Rheumatology International

, Volume 33, Issue 1, pp 167–172 | Cite as

Is magnesium citrate treatment effective on pain, clinical parameters and functional status in patients with fibromyalgia?

  • Selda BagisEmail author
  • Mehmet Karabiber
  • İsmet As
  • Lülüfer Tamer
  • Canan Erdogan
  • Ayçe Atalay
Original Article


The aims of this study were to investigate the relationship between magnesium levels and fibromyalgia symptoms and to determine the effect of magnesium citrate treatment on these symptoms. Sixty premenopausal women diagnosed with fibromyalgia according to the ACR criteria and 20 healthy women whose age and weight matched the premenopausal women were evaluated. Pain intensity, pain threshold, the number of tender points, the tender point index, the fibromyalgia impact questionnaire (FIQ), the Beck depression and Beck anxiety scores and patient symptoms were evaluated in all the women. Serum and erythrocyte magnesium levels were also measured. The patients were divided into three groups. The magnesium citrate (300 mg/day) was given to the first group (n = 20), amitriptyline (10 mg/day) was given to the second group (n = 20), and magnesium citrate (300 mg/day) + amitriptyline (10 mg/day) treatment was given to the third group (n = 20). All parameters were reevaluated after the 8 weeks of treatment. The serum and erythrocyte magnesium levels were significantly lower in patients with fibromyalgia than in the controls. Also there was a negative correlation between the magnesium levels and fibromyalgia symptoms. The number of tender points, tender point index, FIQ and Beck depression scores decreased significantly with the magnesium citrate treatment. The combined amitriptyline + magnesium citrate treatment proved effective on all parameters except numbness. Low magnesium levels in the erythrocyte might be an etiologic factor on fibromyalgia symptoms. The magnesium citrate treatment was only effective tender points and the intensity of fibromyalgia. However, it was effective on all parameters when used in combination with amitriptyline.


Fibromyalgia Magnesium Treatment 


  1. 1.
    Wolfe F, Smythe HA, Yunus MB et al (1990) The American College of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 33(2):160–172PubMedCrossRefGoogle Scholar
  2. 2.
    Goldenberg DL (2003) Fibromyalgia and related syndromes. In: Hochberg MC, Silman AJ (eds) Rheumatology. London, Mosby, pp 701–712Google Scholar
  3. 3.
    Bradley AL (2009) Pathophysiology of fibromyalgia. Am J Med 122:22–30CrossRefGoogle Scholar
  4. 4.
    Ali M, Ali O (1999) Fibromyalgia. An oxidative-dysoxygenative disorder (ODD). J Integr Med 3:17–37Google Scholar
  5. 5.
    Bagis S, Tamer L, Sahin G, Yazici K, Erdogan C (2005) Free radicals and antioxidants in primary fibromyalgia: an oxidative stress disorder? Rheumatol Int 25(3):188–190PubMedCrossRefGoogle Scholar
  6. 6.
    Chung CP, Titova D, Oeser A, Randels M, Avalos I, Milne GL, Morrow JD, Stein CM (2009) Oxidative stress in fibromyalgia and its relationship to symptoms. Clin Rheumatol 28(4):435–438PubMedCrossRefGoogle Scholar
  7. 7.
    Igbal R, Mughal MS, Arshad N, Arshad M (2011) Pathophysiology and antioxidant status of patients with fibromyalgia. Rheumatol Int 31(2):149–152CrossRefGoogle Scholar
  8. 8.
    Milne DB (1999) Trace elements. In: Burtis CA, Ashwood ER (eds) Tietze textbook of clinical chemistry, 3rd edn. WB Saunders Company, Philadelphia, p 1280Google Scholar
  9. 9.
    London M (1994) The role of magnesium in fibromyalgia.
  10. 10.
    Magaldi M, Moltoni L, Biasi G, Marcolongo R (2000) Changes in intracellular calcium and magnesium ions in the physiopathology of the fibromyalgia syndrome. Minerva Med 91(7–8):137–140 (Abstract)PubMedGoogle Scholar
  11. 11.
    Eisinger J, Zakarian H, Pouly E, Plantamura A, Ayavou T (1996) Protein peroxidation, magnesium deficiency and fibromyalgia. Magnes Res 9(4):313–316PubMedGoogle Scholar
  12. 12.
    Clauw D et al (1994) Muscle intracellular magnesium levels correlate with pain tolerance in fibromyalgia [abstract]. Arthritis Rheum 37:29CrossRefGoogle Scholar
  13. 13.
    Eisinger J, Plantamura A, Marie PA, Ayavou T (1994) Selenium and magnesium status in fibromyalgia. Magnes Res 7(3–4):285PubMedGoogle Scholar
  14. 14.
    Romano TJ, Stiller JW (1994) Magnesium deficiency in fibromyalgia syndrome. J Nutr Med 4:165–167CrossRefGoogle Scholar
  15. 15.
    Abraham GE, Glechas JD (1992) Management of fibromyalgia: a rationale use of magnesium and malic acid. J Nutr Med 3:49–59CrossRefGoogle Scholar
  16. 16.
    Melzack R (1987) The short form McGill pain questionnaire. Pain 30(2):191–197PubMedCrossRefGoogle Scholar
  17. 17.
    Prescott EE et al (1992) Red blood cell magnesium and fibromyalgia. Scand J Rheum 94:31Google Scholar
  18. 18.
    Sendur OF, Tastaban E, Turan Y, Ulman C (2008) The relationship between serum trace element levels and clinical parameters in patients with fibromyalgia. Rheumatol Int 28:117–1121CrossRefGoogle Scholar
  19. 19.
    Sakarya ST, Akyol Y, Bedir A, Canturk F (2011) The relationship between serum antioxidant vitamins, magnesium level and clinical parameters in patients with fibromyalgia syndrome. Clin Rheumatol (online publication)Google Scholar
  20. 20.
    Arnold LM (2009) Strategies for managing fibromyalgia. Am J Med 122:31–43CrossRefGoogle Scholar
  21. 21.
    Russel IJ, Michalec JE, Flechas JD, Abraham GE (1995) Treatment of fibromyalgia syndrome with super malic: a randomized, double blind, placebo controlled, crossover pilot study. Rheumatology 22(5):953–958Google Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Selda Bagis
    • 1
    • 5
    Email author
  • Mehmet Karabiber
    • 2
  • İsmet As
    • 3
  • Lülüfer Tamer
    • 4
  • Canan Erdogan
    • 3
  • Ayçe Atalay
    • 1
  1. 1.Department of Physical Medicine and RehabilitationAcıbadem University Medical SchoolIstanbulTurkey
  2. 2.Adıyaman State HospitalAdıyamanTurkey
  3. 3.Department of Physical Medicine and RehabilitationMersin University Medical SchoolMersinTurkey
  4. 4.Department of BiochemistryMersin University Medical SchoolMersinTurkey
  5. 5.Fulya Acıbadem Hastanesi, FTR, Dikilitaş Mah, Hakkıyeten cad, Yeşilçimen sokBeşiktaş-IstanbulTurkey

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