Does Low Iron Intake Impact Migraineurs?


Results of a cross-sectional study point to a potential link between iron intake and migraine that may be dependent on age.

Dietary iron intake leads to different effects on migraine among women of different ages, according to findings of a cross-sectional study published in Frontiers in Nutrition. Researchers hypothesized these differences could be due to age-related menstrual changes.

As iron is closely related to menstruation—during which iron is depleted—and because patients with iron-deficiency or iron-deficiency anemia tend to have a high frequency of migraine, investigators sought to determine whether iron deficiency was associated with severe headache or migraine.

In addition, “ferritin, an important biomarker of body iron stores, deserves attention for its relationship with migraines,” authors explained, while “dopamine plays a role in the pathogenesis of migraine, and iron is an essential trace element for the synthesis of dopamine,” they said.

Using data from the National Health and Nutrition Examination Surveys (NHANES), which are administered by the National Center for Health Statistics at the CDC, investigators assessed responses from 7880 adults (3575 men and 4305 women).

Individuals aged 20 years or older completed the questionnaires between 1999 and 2004. Of the 7880 adults surveyed, 1702 (21.6%) responded "yes" to the question: "During the past 3 months, did you have severe headaches or migraines?"

“Compared with the participants without headache, the participants with headache were more likely to be younger, female, and living alone, had a lower education level, a lower body mass index (BMI), a lower dietary protein intake, a lower dietary iron intake, a lower cholesterol level, a lower hemoglobin level, a lower serum iron level, a lower serum ferritin level, and more likely to take birth control pill,” researchers wrote.

Analyses revealed:

  • Most women aged 20 to 50 years consumed less dietary iron than their recommended dietary allowances
  • Dietary iron intake was inversely associated with severe headache or migraine in women aged 20 to 50 years
  • For women over 50 years, serum ferritin was negatively associated with severe headache or migraine
  • For men, there was no significant relationship between dietary iron and serum ferritin, and severe headache or migraine
  • After adjusting for possible confounders, the odds ratio for the association between dietary iron intake and severe headache or migraine was 0.721 (95% CI, 0.565–0.920) comparing the highest quintile of iron intake (≥ 19.94 mg/day) with the lowest quintile of iron intake (≤ 8.20 mg/day)

Previous studies have shown iron absorption is closely related to the level of sufficient iron in the body, meaning absorption increases when there is insufficient iron storage and decreases when storage is sufficient. An additional investigation also found that a lower ferritin level corresponds with high iron absorption.

“Therefore, women aged 20-50 years may have higher iron absorption than men and women over 50 years, which may be the reason why dietary iron was associated with migraine only in women aged 20-50 years,” researchers hypothesized.

A lack of information on perimenopause marks a limitation to the investigation, while the cross-sectional nature of the study precludes any causal inferences from being made.


Meng S, Zhou H, Li X, et al. Association between dietary iron intake and serum ferritin and severe headache or migraine. Front Nutr. Published online July 6, 2021. doi:10.3389/fnut.2021.685564

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