Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
Acidum malicum, lactic acid, malolactic fermentation, sodium malate, sour apples.
Note: Maleic acid and malonic acid should not be confused with malic acid.
Malic acid is an organic dicarboxylic acid found in wines, sour apples, and other fruits. Phosphoric acid is an acidulant added to cola drinks. An acidulant is a substance added to food or beverages to lower pH and to impart a tart taste. Malic acid is also used a flavoring agent in the processing of some foods. In addition to food uses, malic acid is sometimes used in cosmetics to adjust the pH.
Preliminary studies indicate that malic acid may reduce injury from ischemic reperfusion injury and reduce blood pressure. However, there is insufficient available evidence in humans to support the use of malic acid for any medical indication.
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
No available studies qualify for inclusion in the evidence table.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.
Appetite stimulant, food uses, hypertension (high blood pressure), ischemia-reperfusion injury prevention.
The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Adults (18 years and older):
There is no proven safe of effective dose for malic acid.
Children (younger than 18 years):
There is no proven safe of effective dose for malic acid in children.
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Avoid in individuals with a known allergy or hypersensitivity to malic acid.
Side Effects and Warnings
Reports of malic acid related adverse effects are currently lacking. Although not well studied in humans, malic acid may irritate the skin and eyes when applied to the skin (topically). In a homeopathic pathogenetic trial of Acidum malicum 12 cH, no serious adverse reactions occurred. Use cautiously in patients with sensitive skin, eyes, allergy or sensitivity to malic acid.
Pregnancy and Breastfeeding
Malic acid is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence.
Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
Although not well studied in humans, malic acid may reduce blood pressure. Caution is advised in patients taking blood pressure lowering agents.
Chronic feeding of malic acid may increase weight gain and change eating habits. Although not confirmed in human studies, caution is advised when combining with weight loss agents due to conflicting effects.
Interactions with Herbs and Dietary Supplements
Although not well studied in humans, malic acid may reduce blood pressure. Caution is advised in patients taking blood pressure lowering herbs or supplements.
Chronic feeding of malic acid may increase weight gain and change eating habits. Although not confirmed in human studies, caution is advised when combining with weight loss herbs or supplements due to conflicting effects.
This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Falchi M, Bertelli A, Lo Scalzo R, et al. Comparison of cardioprotective abilities between the flesh and skin of grapes. J Agric Food Chem 9-6-2006;54(18):6613-6622. View Abstract
Fisher P, Dantas F. Homeopathic pathogenetic trials of Acidum malicum and Acidum ascorbicum. Br Homeopath J 2001;90(3):118-125. View Abstract
Fiume Z. Final report on the safety assessment of Malic Acid and Sodium Malate. Int J Toxicol 2001;20 Suppl 1:47-55. View Abstract
Saleem R, Ahmad M, Naz A, et al. Hypotensive and toxicological study of citric acid and other constituents from Tagetes patula roots. Arch Pharm Res 2004;27(10):1037-1042. View Abstract
Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017