Dear Dietitian,

I was recently diagnosed with fibromyalgia. There is a lot of information on the internet about diet to help with this. Some websites say one thing, others say another. It’s very confusing, and I need your help.

Joyce

Dear Joyce,

While the internet has brought a world of information to our fingertips, nutrition information must be evaluated for its authenticity. Fibromyalgia (FM) is a disorder characterized by chronic widespread pain, sleep problems, fatigue, and problems with memory and thinking (‘fibro fog’). According to the Centers for Disease Control and Prevention, FM affects around 4 million Americans (1). The cause of FM is not well understood, and there is no cure.

It is important to note that while nutrition therapy is a hot topic in research, not all diseases are treatable with nutrition. For example, treatment for diabetes and heart disease includes nutrition therapy. However, there is no dietary intervention for the prevention or treatment of Parkinson’s disease. Whether there will be evidence-based nutrition therapy for FM remains to be seen.

Some claim that nutrition therapies for fibromyalgia are promising, but more studies are needed before scientific conclusions can be made. Special diets that have been shown to improve FM symptoms are weight-loss, low FODMAP (fermentable oligo-, di-, mono- saccharides and polyols) and a mostly raw vegetarian diet. Improvements in pain levels, quality of sleep, anxiety and depression, and inflammatory labs were noted (2). If you choose a low FODMAP or mostly raw vegetarian diet, it would be wise to consult with a Registered Dietitian Nutritionist. The RDN will provide diet education to ensure that all your nutrient needs are met.

A weight loss-diet possibly helps in two ways. Extra weight means more work for the muscles and can be damaging to the joints over time. It follows that shedding those unwanted pounds will make it easier on the body. Also, fat cells produce inflammatory molecules, which may contribute to pain. When the fat cells are eliminated, pain is diminished. Similarly, the mostly raw vegetarian diet is believed to improve symptoms by decreasing inflammation.

Many patients who suffer from FM have intestinal problems, such as nausea, vomiting, and abdominal pain. The low FODMAP diet may ease FM symptoms by improving the environment of the intestines, also referred to as the gut microbiota.

As for supplements, there is some evidence that vitamin D or magnesium deficiency is common in those who suffer from FM. You may ask your doctor to test your blood levels to see if you need a supplement. Supplementation with these nutrients is helpful only if there is a deficiency (3).

Other natural remedies have been studied to see if they have a benefit for FM patients. These remedies include soy, Sam-e, and creatine. However, there is not enough evidence to determine if these products are helpful (4).

The development of well-designed studies is needed to determine the effects of nutrition intervention in patients with FM. Not until then will we have a clear path to move forward with nutrition therapy. Consult your doctor if you think you may have fibromyalgia.

Until next time, be healthy!

Dear Dietitian

References

1. What is Fibromyalgia? (Oct 11, 2017) Retrieved from https://www.cdc.gov/arthritis/basics/fibromyalgia.htm
2. Silva, A.R., et al. (2019) Dietary interventions in fibromyalgia: a systematic review, Annals of Medicine, 51:sup1, 2-14, DOI: 10.1080/07853890.2018.1564360

3-4 Fibromyalgia: In Depth (May 2016) Retrieved from

       https://www.nccih.nih.gov/health/fibromyalgia-in-depth