What supplements can help reduce headaches and prevent cerebrovascular accidents (stroke)?

From the Guidelines

Vitamin B complex supplements containing folate, B6, and B12 are recommended to help reduce the risk of stroke by lowering homocysteine levels, as supported by the most recent evidence from 2022 1. When considering supplements to help reduce headaches and support stroke prevention, several options are available.

• Magnesium (400-600mg daily) can relax blood vessels and prevent migraine headaches, while Coenzyme Q10 (100-200mg daily) may reduce migraine frequency by improving mitochondrial function.
• Vitamin B2 (riboflavin, 400mg daily) has shown effectiveness for migraine prevention, typically requiring 1-3 months for results.
• Omega-3 fatty acids (1000-2000mg daily of EPA/DHA) help reduce inflammation and improve cardiovascular health, as seen in the 2021 study 1.
• Vitamin D (1000-2000 IU daily) may reduce headache frequency and supports overall vascular health. For stroke prevention specifically, the use of B vitamins to lower homocysteine levels is supported by a 2022 meta-analysis 1 and a study published in the same year 1, which found that B vitamins reduced ischemic stroke by 43%. Ginger (550mg twice daily) can reduce headache pain and has anti-inflammatory properties. These supplements work best alongside lifestyle modifications including regular exercise, adequate hydration, stress management, and a balanced diet rich in fruits and vegetables. Before starting any supplement regimen, consult with a healthcare provider, especially if you're taking medications or have existing health conditions, as some supplements may interact with medications or be contraindicated for certain conditions. Aspirin (81 mg daily or 100 mg every other day) can be useful for the prevention of a first stroke among women, including those with diabetes mellitus, whose risk is sufficiently high for the benefits to outweigh the risks associated with treatment, as stated in the 2014 guidelines 1.

From the Research

Supplements for Reducing Headaches and Stroke Prevention

• Omega-3 fatty acids have been shown to reduce the risk of cardiovascular disease, which is a major risk factor for stroke 2, 3, 4
• The American Heart Association recommends consuming two servings of fish per week for persons with no history of coronary heart disease and at least one serving of fish daily for those with known coronary heart disease 2
• A combination of aspirin and omega-3 fatty acids may be an effective preventative measure in patients with cardiovascular disease 3
• Omega-3 fatty acids, particularly EPA and DHA, have been linked to healthy aging throughout life, including cardiovascular function and cognitive function 4
• Supplements composed of triglycerides are more bioavailable and effective in raising omega-3 index to recommended levels 5
• Practical recommendations to improve omega-3 index to ≥8% are consumption of 1,000-1,500 mg/d EPA plus DHA as triglycerides for at least 12 weeks 5
• Omega-3 fatty acids have been shown to reduce blood pressure, heart rate, and triglycerides in patients with chronic kidney disease 6

Dosage and Interaction

• Approximately 1 g/day of eicosapentaenoic acid plus docosahexaenoic acid is recommended for cardio protection 2
• Higher dosages of omega-3 fatty acids (2-4 g/day) are required to reduce elevated triglyceride levels 2
• The combination of aspirin and omega-3 fatty acids may have synergistic effects, with optimal aspirin efficacy dependent on EPA and DHA concentrations in blood 3
• The EPA-to-DHA ratio is important, with DHA being more effective in reducing blood pressure and modulating systemic inflammation 3