Malic acid supplement, sumac

I'm still taking 1 tsp of sumac a day, today starting at 1035 today. Earlier I experienced cloudy vision briefly - couldn't focus.

Due to the possibility of hypoglycaemia I'm laying off my usual sugar-free chocolate. Had mildish diarrhoea, but fairly normal now.

Feeling hungry as well as sometimes thirsty.

Reasonable energy.
 
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Still taking 1 tsp sumac a day - don't think I should take more due to the possibility of hypoglycaemia.

This morning my legs were much better than usual - no aching or tiredness. Felt tired after breakfast, but I think that the sumac is kicking in now. I wonder how long it takes to work?

First bowel movement was very normal but a later one was urgent and loose. I'm sleeping OK.

In case anyone is interested (especially @jnmaciuch) I'm 71, of normal weight, mildly-moderately affected by ME and have had it for 30 years.

Took a lot of drugs in my younger days and got addicted to amphetamine, but managed to kick it with difficulty.

By the way, I am occasionally getting a mild pain in the left side of my chest - presumably my heart, as you have also reported.
 
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MeSci said:
Still taking 1 tsp sumac a day - don't think I should take more due to the possibility of hypoglycaemia.

This morning my legs were much better than usual - no aching or tiredness. Felt tired after breakfast, but I think that the sumac is kicking in now. I wonder how long it takes to work?
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Thanks for sharing! For me, I usually feel an effect within ~30 minutes and it lasts for around 2 hrs with the sumac or 3-4 hrs taking half the supplement (though same as you, I think there might be some pain relief effects that carry over into the next day). Did not notice a difference for anything gastrointestinal or in nighttime sleep quality.
 
Update:

I noticed over the past few days that even though the malic acid supplement gave me a lot more energy and endurance physically, I was sometimes getting a similar "fogginess" as @MeSci experienced.
Difficulty focusing my eyes especially when reading, and some more frequent "brain fart" moments (e.g. misreading street signs and making wrong turns when I normally wouldn't). Much less severe and different from the brain fog I normally experience, but still noticeable.

Interestingly, I decided to give another chance to an old supplement I bought back when my doctors where recommending everything and the kitchen sink: mito-Q (aka more expensive ubiquinone). On it's own, it did nothing for me and I stopped taking it. However, since its mechanism of action is just downstream of malate, I thought it might actually do something for me if the malate-aspartate shuttle is "online" again from the malic acid.

So far, taking mito-Q at the beginning of the day with the malic acid has mostly eliminated those neurological effects! I've had consistent results for 3 days so far. I'm trying to find another (non-effective) supplement that is the same color/size as the mito-Q to see if I can do a little "blinded placebo" trial again.
 
I think that there are a lot of supplements that mostly suit men rather than women (and quite possibly vice versa). I tried Co-Q10 years ago and couldn't tolerate it.

I'm still doing OK with a teaspoonful of sumac per day. I don't seem to have had any ill effects from my walk to the shops a couple of days ago, which is quite unusual, I think.
 
I've only tried Coq10 when I was already on a stimulant--I wonder if the ability to tolerate it is determined by glucose availability in the cells. A stimulant causes increased blood glucose levels, which causes more of that glucose to be carried into the cell. You need that glucose for glycolysis, which then supplies the TCA cycle (where malate is acting) and oxidative phosphorylation (where CoQ10 is acting). You'll make a small amount of ATP from glycolysis, but the bulk amount is produced during oxidative phosphorylation. Perhaps stimulating downstream mitochondrial metabolism via CoQ10 without having enough glucose (or glucose + malate) to support it causes those side effects--I would imagine that this would result in increased ROS production at the very least.

Interesting to think about, since this indicates that energy metabolism in ME/CFS is potentially being impaired at multiple different points in the process, rather than everything being downstream of 1 singular issue.
 
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Still getting a great effect from the malic acid + CoQ10. I've been taking ~400 mg malic acid (dumping out half of the 800mg capsule) every 4 hours along with 1 capsule of mito-Q (I usually end up taking 2 capsules instead of 1 first thing in the morning since I want to be more mentally alert for classes in the morning). Mito-Q's manufacturer claims that 10mg mito-Q is equivalent to somewhere between 100-200mg of typical ubiquinone formulations, if anyone is interested in matching the dosage.

The other day I was able to walk nearly 3 miles (on my feet for ~1.5 hours) and only experienced a small amount of tiredness/muscle soreness, which I attributed to just being out of shape. If I needed to walk another mile for some reason, I would have been able to push through. I've been regularly able to go on long walks and haven't experienced PEM once since I started the malic acid.

I'm still experiencing brain fog after about 3-4 hours of trying to read papers/write code/problem solve for school (on par with what I would experience on a stimulant alone). However, I noticed that the brain fog tends to clear away pretty quickly once I allow myself to rest, which is probably why I felt like my brain fog "melted away" when I tried sumac for the first time in the evening.
 
I decided to try l-glutamine again (used to use it every day) instead of sumac. I think I'd overdone things a few times recently and really felt it (felt grotty).

The l-glutamine I'm trying is 500 mg capsules by Solgar.

I threw away the small amount of powdered l-glutamine that I had left as it may have deteriorated.

Feel moderate at the moment - not 'good'.
 
I bought malic acid powder and some 00 capsules because consuming it "raw" is quite bad for your teeth. I estimate each capsule holds about 700mg of malic acid.

I had a crash on Sunday which in my case means a horrendous headache, but I don't experience brain fog. I'm incredibly tired today and I've taken three capsules throughout the day, but haven't noticed a difference so far. I'm mostly symptom-free when I don't have PEM, but I have a very low PEM threshold. Sunday's PEM was triggered by a slow five minute walk.

Edit: my tiredness fluctuates throughout the day which makes to hard to attribute it to rest or any supplements.
 
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Jaybee00 said:
I think mitoq (mitoquinone mesylate), may be under patent—in the US only one company markets it, so it is expensive.

Earlier studies showed it wasn’t effective in MECFS.

https://www.s4me.info/threads/coq10-coenzyme-q10.13640/
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That's correct, it's a proprietary formulation. I've gotten a similar boost taking 2-3 100 mg generic ubiquinone from the convenience store as well, if anyone prefers not to splurge on the expensive mito-Q.

I didn't experience any effect from the mito-Q alone either. I'm thinking the effect might only become noticeable when combined with the malic acid.
 
Interesting change I’ve noticed over time: the amount of malic acid I need for the same effect is decreasing. Perhaps it’s building up in the body?

I ended up staying out of the house for longer than I anticipated, meaning that I would miss the usual time for my 3rd dose. I was expecting to feel the start of a PEM flare, as happened earlier in my “malic acid journey” when I accidentally let it wear off while in the middle of activity. But the PEM never came, 6-7 hours after taking half the supplement.

Now I can go down to 200-400 mg of malic acid once or twice per day and still have the same boost in energy and endurance.
 
Still feeling a huge difference from the malic acid! Going on 2 months now. Even had moments where I started to feel muscle pain setting in (usually the first warning sign of PEM for me) when the malic acid started to wear off after 6 hours and I was still out of the house, but taking another capsule actually reversed it and it never became full-blown PEM.

Started also taking super B-complex vitamin since I thought it might provide some raw materials for NAD+ and FAD+.

Definitely makes a difference in mental clarity—I was able to read a full research paper without losing track of thoughts or getting distracted. Also helps with letting me just get up and do tasks without having to mentally psych myself up first. Seems to get rid of the mental “hurdle” that is still present even when my body seems to have enough physical energy for a small chore.

I get the most noticeable benefit taking 2-3 500mg tablets alongside the coq10 and malic acid.
 
Another interesting thing I noticed: I’ve started to get some slight cravings for each of the supplements at certain points during the day, corresponding with when their effect seems to wear off. It’s like getting a bit of a sugar craving or having a taste for some fresh fruit. I’ll start craving the slightly sweet coating on the coq10 tables or the acidic taste of the B-complex.

Nothing bad happens if I don’t take them except for my regular ME/CFS symptoms returning, if anyone is concerned about some sort of ‘addiction’ dependence. Doesn’t seem to be the case here.

I’ve taken both coq10 and B-complex in the past, both for at least a month, and never experienced something similar. Maybe now that my body can actually utilize them, it’s able to sense that I’m getting a little low?

Might be projecting too much onto it, but my body has been helpful with these kinds of ‘cravings’ before (clued me into low iron and electrolyte imbalance in the past), so I figured I’d note it.
 
jnmaciuch said:
Started also taking super B-complex vitamin since I thought it might provide some raw materials for NAD+ and FAD+.

...

I get the most noticeable benefit taking 2-3 500mg tablets alongside the coq10 and malic acid.
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Is that 2-3 of the B-complex vitamin?
 
MeSci said:
Is that 2-3 of the B-complex vitamin?
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Yes, sorry.

Full regimen currently is:

Morning (around 8 AM):
40 mg vyvanse
~400 mg malic acid (half of 800 mg capsule)
3-4x 100 mg coq10 (a formulation that advertises 5x increased absorption, may need to increase for generic ubiquinone)
2-3x 500 mg super B-complex

Afternoon (Around 1-2pm):
~400 mg malic acid
1-2x 100 mg coq10
1x 500 mg super B-complex

If continuing activity into the evening (around 7pm), repeat afternoon dosages.

Take all with meals—nothing too sugary and no fruit to avoid potential interference with malic acid. I’ve eaten fruit sorbet about an hour after taking malic acid and it didn’t prevent the positive effect, so it might just be immediate absorption that is affected.

Note: Another friend with ME/CFS says they need to take at least ~600mg of the malic acid to feel an effect, so dosages are probably quite variable between people (if it has an effect at all)
 
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I don't want to come off to harsh but I am left wandering: What do you think @jnmaciuch is different about this than the other hundreds of stories we've read about people trying x,y,z amounts of supplements for ME/CFS (or even other conditions such as cancer, autoimmune diseases etc) or Long-Covid or people that swear by the lightening process?

It seems you've tried blinding yourself to some extent. Have you thought about repeated tests with more appropriate blinding? That would seem like a fairly simple thing to do, your partner would just have to remember the sequence of placebo vs non-placebo and somehow ensure that they can't be differentiated by taste or texture (there has been a negative trial with malic acid in fibromyalgia so presumably one could do a similar blinding as done there)? Since you mention the effects to be close to immediate it should be fairly simple to not risk feeling bad for extended periods by simply taking both the placebo and the malic acid at different time-points and noting how you feel aftwards.

Regarding the apple juice conversation. How about trying the malic acid with a juice that is low in malic acid but still contains fructose etc (or the others things conjectured why apple juice might not work). If that works it would seem rather plausible that the effects aren't due to the malic acid or at least it wouldn't immediately explain why apples, apple juice or the like can't work.
 
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