Fish oil seems to reduce migraines

Dear Dr. Roach: I read your recent article about migraines. I’m a millennial who started getting brutal migraines beginning in 2001. I saw several neurologists and took different medications, but nothing really helped.

In 2011, I started taking fish oil with high DHA daily. Since then, my migraines have dropped 95% overall, and it helps lower my migraine pain. It’s been a miracle. I’ve been preaching this for years to whomever will listen, hoping to help.

B.W.

Answer: There are not strong studies to support fish oil supplements to prevent migraines. However, there is a well-done study that showed a diet high in omega 3 reduced about half the number of days with migraines and the hours of migraines, but the study was unable to show an improvement in quality of life measurements. The study recommended 1.5 grams of combined n-3 eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in roughly 1 serving per day, but the study did not look at the plantbased alpha-linolenic acid, a different type of omega 3 oil.

Dear Dr. Roach: In various other countries, diosmin is available as a prescription medication for treating varicose veins, hemorrhoids and lymphedema. In the U.S., hesperidia and diosmin only appear to be available as supplements from companies with uncertain reputations.

Is there some way to determine the efficacy, purity and safety of these compounds available here? D.P.

Answer: Diosmin is a type of flavonoid coming mostly from citrus peel that is sold in the U.S. as a medical food by prescription. There is some evidence that it is effective for varicose veins, but poor evidence that is effective for hemorrhoids. It is generally regarded as safe, but as many as 10% of people who take it will note side effects, such as an upset stomach or skin rash. It costs about $50 per month in the U.S., according to the manufacturer’s website.

I have little experience with it, but my colleagues in wound care and vascular surgery note only modest effectiveness.