An evidence-based review of oral magnesium supplementation in the preventive treatment of migraine
Abstract
Background
Methods
Review
Conclusion
Introduction
The physiological role of magnesium
The role of magnesium in migraine pathophysiology
Methods
Results
Author, year | Study populations | Timing of screening (if known) and magnesium (Mg) measurement method(s) | Outcomes |
---|---|---|---|
Schoenen et al.,16 1991 | 44 migraine patients: - 38 migraine without aura - 6 migraine with aura 25 chronic tension-type headache patients 19 neurological, non-headache patients | Screened between attacks Measures: Serum Mg Erythrocyte Mg | Serum Mg levels were not significantly different between groups. Erythrocyte Mg levels were significantly lower in migraine without aura patients compared to the other three groups. |
Thomas et al.,19 1992 | 79 migraine patients 55 non-migraine patients, who had other disorders not known to alter blood magnesium | Measures: Serum Mg Erythrocyte Mg | Serum Mg levels were not significantly different between groups. Erythrocyte Mg in migraine sufferers was significantly lower than controls. |
Sarchielli et al.,15 1992 | 70 migraine patients: - 41 migraine without aura - 29 migraine with aura 30 tension-type headache patients 40 age-matched controls | Assessed both ictally and interictally Measures: Serum Mg Salivary Mg | Migraine patients showed significantly lower serum and salivary Mg levels compared to healthy controls and tension-type headache patients. |
Gallai et al.,7 1993 | 90 migraine patients: - 60 migraine without aura - 30 migraine with aura 30 healthy age-matched controls | Screened during the interictal and ictal periods Measures: RBC Mg | RBC Mg concentration lower in migraine sufferers, both with and without aura, compared to controls. No significant change in RBC Mg levels when comparing ictal and interictal measurements. |
Mauskop et al.,11 1993 | 33 intermittent migraine patients 13 continuous, daily headache patients 60 healthy controls | Measures: Serum Mg, ionized Mg, and ionized calcium | Ionized Mg was lower in both migraine and continuous headache groups compared to controls. Total Mg was significantly lower in intermittent migraine compared to the other two groups. |
Gallai et al.,8 1994 | 100 migraine patients: - 60 migraine without aura - 40 migraine with aura. 30 healthy controls | Screened during the interictal and ictal periods Measures: Mononuclear blood cell Mg content | Mononuclear blood cell Mg content was significantly lower in migraine sufferers compared to controls during the interictal period. No significant difference noted when comparing interictal and ictal values |
Smeets et al.,17 1994 | 38 familial hemiplegic migraine sufferers (from three families) 23 migraine without aura 9 migraine with aura 11 non-afflicted members 32 healthy controls | Screened between attacks Measures: Intracellular Mg Plasma Mg | No significant differences were found between intracellular or plasma Mg values between any of the study groups. |
Mishima et al.,12 1997 | 36 migraine patients: - 28 migraine without aura - 8 migraine with aura 20 tension-type headache patients 24 healthy controls | Screened between attacks Measures: Platelet Mg concentration Platelet cAMP concentration Platelet cGMP concentration | No significant difference in platelet Mg concentration between migraine and control groups. Significantly lower in tension-type headache patients. |
Ilhan et al.,21 2000 | 40 migraine patients: - 28 without aura - 12 with aura 21 healthy controls All participants had been staying in Malatya for at least one year | Measures: Hair Mg, zinc, copper, and manganese Serum Mg | Hair Mg levels significantly lower in migraine patients than in controls. Serum Mg levels lower in migraine patients compared to controls, but not significantly. |
Lodi et al.,9 2001 | 91 headache patients: - 7 migraine stroke - 13 migraine with prolonged aura - 37 migraine with typical aura or basilar migraine - 21 migraine without aura - 13 cluster headache 36 healthy controls | Screened between attacks Measures: Brain cytosolic-free Mg Cellular bioenergetics | Free Mg was found to be significantly lower in migraine and cluster headache patients compared to controls. Subsequently, free energy released by ATP was found to be reduced. |
Boska et al.,6 2002 | 46 migraine patients: - 19 migraine without aura - 19 migraine with aura - 8 hemiplegic migraine 40 healthy controls | Screened between attacks Measures: P MRS imaging using a 3-T scanner | An inverse correlation was seen between Mg in the posterior brain and increasing severity of neurological symptoms, but only hemiplegic migraine patients showed significantly reduced Mg values. |
Trauninger et al.,20 2002 | 20 migraine patients: - 16 migraine without aura - 4 migraine with aura 20 healthy controls All subjects had a normal BMI | Screened between attacks Measures: Mg load test Serum Mg | Mg excretion of the patients with migraine was found to be significantly lower than the controls. Baseline serum Mg was within reference range for both groups. |
Mauskop et al.,10 2002 | 67 women with migraine without aura whose headaches were more common or worsened during menstruation 66 healthy controls | Screened between and during both attacks and menses Measures: Serum ionized Mg, ionized calcium, and total Mg | Only the ionized Mg levels measured during menstrual attacks (n = 20) were found to be significantly lower than controls. No additional ionized or total Mg measurements were significantly lower than controls. |
Talebi et al.,18 2011 | 140 migraine patients: - 100 migraine without aura - 40 migraine with aura 140 healthy controls | Measures: Serum Mg | Mean serum Mg values were significantly lower in migraine patients compared to controls. A significant linear relationship was found between mean Mg level and frequency of headaches. |
Samaie et al.,14 2012 | 50 acute migraine patients 50 healthy controls | Screened during the postictal phase Measures: Serum Mg | Serum Mg was found to be significantly lower in the migraine patients compared to controls. |
Qujeq et al.,13 2012 | 21 migraine patients 24 healthy controls | Measures: Lymphocyte Mg and calcium | No significant lymphocyte Mg or calcium differences were found between migraine patients and healthy controls. |
Author, year, study design | Study purpose | Study populations | Intervention | Outcomes |
---|---|---|---|---|
Facchinetti et al.,23 1991 Study design: Double-blind, randomized, placebo-controlled | Assess the role of oral magnesium supplementation in the prophylaxis of menstrual migraine Primary measure: Migraine duration and intensity | 20 subjects who suffered from menstrual migraine and 15 women without any history of migraine (control group) Size of placebo and treatment groups not reported Ages: 28 to 36 years | Intervention period: Patients received placebo or magnesium pyrrolidone carboxylic acid administered three times per day for a total of 360 mg of magnesium per day for the first two months. Second two months all participants received magnesium. | Pain total index scores decreased significantly in both placebo and treatment groups. Magnesium supplemented group, however, saw a greater decrease in the first two months. |
Peikert et al.,25 1996 Study design: Prospective, multicenter, double-blind, randomized, placebo controlled | Assess the prophylactic effect of oral magnesium in migraine Primary measure: Reduction in attack frequency compared to baseline | 81 patients who suffered from migraine with or without aura were recruited (68 completed the study per protocol) Treatment group: N = 43 Control group: N = 38 Ages: 18–65 years | Four-week baseline period followed by a three-month intervention period during which patients received either a 600 mg magnesium supplement (trimagnesium dicitrate) once per day or placebo | Results demonstrated an average decrease in frequency of attacks from baseline to weeks 9–12 of 41.6% in the magnesium intervention group Eight subjects in the intervention group reported diarrhea or soft stool |
Pfaffenrath et al.,26 1996 Study design: Prospective, multicenter, double-blind, randomized, placebo-controlled | Assess the prophylactic effect of oral magnesium in migraine Primary measure: Reduction of at least 50% in duration of migraine hours or in the intensity of migraine | 69 patients who suffered from migraine without aura Treatment group: N = 35 Control group: N = 34 Ages 18–60 years | Three-month intervention period. Magnesium-L-aspar tate-hydrochloride-trihydrate was provided twice per day for a total of 243 mg/day. | A 50% reduction of migraine duration from baseline was demonstrated in 20% of the magnesium group and 23.5% of the placebo group 10 patients in the magnesium group (28.6%) reported adverse gastrointestinal events with treatment |
Köseoglu et al.,24 2008 Study design: Double-blind, randomized, placebo-controlled | Assess the prophylactic effect of oral magnesium in migraine Primary measure: Reduction in attack frequency and intensity of migraine | 40 patients with migraine without aura Treatment group: N = 30 Control group: N = 10 Ages 20–55 | Three-month intervention period. Magnesium citrate was provided twice per day for a total of 600 mg per day. | Attack frequency in the magnesium treated group decreased from 3.0 to 2.0 migraine attacks per month. In the placebo groups attacks decreased from 3.5 to 3.0 attacks per month. |
Discussion
Food | Serving size | Magnesium contenta |
---|---|---|
Almonds | 1 ounce (23 whole kernels) | 77 mg |
Mixed nuts (without peanuts) | 1 ounce | 71 mg |
Pumpkin seeds (roasted) | 1 ounce | 156 mg |
Black beans, cooked | 0.5 cup | 60 mg |
Lentils | 0.5 cup | 36 mg |
Whole-grain wheat flour | 100 g | 137 mg |
Oats | 100 g | 177 mg |
Brown rice | 1 cup (cooked) | 86 mg |
Whole wheat spaghetti | 1 cup (cooked) | 42 mg |
Spinach, raw | 1 cup | 24 mg |
Baked potato (Russet) | 1 large potato | 90 mg |
Butternut squash | 1 cup (cubed, cooked) | 59 mg |
Dark chocolate | 1 ounce | 41 mg |
Non-fat milk | 8 ounce | 37 mg |
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