The headaches were back.

Forty-seven-year-old Pat Hagge, an insurance safety director from Fort Collins, thought he had found and eliminated the cause of his migraines several years ago by cutting caffeine out of his diet.

But then they came back with the aura, the pain, the nausea. He tried taking prescription medications, but they left him feeling disassociated.

"I couldn't function," he said. "I'd rather deal with the migraines than the medication. It got so bad that I was having these headaches three or four times a week, and I'd just have to power through them at work."

After seeing several doctors, he was finally referred to a neurologist Tamara Miller who asked him, "How open-minded are you?"

Miller suggested he take vitamin B2 and magnesium treatments, which are showing promise at various headache centers. A few days after starting the supplements, Hagge's migraines diminished to just one a week. When he added one baby aspirin per day, they disappeared completely.

Hagge is delighted. His monthly bill for the supplements and aspirin totals $15, an amount lower than his insurance co-pay for prescription pharmaceuticals. Additionally, he doesn't experience any side effects.

An inexpensive migraine cure with few side effects? You'd think the medical establishment would be all over this. Current remedies are costly. Topomax, Imitrex, and Zomig cost from $2 to $20 per capsule, and they can come with side effects including dizziness and nausea.

Miller points out that these supplements won't help every migraine sufferer, especially those with continuous headaches. But she prefers to start occasional sufferers with other treatments before she turns to expensive pharmaceuticals.

Some of the most authoritative sources on the Internet, however, barely mention riboflavin and magnesium. WebMD, the Mayo Clinic the National Institutes of Health (NIH) mainly discuss pharmaceutical treatment options. Information about non-pharmaceutical treatments doesn't seem to be making it out to the front lines of medical care.

In his book "How Doctors Think," Jerome Groopman, a professor at Harvard Medical School, describes the case of an infant girl adopted from Vietnam whose health was ravaged by pneumonia and several other deadly microbes. The doctors diagnosed her with a rare immune disorder, even though her test results were not typical of the disease. They were on the verge of a risky bone marrow transplant when the girl's immune system rebounded.

Through later study, the doctors concluded that she was most likely suffering from a vitamin or mineral deficiency which they had unknowingly rectified with the standard IV nutrients they'd given her.

While there is little money for research and promotion of nutritional connections, there is plenty of money to promote pharmaceuticals. According to Susan Buckley, a registered dietitian at South Denver Cardiology, pharmaceutical companies have the clout to influence doctors' knowledge and decisions. Big pharma funds the research, their reps meet with the doctors to educate them, and they host educational dinners and seminars which promote their products.

Some doctors such as Miller have become more educated on nutrition, Buckley notes, but they are self-motivated and self-taught, often because their patients are asking questions.

To be sure, pharmaceuticals have a necessary place in our health care, but when we equate the practice of medicine to the practice of dispensing pharmaceuticals, we neglect many low-cost, low side-effect therapies that show promise.

As patients, we need to ask our doctors to learn more about non- pharmaceutical therapies and to work more closely with nutrition professionals. Until that time, patients would be smart to seek out a registered dietitian, as well as an M.D., for advice.