For a migraine sufferer, there’s nothing better than a medicine that will make the headache go away — nothing, that is, except never having the migraine at all. Because let’s face it: Migraine drugs aren’t perfect. They can be pricey, and they can have side effects. What a lot of migraine sufferers don’t realize, though, is that a few simple steps can often work just as well as the drugs, without as much cost or risk. Here are a few moves that may help you control your headaches without so much as looking at your medicine cabinet:

Step 1

Start a food journal. Migraine experts know that some foods may trigger migraines. The biggest culprits are those that have an increased amount of a substance known as tyramine, which can cause headaches by increasing blood pressure. High-tyramine foods include aged cheeses, alcohol, processed meats and red wine. By keeping track, you can learn your triggers. Avoiding them can decrease the number of headaches you suffer.

Step 2

Exercise. A study done in Sweden found that regular exercise can be just as effective at preventing migraines as the drug Topamax. When study participants rode a stationary bike for 40 minutes three times a week, they had as big a reduction in headaches as participants who took 200 milligrams (mg) of Topamax a day. The only difference was that a third of the Topamax users had side effects, while the exercisers had none (unless you count a boost in fitness). Exercise increases endorphins, which may be the mechanism by which it prevents headaches.

Step 3

Try some healthy supplements. A number of studies have found that a daily dose of 400 mg of the B vitamin riboflavin can prevent migraines. It can’t stop one that’s already in progress, but people who take it for three months see their migraines drop by half.

Another nutrient that wards off migraines: magnesium, a common mineral found in beans, pumpkin seed, and nuts. The amount recommended varies according to which expert you ask, but anywhere from 600 to1000 mg daily is recommended, provided you don’t have kidney problems. A study done in Germany found that when migraine sufferers were given 600 mg magnesium daily for a month, their migraines decreased by more than 40%. Magnesium helps by calming the brain. And there’s a bonus: It’s good for the heart, too.

The herbal extract butterbur has been used for thousands of years for a variety of health issues. Several studies have found that in a dose of 50-75 mgs twice daily, it can reduce the number of migraines by as much as 50%.

I generally recommend starting with magnesium and riboflavin. If your headaches have not decreased then I suggest adding butterbur. In addition, I recommend trying 150 mg daily of coenzyme Q10. In one study, this supplement halved the number of “migraine days,” probably, researchers think, by improving blood flow in the brain.
Studies have also found that 1000 mg daily of omega 3 fatty acids reduce the frequency of migraines by reducing inflammation. Both of these supplements are good for general health.

These supplements are all generally safe (though, as with any supplement, you should discuss them with your doctor before you start). Whichever you choose, you’d need to take it regularly. And, unfortunately, none will help with a migraine that’s already in progress. Still, if you’re a migraine sufferer, it’s worth discussing alternatives like these with your doctor. They’re inexpensive, have fewer side effects than many migraine meds – and just might make your head feel much better.