Mitochondrial Dysfunction

Malfunction of mitochondria is believed to be a primary factor in the etiology of FM, and abnormalities of the mitochondrial membranes in these patients have been reported.  Mitochondria, which are concentrated in muscle tissue, are often referred to as the "powerhouses" of the cells due to their role in energy (ATP) production. Compromised mitochondrial activity can result in alterations in muscular function, as well as nervous, immune, and cardiac dysfunction.

Certain nutritional factors play a role in maintaining the integrity and proper functioning of the mitochondria.  The

following formulas have been used in FM patients in clinical settings:

Mitochondrial Antioxidant Formula: A combination of nutrients known to positively influence mitochondrial energy production, along with antioxidants, may support a higher rate of ATP synthesis, as well as  protect mitochondria from free radicals.  Nutrients such as lipoic acid and B vitamins serve as cofactors for cellular energy production and metabolism; thiamin supports the activity of enzymes that influence citric acid cycle activity and activities of the respiratory chain; amino acids like creatine allow muscles to regenerate ATP, and N-acetyl-L-carnitine helps transport nutrients (i.e. fatty acids) into the mitochondria for energy production.  Furthermore, antioxidants such

as coenzyme Q

10,

L-glutathione, N-acetylcysteine, and vitamins C and E help prevent oxidative damage that can

affect cellular and/or mitochondrial function negatively.3-7

Malic  Acid/Magnesium Aspartate Complex: Malic  acid is a natural compound that is necessary for ATP production.8   Combined supplementation with 1,200 mg of malic acid and 300 mg magnesium administered in a dose-escalated fashion produced significant reductions in  the severity of 3 primary pain/tenderness measures

in FM patients. In another study, supplementation with malic acid (1,200-2,400 mg) and magnesium (300-600 mg) resulted in subjective improvements in myalgia within 48 hours and reduced tender point index scores were recorded at 8 weeks.9

Magnesium/Potassium Aspartate Complex: Magnesium, potassium, and aspartate have roles in intermediary metabolism (enzyme-catalyzed processes that extract energy from nutrients to build new cells) that may mitigate physical fatigue. In a study examining the effects of potassium, magnesium, and aspartate (1,000 mg potassium aspartate and 1,000 mg magnesium aspartate per day for 1-2 weeks) on 4 subjects undergoing extremely fatiguing physical exercise, non-athletes demonstrated improved physical endurance.10    Potassium-magnesium-aspartate supplementation of 1.75 g every 6 hours for 4 days was shown to prolong exercise capacity. Researchers postulate that the mechanism behind this anti-fatigue effect was the resynthesis of ATP and phosphocreatine.11