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Fibromyalgia Basics

Diet & Nutrition for Fibromyalgia

Your diet is one thing you have control over, so it is natural to wonder if you are eating foods that might be making your fibromyalgia symptoms worse. In addition, you are probably curious if adding specific ingredients or foods will help. As it turns out, what you eat (or don’t eat) can have a significant impact on your pain and related fibromyalgia symptoms.

Three different dietary approaches that are based on correcting specific abnormalities found in people with fibromyalgia are briefly described below. All work on different aspects of the pain and symptom-generating processes, so if one diet doesn’t work for you, maybe one of the others will. Advice from a dietician would be helpful to make sure you don’t accidentally omit essential nutrients. You should also read Covering the Bases on Nutrition.

Dietary Approaches for Fibromyalgia

Removing Food Additives: Most people have heard of MSG or monosodium glutamate, a common flavor-enhancing additive in processed foods. But did you know that the amino acid, glutamate, can overstimulate your nerves to the point of being toxic in high concentrations? It’s not the only excitatory amino acid you have to be concerned about. Aspartate (the building block for the artificial sweetener, Aspartame) and cysteine can also irritate your nerve endings and lead to more pain.

Research shows fibromyalgia patients have an excessive amount of glutamate in their intestines (e.g., gut), bloodstream, spinal fluid, and brain. Although glutamate levels in the muscles have not been measured in fibromyalgia, injecting the muscles with this compound causes extreme pain. As you will read in the sections on “possible causes of fibromyalgia,” glutamate is a key factor in generating your widespread symptoms.

Removing all sources of glutamate and its partners in crime (aspartate and cysteine) was shown in one 4-week trial to cut fibromyalgia symptoms by greater than a third. This is better than any drug on the market, and more than 80 percent of the patients in the study reaped these benefits. For specific information on the diet and foods you need to avoid, read more.

Calorie-Restrictive: If you are thinking that weight loss is the goal of this diet, the answer is both yes and no. Extra pounds can compound the symptoms of fibromyalgia by impairing function and making it harder to exercise. But researchers found that fibromyalgia patients on a very low-calorie diet experienced substantial pain and symptom improvements within three weeks, long before they experienced significant weight loss.

How can a dramatic drop in caloric intake lead to a 30 percent reduction in fibromyalgia symptoms in just three weeks? Your adipose tissues (which store fats) secrete inflammation-promoting chemicals that activate nerve endings (and the bigger the adipose cells are, the more chemicals they secrete). However, if you restrict food to these fat cells, your immune system switches to secreting anti-inflammatory substances. This leads to a drop in pain-related signals traveling to the nervous system, and it gives the dysfunctional brain in fibromyalgia a break so that it can regulate pain, fatigue, sleep, cognition, etc.

The above study used a weight loss center that dispensed liquid food packets to patients totaling only 800 calories per day. More than 70 percent of the fibromyalgia patients responded favorably to this diet, but it is not something you can do on your own. Yet, this study does point out how enlarged fat cells could be making your symptoms worse.

If you do not have insurance coverage and access to a weight loss program that can put you on low calorie liquid packets, the dietary advice below is your next best option.

Low Carb, Low Fat & Gut Friendly: Unless you exercise daily, some of the carbohydrates and fats that you eat are stored as fat in your adipose tissue. Protein, on the other hand, is not converted into fat. Unfortunately, many protein sources in the grocery stores are heavily processed with food additives and fats, so they may not be as healthy as you might think.

Rather than going on a drastically low-calorie diet, you may benefit from restricting your daily intake of carbs (especially refined sugars) and fats. These are the two food groups that may amplify your fibromyalgia symptoms. As for protein, eat lean meats (fish, poultry and beef) that you purchase in the butchers’ department of grocery stores, not the frozen food isle. This means taking time and energy to cook it (two resources you may be limited on), but it will hopefully pay out in the long run.

Fresh fruits and vegetables (raw or lightly cooked) will give you much-needed fiber for a healthy digestive system, while they are rich with nutrients. They are also a source of low-calorie carbs and a small amount of protein. Unprocessed walnuts and almonds are also a great source of fiber and a healthy snack. When cooking, use olive oil instead of vegetable oil, butter, or margarine.

As you will read in the “Possible Symptoms Causes” section, the bacteria that reside in your intestines (i.e., gut) exert a strong influence over what happens in your body, including your brain. People with fibromyalgia are missing a lot of the healthy bacteria and they have too much undesirable bacteria. The reason for this imbalance is unclear, but at least these dietary suggestions won’t make matters worse.

Nutritional Aides for Pain

A few small treatment trials show that the supplements below may be beneficial for reducing your fibromyalgia symptoms, but larger studies are needed.

  • Magnesium/Malic Acid/B vitamin Complex: Malic acid is a key sugar that is broken down in the muscles to make energy. Both magnesium (500 mg/day) and the B vitamins (B1 and B6) are needed for this process. One small study showed that this combo of supplements reduced muscle pain in fibromyalgia patients.
  • Omega-3 Fatty Acids: These oils are often referred to as antioxidants. They neutralize chemical byproducts that might otherwise harm your cell membranes and interfere with their ability to function. The best formulas contain roughly 500 mg of EPA and 500 mg of DHA (both omega 3s). DHA makes up about 15 percent of your brain’s gray matter and it is vital for protecting your brain cells. A small study indicates that 2,500 mg of EPA/DHA combined per day helps ease fibromyalgia pain. Other larger studies show this supplement reduces triglycerides, protects your cardiovascular system, and works as a mild antidepressant. If you can’t rid your diet of glutamate, omega-3 should help counter its negative impact on your neurons.
  • Antioxidants (Vitamins E and C): These two vitamins work as antioxidants to protect your cells and one study in fibromyalgia patients showed that this combination reduced the symptoms.
  • Melatonin: Melatonin is not a hypnotic sleep-promoter, but it can regulate your body’s internal clock to improve the quality of your sleep (must be taken at same time each night). In addition, melatonin is a potent antioxidant that can help protect your brain from the potentially destructive processes that occur in fibromyalgia.
  • Acetyl L-Carnitine: A small trial in fibromyalgia patients showed that taking 500 mg of Acetyl L-Carnitine three times a day helped ease the pain and fatiguing symptoms of this condition.

Energy and Cognition Aides

The following supplements were not mentioned above but endorsed in a survey of 2,700 fibromyalgia patients:

  • Vitamin D: Some studies show this vitamin to be low. Aside from its key role in making healthy bones, it also improves muscle strength and mood. Purchase it as D3 (not D2) in an oil base for best intestinal absorption.
  • Coenzyme Q10 (CoQ10): This is the key enzyme for producing energy in the cells, helping to power up your muscles and your brain. A few small studies have shown some benefits of adding this supplement but it is very expensive, so shop around for discounts. CoQ10 must be purchased as oil-based gel caps.
  • Creatine: It’s an essential building block for making the “energy currency” referred to as ATP that fuels muscle movements and cognitive processes. Creatine is inexpensive; can be purchased as tablets that are taken throughout the day or as a powder that can be added to fruit drinks.

Help with Muscle Function

When certain nutrients are in the low range, but not necessarily deficient, these inadequacies can interfere with the resolution of myofascial trigger points. Five vitamins of special importance include B1, B6, B12, folic acid, and vitamin C. Minerals for proper muscle function include iron, calcium, potassium, and magnesium.


The bacteria that live in your gut influence how you feel and there are studies to show that this living community is disrupted in fibromyalgia. So, should you take a probiotic and if you do, which one? Research in healthy people shows that Lactobacillus plantarum leads to better brain function after 12 weeks. However, studies in mice (not humans) show that Bifidobacterium adolescentis can convert glutamate in the blood (which is elevated in fibromyalgia) into GABA, one of the body’s natural pain-relievers. In addition, when the bacteria in probiotics are broken down in the intestines, it helps promote sleep. 

At this point, there are no trials to show the efficacy of probiotics in treating the symptoms of fibromyalgia. However, if you choose to try one (perhaps a combo of Lactobacillus and Bifidobacterium), take it before bedtime to aid with sleep.