Is magnesium supplementation effective in preventing migraines?

Magnesium Supplementation for Migraine Prevention

Oral magnesium is recommended for migraine prevention at a dosage of 400-600mg daily, as it is the most evidence-supported supplement for reducing migraine frequency and severity. 1

Efficacy of Magnesium for Migraine Prevention

Magnesium supplementation has demonstrated significant benefits in migraine prevention through several mechanisms:

• Magnesium deficiency plays an important role in migraine pathogenesis by:

  • Promoting cortical spreading depression
  • Altering neurotransmitter release
  • Contributing to platelet hyperaggregation 2

• Clinical evidence shows that oral magnesium:

  • Significantly reduces migraine frequency (p=0.005 compared to placebo)
  • Decreases attack severity (p<0.001 compared to placebo) 3
  • Alleviates both frequency and intensity of migraines (Odds ratios = 0.20 and 0.27, respectively) 4

Dosage and Administration

• The recommended dosage is 400-600mg of oral magnesium daily 1
• Magnesium citrate at 600mg/day has shown effectiveness in clinical trials 3
• Benefits typically become apparent after 3 months of consistent supplementation 3

Mechanism of Action

Magnesium supplementation works through multiple pathways to prevent migraines:

• Dampens neuronal hyperexcitation

• Counteracts vasospasm

• Increases tolerance to focal hypoxia

• Stabilizes platelets

• May reduce sympathetic outflow 5

• Increases cortical blood flow in:

  • Inferolateral frontal regions (p<0.001)
  • Inferolateral temporal regions (p=0.001)
  • Insular regions (p<0.01) 3

Treatment Evaluation

• Assess treatment success after 2-3 months of optimized therapy
• Success is defined as a ≥50% reduction in monthly migraine episodes 1
• Consider maintaining a headache diary to track frequency, severity, and medication use 1

Comprehensive Migraine Management

While magnesium is effective, optimal migraine management should include:

• Addressing modifiable risk factors (obesity, medication overuse, caffeine use, sleep disturbances)
• Regular aerobic exercise
• Consistent sleep schedule
• Adequate hydration
• Regular meals
• Stress management techniques 1

Important Considerations

• Magnesium supplementation is particularly beneficial for patients with migraine without aura 3
• Magnesium is safe, inexpensive, and well-tolerated compared to many prescription medications 2
• Consider food triggers identification through food diaries as a complementary approach 6
• For patients with acute migraine attacks, intravenous magnesium has shown effectiveness in relieving symptoms within 15-45 minutes, 120 minutes, and 24 hours after infusion 4

Magnesium supplementation represents a valuable option in migraine prevention with strong supporting evidence and minimal side effects, making it an excellent first-line supplement before considering more aggressive pharmacological interventions.