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Many fibromyalgia experts and texts recommend nutritional supplements as a way to offset or eliminate fibro symptoms. But do those supplements really work?
Following is a rundown of a few of the most-often recommended supplements, as well as my own personal experience with some of them.
CAUTION: Remember that, as with every potential treatment, you should always consult with your physician before trying any of these supplements out. Even so-called natural remedies can interact dangerously with other remedies and medications, so talk to your doctor first.
Malic Acid and Magnesium
Particularly when taken together, experts suggest, malic acid and magnesium can alleviate the more painful fibro symptoms. Malic acid is derived from tart apples, while magnesium is, of course, an essential mineral necessary for more than 300 bodily biochemcial functions.
Among the most important of these functions are muscular function and the creation/processing of ATP in the body. (ATP, briefly, is adenosine triphosphate, and results from the enzyme-catalyzed processing of sugar and fat.) Magnesium activates the process, and malic acid helps the body make ATP more efficiently.
Past research also suggests that magnesium may work to dampen the processing of some types of pain signals in fibromyalgia sufferers.
You can view more information on magnesium at the NIH fact sheet here, and an abstract of one study’s results looking at the combination of malic acid and magnesium can be found here (results: “significant reduction” in pain symptoms in increased dosages in open trial). However, it should be noted that an earlier double-blind phase of that same study showed no appreciable effect on FM patients who took magnesium/malic acid supplements.
Possible side effects:
- Nausea or diminished appetite
- Respiratory difficulties
- Adverse interactions with some medications (including osteoporosis drugs, certain hypertension medications, antibiotics, and muscle relaxers)
A naturally-occuring chemical compound found in the human body, SAMe plays an important role in several critical functions, including the immune system response and the creation and processing of chemical neurotransmitters such as serotonin and dopamine.
Some research indicates that SAMe might be beneficial for FM patients. In one double-blind study looking at SAMe’s effects on 17 fibromites (more than half of whom also had been diagnosed with depression), both the number of painful tender points and assessed depression decreased appreciably with SAMe as compared to the placebo group. While intriguing, the relatively small number of subjects in this study warrants caution in evaluating its results.
Other study results conflict with each other. In one slightly larger study (44 subjects), there was appreciable decrease in some symptoms (pain, tiredness) but not others (tender points, mood). Another study delivered SAMe via IV, but found no measurable decrease in tender points.
Possible side effects:
- Indigestion and other digestive disorders
- More rarely: diarrhea, acid reflux
- Caution: FM patients who are diagnosed with bipolar disorder should not take SAMe; it may increase the occurrence and severity of manic episodes. SAMe may be contraindicated for those taking antidepressants; consult your doctor first (as you should before taking any new supplement or medication).
There is some promising research on 5-HTP and fibromyalgia, showing that it can reduce tender points and increase serotonin, the “feel good” neurotransmitter.
There is no fact sheet for 5-HTP at NIH, but you can find good information on it at this site. While it’s found in low levels in some foods (turkey, for one), most will want to choose a supplement form.
Possible Side Effects:
- Loss of appetite, nausea, and vomiting
- Pupil dilation
- Muscular coordination problems
- Blurred vision
- Irregular cardiac rhythms
- Caution: Do not take 5-HTP if you’re currently taking any antidepressant.
A few studies with relatively small subject numbers indicate that FM patients may have lower levels of vitamin B12. As B12 is an essential vitamin, it’s certainly worth looking into your intake.
Good dietary sources of B12 are animal products — meats, fish, eggs — and fortified cereals. It’s not usually found in fruits and vegetables. The current RDA for mature men and women ranges from 2.4 to 2.8 micrograms.
You can also take a multivitamin that has B12 in it, or an individual supplement pill for B12 or B Complex (includes B12 as well as B1, B2, B3, and B6).
You can read more information on Vitamin B12 at the NIH website’s fact sheet.
Possible side effects:
- B12 has a very low risk of toxicity but it can be contraindicated with certain medications. As always, talk to your doctor.
Some researchers have found a connection between vitamin D deficiency and general musculoskeletal pain. Certainly, vitamin D is generally recommended for overall nutritional health and wellbeing.
The current recommended intake level for vitamin D in the US is 200 I.U. for men and women up to age 50, rising up to 600 I.U. for older patients. Toxicity has been established at 50,000 I.U.
It’s difficult to get all the Vitamin D you need from foods, but it is present in fortified milk products and certain fatty fish (particularly the skins). You can also increase your body’s own production of the vitamin with sunlight exposure without sunscreen (just a few minutes a day are all that’s required).
Get more info from the NIH Fact Sheet on Vitamin D.
Possible Side Effects:
With too-high intakes of Vitamin D, certain side effects are known:
- Decreased appetite
- High blood levels of calcium may also lead to confusion and irregular heart rhythms
Personal Experience With Supplements for Fibromyalgia
Of these commonly-recommended supplements, I’ve given two-month trials to malic acid and magnesium (taken together); vitamin B12; SAMe; and 5-HTP. I’m currently experimenting with vitamin D.
I experienced no measurable relief with malic acid and magnesium. While on increased levels of B12 (a multivitamin plus an additional supplement, providing a total of 580 mcg, I did notice a slight increase in my energy level, but no decrease in pain symptoms.
SAMe and 5-HTP both produced some interesting results. I believe my pain symptoms leveled off — I had fewer flare-ups, and when I did experience increased pain days, it seemed that my “lows” weren’t quite as low as previously. Also with 5-HTP (but not SAMe), I felt my neck/shoulder tender points were a little diminished in terms of sensitivity.
Of course, in each of these try-outs, I knew what I was taking. My results could be attributable to a placebo effect (although that doesn’t explain why I didn’t experience any benefit with malic acid and magnesium; 10 years ago, when I was first diagnosed, it was the first- and most-often-recommended supplement).
You should never take any one person’s recommendation for a treatment option. Do your own research, talk to your doctor, and if you do want to try one of these supplements, try going in without any expectations.
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