Magnesium & Migraines: What's the big deal?
Magnesium is one of my favorite supplements for migraine prevention and one of the few daily pills that I never skip. Having first heard about this over-the-counter supplement during the 2017 Migraine World Summit in an interview with Dr. Andrea Harriott, my attention peaked when she gave magnesium “two thumbs up” for patients with migraine. A quick google search on information about the treatment of migraine with magnesium and anyone can see that there is no shortage of results. But is there actual evidence?
A systematic review by the NIH looked at all the existing clinical trials from 1990-2016 on the effectiveness of using magnesium in preventing migraine attacks. According to their review,
This systematic review provides Grade C (possibly effective) evidence for prevention of migraine with magnesium. Prophylactic treatment of migraine by means of high levels of magnesium dicitrate (600 mg) seems to be a safe and cost efficient strategy in clinical use.
Additionally, the American Headache Society gave magnesium a B rating in 2012, which translates to it being “probably effective”. Given that over the course of my life, I have tried (and failed) most medication treatment options for migraines, I was game for trying an non-prescription alternative that could probably or possibly help me!
Am I deficient?
Diagnosing magnesium deficiency is actually quite tricky because the levels of magnesium present in the bloodstream is not reflective of the levels of magnesium with cells. What this means is that magnesium levels can be deficient even if serum test results are within a normal range. That’s why it is essential that clinicians are able to recognize deficiencies by review of reported symptoms from patients. According to the NIH, these are a few common symptoms to note:
Muscle cramps (especially at night)
Muscle twitching (including eye twitches)
Insomnia
Irritability
Fatigue & weakness
Numbness & tingling in extremities
Loss of appetite
Headache
Dizziness
Heart arrhythmia
Chest pain
Outside of migraine disease, many coexisting conditions and medications can put you at an even higher risk of magnesium deficiency. For example, patients with migraine disease often deal with gastrointestinal disorders like IBS, Celiac, and GERD, which can make magnesium absorption problematic. Even further, many common drugs deplete the body’s magnesium and lead to deficiency including but not limited to antacids, blood pressure meds, oral contraceptives, and corticosteroids. Because of these types of comorbidities and medication side effects, it is almost guaranteed that patients with chronic migraine disease are deficient in this mineral and is increasingly important to keep an eye out for symptoms.
How can magnesium help me?
Magnesium is a cofactor in over 300 enzyme reactions in the body and essential for a variety of processes including:
Protein synthesis
Nerve pathway signaling
Serotonin production
Bone maintenance & formation
Regulation of heartbeat
Blood glucose regulation
You can see how widespread the problems can be when magnesium is deficient in the body.
Of particular note for people with migraine, it is theorized that appropriate levels of magnesium can prevent cortical spreading depression (involved with auras) and possibly decrease the release of substances that are involved with pain signaling in the brain. These theories lead clinicians to believe that magnesium can be used effectively as both a preventative and acute treatment option for migraine attacks.
If you suspect you may have magnesium deficiency, it is essential to talk with your neurologist or general physician before beginning supplementation. Once cleared to begin, I highly recommend doing a little research on the different forms of magnesium to find some options that are right for you rather than blindly picking something off the shelf at the drugstore. Be sure to checkout these guidelines I put together from my own research in to the world of magnesium.
Additional resources:
Magnesium 101: Its Powerful Health Benefits and How to Get More in Your Diet
Magnesium & Migraine Prevention: American Migraine Foundation