Can Omega-3 Fish Oil Help Prevent and Treat Migraines
Omega-3 fatty acids are often recognized for their beneficial impact on the heart and brain. This is no secret, as supplement industries proudly promulgate such effects on their website or the product itself. For example, Nordic Naturals, a famous fish oil brand, openly advertises its supplement as “doctor recommended for immunity, brain, and heart support. Other supplement brands do a similar type of product promotion (KION).
However, despite the versatility of advert promotion, we rarely hear about Omega-3 and its impact on treating migraines. Perhaps the noise to make the science known is stifled by the drug alternatives we gravitate towards, such as Aspirin and Ibuprofen. Why waste time promoting something that takes weeks or months to notice when we can opt for immediate relief alternatives? Perhaps instead of treating something millions suffer from, we should also look to discover the source and prevent it from occurring.
By the end of this article, we will better grasp the extent to which omega-3s can be used as a therapeutic intervention for bridging the gap between headaches and the lack thereof.
Distinction Between the 3 Types of Omegas
Before we begin, let's distinguish the different types of omegas, as not all are created equal. First, there is Alpha Linolenic Acid (ALA), a type of omega-3 found in walnuts, chia, flax, and plant sources. Then there is EPA and DHA, a type of omega found primarily in fish and algae.
ALA, when consumed, must be converted to EPA and DHA to be used in the body. But because of the structural differences to the other omegas, the conversion rate from ALA to usable EPA or DHA (omega-3) is highly inefficient.
Some studies suggest that we can increase the conversion rate of ALA to other EPA or DHA by decreasing LA in our diet. However, we run into two problems:
Foods high in ALA tend to be high in LA.
Although you may significantly increase the conversion rate relative to what it used to be, the amount that's being converted is still tiny. For example, if your conversion rate from ALA to EPA is 5%, and you increase it by 100% by avoiding LA, the difference is still 1 of 10.
For these reasons, consuming ALA as a viable alternative to EPA and DHA is impractical. That is not to say you shouldn’t eat walnuts, chia, or flax, as they might carry other benefits. Instead, the research that will be discussed looks at the two types of Omegas found in fish and algae: EPA and DHA— not ALA.
Omega 3s for Treating Migraines part 1
It is commonly accepted that diet or lack thereof may contribute to or mitigate migraine onset. For example, consider the ketogenic diet and its role in treating epilepsy. Consider the Mediterranean diet and its implications on heart health. Or consider the standard American diet and its contribution to metabolic disorders. Suppose it is true that not all diets are created equal. In that case, it is reasonable to conclude the particular components that make up a diet, such as magnesium, potassium, olive oil, avocados, and fish oil, and how they cooperate in harmony or lack thereof, account for some of the differences that make a diet more or less healthy.
Some might argue that caloric restriction and weight loss lead to the most significant health outcomes, such as metabolic flexibility, glucose regulation, stable blood pressure, etc. And indeed, there is much truth to this claim. However, many of us are of healthy weight yet still suffer.
Moreover, the argument for genetics and poor health outcomes, although carries some truth, does not suffice when we see many examples of susceptibilities that do not become a reality. For example, when we see APOE4 alleles but never witness the progression of Alzheimer's. Or more so when we notice an adverse predisposition later becoming a strength through concerted and deliberate efforts.
In this spirit, it may be conceivable that a single daily supplement may have the potency to reduce migraine frequency without further diet alteration. But to add breadth to this claim, let's look at two different studies published in the BMJ and the Journal of Pain.
Omega 3s for Treating Migraines pt. 2
Let's first look at the randomized trial published in the Journal of Pain:
Design A 12-week randomized, single-blinded, parallel-group (two or more participants) clinical trial.
Participants 67 patients with chronic headaches (15+ days per month).
Intervention Patients with chronic daily headaches were randomized to 1 of 2 Omega 3-based interventions: high omega-3 + low omega-6 intervention OR a low omega-6 intervention.
Measurements Included Headache Impact Test, Headache Days per month, and Headache Hours per day.
Outcome Of the 56 out of 67 patients that completed the study, the results showed a more remarkable improvement in the Headache Impact Test (-7.5 vs. -2.1), Headache Days per month (-8.8 vs. -4.0), and Headache Hours per day (-4.6 vs. -1.2) in the High Omega-3 plus Low Omega-6 group compared to just the Low Omega-6 group.)
Conclusion Omega-3 supplementation and lower Omega 6 intake improved headache pain, frequency, and quality of life.
Omega 3s for Treating Migraines pt. 2 study 2
Now, let's more closely examine the study published in the BMJ:
Design a 16-week randomized, double-blind, parallel-group clinical trial.
Participants 182 mostly female participants (mean age 38) who suffer from migraines 5-20 days a month.
Intervention Patients were randomized to 1 of 3 groups, including a high omega-3 diet intervention, a high omega-3 diet + low omega-6 diet intervention, or a control group.
Measurements Included the Headache Impact Test, a questionnaire for quality of life, and a daily diary assessing headache frequency.
Outcome Compared to the control diet, the two intervention groups showed a significant decrease in headache hours per day, moderate to severe headache hours per day, and headache days per month. Moreover, the high Omega-3 plus low Omega-6 group performed better than just the high Omega-3 group in reducing the number of headache days per month.
Conclusion High Omega-3 + low Omega-6 intervention and the Omega-3 intervention showed improved headache pain, frequency, and quality of life.
What We Can Learn From the Studies
With some degree of certainty, it is clear that a moderate dose of 1.5-2 grams of Omega-3s can alleviate the symptoms and frequency of headaches. And what’s more— pairing omega-3 with lower dietary omega-6 may carry even more advantages.
Perhaps instead of cooking with vegetable, seed, safflower, or soybean oil, cook with olive or avocado oil. Maybe instead of cooking pork tonight, consider salmon. Foods that seem healthy may indeed not be optimal for you. And healthy foods may not show instantaneous results.
When we modify, we must consider how we feel before the intervention and allow enough time to see if the change was beneficial. Notice that the studies weren't a week but 12-16 weeks long. With that in mind, the effects of Omega-3 may not be instantaneous— they may be subtle for some, pronounced for others, and useless for you.
To know with a higher certainty, allow at least a month and closely monitor the frequency, duration, and severity of headaches. It is not unheard of for a small modification to carry a sweeping transformation.
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