Cyclical Vomiting Syndrome, Migraine and Mitochondrial Support: Could MigraSoothe Riboflavin and CoQ10 Help?
A customer recently contacted us with an interesting question: could MigraSoothe, and particularly riboflavin (vitamin B2) and CoQ10, have a role in supporting someone with Cyclical Vomiting Syndrome (CVS)?
It wasn't a question we wanted to answer simply by assuming that what works for migraine might also apply to CVS. So we went back to the clinical research and looked at what the NHS, NICE and specialist international CVS guidelines actually say.
What we found was surprisingly interesting.
There is a recognised connection between CVS and migraine, including within NHS guidance. More importantly, specialist clinical guidelines for adult CVS specifically discuss riboflavin and CoQ10 as preventative mitochondrial supplements.
So, here is what we learned.
Key Takeaways
- Cyclical Vomiting Syndrome involves repeated episodes of severe nausea and vomiting. These episodes are often separated by periods when someone may feel completely well.
- CVS has a recognised connection with migraine. The NHS recognises that people with CVS are more likely to have migraine themselves or a family history of migraine.
- Riboflavin already has a recognised role in migraine prevention guidance. NICE Clinical Guideline CG150 discusses riboflavin 400 mg once daily as a nutritional approach that may reduce migraine frequency and intensity in some people.
- Specialist CVS guidelines discuss riboflavin and CoQ10 as preventative mitochondrial supplements. However, direct evidence for CVS remains limited and should not be interpreted as proof that they treat or cure CVS.
- Nutritional support should be discussed with a healthcare professional. Particularly for people who are already using prescription medication for CVS or migraine management.
What Is Cyclical Vomiting Syndrome?
Cyclical Vomiting Syndrome is a relatively rare condition involving repeated episodes of severe nausea and vomiting, separated by periods when the person may feel completely well.
In the UK, the NHS specifically recognises the relationship between CVS and migraine. It states that people are more likely to have CVS if they or someone in their family experiences migraines.
The NHS also notes that medicines normally used to treat and prevent migraine may be used to help manage CVS.
This migraine connection is particularly interesting when considering nutritional approaches.
The UK Position: Riboflavin and Migraine
Riboflavin already has an established place within UK migraine guidance.
NICE Clinical Guideline CG150 – Headaches in over 12s: diagnosis and management advises that riboflavin 400 mg once daily may be effective in reducing migraine frequency and intensity in some people.
So, in the UK we already have two important pieces of the picture: the NHS recognises the association between CVS and migraine, while NICE recognises high-dose riboflavin as a potential nutritional approach to migraine prevention.
US Research Goes Further for CVS
Specialist American guidance goes one step further and looks specifically at nutritional supplementation in people with CVS.
In 2019, the American Neurogastroenterology and Motility Society (ANMS) and Cyclic Vomiting Syndrome Association (CVSA) published evidence-based guidelines for the management of CVS in adults.
Importantly, these guidelines conditionally recommend CoQ10 and riboflavin as preventative therapies for adults with CVS.
The authors describe them as mitochondrial supplements and discuss mitochondrial dysfunction as one possible connection between migraine and CVS.
The guidelines discuss riboflavin 200 mg twice daily — 400 mg per day in total. They also review research into CoQ10 and CVS.
However, the researchers are appropriately cautious. They grade the direct evidence for these mitochondrial supplements in CVS as very low quality. So this is an interesting and clinically recognised approach, but it should not be interpreted as proof that riboflavin or CoQ10 treats or cures CVS.
🧬 Riboflavin, CoQ10 and Mitochondrial Support
Riboflavin and CoQ10 are discussed in specialist CVS guidelines as potential preventative mitochondrial supplements. Researchers are interested in their role because mitochondria are responsible for producing energy within cells, and mitochondrial function has been explored as one possible connection between migraine and CVS.
Why Riboflavin and CoQ10?
Both nutrients have important roles in mitochondrial energy metabolism.
Riboflavin is required to produce the flavin cofactors FAD and FMN, which participate in cellular energy production. CoQ10 is an important component of the mitochondrial respiratory chain through which cells generate energy.
This has led researchers to investigate whether supporting mitochondrial function could help some people susceptible to migraine and CVS.
The US CVS guideline also highlights the similarities between the two disorders, including the high prevalence of migraine amongst people with CVS and their families.
Prevention Rather Than Treatment of an Attack
An important distinction is that riboflavin and CoQ10 are considered preventative nutritional approaches.
They are intended to be taken regularly rather than only once a CVS episode has started.
This is similar to their use in migraine prevention. In the UK, NICE recommends considering riboflavin 400 mg once daily as a way of reducing migraine frequency and intensity.
Acute treatment of a severe CVS episode is different. The NHS advises that treatment may include anti-sickness medicines, painkillers and medicines also used for migraine, while severe episodes can require hospital treatment and intravenous fluids.
Where Does MigraSoothe Fit?
MigraSoothe was developed primarily around the nutritional science of migraine prevention.
For somebody with CVS who is interested in nutritional support, a MigraSoothe formulation containing riboflavin and CoQ10 may therefore be particularly relevant.
The rationale is not that MigraSoothe is a treatment for CVS. Rather, the same nutrients used for migraine nutritional support — particularly riboflavin and CoQ10 — are specifically identified in specialist adult CVS guidance as potential preventative mitochondrial supplements.
🌿 Nutritional Support with Riboflavin and CoQ10
Riboflavin (vitamin B2) is commonly discussed in migraine prevention because it supports normal energy production in cells. CoQ10 is involved in mitochondrial energy pathways and has been researched as part of nutritional support approaches.
For people interested in nutritional support for migraine, a formula containing these nutrients may be considered as part of a daily routine.
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What Did We Conclude?
Our research gave us a more interesting answer than we initially expected.
There is good clinical recognition of the connection between migraine and CVS, including here in the UK. There is established UK guidance supporting 400 mg daily riboflavin for migraine prevention, and specialist adult CVS guidelines specifically identify riboflavin and CoQ10 as potential preventative nutritional interventions.
But the direct clinical evidence for supplementation in CVS remains limited. Larger and better-controlled clinical trials are still needed.
So, would we say that MigraSoothe treats Cyclical Vomiting Syndrome? No.
But is there a credible scientific rationale for somebody with CVS to discuss riboflavin and CoQ10 supplementation with the healthcare professional managing their condition? Yes.
Frequently Asked Questions
Is Cyclical Vomiting Syndrome related to migraine?
Yes. The NHS recognises an association between Cyclical Vomiting Syndrome (CVS) and migraine, noting that people with CVS are more likely to have migraine themselves or have a family history of migraine. Treatments normally used for migraine may also form part of CVS management.
Can riboflavin (vitamin B2) help with CVS?
There is some clinical support for its use as a preventative nutritional approach. Specialist US adult CVS guidelines conditionally recommend riboflavin as a mitochondrial supplement for CVS, although the quality of direct evidence remains low. In the UK, NICE CG150 recommends considering riboflavin 400 mg once daily for migraine prevention, which is particularly interesting given the recognised relationship between migraine and CVS.
What dose of riboflavin is used?
The adult CVS literature discusses riboflavin 200 mg twice daily, giving a total of 400 mg per day. This is the same total daily dose recognised by NICE for migraine prevention.
What about CoQ10 for Cyclical Vomiting Syndrome?
CoQ10 is also specifically included in specialist adult CVS guidelines as a potential preventative mitochondrial supplement. More recent US clinical guidance has discussed CoQ10 as part of nutritional approaches related to mitochondrial function.
Should riboflavin and CoQ10 be taken every day?
Yes, when used for preventative nutritional support, they are generally taken regularly rather than only when symptoms begin. They should not be regarded as treatments for immediately stopping an acute vomiting episode.
Can MigraSoothe cure Cyclical Vomiting Syndrome?
No. MigraSoothe is not a treatment or cure for CVS.
The interesting finding from our research is that riboflavin and CoQ10 — nutrients already used in migraine nutritional support — are specifically discussed in specialist clinical guidance for preventative support in CVS.
Can MigraSoothe be taken alongside CVS medication?
The specialist adult CVS guideline states that mitochondrial supplements can be used alongside other preventative treatments.
However, CVS patients may be taking several prescription medicines, so we recommend discussing MigraSoothe with the healthcare professional managing the condition before adding it to an existing treatment regimen.
Which MigraSoothe product is most relevant for CVS?
Based on the available evidence, a MigraSoothe formulation containing both riboflavin (vitamin B2) and CoQ10 would be the most relevant to discuss with your healthcare professional, because these are the two nutrients specifically identified in adult CVS clinical guidance.
Final Thoughts
Our research gave us a more interesting answer than we initially expected.There is good clinical recognition of the connection between migraine and CVS, including here in the UK. There is established UK guidance supporting 400 mg daily riboflavin for migraine prevention, and specialist adult CVS guidelines specifically identify riboflavin and CoQ10 as potential preventative nutritional interventions.
However, the direct clinical evidence for supplementation in CVS remains limited. Larger and better-controlled clinical trials are still needed.
So, would we say that MigraSoothe treats Cyclical Vomiting Syndrome? No.
But is there a credible scientific rationale for somebody with CVS to discuss riboflavin and CoQ10 supplementation with the healthcare professional managing their condition? Yes — and there is considerably more clinical guidance supporting that conversation than we expected when our customer first asked.
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Related Migraine Terms
Learn More in Our Migraine A-Z Glossary
The brainstem is one of many migraine-related terms that can help you better understand how migraine affects the nervous system. To explore more definitions, symptoms, triggers, and treatment language, visit our Migraine A-Z Glossary.
Further reading and evidence:
Readers can review independent migraine education resources here:
The Migraine Trust, migraine with brainstem aura: https://migrainetrust.org/understand-migraine/types-of-migraine/migraine-with-brainstem-aura/
ICHD-3, migraine with brainstem aura criteria: https://ichd-3.org/1-migraine/1-2-migraine-with-aura/1-2-2-migraine-with-brainstem-aura/
NICE migraine guidance: https://www.nice.org.uk/guidance/cg150
Please remember: migraine can affect everyone differently. Brainstem aura-like symptoms should be discussed with a doctor, neurologist, pharmacist, or other qualified healthcare professional, especially if they are new, sudden, severe, or different from your usual pattern.