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Serum Ionized Magnesium Levels and Serum Ionized
Calcium/Ionized Magnesium Ratios in
Women With Menstrual Migraine
Alexander Mauskop, M.D.; Bella T. Altura, PhD;
Burton M. Altura, PhD
Posted June 2002
Headache. 2002; 42:242


Objective: It has been suggested that magnesium deficiency may play an important role in menstrual migraine and that the serum ionized calcium (ICa2+)/ionized magnesium (IMg2+) ratio is important in migraine headache. Studies were designed to test these hypotheses.

Design: We prospectively evaluated 270 women seen at a headache clinic and in 61 women with menstrual migraine measured IMg2+, total magnesium, and ICa2+levels so as to calculate the ICa2+/ IMg2+ ratio.

Results: The incidences of IMg2+ deficiency were 45% during menstrual attacks, 15% during nonmenstrual attacks, 14% during menstruation without a migraine, and 15% between menstruations and between migraine attacks. The serum ICa2+ levels were within our reference range, but the ICa2+/ IMg2+ ratio was elevated (P7<.01) in menstrual migraine.

Conclusions: The high incidence of IMg2+ deficiency and the elevated ICa2+/ IMg2+ ratio during menstrual migraine confirm previous suggestions of a possible role for magnesium deficiency in the development of menstrual migraine.