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Magnesium & Migraine
By Kerrie | April 23, 2007
Should You Be Taking Magnesium?
Two doubleblind studies have shown that magnesium supplementation may reduce the frequency of migraine. In research studies, we have found that magnesium levels affect serotonin receptors, and also have an effect on nitric oxide synthesis and release, as well as on NMDA receptors—all brain structures and chemicals suspected to be important in migraine. In small studies, both migraine and cluster headache patients have responded acutely to intravenous magnesium. In a larger double-blind controlled study, the treatment group, receiving 600mg of magnesium for a 12 week period, experienced a 41.6% reduction in headaches as compared to only 15.8% reduction in migraine headaches in the placebo group.
What Does Magnesium Do?
It is responsible for over 300 essential metabolic reactions in the body. It is required for synthesizing proteins in the mitochondria, and for generating energy in most of the body’s basic cellular reactions. It is necessary for several steps in the synthesis of DNA and RNA. Magnesium is also present in a number of other important enzymes. As important as it is intracellularly, 60% of the body’s magnesium is present in bone, and 27% in muscle.
Magnesium Supplements
If you decide to take supplemental magnesium, start at 400-500 mg/day in divided doses. The limiting factor for most people is diarrhea. If you are on a migraine preventative medication that is constipating, like amitriptyline or verapamil, this might be a plus.
WARNING: If you have heart disease or kidney disease, or are prone to kidney stones, talk to your doctor before starting on calcium and/or magnesium.
To be metabolized effectively, magnesium must be taken with calcium. The amount of calcium should be no more than double the amount of magnesium— this is the ratio commonly recommended for women. Men may require less calcium, and sometimes take a ratio of calcium-magnesium that is equivalent mg/mg.
Many people take in only 60-70% of the recommended daily allowance in the first place, and then things like stress and caffeine can deplete that further throughout the day. Migraine sufferers have been found to have a relative magnesium deficiency in their bloodstream between migraine attacks, and intracellular magnesium levels drop even further during a migraine attack.
Magnesium oxide, magnesium citrate, and magnesium sulfate are bioavailable—look for mixed salts of these forms, or magnesium gluconate, which is ionized, and is biologically active; if you develop diarrhea from those forms of magnesium, look for chelated magnesium.
Magnesium carbonate dissolved in CO2- rich water is 30% more bioavailable than magnesium found in foods or in pill-format.
Foods Rich in Magnesium
- Peanuts*
- Almonds*
- Brown rice
- Hazel nuts*
- Blackstrap molasses
- Bananas*
- Beans
- Tofu*
- Soy beans*
- Avocado*
- Broccoli
- Spinach
- Swiss chard
- Tomato paste
- Sweet potato
- Pumpkin seeds
- Peanut butter*
- Chocolate*
- Cocoa powder*
- Succotash
- Cooked artichoke
- Black-eyed peas
- Whole-grain cereals
- Cooked okra
- Beet greens
- Acorn squash
- Chickpeas
- Split peas
- Lentils
- Kiwi fruit*
- Apricots
- Baked potato
- Raisins
- Yogurt*
- Milk
*these can be migraine triggers for some people
Magnesium-Drug Interactions
- Digoxin - Decreased absorption due to magnesium
- Nitrofurantoin - Decreased absorption due to magnesium
- Anti-malarials - Decreased absorption due to magnesium
- May interfere with quinolone or tetracycline antibiotics.
- May interfere with anticoagulants.
- Diuretics such as furosemide (Lasix) or hydrochlorothiazide can result in magnesium depletion.
- Iron supplements may interfere with magnesium supplement absorption.
This article appeared in the April/May 2006 of the Headquarters Migraine Management newsletter, Dr.
Peterson’s bimonthly newsletter on migraine awareness and education. If
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Topics: Community, News, Treatment |
April 23rd, 2007 at 4:01 am
I’m thinking I might need to try magnesium again. I was taking it when I was also taking preventatives that seemed to maje my migraines worse, rather than better, so I’m thinking I didn’t even have a chance to find out whether it would help.
Great post. Very good information.
April 23rd, 2007 at 3:50 pm
I listened to the webcast with about the 10 unexpected migraine treatments and the doctor that spoke about magnesium on there agreed that magnesium levels are low in patients with migraine. However, he said that for an unknown reason our bodies don’t absorb the amount they should (I guess why we have lower levels in the 1st place?) so oral supplements don’t work. He said he will treat his refractory patients with periodic IV injections and also use IV injections to abort migraine attacks in some patients - but that only the IV form is effective. I have no idea if he is correct or not but might be something to research before spending $ on oral supplements. I have been on an oral supplement for years and I am going to wean off and see what happens.
April 24th, 2007 at 2:38 pm
Research has shown that migraineurs have lower brain levels of magnesium. I don’t think it has been definitively determined that we have defective magnesium absorption mechanisms.
It is more likely that there is some genetic mechanism at play to account for the altered brain biochemistry.
Magnesium supplements vary widely in their bioavailability, which is why I tried to provide information on the magnesium salts that have been studied for their absorptive capacity. Dissolvable powders and liquids tend to be better absorbed than tablets, but the various salts also dissolve at different rates.
The main study that was done to show magnesium’s effectiveness in migraine used oral supplements, so clearly it is not just IV infusions that are effective. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8792038&dopt=Abstract
April 24th, 2007 at 7:12 pm
Well, as I stated, I had no idea if he knew what he was talking about or not as he cited no studies. This German study did find a significant difference in attack frequency, but not in duration nor intensity. Hard to tell from only reading the abstract much about the study (I am at home and cannot access the entire paper) but it along with the fact that Dr. Peterson advocates it seems like there must be clinical evidence of efficacy. Personally, in the last two days as I have halved my dose to begin weaning off I have had a constant headache, but that could be due to anything…. I may start taking the full dose again for the next few days as I will be traveling and decide what to do after that.
April 26th, 2007 at 9:17 pm
I was at work when I posted the other day, and didn’t have time to dig into my files.
Here is better evidence: http://www.blackwell-synergy.com/doi/abs/10.1046/j.1468-2982.1991.1102097.x
http://www.neurology.org/cgi/content/abstract/58/8/1227
http://www.geriatrictimes.com/g020208.html
http://www.blackwell-synergy.com/doi/abs/10.1111/j.1526-4610.1994.hed3403160.x
Hope this is helpful to those who like to read studies.
April 29th, 2007 at 1:06 pm
What a great exchange! Thanks for the informative discussion.
Kerrie