In a report, the American College of Physicians & American Society of Internal Medicine listed malic acid among supplements recommended for reducing continuing or recurring muscle soreness and discomfort. The report was published in the December 1999 issue of the Annals of Internal Medicine and was authored by Lawrence J. Levanthal, M.D.
In their 1999 book by Daniel J. Wallace, M.D. and Janice Brock Wallace, the authors noted the success of malic acid and magnesium supplementation in individuals with recurring soreness or tenderness in the muscles with the following observations:
“An interesting preparation, containing magnesium and malic acid is now available… Controlled studies from England and Texas in peer-reviewed journals have documented modest effects of this preparation in muscle spasm, fatigue and muscle soreness or discomfort. If subjects take a dose larger than recommended on the bottle…its effects become apparent within a week; side effects are uncommon. This combination may work as a result of interactions between magnesium and calcium channels within muscles and the generation of adenosine triphosphate (ATP), our cellular fuel.”
Research Confirms malic acid’s Use to Alleviate Discomfort and Fatigue
Leading healthcare professionals are continuing to recommend malic acid supplementation for the recurring muscle soreness and fatigue that some individuals experience.
They have found that individuals using a combination of malic acid and magnesium hydroxide report improvements with reduction of muscle discomfort and tiredness.
Among those physicians recommending the malic acid/magnesium hydroxide combination are Daniel Peterson, M.D., of Incline Village, CA, Paul Cheney, M.D. and Jay Goldstein, M.D.
Dr. Peterson comments, “the subjects who improved reported diminishing discomfort…and an increase in exercise tolerance.”
Similarly, Dr. Goldstein has found malic acid to be a safe, inexpensive nutritional supplement for muscle fatigue and soreness and suggests it should be added to the list of nutritional approaches. He currently recommends it for his patients suffering continuing or recurring muscle soreness, discomfort and fatigue. He explains,“…it may have a modest effect on fatigue and/or other discomfort.
Muscle soreness or discomfort may respond within 48 hours, while fatigue may take about two weeks.”
The effectiveness of the supplement 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 that is required for over 100 enzymatic reactions in the body. Interestingly, many researchers such as Dr. Cheney, have noted that a large percentage of individuals are magnesium depleted on an intra-cellular basis (inside the cell). Standard blood tests are not sensitive to intra-cellular magnesium.
In a study published in the May, 1995 edition of the Journal of Rheumatology, the results of supplementation with malic acid were assessed in terms of muscle soreness, tenderness, ability to function, and psychological well-being.
The results showed no effects when malic acid was taken at the dosage of 600mg for twice a day for four weeks.
However, when the dosage of malic acid was increased to 1200mg twice a day there were significant reductions in the soreness, discomfort and tenderness of the subjects. [Treatment with Super Malic: a randomized, double-blind, placebo-controlled, crossover pilot study. Russell IJ; Michalek JE; Flechas JD; Abraham GE; J Rheumatol, 22(5):953-8 1995 May]
Jorge Flechas, M.D., M.PH., a holistic practitioner in Hendersonville, N.D., has participated in two studies that have tested the combination of malic acid and magnesium for muscle soreness and fatigue. In these studies, subjects reported a significant reduction in discomfort and tenderness within 48 hours and without any side effects. In his practice, Flechas has used this supplement combination for six years on about 500 individuals. “I have found the results are positive 90 percent of the time,” he says.
Billie Jay Sahley, Ph.D., a San Antonio nutritional specialist and author, reports impressive results in reducing muscle soreness and fatigue. ‘The sooner malic acid and magnesium are started, the faster individuals begin to return to their normal lifestyles,” remarks Sahley. HW