Evidence supporting the use of: Vitamin B3 (Niacin)
For the health condition: Migraine

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Synopsis

Source of validity: Traditional
Rating (out of 5): 2

Vitamin B3 (Niacin) has been used traditionally for migraine prophylaxis and acute treatment, although scientific evidence supporting its efficacy is limited and of low quality. Historical use is based on case reports and small, uncontrolled studies dating back to the 1940s and 1950s, where niacin was observed to provide relief from migraine symptoms, possibly due to its vasodilatory effects. Niacin induces flushing and the dilation of blood vessels, which was hypothesized to counteract the constriction thought to initiate migraine attacks. However, modern understanding of migraine pathophysiology has evolved, and the role of vasodilation is now considered less central.

A few small-scale and anecdotal reports suggest possible benefit, but there are no large, high-quality randomized controlled trials demonstrating a clear effect of niacin in preventing or treating migraines. The American Headache Society and major clinical guidelines do not recommend niacin for migraine due to insufficient evidence. Most contemporary reviews and systematic analyses conclude that while niacin's traditional use is noted, robust scientific validation is lacking. Therefore, while niacin continues to be used by some based on tradition, its clinical utility for migraine remains unproven.

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