The relationship status between niacin and migraines is complicated with little scientific information. Niacin is a vitamin that typically causes widening of the blood vessels, or dilation. Because migraine headaches are associated with fluctuating dilation and constriction of blood vessels in the brain, niacin has been examined as a potential therapy for migraines. Additionally, headaches, but not specifically migraine headaches, have been reported as an infrequent side effect of niacin use.
A few small research studies have evaluated the effects of IV niacin or oral niacin for the treatment of migraine headaches. Niacin was given to adults during a migraine headache attack. Overall, niacin was more often used as an IV injection and was given as an oral medication in a few instances. There was a subjective trend towards migraine headache relief immediately after treatment. However, the studies did not provide rigorous reporting of objective methods or results and did not use controls to decrease the possibility of a placebo effect. An important complication of the results was that some patients reported worsening headaches, non necessarily migraines, immediately after IV niacin injection. (See Reference 1)
Niacin has been evaluated as a treatment for acute migraines, but has not been extensively considered as a treatment for prevention. A report from the June 2003 "Mayo Clinic Proceedings" described one patient whose migraines responded to preventative treatment with sustained release niacin. (Reference 2) Several mechanisms of action have been proposed as the possible link between migraine relief and niacin, including its well known vasodilating effects, its possible interaction with cell metabolism, and a possible impact on pain receptors in the brain. (Reference 1, Reference 2) Any of these proposed physiological actions could produce either a preventative or therapeutic effect on migraines, but have not been proven to do so.
Niacin Causing Headaches
Niacin is used for treatment of high cholesterol. Headaches have been documented in less than 10% of adults who use oral niacin daily for cholesterol treatment. (Reference 3) Oral niacin is safe for children, but the incidence of headaches may be higher. (Reference 4) The National Headache Foundation lists niacin as a possible cause of headaches. Migraine headaches are not specified as a side effect of niacin. (Reference 5)
Ways to Use Niacin For Migraines
Niacin has been used as an IV treatment for headaches or migraine headaches. Oral niacin for migraine headaches can potentially be given as a regular formulation or a sustained release formulation for slower release and longer duration of action. Niacin is not a well established treatment for migraines, and the few available preliminary reports are lukewarm with respect to effectiveness. It may be considered in some instances as an IV treatment for migraine or given as an oral prescription in consultation with an experienced headache doctor.