By Christina Peterson, MD
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.
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
- Brown rice
- Hazel nuts*
- Blackstrap molasses
- Soy beans*
- Swiss chard
- Tomato paste
- Sweet potato
- Pumpkin seeds
- Peanut butter*
- Cocoa powder*
- Cooked artichoke
- Black-eyed peas
- Whole-grain cereals
- Cooked okra
- Beet greens
- Acorn squash
- Split peas
- Kiwi fruit*
- Baked potato
*these can be migraine triggers for some people
- 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 you’re not signed up to receive this electronic newsletter, you’re missing out!