Many fibromyalgia sufferers have stated that the combination of magnesium and malic acid have been helpful for their symptoms associated with fibromyalgia.

Magnesium Malate is a highly absorbable form of magnesium that provides the benefits of this mineral, along with the benefits of malic acid, a nutrient found to contribute to the process of transforming food into ATP, the body’s energy source.

Magnesium Malate and Fibromyalgia

While the cause of fibromyalgia is not fully understood, some leading fibromyalgia researchers believe that there is a malfunction in the body’s ability to manufacture energy. The muscles burn energy faster than it can be produced, which is compounded by a shortage of the nutrients necessary to make the energy. This may cause the muscles to rely too heavily on the inefficient (anaerobic) energy cycle for much of their energy production instead of the more efficient (aerobic) energy cycle. Malic acid plays a key role in the production of energy in the cells; therefore, it is often recommended with magnesium for fibromyalgia and chronic fatigue syndrome.

Additionally, some fibromyalgia patients may be magnesium deficient. An article in the Journal of Nutritional Medicine pointed out that many fibromyalgia patients have responded quite favorably to magnesium malate.  This is most likely because magnesium and malic acid are important substances in the manufacture of energy for the human muscle cell.

Furthermore, magnesium is an essential mineral in over 300 enzymatic reactions in metabolism. These reactions include those involved in the Krebs cycle (one of the body’s energy production systems), such as:

• DNA metabolism
• Vital for cell formation
• Activation of B vitamins
• Energy transport and storage
• The breakdown of fatty acids
• Proper nerve function and neurotransmitter activity
• The formation and maintenance of protein, fatty acids, and bone.
• The formation of adenosine triphosphate (ATP), the body’s energy source.

Recent studies have indicated that those with fibromyalgia tend to have decreased levels of magnesium in comparison to the control groups. [ 1 ] According to a study published in the Journal of Nutritional Medicine, Abraham et al hypothesized that a magnesium deficiency found in muscles cells could possibly play a role in the development of Fibromyalgia. The group demonstrated that a daily supplement of 300-600 of Magnesium Malate resulted in improvements of symptoms, as well as in the number and severity of tender points.[ 2 ]

During another study conducted in 1995, researchers gave 24 subjects with fibromyalgia a low tablet with 50 mg magnesium and 200 mg 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.

Furthermore, in a 1992 study 15 fibromyalgia 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.

 

Low levels of ATP (a cells energy source) are commonly found in those with fibromyalgia and may play a significant role in the origin of fibromyalgia symptoms. [ 3,4 ] Without magnesium, ATP is broken down easily into ADP an inorganic phosphate, which is less efficient than ATP in generating energy for cell metabolism and transport. [ 4 ] This process is important in the brain, which stores 20% of total body ATP. A low level of magnesium leads to a low level of ATP, which may cause a decline in cognitive function.

Both magnesium and malic acid, a non-toxic organic dicarboxylic acid, are known to be involved in ATP synthesis under aerobic and hypoxic conditions, which is the basis of the combined use of malic acid and magnesium in treatment of fibromyalgia. [ 5,6 ]

Along with calcium, magnesium is crucial for adequate muscle metabolism and function. When a magnesium deficiency is present, one may experience excessive muscle tension, which leads to muscle spasms, restlessness, tics, and twitches. Studies have shown that tender points in fibromyalgia muscles are deficient in ATP. Additionally, nuclear magnetic resonance spectroscopy indicates abnormally high-energy phosphate metabolism in exercising fibromyalgia muscles. [ 7 ]

1. Prescott EE, et al. Red blood cell magnesium and fibromyalgia. Scand J Rheum 1992; 94:31.
2. Abraham GE, Glechas ID. Management of fibromyalgia: A rationale for the use of magnesium and malic acid. J Nutr Med 1992; 3:49-59.
3. Heaton FW. Role of Magnesium in Enzyme Systems. In: Sigel H, ed. Metal Ions in Biological Systems.
4. Eisinger J, et al. Glycolysis abnormalities in fibromyalgia. J Am Coll Nutr 1994; 13:144-148.
5. Abraham GE, Glechas ID. Management of fibromyalgia: A rationale for the use of magnesium and malic acid. J Nutr Med 1992;3:49-59.
6. Russell IJ, et al. Treatment of fibromyalgia syndrome with Super Malic: A randomized, double blind, placebo controlled, crossover pilot study. J Rheumatol 1995; 22:953-958.
7. Simms RW, et al. 31P – NMR spectroscopy of muscle in fibromyalgia syndrome patients and sedentary controls. Arthritis Rheum 1993;37:794-800.