Vitamin D Deficiency and Supplementation in Migraine: A Scoping Review of Clinical Efficacy, Evidence Gaps, and Research Priorities

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Vitamin D Deficiency and Supplementation in Migraine: A Scoping Review of Clinical Efficacy, Evidence Gaps, and Research Priorities
Amey Marathe, Shailly Vaghasiya, Arth Shah, Soaham Desai

Published in Annals of Indian Academy of Neurology on November 12, 2025
Link: https://doi.org/10.4103/aian.aian_417_25

Abstract:
Background and Objectives:
Migraine is a debilitating neurological disorder affecting 10%–20% of the global population, with significant socioeconomic burdens. Vitamin D deficiency, prevalent in over 1 billion individuals, has been proposed as a modifiable risk factor in migraine management due to its potential role in pain modulation and neuroinflammation. This scoping review aimed to map global vitamin D deficiency prevalence across migraine subtypes and geographic regions, synthesize clinical correlations between vitamin D status and migraine characteristics, and explore heterogeneity in therapeutic evidence across paediatric, chronic, and refractory migraine subgroups.

Methods:
A systematic search of PubMed, Scopus, and Embase was conducted, identifying 3,447 records initially. After screening and eligibility assessment, 30 studies were included. These encompassed observational studies (n = 14), randomized controlled trials (n = 9), and systematic reviews (n = 7). Data were synthesized narratively due to clinical heterogeneity and the predominance of cross sectional evidence.

Results:
Vitamin D deficiency (serum 25 hydroxyvitamin D [25(OH) D] <20 ng/mL) was highly prevalent among migraine patients (65%–88%), particularly in chronic migraine (80%–92%) and high latitude populations (>40°N: 75%–90%). Inverse correlations were observed between vitamin D levels and headache frequency and disability scores. High dose vitamin D supplementation (≥50,000 IU/week) reduced migraine attacks by 50%–72% in deficient adults, while minimal benefit was seen in replete individuals. Single trials revealed enhanced efficacy when combined with probiotics or topiramate in refractory and paediatric cases, respectively, but this requires further validation.

Conclusion:
Vitamin D deficiency is consistently associated with increased migraine burden. Supplementation shows context dependent efficacy, particularly in deficient individuals and specific subgroups. Future research should focus on mechanistic trials, global standardization of assays, and comprehensive outcome assessments. Clinically, baseline 25(OH)D testing is recommended to guide targeted supplementation strategies.

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