Is Magnesium Important in Headache?

Swenson RJournal of the Neuromusculoskeletal System1996 Fall;4(3): 94-101

Magnesium (Mg2+) is a mineral that has several roles in the body. It functions as an important co-factor for many energy-producing enzymes and also functions as a regulator of calcium flow through the various calcium channels in cell membranes, serving as a type of calcium channel blocker. In addition to the fact that many of the pharmacologic calcium channel blockers have migraine prophylactic capabilities, there are a number of other lines of inquiry that suggest a role for Mg2+, at least in some migraneurs. There is evidence that red blood cells, and cellular elements of the brain contain less Mg2+ than normal in patients who are prone to migraines. This deficit is measurable even in the interictal period (the period between headaches). The precise metabolic reason for this deficit is not yet understood. In addition to this biochemical abnormality, patients with migraine may have more subtle deficits in extracellular Mg2+ or in ionized (biologically active) Mg2+ or in the ratio between ionized calcium and Mg2+ in treating migraine; a relatively few uncontrolled trials have attempted to administer it acutely to abort migraine. The results of these small and uncontrolled reports is mixed. A larger number of studies, including one small randomized controlled trial, have considered the effect of chronic administration of Mg2+ as a method of migraine prophylaxis. These studies have generally been favorable although larger and better designed studies will be necessary to determine if there is a group of migraneurs that would receive particular benefit from Mg2+ supplementation. The role, if any, for Mg2+ in headache syndromes other than migraine remains untested.

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