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Which Magnesium Supplements Work?

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We’ve had a lot of discussion here about magnesium for migraine.  One of the most popular versions of magnesium for migraine is magnesium citrate.  But some ask, what if magnesium citrate isn’t working?  Or is there a better magnesium citrate supplement for headache?  What about the dosage of magnesium for migraine?

Instead of bringing a lot of new information today, I went over some of the practical suggestions that we’ve discussed here before.

Which Magnesium should I take for migraine?

Here are some of the key suggestions:

  • Do NOT take a magnesium supplement that contains calcium.  Read the label.  If you take calcium supplements, take them at another time of day.
  • Usually, the "ate" forms, such as citrate or glycinate are better absorbed.  Although some have recommended magnesium oxide, most people are still going for the "ate" forms.
  • If magnesium tablets aren’t working well for you, try capsules or liquid/water soluble magnesium.
  • If you’re getting diarrhea, your magnesium probably isn’t absorbing well.  Try another type.

Now, what specific brands or types of magnesium have been recommended here?  Here are the most common:

I notice that it can be confusing how much you get in a bottle.  Watch for how many capsules, for example, you need to get a serving.

Here are a few specific comments from you our visitors:

Liz says: I had only been told by my neurologist to take Magnesium during menstruation.  Also i take a more rare, and highly unavailable kind-magnesium glycinate.  It didn’t seem to make much of a difference, but after doing more research I’ve up’d my dose to 400mg/day and will likely double that will menstruating.  It has already begun to make a difference!

Judith:  Recently (summer 2010) you published a testimonial by a reader who indicated that she had had impressive results by using Solaray brand Magnesium Asporotate.  I switched to Magnesium Asporotate in August 2010.  In September the frequency of my migraines began to drop off. … I credit the magnesium asporotate with my 8 week freedom from migraines.  This is huge!

Angie:  I am still on Magnesium, James.  I still have severe attacks but also mild ones and less vomitting.  I am able to walk my dog even while having an attack…I also found this Mg citrate in liquid form [Flora Floradix Magnesium Liquid Mineral Supplement].  It is what I am taking now.

Aurora:  It didn’t stop me from having my attacks, but I am a bit "useful" now than before and the nauseous feeling is lesser so I vomit lesser, too.  I found this Magnesium in syrup form—Floradix Magnesium!  Tastes like tropical fruits with honey so I don’t have to take those large chewable tables.

Evie:  I’ve been taking the Solaray brand of magnesium citrate from Whole Foods because it comes in a capsule which is more easily absorbed than a tablet. … I really noticed a difference and though I’d still get migraines, they were less often and much, much more bearable.

Now, there are some combinations, magnesium + something else, but we’ll talk about those tomorrow.  Let’s talk about dosages next.

How much magnesium supplement should I take?

With the disclaimer that you should always talk to your doctor about the dosage that’s right for you, here are some suggestions and comments from our visitors.

First, let me tell you what my research has turned up.  Generally, around 400mg per day seems to be a good place to start for migraine.  But many are now suggesting larger doses, like 800mg-1200mg.  So you’re probably looking at 400-1200mg of magnesium daily, usually in more than one dose (ie 400mg 3x per day).  Your doctor will probably recommend starting with a lower dosage and raising it slowly.

Now let’s see some of the experiences of our visitors.

Stephen says:  My neurologist told me that the key to dosing magnesium is to increase until it causes diarrhea and then back off until it doesn’t.   I am up to 1250 mg and climbing but it is magnesium oxide so I don’t really know how much I am absorbing.

Shari writes:  700 mg of Magnesium was recommended to me by my neurologist.

Rachael:  [My doctor] recommended I take 500 mg of magnesium every day.  I started this two weeks ago and I have had two minor headaches that I didn’t have to take any medication for and I have not had a migraine since starting the magnesium.

Also we have Liz’ comment above, saying that she wanted to try 400mg and double that during menstruation.  We do know that magnesium levels change in women depending on your time of the month.  See more about Menstrual Migraine here.

So if you haven’t taken magnesium, give it a try!  If your magnesium citrate isn’t working, try a different type of magnesium, or a liquid supplement.

There should be a lot of ideas here to get started.  But there’s more – a lot of people are trying combinations, and that’s what we’ll talk about tomorrow.

Meanwhile, what are your suggestions?  Is there some form of magnesium you’ve found especially helpful?

From Current Studies: What Migraine Treatments Work?

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New guidelines have just come out based on the evidence we currently have for migraine treatment.  We’ll talk about some of the guidelines in a moment, but first there are some key things to remember.

Caution: Dangerous Waters Ahead!

These guidelines were created by checking out the studies that have been published to date.  This means that we do or do not have high quality studies that show successful treatment using [whatever medication or supplement].  If we don’t have enough quality studies, the item will be lower on the list.

We should also note that the guidelines are talking about what works in general, NOT what works for you or what is best for you.  Some treatments high on the list are also high in side effects.  Or they may be dangerous for certain people.  Or they may not work well for your particular type of migraine.  Do not take this as a list of what to try first.  Something lower on the list may be something far better for you that something on the top.

This list also doesn’t address combo-treatments, such as MigreLief (with magnesium, feverfew and riboflavin).

The list does help doctors prioritize what to consider.  If you’ve tried a number of things and haven’t tried something high on the list, it may be time to ask your doctor about it.

Highest rated treatments

Here are some of the highest rated treatments for migraine.  There are four categories:

Lowest rated treatments

These are the items that had a negative rating, meaning that they’re not recommended at this time:  Lamotrigine, Clomipramine, Acebutolol, Clonazepam, Nabumetone, Oxcarbazepine, Telmisartan, montelukast.

Everything in-between

Of course, just because something isn’t on the top of the list doesn’t mean it’s not an excellent, helpful treatment for many people.  For example, very close to the top were well-recognized treatments such as amitriptyline, zolmitriptan, feverfew, naproxen sodium, riboflavin (vitamin B2), and magnesium.

It should also be noted that Botox migraine treatment was not a part of these studies.

For some of the medications that are being used today, check out Migraine Medications: So many choices.

To read more details about the new studies with all the little details, visit Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults and Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults.

Botox and Magnesium for Cluster Headache?

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Yesterday Dr. Alexander Mauskop reported on a man who has been taking Botox and magnesium for cluster headaches for three years.  He’s found it very helpful, although the treatment is not alone.  Here’s what he’s taking:

  • verapamil
  • intravenous magnesium (every 3 weeks to one month)
  • Botox injections (every 2-4 months, usually between 2-3)
  • To take for an attack, he usually uses rizatriptan (Maxalt) tablets or zolmitriptan (Zomig) nasal spray.  If he needs more he takes sumatriptan (Imitrex) injections

Dr. Mauskop says he has found that about 40% of cluster patients are magnesium deficient, and respond to the magnesium injections.  The Botox also seems to be helpful, but there are few long term cases.  The interesting thing about this case is that the man has taken Botox over the course of 3 years.

All of these medications are also used for migraine, though verapamil is one of the less common ones.

For more, read Dr. Mauskop’s post:  Botox for chronic cluster headaches

Watch for it – Ketamine for Migraine and More

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Using ketamine for pain is not a new idea.  But I think we’re going to see it get an increasing amount of attention in the months ahead.

A few weeks ago, NPR featured a news story on the use of ketamine for depression.  Ketamine, originally developed as a human anaesthetic, has since been used for various applications in medicine.

Ketamine for depression, migraine, and more?

 It’s also used as an illegal drug, gaining fame as "K", "Vitamin K" or "Special K".

In recent years there has been sporadic interest in using ketamine for pain.  It’s a difficult drug to study, because it tends to be rather obvious that you’ve taken it.

But it has been suggested as a treatment for cluster headache, familial hemiplegic migraine, chronic daily headache, and migraine, as well as other types of pain.

Ketamine is a neurological drug, classed as a NMDA (N-methyl-D-aspartate) receptor antagonist.  It is believed to work in a number of different ways in the brain – relating to calcium channels, serotonin, and glutamate – terms that will be familiar with migraine researchers in particular.  In fact, ketamine has been especially useful in the treatment of headache or migraine that just won’t go away and isn’t responding to other kinds of treatment (refractory).  It’s given as an IV or intranasal treatment.  Of course, this means it’s way down on the list of treatments that will be given – it’s rare and even when it’s tried it’s often not successful.

However, with the growing interest in ketamine for depression, the game changes.  You can bet that there will be increased interest in ketamine for chronic pain conditions, which often come hand in hand with depression.

Although increased interest doesn’t mean this should be the drug of choice for most people, it does mean that more research will be done.  It may be a treatment that will help a few patients whose pain is seemingly unstoppable.

For more on the background of ketamine, read Ketamine and MDARs in the treatment of neuropathic pain from Dr. Jan M. Keppel Hesselink.  For a review of the studies on ketamine for other types of pain aside from headache, read Ketamine in Chronic Pain Management: An Evidence-Based Review

Spinal Cord Stimulation (video)

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It’s being used for migraine and other types of chronic pain when other treatments haven’t worked.  Here’s an interview with one patient about his experiences with the treatment.  In his case, the pain was back pain.


Have you tried spinal cord stimulation for migraine?  What was your experience?

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