Chinese medicine for migraines
By Dr (TCM) Attilio D'Alberto | Traditional Chinese Medicine Practitioner, Wokingham
On this page
- Overview
- Common triggers
- TCM patterns in migraines
- Acupuncture for migraines
- Chinese herbal medicine
- Diet
- Lifestyle
- Supplements with evidence
- Menstrual migraines
- When to see a doctor
- Frequently asked questions
1. Overview
Migraines affect approximately 1 in 7 people and are one of the leading causes of disability worldwide. Acupuncture has a strong evidence base for migraine prevention — NICE guidelines acknowledge its efficacy as a preventative treatment comparable to standard prophylactic medication, with fewer side effects. In traditional Chinese medicine, migraines are understood through the lens of Liver and Gallbladder patterns, and treatment of the root cause between episodes is as important as managing acute attacks. I am Dr (TCM) Attilio D’Alberto, with over 25 years of clinical experience.
2. Common triggers
- Hormonal changes — oestrogen drops in the late luteal phase are the most potent trigger in women (see headaches during your period)
- Stress and the “let-down” period after stress
- Sleep disruption — both too little and too much
- Skipping meals — hypoglycaemia
- Specific foods — aged cheese, chocolate, processed meats (nitrates), MSG, artificial sweeteners
- Alcohol — particularly red wine
- Caffeine withdrawal
- Dehydration
- Environmental — bright lights, strong smells, weather changes, barometric pressure shifts
- Visual triggers — flickering lights, screen glare
- Neck tension
3. TCM patterns in migraines
Liver yang rising
The most common pattern. Throbbing, often unilateral headache, frequently triggered by stress, hormonal changes or bright light. Associated with irritability, tinnitus, dizziness, red face. Rooted in Kidney yin deficiency failing to anchor Liver yang.
Liver qi stagnation
Headache related to emotional tension, relieved by rest and gentle movement, accompanied by neck and shoulder tension, sighing, premenstrual flares.
Blood deficiency
Dull migraine following menstruation or in blood-deficient constitutions. Often with pallor, fatigue, light-headedness, scanty periods.
Phlegm-dampness
Heavy, pressing headache with nausea, sense of heaviness, foggy thinking, possibly vertigo. The Ban Xia Bai Zhu Tian Ma Tang pattern.
Blood stasis
Fixed, stabbing migraine often with previous head injury or chronic recurrent migraines. Improves with blood-moving treatment.
Liver fire
Severe throbbing headache with red eyes, bitter taste, marked irritability, insomnia, red tongue with yellow coating.
4. Acupuncture for migraines
Acupuncture has a strong evidence base for migraine prevention. A 2025 systematic review of 23 RCTs (2,295 patients) found acupuncture reduced migraine duration by over 4 hours per attack and reduced the number of migraine days compared with sham. Multiple studies show effects comparable to or better than prophylactic medication, with significantly fewer side effects. NICE recommends acupuncture as a prophylactic option.
Key acupuncture points: GB 20 (Feng Chi), LV 3 (Tai Chong), GB 34 (Yang Ling Quan), LI 4 (He Gu), TB 5 (Wai Guan). A typical course is 7–16 sessions over 8–12 weeks, with maintenance every 4–6 weeks thereafter.
5. Chinese herbal medicine
Formulas are tailored to the TCM pattern:
- Tian Ma Gou Teng Yin — for Liver yang rising; contains Tian Ma (gastrodia) and Gou Teng (uncaria), both with clinical evidence for migraine prevention
- Ban Xia Bai Zhu Tian Ma Tang — for phlegm-dampness migraines with nausea
- Xue Fu Zhu Yu Tang — for chronic blood stasis migraines
- Long Dan Xie Gan Tang — for Liver fire
- Ba Zhen Tang — for blood and qi deficiency
- Xiao Yao San — for Liver qi stagnation
I prescribe pharmaceutical-grade granules from Sun Ten in Taiwan.
6. Diet
- Identify and avoid personal food triggers — keep a migraine diary for 3 months to map patterns
- Never skip meals — hypoglycaemia is a potent trigger
- Stable blood sugar — protein and fibre at every meal
- Adequate hydration — 1.5–2 litres a day
- Reduce alcohol, particularly red wine
- Reduce common triggers if relevant — aged cheese, chocolate, processed meats with nitrates, MSG, artificial sweeteners
- Mediterranean-style anti-inflammatory diet
- Reduce phlegm-generating foods in TCM terms — dairy, refined sugar, fried foods — particularly for the phlegm-damp pattern
7. Lifestyle
- Consistent sleep schedule — 7–9 hours; both too little and too much trigger migraines
- Regular exercise — moderate aerobic exercise 3–4 times a week reduces migraine frequency
- Stress management — meditation, yoga, breathwork; chronic stress drives Liver qi stagnation
- Address neck and shoulder tension — physiotherapy, massage, ergonomics
- Reduce screen time and bright light exposure
- Track triggers with a migraine diary or app
8. Supplements with evidence
- Magnesium glycinate (300–500 mg/day) — the strongest single-supplement evidence for migraine prevention
- Vitamin B2 (riboflavin, 400 mg/day) — specific RCT evidence for migraine
- CoQ10 (100–300 mg/day) — supports mitochondrial function
- Vitamin D — deficiency worsens migraines
- Feverfew — herbal evidence for migraine prevention
- Butterbur (Petadolex) — standardised extract has comparable evidence to pharmaceutical prophylaxis
- Omega-3 (1,000+ mg combined EPA/DHA) — reduces inflammation
- Ginger — for the nausea associated with migraine attacks
9. Menstrual migraines
Menstrual migraines (occurring in the perimenstrual window day −2 to +3) are common and respond well to TCM treatment timed across the cycle. See my dedicated guide to headaches during your period. The combined approach of acupuncture, Chinese herbal medicine targeted at the underlying pattern (often Liver qi stagnation with blood deficiency), magnesium and lifestyle change typically reduces frequency by 50%+ within 3 cycles.
10. When to see a doctor
Seek urgent assessment for:
- The worst headache of your life, or sudden severe onset (thunderclap)
- New-onset migraine over the age of 50
- Headache with fever, stiff neck, rash, confusion or vision loss
- Persistent or worsening headache over weeks
- Headache with focal neurological symptoms (weakness, speech change, persistent visual change)
- Headache after head injury
11. Frequently asked questions
Can Chinese medicine cure migraines?
Migraines are typically a chronic condition rather than a curable disease, but the right combination of acupuncture, Chinese herbal medicine targeted to the underlying TCM pattern, supplements, diet and lifestyle change typically reduces attack frequency, severity and duration by 50%+ within 3 months, with continued improvement thereafter.
Does acupuncture really work for migraines?
Yes. NICE recommends acupuncture as a prophylactic option. Multiple systematic reviews and a 2025 meta-analysis confirm acupuncture significantly reduces migraine frequency, duration and severity, with effects comparable to prophylactic medication and fewer side effects.
What is the best Chinese herbal formula for migraines?
For the most common pattern (Liver yang rising), Tian Ma Gou Teng Yin. For phlegm-damp migraines with nausea, Ban Xia Bai Zhu Tian Ma Tang. The right formula depends on the individual pattern.
What is the best supplement for migraines?
Magnesium glycinate (300–500 mg/day) has the strongest evidence. Combine with vitamin B2 (400 mg/day) and CoQ10 (100–300 mg/day) for the strongest stack. Standardised butterbur (Petadolex) has comparable evidence to pharmaceutical prophylaxis.
How long does acupuncture take to work for migraines?
Most patients notice meaningful change within 4–6 sessions. Optimal results are typically seen at 7–16 sessions, with continued improvement through maintenance every 4–6 weeks.
Why are my migraines hormonal?
Oestrogen drops in the late luteal phase (the days before the period) are the most potent migraine trigger in women. The mechanism involves serotonin destabilisation as oestrogen falls. Treatment timed across the cycle, addressing both the underlying TCM pattern and the perimenstrual peak, is most effective.
To discuss migraine treatment, contact me or book a consultation at my Wokingham, Berkshire clinic.
