Magnesium is an essential mineral that’s crucial to your health – in fact, it’s needed for over 300 reactions in your body! Because your body can’t make magnesium, you must get it through the food you eat or supplements you take.
It is recommended that you get about 400mg per day of magnesium for optimum health; however, some studies have found that migraineurs do well with higher doses.
The Science: Magnesium and Migraine
Magnesium acts as a cofactor, or “helper”, in many reactions throughout your body. Some of these include:
- Creating protein
- Muscle and nerve function
- Blood sugar control
- Regulating blood pressure
- Producing raw energy for your body’s cells
- Bone structure (50% of magnesium in your body is found in your bones)
- Creation of DNA
- Creation of an important antioxidant called glutathione
Magnesium is known as an electrolyte, meaning it carries an electrical charge. Your body is essentially a giant battery that runs on these charges, and because of this your body relies on electrolytes like magnesium for your heart beat, muscle contractions, and nerve impulses.
It’s safe to say magnesium is a busy, important mineral!
Magnesium has been studied for migraine in particular because of its apparent ability to prevent cortical spreading depression (the wave of changes that occur in the brain before and during a migraine episode). Magnesium is also able to plug calcium channels that would otherwise allow pain signals to be communicated more easily via the nervous system.
Magnesium may be able to decrease levels of CGRP, or calcitonin gene-related peptide, before and during a migraine episode. CGRP is thought to have a negative effect on blood vessels and pain pathways in the brain, which is why reducing levels of it can be beneficial for migraineuers. You may have heard of calcitonin gene-related peptide in reference to a newer class of drugs called CGRP-antagonists, which are preventative migraine medications that reduce levels of circulating CGRP.
Magnesium may work in other ways that help manage migraine, including preventing elevated serotonin levels and reducing the negative effects of nitric oxide.
It isn’t hard to see why magnesium is used so frequently for migraine prevention and treatment!
Signs of Deficiency
Diagnosable magnesium deficiency is uncommon for a few reasons – for one, our kidneys do a really good job of recycling magnesium for future use. Another reason is that we just don’t have a great way to test for it. However, sub-clinical (aka mild or early) magnesium deficiency is not uncommon, especially if you don’t eat many foods high in magnesium.
Signs of low magnesium include:
- loss of appetite
- nausea / vomiting
- numbness / tingling
- muscle cramps / spasms
Many people also link restless leg syndrome to low magnesium intake. It’s important to note that the above symptoms can also be common migraine symptoms, as well as common side effects of several migraine medications.
Low magnesium levels can results from gastrointestinal issues like irritable bowel disease, celiac disease, increased intestinal permeability (“leaky gut”), and surgeries that include removal of part of the small intestine (especially the ileum). You may also be at higher risk if you have frequent diarrhea or type-2 diabetes.
If you are concerned about magnesium deficiency and would like to test for a deficiency, the best lab tests available right now are RBC magnesium levels and urinary excretion. Although these tests are not perfect, they are more able to show a deficiency than the typical serum magnesium levels you see on your yearly blood work. This is because serum magnesium (the magnesium in your blood) is very tightly controlled by your body and will likely only be low if you’ve had long-term diarrhea or are suffering from alcoholism.
Magnesium From Food
Food is your body’s preferred source of magnesium. Great food sources of magnesium include:
- Brown rice
- Potato w/ the skin
- Fortified cereals and grains
While it’s important to get magnesium from the foods you eat, the reality is that many people with migraine deal with symptoms that make it difficult to consistently prepare healthy meals. There is also some literature showing that migraineurs need more magnesium than someone without migraine – and that’s where supplements come in!
All magnesium you find in supplements will be bound with another molecule – this is due to the fact that magnesium really doesn’t like to float around on its own so will attach itself to other compounds. Because of this, magnesium supplements come in many different forms that are distinguished by which molecule the magnesium is attached to.
Each form of magnesium has a different bioavailability, aka how well your body is able to absorb the supplement. With magnesium supplements, the lower the bioavailablity, the more likely it is to cause diarrhea (and the less likely it is to have a positive impact on your migraine symptoms).
Forms of magnesium with a lower bioavailablity tend to be cheaper, so if you would like to experiment with these forms, it’s often recommended to take multiple smaller doses throughout the day rather than one big dose. This will help reduce the likelihood of diarrhea and increase your body’s chance of absorbing the magnesium.
You’ll also want to take a look at the ingredients within the supplement as well as whether it’s been tested for safety and purity..
Here are the most common forms of magnesium available:
Magnesium L-Threonate: great choice
Magnesium threonate combines magnesium with a substance derived from Vitamin C called threonic acid.
This form of magnesium has a lot of buzz surrounding it, as it is thought to be able to cross the blood brain barrier easily and have a positive impact on brain conditions. Good news for migraineurs!
So far, studies have shown that magnesium taurate has potential for improving conditions like memory loss, dementia, and depression. More research is needed on this newer magnesium supplement, but for those willing to shell out the extra money magnesium taurate is a great option.
Magnesium Glycinate: great choice
Magnesium glycinate combines magnesium with the amino acid glycine. This amino acid can actually be found on its own as a supplement that has been studied for its ability to help with improving sleep and reducing inflammation.
Magnesium glycinate has a high bioavailability and is very well tolerated (won’t make you poop). While both glycinate and magnesium are thought to have calming, anti-anxiety effects and can help with sleep, so this form is likely best taken at night before bed. This is the form I take personally and I’ve had good success with it.
Magnesium Citrate: good choice
Magnesium citrate is a combination of magnesium and citric acid. Citric acid is naturally found in citrus fruits and is often used as a preservative in packaged foods.
Magnesium citrate is thought to have a soothing, calming effect. This is why you’ll often find it in products specifically marketed to people with anxiety. Keep in mind that, while there is some anecdotal evidence to support this (aka people say it works), there is not much scientific evidence backing up the anti-anxiety claim. Does that mean it doesn’t work? Nope! It just means we don’t have many studies to point to proving it can reduce anxiety.
Magnesium citrate has a higher bioavailability than some other forms like magnesium oxide, but the citrate within it also causes a laxative effect. Because of this, magnesium citrate is probably not the best choice unless you have issues with constipation.
Magnesium Malate: good choice
Magnesium malate combines magnesium with malic acid, a naturally-occurring compound found in fruits.
Animal studies show that magnesium malate has a high bioavailability and a lower chance of causing diarrhea and other GI effects, although there are not many human studies supporting this. Some websites say this form of magnesium is a good choice for fibromyalgia patients and chronic fatigue, but research has been unable to support this.
You’ll often find magnesium malate in antacids and heartburn medications, as well as on its own as a magnesium supplement.
Magnesium Taurate: good choice
Magnesium taurate combines magnesium with the amino acid taurine. It has been shown to have good bioavailability (this is true of most magnesium supplements containing an amino acid), although no research has been done on its ability to improve migraine symptoms.
There has been some research on this form’s ability to improve cardiovascular disease and blood sugar control for people with type-2 diabetes, so if you deal with any of these issues along with migraine magnesium taurate may be a good choice for you.
Topical Magnesium: not the best choice
Topical magnesium can be found in the form of epsom salts, lotions, and oils. These products most often contain either magnesium chloride or magnesium sulfate, and while they are popular among migraineuers (I use them myself!), the research is still out on whether they are well-absorbed.
Does this mean they don’t work? Nope! But looking at the current research available, topical magnesium is likely best used as an addition to an oral magnesium supplement rather than as your sole source of magnesium. Many people use it before bed to relax muscle tension or at the earliest signs of a migraine episode.
While we’re on the subject of epsom salts, please don’t use them orally! There have several reported cases of magnesium toxicity caused by ingestion of epsom salts. If you want to use them, stick to enjoying a nice long soak in an epsom salt bath.
Magnesium Oxide: not the best choice
Magnesium oxide combines magnesium with good old oxygen, which we’re all familiar with!
Magnesium oxide is frequently recommended and studied for its ability to decrease migraine symptoms … but I’m not really sure why. It has extremely poor bioavailability (some studies show only 4% is absorbed by your body!) and as such as a pretty sizeable laxative effect.
Chelated Magnesium: marketing term
When shopping for magnesium supplements, you may see magnesium glycinate, taurate, or threonate labeled as “chelated”. The term chelated simply refers to the bond between magnesium and the other substance it’s attached to – chelated bonds (which have two points of attachment rather than one) tend to be more highly absorbed than others.
Here’s the kicker, though – magnesium glycinate, magnesium taurate, and magnesium threonate are naturally chelated, whether the label says so or not. You do not need to pay extra for that “chelated” term!
And while we’re on the topic of labeling, you don’t need to pay extra for “ionic” magnesium either. Most magnesium bonds are ionic, so there is nothing special about this that you need to shell out more money for!
***Have trouble swallowing pills? Try a powdered magnesium supplement.
People with migraine seem to be more susceptible to migraine deficiency than the rest of the population. Even in the absence of a deficiency, many if not all migraineurs can benefit from magnesium. It seems that people with migraine may simply need more magnesium than the average person, or could benefit from using it in higher doses than would normally be recommended.
Dr. Mauskop, director and founder of the New York Headache Center, recommends using magnesium glycinate and starting with 400mg daily. After taking this dose for a few weeks to make sure you don’t experience any GI side effects, Dr. Mauskop stated during the 2016 Migraine World Summit that you can double or even triple the dose.
That being said, it is important to check with your doctor or dietitian before taking doses higher than the recommended daily amount (400mg). While overdosing is unlikely it certainly is possible, especially for certain populations.
Magnesium threonate, a newer form of magnesium, can often be taken in lower doses than other forms of magnesium due to its higher level of absorption. Always start with the directions on the bottle and adjust as needed with the guidance of your doctor or dietitian.
Side Effects and Warnings
Side effects of magnesium are most often seen when using forms of magnesium that are not well absorbed like magnesium oxide.
Common side effects of magnesium include:
- stomach cramps
Sometimes switching to a more easily absorbed form like glycinate can eliminate these unpleasant symptoms. Starting with a smaller dose and working upwards can also help prevent side effects for many people.
You don’t typically have to worry about getting too much magnesium from food, but it is possible to take too much when using supplements. This is especially true for people with kidney disease or impaired kidney functioning, as your body gets rid of extra magnesium via your kidneys (through your urine).
If you take extremely high levels of magnesium (typically 5000mg or more per day), you can experience magnesium toxicity. Signs of toxicity include:
- low blood pressure
- nausea / vomiting
- muscle weakness
- difficulty breathing
- cardiac arrest
Toxicity is not common but is something to be aware of when taking high doses of magnesium.
Magnesium shows promise as a beneficial supplement for migraine as well as anxiety, insomnia, depression, memory loss, and muscle fatigue. Magnesium glycinate is a well-tolerated and well-absorbed form and 400mg is the most widely recommended dosage.