Understanding Migraine Treatment
Leading up to a migraine headache, some people experience something known as aura. These aura are changes in your vision, speech, or the sensation in different parts of your body. Around 1 in 3 people experience aura leading up to their migraine and these symptoms shouldn’t last longer than an hour.
You can start getting migraines at any age, although they most often start during your teenage years. Both men and women get migraines, but women are around three times more likely to experience them.
Conventional migraine treatment typically focuses on relieving the pain and other symptoms of a migraine attack. Taking these reliever medications too often can actually cause medication overuse headaches, so preventative medications are also used to limit their use. These preventative medications aim to reduce how often migraine attacks happen and how severe they are when they do happen.
Medications can be very useful, but they can’t cure migraines. They’re also most effective when used alongside lifestyle changes and avoiding known migraine triggers.
The Regenerative Medicine Approach
Migraines are more than a headache that’s caused by abnormal brain and nerve activity – they’re linked to different metabolic and environmental drivers.
The functional and regenerative approach to migraines frames them as a condition that affects the whole body. With this approach, medications are just one part of migraine treatment and are combined with foundational changes. This approach focuses on avoiding known migraine triggers, making lifestyle changes to manage migraines and finding alternative non-pharmaceutical therapies that help.
Common migraine triggers include:
Blood sugar changes
Hormonal fluctuations (especially leading up to a woman’s period)
Stress
Tiredness and poor sleep
Lack of exercise
Too much caffeine
Certain foods (including histamine-rich foods)
Environmental triggers (like mold, perfume and certain chemicals)
Lifestyle changes focus on cutting out these triggers where possible and managing them effectively if it’s not.
Regenerative therapies can also play a part in this more holistic approach to migraine treatment. We’ll explore the therapies with the most evidence for treating migraines below.
Treatments That May Help
While medications are the main treatment for migraines, lifestyle changes and regenerative therapies can often be helpful add-ons.
Lifestyle changes
We discussed that cutting out common migraine triggers is one effective way to manage migraines, but triggers do vary from person to person.
Keeping a migraine diary is a great way to identify your unique migraine triggers. It involves recording every migraine you have along with what you’re eating, drinking, your stress levels, activities you’re doing, environment triggers, and any exercise. Women may also find it helpful to record where they are in their menstrual cycle.
Diet and migraines
Although it’s generally accepted that diet influences migraines, the exact mechanism isn’t well understood.
Some studies have found links between gut health and migraines via the immune system, while others have suggested that histamine-rich foods (like citrus fruits and fermented foods) can act as migraine triggers (Cavestro, 2025; Gazerani, 2020).
Skipping meals is another potential migraine trigger. Low (hypoglycemia) or falling blood sugar levels may partially explain this, although fasting can trigger migraines when blood sugar levels are within normal limits (Legesse et al., 2025). A diet high in refined carbohydrates can also be a trigger as these foods spike blood sugar and can cause a sharp drop afterwards. Eating regular meals that contain a good amount of protein and healthy fats helps avoid these extreme declines in blood sugar levels.
The ketogenic diet (high fat, low carbohydrate) shows potential for improving migraine frequency in studies, possibly due to improved glucose transport, reduced inflammation and positive changes in the gut microbiome (Cavestro, 2025; Gazerani, 2020).
With any dietary changes, it’s important to make sure you’re getting all the nutrients you need. A dietician can give you personalized advice on this.
Some nutrient deficiencies are known to make migraines worse, including magnesium. Magnesium is a key nutrient for nerve function, and a deficiency can cause nerves to become overexcited which may predispose you to migraine attacks.
Various different studies have shown that magnesium supplementation can help with both treating a migraine attack and limiting how often migraines happen (Dominguez et al., 2025). However, randomized controlled trials in this area are still needed.
It’s generally safe for most people to take magnesium supplements as an add-on migraine treatment, although it’s best to confirm this with your physician.
There’s a smaller amount of evidence that other nutrients like riboflavin and coenzyme Q10 can support cellular energy production and reduce the chances of experiencing a migraine attack (Cavestro, 2025; Fajkiel-Madajczyk et al., 2025).
Omega 3 is another important nutrient for migraine prevention. In fact, data from 40 RCTs found that omega 3 supplementation may even outperform traditional migraine prevention treatments in some cases (Tseng et al., 2024).
Medications
The International Headache Society gathered a group of experts from around the world to review the evidence on which medications should be used to relieve acute migraine attacks.
They found that simple painkillers/nonsteroidal anti-inflammatory drugs (NSAIDs) and triptans (migraine drugs that increase blood flow to the brain) are similarly effective during an acute migraine attack (Puledda et al., 2024). Painkillers and NSAIDs are usually the preferred first-line treatment as they tend to come with fewer side effects.
Anti-sickness medications can be added on if nausea can’t be controlled with painkillers or triptans alone and oral metoclopramide has the most evidence behind it for migraine-related nausea (Puledda et al., 2024).
Gepants are a new category of medication that were specifically developed to treat migraines. They target receptors involved in nerve signaling and are effective for treating both acute migraines and reducing the frequency/severity of attacks. As they’re new, research is more limited than with other medications, but evidence suggests they’re a very effective migraine medication (Puledda et al., 2024; Qaseem et al., 2025).
After summarizing all evidence available, the American College of Physicians created guidelines on which medications should be used to prevent migraines. However, all their recommendations are based on low-certainty evidence, which means findings from different studies vary or there is a risk of bias.
They recommend starting either a beta blocker, the antiseizure medication valproate, the antidepressant venlafaxine, or another antidepressant called amitriptyline. If side effects are severe or the medication doesn’t work, a gepant or similar medication called a CGRP monoclonal antibody should be started. If none of these medications work, the antiseizure medication topiramate can be used (Qaseem et al., 2025). The FDA has also approved botox injections for chronic headaches (≥15 headache days/month).
The most effective medication will be different if you’re pregnant, taking certain other medications or suffering with certain medical conditions.
Regenerative therapies
Regenerative therapies can be used in combination with traditional migraine treatments to offer additional benefits. Although lots of different regenerative therapies are available for migraines, neuromodulation has the most evidence to support its effectiveness.
Transcranial magnetic stimulation (TMS) is one type of neuromodulation. It’s an FDA-approved non-invasive therapy that uses magnetic pulses to stimulate brain cells. Several studies (including multiple controlled trials) have shown that TMS can help with acute migraine symptoms and reduce how often migraines happen and how severe they are (Moisset et al., 2020). Another neuromodulation therapy, non-invasive vagus nerve stimulation, is also FDA-approved.
Biofeedback is another therapy where several randomized controlled trials (RCT) have demonstrated its usefulness as an add-on migraine treatment (Paudel & Sah, 2025). With biofeedback, patients learn to change their body’s reactions to stress/pain, promoting relaxation and preventing migraines.
In a small number of studies (including 2 RCTs), neurofeedback also demonstrates potential for migraine management (Zivoder et al., 2018). This technique is similar to biofeedback, but involves changing your brain activity rather than body signals. Sensors on your scalp measure brain wave activity and provide feedback when your brain produces the desired activity, helping you to learn how to change your brain activity voluntarily.
Acupuncture has also been shown to reduce migraine frequency compared to no treatment or routine care (Linde et al., 2016).
These therapies show some promising benefits when used alongside other migraine treatments. However, the evidence around neuromodulation for migraines is based on a modest number of small trials, with overall low-moderate quality. Further clinical trials are needed.
What the Evidence Supports
Commonly prescribed migraine medications have the most significant evidence behind them which is why they feature in clinical treatment guidelines.
However, there is a growing amount of evidence supporting neuromodulation as a preventative add-on treatment for migraines, including FDA-approved TMS (Moisset et al., 2020).
Where the Evidence Is Limited
Research into high‑dose omega‑3 supplements and CoQ10 has demonstrated some promising results, but the evidence around their potential benefits for migraines is still limited and more research is needed (Fajkiel-Madajczyk et al., 2025).
A study of 9 people with treatment-resistant migraines found that stem cell therapy improved symptoms in 7 participants (Mauskop & Rothaus, 2017). However, this is a very small study and much more research into this type of therapy is needed.
Combining Treatments
The best approach to migraine treatment is a holistic, whole-body one. This often means combining lifestyle changes, acute medications, preventative medications and regenerative therapies in some cases.
Typically, acute and preventative medications are combined to reduce how often migraine attacks happen, how severe they are and the chance of experiencing medication overuse headaches.
In some cases, multiple acute medications (like NSAIDs and triptans) or preventative medications (like topiramate and propranolol) can be used (Lipton et al., 2024). This is usually saved for people who don’t respond well to just a single medication from each category.
Neuromodulation can also be effective for people whose migraines fail to respond to typical treatments, or who are looking for an add-on to more standard treatments.
Finding the Right Provider
When choosing a provider for neuromodulation-based therapies, it’s best to check the website of reputable professional organization, such as the Association for Applied Psychophysiology and Biofeedback, Biofeedback Certification International Alliance, Clinical TMS Society or the International Society for Neuroregulation & Research.
Once you’ve found possible clinics providing the therapy you’re looking for through one of these websites, it’s also a good idea to check their qualifications and experience with migraine patients specifically. If you’re looking for TMS therapy, you may also want to confirm the clinic uses an FDA-accredited device.
Takeaway
Migraines can be painful and disruptive, so it’s important to be able to access reliable treatment options. Medications can be very effective, but lifestyle changes and regenerative therapies can be useful add-on treatments. Regenerative and functional therapies for migraine treatment can be particularly useful for people whose migraines don’t respond to other treatments.
