Serum Vitamin D Levels and Risk for Migraine

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Immune dysfunction and inflammation have been proposed as playing key roles in the pathogenesis of migraine headaches.
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.

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Reference

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

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