- Fibromyalgia: What to Eat, What to Avoid
- 10 Tips for Choosing Foods for Fibromyalgia
- 1. Avoid Foods That Contain Added Glutamate
- 2. Choose Whole Foods Instead of Processed Ones
- 3. Try the DASH or Mediterranean Eating Plan
- 4. Avoid Cured Meats
- 5. Eat Cold-Water Fish and Fortified Foods for Vitamin D
- 6. Choose Dark, Leafy Greens, Nuts, and Seeds for Magnesium
- 7. Add in Fish, Flaxseed, and Chia for Omega-3 Fatty Acids
- 8. Include Good Sources of Antioxidants in Your Meals
- 9. Read the Labels on Packaged Foods
- 10. Avoid Artificial Sweeteners and Limit Sugars
- Fibromyalgia Diet and Meal Plan
- Download the Free Fibromyalgia Pain Management Plan
- Foods to Eat
- Lean Protein
- Vegetarian Protein
- Fruits and Vegetables
- Healthy Fats
- Foods to Avoid
- Fake Food
- Seed Oils
- Your Plate at a Glance
- Download the Free Fibromyalgia Pain Management Guide
- More Fibromyalgia Content and Information
- Foods to Eat for Fibromyalgia
- Foods to Avoid for Fibromyalgia
- Sample Meal Plan for Fibromyalgia
- Other Diet Tips for Fibromyalgia Patients
- Planner sheet and shopping list
- Online Ordering
- 7 Ways to Eat a Healthy Fibromyalgia Diet
- 1. Eat a more plant-based diet
- 2. Boost your omega-3 intake
- 3. Spice up your menu
- 4. Limit sugar
- 5. Consider cutting out gluten
- 6. Keep a food diary to ID food sensitivities
- 7. Ask your doctor about supplements
- Keep Reading
- Fibromyalgia: The Diet Connection
- Definition and causes of fibromyalgia
- Are there natural remedies or diets for fibromyalgia?
- Maintaining a healthy weight is fundamental
- Fibromyalgia and nutrition supplements
- Fibromyalgia and diet: Final thoughts
- Fibromyalgia Diet: Foods You Should Eat and Foods You Should Avoid
- Fibromyalgia Diet
- Best and Worst Foods for Fibromyalgia Pain
- DO EAT:
- DON’T EAT:
- One Diet Does Not Fit All
- Start with a food diary
- Join Our Mailing List
- Make it easy to choose a well-balanced, nutrient-dense diet
- Eat for energy
- Consider going plant-based
- Avoid gluten
- Finding the best diet for fibromyalgia
- Related posts:
Fibromyalgia: What to Eat, What to Avoid
Eating whole foods and avoiding excitotoxins may ease fibromyalgia symptoms.
A diet high in whole, unprocessed foods may help with fibromyalgia symptom management. Darren Muir/Stocksy
Ever since Ellen Wildman was diagnosed with fibromyalgia, 20 years ago, she’s made her self-care a full-time job, and that includes eating the right foods.
For Wildman, 60, who lives in the Ft. Lauderdale area in Florida, good nutrition helps take the edge off her symptoms and reduces pain.
But what constitutes good nutrition for a person with fibromyalgia?
The nutritional neuroscientist Kathleen Holton, PhD, an assistant professor of health studies at the American University in Washington, DC, has researched the effects of a variety of dietary components and nutrients on the brain, and she’s developed specific guidelines to help people with fibromyalgia better manage their condition through what they eat.
“No drug on the market is as important to optimal health as a well-balanced and healthy diet,” Dr. Holton says. “While many people like to call nutrition ‘alternative medicine,’ in reality it is the basis of all human health. We can’t be optimally healthy without giving our bodies the nutrients they need, and that applies to anyone with fibromyalgia.”
10 Tips for Choosing Foods for Fibromyalgia
Holton’s research has focused largely on the effects of dietary excitotoxins, chemicals that “excite” neurons in the brain and that can be toxic if consumed in excess. The most common forms of dietary excitotoxins in the Western diet are food additives used to enhance or sweeten the flavor of foods.
Some early research showed that eliminating excitotoxic food additives from the diets of some individuals with fibromyalgia reduced their symptoms. While results of subsequent research have been mixed, eliminating food additives from the diet remains a low-cost treatment option with few if any side effects and the potential to help. (1)
Here, Holton shares her top tips on choosing foods for fibromyalgia.
1. Avoid Foods That Contain Added Glutamate
Glutamate is a neurotransmitter that occurs naturally in the body and in some foods, but it is also added to foods as a flavor enhancer.
The most common form of dietary glutamate is monosodium glutamate (MSG), which must be listed on the label when it’s included in foods.
Ingredients that include the terms “hydrolyzed,” “autolyzed,” “protein concentrate,” or “protein isolate” are also likely to contain naturally occurring monosodium glutamate. (2)
In a study published in 2012, 37 people with fibromyalgia and irritable bowel syndrome (IBS) — which is common in people with fibromyalgia — followed a diet free of added MSG and aspartame for four weeks. Most reported that more than 30 percent of their fibromyalgia symptoms had resolved during that time. Those whose symptoms improved then consumed either MSG or a placebo for three consecutive days per week for two weeks. The group assigned to the MSG experienced a significant return of symptoms. (3)
Foods that commonly contain MSG include Chinese foods, canned soups and vegetables, some types of chips or similar crunchy snacks, and processed meats. To avoid MSG and other sources of added glutamate, read food labels carefully, and don’t buy those that list MSG or ingredients high in glutamate.
2. Choose Whole Foods Instead of Processed Ones
Steer clear of processed foods and choose more whole foods, advises Holton.
Processed foods typically have more additives and less fiber and nutrients than unprocessed foods. Refined carbohydrates — such as white flour, white pasta, and white rice — are examples of processed foods that have been stripped of naturally occurring nutrients.
When choosing carbohydrate-containing foods for your meals, choose whole grains such as quinoa, amaranth, whole wheat berries, buckwheat groats, or brown or wild rice, or have a sweet potato or plain potato in place of bread, pasta, or rice.
“I try to eat whole, real food,” says Wildman. “That means cauliflower from a fresh head, corn from an ear, and cage-free eggs.”
3. Try the DASH or Mediterranean Eating Plan
Both the DASH Diet (dietary approaches to stop hypertension) and Mediterranean diet have been shown to have real health benefits, including lower blood pressure and cholesterol.
The two diets are slightly different in their specifics, but both are rich in fruits and vegetables, lean proteins, whole grains, nuts, seeds, legumes, and low-fat or no-fat dairy foods.
Many components of the DASH diet reduce inflammation in the body, which can be helpful in controlling many chronic conditions.
4. Avoid Cured Meats
When you buy meat, avoid processed products with added salt or preservatives or meats that have been smoked or cured. This list includes canned meat, sausage, bacon, hot dogs, ham, deli meat, corned beef, and beef jerky.
Also beware of meat products with the words “natural flavor added” on the label. An example of such a product is turkey breast infused with broth (to give it more flavor). Natural flavors are derived from natural sources such as plants, meats, and seafood and may be high in naturally occurring monosodium glutamate.
5. Eat Cold-Water Fish and Fortified Foods for Vitamin D
According to the National Center for Complementary and Integrative Health, vitamin D supplementation may reduce pain in people with fibromyalgia who are deficient in this nutrient. (4)
You can get vitamin D naturally in swordfish, tuna, sockeye salmon, and eggs, and some foods, such as orange juice and milk, are fortified with vitamin D. Vitamin D can also be taken as a supplement or in cod liver oil, which provides both vitamin D and omega-3 fatty acids.
Spending time outside also increases your body’s vitamin D levels, although too much sun exposure increases the risk of skin cancers and eye disease. (5)
6. Choose Dark, Leafy Greens, Nuts, and Seeds for Magnesium
Magnesium citrate supplementation may reduce symptoms of fibromyalgia, according to a 2013 study that showed it was even more effective when paired with amitriptyline, a tricyclic antidepressant. (6)
“Magnesium is necessary for helping to prevent the excitoxicity caused by glutamate,” says Holton.
Magnesium is found in many healthy foods, including legumes (dried beans and lentils), nuts and seeds, avocado, yogurt, bananas, fatty fish, dark chocolate, and dark, leafy greens.
RELATED: 8 Foods High in Magnesium
7. Add in Fish, Flaxseed, and Chia for Omega-3 Fatty Acids
Omega-3 fatty acids may reduce levels of oxidative stress, as well as lower levels of inflammation and boost immunity. Oxidative stress takes place when the body has too many free radicals, or unstable molecules, that damage cells. It is implicated in the development of many medical conditions.
Omega-3s are abundant in wild-caught seafood, walnuts, chia seeds, and flaxseeds. It can also be taken as a supplement.
However, omega-3 capsules are not recommended since they contain gelatin, which contains the amino acid aspartate. Aspartate may active a glutamate receptor on nerve cells that’s implicated in fibromyalgia. Gelatin also contains glycine, a co-activator of that receptor. (7)
8. Include Good Sources of Antioxidants in Your Meals
To combat the effects of dietary excitotoxins on fibromyalgia symptoms, you may need more antioxidants in your diet, as excitotoxins also create oxidative stress.
“To keep this simple, look for foods that add color to your diet, in the fruits and vegetables category,” says Holton. “Focus on increasing consumption of items with bright red, green, orange, yellow, and purple hues to give yourself an antioxidant boost.”
9. Read the Labels on Packaged Foods
If the ingredients list on a food packaging label is long and complex, put the product back on the shelf, Holton advises. You won’t likely see “glutamate” on that label, but you will see other additives that may hide glutamate. Labels should be short, easy to read, and should list ingredients that you could add to a dish when cooking.
Don’t be fooled by the words “spices” or “flavorings,” since the U.S. Food and Drug Administration doesn’t dictate that manufacturers explain what those terms mean on a food label, she says.
10. Avoid Artificial Sweeteners and Limit Sugars
Holton recommends avoiding artificial sweeteners such as aspartame, acesulfame-K, saccharin, and sucralose. Use regular sugar or honey sparingly to sweeten foods.
“It’s much easier to wean yourself off sugar if you aren’t using artificial sweeteners,” she says.
“As you cut back on sugar, you’ll taste sweetness in foods more easily. Even Stevia is hundreds of times sweeter than sugar — which makes you want more sweetness in your food.”
For general good health, avoid high-fructose corn syrup. When you’re fatigued from fibromyalgia, don’t choose sugar or the corn-syrup alternative to boost energy. High sugar intake increases risk of weight gain, diabetes, and other inflammatory diseases, including heart disease and cancer.
“Sugar is my nemesis,” Wildman says. “It makes me more tired, raises my insulin levels, and makes me supersensitive to things. When I’ve had sugar, something can startle me, and I’ll jump sky high.”
“Research suggests excitotoxicity requires a great deal of energy in the body,” says Dr. Holton. “High sugar intake may ‘fuel’ this process.”
Fibromyalgia Diet and Meal Plan
It may have been centuries ago that Hippocrates said “Let food be thy medicine” but these words still ring true. The foods you consume can increase inflammation, create a toxic environment that breeds cancerous cells, or create “sludge blood” by filling arteries with fatty plaque. On the other hand, good food you consume can give you sustainable energy, reduce inflammation, and help the body heal faster; reducing painful symptoms. The fibromyalgia diet and meal plan aims to direct you toward these healthier food choices.
Food is important and if you’re a fibromyalgia sufferer, you should be especially careful about the food you’re eating. The following information is a suggested diet for individuals living with widespread pain from fibromyalgia. Always consult with your doctor or professional health practitioner before making major changes to your diet and lifestyle.
Download the Free Fibromyalgia Pain Management Plan
DR-HO’S has created a comprehensive pain management plan for individuals suffering from fibromyalgia. This plan includes the fibromyalgia diet and meal in greater detail, as well as the following information:
- Workout plan
- Diet and meal plan (with recipes)
- Restful sleep guide
- Mental health tips
- Chronic pain management strategies
- And more!
Foods to Eat
The following are foods that can be advantageous for fibromyalgia sufferers to add to their diet. These foods vary on a person to person basis, but are generally healthy for pain sufferers in moderation.
These proteins support the growth of muscle, strengthen bones, and boost the function of your immune system. Adding lean proteins to a meal “complete” the meal to ensure you feel sustainably full for a longer period.
If you are a vegetarian or vegan you can consume protein through plant based sources.
- Nuts and seeds
- Soy products
Fruits and Vegetables
Fruits and vegetables should take centre stage. We gain high concentrations of antioxidants, vitamins, and minerals from this essential food group. They leave our skin glowing, our energy surging, and our concentration sharp. The fibromyalgia diet and meal plan focusses on a vegetable-dense diet. The most nutrient-rich fruits and veggies include:
- Brussels sprouts
High fat isn’t always a bad thing. Making sure you have the right fats in your diet is the essential part. Healthy fats can help you shed weight, give you shiny hair, and grow your nails, so long as you’re choosing the right ones. High quality fats include:
- Coconuts or coconut oil
- Avocados or avocado oil
- Olive oil
- Fish oil
Foods to Avoid
The fibromyalgia diet should be composed of real whole foods. Avoid the easy grab-and-go foods that are highly processed. In general, the following foods have been shown to aggravate painful symptoms. You may feel okay eating the following foods. Try to transition them out of your diet and see how you feel.
We know this is asking a lot, but those baked goods are not helping soothe pain. In fact, the body struggles to digest the highly processed grains that are stripped of nutrients. Flour, pasta, and other baked up goodies are hard on the body and should be avoided.
Dairy is infamous for flaring up painful symptoms. Many bodies do not react well to the highly processed dairy we find at our local grocery store. Cutting out milk, cheese, cream, and yogurt can result in a radical improvement of pain. You can always substitute for almond milk or other dairy-free trades.
Legumes are also a common trigger for many individuals’ pain. Beans, lentils, and peanuts release insulin in the body. The body struggles to digest these foods and then feels discomfort, pain, and fatigue as a result.
Fast food results in slow pain. Remember that when you’re reaching for a TV dinner, about to swerve into a drive thru, or ordering in. Anything you buy in a box or a bag most likely contains sugar, high-fructose corn syrup, sucralose, and maltodextrin. Next time you enter the grocery store, try spending most of your time in the produce section and avoiding the non-refrigerated goods.
These fats are not like the recommended natural fats. Canola oil, peanut oil, sunflower oil, and other bad fats have trans-fat and can hurt your heart as well as your waistline.
Your Plate at a Glance
Before you sit down to eat a meal, take a look at your plate. The colours on the plate are often a great indicator of the diversity or nutrient-content of the selection. There should be an array of dark leafy greens, and vegetables should be centre stage. The co-stars can include protein-rich meats or meat-alternatives, complex carbs, and a small percentage of healthy fats. The plate should not be primarily deep-fried, from a box, or lathered in condiments. Before biting into your next meal, look at your plate with fresh eyes.
Download the Free Fibromyalgia Pain Management Guide
For a more detailed fibromyalgia diet and meal plan, as well as a comprehensive pain management plan for fibromyalgia, download the free guide below.
More Fibromyalgia Content and Information
Fibromyalgia: This is Everything You Need to Know
Fibromyalgia Causes: Where Did This Pain Come From?
Fibromyalgia Causes: Evidence That It’s Not Just In Your Head
Fibromyalgia Symptoms: How Do I Know If I Have Fibromyalgia?
Fibromyalgia Diet: What to Eat & What to Avoid as a Fibromyalgia Sufferer
Fibromyalgia Exercises: Work Out Chronic Pain
The Fibromyalgia Exercise Plan
Fibromyalgia Tender Points: Where Does It Hurt?
Why is Fibromyalgia More Common In Women?
Note: If you have a health condition or concern, consult a physician or your alternative health care provider. Always consult a medical doctor before modifying your diet, using any new product, drug, supplement, or doing new exercises.
Fibromyalgia is a condition that impacts at least five million Americans, and while there are some medical treatments, more people who have been diagnosed with fibro are turning to alternatives such as a fibromyalgia diet.
Fibromyalgia is a chronic condition that causes, fatigue, pain, and tender points in various regions of the body as well as mental fog. It can be difficult to treat because there are still so many questions about the root cause. There are a few medications that seem to address the symptoms of fibromyalgia, but there are situations where pharmaceuticals do little to ease the sufferer’s discomfort. When this happens, it makes sense to turn to alternatives, including a fibromyalgia diet.
Some research suggests that over 40 percent of fibro patient’s symptoms get worse when they consume certain foods. There is also some evidence that indicates simple adjustments to diet can ease fibromyalgia pain.
Foods to Eat for Fibromyalgia
Years ago, fibromyalgia was thought to be a mental disorder, but in 1981, the first scientific study confirmed that symptoms could be found in the human body. Ten years later, the American College of Rheumatology wrote guidelines to help diagnose fibromyalgia and we have come a long way since then. We can now treat fibromyalgia with diet.
Here’s a look at fibromyalgia and diet, starting with foods to eat with the condition.
Fruits and vegetables
Conditions such as irritable bowel syndrome (IBS), obesity, and autoimmune disorders are common among people who are diagnosed with fibromyalgia. Usually, low calorie, high fiber foods that are rich in antioxidants and phytochemicals are helpful to these individuals. It has been stated by many doctors that natural foods should be a part any diet for fibromyalgia.
This good fat, which can be found in cold-water fish and walnuts, contains anti-inflammatory properties, making it a good part of a fibromyalgia diet plan.
Since fatigue is part of fibro, reducing carbohydrates and increasing protein can help keep blood glucose from fluctuating, leading to more fatigue. The Mediterranean diet is known to help people avoid sugar rushes.
A healthy breakfast that includes some protein and whole grains is advisable when you have fibro. A boiled egg and some oatmeal provide the right kind of energy to get your day going.
They are packed with vitamin C, which has anti-inflammatory properties. Honey and cinnamon have the same anti-inflammatory action, so having some orange slices drizzled with a tablespoon of honey and a sprinkle of cinnamon is a good option to include on a fibromyalgia diet food list.
Avocado with berries
The avocado contains healthy fat that can be good for those with fibro. The vitamin E can help with muscle pain, but avocadoes also contain vitamin B, C, and K, as well as minerals such as manganese and iron. Adding an antioxidant like berries with avocados can be even more powerful. You can make smoothies with avocado and berries.
Lemon juice with chia seeds
Also a good option for the fibromyalgia diet menu, lemon juice has vitamins and minerals to help with inflammation and pain reduction. Chia seeds contain protein, fiber, omega-3 fatty acids, and minerals, making them one of the most nutritious foods you can consume.
Papaya and almonds
This fruit is nutritious and easy to digest. When combined with almonds, it gives you a nutrient-packed meal.
Apples and bananas
Filled with vitamins and fiber, they can give you a much-needed energy boost. When fatigue is a big issue, you can also turn to tofu and dark leafy greens for energy.
Spinach, broccoli, and onions not only help keep glucose levels stable, but they are full of vitamins and fiber. Brussel sprouts and cabbage are also good to include in a fibro diet.
Rich in omega-3’s and is known to reduce fibro-related inflammation and pain. Salmon has also been linked to stronger mental energy.
Lean chicken, beans, and nuts such as almonds and cashews are said to be good for those who are looking to ease fibromyalgia symptoms.
While an anti-inflammatory diet isn’t all about weight-loss, it does help people maintain a healthy weight, which we have mentioned can be of benefit to anyone who is suffering from fibromyalgia.
Here are a few more foods to consider if you are treating fibromyalgia with diet: Olive oil, flaxseed, barley, quinoa, low-fat yogurt, spelt, buckwheat, and brown rice.
Foods to Avoid for Fibromyalgia
While every fibromyalgia patient is different, there are some common foods to avoid if you suffer from the chronic condition. Check out the list below:
While fibro sufferers might want an energy boost, using caffeine to get it isn’t such a good idea. Caffeine can keep some people awake at night and there are studies that link a lack of sleep to fibromyalgia.
Too much sugar can lead to weight gain and leave fibro sufferers feeling even more pain.
MSG and sodium nitrite: These preservatives and flavor enhancers found in a lot of processed foods can aggravate pain and swelling. Avoid prepackaged foods and fast foods.
Many people with fibromyalgia feel bloated and uncomfortable after consuming diary. Some people who don’t have fibromyalgia can experience this as well. Dairy alternatives such as soy milk are available in most food markets today.
Sometimes Celiac disease (intolerance to gluten) overlaps with fibromyalgia. You can substitute with gluten-free alternatives, including pasta and breads.
Cookies, pastries, white rice, and white bread can cause sugar levels to spike and then drop suddenly. These fluctuations make fatigue and pain worse for those who have fibromyalgia.
Vegetable oils have inflammatory effects, especially when used to fry food. Some research has linked consumption of fried foods to worse fibro symptoms. There are a lot of unhealthy fats in processed foods, such as doughnuts, crackers, and pizza.
Some people find that alcohol causes their symptoms to flare up. Additionally, some fibro medications do not interact well with alcohol.
There are many different plants that fall under the category of “nightshades” but here are a few: tomatoes, chili and bell peppers, potatoes, and eggplant. They are known to trigger symptoms of arthritis and fibromyalgia.
Sample Meal Plan for Fibromyalgia
Following a specific diet can be difficult due to our fast-paced lifestyle, so here is a sample fibromyalgia diet plan to get you started.
You can have some fruit, along with some eggs or oatmeal. Another option would be to make yourself an omelet with spinach in it. Enjoy your breakfast with a big glass of juice or consider a fruit smoothie to help boost energy.
Try some tuna, herring, salmon, or lean chicken with broccoli or a green leafy salad. If you are a sandwich person, go for whole wheat bread over white and consider adding a slice of avocado instead of tomato. This type of lunch has been known to help lessen stiffness and pain in fibromyalgia sufferers.
Almonds and cashews, or fresh fruits including apple slices are a good snack. If you want to wash your snack down, instead of a sugary or caffeinated drink, opt for water or an orange juice with no or low sugar added.
This could be a lean piece of chicken, beans, and dark leafy greens such as kale, spinach, or lettuce. Dinner combinations like this can help prevent pain due to inflammation from getting worse.
Other Diet Tips for Fibromyalgia Patients
There are a number of studies that have demonstrated eating a vegetarian or vegan diet, which is high in antioxidants, can help relieve symptoms of fibromyalgia in some individuals. While these diets may be too restrictive for your liking, you can still eat a healthy diet and keep your weight under control, which can go a long way in easing pain. A study in the journal Clinical Rheumatology indicated that those with fibromyalgia who are obese experienced a better quality of life when they lost weight. As it turns out, they had less pain, fewer tender points, slept better, and had less depression.
Some people benefit from an elimination diet. This is when you stop eating a certain food for six to eight weeks and then try adding it back into the diet to see how you feel. Most people with fibromyalgia try eliminating dairy, caffeine, or gluten when starting the elimination process.
One other diet tip for fibromyalgia patients is to drink a lot of water. Water is essential for all of us but can be particularly important for people who have fibro because low energy levels are often associated with dehydration.
Living with fibromyalgia is about making adjustments. This means work adjustments, household adjustments, and it can mean diet changes too. When people with fibro take an active role in helping manage their condition, including carefully planning their diet, they have a better chance at feeling in control of their body and of having a better quality of life.
Related: 27 essential oils for fibromyalgia and how to use them
With fibromyalgia, there are certain foods that will help symptoms. Likewise, there are foods that will aggravate symptoms. These foods make up the Fibro Diet and should be followed if you are looking to alleviate your fibromyalgia symptoms (particularly the stomach issues).
In order to make it easier to plan your daily dinners, I have created a monthly meal plan. These plans will break down the month into weeks and will include the following:
- an interactive PDF monthly calendar that can be printed
- dinner with main course and sides
- ways to make it fibro-friendly (if it’s not already)
- link to the recipe
Disclosure: I get commissions for purchases made through links in this post, but these are products I recommend and have verified and/or used.
Planner sheet and shopping list
As you pick and choose which meals you’d like, you can create the weekly shopping lists using this FREE downloadable one-week menu planner from Andrea Dekker.
It’s not always easy to get to the store for shopping, so take advantage of your local grocery store’s pickup ordering option if available. Other ways to get what you need is by using Amazon Pantry or, my favorite, Boxed which is bulk sizes with warehouse prices. Walmart does grocery pickup, too – !
Here are some resources to help with meal planning.
- Follow me on Pinterest, particularly my slow cooker and freezer meal boards.
- How I manage to only cook 2-3 meals a week
- Back to Basics: Meal planning for beginners
7 Ways to Eat a Healthy Fibromyalgia Diet
While good nutrition is an important part of managing many types of chronic conditions, people with fibromyalgia can often get significant relief from their symptoms by changing their diet. While little research on the link between diet and fibromyalgia exists, nutrition is a promising tool for treating patients, according to a study published in the journal Clinical and Experimental Rheumatology.
There is no one “fibromyalgia diet” that works for everyone with fibromyalgia, but there are certain foods and nutrients that often help — or aggravate — many people with the condition. Fibromyalgia is a disorder where patients have widespread musculoskeletal pain as well as other symptoms such as fatigue, sleep, memory, and mood issues.
Avoiding foods that can trigger fibromyalgia pain may help you feel better; eating more whole, anti-inflammatory foods may help improve your fibromyalgia symptoms.
Here, Sonya Angelone, MS, RD, CLT, a spokeswoman for the Academy of Nutrition and Dietetics, who regularly works with people with fibromyalgia, shares her best advice for finding a fibromyalgia diet plan that works for you.
1. Eat a more plant-based diet
“Fruits and vegetables are loaded with antioxidant and anti-inflammatory components that may ease fibromyalgia pain,” Angelone says. While fibromyalgia isn’t considered an inflammation-based illness, studies suggest that neuroinflammation may play a role in the condition.
And if you’re overweight, swapping out high-fat meats and refined grains for produce could help you slim down and feel better, she adds: “Weight loss decreases inflammation and eases the burden on your muscles and joints.”
2. Boost your omega-3 intake
Angelone advises her clients with fibromyalgia to eat more foods rich in omega-3 fatty acids, including fatty fish, walnuts, and flaxseed. “It can help decrease inflammation and relieve pain in some people,” she explains. Hate fish? Fish oil supplements can help.
Many herbs and spices are potent sources of phytochemicals, which are chemical compounds produced by plants that are associated with anti-inflammatory effects. Angelone’s top picks include turmeric, red pepper, cloves, ginger, cumin, anise, fennel, basil, rosemary, and garlic.
4. Limit sugar
A diet high in sugar and refined carbs (as well as saturated and trans fats) can fuel inflammation. But you can’t just avoid dessert and white bread and assume your diet is low in sugar. “Sugar can lurk in unexpected foods, such as salad dressings and marinara sauce, so it’s important to always read the label when you shop,” Angelone says.
5. Consider cutting out gluten
Could gluten trigger fibromyalgia pain? Because people with fibromyalgia often experience similar symptoms to those associated with gluten-related disorders, it’s suspected that some people with fibromyalgia could have an underlying gluten sensitivity. However, going gluten free isn’t something you should try on your own, according to Angelone: “You need to be on a carefully designed plan so you don’t end up with nutrient deficiencies.”
6. Keep a food diary to ID food sensitivities
People with fibromyalgia sometimes find that their fibro symptoms worsen when they eat certain foods or ingredients, such as dairy, MSG, caffeine, or artificial sweeteners. To identify your triggers, keep a food diary for a couple of weeks and note how you feel after each meal and snack. Keep in mind, however, that fibro symptoms from eating a certain food can take up to a day to appear.
7. Ask your doctor about supplements
Many Americans are low in vitamin D and magnesium, both of which are important for those with fibromyalgia.
“If you aren’t getting enough magnesium, that can make your fatigue worse because magnesium plays an important role in energy production,” Angelone explains.
As for vitamin D, a study published in the journal Pain found that people with fibromyalgia who took vitamin D reported less pain and morning fatigue than those who took a placebo.
- How Your Weight Can Affect Your Fibro Pain
- This Fibromyalgia Patient’s Mantra Is the Inspirational Message You Need Right Now
- Spondyloarthritis May Be Overshadowed by Fibromyalgia
Fibromyalgia: The Diet Connection
Find out what experts say really matters about the foods you eat — and why staying away from certain foods might help your fibromyalgia symptoms.
By Colette Bouchez
Reviewed by Matthew Hoffman, MD
The condition is called fibromyalgia. It consists of a complex array of symptoms that include widespread muscle and joint pain along with overwhelming fatigue. And none of it goes away, no matter how much rest you get.
Fibromyalgia affects up to 4% of the population — mostly women. And there is still no known cause or recognized treatment that works for everyone. That’s one reason, say experts, that so many people have turned to diet as a way to relieve some of the symptoms.
The fact is there’s little scientific evidence to support any single eating plan as a way to deal with fibromyalgia. Nevertheless, a trip around the Internet will show that dietary approaches to fibromyalgia abound. The variety is so diverse it’s hard to imagine they are all aimed at treating the same disease.
Eat more whole grains. Don’t eat any whole grains. All fruit is good. Some fruit is bad. Tomatoes are healthy. Tomatoes are harmful. Sugar is bad. Sugar has no impact. Avoid meat. Eat. . . .
Confused? Don’t be. Experts say diversity is another hallmark of fibromyalgia.
“This is because fibromyalgia is not a specific illness,” says Michael McNett, MD. McNett directs the Fibromyalgia Treatment Centers of America, headquartered in Chicago. “Fibromyalgia is more like a symptom complex, and different people appear to have different reasons why they get this symptom complex,” he says. “So what works for one person very frequently does not work for another.”
And this, say experts, includes dietary measures.
Kent Holtorf, MD, is the medical director of the Holtorf Medical Group Center for Endocrine, Neurological and Infection Related Illness in Torrance, California. He says, “We’re at the point now where we know diet plays a role in this disease — it’s just not the same diet for everybody. And not everybody is helped in the same way.”
Fibromyalgia and diet: Can what you eat help you?
Rheumatology experts like Alex Shikhman, MD, believe the diversity of dietary approaches may have less to do with the impact on fibromyalgia, and more to do with treating a secondary, possibly undiagnosed illness. “When patients are helped by a specific dietary measure,” says Shikhman, who is director and founder of the Institute for Specialized Medicine in San Diego, “it is often because of the presence of a secondary condition that does have a recognized response to diet. And when you take care of that, you do get some relief from all the symptoms. You feel better overall.”
There are a number of co-existing health conditions that have a tendency to occur in people with fibromyalgia. Many of these have overlapping symptoms. These include gluten intolerance, gout (a form of arthritis), and restless legs syndrome. Some doctors believe food sensitivity itself could sometimes be responsible for some of the pain and fatigue of fibromyalgia.
Moreover, Holtorf points out that because each of these secondary conditions responds to a different dietary approach, it’s not hard to understand why “different dietary recommendations are reported to work.”
Shikhman believes that sometimes fibromyalgia may even be the wrong diagnosis. That’s another reason, he says, we can sometimes see such dramatic and immediate response to so many different dietary measures.
“Sometimes, if you carefully note which foods a patient responds to,” Shikhman says, “you can actually get a significant clue as to the true nature of their underlying health problems. And it might not always be fibromyalgia.”
Fibromyalgia: Seven foods to avoid
While there may not be a single set of dietary guidelines that are right for all fibromyalgia patients, there are certain foods, or food groups, that appear to make a difference for a significant number of people. But remember, avoiding these foods is not a guarantee that your symptoms will change. Also, avoiding one group may offer benefit while another may make no difference at all. Nevertheless, the experts WebMD talked to agree that eliminating at least some of these foods is worth a try.
1. Aspartame (NutraSweet). All the experts WebMD talked to agree that for a large majority of people with fibromyalgia, foods sweetened with aspartame could exacerbate fibromyalgia symptoms.
“There is a pain receptor in the nervous system known as NMDA,” says McNett. “When pain turns from acute to chronic, it involves opening the NMDA pain receptor. Aspartame, which is classified as an excitotoxin, helps to stimulate this event.” He also says people with fibromyalgia appear to already have overly active NMDA pain receptors, making them more susceptible to the stimulation.
In one study published in the Journal of Rheumatology in 2006, experts found patients with fibromyalgia did have an increased expression of NMDA receptors in their skin. This indicated a general increase in activity of peripheral nerves.
Fibromyalgia: Seven foods to avoid continued…
Holtorf says aspartame may play a role in stimulating those nerve pathways. Then he adds that for some people, “cutting it out of their diet can have a dramatic impact on pain.”
That appeared to be the case for patients in one small study published in the Annals of Pharmacotherapy in 2001. Researchers found that, when patients with fibromyalgia avoided aspartame as well as the flavor enhancer MSG, they felt better overall.
Other artificial sweeteners such as Splenda, saccharin, and stevia do not appear to have the same effect as aspartame.
2. Food additives including MSG (monosodium glutamate) and nitrates. MSG is an additive or flavor enhancer that’s found in many processed and frozen foods and in some Asian cuisines. Experts say it can intensify pain symptoms in many individuals. Like aspartame, MSG is classified as an excitotoxin and has the same potential for affecting NMDA receptors.
The same is true, says McNett, for foods containing preservatives such as nitrates, commonly found in lunchmeats like ham or bologna or in bacon.
“A lot of people who don’t have fibromyalgia can’t tolerate nitrates or MSG very well. But one of the hallmarks of this condition is that it amplifies unpleasant reactions,” McNett says. “So a stimulus that some people would find mildly unpleasant becomes very unpleasant in those who have fibromyalgia.” Cutting these ingredients out of the diet, he adds, usually helps.
3. Sugar, fructose, and simple carbohydrates. There is no clear evidence that cutting out simple carbohydrates — like sugar, cake, or white bread — will have an impact on fibromyalgia. What it can do, though, is reduce symptoms of chronic yeast infection — a fungus that thrives on sugars and may be a secondary condition contributing to the pain of fibromyalgia. This theory, however, is still being debated by experts.
“Cutting out sugary foods, particularly high fructose corn syrup, can make a difference in these patients,” says Holtorf. “And that’s independent of any weight loss that might occur when they stop eating these foods.”
Shikhman adds that cutting out carbonated beverages sweetened with fructose may yield even more noticeable results. That’s because the carbonation, he says, causes a metabolic reaction. This reaction results in much more sugar pouring into the blood much more quickly.
“It’s this quick rise in blood sugar,” Shikhman says, “followed by the subsequent fall that exacerbates the fatigue element of fibromyalgia. That, in turn, creates more cravings for sugar, followed by still more fatigue — allowing a vicious cycle to develop.” Cutting out the sugar, he says, particularly soda, can result in better, more even control of blood sugar. Better control will help reduce fatigue and at least some of the related pain.
4. Caffeine — including coffee, tea, colas, and chocolate. Because it is considered a stimulant, many fibromyalgia patients turn to caffeine-rich beverages as a source of energy. But McNett says the boost you get is false — and can quickly exacerbate fatigue.
“The problem with caffeine is that the ‘up’ is relatively brief and transient,” he says. “And it’s followed by substantially longer and deeper sedative effect.”
Because people with fibromyalgia are already tired, McNett cautions, those sedative effects can be much more powerful. “They are starting off from a point of fatigue, so the sedative qualities are amplified — leading to a much deeper and long lasting sense of fatigue.”
The good news is that cutting out caffeine can make a difference within less than a week. “Most patients begin to see a difference in their fatigue level almost right away,” he says.
5. Yeast and gluten. Although these are two separate food substances, they frequently appear together — particularly in baked goods like cake, donuts, and bread. For this reason, cutting out one, usually means you are cutting out both. That can actually yield two separate benefits for people with fibromyalgia.
In the case of yeast, some doctors say it fosters the overgrowth of the yeast fungus in the body. This overgrowth may cause or exacerbate much of the joint and muscle pain experienced by people with fibromyalgia. Research, though, has yet to confirm this link.
Gluten can exacerbate a condition known as gluten intolerance. Gluten intolerance, Shikhman says, frequently results in a variety of stomach ailments and other digestive problems. It also is associated with fatigue in patients with fibromyalgia.
“I have seen people with and without fibromyalgia experience enormous positive changes in their health by simply cutting out gluten products,” Shikhman says.
6. Dairy. Be they low fat or high fat, some experts say, dairy products — particularly, milk — have been known to drive the symptoms of fibromyalgia. Avoiding these products may help some people turn their health around.
On the other hand, if you feel as if milk is doing your body some good, keep chugging a glass or two of skim milk a day. It’s got calcium to build bones and protein to build muscle, and it’s fat free.
7. Nightshade Plants: Tomatoes, chili and bell peppers, potatoes, and eggplant. There are over 2,000 species of plants that that can be listed under the category of “nightshade.” Those which are edible comprise a group that some say can trigger flares of various types of arthritis, including fibromyalgia.
“I have seen patients who do much better when they cut these foods out of their diet,” says Holtorf. We’re not sure why, but it seems to work in a significant percentage of fibromyalgia patients.” At the same time, these vegetables are among the most nutritious. So if they don’t trigger your fibro pain, don’t ban them from your fridge.
A final word – Nutrients and the power of a healthy diet
Avoiding certain foods may help individual patients better cope with their disease. Nutritionist Samantha Heller, MS, RD, says, however, that most can also benefit from an overall heart-healthy approach to good eating.
“When you are eating a heart-healthy diet – one low in saturated fat, lean meats, and poultry and high in the fresh fruits and vegetables that don’t cause you problems, your body is going to work in a more healthful way, ” Heller says.
And while, she says, this won’t necessarily reduce your fibromyalgia symptoms, it can help to reduce the risk of other ailments that can only compound your health issues.
“When your body is healthier overall,” says Heller, “you may be better able to cope with any disease, and better able to respond to even small changes you make.”
One small study published in the journal Complementary and Alternative Medicine in 2001 found that patients who ate a vegetarian diet consisting of mostly raw whole foods did see a reduction in their fibromyalgia symptoms.
Holtorf also believes that sticking to a heart-healthy diet may yield some specific helpful effects. “Patients with fibromyalgia have documented mitochondria dysfunction,” he says. “This is the area of the cell where energy is made. Consequently, it’s necessary to have high levels of nutrients to get the mitochondria to work and for energy to be produced.” So, Holtorf adds, the higher your level of dietary nutrients, at least theoretically, the better off you might be.
What can also help, he says, is a high potency vitamin supplement as well as supplements containing omega 3 fatty acids. Omega 3 fatty acids — which are also found in foods such as fish oil, flax seed, walnuts, some fortified cereals, and eggs — are the “good fats” that have been shown to have an impact on inflammation.
“For some fibromyalgia patients,” Holtorf says, “they work extremely well.” Then he adds, “It is definitely worth a try.”
More than 2 decades after the World Health Organization recognized fibromyalgia (FM) as a clinical entity in the International Classification of Diseases,1 and despite updated diagnostic guidelines,2,3 its differential diagnosis and effective treatment remain poorly defined and challenging. Recognized as one of the most common chronic pain conditions, FM is estimated to affect between 3% and 6% of the world population and approximately 10 million people in the United States, disproportionately affecting more women than men.4
FM is characterized by chronic generalized pain and tenderness of unknown etiology, often accompanied by several associated symptoms including fatigue, sleep disturbance, headache, cognitive impairment, morning stiffness, depression, and gastrointestinal disorders.5-7 The significant overlap with several diseases, including chronic fatigue syndrome, migraine, irritable bowel syndrome, and temporomandibular joint disorder complicates FM differential diagnosis and optimal treatment. Despite these challenges, FM has been assigned its own diagnostic code — M79.7 — recognizing the syndrome for the first time as an official clinical diagnosis.8
Currently, there is no cure for FM. In the absence of a clear understanding of FM etiology and pathophysiology, effective and curative treatment has been elusive. The current treatment of FM is multifaceted in its approach, incorporating nonpharmacologic and pharmacologic options. The former approach includes physical exercise, cognitive behavioral therapy, and interventions to minimize triggers of FM, including sleep disorders such as sleep apnea, and mood problems such as stress, anxiety, panic disorder, and depression.9-11 Pharmacologic therapy is recommended when nonpharmacologic approaches fail to control the symptoms of FM adequately. In the United States, 3 drugs are approved by the US Food and Drug Administration for the treatment of fibromyalgia; 2 of these drugs, duloxetine (Cymbalta) and milnacipran (Savella), alter brain chemicals (serotonin and norepinephrine) to help control pain levels.9 Pregabalin (Lyrica) works by blocking overactive nerve cells involved in pain transmission. Other pharmacologic agents are used to manage other presenting symptoms such as sleep problems and depression. Despite the several pharmacologic treatment options available, no agent, or their combination, has demonstrated efficacy in treating all the symptoms of FM. The adverse effects associated with many of the pharmacologic agents, some warning against their use for the treatment of FM,12 call for improved understanding of FM etiology, pathophysiology, and the influences of personal habits and choices on FM symptoms, which may provide a new direction in FM treatment.
Among nonpharmacologic treatment approaches, nutrition is emerging as a promising tool for FM management. It has been proposed that deficiencies or imbalance in certain essential nutritional components may result in dysfunction of the pain inhibitory mechanisms, including fatigue and other FM symptoms. Indeed, deficiencies in certain amino acids, magnesium, selenium, and vitamins B and D are associated with increased muscle pain,5 and the benefits of specific diet and nutritional supplementation have been described in patients with FM.13
Recent efforts have attempted to improve understanding of the relationship between FM and nutrition; specifically, the relationship between metabolic state and muscle pain and the role of vitamins, metals, and antioxidants.5-7 For example, a diet rich in antioxidants, food that can increase nitric oxide level, and specific vitamins including vitamin B12/folic acid and creatine supplementation have been associated with improvement in FM symptoms.5 Specific nutritional deficiencies are also more commonly seen in individuals with FM, including deficiency in vitamin B and D, magnesium, iodine, iron, melatonin, selenium, and branched amino acids.5,6 In contrast, foods rich in histamine and heavy metals, including mercury, cadmium, and lead, exacerbate the symptoms of FM.5 It has been suggested that a diet rich in protein and vegetables may have a beneficial effect in reducing muscle pain, possibly because of higher concentrations of specific amino acids that provide energy for muscle function and strength and the increased antioxidant intake from vegetables.5,6
Not all amino acids are beneficial, however, because increased levels of homocysteine in the cerebrospinal ﬂuid are associated with FM-related musculoskeletal pain.5 A study in which individuals with FM and irritable bowel syndrome were challenged with a diet rich in glutamate found worsened FM symptoms compared with control participants who were not subjected to glutamate challenge.7 The results suggest that glutamate may play a role in FM symptoms in some patients. Studies have also examined the effects of physical exercise, body weight, and obesity in the development of or in exacerbating the symptoms of FM.5-7 A recent systematic review found that individuals with FM generally have a sedentary lifestyle, have higher body mass index, and are more likely to be overweight or obese.6 Furthermore, obese individuals show higher pain sensitivity, lower quality of life, and higher prevalence of fatigue. These symptoms have also been linked with reduced consumption of protein-rich foods and vegetables, poor sleep pattern, and depression.5,6
The link between nutrition and FM may provide a viable approach to explain individual variation in FM symptoms directly linked to personal nutritional habits and may present a potential approach to individualizing its management. When optimal levels of nutrition are achieved, FM pain levels are usually lowered.5 Currently, however, the research supporting dietary intake and FM is premature to categorically link cause and effect and allow the formulation of specific nutritional recommendations for FM management. However, based on the current evidence, there is a clear correlation between FM symptoms and healthy diet, physical exercise, and maintaining a healthy body weight. Among individuals with FM, providing guidance to improve dietary behavior, which may include supplementation to achieve an optimal nutritional status and interventions to maintain normal body weight, can contribute to improved control of FM symptoms.
Do you experience long-term muscle tenderness or joint pain that affects your everyday life?
Are you worried it will only get worse?
Fibromyalgia is an unusual medical condition thought to affect up to 6% of the population, particularly middle-aged women (1).
While it cannot be completely cured, it can be treated… and what you eat appears to be a fundamental piece of the puzzle.
This is a beginner’s guide on fibromyalgia and diet.
Definition and causes of fibromyalgia
Fibromyalgia is a health condition characterised by long-term and widespread pain (not specific to one particular area).
Other symptoms can include a heightened pain-response to physical pressure, abnormal pain or function in the bowel or bladder, excessive tiredness, stiff joints, poor sleep, and even neurological problems to do with memory and anxiety (2, 3, 4, 5).
For a long time there was some debate about the validity of the condition, but it is now a recognized disorder by the US National Institutes of Health and the American College of Rheumatology.
So what causes fibromyalgia?
The cause has not yet been proven, but there are probably numerous factors involved.
One theory is that it fibromyalgia is the consequence of early life stress or prolonged or severe stress. In genetically susceptible individuals, this could alter how neurons in the brain fire and function, influencing how we interpret pain and emotion (6).
These biological abnormalities may not only affect the nervous system, but cause physical differences in the brain. Studies of brain anatomy show structural differences between the brains of fibromyalgia patients and healthy individuals, which could also be the underlying cause for the physical and psychological symptoms (6).
The only widely acknowledged forms of treatment are pharmaceutical drugs – particularly antidepressant medications – and physical exercise, including things like physical therapy and yoga (7). Diet, food intolerances and nutrition supplements are still being investigated for their role either in prevention or treatment.
Summary: Fibromyalgia is a recognised health condition characterised by widespread, non-specific pain and sensitivity that remains long-term. It is thought to be triggered by prolonged stress and likely has a strong genetic component. The link between fibromyalgia and diet is emerging but remains a new area of research.
Are there natural remedies or diets for fibromyalgia?
Unless we consider nutrition supplements as “natural”, there are currently no proven natural remedies or treatments for fibromyalgia, from a dietary aspect.
However, there are a few steps you can take yourself that may help prevent symptoms from escalating in the first place, so that they are much more tolerable.
Keep a daily food diary for at least 2 weeks
Many fibromyalgia sufferers report that certain foods trigger more severe symptoms than others.
In fact, one study found that 42% of fibromyalgia patients reported their symptoms worsened after eating certain foods (21). Discovering your own food sensitivities, and then cutting down or abstaining completely from those trigger foods, may be the most important thing you can do.
In order to do this, you must keep a daily food diary of what you eat and when, as well as if you had any bad reactions or symptoms. Doing this consistently for several weeks allows you to visually identify trends between what you eat and the symptoms.
Here is an example of a daily food diary from Healthy Food Guide NZ:
Food sensitivities that can cause symptoms will vary greatly between individuals, but the most common are dairy, gluten and FODMAPs. This brings us to the next step…
Try an elimination challenge diet
Once you have kept a food diary for at least 2 weeks, you can begin what is known as an elimination challenge diet.
As the name suggests, you eliminate certain foods for a period of time, usually three or four weeks. Then you slowly reintroduce specific foods and monitor your symptoms for possible reactions. This is the only way to determine what type of food may be causing your symptoms to get worse.
Elimination diets are best done under the supervision of a dietitian and is what I strongly recommend, but to give you an example of what to expect:
- Based on your 2-week food diary, if (for example) you notice that symptoms are worse the day after you eat a large amount of pasta, gluten may be the culprit.
- You would then eliminate all sources of gluten from your diet for at least 3 weeks (another reason why expert supervision is recommended) and observe the results. This allows all gluten to be cleared from your system, so you have a “clean slate” so to speak.
- This is followed by a slow re-introduction of gluten-containing foods. At this point you will be able to see if gluten was causing you any problems or not.
Alternatively, you can eliminate numerous food groups all at the same time- which takes a lot more work (and supervision) – but has a much greater payoff down the track. Then you would reintroduce food groups one at a time.
Summary: Certain foods and food groups are often reported as triggers for fibromyalgia. By first identifying what foods give you problems, and then eliminating them in a systematic way, you can prevent or greatly minimise symptoms. This can be done with a daily food diary followed by an elimination challenge diet.
Maintaining a healthy weight is fundamental
The more weight on our skeleton, the more pressure that is applied to the bones and joints. Accordingly then, losing excess weight helps to relieve this pain.
But it appears that those who are overweight, and have fibromyalgia, experience increased muscle pain on top of the joint pain. A study of 179 diagnosed women, aged 20-75 years, found that being overweight was significantly associated with increased pain severity, reduced physical mobility, and poorer quality of life overall (22).
In other words, maintaining a healthy weight is fundamental to effectively treating fibromyalgia.
Now it’s unrealistic to expect that weight-loss exercise programs will be effective long-term when you consider how extreme fibromyalgia-related fatigue can be. Fortunately it’s well-established that what you eat is far more important than exercise when it comes to weight loss… so it all circles back to your diet.
Your priority should be finding a healthy eating pattern that you can sustain long-term, and that factors in your food sensitivities (if any).
Summary: Studies show that if you are overweight, fibromyalgia symptoms become much worse and much more difficult to treat. It is well-established that when it comes to weight loss, what you eat is far more important than exercise, which is why following a healthy diet should be your main priority.
Fibromyalgia and nutrition supplements
The link between fibromyalgia and diet is still a murky area of research.
To be honest, the scientific evidence available so far is quite inconclusive. But there have been some notable results with nutrition supplements, and several are worth consideration if you continue to struggle with symptoms:
Coenzyme Q10 (CoQ10), also known as ubiquinone, is a vitamin-like substance in our cells.
It functions as an antioxidant and the majority of CoQ10 is made by the body itself.
Those with fibromyalgia appear to have much lower concentrations of CoQ10 in the blood. This is linked with higher levels of cell damage, which is thought to be a big part in why it develops in the first place (8, 9).
In a small study of 35 patients, 20 of which had fibromyalgia, 300 mg of CoQ10 (ubiquinone) supplementation daily for three months was shown to increase CoQ10 levels back to normal (10).
Two other clinical trials also found improvements with doses of either 100 mg or 300 mg per day for at least 40 days. The higher dose especially was linked with less pain, fatigue, and joint soreness/stiffness (11, 12).
Based on these early studies, supplementation of at least 100 mg per day of COQ10 is recommended to anyone suffering from fibromyalgia. You can find a good range of CoQ10 supplements on amazon.
It is also worth ensuring you include some CoQ10-rich foods into your regular diet, such as herring, broccoli and cauliflower.
D-Ribose is an organic compound produced by the body.
It has a central role in metabolism, and is involved with energy production (ATP).
Those with fibromyalgia and chronic fatigue syndrome are thought to have reduced ATP levels (of which D-ribose is a component), so it’s been speculated that additional D-ribose may improve energy-related symptoms (13).
A case study of one woman with fibromyalgia observed that 10 grams of D-ribose per day, taken alongside other medication, greatly reduced symptoms. Those symptoms were said to have returned one week after the supplement was stopped (14).
The only study so far found that 15 grams of D-ribose per day for just under three weeks was associated with improvements in energy, sleep, and well-being with an increased pain threshold- as reported by the study participants themselves. However, know that the study was not well-designed and was carried out by a D-ribose supplement manufacturer (15).
D-ribose can be bought as an over the counter supplement, and there is a good range on Amazon, but I’d try CoQ10 first.
S-Adenosyl Methionine (best known as SAMe) is a compound produced by the body that is involved in many chemical processes.
Low SAMe levels are associated with depressive symptoms, and supplementation may aid a partial deficiency.
Small studies that trialled SAMe injections on patients with fibromyalgia noted improvements in ratings of mood and muscle tenderness (16, 17).
This has been followed up with one clinical trial using oral SAMe supplementation.
The study included 44 subjects with fibromyalgia that were supplemented with 800 mg of SAMe per day for six weeks. Compared with those taking the placebo supplement, a dramatic improvement was observed for muscle tenderness, a minor benefit to morning stiffness, and no apparent benefit for muscular strength. Self-rated soreness and fatigue was also much greater in the SAMe group (18).
It certainly seems promising, but there has been no similar studies conducted since, which is generally required before we can draw any concrete conclusions.
Chlorella is a freshwater algae that is very similar to Spirulina.
One study on 18 subjects with fibromyalgia found that 10 grams of chlorella supplementation for two months was linked with a 22% reduction in pain (self-reported). Two people actually reported greater than 50% improvement (19).
The mechanism by which it would help with pain-relief is not understood as it is typically used to supplement nutrient deficiencies more than anything else. Study authors concluded that larger, more well-controlled studies are required before we make any sweeping statements about its effectiveness for fibromyalgia.
L-Carnitine is a compound made by the body that is involved in energy metabolism and cell protection.
It has been suggested that fibromyalgia may be associated with metabolic alterations including a deficiency in carnitine. Naturally then, supplementing a form of carnitine might help.
Similarly to chlorella, however, evidence it can benefit fibromyalgia patients is based entirely on one small study.
Researchers found that 1 gram of Acetyl-L-Carnitine (known as ALCAR) per day was associated with significant improvements in symptoms of fibromyalgia compared to placebo. Although note that this benefit was only experienced after 6 weeks of treatment (20).
Summary: A handful of nutrition supplements have been studied for treating symptoms of fibromyalgia. There is strong evidence that 100-300 mg per day of COQ10 supplementation can help, and D-ribose may be beneficial as well. But the evidence for SAMe, chlorella and L-carnitine is weak at this stage and should not be your first choice.
Fibromyalgia and diet: Final thoughts
Fibromyalgia is a complex condition to treat, but your diet appears to be a fundamental piece of the puzzle.
Aside from pharmaceutical drugs (which are proven to help), there is some good evidence that certain nutrition supplements, such as CoQ10, can help manage symptoms and relieve pain.
Almost half of all fibromyalgia patients also report that certain foods trigger their symptoms. Actively keeping a food diary, followed by an elimination diet challenge, is the only way to learn if any foods or nutrients are driving your symptoms.
Being overweight is also thought to exacerbate symptoms, so following an eating pattern that will help you maintain a healthy weight long-term is critical as well.
When you consider all these different elements, it’s evident that fibromyalgia is not in your head, it’s on your plate.
Fibromyalgia Diet: Foods You Should Eat and Foods You Should Avoid
Pictured Recipe: Tomato & Green Bean Casserole with Spicy Herb Pesto
“Fibromyalgia” means pain of the muscles and connective tissue. However, this chronic pain disorder causes a wide variety of often debilitating symptoms, such as memory issues, muscle weakness and bowel disturbances. Treatment focuses on easing pain and improving quality of life, so a healthy, balanced diet is an important part of the overall lifestyle and treatment plan.
Keep Reading: 3 Surprising Reasons Your Gut Health Matters
Pictured Recipe: South of the Border Buddha Bowl
Fibromyalgia is a chronic disorder characterized by widespread pain, tenderness, fatigue and memory issues, as well as anxiety and depression. According to the Arthritis Foundation, fibromyalgia affects more than 3.7 million Americans. Middle-aged women are more likely to develop the condition, but men, younger women and children are also susceptible.
Symptoms and signs of fibromyalgia cannot be measured by tests or seen on any imaging tools, so a diagnosis is often difficult. Likewise, the condition is frequently misdiagnosed and improperly treated.
Unfortunately, fibromyalgia has no cure, but medications can help minimize symptoms and improve overall quality of life. Many individuals with the condition also find relief in lifestyle changes, including exercise, physical and/or occupational therapy, reducing stress and eating a healthier diet.
While a person’s diet is not a direct cause of fibromyalgia, certain foods may help alleviate symptoms and other foods may trigger symptoms.
Pictured Recipe: Roasted Root Veggies & Greens over Spiced Lentils
These guidelines can help you structure a diet that may help ease symptoms of fibromyalgia.
Put Plenty of Plants on Your Plate
A small study published in the Scandinavian Journal of Rheumatology showed that vegan diets may be beneficial for fibromyalgia patients, at least short-term. The study followed 18 fibromyalgia patients during a three-month intervention period. Half of the people adhered to a strict vegan diet, and the other half continued an omnivorous diet. Those following the vegan diet noted improved sleep quality and reduced joint stiffness and pain. Many participants who were overweight were able to reduce their body mass indexes (BMI).
Another study from BMC Complementary Alternative Medicine had similar findings. It concluded that fibromyalgia symptoms may be relieved by a mostly raw, vegetarian diet.
You don’t have to go all-out vegan or strictly vegetarian, but aim to eat plenty of fresh fruits and vegetables to ensure you get a wide array of important antioxidants. Plus, eating fresh fruits and veggies, as opposed to processed foods full of potentially irritating preservatives, can help improve irritable bowel syndrome (IBS) symptoms. Similarly, you may want to opt for organic produce when possible to avoid consuming pesticides that may trigger pain.
Read More: 9 Healthy Tips to Help You Start Eating a Vegan Diet
Pictured Recipe: Spinach & Egg Sweet Potato Toast
Focus on Vitamin D
A vitamin D deficiency can cause muscle weakness and bone pain, which may make symptoms of fibromyalgia worse. Ask your doctor to check your vitamin D status regularly, and discuss a supplement if your levels are below optimum.
It’s also a good idea to eat vitamin D-rich foods daily. Vitamin D can be found in fatty fish, eggs, and fortified products like cereal, milk and orange juice.
According to a study in the journal Pain, people who have higher vitamin D levels may experience less pain than people with lower levels. In the study, 30 women living with fibromyalgia were divided between two groups: one that took a placebo medication and one that received oral vitamin D supplements. After six months, the group that had received vitamin D reported feeling less pain than the placebo group. This was a small study, however, so more research is needed.
Try These: Recipes to Get More Vitamin D
Pictured Recipe: Salmon Sushi Buddha Bowl
Say Yes to Fish
Omega-3 fatty acids are lauded for their ability to improve heart health and reduce inflammation, and it’s thought that this nutrient could also help reduce stiffness and soreness in people with fibromyalgia. You can find this healthy fat in certain fish like salmon, as well as some nuts and seeds.
Try These: Healthy Fish & Seafood Recipes
Pictured Recipe: Dijon Salmon with Green Bean Pilaf
Foods to Avoid if You Have Fibromyalgia
In a study published in Clinical Rheumatology, 42 percent of the 65 patients with fibromyalgia surveyed said their symptoms were aggravated after eating certain foods. Avoiding some foods may help you reduce symptoms of fibromyalgia or prevent them altogether.
Cut the Coffee and Processed Foods
Though a shot of espresso may seem extra tempting to those with fatigue, many doctors actually recommend that people living with fibromyalgia limit their caffeine intake. Coffee and caffeine in general can make it harder to get a good night’s sleep, which may make symptoms of fatigue worse.
Also, try to avoid foods that are highly processed, full of refined sugar, fried, or found in a vending machine. This may sound obvious but, generally speaking, these foods tend to be high in saturated and trans fats, carbohydrates and sodium. While they will deliver a quick burst of energy, they will ultimately lead to a crash that will just worsen fatigue and tiredness. These foods also offer little in the way of nutrition and are full of calories, which can lead to weight gain. Carrying extra weight can worsen fibromyalgia pain and lethargy, too.
Pictured Recipe: Gluten-Free Banana Bread
Avoid Gluten and Limit Dairy
People living with fibromyalgia may be more prone to a gluten sensitivity. Gluten, a protein in wheat and some other grains, is often present in foods like bread, pasta and crackers, but is also a component of many food ingredients, including thickeners for some ice creams and salad dressings. It’s very important to read ingredient labels if you’re avoiding gluten in your diet.
Similar to gluten, people with fibromyalgia may be more likely to develop a lactose intolerance, or sensitivity to the natural sugar in dairy products. Remember, however, that low-fat dairy can be an important part of a healthy diet. Not all dairy products may cause symptoms or upset your stomach. Certain foods, such as yogurt, are often tolerated better by those with a lactose intolerance.
Keep Reading: A Gluten-Free Foods List
Pictured Recipe: Kung Pao Broccoli
Keep an Eye on Additives
Some food additives can act as triggers for people with fibromyalgia, so beware of ingredients like monosodium glutamate (MSG), which is often used in processed foods, fast food and Chinese food, Watch out for certain artificial sweeteners, such as aspartame, too. MSG has been known to cause headaches in some individuals, and artificial sweeteners can trigger IBS symptoms, including stomach cramps and diarrhea.
A study published in Clinical and Experimental Rheumatology found that MSG may exacerbate fibromyalgia symptoms in some patients. In a four-week study, 37 fibromyalgia patients (all of them had also been diagnosed with IBS) ate an MSG- and aspartame-free diet. At the end of the month, 84 percent of participants reported that their symptoms had improved.
Try These: Healthy Chinese Recipes
Pictured Recipe: Butternut Squash Carbonara with Broccoli
Say No to Nightshades
Overall, the more veggies you eat, the better, if you’re living with fibromyalgia. However, one group of vegetables, the nightshade family, seems to irritate some people with the chronic pain condition. If this is the case for you, limit your intake of these veggies-eggplant, potatoes and tomatoes are among the nightshade family members-but don’t forget to compensate with other vegetables, as they’re nutrient-dense and full of important antioxidants.
Pictured Recipe: Vegetable & Tofu Fried Rice
How to Create a Fibromyalgia Diet That’s Right for You
As far as a fibromyalgia diet goes, one of the best things you can do is keep a food diary. It’s difficult to remember and keep track of everything you eat in a day-let alone a week or month-to detect patterns of potentially problematic foods. Having a diet history written down will be a helpful tool for you and a dietitian if you decide to consult one. The diary can help you two detect trends, find out which foods are bothersome and which foods don’t cause any issues.
Under a dietitian’s supervision, you may want to experiment with eliminating a certain food or a food group you suspect may be a trigger. Most dietitians recommend eliminating these foods or groups of food for a few weeks to see if there’s a noticeable difference in how you feel and what you experience when you eat.
The Bottom Line: Though there is no one medical cure or healing diet to alleviate fibromyalgia pain currently, taking a closer look at your food choices, ideally with a registered dietitian, and making some adjustments may help improve symptoms-and lead to a healthier diet and lifestyle overall.
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The following provides an overview of recent research into nutrients that may be beneficial additions to a fibromyalgia diet:
- Antioxidants as part of a diet to help fibromyalgia: Antioxidants are molecules that stop oxidation (a chemical reaction that can produce something called free radicals that can damage cells). The body’s antioxidant system provides defense to keep these free radicals in check. Dietary antioxidants help our bodies to maintain our antioxidant systems. Examples of antioxidants are vitamins C, A, E, and melatonin to name a few. There may be a relationship between higher oxidation and the occurrence of fibromyalgia symptoms, but further research is needed in this area.
- Ferritin and iron as part of a fibromyalgia diet: There has been research into a possible connection between fibromyalgia symptoms and low blood levels of iron and ferritin (the storage form of iron). Iron is important in the formation of serotonin and dopamine, chemicals in the brain that are involved in pain perception. However, there is no evidence at this time that iron supplementation would help in the treatment of fibromyalgia symptoms.
- Amino acids in the fibromyalgia diet: Amino acids are the building blocks of proteins and make up a large part of human muscles and cells. There has been some research showing that patients with fibromyalgia seem to have lower levels of certain amino acids in their blood.
- Coenzyme Q10 as part of a diet to help fibromyalgia: Coenzyme Q10 is an antioxidant (see above) that is important for cell function. There is some evidence that including coenzyme Q10 in the diet may improve fibromyalgia symptoms.
Best and Worst Foods for Fibromyalgia Pain
While there is no magic food to prevent fibromyalgia pain, doctors and scientists do recommend a few adjustments in your diet, which can make a huge difference in controlling the daunting symptoms.
One strong recommendation is to improve your overall health, which has a positive effect on fibromyalgia pain. Along with living a healthy lifestyle, there are some foods that should be on the table all the time—and a few to be avoided.
Eat Fruits & Veggies
Eating lots of fruits and vegetables can improve the health of a fibromyalgia patient. Fruits and vegetables are low in calories and high in fiber and antioxidants. Vitamins A, C, and E are found in fresh fruits and veggies, and these also fight free radicals to keep your body normalized. Plus, they also lack added preservatives and artificial coloring that often aggravate fibromyalgia patients.
The “healthy fat” in cold-water fish and walnuts can have anti-inflammatory properties. According to Jeffrey Thompson, MD, an associate professor of physical medicine and rehabilitation at the Mayo Clinic College of Medicine “Omega 3’s may not offer pain relief across the board, they’re a worthy addition to any diet.” So seek out fish and nuts, adding these to your diet on a regular basis.
Corn, despite what you were taught in school, is not a vegetable. Corn is found everywhere these days. Did you know your chicken nuggets frequently have corn breading on them? Corn syrups, corn sweeteners, and corn starches may aggravate a fibromyalgia patient’s health.
Avoid peanuts. While nuts in general are healthy, peanuts are the exception. Because of the way peanuts are grown and stored today, they often top the list of foods that can cause inflammation
Avoid Simple Carbs, Whole Wheat & Whole Grains
Fibromyalgia patients often experience general hypersensitivity which translates into increased sensitivity to blood-sugar highs and lows. Avoid simple carbs like white sugar, white flour, and even wheat if possible. Also, be cautious with whole grains, since they can quickly elevate blood-sugar levels.
Avoid Foods Labeled ‘Gluten Free’
Foods labeled ‘gluten free’ can be tricky. These frequently include gluten-free substitutes that shoot blood-sugar up. Common ‘gluten free’ substitutes are starchy flours such as potato flour and tapioca flour. It’s not that these are necessarily bad, but your body may react to them with unpleasant digestive symptoms.
Sleeplessness is a common side effect of fibromyalgia, so if you wake up exhausted after a terrible night’s sleep, it is tempting to down the coffee. However, this may be a mistake. Using caffeine to compensate for a lack of sleep can contribute to circulatory problems, and the ‘solution’ of the caffeine then causes more sleeplessness. Caffeine highs also set patients up for a crash that can disrupt their sleep schedule. Decaf green tea may be an antioxidant rich healthier alternative for some patients.
Avoid Gluten & Yeast
Gluten intolerance frequently accompanies other fibromyalgia issues. It is also frequently associated with fatigue in patients with fibromyalgia.
In the case of yeast, several doctors say it fosters the overgrowth of the yeast fungus in the body. This contributes to joint and muscle pain experienced by people with fibromyalgia. Research in ongoing on this topic.
Avoid Food Additives
This including MSG (monosodium glutamate) and nitrates. While MSG enhances flavor, it can increase pain for patients. Experts say MSG causes a reaction similar to aspartame, which is classified as an excitotoxin and has the same potential for affecting NMDA receptors. Foods with added nitrates commonly include lunch meats, ham, bacon or bologna. These should be avoided.
One Diet Does Not Fit All
Finding the best diet for your fibromyalgia pain can be a challenge. Medical professionals strongly feel that diet has an effect on patients, however finding the exact diet for each individual takes time, requires experimenting, and needs effective use of a food journal. Doctors encourage patients to record what they eat and how they feel afterwards — documenting foods and combinations of foods that have positive or negative reactions on their health. This can be tremendously helpful in assisting fibromyalgia patients to understand their own bodies and create a diet that works well.
According to Kent Holtorf, MD, the medical director of the Holtorf Medical Group Center for Endocrine, Neurological and Infection Related Illness in Torrance, California, “We’re at the point now where we know diet plays a role in this disease — it’s just not the same diet for everybody. And not everybody is helped in the same way.”
Read more about common ‘healthy foods’ that should be avoided by fibromyalgia patients.
Managing symptoms of fibromyalgia is often a bit of a trial and error process. Medications, lifestyle changes and therapies like chiropractic work are an important part of that process. But did you know that focusing on a healthy diet may also play a vital role? The best diet for fibromyalgia relief consists of anti-inflammatory foods and foods high in fiber and low in added sugar. This includes whole grains, fruits and vegetables among other types of food. Let’s look at some specific tips to help ensure your chronic pain is better managed.
Start with a food diary
Fibromyalgia and diet are closely linked. Certain foods can even trigger more severe fibromyalgia symptoms. One study found that 42% of people with fibromyalgia experienced worsening symptoms after they ate particular foods.
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Everyone is different though. Your body may not be able to tolerate particular foods that don’t bother others with fibromyalgia. In order to identify your food sensitivities, start by keeping a daily food diary.
Your food diary is a written account of what you eat and when you eat it throughout a day. Write down if you have any unusually severe symptoms as well as when they occur.
You might not notice patterns right away, but keep writing in the diary for at least a month. With enough data and observations, you may be able to look back and identify links between eating certain foods and corresponding worsening symptoms. Then you can remove or limit these foods from your diet to help improve your quality of life.
Need tips on how to keep a food diary? Watch below:
Make it easy to choose a well-balanced, nutrient-dense diet
A well-balanced diet full of healthy foods like fruits, vegetables, tofu, beans and whole grains is important for all of us. It can be especially important for fighting the depression, pain and fatigue that often accompany fibromyalgia.
When symptoms flare, it’s often much easier to pick up the phone and order in rather than facing the kitchen. However, these are the times you need the best foods the most. If you don’t have someone available who can cook for you, make things easy on yourself by buying easy-to-prepare alternatives. Pre-washed and cut fruits vegetables and pre-made salads are excellent options for those times when your motivation wanes.
Eat for energy
Fatigue is one of the most common fibromyalgia symptoms. Luckily, the right foods and eating habits can be combat it. Eating small meals frequently throughout the day can ensure your energy levels don’t dip. By doing this, you can “reduce your perception of fatigue because your brain, which has very few energy reserves of its own, needs a steady supply of nutrients.”
Protein-rich foods are also excellent for energy. Reach for snacks like a protein bars, nuts and seeds, peanut or almond butter or roasted chickpeas when fatigue strikes. These are better alternatives than sugary treats, which will only spike your energy before sending you crashing back to Earth.
Consider going plant-based
Research has shown us time and time again that many overall health benefits of a plant-based diet. That includes benefits for fibromyalgia pain as well.
If you’re considering diet plans for your fibromyalgia pain, a vegan diet may be your best bet. Mostly vegetarian, mostly raw vegan and raw vegan diets have been put to the test, and one answer is clear: eating more plant-based whole foods is optimal for chronic widespread pain syndromes.
If you switch to a plant-based diet, you may experience weight loss, a factor that may help your overall health. It’s also likely you’ll help to prevent other chronic conditions such as cancer and cardiovascular disease.
Consider upping your fruit, vegetable and grain intake and adding some meat-free meals to your diet.
Gluten intolerance is suspected to cause or worsen issues like headaches, skin rashes, digestive problems, and possibly fibromyalgia. Even if you don’t have celiac disease, if you’re sensitive to gluten, it could be making your fibromyalgia symptoms worse.
A 2014 study focused on the effects a gluten-free diet would have over the course of the year. The participants were women who had fibromyalgia and irritable bowel syndrome. The gluten-free diet resulted in “remarkable clinical improvement” for fibromyalgia patients.
If you suspect you may have a gluten sensitivity, then limiting your gluten intake may help to control your symptoms. Talk to your health care team about making this switch.
Finding the best diet for fibromyalgia
While there are various studies on diet plans that best control fibromyalgia pain, there are strategies that you can use to find the diet that works best for you. Try these steps:
- Eat foods that give your body the nutritional support it needs
- Avoid processed foods, meat and gluten
- Chart which foods help to reduce your symptoms
- Update your doctor about any dietary changes
- Consult with a nutritionist to make sure that your food choices are meeting your body’s needs
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Pain management starts and ends with health awareness and dedication. .
Updated in February 2019 with new information and resources