Comorbidity of migraine and magnesium deficiency: Limitations of diagnosis and treatment

Migraine is a common chronic neurological disease that involves different forms of attacks and is characterized by recurring episodes of intense headache. Migraine is a top ten disabling neurological disease and remains the second-ranked cause of disability in adults among noncommunicable diseases. Magnesium deficiency is also a common pathological condition caused by various reasons including insufficient levels of magnesium intake from food sources or increased losses through the gastrointestinal or renal systems. We finally have a sufficient number of studies that demonstrate the frequent comorbidity between migraine and magnesium deficiency, however measured plasma magnesium levels do not always objectively reflect the presence or absence of total body magnesium deficiency, as only 10% of the total body magnisium is extracellular. Other clinical manifestations of hypomagnesemia should also be considered. Magnesium deficiency in patients with migraine has been proven to lead to aggravation of the disease. The reason for this is an effect of magnesium deficiency on the main mechanisms of migraine pathogenesis, including impaired energy supply, cortical spreading depression, neurogenic inflammation and central sensitization. Numerous studies have revealed the potential effectiveness of adding magnesium supplements to the combination therapy of migraine. The article discusses the relationship between magnesium deficiency and migraine, the role of magnesium in the migraine pathogenesis and the feasibility of use of magnesium supplements to prevent and treat migraine.