Dear Dietitian,

I have been diagnosed with fibromyalgia. There is a lot of information on the internet about fibromyalgia diets. Some websites say one thing, while others say another. I’m confused, 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 widespread chronic 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. 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 diet. For example, treatment for diabetes and heart disease includes nutrition therapy. However, there is no nutrition therapy for preventing or treating 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 drawn. 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, sleep quality, anxiety and depression, and inflammatory markers were noted. If you choose a low FODMAP or primarily raw vegetarian diet, it would be wise to consult with a Registered Dietitian Nutritionist. The RDN will provide diet education to meet your nutrient needs.

A weight loss diet allegedly helps in two ways. Extra weight means more work for the muscles and can damage the joints over time. 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 only helpful if there is a deficiency.

Other natural remedies have been studied to see if they benefit FM patients. These remedies include soy, Sam-e, and creatine. However, there is insufficient evidence to determine if these products are helpful.

Well-designed studies are 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. 

Until next time, be healthy!

Dear Dietitian