Migraines and headaches sometimes get used interchangeably. Neither is fun, but they are not the same, and migraineurs are often on medications that may interact with certain supplements.
Dr. Peter Struck, MD, an HonorHealth neurologist and headache specialist, notes that a migraine is a brain disorder. And in fact, not every migraine causes a headache, he emphasizes, explaining, “Some people have only vision changes, numbness, dizziness or other sensory symptoms.”
Dr. Struck shares that migraine attacks often involve throbbing, pounding head pain and sensitivities to light and sound. Many times, they’re so severe that you can’t engage in your normal daily routine, usually for four to 72 hours.
Medications can help people with migraine live a more normal life.
“Migraine medicines fall into two groups,” Dr. Struck explains. “Acute, or rescue, medicines are taken when a migraine starts to stop the attack…examples include ibuprofen and naproxen. Prescription rescue medicines include triptans and gepants. Other medicines may also be prescribed to treat nausea, which can be associated with migraines.”
He says that your healthcare team will help you determine the best treatment plan. But should it include supplements? That’s something you’ll want to discuss with your doctor first.
“Many people assume that ‘natural’ means safe. Unfortunately, that is not always true,” Dr. Struck says. “Some herbal supplements can change how your body absorbs, breaks down, or removes prescription medications. This may cause medication levels to become too high or too low, making them less effective or increasing the risk of side effects.”
Neurologists are raising the alarm about taking one supplement with migraine medications in particular, saying it can negatively interact with them. Here’s the supplement, why it might harm people on migraine medications and alternatives.
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Stop Pairing This Supplement With Migraine Medication, Neurologists Warn
“St. John’s wort may seem like a harmless herbal supplement, but it can interact with several migraine medications,” Dr. Struck tells Parade.
Wait—what is St. John’s wort?
“St. John’s wort, or Hypericum perforatum, is a yellow-flowering plant native to Europe and Western Asia, now found worldwide,” explains Dr. Adam Mednick, MD, Ph.D., a board-certified neurologist and author of Normal Pressure Hydrocephalus: From Diagnosis to Treatment.
The name comes from St. John the Baptist, as St. John’s Day is June 24, when the plant is usually in bloom.
“It has been used as a medicinal herb for over 2,000 years and today is one of the world’s top-selling herbal supplements,” Dr. Mednick says. “St. John’s wort contains two key active compounds: hypericin, which gives the plant its characteristic red pigment, and hyperforin. Both of these compounds affect the levels of brain chemicals such as serotonin, dopamine and norepinephrine.”
He notes that people often take St. John’s wort as a “natural” alternative to prescription antidepressants. One meta-analysis suggested that St. John’s wort was similarly effective as SSRIs in treating mild-to-moderate depression, and fewer people stopped using it. He says it’s also been marketed for anxiety, sleep difficulties and seasonal mood changes, though the evidence is much weaker.
Related: The Popular Supplement Doctors Say Isn’t as Harmless as It Sounds
How St. John’s Wort Interacts With Migraine Medications
Dr. Regina Krel, MD, the director of the headache center at the Hackensack Meridian Neuroscience Institute at Hackensack University Medical Center, says it’s dangerous to take St. John’s wort with certain migraine medications.
“St. John’s wort induces a liver enzyme CYP3A4, which can reduce the effectiveness of certain migraine medications,” she explains.
It also has side effects, some of which overlap with and may even worsen migraine symptoms, reports Dr. Susan Rubin, MD, a neurologist at Endeavor Health. She shares that side effects of St. John’s wort include:
Dizziness Diarrhea Constipation or stomach upset Dry mouth Fatigue Trouble sleeping Sensitivity to sunlightRelated: The Surprising Household Item That Could Be Giving You a Headache, According to Neurologists
But the neurologists Parade spoke to are most concerned with St. John’s wort’s effect on serotonin.
“Migraine and depression share overlapping brain chemistry, particularly involving serotonin, a chemical messenger that plays a role in both mood regulation and migraine,” Dr. Mednick says.
He points out that St. John’s wort and certain migraine medications might interact negatively, and this includes triptans and antidepressants.
“When taken with St. John’s wort, these migraine medications can raise serotonin to dangerously high levels, triggering serotonin syndrome associated with shivering, rapid heartbeat, flushed skin, sweating, high fever, seizures and, in rare cases, death,” Dr. Mednick warns.
Plus, since the FDA doesn’t hold supplements to the same regulatory standards as prescription medications, he says there’s “no guarantee of consistency among the dozens of St. John’s wort brands sold in the United States.” In fact, several studies have found discrepancies and undisclosed additives (such as food dyes) in St. John’s wort supplements.
“You need to check with your doctor before starting to take St. John’s wort,” Dr. Rubin stresses, adding that it can also interact with medications for other conditions, like high cholesterol.
Related: The ‘Healthy’ Supplement That’s Secretly Destroying Your Energy
Other Options for Depression Treatment, Especially if You Have Migraines
If you’re one of the many people living with migraines and depression, you’re not alone, nor are you out of options, since St. John’s wort can interact with medications. Instead, Dr. Mednick says you might benefit from:
Cognitive behavioral therapy (CBT) Meditation Regular exercise, including yoga and cardiovascular and strength trainingDr. Krel adds that medications, including SSRIs and SNRIs, can also help treat depression in conjunction with the above strategies.
“It’s important to understand that finding the right medication is often a process, as there is no single antidepressant that works best for everyone,” she says. “While these medications are safe, they can have side effects, though they are usually mild and often fade after a few weeks.”
Dr. Krel says a doctor can help you navigate these issues and switch medications to find one that benefits you most with fewer side effects.
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Sources:
Dr. Peter Struck, MD, an HonorHealth neurologist and headache specialist Dr. Susan Rubin, MD, a neurologist at Endeavor Health Dr. Regina Krel, MD, the director of the headache center at the Hackensack Meridian Neuroscience Institute at Hackensack University Medical Center Dr. Adam Mednick, MD, Ph.D., a board-certified neurologist and author of Normal Pressure Hydrocephalus: From Diagnosis to Treatment A Meta-Analysis on the Efficacy and Safety of St John’s Wort Extract in Depression Therapy in Comparison With Selective Serotonin Reuptake Inhibitors in Adults. Neuropsychiatric Disease and Treatment. Is There an Association Between Migraine and Major Depressive Disorder? A Narrative Review. Cureus. Highly Variable Contents of Phenolics in St. John’s Wort Products Affect Their Transport in the Human Intestinal Caco-2 Cell Model: Pharmaceutical and Biopharmaceutical Rationale for Product Standardization. Journal of Agricultural and Food Chemistry. Comparative Authentication of Hypericum Perforatum Herbal Products Using DNA Metabarcoding, TLC and HPLC-MS. Scientific Reports. St John’s Wort (Hypericum Perforatum) Products – An Assessment of Their Authenticity and Quality. Phytomedicine : International Journal of Phytotherapy and Phytopharmacology.Hence then, the article about neurologists are begging people to stop pairing this supplement with migraine medication was published today ( ) and is available on Parade ( Saudi Arabia ) The editorial team at PressBee has edited and verified it, and it may have been modified, fully republished, or quoted. You can read and follow the updates of this news or article from its original source.
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