Magnesium Malate for Fibromyalgia & Chronic Fatigue Syndrome

Magnesium malate is found in apples
Magnesium malate is found in apples. Darren Robinson/Getty Images

Magnesium malate is a combination of magnesium and malic acid. Both of these substances help produce energy for your cells in the form of adenosine triphosphate (ATP), which studies show can be deficient in fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS).

In addition to producing energy, magnesium and malic acid have jobs in your body that may help alleviate symptoms of these conditions. Magnesium is important for the formation of cells, and the maintenance of muscles, bones, and nerves. Malic acid is believed to help with muscle performance, reduce fatigue after exercise, and improve mental focus.

Some research supports the use of magnesium malate for boosting energy and alleviating the pain and tenderness of FMS. One study found magnesium is one of the most commonly recommended supplements for these conditions. Many doctors and patients say they've had success with it.

So far, studies are mixed as to whether these supplements are helpful for us, but a 2010 review of treatments for FMS and ME/CFS stated that magnesium is among the supplements with the most potential for future research.

Do We Have Deficiencies?

Several studies suggest that some of us with these conditions may have deficiencies of both magnesium and malic acid, which could contribute to our symptoms.

Symptoms of magnesium deficiency can include:

Several of these symptoms are common in people with FMS and ME/CFS. FMS can involve anxiety, RLS, sleep disorders, confusion, and muscle spasms. ME/CFS can involve all of those in addition to abnormal heart rhythms.

Low magnesium levels may also lower levels of serotonin, a neurotransmitter that's believed to be involved in FMS and ME/CFS as well as depression, migraine, PMS, RLS, and sleep.

A 2016 study published in the journal Pain Management suggests that low levels of magnesium, along with zinc, in FMS may encourage a process called excitotoxicity, in which the neurotransmitter glutamate, which stimulates brain cells, gets carried away and overstimulates those cells to death. Excess glutamate activity is believed to be an important feature of this condition. However, we don't yet know whether magnesium supplements can counter heightened activity of this brain chemical.

Inadequate malic acid may hamper your body's ability to convert the food you eat into energy. Low energy is a key feature of both FMS and ME/CFS.

Magnesium Malate in Your Diet

Your body doesn't produce magnesium, so you have to get it through diet or supplements.

Magnesium is found in multiple common foods, including:

  • Nuts:
    • Almonds
    • Cashews
    • Peanuts
  • Vegetables:
    • Boiled spinach
    • Black beans
    • Avocado
    • Baked potato
    • Broccoli
    • Carrot
  • Grains:
    • Whole wheat bread
    • Magnesium-fortified cereals
    • Oatmeal
    • Rice
  • Meats/Fish:
    • Salmon
    • Halibut
    • Chicken
    • Beef
  • Fruits:
    • Bananas
    • Raisins
    • Apples
  • Dairy/Dairy substitute:
    • Yogurt
    • Milk
    • Soy milk

Your body does produce malic acid, but some people may benefit from increasing it through diet or supplements, especially in case of deficiency. Malic acid is in:

  • Fruits:
    • Apples
    • Watermelon
    • Bananas
    • Blackberries and strawberry
    • Stone fruits: mangos, apricots, nectarines, peaches, cherries
    • Oranges
    • Pears
    • Grapes
    • Kiwi
  • Vegetables
    • Broccoli
    • Beans
    • Carrots
    • Peas
    • Potatoes
    • Tomatoes
    • Rhubarb

Magnesium Malate Dosage

So far, we don't have recommended dosage of these supplements—alone or together—specifically for treating FMS or ME/CFS.

The Recommended Daily Allowance (RDA) of magnesium, for the population in general, varies by age and gender.

For women:

  • 19-30 years: 310 mg
  • 31-Up: 320

For men:

  • 19-39 years: 400 mg
  • 31-Up: 420

Daily dosages of malic acid generally range from 1,200 mg to 2,800 mg.

It's likely to take some experimentation to find your optimal dosage. Your doctor and pharmacist can guide you on this.

A few studies have had success with intramuscular magnesium (injected into the muscle) as well as transdermal magnesium (applied to the skin.) Your doctor can tell you whether these options are available to you.

Side Effects of Magnesium Malate Supplements

Both magnesium and malic acid can cause intestinal problems. So if you develop symptoms such as persistent diarrhea, bloating, or cramping, you might want to take a break from these supplements to see if symptoms resolve. You may also want to try them individually to see if one is easier to tolerate than the other.

If you have kidney or heart problems, be sure to check with your doctor before starting magnesium supplements.

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