Migraine and Headache: Integrative Care for Migraine, Tension and Neck Headaches

Are low vitamin D and magnesium linked with migraine? What the research shows

People with migraine have lower vitamin D levels than people without it: a 2020 meta-analysis of 8 studies in Revue Neurologique found an average difference of about 4 ng/mL [4], and a 2023 Indian meta-analysis from JIPMER found that low vitamin D almost doubled the odds of migraine (odds ratio 1.95, low-certainty evidence) [7]. Vitamin D trials show fewer attacks, but not shorter or milder ones; results for other supplements are mixed.

• Vitamin D trials: in a 2021 meta-analysis of 6 trials (301 patients), vitamin D reduced headache attacks by about 2.7 a month and headache days by about 1.6 a month, but did not change attack length or severity [5]; a 2023 meta-analysis from JIPMER, India, found the same pattern [7].
• Magnesium trials: a 2016 meta-analysis of 10 trials found that oral magnesium reduced the frequency and intensity of migraine [6], and a 2025 meta-analysis of supplement trials found fewer attacks and migraine days [8].
• The studies disagree: a 2019 Canadian meta-analysis concluded that the evidence was not enough to know whether magnesium or coenzyme Q10 prevent migraine [9], and a Swiss systematic review graded magnesium “possibly effective” [10].
• Magnesium testing: a blood (serum) magnesium test does not show how much magnesium the body holds, because most of it sits in bones and cells, according to the US National Institutes of Health [11]; we assess it from diet, symptoms and history.
• What this means for you: check vitamin D as part of a full assessment, and correct deficiencies under supervision rather than on your own.

What are migraine and headache? The main types

Headache disorders are among the most common conditions worldwide: the Global Burden of Disease 2023 study estimated that 2.9 billion people are affected, with migraine causing most of the disability [12]. Doctors classify headaches with the International Classification of Headache Disorders (ICHD-3) [13].

• Migraine without aura: recurring attacks of moderate or severe, often one-sided, throbbing headache with nausea or sensitivity to light and sound [13][1].
• Migraine with aura: warning signs such as zigzag lines, flashing lights, numbness or difficulty speaking, usually lasting no longer than an hour, before or with the headache [1].
• Tension-type headache: a pressing or tight pain on both sides of the head, face or neck, which usually does not stop daily activities [2].
• Neck (cervicogenic) headache: headache caused by a disorder of the neck, usually with neck pain [13]; see our Neck Pain & Cervical Spondylosis page.
• Medication-overuse headache: headache that develops or worsens when painkillers are taken too often (see below) [14].
• Chronic migraine: headache on 15 or more days a month for more than 3 months, with at least 8 days having migraine features, according to NICE [14].
• In Delhi and the National Capital Region: 1-year prevalence was 26.3% for migraine and 34.1% for tension-type headache, and migraine was more than twice as common in women (35.7%) as in men (15.1%) [3].

Migraine or tension headache: how can you tell the difference?

Migraine is usually a throbbing pain on one side that worsens with movement and comes with nausea or sensitivity to light and sound, while tension-type headache is a pressing or tight pain on both sides that usually allows daily activities, according to the NHS and NICE [1][2][14].

What helps during a headache or migraine attack?

The NHS suggests taking painkillers as soon as a migraine starts, and resting or sleeping in a darkened room [1]; for tension headaches it suggests painkillers, relaxation, exercise, yoga or massage, and for neck pain with headaches a low, firm pillow and heat or cold packs [2].

• Medicines for attacks: NICE recommends options such as a triptan combined with an anti-inflammatory or paracetamol for migraine attacks, prescribed by your doctor [14].
• Preventive medicines: for frequent migraine, doctors may offer preventive medicines such as beta blockers, some antidepressants or epilepsy medicines, and the NHS also lists acupuncture, relaxation techniques and vitamin B2 [1].
• Limit painkillers: the NHS advises not taking painkillers for migraine on more than 2 days a week (see medication-overuse headache below) [1].

What causes headaches and migraine? Common triggers and root factors

Common headache causes and migraine triggers include stress, tiredness and poor sleep, skipped meals, dehydration, too much caffeine or alcohol, poor posture, eye strain, hormonal changes and taking painkillers too often, according to the NHS [1][15][2]. At Cure4Pain we also look for root factors that research links with headache:

• Jaw and teeth: jaw joint and muscle problems (TMD) and daytime teeth clenching (see below) [16][17].
• Sleep and breathing: sleep apnoea is linked with a higher risk of migraine (see below) [18].
• Metabolic and gut factors: gut conditions, raised blood fats and histamine (see below) [19][20][21].
• Deficiencies: low vitamin D and magnesium (see above) [4][6].
• Family history: migraine is more likely if a close family member has it, and women get it more often than men [1].
• A headache diary: NICE suggests recording headaches, symptoms, medicines and possible triggers for at least 8 weeks to help diagnosis [14].

Can a jaw problem (TMJ) or teeth grinding cause headaches?

Jaw problems and headache occur together far more often than chance: a 2026 meta-analysis in the Journal of Oral Rehabilitation found that people with migraine were about 6 times more likely to have a temporomandibular disorder (TMD), and people with TMD about 2.6 times more likely to have migraine, with high-certainty evidence [22]. These studies show a strong link but do not prove which causes which.

• Tension-type headache: a 2024 meta-analysis found painful and muscle-type TMD more often in people with migraine and tension-type headache [16].
• Teeth clenching and grinding (bruxism): daytime clenching went with 5 to 17 times higher odds of tension-type headache; night-time grinding was not linked with tension-type headache, and the link with migraine is uncertain (low-certainty evidence) [17]. The NHS lists headaches and jaw pain among the effects of teeth grinding [23].
• Bite splints: in a review of 9 small trials, hard stabilisation splints reduced headache in people with both TMD and headache, but the evidence was of low quality [24].
• Tongue posture and tongue thrusting: at Cure4Pain we correct resting tongue posture and tongue thrusting as part of care for jaw-related headaches. We found no trial of tongue-posture correction for headache; myofunctional (tongue and throat muscle) therapy has been studied mainly in sleep apnoea [25]. Further studies are needed.

Can poor sleep or sleep apnoea cause migraine?

Sleep apnoea is linked with migraine: in a 2025 US study of about 394,000 adults, people with obstructive sleep apnoea had 1.85 times the risk of developing migraine compared with matched people without it [18], and “sleep apnoea headache” (a morning headache that usually clears within 4 hours) is a recognised type in the international classification [13]. The NHS lists sleep problems among the causes of tension headaches [2].

• Light or broken sleep: in our clinic, many people with migraine have mild or partial sleep apnoea or broken sleep, where they seem to be asleep but do not reach deep sleep stages. This is a clinic observation.
• Dr Stasha Gominak’s approach: we use the sleep and breathing approach of Dr Stasha Gominak, a US neurologist who has published in clinical neurology since the 1990s. In two papers in Medical Hypotheses, she described about 1,500 neurology patients with abnormal sleep whose sleep and neurological symptoms improved when vitamin D was kept within a narrow blood range [26], and over 1,000 patients whose sleep, pain and bowel symptoms improved with vitamin D plus B vitamins [27]. These are hypotheses with uncontrolled observations, not controlled trials, and we found no controlled trial of her approach in migraine; further studies are needed.
• Independent evidence: a 2022 meta-analysis of 3 trials found that vitamin D supplements improved sleep quality scores compared with placebo (moderate certainty) [28], and a 2015 meta-analysis found that myofunctional therapy roughly halved the number of breathing pauses in adults with sleep apnoea (9 small studies) [25].
• Sleep tests: if sleep apnoea is suspected, a sleep study confirms it [13]; see our Snoring & Mouth Breathing and Insomnia & Sleep Problems pages.

Are acidity, blood fats and histamine linked with headaches?

Research links migraine with gut and metabolic factors, mostly through association studies: a 2020 review in The Journal of Headache and Pain describes links between migraine and gut conditions such as Helicobacter pylori stomach infection, irritable bowel syndrome and celiac disease through the gut-brain axis [19], and a 2021 meta-analysis of 17 observational studies in Headache found higher total cholesterol and triglycerides in people with migraine than in healthy people [20].

• Histamine: histamine from food is broken down in the gut by an enzyme called DAO. In a randomised double-blind trial of 100 people with migraine and low DAO, a DAO supplement shortened attacks by about 1.4 hours, but attack numbers and pain scores fell similarly with placebo [21].
• Acidity: in our clinic, many people with long-standing migraine also have hyperacidity; this is a clinic observation, and research on acidity treatment for migraine is limited.
• At Cure4Pain: these factors are assessed with blood tests and history, and treated with the right medicines and nutritional support under clinical guidance from Team Cure4Pain; see our Acidity & Hyperacidity page.

Is migraine linked with Raynaud’s phenomenon and autoimmune conditions such as systemic sclerosis?

Small studies report migraine more often in people with autoimmune conditions and Raynaud’s phenomenon: in a study of 50 people with lupus, migraine affected 86% of those with both Raynaud’s and antiphospholipid antibodies, compared with 27% of those with neither, which suggests that blood-vessel spasm may be a shared mechanism [29]. Raynaud’s is sometimes caused by another health condition, and doctors may test for conditions such as lupus or rheumatoid arthritis, according to the NHS [30]. The research on migraine in these conditions is limited.

• Clinic observation: in people with early autoimmune conditions such as Raynaud’s phenomenon or systemic sclerosis, we have observed headache intensity reduce with supervised-dose vitamin D therapy, although the headaches did not settle completely. This is a clinic observation; further studies are needed. We found no trial of vitamin D for headache in these conditions.
• Testing: our standard panel includes ANA by the IFA method for every patient, which can point to autoimmune activity; a positive ANA alone does not mean you have an autoimmune disease (see below).
• Migraine medicines and Raynaud’s: in a 2021 Mayo Clinic study of 169 people with Raynaud’s taking newer CGRP migraine medicines, 5.3% had blood-flow complications in the fingers, so these medicines are used with caution in Raynaud’s [31]; your neurologist and our team review them together.
• See our Autoimmune conditions page.

How does Cure4Pain manage migraine and headache?

Cure4Pain first identifies the source of each person’s headaches, then matches treatment to it: jaw and muscle work for myofascial and myofunctional headaches, nutrition for deficiency states, medicines and nutrition for metabolic factors, and supervised-dose vitamin D therapy (Coimbra Protocol-based methods) for autoimmune and metabolic types, with sleep and breathing care throughout. Cure4Pain is an integrative and functional medicine clinic in Mumbai, with online consultations worldwide; Dr Krushal Pabari focuses on rheumatic and musculoskeletal diseases and AT. Chintan Dalal, N.D. on chronic pain management:

1. Tests first: our standard panel of more than 100 measures, including ANA by the IFA method, the lipid profile and markers of inflammation (see below).
2. Jaw, neck and muscle (myofascial and myofunctional) headaches: tongue-posture correction, and dry needling and acupuncture to release tense neck, shoulder and jaw muscles, often where headaches come from jaw (TMJ/TMD) problems, a bite problem (malocclusion) or tongue thrusting.
3. Deficiency states: headaches linked with severe magnesium deficiency, or calcium deficiency confirmed by blood tests, are treated with nutritional supplementation as a therapy, with calcium and PTH monitored; we found no trial of calcium for headache, and further studies are needed.
4. Metabolic factors: acidity, raised triglycerides and histamine responses are treated with the right medicines and nutritional support.
5. Supervised-dose vitamin D therapy (Coimbra Protocol-based methods): mainly for autoimmune and metabolic types, at doses above standard supplement amounts but below high-dose protocols, set for you and monitored with blood tests (see below).
6. Nutrients: magnesium by mouth and, where needed, on the skin for comfort during mobility exercises, riboflavin (vitamin B2), coenzyme Q10, omega-3 and vitamin B12, within official limits where these exist.
7. Diet: caffeine, alcohol, MSG and nightshades removed, and cruciferous vegetables limited at times (see the diet section).
8. Gut: probiotics and support for digestion and bile flow.
9. Sleep and breathing: correcting sleep and breathing patterns, based on Dr Stasha Gominak’s approach.
10. Medicines: painkillers and any preventive medicines are reviewed and, where they are overused, reduced gradually under clinical guidance from Team Cure4Pain.

What tests does Cure4Pain do for headaches?

Before the first consultation, Cure4Pain tests deficiencies, metabolic and inflammatory factors and autoimmune activity as part of a panel of more than 100 measures; this is our clinic protocol, not a guideline requirement, as NICE does not require blood tests to diagnose migraine or tension-type headache [14]:

• Vitamin D status with PTH and calcium, vitamin B12, iron studies
• Lipid profile (cholesterol and triglycerides), HbA1c
• Markers of inflammation such as hsCRP, and a complete blood count
• Thyroid tests, kidney function, liver function
• ANA (antinuclear antibodies) by the IFA method, part of our standard panel for every patient

In India, the panel is available at a lower cost through our patient portal, with home collection across India. Outside India, the tests are done at a laboratory near you and reviewed with you in the consultation.

Supervised-dose vitamin D therapy for migraine: dose, safety and evidence

Supervised-dose vitamin D therapy uses vitamin D as an immune modulator rather than only as a bone supplement, with doses that differ by condition and are set and monitored by a clinician; for headaches linked with autoimmune and metabolic conditions we use doses above standard supplement amounts but below the high doses used for some autoimmune diseases. Our approach is based on methods of the Coimbra Protocol, which sets doses from blood tests including PTH and calcium [32]; see our Coimbra Protocol page.

• Safety limit: the upper limit for adults is 4,000 IU a day, and too much vitamin D can raise blood calcium, according to the US National Institutes of Health [33]; doses above this are used only under medical supervision with regular blood tests.
• Safety data: in a 2022 study of 319 people with autoimmune diseases on supervised high-dose vitamin D, average calcium and kidney results stayed normal; it came from a single centre without a comparison group [32].
• The cautious view: a 2020 review in multiple sclerosis notes that the long-term safety of high-dose vitamin D is not well studied and requires physician supervision [34].
• Evidence in migraine: standard-dose trials show fewer attacks [5]; we found no trial of Coimbra Protocol-based dosing in migraine, so further studies are needed.
• Never on your own: please do not copy doses from the internet or from videos.

Magnesium, riboflavin, CoQ10 and omega-3 for migraine: what the research shows

Several supplements reduced migraine frequency in trials, with mixed results: a 2025 dose-response meta-analysis of 22 trials in Neurological Sciences found fewer attacks with magnesium, coenzyme Q10, riboflavin, probiotics and vitamin D, but no significant effect of omega-3 [8]. They are used alongside the plan, within official limits where these exist, not instead of it.

• Magnesium: the upper limit from supplements is 350 mg of elemental magnesium a day for adults, and higher amounts can cause diarrhoea; absorption varies by form, according to the US National Institutes of Health [11]. Migraine trials often used higher amounts, so these are taken only under medical supervision [10].
• Magnesium on the skin: we use topical magnesium for comfort during mobility exercises for the neck and shoulders, not as a replacement for magnesium by mouth.
• Riboflavin (vitamin B2): NICE advises that riboflavin (400 mg once a day) may reduce migraine frequency and intensity for some people [14]; a 2022 meta-analysis of 9 trials (673 people) found fewer migraine days and attacks [35]. The NHS lists vitamin B2 among preventive options [1].
• Coenzyme Q10: a 2021 meta-analysis of 6 trials (371 people) found shorter and fewer attacks, but no change in severity [36]; a 2019 Canadian meta-analysis found the evidence insufficient [9].
• Omega-3: a 2025 meta-analysis of 22 trials found no significant reduction in migraine with omega-3 [8]; we use it as part of general nutrition.
• Vitamin B12: checked in our panel and corrected when low [37].

Which foods trigger migraine? Caffeine, alcohol, MSG and nightshades

No single diet is proven to prevent migraine; the NHS lists too much caffeine, alcohol and skipped meals among common triggers and advises regular meals and good hydration [1][15]. As clinic practice, Cure4Pain removes caffeine, alcohol, MSG and nightshades, and limits cruciferous vegetables at times; we state the research on each plainly.

• Caffeine: too much caffeine is a common trigger, and stopping it suddenly can itself cause a caffeine-withdrawal headache [1][13], so we reduce it gradually.
• Alcohol: a common headache trigger, according to the NHS [15].
• MSG: a systematic review found no consistent effect of MSG on headache when taken with food; effects appeared mainly with large doses taken without food, in poorly blinded studies [38]. Removing MSG is our clinic practice.
• Nightshades (tomato, potato, brinjal, peppers): avoiding them is our clinic practice; we found no study of nightshade avoidance in migraine.
• Cruciferous vegetables: limited at times as clinic practice; research has not shown that they trigger migraine.
• Regular meals and water: skipping meals and dehydration are common triggers [1][15].

Do dry needling and acupuncture help headaches?

A 2016 Cochrane review of 22 trials (4,985 people) found that adding acupuncture reduced migraine frequency (attacks at least halved in 41% with acupuncture and 17% without), that the effect over sham acupuncture was small, and that in 3 trials comparing acupuncture with preventive drugs, results were similar at 6 months, with fewer side effects with acupuncture (moderate-quality evidence) [39]. A separate 2016 Cochrane review of 12 trials found acupuncture helpful for frequent tension-type headache, with a small effect over sham acupuncture [40].

• Dry needling: a 2024 meta-analysis of 13 trials found less headache intensity and frequency at one and three months across headache types, with varied results between studies [41].
• Neck headache: for cervicogenic headache, a 2024 network meta-analysis ranked spinal manipulation plus dry needling, and dry needling plus exercise, among the best short-term options, with low-certainty evidence [42].
• Guideline views: NICE advises considering up to 10 acupuncture sessions over 5 to 8 weeks to prevent chronic tension-type headache, and for migraine when preventive medicines have not worked or are unsuitable [14]; NICE does not cover dry needling.
• Exercise: a 2026 meta-analysis of 15 studies found that aerobic exercise reduced migraine intensity and frequency, with a moderate effect after about 300 minutes in total over a programme [43]; the NHS advises regular exercise [1].
• At Cure4Pain: we use dry needling and acupuncture only for myofascial and myofunctional tension headaches, often linked with jaw problems, a bite problem or tongue thrusting.

Do painkillers make headaches worse? Medication-overuse headache

Yes, taking painkillers too often can cause more headaches: NICE defines medication-overuse headache as headache that develops or worsens while taking triptans, opioids, ergots or combination painkillers on 10 or more days a month, or paracetamol, aspirin or anti-inflammatories on 15 or more days a month, for 3 months or more [14]. The NHS advises not taking painkillers for migraine on more than 2 days a week [1].

• How common: 3.0% of adults in the Delhi and National Capital Region study had probable medication-overuse headache [3], and the Global Burden of Disease 2023 study found that much of the burden of headache could be avoided by not overusing medicines, including those bought without a prescription [12].
• At Cure4Pain: painkillers are reviewed and reduced gradually under clinical guidance from Team Cure4Pain while the causes are treated; never stop or change prescribed medicines without medical guidance.

Does migraine go away, or is it lifelong?

There is no single treatment that ends migraine for everyone: migraine is a long-term condition that treatment manages, and attacks often become less frequent with the right management and tend to improve with age, according to the NHS [1]. At Cure4Pain, the outlook depends on the source: when headaches come from jaw, neck or muscle tension, many people in our clinic notice relief within 6 to 8 weeks; when they are linked with autoimmune or metabolic conditions, they need lifelong management. These are clinic observations; individual results vary, and further studies are needed.

• What helps long term: treating the causes, a headache diary, regular sleep, meals and exercise, and avoiding painkiller overuse [14][1].

When is a headache an emergency?

Call emergency services or go to the emergency department if a headache comes on suddenly with extreme pain, or comes with a seizure, numbness or weakness in the body or face, difficulty speaking, walking or remembering, drowsiness or confusion, loss of vision, a recent head injury, a rash that does not fade under a glass, or a very high temperature with a stiff neck, according to the NHS [15]. Call 112 in India, 911 in the US or 999 in the UK, and do not drive yourself.

• See a doctor soon: if headaches are getting worse, come with vomiting, vision problems or jaw pain when eating, are triggered by coughing or bending, or a migraine attack lasts longer than 72 hours [15][1].
• New headaches: NICE advises further assessment for new or changed headaches with warning features [14].

Does Cure4Pain work with my neurologist?

Yes. Many people come to us referred by their neurologist for holistic management. We work alongside your neurologist and own doctor, share our findings with them, and any change to medicines is made under clinical guidance from Team Cure4Pain, in coordination with your neurologist and existing consulting physician. A sudden, severe or new kind of headache needs urgent medical assessment first.

What happens at a migraine and headache consultation?

After your tests, your first consultation (in Mumbai or online) covers your headache pattern and diary, jaw, neck, posture, sleep and breathing, diet, gut and medicines, and a written plan for nutrition and vitamin D, jaw and muscle work, sleep and breathing, diet and medicine review. We see adults and young people aged 16 and over. We do not manage gynaecological conditions: for headaches linked with periods, pregnancy or the contraceptive pill, we ask you to see your existing consulting gynaecologist, or we refer you to an experienced gynaecologist in your area. Follow-up reviews are planned at regular intervals. Individual results vary.

Evidence: key studies

Who treats you

• Dr Krushal PabariMD, PGCP - Rheumatic & Musculoskeletal Diseases. Assistant Professor, Cooper Hospital; Guest Professor, CMP Homoeopathic Medical College.
• AT. Chintan Dalal, N.D.BNYS, R.AP. Functional nutrition and Coimbra Protocol practitioner.

Consultations look at the whole person: alongside the medical and nutritional plan, we bring a strong interest in behavioural science to counselling on stress, sleep and lasting lifestyle change.

How consultations work: Mumbai or online worldwide

Book through our patient portal. You can see us in person at our clinic in Malad West, Mumbai, or online from anywhere. Your first consultation reviews your history and tests; we then agree a plan together and set the monitoring schedule.

Related conditions and articles

• Neck Pain & Cervical SpondylosisAge-related wear in the neck, stiffness and headaches.
• Insomnia & Sleep ProblemsTrouble falling or staying asleep; vitamin D, nutrition, breathing and sleep habits.
• Allergic RhinitisSneezing, blocked nose and dust allergy; vitamin D, gut and nasal care.

• Lifestyle and metabolic conditions
• Neck pain and cervical spondylosis

This page is for education and does not replace medical advice. Do not start, stop or change any medicine or supplement without medical guidance.

References

1. NHS. Migraine. nhs.uk/conditions/migraine

2. NHS. Tension headaches. nhs.uk/conditions/tension-headaches

3. Chowdhury D, et al. Headache prevalence and demographic associations in the Delhi and National Capital Region of India: estimates from a cross-sectional nationwide population-based study. J Headache Pain 2024;25(1):108. doi:10.1186/s10194-024-01814-2

4. Liampas I, et al. Vitamin D serum levels in patients with migraine: A meta-analysis. Rev Neurol (Paris) 2020;176(7-8):560-570. doi:10.1016/j.neurol.2019.12.008

5. Hu C, et al. Vitamin D supplementation for the treatment of migraine: A meta-analysis of randomized controlled studies. Am J Emerg Med 2021;50:784-788. doi:10.1016/j.ajem.2021.07.062

6. Chiu HY, et al. Effects of Intravenous and Oral Magnesium on Reducing Migraine: A Meta-analysis of Randomized Controlled Trials. Pain Physician 2016;19(1):E97-112. pubmed.ncbi.nlm.nih.gov/26752497

7. Das S, et al. Effects of Vitamin D on Migraine: A Meta-Analysis. Neurol India 2023;71(4):655-661. doi:10.4103/0028-3886.383862

8. Talandashti MK, et al. Effects of selected dietary supplements on migraine prophylaxis: A systematic review and dose-response meta-analysis of randomized controlled trials. Neurol Sci 2025;46(2):651-670. doi:10.1007/s10072-024-07794-0

9. Okoli GN, et al. Vitamins and Minerals for Migraine Prophylaxis: A Systematic Review and Meta-analysis. Can J Neurol Sci 2019;46(2):224-233. doi:10.1017/cjn.2018.394

10. von Luckner A, Riederer F. Magnesium in Migraine Prophylaxis-Is There an Evidence-Based Rationale? A Systematic Review. Headache 2018;58(2):199-209. doi:10.1111/head.13217

11. Office of Dietary Supplements, US National Institutes of Health. Magnesium: Fact Sheet for Health Professionals. ods.od.nih.gov/factsheets/Magnesium-HealthProfessional

12. GBD 2023 Headache Collaborators. Global, regional, and national burden of headache disorders, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet Neurol 2025;24(12):1005-1015. doi:10.1016/S1474-4422%2825%2900402-8

13. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;38(1):1-211. doi:10.1177/0333102417738202

14. National Institute for Health and Care Excellence (NICE). Headaches in over 12s: diagnosis and management (CG150). nice.org.uk/guidance/cg150/chapter/Recommendations

15. NHS. Headaches. nhs.uk/conditions/headaches

16. Bizzarri P, et al. Temporomandibular disorders in migraine and tension-type headache patients: a systematic review with meta-analysis. J Oral Facial Pain Headache 2024;38(2):11-24. doi:10.22514/jofph.2024.011

17. Réus JC, et al. Association Between Primary Headache and Bruxism: An Updated Systematic Review. J Oral Facial Pain Headache 2021;35(2):129-138. doi:10.11607/ofph.2745

18. Chen TY, et al. Association between obstructive sleep apnea and migraine: A United States population-based cohort study. Headache 2025;65(4):608-618. doi:10.1111/head.14904

19. Arzani M, et al. Gut-brain Axis and migraine headache: a comprehensive review. J Headache Pain 2020;21(1):15. doi:10.1186/s10194-020-1078-9

20. Liampas I, et al. Serum lipid abnormalities in migraine: A meta-analysis of observational studies. Headache 2021;61(1):44-59. doi:10.1111/head.14039

21. Izquierdo-Casas J, et al. Diamine oxidase (DAO) supplement reduces headache in episodic migraine patients with DAO deficiency: A randomized double-blind trial. Clin Nutr 2019;38(1):152-158. doi:10.1016/j.clnu.2018.01.013

22. Dias MF, et al. Exploring the Bidirectional Association Between Migraine and Temporomandibular Disorders: A Systematic Review and Meta-Analysis. J Oral Rehabil 2026;53(3):794-806. doi:10.1111/joor.70110

23. NHS. Teeth grinding (bruxism). nhs.uk/conditions/teeth-grinding

24. Manrriquez SL, et al. Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis. J Dent Anesth Pain Med 2021;21(3):183-205. doi:10.17245/jdapm.2021.21.3.183

25. Camacho M, et al. Myofunctional Therapy to Treat Obstructive Sleep Apnea: A Systematic Review and Meta-analysis. Sleep 2015;38(5):669-75. doi:10.5665/sleep.4652

26. Gominak SC, Stumpf WE. The world epidemic of sleep disorders is linked to vitamin D deficiency. Med Hypotheses 2012;79(2):132-5. doi:10.1016/j.mehy.2012.03.031

27. Gominak SC. Vitamin D deficiency changes the intestinal microbiome reducing B vitamin production in the gut. The resulting lack of pantothenic acid adversely affects the immune system, producing a “pro-inflammatory” state associated with atherosclerosis and autoimmunity. Med Hypotheses 2016;94:103-7. doi:10.1016/j.mehy.2016.07.007

28. Abboud M. Vitamin D Supplementation and Sleep: A Systematic Review and Meta-Analysis of Intervention Studies. Nutrients 2022;14(5). doi:10.3390/nu14051076

29. Annese V, et al. [Migraine in SLE: role of antiphospholipid antibodies and Raynaud’s phenomenon]. Reumatismo 2006;58(1):50-8. pubmed.ncbi.nlm.nih.gov/16639488

30. NHS. Raynaud’s. nhs.uk/conditions/raynauds

31. Breen ID, et al. Evaluation of the Safety of Calcitonin Gene-Related Peptide Antagonists for Migraine Treatment Among Adults With Raynaud Phenomenon. JAMA Netw Open 2021;4(4):e217934. doi:10.1001/jamanetworkopen.2021.7934

32. Amon U, et al. Safety Data in Patients with Autoimmune Diseases during Treatment with High Doses of Vitamin D3 According to the “Coimbra Protocol”. Nutrients 2022;14(8). doi:10.3390/nu14081575

33. Office of Dietary Supplements, US National Institutes of Health. Vitamin D: Fact Sheet for Health Professionals. ods.od.nih.gov/factsheets/VitaminD-HealthProfessional

34. Feige J, et al. Vitamin D Supplementation in Multiple Sclerosis: A Critical Analysis of Potentials and Threats. Nutrients 2020;12(3). doi:10.3390/nu12030783

35. Chen YS, et al. Effect of Vitamin B2 supplementation on migraine prophylaxis: a systematic review and meta-analysis. Nutr Neurosci 2022;25(9):1801-1812. doi:10.1080/1028415X.2021.1904542

36. Sazali S, et al. Coenzyme Q10 supplementation for prophylaxis in adult patients with migraine-a meta-analysis. BMJ Open 2021;11(1):e039358. doi:10.1136/bmjopen-2020-039358

37. Office of Dietary Supplements, US National Institutes of Health. Vitamin B12: Fact Sheet for Health Professionals. ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional

38. Obayashi Y, Nagamura Y. Does monosodium glutamate really cause headache? : a systematic review of human studies. J Headache Pain 2016;17:54. doi:10.1186/s10194-016-0639-4

39. Linde K, et al. Acupuncture for the prevention of episodic migraine. Cochrane Database Syst Rev 2016;2016(6):CD001218. doi:10.1002/14651858.CD001218.pub3

40. Linde K, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev 2016;4(4):CD007587. doi:10.1002/14651858.CD007587.pub2

41. Kandeel M, et al. Dry needling techniques as a treatment for improving disability and pain in patients with different types of headache: A systematic review and meta-analysis. Complement Ther Med 2024;86:103085. doi:10.1016/j.ctim.2024.103085

42. Jung A, et al. Physical Therapist Interventions to Reduce Headache Intensity, Frequency, and Duration in Patients With Cervicogenic Headache: A Systematic Review and Network Meta-Analysis. Phys Ther 2024;104(2). doi:10.1093/ptj/pzad154

43. Ogrezeanu DC, et al. How much aerobic exercise is needed to reduce migraine? A dose-response meta-analysis of pain intensity and frequency. Headache 2026;66(1):40-52. doi:10.1111/head.15070