Functional Vitamin B12 Deficiency Common in Migraines

Vitamin B12 supplements were first used in the treatment of migraine headaches almost 50 years ago, but recent studies have produced conflicting results. The reason may be related to not properly diagnosing a deficiency of vitamin B12.

Levels of the vitamin are most often assessed based on its level in the blood. However, a functional measurement assesses levels of methylmalonic acid, which reflects actual vitamin B12 activity. When vitamin B12 levels are low, methylmalonic acid levels are elevated.

Osman Metin Ipcoiglu, MD, of the Gulhane Military Medical Academy, Istanbul, Turkey, studied 50 women who had a history of migraine headaches without an aura and compared them to 46 healthy subjects. Blood levels of both vitamin B12 and folic acid (another B vitamin) were similar among women with migraines and those without migraines.

However, almost three-fourths of the women with migraine headaches had elevated levels of methylmalonic acid. In fact, their levels of methylmalonic acid averaged twice that of women without migraines.

Ipcoiglu noted that a functional deficiency of vitamin B12 might be missed with simple blood tests for the vitamin. He recommended that migraine patients be tested for methylmalonic acid and, if it was elevated, be treated with vitamin B12.

Reference: Ipçoiglu OM, Özcan O, Gültepe M, et al. "Functional vitamin B12 deficiency represented by elevated urine methylmalonic acid levels in patients with migraine." Turkish Journal of Medical Sciences, 2008;38:409-414.