Magnesium: migraine prevention without pills

Migraine is difficult to prevent. Beta blockers, antiepileptics, and antidepressants reduce the number of seizures and pain (1), but the search for less severe drugs continues. Magnesium is the main object of study in this direction.

Should you take magnesium to prevent migraines? Let’s figure it out based on the latest and fundamental research.

Magnesium and migraine: what is the connection?

Mg as an ion takes part in 325 physiological processes, including the synthesis of DNA and RNA. Its lack plays an important role in the development of headaches and aura (2).

Lack of intracellular Mg contributes to cortical spreading depression (CSD), which gives us an aura during an attack.

The connection between magnesium and migraine has been studied since the 1980s, when a method emerged to determine its amount in brain cells using [tooltip tip=“The method determines biochemical changes in tissues by the concentration of certain metabolites. Magnetic resonance spectra show the approximate content of biologically active substances in the studied area organism”]spectroscopy[/tooltip] (MRS). It became known that during an attack the level of the substance in cells decreases by 23% (3, 4). How does this affect the brain? The function of mitochondria is disrupted, blood vessels constrict (cerebral vasoconstriction), platelets stick together, serotonin is released and the sensitivity of glutamate receptors increases. All this leads to the KRD shown in the video above and the attack.

Why is so much magnesium lost during an attack?

This is partly due to genetic characteristics. For example, one type of migraine involves mutated proteins that are responsible for the movement of calcium ions in cells (mutation in the α1 subunit of the voltage-type Ca2+P/Q channel) (5). There are other mutations that are responsible for the aura. The chain of reactions leading to an attack includes a whole set of “extra” interactions in which the mineral is actively consumed.

Menstrual migraine and Mg deficiency

Hormone-dependent headaches do not respond well to medications, especially menstrual migraines without aura. Clinical studies show (7) that Mg2+ deficiency occurs in 45% of women with menstrual attacks. In 15% of them, the deficiency of the element is chronic. Effective hormonal drugs such as danazol, tamoxifen, leuprolide do not cope with headaches in this group, but magnesium helps as emergency therapy (up to 2 g intravenously).

The effect of magnesium supplements on MM continues to be studied (8), and the results of prevention are encouraging. Treatment and prevention of migraines during pregnancy were discussed in the previous article.

Migraine, menopause and magnesium

Unfortunately, there are not enough large studies of the impact of menopause on the disease, especially since 18% of women experience worsening symptoms after age 50.

How does a migraine occur during menopause:

• In the early stages, attacks can be especially severe due to hot flashes and “hormonal wars.” Lack of Mg during this period is associated with hormonal imbalance ( 9 ).
• During menopause, up to 30% of women forget about attacks. The hormonal background favors significant relief of the disease, and the amount of Mg is stabilized due to the decrease in estrogen. However, hormone replacement therapy, designed to prolong youth, prolongs pain and provokes aura (10).
• In postmenopause, migraines should stop. If, a year after the last menstruation, attacks continue, it is worth further examination (10).

Do I need to take extra magnesium during and after menopause?

Perhaps this makes sense. Due to the loss of estrogen and progesterone, the mineral partially takes over the protective function of the cardiovascular system (10). The amount of Mg in urine and blood serum increases due to the depletion of bone tissue, leading to osteoporosis, which distorts the test results. At the same time, its level in erythrocytes and lymphocytes will be reduced (11), and consumption will increase significantly.

How to determine magnesium deficiency?

Test for Mg level in [tooltip tip=“The liquid in which dissolved ions, proteins, salts, hormones and other organic and inorganic substances “float”. Makes up about 60% of the blood.”]blood plasma[/tooltip] will tell you virtually nothing about its deficiency. The fact is that 99% of the element is found in cells, bones and tissues, and only 1% in extracellular fluid. When its level in the blood drops, the heart reacts with irregular rhythms, and this is a signal for urgent hospitalization - such a deficiency rarely occurs, so it is difficult to diagnose it before an attack (12).

There is no quick or cheap test to determine whether you have enough intracellular Mg in your body.

The overall picture is based on three tests:

1. Concentration in erythrocytes, saliva and [tooltip tip=“Blood plasma deprived of fibrinogen”]serum[/tooltip].
2. Fractional excretion in urine (Urinary Fractional Excretion, Total Excretion of Urinary Magnesium) (13).
3. Spectroscopy.

Such tests are not carried out in every hospital, since correct sample collection and the speed of the test directly affect the result. Spectroscopy is only possible if you have a tomograph and a specialist in this field (14).

Throughout the world, clinical assessment of deficiency based on symptoms is critical when a quality test is impossible or very expensive. The first symptoms of magnesium deficiency are night cramps, apathy, weakness, prolonged PMS and insomnia.

##What reduces Mg levels?

A huge number of factors influence the absorption of the element and its consumption (15). Since the compound is involved in most reactions and does not accumulate, its concentration in cells must be maintained daily.

Which magnesium is better?

Chlorophyll in green leafy vegetables contains the most bioavailable form of the mineral. There is a lot of it in nuts and whole grains, but due to phytin in cereals, the mineral is poorly absorbed. If an additional source of the element is needed, the best compounds are citrate, lactate, and chloride (16). Only citrate and lactate can achieve a significant increase in Mg in blood cells, and not just in plasma and serum.

Tablet from the RCT Bioavailability and Pharmacokinetics of Magnesium After Adrninistration of Magnesium Salts to Humans (2001). By enlarging the picture you will see that the oxide and carbonate have the lowest bioavailability.

A balanced diet provides an average of 90 mg Mg per meal (17). Fortified mineral water may be a good source (18, 19). It can be difficult to get the minimum amount of food you need if you need to monitor your calorie intake, have food allergies, or have certain foods that are contraindicated due to chronic illnesses. In addition, healthy people can absorb up to 40% of the element supplied with food.

A recent review in Nutrients magazine, to my shame and regret, completely refuted the absorption of Mg through the skin (20). Transdermal magnesium oil is nothing more than a marketing myth.

Selected list from the huge USDA list

There are two huge lists of foods sorted by the magnesium content per cup of the food: “1 cup” is the traditional measure of weight in the West. The weight of the product that fits in the cup is described, and how much mineral it holds USDA National Nutrient Database for Standard Reference Magnesium, Mg (mg) .

How to take magnesium for migraines

They will not be able to stop an attack, but they can reduce the number of attacks and the level of pain. Most studies agree on a course of prophylaxis of at least 2 months. Enrich your diet with the right foods, and support it with a minimum dosage of citrate or lactate from supplements if necessary.

In a study of intestinal absorption of magnesium from food and supplements (21), the optimal single dose was indicated as 121 mg Mg; taking one tablet of 300 mg is impractical - phosphorus ceases to be absorbed. Co-administration of zinc (from 140 mg) has a negative effect on the metabolism of the element (22).

Pay attention to the form of the substance in the supplements, not the milligrams. There is no need to worry about an overdose. The laxative property of Mg at a certain concentration is not due to toxicity, but to osmotic pressure in the intestine and water accumulation. By exceeding the dose, you will simply cleanse the intestines.

Conclusions

The effect of nutrients on migraine is being actively studied and should not be ignored. Sometimes enriching your diet with foods high in Mg is enough to reduce the number of attacks and relieve pain. [tooltip tip=“Randomized placebo-controlled clinical trials”]RCTs[/tooltip] show that migraine prevention with magnesium has level C evidence (possibly effective), which is good for nutraceuticals (23).

Meta-analysis of several RCTs on the effectiveness of Mg for migraine headaches in adolescents.

Literature, links, sources

All links are collected in a folder on Google Drive . Almost all the articles were downloaded in the original and some were translated by machine translation, so you can familiarize yourself with the sources personally and in detail.