Must read! A very important new study of magnesium.
A study just published in Neurology by the MEGASTROKE project of the International Stroke Genetics Consortium found that “genetically higher serum magnesium concentrations are associated with a reduced risk of cardioembolic stroke…” It is an open access article, so you can download the full text. The study looked at 34,217 cases of strokes and 404,630 noncases, which makes the data highly reliable.
Here are some quotes (some modified) from the paper.
Several observational prospective studies have reported that low circulating magnesium concentrations and low magnesium intake are associated with increased risk of stroke. In the Nurses’ Health Study, low plasma magnesium concentrations were associated with an approximately 70% to 80% increased risk of embolic and thrombotic stroke.
Magnesium may in part reduce the risk of cardioembolic stroke through its antiarrhythmic effects and via atrial fibrillation. Low serum magnesium concentrations are associated with increased risk of atrial fibrillation, which is a strong risk factor for cardioembolic stroke. (My recent post mentioned that the increased risk of strokes in patients with migraines with aura is possibly related to the higher incidence of atrial fibrillation) Two of the magnesium-associated SNPs (genetic variants) were significantly associated with atrial fibrillation, with higher serum magnesium concentrations being associated with lower risk of atrial fibrillation.
Magnesium also has anticoagulant and antiplatelet properties (platelet aggregation is also implicated in migraine). Magnesium is considered to be nature’s calcium blocker as it suppresses many of the physiologic actions of calcium. For example, calcium promotes blood coagulation, whereas magnesium suppresses blood clotting and thrombus formation and reduces platelet aggregation. Antithrombotic effects may lead to reduction in risk of both cardioembolic and large artery stroke.
Other possible mechanisms whereby high serum magnesium concentrations may reduce ischemic stroke risk include improvement of endothelial function and reduction in blood pressure, atherosclerotic calcification, arterial stiffness, oxidative stress, fasting glucose concentration, insulin resistance, and risk of type 2 diabetes. Some of those beneficial e?ects may also lead to a reduction in small vessel stroke, which was not observed in this study.
Magnesium also reduces the size of a hemorrhagic stroke (bleeding into the brain), according a another recent study.
Magnesium has been my main area of research and because I never tire of promoting the role of magnesium in the treatment of migraines some colleagues call me Dr. Magnesium. The evidence is overwhelming – many studies have shown that magnesium deficiency is common in migraine sufferers and that taking magnesium can help. The American Academy of Neurology and the American Headache Society guidelines for the treatment of migraines include magnesium, but it is still underappreciated and underutilized. This is in part because there have been no large-scale (i.e. expensive) trials of magnesium which are done by pharmaceutical companies for new drugs. Another reason is that the trials that have been conducted supplemented migraine patient regardless of their magnesium status – both deficient and non-deficient patients were given magnesium, thus obscuring the great benefit obtained by the deficient cohort.
As mentioned in several previous posts, magnesium also helps asthma, palpitations, feeling cold or having cold hands and feet, muscle twitching, cramps or diffuse muscle aches (fibromyalgia), premenstrual symptoms (PMS), brain fog, and many other symptoms. If you have any of these symptoms you may want to have a blood test for magnesium. And even if you don’t have symptoms, the next time you have any kind of a routine blood test, ask your doctor to add a test for “RBC magnesium”, which is more accurate than the usual “serum magnesium”.
If you have any of the above symptoms, you can also just start taking 400 mg of magnesium glycinate, which is the daily recommended allowance for magnesium. If oral magnesium does not help and the RBC magnesium level is low we usually give monthly infusions of magnesium. They take 10 minutes to do, have no side effects and are covered by most insurance plans.
Magnesium citrate can be effective but it is more likely to cause upset stomach and diarrhea. Time of day does not matter but many people find that taking it at night helps them sleep better. It is best to take it with food. Powder is OK, but it is usually magnesium citrate and gummies don’t have enough magnesium and have too much sugar.
Hi Dr. Mauskop,
Is magnesium citrate effective? Also, does it matter what time of day you take magnesium and should you take it with food? Lastly, a lot of magnesium tablets are large and difficult to swallow. Do gummies or powder work the same way?
Thank you,
Lisa
Yes, intravenous magnesium could help but another option is to ask his doctor about increasing the dose of magnesium to twice a day (with food).
My son 12 yo has had 18month of headache and dizziness. He has also had aura like symptoms (brief loss vision, trouble walking) as well as more recently Tourette like ticks. We think we had some success with Periactin 12mL per day to reduce the headache somewhat. We gave him 500mg of Mg and (knock on wood)saw the Tourette ticks subside dramatically. He has had blood work that showed low CoQ10, low b vitamin levels so we supplemented that for a few months but nothing has broken the 18 months of constant headache. He also tried three Botox sessions with no relief. We wonder if a Mg infusion would bring relief (tho not sure where in SoCal would do a Mg IV).
Yes, you cannot compare milligrams – only 8% of 2,000 mg of threonate is actual magnesium, while 14% of milligrams of glycinate is pure (elemental) magnesium. This is compounded by different absorption rates of different magnesium preparations. Magnesium oxide has the highest amount of elemental magnesium – 60%, however some people absorb more from magnesium glycinate. Bottom line, it is best to have your RBC magnesium checked and if you are low or in the bottom third of normal range, try taking a supplement. If you feel better, great, but if not, recheck the level. If the level remains low, try a different supplement or get an IV infusion. About 20% of migraine sufferers do not absorb oral supplement and visit our clinic monthly for a quick, 5-minute infusion.
Dr. A. M. On Amazon they sell a Mg. L Threonate capsules high absorption supplement 2000 mg. Why are so many kinds Mg sold, is it simply marketing , or are needs so varied? Your site suggests a 400 mg Mg. Supplement so would this 2000 mg. Be excessive amount or is this all an apples and oranges issue? Also, if we tried to offer a local support group is it likely to be less people and less expertise rich than say one of the multiple Facebook sites available to those who suffer with migraines? Your site is a wonderful support to all those who find and can benefit from the content and even replies to unique questions. Tx. Jim
Thank you, that’s great. I switched to magnesium glyconate after your previous email about magnesium and I am not sure if it’s coincidental, but I have had a couple of good weeks with less migraines. I really appreciate all the info.