50,000 IU every 2 weeks.
The probiotics contained eight different strains of Lactobacillus plantarum, Lactobacillus casei, Lactobacillus acidophilus, Lactobacillus bulgaricus, Bifidobacterium infantis, Bifidobacterium longum, Bifidobacterium breve, and Streptococcus thermophilus. They were provided by Farabiotic Pharmaceutical Company in Tehran, while the vitamin D was provided by Zahravi Pharmaceutical Company in Tabriz.
In the control group, each of the 36 participants took a daily dose of placebo capsule for probiotics, which contained starch and maltodextrin. They also each took a placebo pearl for vitamin D, which contained corn oil, every 2 weeks.
The Headache Impact Test (HIT-6) and Depression, Anxiety, and Stress Scale (DASS) questionnaires were administered to patients at baseline and after 12 weeks.
In addition, the frequency, duration, and severity of migraine headaches per month were assessed using a self-administered 30-day headache diary at baseline and the end of the intervention.
Serum levels of 25-hydroxy vitamin D and the inflammatory marker hs-CRP were also examined at baseline and at the end of the study.
Results
After 12 weeks, the probiotic and vitamin D group showed significantly greater improvement in migraine symptoms than the placebo group.
The probiotic and vitamin D group had a significant increase in serum levels of vitamin D at +12.86 ± 1.64ng/mL compared to the control group, which showed at increase of +1.12 ± 0.80ng/mL.
In the probiotic and vitamin D group, there was also a significantly greater reduction in migraine headache frequency at −3.17 ± 0.84 compared to the placebo group, which showed a reduction of −1.25 ± 0.34.
Headache severity also declined significantly in the probiotic and vitamin D group at −1.55 ± 0.35. On the other hand, the headache severity for the placebo group was +0.67 ± 0.29.
However, no significant difference was found between the two groups in terms of headache duration, hs-CRP, scores of DASS, and HIT-6 questionnaires.
The mean hs-CRP level dropped from 1.85 to 1.53mg/L for the probiotic and vitamin D group, and from 1.84 to 1.51mg/L for the placebo group.
The difference in depression scores between the two groups was −2.11 ± 1.74, which was not statistically significant.
The difference in migraine duration between the two groups was −4.69 ± 2.69 hours; for the HIT-6 scores, the difference between the two groups was − 1.00 ± 1.72. Both were not statistically significant.
According to researchers, the insignificant difference in HIT-6 score compared to the placebo can be explained by the possible effect of other factors such as the migraine type and psychological disorders on the score.
“Furthermore, based on the results of recent systematic reviews and meta-analyses, the effect of probiotics or vitamin D supplementation on mental health indices in various populations might be doubtful,” said researchers.
Therefore, while this trial demonstrated that probiotic and vitamin D co-supplementation for 12 weeks has beneficial effects on migraine headache characteristics, further research is required.
“In conclusion, we found that probiotic and vitamin D co-supplementation may have beneficial effects on migraine headache frequency and severity, but did not affect migraine headache duration, and serum levels of hs-CRP. Further research is required to find alternative treatment options for the management of mental health problems in migraineurs,” researchers said.
Source: BMC Medicine
DOI: https://doi.org/10.1186/s12916-024-03684-6
“Effects of probiotic and vitamin D co-supplementation on clinical symptoms, mental health, and inflammation in adult patients with migraine headache: a randomized, triple-blinded, placebo-controlled trial”
Authors: Shahnaz Amani Tirani, Fariborz Khorvash et al.
