Magnesium is the supplement I recommend most in my clinical practice for migraine prevention — and the one with the strongest evidence. Research shows that a significant proportion of migraine patients have magnesium deficiency, and supplementation can substantially reduce attack frequency.
1. Clinical Evidence
Peikert et al. (1996, Headache) — RCT for migraine prevention. Magnesium citrate 600 mg/day for 12 weeks reduced attack frequency by 41.6%, compared to only 15.8% in the placebo group.
Two meta-analyses (2024–2025) reconfirmed: magnesium supplementation reduces attack frequency by 30–40% in magnesium-deficient migraine patients.
American Headache Society (AHS): Now classified as Grade A evidence.
2. Mechanism of Action
Magnesium regulates neuronal excitability and NMDA receptor activity. When magnesium is deficient, cortical spreading depression (CSD) — the neurophysiological basis of migraine aura — is more easily triggered. Supplementation stabilizes neuronal membrane potential and raises the attack threshold.
3. Recommended Dosage and How to Take It
Dose: 400–600 mg/day (elemental magnesium)
Preferred form: Magnesium glycinate or magnesium citrate (best absorption, fewer GI side effects)
Avoid magnesium oxide — very low bioavailability (only ~4%)
Timing: After dinner or at bedtime (also supports sleep quality)
Duration: At least 12 weeks
⚠️ The most common side effect is diarrhea. If this occurs, reduce to 200 mg/day and increase gradually, or switch to magnesium glycinate.
4. Which Patients Benefit Most
• Menstrual migraine patients — especially effective when started before menstruation
• Patients with neck and shoulder muscle tension
• Patients with stress or sleep disorders
• Migraine patients during pregnancy (good safety profile, but consult your doctor)
5. Combining with Other Supplements
Magnesium can be combined with Riboflavin B2 (400 mg/day) and Coenzyme Q10 (300 mg/day) to form the “Migraine Nutrition Triple Protocol.” The three act through different mechanisms and work synergistically — an important complementary strategy alongside medication.