Research has shown a link between magnesium deficiency and fibromyalgia. In The Journal of Nutritional Medicine (1994;4:165-167) research on 100 fibromyalgia patients and 12 controls with osteoarthritis found that the patients with fibromyalgia had very low red blood cell magnesium levels. Other research published in The Journal of Nutritional Medicine (1992;3:49-59) 15 patients with fibromyalgia were treated with a combination of magnesium and malic acid for eight weeks. Those receiving the supplementation experienced a decrease in the sensitivity of the tender points. Within two days of the start of supplementation, the patients experienced decreased myalgia. Subjects receiving the placebo actually got worse. Magnesium and malic acid are necessary for the production of ATP. Magnesium is also necessary for most enzymes that require B vitamins as a cofactor.

In the Journal of Advancement in Medicine (Summer 1992;5(2):105-113) there was an article about the connection between fibromyalgia, the erythrocyte transketolase test, and thiamin. Researchers tested erythrocyte transketolase (a means of measuring thiamin need) in 137 subjects. Seventy-five of the subjects experienced chronic pain. They were divided into five groups. Group one was the control group and had no symptoms. The second group had pain that occurred only with excess activity or stress. Group three had chronic joint pain. Group four were alcoholics, and group five had taken B complex vitamins orally. Erythrocyte transketolase activity was lower in fibromyalgia patients and in alcoholics. The authors of the article note that fibromyalgia patients have responded to thiamin injections. According to the article, fibromyalgia patients respond better to the phosphorylated form of thiamin than they do to thiamin hydrochloride. The problem may be due to how the thiamin is metabolized rather than a simple deficiency.

Adrenal function may be an issue for fibromyalgia patients. A small study appearing in the American Journal of Medicine (May, 1999;106:534-543) looked at cortisol levels and ACTH levels in 15 women with fibromyalgia and in 13 healthy controls. To quote the authors, “Women with fibromyalgia had normal 24-hour urinary free cortisol levels and normal diurnal patterns of ACTH and cortisol. There was a significant, approximately 30%, reduction in the ACTH and epinephrine responses to hypoglycemia in women with fibromyalgia compared with controls. Patients with fibromyalgia have an impaired ability to activate the hypothalamic-pituitary portion of the hypothalamic-pituitary-adrenal axis as well as the sympathoadrenal system, leading to reduced ACTH and epinephrine responses to hypoglycemia.” The fibromyalgia patients had an impaired adrenal response to the hypoglycemia.

About 90% of fibromyalgia sufferers are women. Published in the Annals of Rheumatic Disease (2001; 60: 21-26) was a small study, involving 21 women. Eleven went through a strength-training program, 10 received no special care. After a 21-week strength training program, women with fibromyalgia experienced a reduction in their levels of depression and fatigue. Their pain levels, however, did not change. In another study, published in the British Medical Journal (Volume 325, Number 7357, Issue of 27 Jul 2002), point-tenderness did improve with exercise.

The British study, involving 130 fibromyalgia patients, had the subjects performing either progressive aerobic exercise (on a treadmill or stationary bike), or relaxation and stretching. Researchers found that subjects performing exercise were twice as likely to rate themselves as much better or very much better, as compared to those who did flexibility training and relaxation techniques. The benefits of the exercise were sustained when patients were checked at a one-year follow up. Patients in the exercise group also showed larger reductions in terms of the number of tender points. Tender points, or “trigger points,” are locations on patients that produce a sharp pain if pushed on during an examination.


Dr. Paul G. Varnas graduated from National College of Chiropractic in 1983 and has been in private practice in the Chicago area for over 25 years. He is a Diplomate of the American Clinical Board of Nutrition and has written several books and hundreds of articles about health care. Dr. Varnas is the founder of Whole Health America, which is a resource for chiropractors and other health practitioners that provides Web sites, newsletters, marketing material, and other practice development material.


There is a good resource for your practice, There you will find free newsletters, patient education material, marketing information, health articles and more—all free.