Fibromyalgia: What’s The Best Diet?

Welcome to my blog post ‘Fibromyalgia: What’s The Best Diet? ‘.

You may like to check out my other blog:

• Fibromyalgia: A Functional Medicine Approach

Muscle pain has been associated with deficiencies in amino acids, magnesium, selenium, vitamins B and D, as well as with the harmful effects of heavy metals, such as mercury, cadmium, and lead. Research indicates that patients deficient in certain essential nutrients may develop dysfunction of pain inhibitory mechanisms together with fatigue and other FM symptoms. Additionally, mercury and other toxic elements may interfere with the bioavailability of essential nutrients. This review examines the many effects of metals and vitamins in pain evaluation of FM patients.

Dietary guidance is therefore critical for FM patients to help them in correcting a suboptimal or deficient intake of essential nutrients. When optimal levels of nutrition are achieved, pain levels are usually lowered.

B Vitamins

Some FM patients might have B vitamin deficiencies, especially B12. The positive effects of B12/folic acid supplementation for FM patients have been reported. In this study of FM patients who reported themselves as “much improved” subjects had been given higher, more frequent doses for a longer period. Furthermore, increased levels of homocysteine in the cerebrospinal fluid and low levels of B12 in the brain of FM subjects were described and further associated with FM-related musculoskeletal pain. In many of these cases, FM patients may benefit from B vitamin supplements.

Vitamin D

In some FM patients, problems may be associated with low vitamin D levels, which also interferes with the absorption of Mg.

study demonstrated a strong association between FM symptoms and hypovitaminosis D. Also, studies on the muscles of vitamin D deficient patients showed a reduction of adenosine triphosphate (ATP) levels, similar to those of FM patients, causing acute pain. Another study showed that deficiency of vitamin D was related to depression and anxiety in FM. It has been reported that vitamin D supplementation can improve the quality of life in FM patients.

Magnesium

Deficiency of Mg appears to accompany low-grade chronic systemic inflammation and may increase substance P levels, a signal sub- stance that has been reported as being responsible for elevated levels of pain in patients with FM. Also, Mg deficiency could induce a minor increase in pro-inflammatory cytokines and C-reactive protein (CRP) and thus accentuate health problems accompanying FM. Research has also shown that chronic sleep deprivation leads to intracellular Mg deficiency and reduced tolerance to exercise.

Disruptions of hormonal balance may in some cases precipitate Mg deficiency. For example, the presence of estrogen increases Mg utilisation, which may explain why numerous women are diagnosed with FM after menopause when the levels of estrogen are declining.

Antioxidants

Antioxidants and mitochondrial dysfunction might offer a new approach to the treatment of these patients.

Actually, recent hypotheses associate FM with an inflammatory response caused by mitochondrial dysfunction or redox-mediated impairment of mitochondria.

Selenium

In a study from Germany of 68 consecutively referred FM patients (59 females, mean age 49 years and nine males, mean age: 47 years), the serum levels of Se were evaluated. The Se status in the FM patients was found to be significantly reduced compared to the control group . Also, skeletal muscle disorders characterised by fatigue, muscle pain, and proximal weakness have been recognised in patients with Se deficiency

I add these nutrients here as, in some ways, they are the building blocks of our ‘diets’. But what does the research show from an actual dietary perspective?

What’s The Best Diet For Fibromyalgia?

Significant improvements in reported pain were observed for those following a vegan diet, as well as with the low fermentable oligo di-mono-saccharides and polyols (FODMAP) diets.

Dietary intake as a whole, influences many physiological systems and processes, therefore, we should be aware of the dangers of following anecdotal evidence in regards to dietary interventions. Even if such changes positively influence fibromyalgia and its underlying mechanisms, it may negatively influence other physiology.

There exist a number of potential mechanisms by which nutrition could be beneficial including but not limited to:

• Oxidative status or damage
• Dysfunction of pro-inflammatory or anti-inflammatory modulation
• Dysfunction of energy production
• Dysfunction of the neuromodulation within the peripheral or central nervous systems.

To recommend any nutritional intervention, will require extensive randomised, controlled, human trials. These will lead to informed and evidence-based choices and will therefor protect both the individual’s health and financial status. Currently there is a lack of conclusive data on any nutritional interventions.

There are a few things to consider here though before jumping in to a generic diet in the hope it alleviates symptoms of fibromyalgia (I completely understand how appealing this is though!!):

• Studies almost never assess a participants base line – meaning someone might have been eating McDonald’s once a day and then suddenly eating a vegan diet. What changes with nutrient status for example contributed to any improvement in symptoms? It may have not been the vegan diet per se that helped, just a simple increase in nutrients from more fruit and vegetables.
• Can we choose a specific diet, I am primarily thinking of the FODMAP diet here, because testing has shown a specific imbalance which allows for a more specific intervention. At least one study has shown that 100% of participants with Fibromyalgia had SIBO (small intestine bacterial overgrowth). In this circumstance, a FODMAP diet may be an appropriate choice for a 4-12 week period.

Overall, it would appear there is no one diet to choose – it will depend on numerous aspects of your current physiological state, your dietary preferences, your willingness to change among many others. What seems obvious from the research is this:

A high intake of phytonutrients, anti-inflammatory fats, antioxidants is essential.

But ultimately the diet for you could be anything from the carnivore diet (all meat) to the vegan diet (all plants!). There is a journey we made need to go on, trying things in a systematic way to understand what interventions are best for you.

It is clear there is huge hope though, that through this exploration you will be able to find the diet, lifestyle and supplements that allow you to become pain free and vibrant again.

Supplements And Fibromyalgia

This review of 22 nutritional intervention studies provided conflicting results across a multitude of outcome measures. Pain which is often regarded as the characterising symptom of FMS was significantly improved after the consumption of: Chlorella green algae, vegan diet, coenzyme Q10, acetyl-l-carnitine; a low-FODMAP diet; and, a combination of vitamin C, E and Nigella sativa seeds.