How Malic Acid (Malate) Helps Fibromyalgia Pain

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Fibromyalgia is a chronic condition that affects almost 10 million Americans, according to the National Fibromyalgia Association, and is characterized by fatigue and widespread pain in various tender points in the body. Although exercise is one of the recommended therapies to help with fibromyalgia symptoms, the pain the condition causes can often make it difficult for you to start or continue with an exercise program, such as running, even if you’ve been an active runner before the onset of symptoms.

Fibromyalgia symptoms and multiple severe vitamin deficiencies

There is room for hope, however. Growing research shows a strong correlation between fibromyalgia symptoms and multiple severe vitamin deficiencies. Though this correlation alone isn’t enough on its own to understand fibromyalgia’s mechanism of action, researchers are hopeful that vitamin deficiencies and their causes might be a better starting point from which to work toward discovering the underlying processes of fibromyalgia than a cluster of symptoms alone.

In the meantime, though, there is also increasing evidence that correcting for these vitamin deficiencies can significantly improve fibromyalgia pain and other symptoms. While there are multiple supplements increasingly used to regulate fibro patients’ vitamin levels, I’ll discuss only one of them in this article: the supplement malic acid (or malate).

Malic acid

Malic acid is a type of alphy hydroxy acid found naturally in all fruits and some vegetables. Malic acid preparations can also be purchased for oral and topical use. Individuals often use malic acid orally along with magnesium in order to ease the pain and tenderness associated with fibromyalgia. Another common use for malic acid is as a topical agent to treat various skin conditions. It is important to use careful consideration when it comes to the dose of malic acid used.

Malic acid:

  • >Supports energy production;
  • >Increases muscle performance;
  • >Reduces fatigue after exercise;
  • >Helps boost energy levels.

In addition, malic acid plays an essential role in the Krebs cycle: “A process that turns carbohydrates, proteins and fats into energy and water in your body. If there isn’t an adequate supply of malic acid in the body, the Krebs cycle can’t function properly, leading to fatigue.”


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Malic acid supports energy production in fibromyalgia sufferers

Malic acid supports energy production and carries out reactions in the body. It also increases muscle performance and mental focus while reducing fatigue after exercise. As a result, malic acid can help those suffering side effects from fibromyalgia and chronic fatigue syndrome. A study in the “Journal of Rheumatology” revealed that supplementing with 1,200 milligrams of malic acid and 300 milligrams of magnesium daily for six months decreased the symptoms of pain and tenderness in those suffering from fibromyalgia.

Fibromyalgia and Malic Acid Deficiency

Researchers have found that people with fibromyalgia have decreased levels of oxygen in their muscles, also known as muscle hypoxia. Biopsies of those muscles have shown muscle tissue breakdown, mitochondrial damage, and low levels of ATP, which helps explain the widespread muscle pain characteristic of FM. Evidence suggests that malic acid can help ease pain caused by muscle and tissue hypoxia.

It allows the body to make ATP and thereby energy more efficiently, even under low oxygen or hypoxic conditions. Malic acid also enhances cellular stamina and endurance. (Malic acid is derived from food sources such as tart apples and is used/synthesized in the mitochondria as part of the ATP-producing citric acid or ‘Krebs’ cycle.)

As a team, malic acid and magnesium work together especially well to fight aluminum toxicity, which is thought to play a role in fibromyalgia. Malic acid acts as a potent aluminum detoxifier, while magnesium prevents future aluminum build-up.

It may reduce fatigue and improve stamina

Since malic acid participates in the aerobic (oxygen requiring) energy production process, its supplementation is thought to improve stamina. In an animal model, L-malate (malic acid supplement) was found to improve stamina, reduce fatigue and muscle damage in response to physical exertion.

Citrulline malate supplementation is proven to improve muscle function in an animal study. In fact, creatine malate supplementation is found to serve as an ergogenic aid for athletes and weight lifters. It helps in boosting performance, growth hormone levels and improves time to exhaustion.

Additional Benefits

In addition to its presence in food and supplements, malic acid is found in different commercial products. It is an ingredient in mouthwashes and toothpastes because it stimulates saliva production and reduces the amount of harmful bacteria in mouth. Malic acid is also an alpha hydroxy acid, which has exfoliating properties when applied to the skin. And it is less irritating than other alpha hydroxy acids, making it suitable for individuals with sensitive skin.

How much Malic Acid Should You Take?

Three of ProHealth’s Double Strength Ultra ATP+ tablets contain 125 mg of magnesium and 1200 mg of malic acid a very effective balance based on years of patient experience. The recommended starting dose is three tablets taken an hour before breakfast and at bedtime. The dosage can be gradually increased as needed. Dr. Sarah Myhill says, “Magnesium is extremely safe by mouth  too much simply causes diarrhea.

Try increasing the amount of magnesium you take by mouth until it causes diarrhea, then reduce the dose slightly so it does not. This is called taking magnesium to bowel tolerance. Some people taking magnesium and malic acid have noticed symptom improvement in as little as 48 hours; however, it may take as much as four to six weeks.

While malic acid can help restore your body’s levels of ATP, it can’t reverse mitochondrial damage, which is usually caused by free radicals. Taking additional antioxidants especially alpha lipoic acid can help to reverse this free radical damage and heal your mitochondria so that they are better able to produce essential fuel for your body themselves.


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