Magnesium Treats Fibromyalgia Pain

by Kristin Thorson, Editor, Fibromyalgia Network
Posted: January 31, 2012

Why would magnesium reduce your fibromyalgia symptoms, and how does the addition of an old drug, amitriptyline, improve its effectiveness? Similarities certainly exist between the clinical symptoms of fibromyalgia and magnesium deficiency, such as muscle pain, cramping, headache, and poor sleep. But do fibromyalgia patients have low levels of magnesium? The answer is mixed because it all depends on which part of the blood is sampled.

A study headed up by Selda Bagis, M.D., of Turkey, helps clarify the link between magnesium deficiency, your symptoms, and how supplementation therapy might play a role in fibromyalgia.*

First Bagis looked at the magnesium levels in the serum (clear liquid fraction of the blood containing nutrients but no cells) and the red blood cells (loaded with oxygen and sugar needed by the muscles). She compared the results of fibromyalgia patients to that of age-matched healthy control subjects. She also checked to see if any symptoms corresponded to the magnesium levels in the serum and red blood cells.

Overall, Bagis found the lower the magnesium level, the greater the fibromyalgia-related symptoms. The symptoms associated with reduced magnesium in the serum and the red blood cells are listed in Table 1 below.

Low serum magnesium levels also corresponded to an increase in sleep disorders and gastric upset. This makes sense because magnesium is involved in the production of the sleep-promoting hormone, melatonin, and it is a known agent for settling the stomach (e.g., Milk of Magnesia). On the other hand, the red blood cells cannot provide oxygen and glucose fuel for powering muscle movements unless ample magnesium is present.  So lower levels of this mineral in red blood cells would likely influence muscle symptoms, such as the number of tender points and the patient’s pain rating.

The second part of Bagis’ study was to compare the effectiveness of three different therapies for treating fibromyalgia (using three groups of 20 patients each): 300 mg of magnesium citrate, 10 mg of amitriptyline (an inexpensive antidepressant that works similar to Cymbalta), and the combination of the two therapies (300 mg of magnesium citrate plus 10 mg of amitriptyline). The trial lasted for eight weeks and all treatments were taken in the evening.

Antidepressants that increase both serotonin and norepinephrine at the nerve junction are often prescribed to treat pain because they supposedly work by bolstering the spinal cord’s pain fighting system. It would be important to know if a commonly prescribed medication eases different symptoms than magnesium or if the combo might work synergistically to reduce the impact of fibromyalgia. Table 2 shows a comparison of the three different treatment approaches.

“We found that magnesium supplementation was effective on reducing muscle tenderness and functional status,” says Bagis. “But amitriptyline plus magnesium supplementation was more effective on all parameters than either treatment alone.”

The sedating effects of amitriptyline likely led to the reported improvements in sleep (in addition to increasing serotonin, it also works like an anti-histamine). In turn, this may have improved next-day energy levels. However, Bagis cautions this was a short-term study and the drug may lose potency over time. Magnesium, on the other hand, should not lose its effectiveness with continued use.

The use of magnesium at bedtime appears to be able to augment the impact of standard fibromyalgia treatments. In addition, Bagis found magnesium levels are lower in fibro patients compared to healthy controls, and these lower levels appear to be associated with many commonly reported symptoms for this condition.

“All of these findings support the fact that magnesium plays an important role in the development of fibromyalgia,” claims Bagis. Regardless of what your current treatments are, you may talk to your doctor about adding 300 mg per night of magnesium citrate. Although this dose produced minor gastrointestinal irritation in the study participants, keep in mind all fibromyalgia patients are different and you may need to adjust the dose accordingly.

* Bagis S, et al. Rheumatology Int [epub ahead of print] Jan. 22, 2012.

51 Responses to Magnesium Treats Fibromyalgia Pain

  1. Zena says:

    I was diagnosed with fibromyalgia nearly 10 years ago after being referred to a rheumatologist at my request. I have taken 10mg of amitriptyline nightly since then and always found it to not only assist with sleep but also with muscular aches and pains in the morning in particular. At least 7 or 8 years ago I also started taking magnesium as I found I was getting a lot of muscular cramps and I have found this also to assist. My ability to sleep the whole night was starting to flag so I now also have a couple of cups of ‘sleep’ tea before retiring for the night and this has certainly improved the length and quality of my sleep. One other thing that I have taken for at least the past 8 to 10 years is resveratrol. I can honestly say with this group of supplements/medications that I am feeling the best that I have for at least 15 to 20 years. Reading up about fibro and trying things out for myself has certainly helped me personally so your findings are no surprise to me at all.

  2. Kerry Hobbs says:

    This is exactley what worked for me although my dosage of amitriptyline is much higher. Approx. 100mg per night.

  3. Mary says:

    Thank you for publishing this. I notice a big difference if I stop taking my magnesium.

    I also find it pronouncedly helpful when I take warm Epsom salt baths. Magnesium is a natural muscle relaxant and is absorbed through the skin.

    I appreciate your website very much. Thank you!

  4. Jeanne says:

    I found that taking magnesium caused diarrhea…wonder if anyone has a remedy for that side effect?

    • Channing says:

      It’s probably the form. Chelated magnesium can be taken at higher doses without that side effect, but if you are taking mag oxide that’s common.

    • Shelly says:

      Jeanne, I found that eating things higher in fiber helps put bulk in the bowel movement or try a lower dose of Magnesium.
      hope you get some relief :)

      • Linda says:

        Fiber is not an option if you have IBS. My gastroenterologist says that IBS is the only G.I. condition for which fiber is bad. Fiber/bulk irritates the intestinal wall and causes dirrhea. I found this out when I went on
        the South Beach Diet and had IBS for 6 months and finally went to see the specialist.

    • Kaye says:

      About the diarrhea side effect…. me too so I just bought magnesium oil online (Ancient Minerals) to rub on skin so it bypasses the gut. Also comes in lotion and gel.

    • Kris says:

      I also suffer from irritable bowel & interstitial cystitis in addition to fibro. It was my urologist who recommended adjusting magnesium. I found the only one I could take is Magnesium Glycinate. I usually take 100mg at night but if I get constipated my doctor said to take up to 400mg, which usually gives me diarrhea. You can also take 2X a day. So it could be dose related. I tried other brands & had trouble with all of them except this one. I think because most contain a lot of other ingredients. This one doesn’t. Good luck.

    • Linda says:

      Not much to do for Magnesium-related dirrhea that I know of except to reduce dose. I don’t usually have aproblem unless I get over 500mg.

  5. Leslie Wilson says:

    I have always read that Magnesium should be taken with Malic Acid for Fibromyalgia muscle pain. Can anyone verify this? I believe I first read this in the Fibromyalgia Network! I take 400 mg of Magnesium and 800 mg of Malic Acid each day. (I will be switching this to a night dose, after reading this article.)I have had Fibro and Myofacial Pain Disorder since the 1980′s, and my muscle pain isn’t anywhere near as severe as it was, since I started taking Magnesium and Malic Acid.

  6. Jan says:

    I started Cymbalta six years ago and find that it helps a great deal with morning pain. Unfortunately, I seem to have some sort of allergy to magnesium in all forms which I discovered after a lot of trial and error. It actually increases my leg cramping as well as fatigue. Blood test shows significant magnesium level in the body. Also, potassium rich foods add to my RLS. Wondering if anyone else with FM has this problem?

  7. Mary Davidson says:

    I have taken Malic Acid (a form of magnesium) for over 10 years. It was much more effective when I first took it than now as the pain level has escalated over the intervening years. I am also taking Amitriptyline, Tizanadine (muscle relaxer) and tramadol (pain killer) and still have sufficient pain that I can barely walk. Never mind get up and actually DO something. I will try resveratrol as I’m willing to take just about anything short of rat poison to find a medication that allowed me to get back to my previous level of activities!!!

    • margaret walker says:

      Mary i am so disheartened to hear how much pain you are in. I can fully understand. My doctor put me on Lexapro about 6 years ago and i could tell a difference almost overnight. Please don’t give up. I take it in the morning, along with the same two meds you mentioned at night.

    • sharon says:

      Magnesium did not seem to help, except with my migraines. What has made a world of difference for me is Savella, which I started on last August; within weeks my pain level decreased from 8 to 3 or 4, and my skin sensitivity is way less. The only thing it hasn’t helped with is the trigger points, and I do have some stomach upset with Savella. But I’m a lot better than I’ve been in years! And a bonus is I lost most of the weight Cymbalta put on. I’ll be praying you find some relief!

  8. Todd says:

    My experience with Magnesium has been that it knocks me out. I will sleep all day literally unable to stay awake.

  9. Deborah says:

    I’m in the midst of testing to see if Magnesium Malate at 400 mg daily makes any difference to my muscle pain. The test I have devised is how long can I use the hair dryer with my left hand before I need a break. After nearly 4 weeks no improvement yet. I suspect that it’s going to be one of those “minor improvements and not worth the high expense” kind of supplement. Having read this article, I think I’ll do the same with Magnesium Citrite (after a few week break from the Magnesium Malate). I can’t add amitriptyline or cymbalta .. I go bananas with the tiniest dose. Good luck to all who try the magnesium and amitriptyline.

  10. jeanette says:

    Can anyone offer me some advise. I live in the uk and am not up to date with any medications for fibro. I have had OA since 1999 and fibro since 2005. I go to pain clinic at the hospital once a year for a review and sometimes have pain relief injected into my joints, but that’s it. I don’t have anything for pain. I read my fibro network and e-mails from the network to gain all my information as my gp and specialist dont give me any info at all, or pain meds. My quality of life is very poor in that every inch of my body hurts, I can’t remember the last time I had quality sleep. I am almost housebound and only go out if someone comes with me. Can anyone suggest to me what I should ask my pain specialist and gp in order to improve my quality of life.

    • Aylesbury CP & FMA Support says:

      Jeannette, have a look on the website of FMA-UK.
      There’s a leaflet for health professionals on there as well as lots of information. They will also be able to direct you to your local support group where you can get more information and if they run meetings you can meet other people in your area with Fibromyalgia. Very often in the support groups you will find people who have gone through the same problems as you’re experiencing. Not all health professionals on the NHS are aware of fibromyalgia and thats why the support for patients is not great within the NHS.

    • Beth says:

      I would start by finding a new primary. I have a wonderful primary and he is willing to help me try anything. I have not had much help with any antidepressants. I have to take hydrocodone and oxy for break through pain. I also take muslce relaxers and ambien. Magnesium makes me experience stomach upset and diarrhea. I take cell food drops to stay healthy and lots of acidopholis and as much vitamin C as I can without causing diarrhea. Everything else I was taking would make me so drowsy I could not even get out of bed. Cymbalta casued vertigo. My life has changed so dramtically. I don’t do much for enjoyment, but at least I can say I have tried everything I possibly can. I go for massage therapy for trigger point release and cranio sacral therapy weekly. My pain has improved but I have not found anything to give me my life back short of major narcotics which I am very careful with. Please find a new primary to work with you. Don’t give up. Sometimes you just need someone who is really listening to you and not blowing off your pain. Good luck Jeanette.

      • cindy stearns says:

        Beth- I related to your input on finding the right doc. I adore mine, however, it seems I am on so many drugs that give horrible side effects. My stomach extended out 4 inches, and endocscopy said I’m fine. Finally, I just stopped eating and after 5 months, lost the 25 pounds. I was reading the above…wondering about the many suggestions about Magnesium or amitriptyline or resveratrol or tramadol. This is the first time I have seen this sight, so have many questions. I am getting no relief from 6 drugs (some 3xday). The side effects have brought on IBS, nausea, dizziness, and headaches.

    • Linda says:

      Jeanette, I too fnd your situation untolerable in this day and age. You definitely need to find a more sympathetic doctor. Persoanally, I was diagnosed with Fibro in the mid-80′s, and still try new things. Currently the most effective for me is LUNESTA 20mg at night with AMITRIPTALINE 5mg, and MAGNESIUM 250mg. CYMBALTA 60mg for the depression (does not seem to help my pain, but many say it does help theirs.) Also take TYLENOL WITH CODIENE 5mg as needed for flares.
      I have been very fortunate in my primary care doctors. Since my pain and symptoms have been documented for many years, and my self management and use of the narcotic is very carefully chosen, I have never had anyone deny me pain relief.
      Very best of luck to you. Do not give up in seeking relief.

    • Paula says:

      I have had fibro since 2001 and now i am 51. I have hypertension high blood pressure and take meds for that. When I was told I had Fibro, my doctor pt me on Trazadone. I finally got sleep it was a miracle! I could finally sleep. Now over the years I still am on 2 antidepressants. I take trazadone and the anti depressants at night a about 30 mins. before I go to bed. I am also on clonazepam 1mg and i take this at night with my other meds and i found i sleep even better now. Having fibro you it is a must to get a good full night sleep is the key to helping you feel better. I am now up to 150 mgs on trazadone over the years i have had to work myself up to that where i can sleep and this helps me so much. Everyone’s body is different. Do not give up. The Trazadone really helps me sleep good. It is an old medicine. We make look ok on the outside,but it is what is going on on the inside and how we hurt all the time. More doctors need to be educated in this illness. They think you are a complainer, and to them it is not real. Again I hope you may try some of the things I am doing, maybe it will help you. It has been along journey to get where I am today. Paula

  11. marilyn hill says:

    I also experience diarrhea with magnesium. It is almost intolerable without taking more meds to solve THAT symptom.

  12. Susan Oliver says:

    Is Amitriptyline only available by prescription? Is a Magnesium over-the-counter supplement OK, or is everyone talking about a prescribed med? Thanks.

    • Gloria says:

      Amitrypiline or Elavil is a prescribed med but Magnesium isn’t. I use a supplement called Fibro M which has 60 mg mag plus malic acid and a few other things. I take 5 capsules every night and it does help.
      Hope you find help soon.

  13. Lorri says:

    I have taken Amitriptylene for the past year, and calm(Mgnesium) with Sleepy time Extra tea for over 5 years. The Amitriptylene was giving me nightmares, so I gave it up and will stick with the Calm and the tea. I am done with prescription meds-except the vicodin for the flare ups. I am going the natural route to see if I can get some relief that way. I have already been on all the prescriptions out there except Savella, and I am not anxious to give another one a try. I know that they work for some people, I am just not one of them. Good luck everyone!

  14. Trace says:

    Susan, Yes amitriptyline is only available with a prescription (at least in the US it is). Magnesium over the counter works just fine.

  15. Lourdes says:

    I was diagnosed with fibromyalgia on 7/2008. I have had many ups and downs as far as medications are concerned. I am currently on Amitriptyline, Wellbuturin, Magnesium and Norco. In all honesty, the pain level hasn’t changed much. I just don’t know what to do anymore.

  16. Beth says:

    When I first started taking Magnesium nearly 10 yrs ago, I too had severe diarrhea accompanied by abdominal pain. I was taking 1000 mg twice a day. However, determined to get relief, I continued with the therapy. After about a month my body began to get used to the dosage and the diarrhea and bowel pains began to fade. Simply put, TIME and patience was what was needed for the magnesium therapy to work for me. After starting cymbalta, then Lyrica, and finally Savella therapy, I reduced my mag intake down to 500 mg twice daily. I am an avid supporter of magnesium supplements for FMS.

  17. LRybka says:

    My chiropractor recommended massaging magnesium oil into all major muscle groups as opposed to taking mag orally. It is better utilized by the body when it doesn’t have to go through the digestive process. This also prevents the digestive upsets and diarrhea caused by taking magnesium in the therapeutic doses needed to work.

  18. Terri says:

    I, too, live in the uk and have recently gone down the fibro route after putting up with a ton of symptoms, my doctor has been really helpfuland put me on codeine and naproxen as having 4 children ( 2 of which are special needs ) I can’t let the pain take control , go back to your doctor and ask why you can’t have these meds as it’s really commonly prescribed for fibro, don’t put up with it see another doctor if you have no luck .

  19. dot says:

    I have dealt with fibro and chronic fatigue since in the 70′s way before there a name for either condition. I have tried about every treatment out there. I just went through one of the worse times in a long time in December and January. Things are better, pain tolerable It is like turning a light switch on and off. I am now 76 and guess I will just keep dealing with the wickedness of fms and cf. Good luck to all of you who are suffering with this, hope someday, there will be a cure or as least better relief. sincerely Dot

  20. Wendy says:

    I take perscribed hydrocodone which with me caused chronic constipation for 10 yrs.
    Because I saw on the Dr Oz Show that magnesium was a good supplement (for what I dont remember now) I recently (6-8 wks ago) started taking magnesium 400mg capsules 2x qd. It evened out the issue above. I also noticed a little less fibro pain not knowing people use it to treat fibro pain until I read this article.

  21. Wendy says:

    I do not take amitriptyline although my doctors have suggeted it to me. I strongly believe in stretching every day. When I am in pain & I stop what I’m doing whether, it be cleaning my home or just sitting. If I stretch it helps alot on decreasing the pain level. To me that is amazing. Best of luck to you all.

  22. Raquel says:

    I live in Brazil, with fibro since 2003;I took Cymbalta, Effexor and others with no results. In 2006 I started to take amitriptyline 25mg and melatonin 1,5 at bed time, chelated magnesium 200 mg twice daily and malic acid 50 mg. Good results. I feel much better
    Of course, add to this hydro gymnastic, walking, Yoga and meditation!
    I appreciate very much all your information. Congratulations for your work Kristin.

  23. Karen says:

    I find that balancing magnesium intake with calcium helps reduce diarrhea. I tweak the amounts of each as needed for digestive problems.
    Note:. take calcium supplements separately from other supplements or medications – calcium can block absorption.

  24. Joan says:

    Glad to hear about this. Have had fibro since 1989 and have been on Amitriptyline, cyclobenzadrine (muscle relaxant), small amount of ambien and melatonin. I have taken malic acid in the past but had put it aside and on other meds. My primary doctor recently decided I should stop taking the Lipitor 20 mg. as that could be contributing to my pain. Hurrah…in just a few short weeks some of my pain subsided, (had been taking either tylenol or advil) but I then started on more of the Calcium and Magnesium supplement taking three times/day…so that becomes 700 mg of calcium and 300 mg. of magnesium. Believe those that have stomach or diarrhea problems might try taking it with calcium. It is my understanding that calcium will not be assimilated unless you take magnesium with it. I still have insomnia problems but hoping this new regimen will start kicking in with time. I sure do understand your pain and frustration. I have also started walking again and working on a better nutrition agenda and hope that will help me sleep. Thanks for your comments and for the Fibro network.

  25. Mindy says:

    I was planning on buying magnesium & malic acid together. Right now i am on magnesium oxide. The only med i am on is topamax., originally for hormonal migraines but my neurologist just began raising the dose to help with the fibromyalgia. My neurologist just set me up for a consult with a rheumatologist as well as ultrasound appointements. He is getting me my own TENS unit too. I am thinking of going on CoQ10.

  26. Mary Pryor says:

    I was diagnosed in 1994 and have lived with Fibro a long time. At first I tried all kinds of drugs desperate to get my life back. I found I actually got worse as the drugs seemed to cause other problems. I eventually stopped most of them, accepted my condition, and made lifestyle changes. I pace myself better, I try not to stress myself out or worry too much. I accept my limits but at times I still push too hard. I try to eat better, exersize daily especially walking. I keep my sleep and meal patterns consistant. I also think my hysterectomy improved my fibro and I am mostly drug free now. I use hot packs daily and go for massage therapy about once a month. Everyone is different and what works for me might not work for others, but there was a time I thought my life was over. I am doing better than ever now, and live a full and happy life. I make the most of the good days, rejoice at the great days, and tolerate the bad days. Good luck to finding what works for you!

  27. Maggie says:

    I’ve had Fibro since 2007. I started Savella in 2010 and I was pretty happy with it until the end of 2011. I started having more devastating pain, not sleeping, and tired all the time with pain. I began Magnesium and my sleep is so improved and so is my anxiety. When I skip a dose, I am miserable.
    I take savella, skellaxin , and the magnesium and I am sleeping so well.
    Thank goodness. Lets Not Give up Hope! Just keep trying and learning about how to take care of yourself. We need to hang in there despite how sucky this FM is for us..
    Have a great February.

  28. Linda says:

    Started taking magnesium 250mg years ago for leg cramps at night. Also, took Amitriptyline 10 mg for years at the same time. I have not noticed any difference in “fibro” pain, but it did certainly stop the leg cramps.

  29. Leslie D. says:

    Does anyone out there with Fibro experience a burning pain in their body? Mine seems to be in the skin and can move all over–sometimes back, chest, arms, legs. My doc says this is not uncommon but I never hear of anyone else having it. Anyone heard of it? Good luck to everyone. This condition is a real challenge.

    • BenLes says:

      Hi Leslie, I too have skin sensitivity. It’s called allodynia which means other pain. I can remember one time my scalp was so sensitive I couldn’t touch it. Sometimes I can hardly bear to have my clothes touching my skin. When this happens I take Tramadol and that seems to do the trick plus rest somewhere warm and comfortable. When I can tolerate it I have an aromatherapy massage which is very calming.

      • Rachel Escamilla says:

        Me too, can’t wear cloths. I wear shorts 90% of the time. Undercloths hurt the most. I now wear mens underwear and an ahh bra. Seems to work for me. Shoes, socks, coats, heavy stuff I can’t wear. Sometimes just in my room with a light night gown. The worst part is family don’t believe me.

    • Rachel Escamilla says:

      I too get burning. I use goldbond cream. Its awful the burning, cause there isnt any rash. Funny HuH.

  30. AliceK says:

    If you add calcium and potassium you won’t have diahrreah. Or eat a couple of bananas – that’s your potassium. Might even get constipated.

  31. Catherine S. says:

    I have struggled with FM since 1990. I was not able to tolerate amitriptyline. I take 5mg (half a 10 mg tablet) of cyclobenzeprine (Flexeril) in the early evening to help with quality sleep and pain. Previous studies reported in the FMNewsletter showed that less is often better than more for FM (2-3 mg being the best dose for many people). I have minimal problems waking up in the morning if I take it 12- 13 hours before I want to wake up. Each person needs to start low on many meds used for FM and tailor it for their system. In addition, it can take up to 2 weeks to know if many medications are helping.
    As a dietitian, I know it is important to adjust the dose of Mg to reduce GI problems. It helps with the mild constipation caused by the 50mg tramadol (Ultram) I take 3 times a day for pain. Magnesium competes for absorption with calcium and other minerals so it is important to eat/supplement calcium and vitamin D earlier in the day or evening.
    Magnesium can interfere with throid replacement medications as well as other medications and supplements. It is recommended to search “magnesium-drug interactions” and choose a reputable site to look for any cautions about taking magnesium. It is also recommended to check with a medical/pharmacy professional before taking anything, including magnesium.

  32. Deborah says:

    To Leslie
    I experience burning pain. At first it was in my upper /middle back. It would come and go for years. Also, burning spots in my arms.
    It seems better now that I am doing yoga and have made many lifestyle changes. Eating healthier (no processed foods) basically a yogi diet.

  33. Esperanza Abinsay says:

    I have cramps, tingling, stiffness, tender/trigger points and numbness and I can’t tolerate walking continously for more than 15 minutes. I tried Malic Acid, Magnesium, and I am on Neurontin. I get massages every now and then to release my trigger points, and heated pool exercises. My legs tend to get really stiff, so I tried Magnesium Oil plus Frankincense or coconut oil on my legs. It seemed to alleviate the symptoms to some degree. I have read that Magnesium oil is better absorbed by the skin, rather than taking it by mouth. So I would imagine that even the Epsom Salt soaks would be beneficial

  34. krysta says:

    I am taking magnesium and 10 mg of Amitryptiline and have been doing so for awhile amitryptiline helps my sleep, and I guess compared with not taking it, it is better, but I have been in a “flare” that has lasted 2 weeks right now, and nothing seems to help. I do all the right things: vegetarian healthy diet, no, or very low alcohol, no aspartame or nutrasweet, I swim and do yoga regularly, I have started breathing exercises, and I try and relax, but other than very slow swims. Sorry… this is a bit more than the response to the magnesium post, but suffice to say, tried everything, including magnesium, and when I get a flare, not much one can do….

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