Migraine Detective™: Baseline Test List
Start here. These tests are commonly available, lower cost, and often already done - listed here to support pattern interpretation, not to direct medical care.
Common Trap
Stopping here because results are "normal." Foundational labs rule out big problems - but migraine patterns often live one layer deeper, in timing and interaction effects.
Blood & Nutrient Foundations
CBC with differential
Red/white blood cells, anemia indicators
CMP (Comprehensive Metabolic Panel)
Electrolytes, albumin, total protein, liver & kidney markers
Iron panel
Iron, ferritin, TIBC, transferrin saturation. Case-control and population studies find iron-deficiency anemia and low ferritin are more common in people with migraine, especially women.[4]
Vitamin D
Frequently discussed in migraine research and clinical pattern reviews. Large observational and trial data link low serum vitamin D with higher odds of migraine and modest reductions in attacks with supplementation.[1]
Vitamin B12 and folate
Nerve function and methylation. Systematic reviews show migraine patients often have lower B12 and folate and higher homocysteine, and B-vitamin therapy can reduce homocysteine and migraine frequency in some groups.[2] Higher dietary folate intake is also associated with lower odds of severe headache or migraine in US adults.[3]
Homocysteine
Methylation and cardiovascular marker
Fasting insulin (± fasting glucose or A1c)
Glucose regulation and metabolic health. Migraine is frequently comorbid with metabolic syndrome and insulin resistance, which are linked to more severe and chronic disease.[5]
Cholesterol panel
Lipid metabolism
CRP (C-Reactive Protein)
Broad inflammation marker. High-sensitivity C-reactive protein is often elevated in people with migraine in cohort and case-control studies, supporting a role for low-grade systemic inflammation.[6]
TSH + Free T4 (± Free T3)
Thyroid function. Subclinical and autoimmune hypothyroidism are repeatedly associated with higher migraine prevalence in observational studies.[7]
Hormonal Timing
(for cycling individuals)Day 3 of Cycle
- FSH
- LH
Day 19-21 of Cycle
- Estradiol
- Progesterone
Decades of work on menstrual migraine support the estrogen-withdrawal hypothesis: rapid late-luteal estradiol drops are a key trigger for perimenstrual attacks in susceptible women.[8]
Fluids & Elimination
Urinalysis
Hydration status, protein, glucose, infection clues
Pattern Context
(Non-lab but essential)These inputs provide the time-based context labs alone can't capture.
3-day food & liquid diary
Including timing and approximate quantities
Cycle tracking with symptom timing
For menstruating individuals: when do attacks cluster?
Why This Tier Matters
Small imbalances in iron, B vitamins, glucose regulation, electrolytes, or hormones can quietly lower the brain's resilience to stress, pressure shifts, and inflammation.
These tests form the foundation for understanding your migraine patterns. Many are already covered by insurance and may have been done previously - but rarely interpreted in context with your symptoms. If you already have results, a structured review of your existing tests can reveal patterns that standard interpretations miss.
Already Have These Results?
Upload your existing labs for interpretation - or explore advanced testing when basics aren't revealing enough.
Clinical and review articles
- Niu PP et al. Higher circulating vitamin D levels are associated with decreased migraine risk: a Mendelian randomization study. Frontiers in Nutrition. 2022. Hao S et al. Association between serum vitamin D and severe headache or migraine: a population-based analysis. PLoS One. 2025.
- Omer IIA et al. Association between homocysteine, vitamin B12, folate and migraine: an updated systematic review and meta-analysis. Brain Sciences. 2026. Liampas I et al. Serum homocysteine, pyridoxine, folate, and vitamin B12 levels in migraine: a systematic review and meta-analysis. Headache. 2020.
- Zhao D et al. Association between dietary folate intake and severe headache or migraine in adults: NHANES 1999-2004. Frontiers in Nutrition. 2024.
- Youssef K et al. Iron deficiency anemia and migraine: a literature review of epidemiology, mechanisms and treatment implications. Cureus. 2024. Alghamdi A et al. Association between dietary iron intake and serum ferritin and severe headache or migraine. Frontiers in Neurology. 2021.
- Bhoi SK et al. Metabolic syndrome and insulin resistance in migraine. The Journal of Headache and Pain. 2012. Ali M et al. The potential impact of insulin resistance and metabolic syndrome on migraine. Clinical Neurology and Neurosurgery. 2022.
- Hagen K et al. High sensitivity C-reactive protein and risk of migraine in an 11-year follow-up study. The Journal of Headache and Pain. 2020. Kim HJ et al. Association between serum high-sensitivity C-reactive protein levels and migraine subtypes. Cephalalgia. 2025.
- Rubino E et al. Subclinical hypothyroidism is associated with migraine: a case-control study. Cephalalgia. 2019. Chmielewska A et al. The relationship between migraine and Hashimoto's thyroiditis: a single-center experience. Frontiers in Neurology. 2024.
- Raffaelli B et al. Menstrual migraine is caused by estrogen withdrawal. The Journal of Headache and Pain. 2023. Vetri F et al. Role of estrogens in menstrual migraine. Frontiers in Neurology. 2022.