Dr. Ahmed
IV magnesium for migraines allows for faster and more efficient delivery of magnesium to the body, which can help to quickly alleviate migraine symptoms. However, this type of treatment is often reserved for more severe types of migraine.
Migraine headache is one of the most common nuisances. It affects about 10% of the world’s population.
People with migraines may have an aura before the actual headache starts. An “Aura” is a sensation that a person feels, like a sixth sense that the headache is about to start. It may be an abnormal smell, flashing lights, or anxiety.
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Symptoms of Migraine
Migraines are characterized by the following symptoms:
- Throbbing or pulsating pain, usually on one side of the head
- Sensitivity to light, sound, and sometimes smell and touch
- Nausea and vomiting
- Blurred vision or visual disturbances, such as flashing lights or zigzag lines
- Lightheadedness or fainting
- Fatigue or dizziness
- Difficulty speaking or finding words
- Tenderness in the scalp, neck, and shoulder muscles
Migraines affect a person’s quality of life and daily life activities. The condition is manageable with medications, physical therapies like yoga and acupuncture, novel neurostimulation devices like Cefaly, and supplements, especially magnesium.
The response to each intervention is different for every individual. Some people may not respond to any medicine or medical intervention, others may best respond to supplements like magnesium and co-enzyme Q.
Here we discuss the role of Intravenous Magnesium in the treatment of migraines. In addition, we will compare Intravenous magnesium with oral magnesium for the treatment of migraines.
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What is Magnesium?
Magnesium is an essential mineral that is involved in a wide range of bodily functions, including muscle and nerve function, blood pressure regulation, and the production of energy.
It is also involved in the regulation of the neurotransmitters that are implicated in migraines, including serotonin and dopamine.
Magnesium can be obtained through diet, with sources including nuts, seeds, whole grains, and leafy green vegetables.
How Does IV Magnesium Help with Migraines?
The precise mechanism by which IV magnesium helps to alleviate migraines is not yet fully understood.
However, it is thought to be related to magnesium’s ability to block the NMDA receptor, which is primarily involved in pain perception and the development of migraines.
Magnesium also has a relaxing effect on blood vessels, which can help to reduce the intensity of headaches.
Additionally, magnesium is involved in the regulation of serotonin levels in the brain, which is an important neurotransmitter that is involved in the development of migraines.
Low levels of magnesium have been associated with reduced serotonin activity, which may contribute to the development of migraines.
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What Are the Benefits of IV Magnesium for Migraines?
IV magnesium is associated with several benefits for individuals with migraines.
Firstly, it is a relatively safe treatment, with few serious side effects reported.
Additionally, it can be administered quickly and easily in a clinical setting, making it a convenient treatment option.
IV magnesium is also effective at reducing the severity and frequency of migraines. Several studies have shown that IV magnesium can significantly reduce the number of migraine attacks experienced by individuals with chronic migraines.
It may also help to reduce the intensity and duration of migraines, making them more manageable for individuals who experience them.
Furthermore, IV magnesium may be beneficial for individuals who do not respond well to other migraine treatments.
It can be used as a standalone treatment or in combination with other medications, making it a versatile treatment option.
In one study, IV magnesium in a dose of 1 gm alleviated the symptoms of pain in about 86% of the patients, and improvement in the symptoms was noted in the rest of the patients. It was well-tolerated and safe for treating acute migraine attacks [Ref].
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What Are the Risks of IV Magnesium for Migraines?
IV magnesium is generally safe when administered by a healthcare professional. However, treatment with IV magnesium can result in serious side effects too.
The most common side effect of IV magnesium is a sensation of warmth or flushing in the face and neck. This is typically mild and short-lived, but in rare cases, it can be more severe and lead to nausea, dizziness, or low blood pressure.
In very rare cases, IV magnesium can cause more serious side effects, such as allergic reactions or an irregular heartbeat. For this reason, IV magnesium should not be administered at home or in facilities where resuscitation measures are not available.
It is imperative to try oral magnesium supplements before using intravenous magnesium for migraines.
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How effective is Oral Magnesium vs IV Magnesium for Migraines?
Data regarding the use of oral magnesium supplementation is limited and conflicting. Here is a table comparing the efficacy of oral and intravenous magnesium for migraines based on available research:
Oral Magnesium | Intravenous Magnesium | |
| Efficacy | Studies have shown mixed results, with some finding it effective for preventing migraines and others showing no significant benefit. | Studies have shown that IV magnesium is effective at reducing the frequency and severity of migraines. |
| Speed of Onset | Slow onset as oral magnesium must be absorbed through the digestive system. | Rapid onset, as magnesium is delivered directly into the bloodstream. |
| Dosage | Higher dosages may be required to achieve therapeutic effects. | Lower dosages may be effective due to the faster and more efficient absorption of magnesium. |
| Side Effects | Oral magnesium is generally well-tolerated, but high doses may cause diarrhea or gastrointestinal upset. | IV magnesium may cause mild side effects such as warmth or flushing, but serious side effects are rare. |
| Administration | Oral magnesium can be taken at home, but compliance may be an issue. | IV magnesium must be administered in a clinical setting, which may be inconvenient for some individuals. |
Overall, while oral magnesium may be a useful supplement for some individuals, intravenous magnesium appears to be a more effective treatment option for migraines.
Its rapid onset, high bioavailability, and ability to achieve therapeutic doses quickly make it a valuable tool for managing migraine symptoms.
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How safe is Oral Magnesium Vs IV magnesium for migraines?
Generally, oral magnesium is a much safer alternative compared to IV magnesium for migraines.
Here is a table comparing the side effects of IV and oral magnesium by system:
| System | Oral Magnesium Side Effects | Intravenous Magnesium Side Effects |
| Gastrointestinal | Diarrhea, Nausea, Vomiting, Abdominal pain, Bloating | Nausea, Vomiting, Diarrhea |
| Cardiovascular | Irregular heartbeat (rare) | Low blood pressure, Flushing, Warmth |
| Nervous | Headache | Dizziness, Lightheadedness |
| Muscular | Muscle weakness | Muscle cramps |
| Other | Allergic reaction (rare) | None reported |
While the side effects of oral magnesium are generally mild and tolerable higher doses may lead to gastrointestinal symptoms.
On the other hand, IV magnesium may cause mild cardiovascular and nervous system symptoms, but serious side effects are rare.
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Dose of Oral vs IV magnesium for migraines:
The doses of oral and intravenous magnesium for the treatment and prevention of migraines:
Oral Magnesium | Intravenous Magnesium | |
| Treatment | 400-600 mg/day (as magnesium oxide or citrate) for 3-4 months, or 1 gram as a single dose during an acute attack | 1-2 grams administered over 15-30 minutes, repeat as needed |
| Prevention | 400-600 mg/day (as magnesium oxide or citrate) for 3-4 months | 1-2 grams administered over 15-30 minutes, repeated every few weeks or as needed |
Which oral magnesium is more effective for the treatment of migraines:
There are several types of magnesium supplements available, each with varying degrees of absorption and bioavailability.
Some of the most commonly used forms of magnesium for migraines include magnesium sulfate, magnesium oxide, magnesium citrate, magnesium glycinate, and magnesium threonate.
Research studies have used different forms of magnesium, and the results have been mixed.
However, studies suggest that magnesium citrate and magnesium threonate absorbs readily and may have better bioavailability than magnesium oxide.
Magnesium glycinate may also be well-absorbed and less likely to cause gastrointestinal side effects compared to other forms of magnesium.
Here is a table comparing the efficacies of different oral magnesium formulations:
Efficacy | Dosage | Absorption | |
| Magnesium Sulfate | IV form is more effective than oral forms. | 100 – 200 mg/kg three to four times a day | 4% of oral magnesium is absorbed. It is commonly used intravenously |
| Magnesium Oxide | May or may not be effective | 400-600 mg/day for 3-4 months or 1 gram as a single dose during an acute attack | Require higher dosages because of poor absorption. |
| Magnesium Citrate | It is more easily absorbed with better bioavailability than magnesium oxide. | 400-600 mg/day for 3-4 months | More easily absorbed and may have better bioavailability than magnesium oxide. |
| Magnesium Glycinate | Well absorbed and least likely associated with GI side effects. | 200-400 mg/day for 3-4 months | Well-absorbed and less likely to cause gastrointestinal side effects. |
| Magnesium Threonate | It is one of the best oral magnesium for migraines. It improves cognitive function as well. | Doses of up to 2 grams per day have been used in clinical trials. | Better bioavailability in the brain compared to other forms of magnesium. |
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Can magnesium supplements relieve headaches during pregnancy?
Magnesium supplementation has been used to treat headaches during pregnancy, and it is important to choose a form of magnesium that is safe for both the mother and the developing fetus.
Magnesium oxide is the most common form of magnesium for headaches during pregnancy, as its dosage is safe and tolerable.
However, it is important to note that high doses of magnesium can be harmful during pregnancy.
Magnesium glycinate is another form of magnesium that is often recommended during pregnancy, as it may be well-absorbed and less likely to cause gastrointestinal side effects compared to other forms of magnesium.
However, there is scarce data on the safety and efficacy of magnesium glycinate specifically during pregnancy, so it is important to consult with a healthcare provider before taking any magnesium supplement.
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