Fibromyalgia Basics

Diet & Nutrition for Fibromyalgia

You control what you eat, so it’s natural to wonder: Is there a fibromyalgia diet that helps? Research shows that certain food ingredients will make your symptoms worse. Conversely, adhering to specific diets or adding certain nutritional supplements can reduce fibromyalgia symptoms. Given that medications by themselves offer limited symptom relief, dietary strategies may bolster your treatment success.

Five different dietary approaches that are based on correcting specific abnormalities found in people with fibromyalgia are briefly described below. All work on different aspects of the pain and symptom-generating processes, so if one diet doesn’t work for you, one of the others might.

Most diets strive to reduce your body’s level of inflammation because it’s tied to enhanced pain perception and greater fatigue. Some diets also focus on removing foods that irritate the intestinal lining (i.e., gut friendly). But before you embark on a new diet, advice from a dietician will make sure you don’t accidentally omit essential nutrients. Several key points are offered in our article: Covering the Bases on Nutrition.

In addition to certain diets shown to reduce the impact of fibromyalgia, various nutritional supplements can also help. The research on dietary aids is based on small studies or patient surveys, but some stand out as being beneficial.

Removing Food Additives

Most people know about MSG or monosodium glutamate, a common flavor-enhancing additive in processed foods. But did you know that the amino acid, glutamate, can overstimulate your nerves to the point of being toxic in high concentrations? It’s not the only excitatory amino acid you have to be concerned about. Aspartate (in the artificial sweetener, Aspartame) and cysteine also irritate your nerve endings to cause pain.

Research shows excessive amounts of glutamate throughout the body in people with fibromyalgia.  It’s elevated in the intestines (e.g., gut), bloodstream, spinal fluid, and brain. Glutamate is a potent pain transmitter. Injecting this chemical into the muscles causes extreme pain. So, it should be no surprise that glutamate is a key factor in generating your widespread pain. For more information about the detrimental effects of glutamate, check out the section on possible causes of fibromyalgia.

A four-week trial shows that removes glutamate from the diet cuts fibromyalgia symptoms by more than a third. This is better than any drug on the market, and more than 80 percent of the patients in the study reaped these benefits. For specific information on the diet and foods you need to avoid, read more.

Fibromyalgia Diet
Restricts Calories

If you suspect weight loss is the goal of this diet, the answer is both yes and no. Extra pounds compound the symptoms of fibromyalgia by impairing function and making it harder to exercise. That’s why weight loss programs are prescribed, but researchers stumbled upon an unexpected finding. Patients with fibromyalgia experienced substantial pain and symptom improvements within three weeks of being on a calorie restrictive diet. These benefits occurred long before the patients demonstrated significant weight loss.

How can a dramatic drop in caloric intake lead to a 30 percent reduction in fibromyalgia symptoms in just three weeks? Your adipose tissues (which store fats) secrete inflammation-promoting chemicals that activate nerve endings. And the bigger the adipose cells are, the more chemicals they secrete. However, if you restrict food to these fat cells, your immune system switches to secreting anti-inflammatory substances. This leads to a drop in pain-related signals traveling to the nervous system. In turn, your dysfunctional brain gets a break so that it can regulate pain, fatigue, sleep, cognition, etc.

The above study used a weight loss center for dispensing liquid food packets to patients totaling only 800 calories per day. More than 70 percent of the patients responded favorably to this fibromyalgia diet. However, you can’t do it on your own; you need the oversight and support of a quality weight loss facility. Although weight loss was the goal of this study, it illustrates how enlarged fat cells can make your symptoms worse.

If you do not have insurance coverage for a weight loss program, the anti-inflammatory diet below is your next best option.

Anti-inflammatory

Certain foods trigger an inflammatory reaction, and some much more than others. In fact, all foods have an inflammation rating and the higher it is, the greater the immune activation. But how does this relate to your symptoms? A study shows that fibromyalgia patients with higher dietary inflammation ratings also have greater pain levels.²

The Western diet containing red meat, fats and refined sugars does a poor job of controlling blood glucose, cholesterol, and inflammation. On the other hand, a vegetarian-focused diet minimizes these unwanted nutritional influences on the body.

For the most part, an anti-inflammatory diet is rich in fresh fruits and vegetables, plant-based proteins (beans and nuts), fish, poultry, and fiber. Butter and vegetable oils are replaced with virgin olive oil due to its anti-inflammatory properties. Processed foods are avoided because they contain sugar, fats, and food additives. In addition, gluten and dairy products can irritate the gastrointestinal tract lining and are sometimes eliminated as well.

Anti-inflammatory diet do’s and don’ts vary depending upon which website you visit. For example, a Mediterranean style diet is often recommended for people with fibromyalgia because it is full of antioxidants. These are nutrients that counter inflammation. It’s another version of an anti-inflammatory diet and resembles what people living in the Mediterranean eat. For a list of foods commonly found on this diet, click here.

Making nutritional changes is difficult. However, as you eliminate foods that activate your immune system, hopefully you will notice fibromyalgia symptom improvements. Maintain a food diary with key symptom scores, such as 0 to 10 ratings for pain and fatigue. View your transition to an anti-inflammatory diet as a process, not an all or nothing achievement. Three months of a rigorous anti-inflammatory diet in fibromyalgia patients reduced pain and fatigue by 30 percent.³

Gluten-Free

Even if you don’t have Celiac disease, a gluten-free diet can reduce intestinal irritation. Your intestines are lined with immune cells and research in fibromyalgia patients indicates a disruption of the bacteria that protects this lining.⁴ As a result, gluten’s irritation of the immune lining can lead to increased production of cytokine chemicals. Theoretically, these chemicals are transported in the blood to irritable nerve endings throughout the body (causing pain). But is there any evidence that eliminating wheat, barley and rye (key gluten-containing offenders) will reduce your fibromyalgia symptoms?

Treatment trial results of gluten-free diets in fibromyalgia patients are mixed. One study showed that the patients with gastrointestinal symptoms (especially diarrhea) were most likely to benefit from a gluten-free diet.⁵ This subgroup was close to one-fourth of the patients in the six-week trial.

A longer-term gluten-elimination trial of six months produced more encouraging results.⁶ People with fibromyalgia reaped a 25 percent improvement in pain and a 35 percent reduction in fatigue/sleep disorder/brain fog. And when gluten was reintroduced into their diet, the symptoms were reversed. This means the benefits were not fueled by a placebo response (wishful thinking). It also implies a gluten-free diet takes a few months to exert maximum benefits.

A gluten-free diet involves the avoidance of wheat, barley, rye, spelt, Kamut, and triticale. If you love bread and pasta, this diet will present a challenge. However, you can substitute these carbohydrate sources with products containing rice, quinoa, corn, buckwheat, and legumes. In addition, there are many gluten-free products on the market to ease the difficulty of adherence to the diet. But beware, these pre-made products are expensive. To get a healthy quantity of dietary fiber, you need to eat more fruits and vegetables and potentially add gluten-free fiber supplements.

Low-FODMAP

This is the hardest diet to adhere to, and the goal is to reduce or eliminate foods containing fermentable sugars.  The acronym FODMAP stands for low fermentable oligo-, di- and monosaccharides and polyols. Ingesting these foods leads to excess gas production, as well as abdominal cramping and pain. A low-FODMAP diet is commonly prescribed for people with irritable bowel syndrome (IBS). It’s highly restrictive of certain sugars, lactose, fructose, fructans, and sorbitol. Fortunately, this diet is only intended to be short-term (maybe one or two months) to get IBS symptoms under control.

For more information on this diet and a table of the “Foods to Avoid and Foods to Enjoy,” click here. Although this diet was developed for people with IBS, roughly 40 percent of fibromyalgia patients also have IBS. So, if you are in this subgroup (especially if your IBS is severe), a low-FODMAP diet could benefit you.

A recent trial in fibromyalgia patients shows this diet might produce significant reductions in pain, fatigue, and sleep disruption. Patients were only on the low-FODMAP for one month, followed by two months of an anti-inflammatory diet. Unfortunately, the authors of this study did not measure the individual contributions of each type of diet. One more thing: low-FODMAP diets are highly restrictive and should be supervised by a specialist to avoid nutritional deficiencies.

Wine with Dinner?

Red wine with dinner is considered part of the Mediterranean diet. It’s rich in antioxidants, reduces stress hormones, and contains tryptophan. All these actions might reduce fibromyalgia symptoms, and there is one small study showing it might help.

Researchers in Spain, a country that takes its red wine seriously, tested the effects of one glass of wine with dinner in fibromyalgia patients.⁷ Subjects were instructed to drink 5 ounces of red wine with dinner for one month. At the end of the trial, the patients’ pain and anxiety levels were significantly reduced, compared to the control group who did not drink. The study authors concluded that both the alcoholic and nonalcoholic components contribute to the beneficial effects of the wine.

Nutritional Aids 

The supplements below may be beneficial for reducing your fibromyalgia symptoms, but larger studies are needed.

• • Magnesium: This mineral plays a role in muscle function and low levels are linked to greater stiffness in fibromyalgia patients.⁸ Also, low dietary intake of magnesium contributes to reduced pain thresholds and greater pain.
  • Omega-3 Fatty Acids: These oils are antioxidants and are often added to anti-inflammatory diets. They neutralize chemical byproducts that harm your cell membranes and interfere with their function. The best formulas contain roughly 500 mg of EPA and 500 mg of DHA.
  • Melatonin: Melatonin regulates your body’s internal clock to improve sleep. It must be taken at same time each night to anchor sleep. In addition, melatonin is a potent antioxidant that protects your brain tissues.
  • Acetyl L-Carnitine: A small trial in fibromyalgia patients showed that taking 500 mg three times a day eased the pain and fatiguing symptoms.
  • Vitamin D: Aside from its role in making healthy bones, this vitamin also improves muscle strength and mood. Physical function sores improve in fibromyalgia patients when vitamin D is in the optimal range.⁸ Oil-based D3 formulas are best.
  • Coenzyme Q₁₀(CoQ₁₀): This enzyme produces energy in the cells to help power your muscles and your brain. A few small studies in fibromyalgia patients show mild benefits of adding this supplement. In addition, a trial using 100 mg/day of CoQ₁₀ plus alpha lipoic acid to treat chronic COVID patients (many who had fibromyalgia) showed significant improvement in fatigue scores.⁹  CoQ₁₀ must be purchased as oil-based gel caps and it’s very expensive. Shop around for discounts.

Stay Current on Treatments & Research with Membership: Join FREE today!

Symptoms  |  Medications | Nondrug Treatments |  Muscle Pain Relief  |  Movement Therapies   

References for Fibromyalgia Diet & Nutrition

1. Stubbs A, et al. ACR Open Rheumatol 5(5):464-469, 2022. Free Report
2. Currea-Rodriguez M, et al. Pain Med 21(3):586-594, 2020. Free Report
3. Silva AR, et al. Frontiers Nutr 9:856216, 2022. Free Report
4. Minerbi, Fitzcharles MA. Clin Exp Rheum 123(1):99-104, 2020. Free Report
5. Almirall M, et al. Rheumatology 6:1069-1077, 2023. Free Report
6. Bruzzese V, et al. Reumatismo 75(3)128-133, 2023. Free Report
7. Gonzalez-Lopez-Arza MV, et al. Nutrients 15:3469, 2023. Free Report
8. Tarsitano MG, et al. Eur Rev Med Pharmacol Sci 28(14):4038-4045, 2024. Free Report
9. Barletta MA, et al. Clin Exp Med 23(3):667-678, 2023. Free Report