June of 2016 brought about a flurry of media activity surrounding the idea that migraineurs had low levels of some vitamins compared to non-sufferers. The good news story was based on some preliminary findings presented at a conference. When researchers present findings of studies at conferences they are usually results that have yet to be published in the scientific literature. Therefore they have not passed the rigors of peer review; the quality control mechanism for research and we need to consider the results cautiously.

Nevertheless, the findings were promising in the context of the existing scientific evidence. The researchers reported that migraineurs’ levels of vitamins D, B₂ (a.k.a. riboflavin) and B₁₂ were below normal. Vitamins D, B₂ and B₁₂ were not low enough to be deficient in these vitamins, which could be life threatening, but they were well below the levels recommended for the proper functioning of the body.

This is not a new finding. As far back as 2005, a review of the scientific literature to date puts in context the important role of these vitamins for migraineurs. The overwhelming evidence is that migraine sufferers have lower levels of vitamins D, B₂ and B₁₂ than non-sufferers. The frequency of migraines is significantly reduced when the levels of these vitamins are raised to those of non-sufferers. Even older evidence exists that in women, below normal levels of vitamin D and calcium go hand in hand, and that a reduction in migraine frequency was achieved by increasing both.

The bottom line is that migraineurs need to be sure and reach their daily intake targets of vitamins D, B₂, B₁₂ and calcium.

Vitamin D

The main source of vitamin D is exposure to sunlight. A bit of a double edged sword for Australians. Australia has the highest rate of skin cancer in the world and we’ve taken the advice of our medical community to heart. Our slip, slap, slopping of sunscreen has resulted in the decrease of skin cancer with an unwanted side effect of vitamin D deficiency in the population. This is compounded by the fact that most of us don’t get enough vitamin D from our diet.

In 2005, yes 2005, the official position of the Medical Association of Australia and New Zealand was updated stating that we need more sun exposure to rectify this vitamin D deficiency:

“Exposure of hands, face and arms to one-third of a minimal erythemal dose (MED) of sunlight (the amount that produces a faint redness of skin) most days is recommended for adequate endogenous vitamin D synthesis. However, deliberate sun exposure between 10:00 and 14:00 in summer (11:00–15:00 daylight saving time) is not advised.”

It isn’t just sunscreen that inhibits vitamin D production. Those living in higher latitudes, farther from the equator, are prone to insufficiencies simply because there is less time to spend in the sun.

So my friends, get outside for a bit each day without any sunscreen. I know they say to avoid the midday sun, but a short lunch (10-15 minutes) in the sun can give you a break from work; doing wonders for the soul and your vitamin D.

Calcium, B₂ and B₁₂

Lucky for us, foods rich in one of these is usually rich in the other two. Just like we saw for magnesium and potassium, the best way to reach you target intakes is to hit one or two foods that are rich in calcium, B₂ and B₁₂:

One cup of dairy each day. We like to mix it up with small amounts of heavy hitters, a bit of yoghurt with Migraineur’s Muesli, milk in a Migraineur’s Hot Chocolate, and some cheese. A little bit here and a little bit there and before you know it you’ve hit one cup. If you are looking for a super food, one cup of feta cheese is the target amount of B₂ and B₁₂.

Get some pork on your fork. Pork is not only very high in B₂ and B₁₂ but lysine rich, so it slows down the synthesis of nitric oxide that drives the migraine beast. A great way to get more pork into your weekly diet is to substitute ground pork for ground beef in your favourite recipes. Or you could try this recipe for a Cuban mojo marinated roasted pork shoulder, lechon asado. It’s a great main dish with plenty leftover for sandwiches during the week.

Liver. Liver is by far the richest source of B₂ and B₁₂ as a single serve is four times the intake target. I know that it’s not everyone’s favourite, but if you like it you should definitely have it on your list of go to foods.

So my friends, perhaps the best preventative medicine is a picnic lunch in the sun (vitamin D) with a hamper that includes pate (B₂ and B₁₂), cold roast pork (B₂ and B₁₂), feta cheese (calcium, B₂ and B₁₂), sun-dried tomatoes (magnesium and potassium), almonds (magnesium and potassium) and some dried apricots (magnesium and potassium). Throw in some good company, a view (Greece perhaps?) and watch the world go by. Enjoy my friends.

As always, whenever making lifestyle changes be sure and consult your healthcare team. Under no circumstances should you stop or start taking medication or supplements without their consent.

Informed by science, cooked by you.