Fibromyalgia Basics

Covering the Bases on Nutrition

Are the nutritional recommendations for fibromyalgia patients the same as healthy individuals? Reports showing lower levels of vitamins or minerals in patients are misleading. It prompts patients to take a lot of individual supplements when it is better to strive for a balanced diet. Fibromyalgia patients need a good multivitamin, along with adequate calcium and iron and proper timing of food intake that doesn’t interfere with thyroid medication.

Kathleen Holton, Ph.D., M.P.H., of Oregon Health and Sciences University in Portland, points to two situations that necessitate nutrient increases: infections and tissue injury. Based on studies showing increased infection rates in this disease, you could be more vulnerable. However, it remains unknow how fibromyalgia specifically impacts your dietary needs, so Holton offers nutritional advice.

Hit or Miss

“When a study shows that fibromyalgia patients are deficient in a nutrient, let’s say a mineral, it encourages patients to take it,” says Holton. “As a result, patients ingest higher amounts of that nutrient than their body needs. Worse yet, it doesn’t ensure that they are getting the proper balance of daily nutrients they need.”

“This is dangerous, and I don’t want to encourage people to take individual supplements like that.”

“You cannot just say that this vitamin or mineral helps with energy, so taking it relieves fatigue,” cautions Holton. “Our bodies don’t work that way.” There are lots of nutrients involved in the pathways that lead to energy production. So, supplementing with any one element that is important in helping your cells make energy won’t cut it.

“Sometimes fibromyalgia patients come in with a bag full of all the supplements that they are taking. Most often, they consume these individual supplements because they heard that each one could be beneficial for fibromyalgia. Yet, they are seldom taking a multivitamin and mineral supplement.”

Holton does not advise fibromyalgia patients to take nutrient supplements on a hit-or-miss basis “because it does not ensure good nutrition across the board. The body requires multiple nutrients working together for it to function properly.”

A Better Balance

“Above all, I stress the importance of a healthy diet,” says Holton. “But I do recommend using a multivitamin and mineral supplement as an insurance policy. If you dose with one or two nutrients, it is very short-sighted because that is not how our bodies prefer to work.” Keep in mind, less than optimal levels of many other nutrients could also be adversely affecting your body’s metabolic processes. So, raising only one or two nutrients required for a process has a smaller likelihood of helping.

Rather than supplementing individual nutrients, Holton prefers to look at the other side of the spectrum. “I want to increase vitamin and mineral levels across the board to improve a fibromyalgia patient’s overall nutritional status.”

Searching for a good multi that contains everything you need isn’t easy and many contain unnecessary ingredients. The manufacturers hype these special additives as being wonderful for your health. However, they lack a scientific basis and can irritate a gastrointestinal (GI) system that is already contributing to your symptoms

Finding a Multi

What should you look for in a multivitamin and mineral supplement? Holton recommends a broad-spectrum containing 100 percent of all the essential nutrients for fibromyalgia patients, including iron. It’s okay to have elevated B vitamins and fruit/vegetable compounds that help with cell function.

Avoid products with additives and extra ingredients with questionable value because they could make your symptoms worse. Multiviatmins need to be suitable for vegetarians and people with common food allergies. This makes selecting a multi tricky because you need to read the labels, and you have hundreds to select from.

A hassle-free option is to use a multivitamin like Alive! Once Daily Multi-Vitamin Ultra Potency—it’s the nutritional advice Holton gives her patients with fibromyalgia. A 60-day supply costs about $20, but you save money by not buying lots of individual supplements.

Iron and Vitamin B12

The thought of eating energy-rich foods that can help you push back daily fatigue sounds like many of the commercials on TV, but it’s just not practical. “A person can eat a healthy diet with adequate levels of all the nutrients, and still be exhausted due to other reasons,” says Holton. Two common causes of fatigue are hidden food allergies and digestive disorders. But, if either iron or vitamin B12 is deficient, you most certainly will be dragging regardless of your fibromyalgia.

Iron deficiency anemia and pernicious anemia (low vitamin B12) are corrected by increasing dietary intake of these two nutrients. But don’t wait for these deficiencies to occur. Instead, guard against low iron and B12 by ensuring that your diet contains adequate amounts of each.

“The best source of iron and vitamin B12 is from red meat,” says Holton. “The iron in red meat is much more readily absorbed and used by the body than from any type of supplement. From a health perspective, select meat that is grass fed and as lean as possible.”

If you don’t consume meat, it’s essential fibromyalgia patients take a high quality multi with iron and vitamin B12 to minimize fatigue.

“Vegetable sources of iron exist, such as spinach, but the absorption of iron from plant-based foods is poor,” says Holton. “So, if you are a vegetarian, take a multivitamin and mineral supplement.”

Timing

Most people think of taking their vitamins and other supplements in the morning, but is this the ideal time?

Multi at Dinner – “The best time to take a multivitamin is right after dinner on a full stomach,” advises Holton. “This will maximize nutrient absorption and minimize stomach upset.”
GI Matters – If you are prone to gastric reflux, don’t take your multi or food within two hours of bedtime. Fluids too late in the evening can also aggravate reflux. “High doses of individual nutrients may cause constipation, but this should not happen with the multi,” says Holton.
Calcium – “Calcium inhibits the absorption of iron, so avoid taking them at the same time,” says Holton. “This is why multivitamin and mineral supplements that contain 100 percent of your daily iron needs are low in calcium.” Fortunately, taking iron with calcium-containing foods does not appear to contribute to iron deficiency in the long term.¹ Fibromyalgia patients should take calcium earlier in the day, either with breakfast or lunch. The actual timing depends upon whether you are also on thyroid hormone supplementation.
Thyroid Medication – Not only does calcium interfere with the absorption of iron, but it also disrupts absorption of supplemental thyroid hormone, which must be taken first thing in the morning.² In fact, neither calcium nor iron should be taken within four hours of thyroid. This means calcium supplementation and consumption of foods like milk, yogurt, cheese, and calcium fortified juice or cereal, should be postponed till lunchtime for anyone on thyroid hormone. Hypothyroidism is common in fibromyalgia, making the timing of thyroid medication a challenge. If you always wake up during the night, place your medication with a glass of water on your nightstand. Just take a sip so you minimize the impact on gastric reflux.

Exception

Consuming a diet rich in antioxidants is ideal for optimal health. For fibromyalgia patients with sleep disturbance, there is a special antioxidant that Holton recommends, which is not found in a multivitamin: melatonin. It crosses the blood-brain barrier to provide the brain with antioxidant protection. And if you have sleep difficulties, take melatonin at the same time each night to strengthen your sleep cycle.

Stay Current on Treatments & Research News: Sign up for a Free Membership today!

References

Abioye AI, et al. J Nutri151(5):1084-1101, 2021. Free Report
Weisner A, et al. Pharmaceuticals 14(3):206, 2021. Free Report