Migraine headaches are generally severe and typically affect one side of the head, and may be preceded by neurological symptoms including visual disturbance. In some people, they can be common and extremely debilitating. The good news is that certain naturally-oriented strategies can be very effective in reducing the frequency and/or severity of attacks.
One of my standard approaches here will be to consider whether there are any food triggers. The classical triggers I learned at medical school include cheese, chocolate, coffee and red wine. Actually, in practice I find perhaps the most common food trigger of migraines and headaches in general is wheat. Actually, I had a conversation today with someone with coeliac disease (gluten sensitivity) whose predominant symptom (on eating gluten) is headache.
One other natural strategy I use in practice is magnesium. Studies show that, generally speaking, magnesium deficiency is more common in migraine sufferers than non-sufferers. There’s also several ways in which magnesium deficiency may predispose to attacks. For example, magnesium deficiency can make constriction in blood vessels more like (magnesium normalises the function of the ‘smooth’ muscle that lines blood vessels). It is thought that constriction and then dilation of blood vessels around the brain can be at the root of some migraine headaches. By reducing the risk of changes in the blood vessels, magnesium might help with migraines too.
Recently, the Journal of Neural Transmission (to be honest, I’m not a regular reader) published a piece from a couple of doctors with a special interest in headache who make a case for magnesium therapy for all individuals with migraine . They point to the links between magnesium deficiency and migraine, and list a number of risk factors for deficiency which include poor intake and/or poor absorption, excessive excretion by the kidneys and stress (increasing depletion). They also point to a mixed bag of evidence in which magnesium has been given to migraine sufferers.
If the evidence is mixed, why give it to everyone? The authors reasons that one reason for why some studies are positive and some less so may have something to do with the fact that in some studies, magnesium was given to people who were not magnesium deficient and were therefore unlikely to benefit from it. Then why not test? As the authors point out, conventional testing for magnesium in the blood is not particularly accurate. Only a very small amount of magnesium in the body is found in the serum (watery component of the blood). Most is found in the bone and within cells. For this reason, serum levels are not a very good guide to overall magnesium status in the body.
This leads the authors to conclude that a reasonable approach is to treat all migraine sufferers with magnesium, particularly seeing that this mineral is cheap, safe and readily available. It’s an approach that I, largely, endorse. I do think, though, that such an approach is best taken with the support of a health professional.
As to what to take, I tend to use magnesium citrate in practice, and usually aim for a dose of about 300-400 mg of magnesium each day (this equates to about 1750-2350 mg of magnesium citrate each day).
1. Maukop A, et al. Why all migraine patients should be treated with magnesium. J Neural Transm 2012 May;119(5):575-9