From the Guidelines
Magnesium supplementation, specifically magnesium oxide (MgO), is a recommended first-line option for individuals with chronic idiopathic constipation (CIC) due to its efficacy, tolerability, availability, and low cost. The most recent and highest quality study, published in 2023 in the journal Gastroenterology 1, suggests that MgO dosing of 1.5 g/d can exert a beneficial effect on constipation-related symptoms. However, lower doses of 500 mg/d to 1 g/d are often used in clinical practice, although their bioavailability and clinical efficacy are unknown. Some key points to consider when recommending magnesium supplementation include:
- The mechanism of action, where nonabsorbed magnesium creates an osmotic gradient, leading to net secretion of water and electrolytes in the GI tract 1
- The potential for adverse effects, such as diarrhea, although the available data suggest no increased reports of diarrhea with MgO compared with placebo 1
- The importance of renal excretion in regulating magnesium levels, and the need to avoid magnesium supplements in individuals with significant renal impairment (creatinine clearance of <20 mg/dL) 1
- The limitations of the current evidence, including the small number of clinical trials and the lack of long-term effectiveness or harms data 1
From the FDA Drug Label
PURPOSE Magnesium is a vital mineral essential for energy production, enzyme activity, nerve and muscle function, cardiovascular health, and bone maintenance. The research on magnesium supplementation is that magnesium is a vital mineral essential for various bodily functions, including:
- Energy production
- Enzyme activity
- Nerve and muscle function
- Cardiovascular health
- Bone maintenance 2
From the Research
Magnesium Supplementation Research
- Magnesium deficiency is a common condition that can contribute to the development of migraine, with studies suggesting that up to half of migraine patients may be magnesium deficient 3.
- Research has shown that magnesium supplementation can be effective in alleviating migraine symptoms, both acutely and chronically, with mechanisms including the potential link between magnesium deficit and spreading cortical depression, vascular changes, oxidative stress, chronic inflammation, nervous excitation, neurotransmitter release, and electrolyte imbalances 4.
- A review of the literature found that the strength of evidence supporting oral magnesium supplementation for migraine prevention is limited, but increasing dietary magnesium intake may be a more advantageous alternative for patients willing to make lifestyle changes 5.
- Double-blind, placebo-controlled trials have produced mixed results, likely due to the inclusion of both magnesium deficient and non-deficient patients, highlighting the importance of considering individual magnesium status when evaluating the effectiveness of supplementation 3.
- Dietary magnesium intake has been found to be below the recommended dietary allowance (RDA) for many Americans, and attainment of the RDA through a combination of diet and supplements has been associated with lower adjusted odds of migraine 6.
- Magnesium has been extensively used in migraine prophylaxis and treatment, and its role in pathogenesis and potential utilizations in prevention and treatment have been summarized in recent reviews 7.
Key Findings
- Magnesium deficiency is prevalent in migraine sufferers and may contribute to the development of migraine 3.
- Magnesium supplementation can be effective in alleviating migraine symptoms, but individual magnesium status should be considered when evaluating effectiveness 3.
- Increasing dietary magnesium intake may be a more advantageous alternative to supplementation for patients willing to make lifestyle changes 5.
- Attainment of the RDA for magnesium through a combination of diet and supplements is associated with lower adjusted odds of migraine 6.