migraine thiamine

Migraine, Diet, and Thiamine

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In US population studies, the prevalence of migraine is approximately 18% in women and 6% in men. About 90% of sufferers have moderate or severe pain and 75% have a reduced ability to function during the headache attacks. One third require bed rest during an attack. A study at the Mayo Clinic showed the incidence in women increased 56% during the 1980s and 34% during the same period in men. Although the term “migraine” is often used to describe any severe headache, a migraine headache is the result of specific physiologic changes that occur within the brain leading to the characteristic pain and associated symptoms. They are usually accompanied by sensitivity to sound, light and odors and there may be nausea or vomiting. Typically, the headache involves only one side of the head but in some cases it may be bilateral. The pain is often described as throbbing, pounding and maybe made worse with physical exertion. Silent migraine is a variant where the patient may experience aura, nausea, vomiting and other nervous symptoms without headache.

Migraine headache is estimated to affect up to 28% of adolescents, most of whom are female. It has been associated with reduced quality of life and academic disruption due to missed school days. In 2014 the US Food and Drug Administration approved an existing medication called topiramate for prophylaxis in adolescents between the ages of 12 and 17 years. There are several possible adverse effects from this drug, some potentially serious. Prophylactic drugs are unpromising and unpredictable. A mild degree of prevention could be obtained from the use of acupuncture.

Migraine Precipitants

Of 171 patients who fully completed a survey, 49.7% reported alcohol as a precipitating factor of headache other than migraine. Only 8.2% reported aspartame and 2.3% reported carbohydrate. Patients with migraine were significantly more likely to report alcohol as a trigger. They also reported aspartame as a precipitant three times more often than those having other types of headache. Non-nutritive sweeteners, including aspartame, saccharin, sucralose, neotame, acesulfame-K and stevia have all been questioned as to their safety. Pregnant and lactating women, children, diabetics, migraine and epilepsy patients, represent the susceptible population. Although sucralose is not considered to be a migraine trigger, a patient was reported with attacks of migraine consistently triggered by this sweetener.

Hypoxia, Pseudo-hypoxia, and Migraine

Migraine with aura is prevalent in high-altitude populations, suggesting that hypoxia has a part to play in etiology. Of 15 patients with migraine headaches, artificially induced hypoxia triggered migraine attacks in eight patients.

Thiamine deficiency produces abnormal gene expression in brain exactly like that induced by true hypoxia. Migraine is a risk factor for thiamine deficiency and Wernicke encephalopathy (WE), the classic thiamine deficiency disease that affects the brain. Two female patients have been reported with chronic migraine. They also had clinical signs and laboratory support for WE. Both patients received intravenous thiamine supplementation, leading to improvement of both WE and the associated headache. The authors suggested that nausea and vomiting, occurring with migraine, may lead to the thiamine deficiency. However, headache, nausea, vomiting and loss of appetite are symptoms that occur in the early stages of WE, thus simulating migrainous features and the association is by no means clear. The authors suggest that thiamine supplementation might be a promising therapy in a subset of patients with chronic migraine.

Also, the range of pathologies associated with magnesium deficiency is staggering, including migraine, multiple sclerosis, glaucoma and many other disorders. It is important to emphasize once more that magnesium and thiamine work together in the cellular machinery that produces energy and deficiency of either is critical. Chronic recurrent nausea in childhood is a poorly described symptom and in a study of 45 affected children, 62% had migraine headaches. They also suffered from dizziness, anxiety, fatigue and sleep problems. The exact incidence of dizziness and vertigo during adolescence is not known. For those few adolescents who seek outpatient evaluation, the majority are diagnosed with migraine headaches and many suffer from postural orthostatic tachycardia syndrome (POTS), a condition that has been reportedly due to thiamine deficiency in some cases.

Autonomic Asymmetry

Normally there is a balance between the autonomic tone of the right and left half of the body. However, under stress or with hypothalamic instability this balance may be disrupted and result in the marked autonomic asymmetry seen in migraine. Abnormal regulation of the large cranial arteries appears to play a significant role in the mechanisms of migraine pain, also reflecting abnormal autonomic function.

Migraine and Diet

Attack frequency of migraine in children was associated with higher intake of high fat or sugar. The processing of both is dependent on thiamine. With these strong associations in the medical literature, it is impossible not to contemplate that the sweet sensory input from the tongue to the brain is an important trigger for migraine. There has been a steady increase in sugar consumption in America over the past few decades, suggesting the possibility that it represents the published increased incidence of migraine in the 1980s as mentioned above. It also suggests the possible implication of artificial sweeteners as migraine triggers.

The association of migraine with alcohol ingestion might be an important observation, since alcohol has long been known to be a cause of thiamine deficiency in the part of the brain that controls the autonomic nervous system. It has also long been known that beriberi, the classical thiamine deficiency disease, causes autonomic dysfunction in its early stages. One of the most important observations that I observed in practice was that a mild degree of this deficiency makes the brain extremely sensitive to many different input stimuli. It results in a high degree of sympathetic nervous system activity, hence so-called panic attacks that are really distorted fight-or-flight reflexes. Patients complain of constant anxiety, heart palpitations, unusual sweating, nausea, vomiting, dizziness and brief fainting attacks known as syncope. This collection of symptoms, thought by many physicians to be psychological in nature, is also referred to as postural orthostatic (positional) tachycardia (rapid heart) syndrome (POTS).

In a person who is in a marginal state of malnutrition, any mild stress such as a vaccination, a mild infection or some form of trauma may initiate POTS. A reader might conclude that this diversity of symptoms, that include the incidence of migraine, cannot be caused by a deficiency of a single nutritional element. In order to understand, it is necessary to be aware that a deficiency of energy in the brain resulting from a common form of malnutrition creates a multiplicity of cellular dysfunction according to the distribution of the deficiency. If this is the truth, it makes a mockery of the present medical model in which each described disease is thought to have a specific underlying cause. Hence, money is collected to find the cause of Alzheimer’s disease and is probably a pipe dream. It is well known a published association with thiamine metabolism strongly suggests that we should be looking for prevention rather than spending millions in trying to find a curative drug.


The clues that alcohol, sugar and artificial sweeteners are major triggers for producing migraine headaches are so strong, their avoidance would appear to be mandatory. However, it is almost certainly true that many sufferers know this, but make no attempt at avoidance, marking the taste of sweeteners as addictive. I became aware that there were millions of people in America suffering from symptoms that are constantly being unrecognized in medical clinics. Even if they are recognized as nutritional in nature, the doctor and patient are likely to ignore the appropriate prevention by adopting the consumption of an appropriate diet. Since most of the population is ingesting pills of one sort or another, perhaps advising the use of vitamin supplements as part of the dietary discretion might at least partially serve in the reversal of these common symptoms.

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Photo by Mehrpouya H on Unsplash.


Derrick Lonsdale M.D., is a Fellow of the American College of Nutrition (FACN), Fellow of the American College for Advancement in Medicine (FACAM). Though now retired, Dr. Lonsdale was a practitioner in pediatrics at the Cleveland Clinic for 20 years and was Head of the Section of Biochemical Genetics at the Clinic. In 1982, Lonsdale joined the Preventive Medicine Group to specialize in nutrient-based therapy. Dr. Lonsdale has written over 100 published papers and the conclusions support the idea that healing comes from the body itself rather than from external medical interventions.


  1. Hi!

    Can Thiamine also cause rashes and/or migraines? I take thorne b-vitamin complex with 10000% of recommended daily intake of thiamin and sometimes I get allergic reactions (red rashes in face and on throat) but I am not sure it is from that. I also suffer from migraines (thats why I am taking the vitamins) but now I am afraid that Thiamin can cause migraine. Any knowledge about this?

    Thanks! Paula

    • My experience is that, if anything, it relieves it. It certainly does not cause it

    • Paula,

      Standard B vitamin complexes don’t have the right type of B vitamins in them. In addition, you may not need B vitamins other than B1 and B2. Migraine is not caused by thiamine deficiency but by carbohydrates and not enough salt. Migraine is a genetic condition, best described as a channelopathy–meaning that voltage dependent ionic channels, such as the sodium-potassium/ATPase pump–the one that generates the electricity–is mutated such that it is activated more often, and thus needs more salt, but has trouble in a body that uses glucose as the primary fuel. Carbohydrate-rich diets reduce sodium in cells, causing a shortage of sodium and lack of voltage. This is the direct cause of migraine and not vitamin deficiency.

      To see if you are deficient in vitamins, get a blood test and a person who understands the results–meaning the normal lab ranges are often estimated very widely and incorrectly. You need someone who can interpret your results. You are welcome to join my Facebook migraine group to get help.


  2. Hi Dr. Lawnsdale,

    I have been treating my gastrointestinal issues, thiamine deficiency and beriberi for the past year at 875 mg Lipothiamiane. I took a break when after switching to a different brand, I started to get debilitating migraines. After 6 weeks without B1, I started back on Allithiamine at only 100mg (in order to gradually increase again) however I seem to have gotten another migraine?!
    I never used to have this problem and I’m afraid I won’t be able to tolerate it. What am I missing? Is this paradox? Should I push through? Is it a vitamin imbalance? Any information or insight you have would be greatly appreciated!
    Thank you so much for your time and knowledge!!

  3. Can anyone help? after a bad viral bronchitis episode last month my gait and balance problems have returned with a vengance. I began B12 injections and B1 supplements one year ago and most of my balance, energy and gait problems vanished within a few weeks. But now I am staggering around and running into walls again. Are there any doctors in Utah who are knowledgeable about thiamine? B12?

    Please forgive if this posts twice, i can’t figure this website out.

  4. Karin do you drink coffee? Anecdotal, but I noticed that my Thiamine supplement only helps my energy on days I don’t drink coffee. So strong is the correlation I simply don’t waste the supplement by taking on days I choose to have coffee because it would simply be a waste of money. I’m trying to quit coffee for good, I have felt best during the periods I stop coffee for weeks at a time.

  5. Thank you for your expertise. I will work with her to clean up her diet and take thiamine. You are so kind to help.

  6. Is it not curious that the very things supplied by the pharmaceutical companies and prescribed by physicians are the very substances that are doing us more harm than good? Dr. Marrs has published information on Metformin on Hormones Matter.

  7. Dr. Lonsdale my daughter gets migraines and was recently diagnosed with hyperthyroidism. I’m sure she needs thiamine. She eats lots of sugar each day. Would thiamine cause her thyroid to function more and worsen her hyperthyroidism? I would like to see if thiamine can help her migraines. Thank you,

    • Unfortunately, the sugar is the problem. It induces thiamine deficiency and is the reason that sugar is a cause of many different diseases. It may even have been the cause of the hyperthyroidism. I assure you that she cannot possibly improve unless she removes the sugar in all its different forms and takes thiamine as a supplement. I am well aware that sugar is addictive and it will not be an easy transition but if she wishes to regain her health it is an essential part of her self responsibility. In her present state, even a little sugar in ANY form will keep the pot-a-boiling. Therefore it includes soft drinks, candy, chocolate, deserts, donuts. She can get the sweet taste from fresh fruit only.

  8. Since about 2012 my whole family, including all the animals, have been doing poorly. In 2015 looking for information that could help my horses I read an article by Lennart Balk about thiamin deficiency in wild animals and decided to give my horses a substantial amount of thiamin mononitrate. Just in case, I also took the same amount per kg of bodyweight to feel what it felt like. You can’t ask the horses … I was afraid that they would become even sicker. At the time I was very depressed and anxious and spent most of the day in bed to be honest. I could not work. To my big surprise the hiccup that “was all in my head” according to my doctor went away overnight. I’m still not back to my old self, but at least I don’t feel bad. The horses got better too and I have since given the whole family thiamin of different sorts. Now, the only thing that I can think of that we all share are the well (groundwater), the tank and the pipes. Could there be anything in the water that affects the thiamin in our bodies. I don’t know what to test for. We manage by continuing taking thiamin but if I can I would like to fix the reason for this great need for it. I have ordered the book (Thiamine Deficiency Disease, Dysautonomia, and High Calorie Malnutrition). Thank you! /Karin (Sweden)

    • I suggest that you take a sample of the water to a laboratory where such an analysis is conducted. I have no idea whether there is something in the water or not but there has been a recent report of thiamine deficiency in alligators. It may well be that we are pouring our toxins into the water supply

      • Thank you for your reply! I’m certain that we have chemicals in our water but I do suspect bacteria or something like that. Actually, the only time I have been feeling really energetic since we moved here was when they talked me in to taking antibiotics against urinary infection when I was 8 och 9 months pregnant in 2011. Also, even now when I have been taking thiamine tetrahydrofurfuryl disulfide I still have to take 200 mg several times per day to feel good and well. It’s like something is robbing me of the thiamin I eat and I have to take a lot to get some for myself. Something that didn’t survive antibiotics. Well, today I got your book. I hope that I will get more answers from it. I have spent 3 years trying to understand why high doses of thiamin help me. I won’t give upp until I do.

          • I came to think of something else that I and the horses have in common. We both eat food that have been fertilized with (pig) manure. Could it be possible that thiaminase producing bacteria somehow affect us this way?

  9. I stopped my Metformin dose a few months ago after I learned it was causing a thiamine deficiency. I’m taking 100 mg 3x TTFD to recover. I was concerned because my fasting glucose was so high, so after a few weeks of the thiamine dosing I thought it would be safe to restart the medication. I took a 500 mg dose ER in the morning and in the evening when I was out shopping I had a visual migraine. I’ve had them before it starts out with a blind spot in the middle of the visual field and works its way out to the edge over a 1/2 hour. I had to stay at the store til I was safe to drive. The first few migraines were painful but now they are just aura I will not ever take that medication again.

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