By: Fernando Gonzalez, CSUN Dietetic Intern Cohort 2021-2023 

The prevalence of self-reported migraines and headaches in the US population is a significant issue, affecting approximately one-sixth of the American populace, with a notably higher incidence among females.¹ Migraines are a type of intense headache that can elicit a sensation of throbbing or pulsating pain in the cranial region.² Migraine episodes have the potential to continue for extended periods, spanning several hours to multiple days, and the associated discomfort can be severe, impeding routine activities.² Despite the absence of a definitive cure for migraines, a considerable number of individuals afflicted with this condition have turned their attention towards alternative therapies and modifications to their way of life, which have been shown to mitigate the frequency and intensity of episodes and associated symptoms. Some affected individuals have considered supplementation, aromatherapy, the use of oils, and even workout programs such as yoga. However, it is sometimes difficult to distinguish between quack treatments and evidence-based treatments. Magnesium supplements are a popular supplement option among those with migraines.  With the many studies available on magnesium supplements and migraines, it may be possible to determine whether magnesium supplementation is a reliable home treatment for migraines. 

Studies have observed that individuals who suffer from chronic migraines tend to have low serum magnesium levels during migraine attacks and may also face a magnesium deficiency. One study concluded that migraine sufferers with tension-type headaches have significantly lower levels of serum magnesium.³ Although there is literature indicating a link between magnesium and migraines, researchers continue to face uncertainties and doubts concerning their association; yet, there are certainly valid and rational theories that have been agreed upon.⁴ Researchers and scientists believe this may be a mechanism that causes migraines: 

• A trigger, such as a magnesium deficiency, causes brain cells to create chemical messengers, such as peptides known as CGRP (calcitonin gene-related peptide) and Substance P.⁴ 
• These neurotransmitters (the chemical messengers) lead to an increase of blood flow, promoting inflammation and swelling in the brain.⁴ 
• Nerve cells respond to these symptoms and transmit messages to other sections of the brain where pain is recognized, leading to migraines throughout a period.⁴ 

Treatment with magnesium has been found in studies to reduce the development of CGRP and block pain receptors, which may explain how magnesium helps cure and prevent the development of chronic migraines.⁵ 

Magnesium plays a role in numerous physiological functions in the body, such as proper energy production and regulating muscle contractions, but more than half of all Americans fail to meet their daily magnesium needs.⁶ With symptoms related to deficiencies being key elements of migraine development, such as platelet aggregation and cortical spreading depression, it has been proven that magnesium deficiency may be the cause of chronic migraines that many face.⁷ 

Not only has the relationship between magnesium and migraines been observed, but there is also evidence supporting the use of magnesium for migraine treatment and prevention. In a recent study conducted in 2021, the efficacy of magnesium oxide and sodium valproate, a prescribed medication used to prevent migraine headaches, was trialed amongst 70 participants during 8 weeks.⁸ It was concluded that 500 mg of magnesium oxide appeared to be as effective for migraine treatment as valproate sodium without any significant side effects.⁸ Additionally, another study found that magnesium supplementation can reduce the frequency of migraine attacks by 41.6% while individuals who took a placebo supplement had a 15.8% reduction.⁹

The recommended dietary allowance of magnesium is 420 mg for adult males and 320 mg for adult females.¹⁰ The American Headache Society recommends magnesium supplementation for acute migraine prophylaxis, however, no recommended dosage or form has been determined.¹¹ Although there is no established dosage for migraine prevention, studies have shown that a dose of 400-600 mg of magnesium oxide has been proven to be effective.¹²  Though magnesium supplements are a convenient way to get magnesium on a regular basis, the best and most natural way to get magnesium is through a healthy diet. Approximately 40% of dietary magnesium is absorbed, which is significantly more than the amount absorbed from most supplements.¹³ If you would like to avoid supplements, consume foods high in magnesium instead, such as 1 oz of pumpkin seeds (37% Daily Value [DV]), 1 oz of chia seeds (26% DV), ½ cup of spinach (19% DV), ¼ cup of peanuts (15% DV), 3.5 oz baked potato (10% DV), and 1 cup of milk (6% DV).¹³

Magnesium is not only safe, but it may also be a cheap and effective way to cure and prevent migraines. Most people have relatively little risk from taking magnesium supplements. Mild diarrhea is the most typical side effect of consuming too much magnesium from supplements and dietary sources, and it tends to worsen with increasing dosages.¹³ Individuals with kidney problems are also at a higher risk of toxicity, thus it is critical to see your doctor before taking magnesium supplements.¹³ Although no specific dose has been confirmed to cause these unpleasant symptoms, it is important to keep track of how much magnesium one is taking and reduce if a certain dosage causes symptoms. 

Magnesium has been found to be an effective preventive solution for migraines in numerous individuals when consumed within safe dosages. Magnesium may be a more appropriate alternative to prescription migraine medication due to its comparatively lower incidence of adverse effects. It is advisable to consult a physician if one experiences multiple migraine episodes for the first time or if the frequency and intensity of the migraines have escalated as they can assist in determining the appropriate magnesium dosage and suggest alternative treatment methods.  

References

1. Burch R, Rizzoli P, Loder E. The Prevalence and Impact of Migraine and Severe Headache in the United States: Figures and Trends From Government Health Studies. Headache. 2018;58(4):496-505. doi:10.1111/head.13281 
2. Mayo Clinic Staff. Migraine. Mayo Clinic. July 2, 2021. Accessed May 19, 2023. https://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/syc-20360201#:~:text=A%20migraine%20is%20a%20headache,sensitivity%20to%20light%20and%20sound.  
3. Sarchielli P, Coata G, Firenze C, Morucci P, Abbritti G, Gallai V. Serum and salivary magnesium levels in migraine and tension-type headache. Results in a group of adult patients. Cephalalgia. 1992;12(1):21-27. doi:10.1046/j.1468-2982.1992.1201021.x 
4. Dolati S, Rikhtegar R, Mehdizadeh A, Yousefi M (2020). The Role of Magnesium in Pathophysiology and Migraine Treatment. Biological trace element research, 196(2), 375–383. https://doi.org/10.1007/s12011-019-01931-z 
5. Myrdal U, Leppert J, Edvinsson L, et al. Magnesium sulphate infusion decreases circulating calcitonin gene-related peptide (CGRP) in women with primary Raynaud’s phenomenon. Clinical Physiology. 1994;14(5):539-546. doi:10.1111/j.1475-097x.1994.tb00412.x  
6. DiNicolantonio JJ, O’Keefe JH, Wilson W. Subclinical magnesium deficiency: A principal driver of cardiovascular disease and a public health crisis. Open Heart. 2018;5(1). doi:10.1136/openhrt-2017-000668  
7. Yablon LA, Mauskop A. Magnesium in headache. In: Vink R, Nechifor M, editors. Magnesium in the Central Nervous System [Internet]. Adelaide (AU): University of Adelaide Press; 2011. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507271/?report=classic 
8. Karimi N, Razian A, Heidari M. The efficacy of magnesium oxide and sodium valproate in prevention of migraine headache: a randomized, controlled, double-blind, crossover study. Acta Neurol Belg. 2021;121(1):167-173. doi:10.1007/s13760-019-01101-x 
9. Peikert A, Wilimzig C, Köhne-Volland R. Prophylaxis of migraine with oral magnesium: results from a prospective, multi-center, placebo-controlled and double-blind randomized study. Cephalalgia. 1996;16(4):257-263. doi:10.1046/j.1468-2982.1996.1604257.x 
10. Magnesium. The Nutrition Source. March 7, 2023. Accessed May 19, 2023. https://www.hsph.harvard.edu/nutritionsource/magnesium/#:~:text=RDA%3A%20The%20Recommended%20Dietary%20Allowance,cause%20harmful%20effects%20on%20health.  
11. Loder E, Burch R, Rizzoli P. The 2012 AHS/AAN Guidelines for prevention of episodic migraine: A summary and comparison with other recent clinical practice guidelines. Headache: The Journal of Head and Face Pain. 2012;52(6):930-945. doi:10.1111/j.1526-4610.2012.02185.x  
12. Tepper D. Magnesium and Migraine. American Migraine Foundation. November 29, 2022. Accessed May 19, 2023. https://americanmigrainefoundation.org/resource-library/magnesium/.  
13. National Institutes of Health Office of Dietary Supplements. Magnesium. June 2, 2022. Accessed May 19, 2023. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/