Expert Answer: Magnesium for Migraine
Posted by Dr. Alex Mauskop—September 27th, 2011

Question: How is magnesium used to help with migraines? How do I know if I’m deficient and how much should I take? What are the side effects?

Migraine is known to have a strong genetic component, but what exactly
is wrong with the genes varies widely from person to person. One of the possible problems is genetic difficulty in absorbing magnesium.

Our research done at SUNY — Downstate showed that up to 50% of migraine sufferers and 40% of those with cluster headaches are deficient in magnesium. In addition to genetic reasons for magnesium deficiency, stress, alcohol, chronic illness, poor diet, gastro-intestinal disorders, such as irritable bowel syndrome, can cause depletion of magnesium.

Magnesium is an essential element that is vital to the function of every cell in the body. It regulates literally hundreds of chemical reactions, modulates the function of
various cell receptors, helps open and close blood vessels, and performs many other functions. Changes in some of these receptors (serotonin, NMDA, and others) and blood vessel constriction are intimately involved in the development of migraine headaches. Our research also showed that a regular blood test is completely unreliable.

So, how do you know if you are deficient and should take a supplement? Here are some other signs of magnesium deficiency: cold hands and feet or just feeling colder than other people around you, muscle cramps in your legs or feet, which often occur at night, and PMS symptoms in women. But you may be deficient even if you don’t have these additional symptoms and since there is little downside in taking a magnesium supplement, it may be worth a try.

It may take a month or two of daily intake of about 400-500 mg of magnesium oxide or chelated magnesium, before headaches improve. Magnesium can cause is diarrhea or stomach upset, so it should be always taken with food. People with impaired kidney function (you
would know if you had it) should not take magnesium supplements without their doctor’s permission.

Magnesium can interfere with absorption of some antibiotics and other medications, so if you are taking prescription drugs it is important to talk to your doctor. Some people do not absorb enough magnesium even if they take a daily supplement, which we can tell if they get diarrhea or if their symptoms do not improve. We give these patients an intravenous infusion of magnesium and if it is effective, we repeat them monthly. We also give infusions for severe attacks and if the person is deficient, magnesium will provide immediate and dramatic relief. We also use the infusion as a test — if it helps, then a deficiency is probably present and taking an oral supplement may also help.

Even patients suffering from chronic daily headaches sometimes have
complete relief of their headaches from magnesium, although more often magnesium alone is not sufficient and we also need to give Botox injections, other supplements, such as CoQ10, biofeedback, and medications.

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About Dr. Alex Mauskop

Dr. Alexander Mauskop is a Fellow of the American Academy of Neurology and is the Director and founder of the New York Headache Center in New York, NY. Dr. Mauskop is an Professor of Clinical Neurology at SUNY Downstate Medical Center. He is board-certified in Neurology and Headache Medicine.

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