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These two supplements may reduce fibromyalgia pain and fatigue

Tracy Woolrich's picture
supplements for Fibromyalgia pain

Individuals that suffer from fibromyalgia are often medicated with numerous medications in order to treat their symptoms. However there maybe some help available through the use of magnesium and malic acid.

The most common medications used to treat fibromyalgia are analgesics, antidepressants and muscle relaxers. As someone who has suffered from fibromyalgia and its sister disease chronic fatigue, I can tell you it is a hard thing to accomplish much when you are heavily medicated. Pain meds and muscle relaxers can make you drowsy. Antidepressants can make you manic and irritable. For me I try to find alternative ways to deal with the symptoms such as guided imagery, meditation, massage, chiropractic, diet and supplements. Since my allergy to NSAIDS came about last year it makes it more important than ever to find alternative methods. My go to combo when my symptoms flair is magnesium and malic acid. Since the 1990’s I have found that combo helps me with muscle spasms, tender trigger points, depression and sleep.

Traditionally doctors have prescribed analgesics such as NSAIDS (Motrin, aspirin and naproxen) along with tramadol (Ultram) and even narcotics.

Along with these antidepressants such as fluoxetine, sertraline, and paroxetine can be prescribed to assist in restoring serotonin levels in hopes of relieving pain and depression. Also amitriptyline, nortriptyline, or doxepin have been used to alleviate depression and help promote sleep.

Of course for good measure muscle relaxants and hypnotics may be prescribed to help reduce muscle spasms and allow for a more peaceful night sleep. Medications such as cyclobenzaprine or benzodiazepines and hypnotics like Ambien, Lunesta and Restoril are used for this.

However research has shown that a combination of magnesium and malic acid may be helpful in easing pain and fatigue, especially for those with fibromyalgia or CFS.

In 1990, an open clinical setting utilizing 15 patients aged 32-60 were given a combination preparation named Super Malic. It contained 50 mg of magnesium and 200 mg of malic acid per tablet. A total daily dosage of between 300-600 mg of magnesium and 1200-2400 mg of malic acid was administered. TPI (Tender Point Index) readings were assessed prior to as well as after the treatment was given at 4 week intervals. The average TPI score was 19.6 plus/minus 2.1 before the Super Malic, 8 plus/minus 1.1 after 4 weeks taking the preparation and down to 6.5 plus/minus 0.74 after 8 weeks. All patients reported improvement in pain within 48 hours of starting the Super Malic preparation. In order to see if it was a placebo effect, after 8 weeks of being on it, 6 patients were switched to placebo tablets for 2 weeks. The TPI scores were 6.8 plus/minus 0.75 before the placebo and 21.5 plus/minus 1.4 after the placebo was given. In addition, pain resumes within 48 hours in 100% of the patients on placebo tablets. Therefore despite the fact that the study was very small in its scope it was deemed a success and appeared to be a very promising approach to the management of fibromyalgia pain.

So why is this information not more known? After all, that was over 20 years ago. One can only assume that it is due to the powers of the pharmaceutical industry that this has not been more evaluated and broadcasted in the media.

Importance of magnesium

Magnesium is one of the more important minerals that are required by our bodies. It is considered an essential mineral as it is not produced by our body and must be replenished daily. A few of magnesium's more important functions are:

  • Maintaining normal muscle function
  • Maintaining normal nerve function
  • Supporting a strong immune system
  • Maintaining proper heart rhythm
  • Supporting normal blood pressure

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According to a USDA survey nearly 80% of American adults consume less that the required daily amount of magnesium. The main reason is that we eat a lot of processed foods, and not enough green vegetables, nuts and seeds, whole grains, and legumes. Also medications such as estrogen, diuretics, steroids and some antibiotics deplete magnesium as well.

Magnesium Deficiency in Fibromyalgia

Individuals with fibromyalgia are often deficient in magnesium. Therefore, this tends to exacerbate some of the many symptoms of fibromyalgia which include:

  • Fatigue
  • Insomnia
  • Depression
  • Headaches
  • Muscle cramps and spasms
  • Poor memory (Fibro fog)

How Magnesium helps Fibromyalgia

Magnesium is involved in the production of serotonin which is a neurotransmitter involved in mood regulation, pain perception and sleep cycles. Most individual with Fibromyalgia typically have low serotonin levels. This is often why antidepressants are sometimes prescribed.

In addition, Magnesium activates adenosine triphosphate (ATP). It is through the use of ATP that the intracellular mitochondria supplys our body with energy. There is often mitochondria dysfunction in fibromyalgia sufferers. This might be why chronic fatigue can also be a symptom.

Malic acid Deficiency in Fibromyalgia

Research has shown that individuals with fibromyalgia often have decreased oxygen levels in their muscles. Muscle biopsies have indicated muscle damage, mitochondrial damage and decreased levels of adenosine triphosphate (ATP). This could help to explain the muscle pain that is a signature sign of fibro. Malic acid allows the body to produce more ATP, thereby increasing energy and endurance. It can even allow muscles to work more efficiently despite hypoxic low oxygenation conditions.

Take home message:
Most people are deficient in magnesium and malic acid. Yet they are essential nutrients that are especially important for individuals with fibromyalgia and chronic fatigue.

If you do start to take these supplements start with the lowest dosing and slowly increase as magnesium can cause GI distress (Think Milk of Magnesia here!) Inform your doctor of any and all supplements you are taking especially if you have heart or kidney health issues.

"Journal of Nutritional Medicine"; Management of Fibromyalgia: Rationale for the Use of Magnesium and Malic Acid; G.E. Abraham et al.; March 1992

Morgan KJ, et al. Magnesium and calcium dietary intakes of the U.S. population. J Am Coll Nutr. 1985;4(2):195-206.



The "malic acid/magnesium" combination has been an old urban legend. Note that the studies date backwards to almost 20 - 25 years ago.
The studies date back 2 decades because Big Pharma would not want more recent studies that indicate there is hope for those that suffer from Fibro pain other than through prescription drugs. Complimentary medicine is not studied nearly as much as "traditional Western" medicine and when it is it is often not accurate. Most of the time the more accurate studies come out of Europe. I for one do NOT need any other studies other than the fact that I am able to work again and have less pain. What else could I ask for?
Note for the future it is spelled "complementary" medicine, not "complimentary" medicine. You are free to pursue your own treatment, as we all are. God bless you and good luck.
Magnesium is not easily obsorbed, so my naturopathic allopathic trained Dr advises magnesium oil which is really concentrated mineral rich water which one rubs on for transdermal absorption. I'm in UK and we are also affected by suppressed natural remedies. Ribose also helps.
I've never heard of magnesium oil, not Ribose. I suffer from both, FM, CFS and a list continues. I'm 64 and have tried to fight, or at least lessen these conditions since I was 38 yrs ago. Thank you for the article.
Any new reports on the supplement combo? Has anyone else tried it & had good results
How do I know if I need magnesium? Thanks
I have fibromyalgia and associated conditions (ie: IBS, fibro fog, fatigue, etc.). Think this article was helpful.