Magnesium Malate for Fibromyalgia & Chronic Fatigue Syndrome

Easing Pain, Boosting Energy

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Energy, Pain & Tenderness:

Magnesium malate combines magnesium and malic acid. Both substances help produce energy in the form of adenosine triphosphate (ATP), which studies show can be deficient in fibromyalgia (FMS) and chronic fatigue syndrome (CFS or ME/CFS). Magnesium helps cells form and maintains muscles, bones and nerves.

Some research supports magnesium malate for boosting energy and alleviating the pain and tenderness of FMS.

According to a 2007 study (Wall), magnesium is one of the most-often recommended supplements for this conditions. Many doctors and patients say they've had success with it.

Studies are mixed on whether these supplements are helpful, but a 2010 review of treatments for FMS and ME/CFS (Porter) stated that magnesium is among the supplements with the most potential for future research.


Some studies suggest that some people with these conditions have deficiencies of both magnesium and malic acid, which could contribute to our symptoms. Magnesium deficiency symptoms include:

You'll notice that some of those are similar to FMS/ME/CFS symptoms.

Low magnesium levels may also lower levels of serotonin, a neurotransmitter that's involved in these conditions as well as depression, migraine, PMS, RLS, and sleep.

Inadequate malic acid may hamper your body's ability to produce energy in the form of ATP.

Magnesium Malate in Your Diet:

Your body doesn't produce magnesium, so you have to get it through diet or supplements. (Your body does produce malic acid.)

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.

Malic acid is in:

  • Fruits:
    • Apples,
    • Watermelon,
    • Bananas,
    • Berries: blackberry, strawberry,
    • Stone fruits: mango, apricot, 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 -- for 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.) These may or may not be options that are available to you.

Talk to your doctor.

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.

More Supplement Information:


Bazzichi L, et al. Clinical biochemistry. 2008 Sep;41(13):1084-90. ATP, calcium and magnesium levels in platelets of patients with primary fibromyalgia.

Engen DJ, et al. Journal of integrative medicine. 2015 Sep;13(5):306-13. Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia: a feasibility study.

Institute of Medicine. Food and Nurition Board. Dietary Reference Intakes: Calcium Phosphorus, Magnesium, Vitamin D and Fluoride. Accessed: January 2016.

Myhill S, Booth NE, McLaren-Howard J. International journal of clinical and experimental medicine. 2009;2(1):1-16. Chronic fatigue syndrome and mitchondrial dysfunction.

Porter NS, et al. Journal of alternative and complementary medicine. 2010 Mar;16(3):235-49. Alternative medical interventions used in the treatment and management of myalgic encephalomyelitis/chronic fatigue syndrome and fibromyalgia.

Reid S, et al. BMJ clinical evidence. 2011 May 26;2011. Chronic fatigue syndrome.

Sendur OF, et al. Rheumatology international. 2008 Sep;28(11):1117-21. The relationship between serum trace element levels and clinical parameters in patients with fibromyalgia.

Wall GC, et al. Pharmacy practice. 2007 Oct;5(4):185-90. A pilot study of complementary and alternative medicne use in patients with fibromyalgia syndrome.

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