As someone who gets migraines, any time I stop a magnesium supplement, I am advised to restart anytime I report a migraine (PCP and neurology). I’ve never anecdotally found this makes any difference. I do take real medication (CGRP preventive and abortive along with caffeine) that DO help but not 100%. I’d love to stop wasting my money (only buy 3rd party certified so $). Can you comment on state of the evidence/recommendations for migraine specifically? Thank you.
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Howdy.
Good question here on magnesium supplementation.
The current guidelines (American Headache Society / American Academy of Neurology) gives oral magnesium a Level B recommendation (“probably effective”) for episodic migraine prevention. That rating is based on a small number of RCTs:
The trials it rests on:
- Peikert 1996, 81 patients, magnesium 600 mg, 41.6% reduction in attack frequency vs. 15.8% placebo over 12 weeks
- Pfaffenrath 1996, 69 patients, magnesium 486 mg, no significant benefit (negative trial)
- Köseoglu 2008, 40 patients, magnesium 600 mg, reduced attack frequency and severity
So you have one positive, one negative, one small positive. That’s the entire evidence base for the Level B rating. The trials are old, small, and not consistently replicated. No large modern RCT has been done.
That said, the recommendation persists because mag is generally cheap, low risk, and there’s a thought that those with low magnesium status (which is somewhat common) may benefit.
I can’t provide medical advice, but you are on one of the most effective preventive meds available. I’m not confident mag has an additional benefit, but to the extent it does, it needs to be taken consistently (for like 2-3 months) for it to appear.
I would recommend talking to your neurologist about this, perhaps saying something like: “I’ve tried magnesium consistently, stopped it on multiple occasions, and don’t notice a difference in migraine frequency or severity. I’d like to discontinue. Is there a clinical reason to continue specifically that I’m missing?”
Just my 0.02
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Thank you! Helpful to know the rationale for the recommendation.
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