Effects of Folic Acid Supplementation on Headache in Children

Purpose: Headaches are common in pediatric patients and often require preventive treatment. Recent studies in adults suggest that low folate levels may contribute to headaches. However, research on folic acid supplementation for pediatric headaches remains limited. This study evaluated the effects of folic acid supplementation on pediatric migraine disorders and tension-type headaches. Methods: We retrospectively reviewed medical records of pediatric patients with headaches who received folic acid supplementation between January 2021 and December 2024. Folate levels, headache frequency, and pain severity were analyzed. The primary outcome was the reduction in headache frequency and severity 2 months after supplementation. Responders were defined as patients whose headache frequency or pain severity decreased by more than 50% following treatment. Results: Among 82 patients, 60 (73.2%) were classified as responders and 22 (26.8%) as non-responders. No significant difference in baseline folate levels was observed between the two groups (P=0.42). Over 2 months of folic acid supplementation, headache intensity significantly decreased from 6.0 (interquartile range [IQR], 5.0 to 7.0) to 1.5 (IQR, 0 to 2.9) in responders (P<0.001). Headache frequency also significantly decreased in responders from a median of 6.0 days/week (IQR, 3.5 to 7.0) to 0.5 days/week (IQR, 0 to 2.0) (P<0.001). Tension-type headaches were significantly more common in the non-responder group (59.1%, P=0.04). Conclusion: This study provides evidence that folic acid supplementation is an effective and safe treatment for pediatric patients with low plasma folate levels.