Many research studies that show that Malic Acid can help people that suffer from this type of pain associated with muscle and tissue hypoxia. Malic acid is found not only in food but also is synthesized through the (Krebs) cycle. In a study on the effect of the oral administration of malic acid to rats, a significant increase in anaerobic endurance was found. Interestingly, the improvement in endurance was not accompanied by an increase in carbohydrate and oxygen utilization, suggesting that malic acid has carbohydrate and oxygen-sparing effects. In addition, malic acid is the only metabolite of the citric acid cycle positively correlated with physical activity. It has also been demonstrated that exercise-induced mitochondrial respiration is associated with an accumulation of Malic acid.

Because of the compelling evidence that Malic acid plays a central role in energy production, especially during hypoxic conditions, Malic acid supplements have been examined for their effects on FM. Subjective improvement in pain was observed within 48 hours of supplementation with 1200 – 2400 milligrams of Malic acid, and this improvement was lost following the discontinuation of malic acid for 48 hours. While these studies also used magnesium supplements, due to the fact that magnesium is often low in FM patients, the rapid improvement following malic acid, as well as the rapid deterioration after discontinuation, suggests that malic acid is the most important component. This interesting theory of localized hypoxia in FM, and the ability of malic acid to overcome the block in energy production that this causes, should provide hope for those afflicted with FM.

With the vast majority of my Fibro patients I recommend that they supplement with approximately 1500 – 2000mg of Malic Acid and 500 -750mg of Magnesium daily. Magnesium should not only aid with muscle spasm but does help patients obtain a better quality sleep. Because of this I prefer not having them obtain a combination supplement but rather take their Malic and Magnesium seperately. Malic acid can be split up 3 times per day but the bulk of their Magnesium supplement should be taken approximately 1 hour before sleep.

Growth hormone is not only important during our childhood but we need it as adults to help tissue heal. That is why the deepest levels of sleep are known as the levels of “restorative” sleep. When we move and exercise there are small microscopic changes or breakdowns in our muscles. These microscopic changes in people with normal growth hormone levels heal rapidly and there is no true discomfort. With FMS and lower levels of somatomedin C (HGH), the tissue doesn’t heal readily. Stiffness, pain and muscle fatigue result and this has a cascading effect on a person’s overall activity level. This is one of the main reasons why many with FMS become deconditioned. It is not because they are lazy or don’t want to exercise: it is because they truly can’t. It just hurts too much. The “post exertional soreness” that non fibro people feel after a “good” workout at the gym goes away in a day. In actuality many people even enjoy that slight soreness that happens after a “good workout” because they know that in a day or so, they will feel great again and be ready to hit the gym. Sadly this is often not the case for those with FMS.

In my office, I constantly see this as a major point of confusion even with many health care providers who wrongly minimize the patient’s true condition and dismiss them by suggesting that they are deconditioned and just need to exercise more. This point has become extremely irritating to me because I hear it repeated so often. With Fibro patients, less is more. If a patient with low HGH is told to work out harder in order to get in better condition, they will likely find themselves not only frustrated but often in a severe Fibro Flare. Only a patient with FMS can know the real frustration that comes when a health care provider or maybe a spouse thinks that they are lazy for not working out. This is the reason why there are times when I ask patients if they would like to bring their spouse along so that I can explain some of the true “chemical” reasons why people with FMS can’t just “work through the pain”.

So how does one go about getting a more restorative sleep and help boost their levels of HGH? Well, first and foremost, they should realize that it is not the quantity of sleep as much as the quality. Getting into those deep levels of sleep is what is most important because that is when most of our brain chemistry is manufactured. I realize that there are many prescription sleep aids that are now on the market and although they will make you sleep, they don’t seem to provide a “normal” pattern and subsequently do little to change HGH levels.

In my practice I first suggest a patient take 5HTP, which is a precursor to tryptophan. I also often will recommend 3mg. of melatonin 30 minutes before sleep. Both of these products are natural and help the body get into a “normal” cycle or pattern of sleep.

Another incredibly beneficial aid to good restorative sleep is meditation and deep breathing techniques. This does more than just relax a person but helps to set the stage for someone to enter stage 4 delta sleep more readily. Again, this is the most important level of sleep for those needing an increase in those all important neurochemicals like HGH. I will often advise people to listen to some guided imagry CDs or download the CDs unto their IPODS. We recommend many meditative CDs offered through our Amazon A-store.

Though this is a very brief discussion of the science of sleep and the connection it has to FMS, I wanted to at least make people aware of that very important connection. I encourage you to become a member of our site as we will be getting into much more detail on this and more Fibromyalgia topics in our forums, our chats and podcasts.