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Fibromyalgia, Magnesium & Malic Acid

By Ashley Miller

Fibromyalgia causes a variety of unpleasant symptoms that can make you feel like staying in bed all day. According to the National Fibromyalgia Association, almost 10 million Americans, with a majority of women, are affected by this often-debilitating chronic pain disorder. While the causes aren't entirely known, a shortage of adenosine triphosphate, or ATP, is thought to play a role. Magnesium and malic acid are two important nutrients that play a role in the production of ATP and may help improve certain symptoms of fibromyalgia. Consult your doctor before using any nutritional supplements.

About Fibromyalgia

Fibromyalgia is characterized by symptoms of widespread, chronic muscle and joint aches and pains; depression; excessive, persistent fatigue that doesn't resolve despite rest; irritable bowel syndrome; migraine headaches; and problems with cognitive functioning. Since there is no known cure for fibromyalgia, treatments focus on symptom management or improving the severity of symptoms, according to the National Fibromyalgia Association. Increasing attention has been given to the role of nutritional deficiencies and the potential benefits of dietary supplements, such as magnesium and malic acid.

Fibromyalgia and ATP

Patients suffering from fibromyalgia may also be suffering from lowered levels of ATP, the body's energy source. According to a study published in 1992 in the "Journal of Nutritional Medicine," magnesium and malic acid are necessary for ATP production; the authors postulate that fibromyalgia symptoms are primarily caused by a deficiency in oxygen related to deficiencies in magnesium and malate, also known as malic acid. An October 2010 review for "The American Chiropractor" magazine explains that the soft tissue pain commonly experienced by patients with fibromyalgia may be caused by compromised ATP production. The review further suggests that supplementation with magnesium and malic acid may help due to their crucial role in ATP synthesis.

Clinical Evidence

The study by Abraham and Flechas reports that patients with fibromyalgia who were treated with 1,200 to 2,400 milligrams of oral malate and 300 to 600 milligrams of oral magnesium over the course of eight weeks experienced a significant improvement in tender point index scales, which are used to measure the level of pain in soft tissues when compared with patients who only received a placebo. Subjective reports of decreased levels of pain were also noted among study participants within 48 hours of administration of these nutrients. Another study, published in the May 1995 issue of the "Journal of Rheumatology," examined the effects of a proprietary tablet containing 200 milligrams of malic acid and 50 milligrams of magnesium on patients suffering from fibromyalgia. While no clear benefits were seen in the first phase of the trial, in which patients were given three tablets daily, significant benefits in pain and tenderness reduction were experienced by patients after a six-month, open label, dose escalation, in which patients were given up to six tablets daily.


While the available clinical evidence appears to support the benefits of malic acid and magnesium supplementation on alleviating the muscle pain and tenderness associated with fibromyalgia, you should not use dietary supplements to self-treat your symptoms. Consult your doctor to discuss treatment options. Inform your doctor if you plan to use any dietary supplements.

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