Magnesium For Migraines

Overview

For those who experience or have experienced migraines, they would agree that it is a most unpleasant experience. A migraine is a one sided headache usually characterized by throbbing pain so intense it makes your eye(s) tear up.

Since the exact causes of the disease is largely based in theory, the medications used in preventing or treating migraines also mainly tackle the symptoms. Among these drugs, the use of Magnesium is becoming more popular, especially because it has a large safety margin. 

There are various studies which show how magnesium (or the lack of) affect migraines to a large extent. Studies show that lower levels of magnesium usually lead to migraines. The ideal migraine medication is one that will be effective in more than 90% of migraine cases. Magnesium oxide is the ideal migraine medication that is safe for use during migraine attacks in pregnancy. It is also highly affordable. The American Migraine Foundation¹ is of the opinion that magnesium supplement is the closest we will ever come to such a drug in the treatment of migraines. 

How does magnesium affect migraines?

The effect of magnesium on migraine is one that is gaining more attention worldwide. Studies have been carried out that show a relationship between the levels of magnesium in the body at a given point and the onset of migraine episodes. According to the work by Lisa A.Y. and Alexander M.², deficiency in magnesium levels have been found to lead to effects similar to those that occur during migraine episodes. The most common effects are cortical spreading depression and hyperaggregation of platelets. 

Magnesium is one of the most essential and plentiful ions in the body. Its deficiency is related to diseases affecting the nervous system (depression and tremors), the circulatory/ cardiac system, and even the digestive system. Before now, the usefulness of magnesium in treating migraines has been in flux as a result of varying results. 

The major obstacle remains that the levels of magnesium in various parts of the body vary. This makes getting an accurate magnesium level reading for individuals a bit challenging. 

The study Lisa A.Y. and Alexander M.² indicated that more than 50% of 40 migraine afflicted patients had low to normal levels of magnesium. Interestingly, more than 80% of them reported the next 24 hours to be migraine free when they were injected with a sufficient dose of intravenous magnesium sulfate.  

The importance of magnesium supplementation in migraine prophylaxis is becoming increasingly important to migraine prevention. So much so that the American Headache Society’s added magnesium supplementation to its guidelines for migraine prevention and treatment. Right after the “steady routine” recommendation, we find magnesium intake.³

Of course, it should be taken with a few more supplements such as melatonin (to aid sleep) and coenzyme-Q10. But magnesium levels supplementation is the major factor. 

More than migraines, magnesium has been found effective in alleviating headaches generally. Tension headaches included. 

How much magnesium should I take for migraines?

Thankfully, there is no need for one to get a magnesium shot whenever a migraine episode is around the corner. There are studies indicating that oral doses are equally effective. The oral dose is the same for everyone most times. 

The American Migraine Foundation ¹ recommends a total oral dose of 400 to 600 mg Magnesium oxide. This is usually prescribed in divided doses of 200mg every 6 to 8 hours. A maximum dose of 2g for magnesium sulfate injection can also be administered when necessary.

For complicated acute migraines

Magnesium oxide 600 mg dose is ideal for those experiencing prolonged acute migraine. Acute migraine could last anywhere from a few hours to a few days. Prolonged acute migraines refer to those that last more than 48 hours. For such migraine sufferers, a 600mg daily dosing for a few days is ideal.

Chronic migraines

For those suffering from chronic migraines (more than 15 episodes per month), prevention and management is the way to go. For such cases a lower dose of 400 or 500 mg daily is usually recommended by the headache Journal.³ 

The reason the chronic cases are placed on a lower dose daily is to facilitate prevention. For migraine sufferers who experience up to 15 episodes a month, the goal is to reduce frequency. The magnesium oxide supplementation plan when properly prescribed and monitored should significantly reduce episodes over time. It is expected that after the first month of treatment, the number of episodes should not exceed 10.  

Migraines in pregnancy

The 400mg oral magnesium oxide dose is safe for pregnancy. This is to be taken in doses of 200mg every 12 hours. If possible, avoid the injection. 

Menstrual related migraines (MRM)

This dosage could also be applied to those experiencing Menstrual-related migraines (MRM), more commonly known as menstrual migraine. This is a safe dose for every migraine sufferer. 

For those who experience premenstrual migraines, magnesium could also be used. Daily supplementation could serve as preventive treatment.

General guidelines

While magnesium oxide oral doses are largely safe for use, it is best to periodically check in with your physician before use. This way the physician could keep track of your progress. This monitoring is essential in knowing when to reduce or increase the dose. 

This is especially so for those who suffer:

• Vestibular migraine (characterized by lightheadedness and dizziness)
• Acute Migraines
• Migraines with Aura (characterized by “cues” that come before the migraine such as speech or sensory impediments)⁴

Magnesium oxide tablets do not require a prescription. But consult a physician before considering the use of magnesium sulfate injection. 

For pregnant migraine sufferers, the need to see a physician before starting on a magnesium supplementation regimen increases exponentially. This is to ensure that none of the other pregnancy supplements and drugs in use interact adversely with magnesium. 

Side effects and other concerns

As of now, the most common side effect of magnesium oxide is magnesium-induced diarrhea. In most cases however, this is dose dependent. So a reduction in the dose being taken, should stop the diarrhea.⁵

Note: Intravenous magnesium sulfate carries a fetus bone thinning warning in pregnancy. This is especially so for extended use (longer than 5 days).⁵ 

Summary

Migraines, often debilitating one-sided headaches, have unclear causes, but magnesium, particularly magnesium oxide, is gaining traction as a remedy due to its safety and affordability. The American Migraine Foundation highlights magnesium's potential as a near-ideal migraine solution. Research indicates a link between low magnesium levels and migraines. In one study, while over half the participants had low magnesium levels, 80% found relief post magnesium sulfate injection. The American Headache Society includes magnesium in its migraine prevention guidelines, recommending an oral dose of 400 to 600 mg. While generally safe with diarrhea as a common side effect, consulting a physician, especially during pregnancy, is crucial due to potential risks like fetus bone thinning with prolonged intravenous use.