Magnesium

Summary:
Magnesium is a mineral involved in neuronal excitability and vascular tone. Supplementation may prevent migraine by correcting deficiencies or modulating NMDA receptor activity.

Biological Plausibility

Magnesium deficiency is more common in people with migraine. It modulates NMDA receptors, serotonin, and calcium channels—all involved in migraine pathogenesis. It also improves mitochondrial and endothelial function.

Evidence

Multiple RCTs show that magnesium supplementation (especially magnesium citrate or glycinate at doses ≥400 mg/day) reduces migraine frequency and severity.

Effect Size

Reduction of 1–2 migraine days/month. 40–50% responder rates in some trials. Particularly effective for menstrual migraine and migraine with aura.

⚠️ Risk

Low. May cause GI upset or diarrhea, especially with poorly absorbed forms. Safer forms include glycinate and citrate.

Cost

$

Scores

  • Benefit: 2
  • Burden: 2
  • Ratio: 1

Clinical Takeaways

  • First-line nutraceutical for prevention.
  • Use highly absorbable forms (e.g., citrate or glycinate) at ≥400 mg/day.
  • Well-tolerated and widely accessible.

Key References

  • Peikert A, et al. *Prophylaxis of migraine with oral magnesium: results from a randomized, placebo-controlled study.* Cephalalgia. 1996.
  • Mauskop A, et al. *Why all migraine patients should be treated with magnesium.* J Neural Transm. 2009.
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