Magnesium and Migraine

The International Headache Society (IHS) defines migraine as a headache disorder with recurrent attacks (at least five) that last from 4 to 72 hours, are associated with nausea and/or sensitivity to light and sound, and also have at least two of four other characteristics including: pain that is of moderate or severe intensity; throbbing or pulsing; affects only one side of the head; or is worsened by routine activity such as walking. According to the 2017 Global Burden of Disease Study, migraine is a major cause of disability worldwide. “Migraine headaches have been recognized as a specific condition for centuries,” says Stephanie W. Goldberg, MD, a neurologist with Tufts Medical Center board-certified in neurology and headache medicine. “The word ‘migraine’ comes from the Greek ‘hemicranium’ meaning ‘on one side of the head.'” Women are disproportionally affected, and they may be even more susceptible during menstruation.

Could magnesium, a mineral commonly found in food, help prevent or alleviate these often-debilitating headaches?

Magnesium: Magnesium is essential for human health. According to the National Institutes of Health (NIH), this mineral is part of more than 300 reactions that regulate everything from protein synthesis to blood glucose levels, blood pressure, and nerve and muscle function. It is required for energy production, contributes to bone development, helps keep the heart’s rhythm normal, and is necessary for the synthesis of DNA. A considerable amount of evidence indicates that migraine headache sufferers are more likely to be magnesium deficient than healthy controls, and magnesium has been looked at as a potential option for preventing and treating migraine headaches.

What the Science Says: The American Headache Society (AHS) has concluded that intravenous magnesium therapy is “probably effective” for acute migraine treatment. “Magnesium can be given to a migraine headache sufferer when they are in pain to try to break the cycle of pain,” says Goldberg. “This is typically done through an IV in an emergency room setting.” Although 2018 guidelines from the AHS do not include magnesium in the list of options with evidence of efficacy in migraine prevention, some doctors prescribe magnesium supplements for a subset of people suffering from chronic migraines.

A 2018 study published in the journal Headache systematically reviewed randomized, double-blind, placebo-controlled trials investigating the use of magnesium to prevent migraines in migraine sufferers aged 18 to 65. Evidence from the five clinical trials deemed eligible for inclusion indicated that supplementation with high levels of magnesium dicitrate is safe, cost efficient, and “possibly effective” for preventing migraine, but the authors cautioned that the studies were small, of varying quality, and had inconsistent results. The most common side effect was diarrhea.

Safe Supplementation: Because the dose of magnesium suggested by the review discussed above — 300 milligrams (mg) of magnesium twice a day — exceeds the recommended Upper Limit considered safe for most adults, the NIH cautions that this treatment should only be used under the direction and supervision of a healthcare provider. “There is the impression that over-the-counter supplements are safe to use, and people sometimes think they can use as much as they want, but magnesium in high quantities can have toxic effects,” says Goldberg. “At very high levels it can cause muscle weakness, cardiac problems, loss of normal reflexes, and trouble breathing. While the likelihood of experiencing these side effects with oral magnesium is limited, people need to be aware of the possibility. There are some conditions, such as kidney disease and significant cardiac disease, which could cause even an over-the-counter dose of magnesium to have toxic effects, so it’s important to talk to a general practitioner or neurologist before starting supplements.”

Dietary Magnesium: The recommended dietary allowance for magnesium is 420 mg per day for men over 31, and 320 mg per day for women in that age bracket (or 360 mg during pregnancy). According to the 2015 Dietary Guidelines for Americans, many Americans are not meeting the recommended intake for dietary magnesium, however, it was not classified as a nutrient of public health concern. Habitually low dietary intake of magnesium could potentially cause changes in biochemical pathways that might, over time, be associated with increased risk of migraine headaches (as well as high blood pressure and cardiovascular disease, type 2 diabetes, and osteoporosis).

Magnesium is found in many foods that are associated with good health. Although the jury is out on whether or not magnesium (dietary or supplemental) will help to prevent or treat migraines, there is no doubt that most magnesium-rich foods are good for overall health.