Synopsis

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

Vitamin B6 (pyridoxal 5-phosphate) has a modest scientific basis for use in supporting or treating migraines. Several small-scale clinical studies and observational research have explored the role of B vitamins, including B6, in individuals with migraine, especially when combined with folic acid and vitamin B12. The rationale comes from B6’s role as a cofactor in homocysteine metabolism. Elevated homocysteine levels have been found in some migraine sufferers, and lowering homocysteine through B-vitamin supplementation has been associated with a reduction in migraine frequency and severity in certain studies.

A notable randomized controlled trial (RCT) by Lea et al. (2009) found that supplementation with vitamin B6, folic acid, and B12 reduced the frequency and severity of migraine with aura, likely via homocysteine-lowering effects. However, most evidence points to the benefit of combined B vitamin therapy rather than B6 alone. Data on pyridoxal 5-phosphate specifically are limited, and the effect size is modest.

Overall, scientific evidence for the use of vitamin B6 in migraine is limited and not robust enough to warrant widespread recommendation as a sole therapy. Its use is better justified as part of a combined B-vitamin regimen in specific subgroups (e.g., migraine with aura, elevated homocysteine). Larger, more rigorous studies are needed to confirm efficacy and clarify B6's role. Most guidelines do not recommend B6 supplementation for migraine except in special circumstances.

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