While magnesium can reduce pain in some fibromyalgia patients, not everyone with FMS has low levels of magnesium. Yet research indicates that taking adequate doses of magnesium in combination with malic acid over an extended period of time can significantly reduce the muscle and soft tissue pain associated with fibromyalgia.
Fibromyalgia and Muscle Energy Disruption
It’s unclear how or if these two elements work synergistically, yet magnesium and malic acid are both key components in how energy is produced and transported within the cells of the muscles. Evidence suggests that one cause of fibromyalgia pain is local hypoxia in the muscles (low oxygen) which contributes to muscle tissue breakdown.
Magnesium Deficiency and Fibromyalgia Pain
Magnesium is an essential mineral for good health and is involved in a long list of critical functions in the body including: nerve signaling, muscle contraction, and as a co-factor for 350 enzymes. Some people with fibromyalgia are low in magnesium.
Magnesium activates the most important enzyme in the body, ATP (adenosine triphosphate) an energy molecule produced within a component of cells called the mitochondria, the body’s “energy furnace.” About 20 percent of the body’s production of ATP is located in the brain. As a result, diminished levels can reduce the brain’s cognitive functions, a common problem in people with fibromyalgia.
Magnesium is needed in the production of serotonin, a brain neurotransmitter involved in the perception of pain. Serotonin levels have been shown to be significantly lower in people with fibromyalgia. Magnesium is one of the many co-factors needed to release and bind serotonin in the brain to provide balanced mental functioning.
Magnesium deficiency increases a chemical in the body called substance P, a neurotransmitter and protein found in the brain and spinal cord. People with fibromyalgia have abnormally high levels of substance P. Substance P serves as a pain messenger and is associated with inflammatory processes in the joints. Excess levels can cause pain signals to be sent to the brain even when there is no actual injury or illness.
Malic Acid and Fibromyalgia Pain
Malic acid is an organic substance found in fruits (particularly apples) and plants.
Malic acid is involved in the production of energy in the body. It plays a role in the molecules involved in controlling mitochondrial, energy production, within the cells. Malic acid provides greater stamina and endurance in muscle cells.
Malic acid is particularly useful in helping remove aluminum from the body. Aluminum toxicity is thought to be one contributor to fibromyalgia symptoms. While magnesium also helps block the toxic effects of aluminum, malic acid may be even more effective.
Studies On Magnesium and Malic Acid To Reduce Fibromyalgia Pain
In a 1992 study 15 fibromylagia patients received an oral dose of 1200-2400 mg of malate (malic acid) and 300-600 mg of magnesium over a four and 8 week period. Patients reported a reduction in pain across a tender point index (TPI). Six subjects felt an improvement in 48 hours.
During another study conducted in 1995, researchers gave 24 subjects with fibromyalgia a “Supermalic” low tablet with 50 mg magnesium and 200mg malic acid. Scientists measured pain levels through patient self-assessment and the tender point index. Results showed that the low dose, short term trial was not effective to reduce fibromyalgia pain. However, higher doses over an extended duration significantly reduced subjects’ pain.
Magnesium Malate Dosage and Side Effects
Magnesium Malate has been shown to be the most effective form of magnesium to reduce fibromyalgia pain. The recommended dose is 1,500 mg, although people should adjust their dose according to their pain level and side effects.
Side effects with extended use may include headache, muscular pain, and mild gastrointestinal symptoms. The most common side effect is loose stools. Should this occur people should decrease their next dose by 50%.
Abraham GE, Glechas ID. “Management of fibromyalgia: A rationale for the use of magnesium and malic acid.” Journal of Nutritional Medicine,1992;3:49-59.
Russell IJ, et al. “Treatment of fibromyalgia syndrome with Super Malic: A randomized, double blind, placebo controlled, crossover pilot study.” Journal of Rheumatology, 1995; 22:953-958.
“The Team Value of Magnesium and Malic Acid,” Marc D. Braunstein, Oralchelation.com. Accessed 11/6/08.