Research has suggested a relationship between magnesium deficiency and fibromyalgia. Studies published in Journal of Nutritional Medicine (1994; Volume 4:165–167) evaluated 100 patients with fibromyalgia and 12 control subjects with osteoarthritis. The researchers found that individuals with fibromyalgia had markedly low red blood cell magnesium levels compared with controls.
Additional research published in the same journal (1992; Volume 3:49–59) examined 15 patients with fibromyalgia who received a combination of magnesium and malic acid for eight weeks. Participants receiving supplementation experienced a reduction in tenderness at trigger points, and decreased muscle pain was reported within two days of starting supplementation. In contrast, subjects receiving placebo reported worsening symptoms. Magnesium and malic acid are both involved in ATP production, and magnesium is required for the activity of many enzymes that depend on B vitamins as cofactors.
Research has also explored the role of thiamin (vitamin B1) in fibromyalgia. An article published in the Journal of Advancement in Medicine (Summer 1992; Volume 5, Issue 2, Pages 105–113) examined erythrocyte transketolase activity—a functional marker of thiamin status—in 137 subjects. Seventy-five participants reported chronic pain and were divided into groups based on symptom patterns. Erythrocyte transketolase activity was reduced in patients with fibromyalgia and in individuals with alcoholism. The authors noted that fibromyalgia patients had responded to thiamin injections, and that phosphorylated forms of thiamin appeared more effective than thiamin hydrochloride. This suggested that altered thiamin metabolism, rather than simple deficiency, might be involved.
Adrenal function has also been investigated in fibromyalgia. A small study published in the American Journal of Medicine (May 1999; Volume 106:534–543) evaluated cortisol and ACTH responses in 15 women with fibromyalgia compared with 13 healthy controls. While baseline cortisol levels and daily hormonal rhythms were normal, women with fibromyalgia showed an approximately 30% reduction in ACTH and epinephrine responses to hypoglycemia. The authors concluded that fibromyalgia patients may have impaired activation of the hypothalamic–pituitary–adrenal axis and the sympathoadrenal system under stress.
Approximately 90% of individuals with fibromyalgia are women, and exercise interventions have also been studied. A small study published in the Annals of the Rheumatic Diseases (2001; Volume 60:21–26) followed 21 women with fibromyalgia. Eleven participants completed a 21-week strength-training program, while 10 received no special intervention. Those in the exercise group experienced reductions in fatigue and depression, although pain levels did not change significantly.
Larger studies have suggested broader benefits from exercise. Research published in the British Medical Journal (July 27, 2002; Volume 325, Issue 7357) followed 130 patients with fibromyalgia who were assigned to either progressive aerobic exercise or relaxation and stretching. Participants in the exercise group were twice as likely to rate themselves as “much better” or “very much better” compared with those performing flexibility and relaxation exercises. These improvements were maintained at one-year follow-up, and the exercise group also demonstrated greater reductions in the number of tender points.
