Magnesium Treats Fibromyalgia Pain
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.