Pain Centre

Updated 12 November 2013

Fibromyalgia - can diet help?

Despite the fact that millions of people suffer from fibromyalgia worldwide, very little is known about the origins of this debilitating chronic pain disorder and any potential cures.

It is decades since the first patients were diagnosed with fibromyalgia which was the medical term given to a condition that in the 80s was called "yuppie flu". Despite the fact that 12 million or more people in countries such as the USA suffer from fibromyalgia, woefully little is known about the origins of this debilitating illness and any potential cures.


Fibromyalgia and chronic fatigue syndrome (CFS) have many characteristics in common, with 50 to 70% of patients diagnosed with fibromyalgia exhibiting symptoms of CFS and vice versa (Mahan et al, 2012). Both conditions are associated with rheumatic symptoms and have been classified as probably due to autoimmune reactions to unknown disease vectors (bacterial or virus infections).

The incidence of fibromyalgia in the USA varies between 2 and 4% of the population with women being up to four times more prone to developing this condition than men (Mahan et al, 2012).


Fibromyalgia can cause the following symptoms:
  • pronounced, debilitating fatigue to an extent that the patient becomes incapable of working or living a normal life
  • widespread tenderness throughout the musculature and joints - these ‘tender points’ can become excruciatingly painful
  • disturbed sleep with patterns of insomnia contributing to fatigue
  • pronounced depression
  • weight gain
(Cordero et al, 2013;Mahan et al, 2012)


At present no one can say with certainty exactly what causes fibromyalgia, but there are many different theories that attempt to explain this destructive disease.

Some researchers attribute the fatigue that is so characteristic of fibromyalgia to mitochondrial dysfunction. As mentioned in a previous article, the mitochondria are the powerhouses of the body cells which are responsible for providing energy required for every single body function. If these mitochondria are damaged or switched off possibly because of damage by infective agents such as viruses or bacteria, then it is plausible that the body cells will not have sufficient energy to sustain body function and activity. If the mitochondria are incapacitated then this can lead to inadequate growth, lack of coordination and muscle weakness. As a knock-on effect this may lead to a long list of disabilities including mental retardation, heart, liver and kidney disease, disorders of the respiratory, gastrointestinal and neurological systems and even dementia (Mahan et al, 2012).
Other researchers classify fibromyalgia as an autoimmune disease similar to systemic lupus erythematosus or Hashimoto’s hypothyroidism.

In some cases fibromyalgia is regarded as a consequence of severe depression. It is, however, often not clear if patients start out with depression that leads to the other symptoms of fibromyalgia or if the many enervating symptoms of fibromyalgia make patients develop severe depression.


If there are many different theories that try to explain why some individuals suffer such widespread pain, exhaustion and sleep disorders, then there are just as many different treatments which desperate patients turn to in an attempt to alleviate their problems (Arranz et al, 2012). Complementary and alternative medicines, herbal mixtures, supplements, homeopathy, massage, lymph drainage, chiropractic manipulation, dietary changes, detox and ayurvedic reginens are all part of the search for healing.

According to Mahan and her coauthors (2012), “A recent systematic review with meta-analysis concluded that acupuncture may have a small analgesic effect but cannot be recommended as single therapy for management of fibromyalgia.”

In regard to dietary changes and vitamin and mineral supplements, the use of the vegan “living food” diet has evidently produced some benefits, but as no controlled studies have been conducted to compare the effects of this diet with those of a standard diet, the results are still regarded as anecdotal in nature and not proven (Arranz et al, 2010; Mahan et al, 2012). Such a diet consists of eating berries, fruits, vegetables, roots, nuts, germinated seeds, and sprouts. It is suggested that the high antioxidant and phytonutrient content of such a diet helps the body’s immune system to overcome the damage caused by chronic infection due to viruses and bacteria.

No link to coeliac disease

Many patients with fibromyalgia diagnose themselves with a gluten allergy or coeliac disease and cut out all foods containing wheat or gluten. In a study conducted in the USA by Taubman and coauthors (2011), 50 young patients between the ages of 12 and 17 years who fulfilled the 1990 American College of Rheumatology diagnostic criteria for fibromyalgia, were tested for coeliac disease by means of small bowel biopsy. The results showed that wheat/gluten allergy does not seem to be associated with fibromyalgia.

The single patient who was diagnosed with coeliac disease was placed on a gluten-free diet and observed to see if her fibromyalgia symptoms would improve or disappear. Although the patient’s reaction to gluten disappeared on the gluten-free diet, her fibromyalgia did not. The authors therefore concluded that patients with fibromyalgia do not have a higher incidence of coeliac disease or wheat/gluten allergy than the general population and that the routine use of  a wheat-free diet by patients with fibromyalgia will not improve their symptoms or condition.
Losing weight

One dietary change that appears to show some promise, is weight reduction particularly in fibromyalgia patients who are overweight or obese (Arranz et al, 2010 Cordero et al, 2013). The weight issue is also as yet unresolved, as it is not possible to determine if patients with fibromyalgia tend to gain weight because of the actual illness or because they become physically  incapacitated and depressed. Both these conditions will hamper physical activity and may prompt overeating which can cause weight gain. It is possible that by losing weight, fibromyalgia patients are empowered to improve their situation both physically and mentally. They become more active and can participate in exercise, which is one of the few treatments that has been found to be beneficial in this disease. Doing exercise also improves depression thus breaking the vicious cycle of fibromyalgia.

In a recent study carried out with 183 patients with fibromyalgia in Spain, Cordero en co-workers (2013) found that the number of tender points patients suffered from correlated with BMI - patients which higher BMI values who were overweight or obese, had more tender points than those who had normal BMI values. The overweight patients also had higher cholesterol levels, so that the researchers suggest, “Overweight and lipid profile could be associated with fibromyalgia symptoms.” They advise patients to lose weight and increase their levels of physical activity.


At present we do not know for sure what causes fibromyalgia and what treatments will improve or cure this mysterious disease. Understandably patients suffering from fibromyalgia will literally try anything to cure themselves. Of the many suggested remedies, so far  only weightloss, and regular exercise combined with treatment by a medical team consisting of a physician/rheumatologist, a psychologist and a dietitian seem to be moderately successful. The use of a vegan diet under the supervision of a dietitian may also be of benefit.

Hopefully scientists will pinpoint exactly what causes fibromyalgia and researchers from a variety of disciplines will come up with an integrated therapy for this disease which disrupts so many lives.   

References: Arranz LI et al (2010). Fibromyalgia and nutrition, what do we know? Rheumatology International, 30(11):1417-27;  Arranz LI et al (2012). Dietary aspects in fibromyalgia patients: results of a survey on food awareness, allergies and nutritional supplementation. Rheumatology International, 32(9):2615-21; Cordero MD et al (2013). Clinical symptoms in fibromyalgia are associated to overweight and lipid profile. Rheumatology International, 2013 Jan 3; Mahan LK et al (2012). Krause’s Food and the Nutrition Care Process,13th Edition. Elsevier, USA; Taubman B et al (2011). Pediatric Rheumatology Online Journal. doi:10.1186/1546-0096-9-11)

Dr Ingrid van Heerden is a registered dietician and holds a doctoral degree in Nutrition and Biochemistry. She believes that "we are what we eat" and offers free nutrition and weight loss advice via her DietDoc service on Read more of her articles.


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