Welcome to my blog post ‘The Most Researched Supplements For Fibromyalgia ‘.
You may like to check out my other blog:
- Fibromyalgia: A Functional Medicine Approach
- Fibromyalgia: What’s The Best Diet And Can It Be Reversed?
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 fibromyalgia 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 fibromyalgia patients.
Dietary guidance is therefore critical for fibromyalgia 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.
Supplements For Fibromyalgia
B Vitamins
Some fibromyalgia patients might have B vitamin deficiencies, especially B12, and evidence has shown that the supplementation of these nutrients does indeed help some patients with fibromyalgia. For example, one study that investigated vitamin B12 showed that a short course of sublingual vitamin B12 at 1000 mcg daily, led to significant improvements in the severity of fibromyalgia symptoms and anxiety (source).
Further evidence that B vitamins may be helpful in fibromyalgia comes from the findings that increased levels of homocysteine in the cerebrospinal fluid and low levels of B12 in the brain have been detected in fibromyalgia subjects and associated with fibromyalgia-related musculoskeletal pain.
It’s important to note not all studies have shown improvement in fibromyalgia symptoms from supplementing B vitamins but this is to be expected. Also, in some of these studies, a baseline wasn’t taking. Should we expect to see improvement in someone who already has good B vitamin status?
- Recommended Supplements For Fibromyalgia (U.K): Sublingual B12 or a B complex.
- Recommended Supplements For Fibromyalgia (U.S.A): Sublingual B12 or B Complex.
Vitamin D
In some fibromyalgia patients, problems may be associated with low vitamin D levels, which also interferes with the absorption of magnesium.
One study demonstrated a strong association between fibromyalgia symptoms and vitamin D deficiency. Also, studies on the muscles of vitamin D deficient patients showed a reduction of adenosine triphosphate (ATP) levels, similar to those of fibromyalgia patients, causing acute pain. Another study showed that a deficiency of vitamin D was related to depression and anxiety in fibromyalgia.
It has been reported that vitamin D supplements for fibromyalgia can improve the quality of life in patients.
Ninety fibromyalgia patients with mild to moderate vitamin D deficiency were randomly assigned to receive 50,000 units of vitamin D3 per week compared with a placebo. After 8 weeks of intervention, the treated group showed a significant improvement in fibromyalgia scores, in contrast to the placebo group.
All of these studies reported a beneficial effect of vitamin D supplementation… However, all authors stressed the importance of testing serum vitamin D levels and recommended supplementation when risk factors for vitamin D deficiency are present.
- Recommended Supplements For Fibromyalgia (U.K): Vitamin D.
- Recommended Supplements For Fibromyalgia (U.S.A): Vitamin D.
Magnesium
Magnesium deficiencies were largely associated with low-grade inflammation, muscle weakness and paresthesia, which are typical symptoms of fibromyalgia.
A deficiency of magnesium appears to accompany low-grade chronic systemic inflammation and may increase substance P levels, a signal substance that has been reported as being responsible for elevated levels of pain in patients with fibromyalgia. Also, magnesium deficiency could induce a minor increase in pro-inflammatory cytokines and C-reactive protein (CRP) and thus exacerbate many health problems accompanying fibromyalgia. Research has also shown that chronic sleep deprivation leads to intracellular magnesium deficiency and reduced tolerance to exercise.
Disruptions of hormonal balance may in some cases precipitate magnesium deficiency. For example, the presence of oestrogen increases magnesium utilisation, which may explain why numerous women are diagnosed with fibromyalgia after menopause when the levels of oestrogen are declining.
Iron
With regard to other minerals, some studies indicated a potential link between iron deficiency and fibromyalgia; however, only one study evaluated the effect of iron supplementation on fibromyalgia symptoms, fatigue and iron status of 81 fibromyalgia subjects, showing an overall improvement only in the treated group.
Antioxidants
Antioxidants and mitochondrial dysfunction might offer a new approach to the treatment of these patients.
Actually, recent hypotheses associate fibromyalgia with an inflammatory response caused by mitochondrial dysfunction or redox-mediated impairment of mitochondria.
Treatment with vitamin C and E combined with or without exercise compared to exercise only in 32 women with fibromyalgia over a 12 week period did not show a statistically significant improvement in fibromyalgia symptoms, although both interventions resulted in significantly higher serum levels of vitamin A, C and E.
- Recommended Product (U.K): Pure Defence.
- Recommended Product (U.S.A): NAC,
Melatonin
Melatonin diminishes fatigue during the day and has anti-anxiety properties. Unfortunately, research has shown that fibromyalgia patients have lower melatonin production during the night compared to healthy individuals. Suboptimal melatonin production may contribute to poor sleep, fatigue during the day, and changed pain perception. Thus, melatonin supplements for fibromyalgia can reduce pain and improve sleep quality, improving the overall quality of life. (source).
- Recommended Product (U.K):
- Recommended Product (U.S.A): Melatonin
Probiotics
Another consideration is a probiotic supplement for fibromyalgia. This is particularly worth considering if you have gut symptoms (and the majority of people with fibromyalgia do). Increasing evidence does suggest that fibromyalgia patients have imbalances in their gut microbiome, with the abundance of different taxa selectively correlated with disease-related symptoms.
A study published in 2023 demonstrated that probiotic supplements for fibromyalgia significantly improved sleep quality, depression, anxiety, and pain scores compared to those at baseline in fibromyalgia patients, while prebiotic supplementation significantly improved pain scores and sleep quality.
- Recommended Product (U.K): Bio.Me Barrier
- Recommended Product (U.S.A): Probiotic.
Selenium
In a study from Germany of 68 consecutively referred fibromyalgia patients (59 females, mean age 49 years and nine males, mean age: 47 years), the serum levels of Se were evaluated. The selenium status in the fibromyalgia 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 selenium deficiency.
Coenzyme Q10
After treatment, all patients showed an important improvement in clinical symptoms in all evaluation methods.
The authors of this paper concluded: “According to our results, and evaluated by three methods, patients with FM are candidates for treatment with CoQ10.”
- Recommended Supplements For Fibromyalgia (U.K): CoQ10
- Recommended Supplements For Fibromyalgia (U.S.A): CoQ10
L-Carnitine
In one study, one hundred and two patients meeting the American College of Rheumatology criteria for FMS were randomised into the study. The treatment consisted of 2 capsules/day of 500 mg LAC or placebo plus one intramuscular (i.m.) injection of either 500 mg LAC or placebo for 2 weeks. During the following 8 weeks the patients took 3 capsules daily containing either 500 mg LAC or placebo.
The results?
A statistically significant between-group difference was observed for depression and musculoskeletal pain.
- Recommended Product (U.K): L-Carnitine
- Recommended Product (U.S.A): L-Carnitine.
Chlorella
In a pilot study, each day for 2 months, participants consumed two commercially available Chlorella-based products, 10 g of ‘Sun Chlorella’ tablets and 100 mL of liquid ‘Wakasa Gold’.
The results of this pilot study suggest that Chlorella supplements for fibromyalgia may help relieve the symptoms in some patients and that a larger, more comprehensive double-blind, placebo-controlled clinical trial in these patients is warranted.
SamE
Two small randomised trials have found a benefit of SAM-e supplements for fibromyalgia in tender points, pain perception, and fatigue when dosed at 800 mg/d in adults.
- Recommended Product (U.K): SamE.
- Recommended Product (U.S.A): SamE
Curcumin
The final supplement for fibromyalgia is curcumin. This review focuses on pre-clinical and clinical studies in the treatment of pathological pain. Although the mechanisms of pain mitigating effects are not very clear, there is compelling evidence proving that curcumin plays an essential role. However, further high-quality clinical studies should be undertaken to establish the clinical effectiveness of curcumin in patients suffering from pathological pain.
Conclusion
In conclusion, there are numerous supplements for fibromyalgia but a food first approach must ensure our diet is as nutrient-dense as it can be to support recovery. But it is clear that:
- In the therapy of fibromyalgia, some minerals and vitamins have been shown useful.
- Numerous supplements for fibromyalgia have been shown to be helpful.
- When ever possible, functional testing may help personalise supplements for fibromyalgia.
There is a saying in Functional Medicine, “treat the individual, not the disease”. While I hope this blog is helpful for people, it is important to appreciate that not all of these are needed, and that just because evidence suggests a supplement is helpful, doesn’t mean it will be in your case. It is important (and I truly appreciate often incredibly challenging) to stay patient, to stay curious, as your travel on your journey back to optimal health.
Finally, please please please do not ignore the role that our diet, exercise, stress management, sleep and time spent outside grounding plays within recovery!
Resources
Check out this book on Fibromyalgia, and the books I recommend in my library, such as Mindfulness For Health.
References
- Effect of coenzyme Q10 evaluated by 1990 and 2010 ACR Diagnostic Criteria for Fibromyalgia and SCL-90-R: four case reports and literature review: click here.
- Nutritional Interventions in the Management of Fibromyalgia Syndrome: click here.
- Effect of vitamin D supplementation in chronic widespread pain: a systematic review and meta-analysis: click here
- Magnesium and Pain: click here.
- Double-blind, multicenter trial comparing acetyl l-carnitine with placebo in the treatment of fibromyalgia patients: click here.
- Nutritional supplementation with Chlorella pyrenoidosa for patients with fibromyalgia syndrome: a pilot study: click here.
- Oral S-adenosylmethionine in primary fibromyalgia. Double-blind clinical evaluation: click here.
- Complementary and Integrative Methods in Fibromyalgia: click here.
- Role of curcumin in the management of pathological pain: click here.
Alex is a certified Functional Medicine Practitioner (IFMCP) and has a MSc in Personalised Nutrition. He is also a breathwork facilitator with a background in personal training and massage therapy. He also runs The Resiliency Program - a 24 week program aimed at building physical, mental, emotional, and spiritual resilience.
