Fibromyalgia (Holistic)

About This Condition

Fibromyalgia—an unsolved mystery—is a complex syndrome with no known cause or sure cure. According to research or other evidence, the following self-care steps may be helpful.

Exercise
Low-intensity exercise (like walking or swimming) is the best known treatment
Address your stress
Reducing stress and unpleasant emotions may also reduce symptoms
Try 5-HTP
100 mg of the supplement 5-hydroxytryptophan three times a day may ease symptoms
Check out SAMe
800 mg of the supplement S-adenosyl-l-methionine a day may help symptoms

About

About This Condition

Fibromyalgia is a complex syndrome with no known cause or cure. Its predominant symptom is pain in the fibrous tissues, muscles, tendons, and ligaments, although other symptoms may be experienced.

Research has demonstrated that the axis connecting the three glands primarily responsible for the stress response (hypothalamus, pituitary, adrenals) may be dysfunctional in people with fibromyalgia.¹ Inflammation of the involved structures is generally absent in fibromyalgia.

Of the estimated three to six million people² affected by this disorder in the United States, the vast majority are women between 25 and 45 years of age.

Symptoms

Trigger-point pain at characteristic locations is the defining symptom of fibromyalgia. The most commonly affected locations are on the occiput (nape of the neck), the neck itself, shoulders, trunk, low back, and thighs. Other symptoms may also be experienced, including fatigue, chest pain, low-grade fever, swollen lymph nodes, insomnia, frequent abdominal pain, irritable bowel syndrome, and depression.³

Healthy Lifestyle Tips

Low-intensity exercise may improve fibromyalgia symptoms. People with fibromyalgia who exercise regularly have been reported to suffer less severe symptoms than those who remain sedentary.⁴^{, 5}^{, 6} In a controlled trial, a program consisting of two 25-minute exercise classes plus two educational sessions per week for six weeks resulted in immediate and sustained improvement in walking distance, fatigue, and well-being in a group of people with fibromyalgia;⁷ however, no reductions in pain, anxiety, or depression were seen. In a more recent controlled trial, a 35-minute exercise program in a warm pool once a week for six months, coupled with counseling sessions, led to improvements in hand-grip strength and endurance, as well as to reductions in pain, distress, depression, and anxiety.⁸ The results of this trial, and other similar trials, suggest that underwater exercise training, in combination with a counseling intervention, should be considered by people with fibromyalgia.

Holistic Options

Stress is believed by some researchers to be capable of aggravating fibromyalgia symptoms. Stress-reduction techniques, such as meditation, have proven helpful in preliminary research.⁹

Acupuncture may be useful for short-term relief of fibromyalgia symptoms. In one preliminary trial, acupuncture produced a significant decrease in pain and point tenderness along with related biochemical changes measured in the fibromyalgia patients’ blood.¹⁰ Another uncontrolled trial used electroacupuncture (acupuncture with electrical stimulation) treatment in people with fibromyalgia who were unresponsive to conventional medical therapies. After an average of seven treatments per person, 46% claimed that electroacupuncture provided the best relief of symptoms when compared to all other therapies, and 64% reported using less medication for pain relief than prior to electroacupuncture.¹¹ A double-blind trial compared fake acupuncture to electroacupuncture and reported significant differences in improvement in five of eight outcome measurements among people with fibromyalgia.¹² Short-term pain reduction in people with fibromyalgia has been reported in other studies, some of which were at least partially controlled; however, long-term benefits have never been investigated in a controlled clinical trial.¹³ Long-term controlled trials are necessary to conclusively determine whether acupuncture is a useful treatment for fibromyalgia.

Joint manipulation, chiropractic, and related treatments may be helpful for relieving some of the symptoms of fibromyalgia. A preliminary study¹⁴ found that almost half of people with fibromyalgia who received chiropractic care had “moderate to good” improvement. A small preliminary trial¹⁵ evaluated the effect of four weeks of chiropractic treatment (three to five times per week) consisting of soft tissue massage, stretching, spinal manipulation, and general advice and information. Treatment resulted in a significant decrease in pain and an increase in range of neck movement, but there was no improvement in tender points or in ability to function in daily life. Another preliminary trial¹⁶ evaluated a longer treatment period (30 sessions) consisting of spinal manipulation and deep pressure massage to tender points in the muscles. More benefit was reported by this study, as 60% of the patients experienced significant pain reduction, reduced sensed of fatigue, and improved sleep. These benefits persisted one month after the treatment was completed. People who did not feel better after 15 treatments were not likely to benefit from this type of treatment. No controlled research has evaluated manipulation therapies for fibromyalgia.

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation	Why
Try a vegan diet	A vegan diet (includes no animal products) that is also low in salt may help women with fibromyalgia. A vegan diet (includes no animal products) that is also low in salt may help women with fibromyalgia. In a controlled clinical trial, women with fibromyalgia were put on a special diet consisting only of raw foods—primarily fruits, vegetables, nuts, seeds, legumes, and cereals (such as rolled oats). The diet also contained several fermented foods, including a fermented yogurt-food made from oats, a fermented beverage made from wheat berries (called Rejuvalac), and several types of fermented vegetables, particularly cabbage. During the three-month trial, women following the therapeutic diet experienced a significant reduction in body weight, pain, morning sickness, use of painkillers, depression, and the number of sore fibromyalgia points, compared with those who continued to eat their regular diet. Due to the liberal use of nuts and seeds, this diet was not low in fat; for example, 31% of all calories came from fat. Nonetheless, the total number of calories was relatively low (less than 1,900 calories per day), which was probably responsible for the decrease in body weight.
Cut out MSG	In one report, women with fibromyalgia experienced improvement or complete resolution of their symptoms after eliminating MSG or MSG plus aspartame from their diet. In a preliminary report, four women with fibromyalgia experienced marked improvement or complete resolution of their symptoms within months after eliminating monosodium glutamate (MSG) or MSG plus aspartame from their diet. In each case, symptoms recurred whenever MSG was ingested.

Recommendation

Why

Try a vegan diet

A vegan diet (includes no animal products) that is also low in salt may help women with fibromyalgia.

A vegan diet (includes no animal products) that is also low in salt may help women with fibromyalgia. In a controlled clinical trial, women with fibromyalgia were put on a special diet consisting only of raw foods—primarily fruits, vegetables, nuts, seeds, legumes, and cereals (such as rolled oats). The diet also contained several fermented foods, including a fermented yogurt-food made from oats, a fermented beverage made from wheat berries (called Rejuvalac), and several types of fermented vegetables, particularly cabbage. During the three-month trial, women following the therapeutic diet experienced a significant reduction in body weight, pain, morning sickness, use of painkillers, depression, and the number of sore fibromyalgia points, compared with those who continued to eat their regular diet. Due to the liberal use of nuts and seeds, this diet was not low in fat; for example, 31% of all calories came from fat. Nonetheless, the total number of calories was relatively low (less than 1,900 calories per day), which was probably responsible for the decrease in body weight.

Cut out MSG

In one report, women with fibromyalgia experienced improvement or complete resolution of their symptoms after eliminating MSG or MSG plus aspartame from their diet.

In a preliminary report, four women with fibromyalgia experienced marked improvement or complete resolution of their symptoms within months after eliminating monosodium glutamate (MSG) or MSG plus aspartame from their diet. In each case, symptoms recurred whenever MSG was ingested.

Supplements

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Supplement	Why
2 Stars 5-HTP 100 mg three times per day	Supplementing with 5-HTP may ease symptoms. People with fibromyalgia often have low serotonin levels in their blood. Supplementation with 5-HTP may increase serotonin synthesis in these cases. Both preliminary and double-blind trials have reported that 5-HTP supplementation (100 mg three times per day) relieves some symptoms of fibromyalgia.
2 Stars Acetyl-L-Carnitine 1,500 mg daily for ten weeks	Supplementing with acetyl-L-carnitine may improve musculoskeletal pain, depression, and general health in people with fibromyalgia. In a double-blind trial, supplementation with acetyl-L-carnitine in the amount of 1,500 mg per day for ten weeks was significantly more effective than a placebo in improving musculoskeletal pain, depression, and general health in people with fibromyalgia.
2 Stars Coenzyme Q10 Refer to label instructions	In a preliminary trial, headaches and overall symptoms in people with fibromyalgia significantly improved after supplementing with coenzyme Q10. In a preliminary trial, supplementing with coenzyme Q10 (100 mg three times per day for three months) resulted in significant improvements in headaches and overall symptoms in patients with fibromyalgia. In another study, cellular levels of CoQ10 were significantly lower in women with fibromyalgia than in healthy women. In the same study, ten women with fibromyalgia received 300 mg of CoQ10 per day for three months. Significant improvements were seen in symptoms such as fatigue, pain, depression, and anxiety. A placebo-controlled trial confirmed that CoQ10, in the amount of 100 mg 3 times per day, can improve depression in people with fibromyalgia.
2 Stars SAMe 800 mg daily	Supplementing with SAMe may increase serotonin levels in the blood and help relieve symptoms. Intravenous SAMe (S-adenosylmethionine) given to people with fibromyalgia reduced pain and depression in two double-blind trials; but no benefit was seen in a short (ten-day) trial. Oral SAMe (800 mg per day for six weeks) was tested in one double-blind trial and significant beneficial effects were seen, such as reduced pain, fatigue, and stiffness, and improved mood.
2 Stars Vitamin D Refer to label instructions	In a double-blind study of women with fibromyalgia who had low or moderately low blood levels of vitamin D, supplementing with vitamin D improved pain, compared with a placebo. In a double-blind study of women with fibromyalgia who had low or moderately low blood levels of vitamin D (25-hydroxyvitamin D), supplementing with vitamin D for 24 weeks improved pain, compared with a placebo. The amount of vitamin D used was 1,200 to 2,400 IU per day, depending on the blood level of vitamin D. The amount given was adjusted during the study, to maintain blood levels of vitamin D between 32 ng/ml and 48 ng/ml.
1 Star Magnesium Refer to label instructions	A preliminary trial found that a combination of magnesium and malic acid might lessen muscle pain in people with fibromyalgia. In a preliminary trial, supplementing with 300 mg per day of magnesium (as magnesium citrate) improved symptoms in women with fibromyalgia. Another preliminary trial found that a combination of magnesium and malic acid might lessen muscle pain in people with fibromyalgia. The amounts used in this trial were 300–600 mg of elemental magnesium and 1,200–2,400 mg of malic acid per day, taken for eight weeks. A double-blind trial by the same research group using 300 mg magnesium and 1,200 mg malic acid per day found no reduction in symptoms, however. Though these researchers claimed that magnesium and malic acid appeared to have some effect at higher levels (up to 600 mg magnesium and 2,400 mg malic acid per day), the positive effects were not demonstrated under blinded study conditions. Therefore, the evidence supporting the use of these supplements for people with fibromyalgia remains inconclusive.
1 Star Malic Acid Refer to label instructions	A preliminary trial found that a combination of magnesium and malic acid might lessen muscle pain in people with fibromyalgia. A preliminary trial found that a combination of magnesium and malic acid might lessen muscle pain in people with fibromyalgia. The amounts used in this trial were 300–600 mg of elemental magnesium and 1,200–2,400 mg of malic acid per day, taken for eight weeks. A double-blind trial by the same research group using 300 mg magnesium and 1,200 mg malic acid per day found no reduction in symptoms, however. Though these researchers claimed that magnesium and malic acid appeared to have some effect at higher levels (up to 600 mg magnesium and 2,400 mg malic acid), the positive effects were not demonstrated under blinded study conditions. Therefore, the evidence supporting the use of these supplements for people with fibromyalgia remains weak and inconclusive.
1 Star Melatonin Refer to label instructions	In one study, supplementing with melatonin reduced tender points and improved sleep in people with fibromyalgia. Melatonin supplementation may be useful in the treatment of fibromyalgia. In a preliminary trial, 3 mg of melatonin at bedtime was found to reduce tender points and to improve sleep and other measures of disease severity, though pain and fatigue improved only slightly.
1 Star Tart Cherry 80 mg anthocyanins, the equivalent of approximately 100–120 cherries, 16–24 ounces tart cherry juice blend, 1 ounce of liquid concentrate, or 400 mg of concentrate in tablets or capsules	Tart cherries contain antioxidants and anti-inflammatory substances that may reduce muscle pain. Tart cherries contain antioxidants and anti-inflammatory substances that may reduce muscle pain, and double-blind research in athletes has shown pain-reducing properties of tart cherry preparations. In a small double-blind study, women with fibromyalgia drank 10.5 ounces twice daily of either tart cherry juice (equivalent to 100 to 120 cherries or 80 mg of anthocyanins per day) or a placebo juice for ten days prior to performing a session of intense elbow flexion exercise. While about one-third of the women reported significantly less elbow muscle pain when using tart cherry juice before exercise, the average effect in the overall group was no better than with the placebo.
1 Star Vitamin B1 Refer to label instructions	People with fibromyalgia may be deficient in vitamin B1. Supplementing with the vitamin may correct the deficiency and improve symptoms. Some studies have found low vitamin B1 (thiamine) levels and reduced activity of some thiamine-dependent enzymes among people with fibromyalgia. The clinical significance of these findings remains unknown.
1 Star Vitamin E Refer to label instructions	Vitamin E was used in one early study with beneficial and sometimes dramatic results. One early preliminary study described the use of vitamin E supplements in the treatment of “fibrositis”—the rough equivalent of what is today called fibromyalgia. Several dozen individuals were treated with vitamin E using amounts ranging from 100–300 IU per day. The results were positive and sometimes dramatic. Double-blind trials are needed to confirm these preliminary observations.

References

1. Griep EN, Boersma JW, Lentjes EG, et al. Function of the hypothalamic-pituitary-adrenal axis in patients with fibromyalgia and low back pain. J Rheumatol 1998;25:1374-81.

2. Anonymous. Is fibromyalgia caused by a glycolysis impairment? Nutr Rev 1994;52(7):248-50.

3. Wolfe F, Ross K, Anderson J, Russell IJ. Aspects of fibromyalgia in the general population: Sex, pain threshold, and FM symptoms. J Rheumatol 1995;22(1):151-5.

4. Wilke W. Fibromyalgia: Recognizing and addressing the multiple interrelated factors. Postgrad Med 1996;100(1):153-70.

5. Carette S. Fibromyalgia 20 years later: What have we really accomplished? J Rheumatol 1995;22(4):590-4.

6. Mengshail AM, Komnaes HB, Forre O. The effects of 20 weeks of physical fitness training in female patients with fibromyalgia. Clin Exp Rheumatol 1992;10:345-9.

7. Gowans SE, deHueck A, Voss S, Richardson M. A randomized, controlled trial of exercise and education for individuals with fibromyalgia. Arthritis Care Res 1999;12:120-8.

8. Mannerkorpi K, Nyberg B, Ahlmen M, Ekdahl C. Pool exercise combined with an education program for patients with fibromyalgia syndrome. A prospective, randomized study. J Rheumatol 2000;27:2473-81.

9. Kaplan KH, Goldberg DL, Galvin-Naduea M. The impact of a meditation-based stress reduction program on fibromyalgia. Gen Hosp Psychiatry 1993;15:284-9.

10. Sprott H, Franke S, Kluge H, Hein G. Pain treatment of fibromyalgia by acupuncture. Rheumatol Int 1998;18:35-6.

11. Waylonis GW. Long-term follow-up on patients with fibrositis treated with acupuncture. Ohio State Med J 1977;73:299-302.

12. Deluze C, Bosia L, Zirbs A, et al. Electroacupuncture in fibromyalgia: results of a controlled trial. BMJ 1992;305(6864):1249-52.

13. Berman BM, Ezzo J, Hadhazy V, Swyers JP. Is acupuncture effective in the treatment of fibromyalgia? J Fam Pract 1999;48:213-8.

14. Wolfe F. The clinical syndrome of fibrositis. Am J Med 1986;81(Supp 3A):7-14.

15. Blunt KL, Moez HR, Rajwani MH, Guerriero RC. The effectiveness of chiropractic management of fibromyalgia patients: a pilot study. J Manipulative Physiol Ther 1997;20:389-99.

16. Hains G, Hains F. Combined ischemic compression and spinal manipulation in the treatment of fibromyalgia; a preliminary estimate of dose and efficacy. J Manipulative Physiol Ther 2000;23:225-30.

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Last Review: 06-03-2015

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The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2024.

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