Micronutrients and tension-type headache: A case–control study on intake and blood levels

Background: Tension-type headache (TTH) is the most common form of primary headache, in which diet plays a key role as a modifiable lifestyle component. Objectives: This study aimed to assess the levels of micronutrients in individuals with TTH compared to healthy participants. Design: This population-based case–control study was conducted using data from the Isfahan Functional Disorders longitudinal cohort study. The cohort consisted of 1943 adults aged 18–65 years, randomly selected between September 2017 and March 2018. Methods: Participants with TTH were clinically diagnosed according to the International Classification of Headache Disorders III criteria by trained physicians, and a control group was defined as individuals without any diagnosed primary headache disorder. Dietary intake was assessed using a food frequency questionnaire, validated for the Iranian population, and serum levels of certain micronutrients were measured. Results: Out of 1638 participants who completed dietary and headache-related information, 1072 were diagnosed with TTH, with 596 classified as infrequent TTH (iTTH), 425 as frequent TTH (fTTH), and 65 as chronic TTH (cTTH). Individuals with TTH had higher intakes of vitamin B6 and vitamin K, lower serum magnesium levels, and higher serum vitamin D levels compared to healthy controls. Additionally, participants with cTTH had higher dietary intake of folate, biotin, potassium, magnesium, molybdenum, and serum levels of vitamin D compared to those with iTTH. Conclusion: This study underscores the higher intake of vitamin B6 and vitamin K among subjects with TTH, along with lower serum magnesium levels and higher serum vitamin D levels. Further longitudinal studies are needed to explore these associations and develop effective interventions for TTH.