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Treating Fibromyalgia With Malic Acid

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Malic acid appears to be beneficial to fibromyalgia patients, not as a pain reliever, but to boost muscular performance. It may be taken as a supplement with magnesium. Malic acid may also be consumed by drinking juice from tart fruit and apple cider vinegar.

The only medical study that has ever been published regarding fibromyalgia treatment with malic acid was performed in 1995 and published in the Journal of Rheumatology.

There, a commercial tablet containing 200 mg malic acid and 50 mg magnesium was undergoing safety and efficacy studies before going to market. Twenty- four fibromyalgia patients took three tablets twice a day of a product called “Super Malic” for four weeks.

The study was placebo-controlled. Patients had to be free of prescription medications in order to participate in the trial. After the first four weeks, the patients were allowed to take up to six tablets of “Super Malic” twice a day for a period of six months.

Scientists measured pain and tenderness, psychological levels, and functionality over the course of the study.

At the lower dose, no benefits were seen at all in the study participants. However, when the dose was doubled to six tablets twice a day, the participants reported significant reductions in pain and tenderness, plus improvements in functionality and mood.

Quoting this medical study, several articles state that malic acid may be beneficial in the treatment of fibromyalgia. However, the researchers did not study malic acid alone, but a dietary supplement containing both malic acid and magnesium.

Magnesium has been clearly demonstrated to relieve several fibromyalgia symptoms, including pain, both clinically and with copious amounts of anecdotal support.

It could very well be that the fibromyalgia patients who took the “Super Malic” supplement were benefitting and commenting more from the magnesium boost than the malic acid.

What is malic acid? What health benefits does it have?

Malic acid is the organic compound found in tart fruits such as Granny Smith apples, certain grapes, and cranberries. Malic acid is added to “sour” candies to give them an extremely tart flavor.

Malic acid is also formed in the human body. It is an important element in the Krebs', or citric acid cycle, which creates energy for both aerobic and anaerobic activities.

In fibromyalgia, it is postulated that malic acid may prevent hypoxia to the muscle tissues. This means that malic acid may help muscle tissues get more oxygen, improve energy production in the muscle cells, and prevent muscle tissue breakdown.

This muscle tissue breakdown may be one part of the reason fibromyalgia patients experience so much pain and tenderness.

Since malic acid delivers oxygen to muscle tissues, it positively affects muscle performance and recovery after exercise. Both fibromyalgia and healthy individuals may elect to take malic acid to increase athletic endurance.

If the fibromyalgia patient chooses to take a malic acid- magnesium supplement, it is best to start with 600mg malic acid combined with 150mg magnesium twice a day. Over time, this can be increased to as much as 1200 mg malic acid and 300 mg magnesium.

How to obtain malic acid naturally

Rather than taking synthetic dietary supplements, there are a few natural sources of malic acid. One source is apple cider vinegar.

The late traditional herbalist Dr. John R. Christopher recommended that each of his patients make a tart beverage containing eight ounces distilled water, one tablespoon raw, organic apple cider vinegar, and two teaspoons raw honey.

This beverage should be consumed three times a day for a multitude of health benefits. Adding Epsom salt into this beverage to bowel tolerance has the same effect as a malic acid and magnesium dietary supplement.

Dr. Christopher and many naturopathic physicians recommend making fresh apple juice with Granny Smith apples to get the daily dose of malic acid.

Freshly juiced, raw, unsweetened cranberries are also high in malic acid and provide a tart beverage. The two juices may be blended together for another option.


PubMed.gov, Journal of Rheumatology. 1995 May;22(5):953-8.“Treatment of fibromyalgia syndrome with Super Malic: a randomized, double blind, placebo controlled, crossover pilot study.” Russell IJ, et al.

Vitamin Research Products.com, “Krebs' Cycle Intermediate Also Important for Exercise Recovery & Endurance,” By VRP Staff

Herbal Legacy.com, “Apples,” by Anna Lovett- Brown

Next Article: 39 Signs and Symptoms of Fibromyalgia