Background Migraine, as a widespread neurological condition, substantially impacts quality of life, particularly among women. Therefore, this study aimed to explore the potential effects of alpha-linolenic acid (ALA) and L-baseline and study end. Results The intervention group demonstrated a significant reduction in migraine frequency (-2.96; 95% CI (-3.48, -2.45) vs -0.07; 95% CI (-0.68, 0.53), P <0.001), severity (-1.6; 95% CI (-2.05, -1.15) vs − 0.44; 95% CI (-0.91, 0.02), P = 0.001), and duration (-4.9; 95% CI (- 6.34, -3.45) vs -0.5; 95% CI (-1.06, 0.66) hours, P < 0.001) compared to the placebo group. Mental health improvements were observed in depression (-7.4; 95% CI (-9.24, -5.55) vs 0.05; 95% CI (-1.16, 1.26), P < 0.001), and anxiety scores (-5.7; 95% CI (-7.26, -4.14) vs − 0.65; 95% CI (-2.33, 1.03), P < 0.001). Quality of life measures showed significant enhancement, with increased migraine-specific quality of life (9.75; 95% CI (8.01, 11.49) vs 1.22; 95% CI (-0.66, 3.11), P < 0.001) and decreased headache impact test-6 scores (-8.57; 95% CI (-11.79, -5.36) vs -1.35; 95% CI (-3.41, 0.71), P = 0.005) in the intervention group compared to the controls. Conclusion Co-supplementation with ALA and L-carnitine may offer a promising adjuvant therapy for managing migraine in women, addressing both physical symptoms and psychological burdens.
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