One of the women I work with has migraines and has tryed almost every prescribed medication there is without much success. Someone suggested magnesium to her and after looking on the net it looks quite postive. I am just wondering if anyone on here has used it and whether it was successful?
- Thread starter Jackie
- Start date
A review of available (credible) literature suggests the use of magnesium supplements may benefit some people in reducing migraine frequency, but the use of magnesium supplements is not without risk.
The Mayo Clinic:
Magnesium acts peripherally to produce vasodilation. With low doses only flushing and sweating occur, but larger doses cause lowering of blood pressure, in addition can lead to the risk of renal failure, a drop in potassium and / or calcium levels.
While perhaps 90% of headaches are tension headaches, that can be treated with over the counter pain releivers or even correctly prescribed muscle relaxants, most of these are innefective in the long term in treating a true migraine.
Blood vessels increase and decrease in diameter as part of their normal physiology (vasoconstriction and vasodilation). This is the normal way that blood vessels control blood flow. However, when they start to dilate or constrict for no good reason, they could be involved in causing migraine symptoms.
Changes in blood vessels were once believed to be a main cause of migraine (15-20 years ago). However, now researchers believe the problem has more to do with other chemical messages in the brain.
Migraine is not just a bad headache. In fact, some people get migraine without any headache at all! The exact cause of migraine is still not fully understood. The research to date seems to indicate that migraine is a neurological disorder based on an inherited genetic abnormality.
A cause of migraine symptoms is usually called a "trigger". A trigger, which in some people mght be red wine, nuts, chocolate, caffeine even changes in the weather, is what starts the chain reaction, usually leading to migraine headaches. If you are familiar with migraine, you may have heard about various things that happen to the body - serotonin levels, changes in blood vessels - a variety of things happen that cause those terrible symptoms, such as nausea and headache.
The most effective treatment for migraine today appears to be correctly prescribed,migraine specific medications, called triptans, that act on the neurotransmitters thought to be responsible for migraine. These medications actually abort a migraine episode within hours when used correctly.
Recently researchers who treat migraine have found that the addition of a non steroidal anti inflammatory NSAID, specifically Naprosyn (naproxen) to the triptan improves relief from migraine by targeting the neurotransmitters anlong with relieving the inflammation within the blod vessels thought to be causing the pain.
Has your friend been diagnosed by a neurologist with a clinical interest in migraine who has ruled out other causes to this lady's headache patterns? If the triptans do nt provide relief, or if the episodes are too numerous to safely treat with triptans, she may be a candidate for prophylactic (preventative) treatments specifically for migraine.
Having followed the literature connected with migraines for the last two decades, I would propose that your friend seek out a competent migraine specialist, or a clinic specializing in pain for a consulatation before resorting to alternative treatments that have limited scientific support and can sometimes be dangerous when used incorrectly.
The Mayo Clinic:
Magnesium acts peripherally to produce vasodilation. With low doses only flushing and sweating occur, but larger doses cause lowering of blood pressure, in addition can lead to the risk of renal failure, a drop in potassium and / or calcium levels.
While perhaps 90% of headaches are tension headaches, that can be treated with over the counter pain releivers or even correctly prescribed muscle relaxants, most of these are innefective in the long term in treating a true migraine.
Blood vessels increase and decrease in diameter as part of their normal physiology (vasoconstriction and vasodilation). This is the normal way that blood vessels control blood flow. However, when they start to dilate or constrict for no good reason, they could be involved in causing migraine symptoms.
Changes in blood vessels were once believed to be a main cause of migraine (15-20 years ago). However, now researchers believe the problem has more to do with other chemical messages in the brain.
Migraine is not just a bad headache. In fact, some people get migraine without any headache at all! The exact cause of migraine is still not fully understood. The research to date seems to indicate that migraine is a neurological disorder based on an inherited genetic abnormality.
A cause of migraine symptoms is usually called a "trigger". A trigger, which in some people mght be red wine, nuts, chocolate, caffeine even changes in the weather, is what starts the chain reaction, usually leading to migraine headaches. If you are familiar with migraine, you may have heard about various things that happen to the body - serotonin levels, changes in blood vessels - a variety of things happen that cause those terrible symptoms, such as nausea and headache.
The most effective treatment for migraine today appears to be correctly prescribed,migraine specific medications, called triptans, that act on the neurotransmitters thought to be responsible for migraine. These medications actually abort a migraine episode within hours when used correctly.
Recently researchers who treat migraine have found that the addition of a non steroidal anti inflammatory NSAID, specifically Naprosyn (naproxen) to the triptan improves relief from migraine by targeting the neurotransmitters anlong with relieving the inflammation within the blod vessels thought to be causing the pain.
Has your friend been diagnosed by a neurologist with a clinical interest in migraine who has ruled out other causes to this lady's headache patterns? If the triptans do nt provide relief, or if the episodes are too numerous to safely treat with triptans, she may be a candidate for prophylactic (preventative) treatments specifically for migraine.
Having followed the literature connected with migraines for the last two decades, I would propose that your friend seek out a competent migraine specialist, or a clinic specializing in pain for a consulatation before resorting to alternative treatments that have limited scientific support and can sometimes be dangerous when used incorrectly.
Thanks Steve. She is on a waiting list to see specialist and have some investigative procedures, such as scans, but waiting time is long on the NHS. I know she has had many medications from her GP and nothing works, and she is getting desperate trying to find something that might help until her appointment comes through.
The doctors would likely order head scans in order to rule out other more serious conditions. Then after interviewing her and asking specific questions to determine the exact type of headache she experiences, along with the frequency of the events, they will likely make some recommendations for a treatment plan.
Encourage your friend to do some advance research into modern migraine treatment. Psychlinks has a wealth of information about current treatment options, as several of our members, myself included, have a personal interest in migraine.
Unfortunately some doctors continue to treatmigraine "the old fashioned way" ignoring migraine specific medications that actually abort the migraine rather than mask the pain. Over the counter pain relievers (analgesics) may be effective for a very short time in providing relief, but eventually result in a condition callled rebound headaches, where the absence of the aspirin, ibuprophen or acetomenophen causes a headache.
If her diagnosis is indeed migraine, suggest she ask her doctor if a triptan type medication is right for her.
Encourage your friend to do some advance research into modern migraine treatment. Psychlinks has a wealth of information about current treatment options, as several of our members, myself included, have a personal interest in migraine.
Unfortunately some doctors continue to treatmigraine "the old fashioned way" ignoring migraine specific medications that actually abort the migraine rather than mask the pain. Over the counter pain relievers (analgesics) may be effective for a very short time in providing relief, but eventually result in a condition callled rebound headaches, where the absence of the aspirin, ibuprophen or acetomenophen causes a headache.
If her diagnosis is indeed migraine, suggest she ask her doctor if a triptan type medication is right for her.
David Baxter PhD
Late Founder
Magnesium for Migraine
by Steven Novella, MD
Mar 10, 2010
I received the following question from an SGU listener:
However, the current state of loose regulation did result in an explosion of the supplement industry, with a multiplication of dubious claims. This had the additional consequence of drowning out legitimate nutritional advice with all the nonsense, in a ?boy who cried wolf? phenomenon. Now the skeptical consumer is and should be wary of any and all supplement claims.
Magnesium for migraine is a plausible hypothesis. Magnesium can affect both regulation of blood flow and neuronal function ? both of which are physiological factors important in migraine. There is evidence that magnesium deficiency is common, and is more common in migraine patients than non-migraine sufferers.
But the basic science is complex, and there is evidence that low magnesium in brain tissue may be a side effect, and not a cause, of the physiological mechanisms of migraine. So the bottom line is that magnesium as a treatment for migraine is plausible, but there are still unknowns.
The clinical evidence needs to be divided into specific clinical claims: magnesium as a treatment for children vs adults, migraine with aura vs migraine without aura, acute treatment of migraine attacks vs migraine prophylaxis, and treatment of menstrual migraines.
Here is my quick summary of the evidence: There is preliminary evidence only in children, and more research is needed. Treatment of acute attacks with IV magnesium sulfate has mixed evidence, but more positive than negative. One study showed, however, that it can decrease the effectiveness of medication for nausea, often given to treat the nausea of severe migraines.
There is more evidence for migraine with aura than without, but probably not enough to make a critical difference. The best evidence is for menstrual migraines.
Overall the evidence for prophylaxis shows a small but significant effect. Evidence is still preliminary, and large definitive trials are needed to fully settle the question.The effect seems to be smaller than for other nutritional interventions for migraine, specifically vitamin B2 and Coenyzme Q10, and all the supplements are less effective than the best prescription medications.
As a neurologist who treats migraine frequently, I also have experience using magnesium. This is how I put it all together: Most of my patients have not noticed a significant improvement with magnesium. While it is safe, in the doses used for migraines (400-600mg per day) diarrhea can be a significant side effect, and many of my patients stopped using it or had to decrease the dose for that reason.
While the evidence is preliminary, it tends to be positive and so magnesium is a plausible and generally benign treatment option (if you don?t get diarrhea). It may have a role more as adjunctive treatment (in addition to other treatment) rather than stand-alone treatment because the effect is modest.
Typically I will check the magnesium level in patients with migraine and supplement magnesium if it is low. These patients may represent a subset that responds to magnesium, and in any case they are low in magnesium and probably should be supplemented anyway.
Overall magnesium has a minor role to play in the management of migraine. We could benefit from larger studies to more definitively clarify its role in the various clinical situations I outlined above, primarily because it is inexpensive and relatively benign.
I do not think that the evidence supports using magnesium as a primary treatment for migraine before other more effective treatments. However, some patients may wish to give it a try in the hopes of avoiding medication, and that is reasonable.
The use of magnesium in migraine is a good example of how a science-based practitioner might incorporate benign and plausible treatments but with only preliminary evidence into their practice.
Dr. Novella is an academic clinical neurologist at Yale University School of Medicine. He is the president and co-founder of the New England Skeptical Society. He is the host and producer of the popular weekly science podcast, The Skeptics? Guide to the Universe.
by Steven Novella, MD
Mar 10, 2010
I received the following question from an SGU listener:
Recently when I visited a neurologists with my daughter to seek help for her migraines the doctor prescribed something that caught me off guard and in my research since the visit I still have not convinced myself of the validity. The doctor told my daughter she should start taking magnesium supplements. The doctor told her this would serve as a natural muscle relaxant.
I have been listening to your podcast for about 6 months now and enjoy it very much. I enjoy the entire crew and would really like your team?s take on the Migraine and Magnesium relation.
This is an excellent question, and reinforces the notion that science-based medicine is not about a list of acceptable beliefs or modalities ? it is about method. There is nothing inherently implausible or unscientific about using vitamins, minerals, or other nutrients to address diseases or symptoms. All that matters is the science.I have been listening to your podcast for about 6 months now and enjoy it very much. I enjoy the entire crew and would really like your team?s take on the Migraine and Magnesium relation.
However, the current state of loose regulation did result in an explosion of the supplement industry, with a multiplication of dubious claims. This had the additional consequence of drowning out legitimate nutritional advice with all the nonsense, in a ?boy who cried wolf? phenomenon. Now the skeptical consumer is and should be wary of any and all supplement claims.
Magnesium for migraine is a plausible hypothesis. Magnesium can affect both regulation of blood flow and neuronal function ? both of which are physiological factors important in migraine. There is evidence that magnesium deficiency is common, and is more common in migraine patients than non-migraine sufferers.
But the basic science is complex, and there is evidence that low magnesium in brain tissue may be a side effect, and not a cause, of the physiological mechanisms of migraine. So the bottom line is that magnesium as a treatment for migraine is plausible, but there are still unknowns.
The clinical evidence needs to be divided into specific clinical claims: magnesium as a treatment for children vs adults, migraine with aura vs migraine without aura, acute treatment of migraine attacks vs migraine prophylaxis, and treatment of menstrual migraines.
Here is my quick summary of the evidence: There is preliminary evidence only in children, and more research is needed. Treatment of acute attacks with IV magnesium sulfate has mixed evidence, but more positive than negative. One study showed, however, that it can decrease the effectiveness of medication for nausea, often given to treat the nausea of severe migraines.
There is more evidence for migraine with aura than without, but probably not enough to make a critical difference. The best evidence is for menstrual migraines.
Overall the evidence for prophylaxis shows a small but significant effect. Evidence is still preliminary, and large definitive trials are needed to fully settle the question.The effect seems to be smaller than for other nutritional interventions for migraine, specifically vitamin B2 and Coenyzme Q10, and all the supplements are less effective than the best prescription medications.
As a neurologist who treats migraine frequently, I also have experience using magnesium. This is how I put it all together: Most of my patients have not noticed a significant improvement with magnesium. While it is safe, in the doses used for migraines (400-600mg per day) diarrhea can be a significant side effect, and many of my patients stopped using it or had to decrease the dose for that reason.
While the evidence is preliminary, it tends to be positive and so magnesium is a plausible and generally benign treatment option (if you don?t get diarrhea). It may have a role more as adjunctive treatment (in addition to other treatment) rather than stand-alone treatment because the effect is modest.
Typically I will check the magnesium level in patients with migraine and supplement magnesium if it is low. These patients may represent a subset that responds to magnesium, and in any case they are low in magnesium and probably should be supplemented anyway.
Overall magnesium has a minor role to play in the management of migraine. We could benefit from larger studies to more definitively clarify its role in the various clinical situations I outlined above, primarily because it is inexpensive and relatively benign.
I do not think that the evidence supports using magnesium as a primary treatment for migraine before other more effective treatments. However, some patients may wish to give it a try in the hopes of avoiding medication, and that is reasonable.
The use of magnesium in migraine is a good example of how a science-based practitioner might incorporate benign and plausible treatments but with only preliminary evidence into their practice.
Dr. Novella is an academic clinical neurologist at Yale University School of Medicine. He is the president and co-founder of the New England Skeptical Society. He is the host and producer of the popular weekly science podcast, The Skeptics? Guide to the Universe.
While I find this information fascinating and deserving of further research, I would repeat the caution mentioned earlier on this topic:
If magnesium supplements are recommended by one's physician, they should be used in strict compliance with the physician's orders, following a detailed medical history to determine potential cautions or risks. I would not be surprised the doctor would likely order tests to track levels of calcium and potassium to ensure neither of these are being depleted by excessive doses of magnesium.
I would expect that people with renal insufficiency or on dialysis would not be candidates for the magnesium supplementation option.
If magnesium supplements are recommended by one's physician, they should be used in strict compliance with the physician's orders, following a detailed medical history to determine potential cautions or risks. I would not be surprised the doctor would likely order tests to track levels of calcium and potassium to ensure neither of these are being depleted by excessive doses of magnesium.
I would expect that people with renal insufficiency or on dialysis would not be candidates for the magnesium supplementation option.
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