We don’t quite know what causes migraines, though scientists believe it is often a combination of genetic and environmental factors, like hormonal changes, diet, drinking alcohol or caffeine, and stress. New research, however, suggests that vitamin deficiency may be to blame. The study, conducted at Cincinnati Children’s Hospital Medical Center, found that a large number of children, teenagers, and young adults who suffered from migraines also tended to have mild deficiencies in vitamin D, riboflavin, and coenzyme Q10.

The researchers examined data on migraine patients which included their baseline blood levels for vitamin D, riboflavin, coenzyme Q10, and folate. Vitamin D, which is a fat-soluble vitamin typically absorbed through sunlight or fatty fish, cheese, and egg yolks, helps your body absorb calcium and boost bone growth. Riboflavin, or vitamin B2, aids in the production of red blood cells and energy release from carbs. Coenzyme Q10, meanwhile, works to convert sugars and fats into energy; and folate (folic acid) is another B vitamin that’s found in fortified cereals and is helpful for the production of red blood cells. All of these vitamins have been linked to migraines in the past.

The study found that adolescent girls and young women, in particular, were more likely to have a coenzyme Q10 deficiency at baseline than boys. Boys and young men, however, were more likely to have a vitamin D deficiency. Interestingly, patients with chronic migraines were more likely to have coenzyme Q10 and riboflavin deficiencies compared to those with episodic migraines.

Most participants in the study were on preventive migraine meds and some also were receiving vitamin supplements. But not many patients were receiving vitamins by themselves, so it was difficult for the researchers to conclude that vitamin deficiency was a direct cause of migraines. In addition, past research on the link between migraines and vitamin deficiency has been inconclusive and sometimes controversial, so more research will be needed in order for physicians to begin prescribing vitamin supplementation as a potential migraine prevention or treatment plan.

“Further studies are needed to elucidate whether vitamin supplementation is effective in migraine patients in general, and whether patients with mild deficiency are more likely to benefit from supplementation,” said Dr. Suzanne Hagler, a Headache Medicine fellow in the division of Neurology at Cincinnati Children’s Hospital Medical Center and lead author of the study, in a press release.

Research has shown that migraines may boost the risk of heart disease and mortality in women, though it’s not clear whether that’s a causal or correlated link. Past research has also found a link between migraines and emotional abuse in children, as well as irritable bowel syndrome.

Source: Hagler S, et al. American Headache Society, 2016.