Fibromyalgia Syndrome (FMS) is a condition characterized by generalized musculoskeletal pain, aches, stiffness, and tenderness at specific sites. One of the primary and most debilitating symptoms of FMS is muscle pain and stiffness.
Researchers believe that this pain is caused by a local hypoxia of the muscles. Hypoxia refers to a low level of oxygen in the muscle, which leads to muscle tissue breakdown and mitochondrial damage. It has been hypothesized that in hypoxic muscle tissue, glycolysis is inhibited. This leads to a reduction of ATP synthesis. ATP is the body’s main source of biochemical energy. As a result, the body begins to break down muscle proteins into amino acids to be utilized for ATP synthesis. This breakdown of muscle tissue is thought to be the cause of the muscle pain characteristic of FMS.
Leading FMS researchers and physicians such as 1. Jon Russell, M.D., Ph.D. prescribe malic acid as part of the multi- modal treatment plan for FMS, specifically for symptoms of hypoxia. In recent research at the University of Texas at San Antonio, malic acid was an element of the treatment program that showed improvement with FMS symptoms such as muscle pain.
Malic acid is a nutrient derived from fruit; it is also synthesized in the body through the citric acid cycle. It is involved in the production of energy in the body during aerobic and anaerobic conditions. It is capable of reversing the inhibition of glycolysis due to hypoxia. It removes accumulated reducing agents that build up during anaerobic conditions which inhibit glycolysis. This restores the production of ATP, thereby increasing available energy to the body. The body then no longer needs to break down muscle for ATP synthesis, which means that pain can be alleviated. Malic acid can thus alleviate pain and stiffness in FMS patients.