From the Guidelines
Magnesium supplements can be effective for preventing and treating migraines, with a recommended dose of 400-600 mg per day, taken orally in divided doses. The evidence from 1 suggests that magnesium has modest efficacy in certain circumstances, although more trials are needed to confirm its effectiveness. To implement magnesium therapy:
- Start with 200 mg twice daily
- Take with food to improve absorption and reduce potential gastrointestinal side effects
- Continue for at least 3-4 months to assess effectiveness
- If well-tolerated, you can increase the dose up to 600 mg daily if needed Magnesium works by helping to regulate neurotransmitters and blood vessel constriction in the brain, which are involved in migraine pathophysiology. It may also reduce cortical spreading depression, a wave of brain activity linked to migraine auras. Be aware that magnesium can cause loose stools in some people, and if this occurs, reduce the dose or switch to a different form of magnesium. Also, consult with a healthcare provider before starting any new supplement regimen, especially if you have kidney problems or are taking other medications, as noted in 1.
Some key points to consider when using magnesium for migraine prevention and treatment include:
- Magnesium oxide or magnesium citrate are common forms used for this purpose
- Patient education and involvement in their own management are crucial, as emphasized in 1
- Regular reevaluation of therapy is necessary to assess effectiveness and adjust the treatment plan as needed
- Magnesium can be used in conjunction with other preventive therapies, such as propranolol, timolol, amitriptyline, divalproex sodium, and sodium valproate, which are recommended as first-line agents for migraine prevention in 1.
From the Research
Role of Magnesium in Migraine Treatment
- Magnesium is an important intracellular element that plays a crucial role in numerous cellular functions, and its deficiency may contribute to the pathogenesis of migraine headaches 2, 3.
- Magnesium deficiency can promote cortical spreading depression, alteration of neurotransmitter release, and the hyperaggregation of platelets, all of which are involved in the pathogenesis of migraine 2, 3.
- Studies have shown that preventive treatment with oral magnesium and acute headache treatment with intravenous magnesium may be effective in treating migraine, particularly in certain subsets of patients 2, 4.
Efficacy of Magnesium in Migraine Treatment
- A randomized, single-blind, placebo-controlled trial found that 1 g of intravenous magnesium sulfate was effective in treating acute migraine attacks, with a response rate of 100% and a pain-free rate of 87% 4.
- Another study found that magnesium sulfate was superior to placebo in treating migraine attacks, with a response rate of 100% and a pain-free rate of 87% 4.
- However, not all studies agree that magnesium should be given to every migraineur, citing that while it may have a potential role in prophylaxis, the results in acute therapy are less convincing 5.
Magnesium Deficiency and Migraine
- Magnesium deficiency is more prevalent in migraine sufferers than in healthy controls, and routine blood tests may not reflect true body magnesium stores 3.
- Magnesium deficiency can cause neurological complications, and deficits in magnesium have a significant role in the pathogenesis of migraine 3, 6.
- Transdermal magnesium delivery may be a potential utilization of magnesium in the prevention and treatment of migraine 6.