MigreLief^®

Understanding the Ingredients

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MigreLief is a unique combination of herbal and nutritional supplements including magnesium, feverfew and riboflavin (Vitamin B2). These supplements are aimed at supporting cerebrovascular tone, and reducing platelet aggregation and the production of pro-inflammatory mediators. The herbal and nutritional ingredients in MigreLief are used in the amounts shown to be beneficial in scientific studies. Following is a detailed discussion of these ingredients.

Feverfew

Feverfew (Tanacetum parthenium) is a member of the daisy family (Asteraceae) and is a short, bushy perennial that grows along fields and roadsides. Its yellow-green leaves and yellow flowers resemble those of chamomile, for which it is sometimes confused. MigreLief contains Puracol^TM, a specially sourced whole herb feverfew with all of its naturally occurring elements intact and a high-parthenolide content.

The flowers bloom from July to October. The leaves are used in medicinal preparations. The name "feverfew" is derived from the Latin for "chase away fevers." It is mentioned in the Greek literature as a remedy for inflammation and swelling as well as menstrual cramps. Feverfew enjoyed wide use by British herbalists as an analgesic in the treatment of fevers and arthritis, but faded into obscurity.

Feverfew has enjoyed a revival over the past two decades due to approval of its use for treatment of migraine by both the Canadian and British governments.

ACTIVE CONSTITUENTS: The most important of these compounds is parthenolide . First identified in 1960, parthenolide is the portion of the leaf believed to be responsible for feverfew's anti-migraine activity. A critical consideration in commercial feverfew products has been the highly variable content of parthenolide. An analysis of commercial feverfew products in Canada found about half are virtually devoid of this compound. As a minimal standard, the Health Protection Branch of the Health and Welfare Department of the Canadian Government has proposed that feverfew preparations should contain at least 0.2% parthenolide content.
Health care practitioners should also be aware that parthenolide is highly unstable and seek feverfew extracts that address this issue. Your pharmacist has identified one of the few sources of feverfew where the parthenolide content is assured.

MECHANISM OF ACTION: Feverfew, and specifically parthenolide, inhibits platelet aggregation (which can release serotonin which may fuel migraines) and histamine release. It has also been shown to inhibit release of serotonin from platelets. This is believed to reduce the severity, duration and frequency of migraine headaches and lead to an improvement in blood vessel tone.

CLINICAL APPLICATIONS: Clinical studies with feverfew have focused on the treatment and prevention of migraine and have primarily taken place in Great Britain. These studies indicate the efficacy of feverfew as a useful tool in the long-term management of migraines.

The initial clinical study enrolled migraine patients who had been using feverfew for several years. Seventeen patients were enrolled and given either feverfew (50 mg daily) or placebo. Eight patients, who remained on feverfew, experienced continued relief of migraines over a six month period. The nine receiving placebo had an almost three-fold increase in migraines. Many of these headaches were incapacitating, and anxiety, insomnia and muscle and joint soreness were also reported. This has prompted some concern at the abrupt cessation of feverfew therapy. A second study enrolled 72 migraine sufferers. They received either 82 mg of feverfew daily or placebo.

Treatment with feverfew for four months led to a decreased incidence and severity of migraines. Feverfew also led to less vomiting attacks and fewer visual disturbances during migraine attacks. Adverse events were mild (primarily mild gastrointestinal upset and nervousness) and did not result in discontinuation of treatment.

Magnesium

It has pointed out that various factors which are known to trigger migraines (namely stress, pregnancy, menstruation, alcohol ingestion, and some diuretics) also promote magnesium depletion. In addition, magnesium exerts many of the same effects as drugs that are helpful in the prevention or treatment of migraines. These effects include:
(1) inhibition of spasm;
(2) inhibition of platelet aggregation;
(3) stabilization of cell membranes;
(4) interference with the synthesis, release or action of inflammatory compounds:
(5) improvements in cerebral vascular tone.

In addition, brain magnesium concentrations were significantly lower by 19% in patients during a migraine attack than in healthy controls. These observations suggest that magnesium may play a role in the prevention and/or treatment of migraine. Clinical trials have supported that possibility. In an open trial, more than 3,000 patients with common or classical migraine received magnesium (usually at a dose of 200 mg/day). Almost all of the patients were women and most were of childbearing age. The "success rate" was reported to be 80%, but the criteria for determining success were not specified.

Magnesium Study

That uncontrolled study was followed by a double-blind trial in which 20 patients with perimenstrual migraine received 360 mg/day of magnesium or a placebo. The treatments were given for two months, starting on the 15th day of each menstrual cycle and continuing until menstruation. At the end of the treatment period, the "Pain Total Index" (which measures duration and intensity of migraines) was significantly lower in the magnesium group than in the placebo group. The number of days with headaches was significantly reduced in patients receiving magnesium, but not in those given placebo. Prior to the start of treatment, white-blood-cell (WBC) magnesium concentrations were lower in the migraine patients than in healthy controls.

Magnesium treatment was followed by a significant increase in WBC magnesium levels. These data suggest that magnesium deficiency contributes to the dysfunction of perimenstrual migraine. In another double-blind study, 81 patients aged 18 to 65 years with migraines (mean attack frequency, 3.6 per month) were randomly assigned to receive magnesium (600 mg every morning) or a placebo for 12 weeks. The frequency of attacks was significantly reduced in the magnesium group, compared with the placebo group (by 41.6% vs. 15.8%; p < 0.05).

Magnesium has also been given intravenously to treat acute episodes of migraine.56 Forty patients with an acute migraine attack were given 1 g of magnesium sulfate (in a 10% solution) over five minutes. Fifteen minutes after the infusion, 35 patients (87.5%) experienced at least a 50% reduction in pain. Nine patients (22.5%) had complete relief of pain. In 21 of the 35 patients who improved, relief persisted for 24 hours or more. The effectiveness of magnesium was related to the pre-treatment serum concentration of magnesium. This study suggests that intravenous administration of magnesium is an effective treatment for acute migraine attacks, particularly in patients whose serum magnesium concentrations are low. These studies provide a rationale for oral magnesium supplementation for migraine prophylaxis.

Riboflavin (Vitamin B2)

49 patients with recurrent migraines were given riboflavin, 400 mg/day with breakfast, for at least three months.57 The mean number of migraine attacks fell by 67% and mean migraine severity improved by 68%. One patient stopped treatment because of gastric intolerance (that person was also taking small amounts of aspirin), but no other side effects were reported. This study suggests that riboflavin supplementation may reduce the recurrence rate of migraines.