Fibromyalgia (FM) is an often misdiagnosed condition that affects 10 times more women than men. It presents mainly as a cluster of symptoms in women, who are 90 percent of all diagnosed cases in the U.S. Men experience symptoms as well, but to a lesser extent.

Traditional medicine will often consist of pain medications and antidepressants to manage the myriad of sensitivity and mood fluctuations in this disease. But, personally, I feel this approach only creates roadblocks to understanding its cause.

Hormone imbalances, spinal misalignments, poor digestion, neurotransmitter deficiencies, allergies to chemicals, trauma, stress, diet and lifestyle are important anchors to investigate when presented with an individual suffering from symptoms of pain, sleep disturbances, depression, fatigue, and GI distress. Often these symptoms are an expression of an underlying malfunction in inflammatory systems on a grander scale, affecting the entire organ matrix.

A study published in 2017 in the Journal of Pain Research supports this inflammation hypothesis. In what is said to be the most extensive “holistic” inflammatory profiling study of FM patients to date — instead of one looking at a limited number of predetermined cytokines — the authors used a comprehensive panel to study these inflammation-related proteins in patients, analyzing both cerebrospinal fluid (CSF) and blood plasma. Group separation was achieved for both body fluids, and results found evidence of both neuroinflammation (as assessed in CSF) and chronic systemic inflammation (as assessed in plasma).

Estrogen fluctuations in women has been postulated as a trigger for fibromyalgia. Estrogen, a major female sex hormone, is often seen as protective against pain, so that when estrogen is lowest, either pre-menstruation or post menopause, disease symptoms can feel the most intense. Testosterone, primarily a male sex hormone, is thought to be protective against FM discomfort, as well as defensive against migraines, fatigue and depression.

Diet and gut health have a large impact on hormone balance and metabolism. Taking care to prepare and consume foods and supplements that help reduce the toxic load that certain choices put on the body can also help to increase the quality of living.

So, what are some modifications we can start with?

Let’s first address what to remove:

1. Eliminate gluten. A study was published in 2014 in Rheumatology International described work with 20 selected FM patients without celiac disease, a gluten-reactive autoimmune condition, who improved when placed on a gluten-free diet. The results supports the hypothesis that non-celiac gluten sensitivity may be an underlying cause of FM syndrome.
2. Eliminate caffeine. Stimulants tax the adrenal glands and can throw off the natural body rhythm of “rest and digest,” shifting it more toward “fight or flight” during inopportune times, like when we are trying to sleep. Caffeine has also been shown to increase levels of anxiety and restlessness.
3. Avoid artificial sweeteners and partially hydrogenated oils, as they can be loaded with chemicals that stress the body and create inflammatory cytokines, triggering the cascade of hormones that may contribute to symptoms of FM.

Now, let’s talk about some healing foods we can include in our day-to-day diet:

1. Foods high in tryptophan. Tryptophan is a precursor for serotonin, which is associated with rest, sleep and relaxation. Examples of foods to include are nuts, grass-fed dairy, wild fish, free-range chicken or turkey, sprouted grain, and sesame seeds
2. Fermented foods and drinks for gut integrity. Irritable bowel syndrome can be a symptom of fibromyalgia, and foods like kefir, kombucha, pickles, miso, natto and kimchi are great additions.
3. Omega 3 fatty acids from wild tuna and salmon, or from supplements, are essential and can curtail symptoms like stiffness, joint pain and depression.
4. Turmeric. The active form of turmeric is curcumin, and should be consumed with black pepper for optimal absorption. Its anti-inflammatory and antioxidant effect is well-researched, as represented by this review article published in 2017.
5. Magnesium. Foods high in magnesium include green leafy vegetables, pumpkin seeds, yogurt or kefir, almonds, and avocados.  Aim for a minimum of three servings a day of these foods to help with muscle and connective tissue discomfort.
6. Melatonin-rich foods.  Melatonin is a sleep hormone typically produced in low amounts by individuals with FM. Supplements are often prescribed, but can be contraindicated with certain medications and birth control pills.
   
   Luckily, there are many foods that can provide melatonin, including:

• Fruits and vegetables (tart cherries, corn, asparagus, tomatoes, pomegranate, olives, grapes, broccoli, cucumber)
• Grains (rice, barley, rolled oats)
• Nuts and seeds (walnuts, peanuts, sunflower seeds, mustard seeds, flaxseed)

Certain nutrients also merit special consideration as essential nutrients. The reason is deficiencies in them may contribute to the development and pervasiveness of FM and its symptoms.  These nutrients include folate, zinc, vitamin D, selenium, glutathione, and magnesium.

Concrete findings into the cause or causes of fibromyalgia are still being researched, but there is hope for relief and symptom management through strategic diet and lifestyle modifications. FM is a multi-factorial condition that differs from person to person. Everyone will have their own unique disease expression, with some symptoms more prevalent than others.

Nutrition therapies tailored and continually adapted to unique circumstances are vital, and will prove to show the greatest success with long-term use.

In my next article, I will share insights into the importance of stress management, movement, and the mind-body connection.

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Alana Kessler, MS, RD, CDN, E-RYT, is a registered dietitian, nutritionist, weight management expert, and an accredited member of the CDR (Commission on Dietetic Registration) and the American Dietetic Association. She is also a yoga and meditation teacher, Ayurveda specialist, and the founder of the New York City-based fully integrated mind, body, and spirit urban sanctuary, BE WELL. Alana’s BE WELL ARC System and Method Mapping technique is a holistic multidisciplinary approach to health and wellness that blends Eastern and clinical Western diet and lifestyle support to effect long-lasting behavior change.

A graduate of NYU with a BA and MS in clinical nutrition, Alana is dedicated to helping others learn how to nourish themselves, create balance, and understand their true nature through nutrition, yoga, and inner wellness. She leads Yin Yoga workshops and trainings as well as wellness retreats at international locations. Her health, fitness, and lifestyle expertise has been featured in Aaptiv.com, Droz.com, EatThis.com, RD.com, Redbook, WomensHealthmag.com, and Vogue. For more information, visit her website at bewellbyak.com.