A Follow-Up on Malic Acid

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Leading health care professionals familiar with CFIDS are continuing to recommend a new substance for the chronic muscle soreness and fatigue that most PWC’s experience to some degree.

They have found that patients using a combination of malic acid and magnesium hydroxide report improvements-with reduction of muscle pain and tiredness. Among those physicians now recommending the malic acid/magnesium hydroxide are Dr. Daniel Peterson of Incline Village, CA, Dr. Paul Cheney, a North Carolina clinician, and Dr. Jay Goldstein, director of the CFS Institute.

Dr. Peterson comments, “the patients who improved reported diminishing symptoms… and an increase in exercise tolerance.” He reports that 40% of those who try the supplement will benefit from it.

Similarly, Dr. Goldstein has found malic acid to be a safe, inexpensive nutritional supplement for CFIDS symptoms and suggests it be added to the list of potential therapeutic approaches. He currently prescribes it for his patients with symptoms associated with CFIDS, and those diagnosed with Fibromyalgia. He explains, “it may have a modest effect on fatigue and/or other symptoms. Fibromyalgia pain may respond within 48 hours, while fatigue may take about two weeks.”

One of the many people who have benefited by taking malic acid and magnesium hydroxide is Ann Lessel of Westlake Village, CA. She noticed improvements in her symptoms almost immediately.

“After about four days I noticed my energy level and stamina was beginning to increase,” she reports. “After taking the product for three weeks I had an incredible amount of energy. For the first time in the six years that I have been sick, I can say I feel normal. I now have been on the product for about two months, and am keeping up a pace that would make a healthy person tired.”

The effectiveness of the product has a sound scientific base. Malic acid, a fruit acid, extracted from apples and widely used in the food industry, is essential in the formation of ATP, which is our body’s energy source. Malic acid has the ability to allow the body to make ATP more efficiently, even under low oxygen, or hypoxic conditions. Magnesium is a mineral which is required for normal activity, including those enzymes which function in energy transfer.

“Malic acid is a primary ingredient in apples,” explains Dr. Cheney. “It is a primary component of the Kreb’s citric acid cycle where fats and glucose are converted to energy. It may promote cellular production of energy (cellular respiration).”

A recent study in the Journal of Nutritional Medicine postulates that muscle pain and fatigue are predominantly caused by the breakdown of muscle proteins due to a deficiency of oxygen and other substances needed for ATP production. Further, the study presented data supporting the critical role of magnesium and malic acid in ATP production under hypoxic conditions.

Most physicians start their patients on malic acid/magnesium hydroxide slowly, working up to between six and 12 capsules daily. It is also recommended to be taken with food and water. Although safe, sensitive people may experience slight gastrointestinal problems. These can usually be eliminated by reducing the dosage. Finally, patients must try it for a period of time to see whether they will benefit from its use.

The only two malic acid products on the market contain 300 mg of magnesium hydroxide and 1200 mg of malic acid in every six tablets. It is available in some health food stores and can also be ordered through the CFIDS Buyers Club, a patient-owned and operated company that supplies CFIDS patients with nutritional supplements, frequently recommended by leading clinicians and researchers.

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