Fibromyalgia (FM) management involves many treatment approaches. Last month, we discussed the importance of sleep quality, hormonal balance, infection management, nutritional supplementation, exercise, and the “SHINE” approach. This month, we are going to explore how important diet is in the management of FM.

It’s been said that one of the most powerful tools the FM patient has in their possession is their FORK because, “…food becomes cells.” That is to say, the food we eat is used to build cells, tissues, and support our organ systems. The National Fibromyalgia Association (NFA) has reported that all FM patients have some common physiological abnormalities that include:

• Too much Substance P (a pain producing neurotransmitter).
• Too little tryptophan (an essential amino acid that helps make serotonin which helps mood and many other things).
• Not enough serotonin (a brain neurotransmitter that fights depression)..
• Abnormalities in muscle cells, especially the mitochondria that provides energy (ATP) to the cell.

With the exception of substance P, we can control ALL of the above, at least in part, via the diet by eating the right foods. The following  nutritional recommendations can lead to a significant improvement for the FM sufferer:

1. ELIMINATE FOOD TRIGGERS: Eliminate foods that irritate the digestive system. The NFA reports that 40% of FM patients have irritable bowel problems and food sensitivities that trigger abdominal pain, diarrhea, and headaches. Common food triggers include: monosodium glutamate (MSG), caffeine, food coloring, chocolate, shrimp, dairy products, eggs, gluten, yeast, milk, soy, corn, citrus, sugar, and aspartame. Regarding aspartame and MSG – a 2010 study out of France reported FM symptoms subsided significantly after eliminating both from the diet, as the researchers found that both substances stimulated certain neurotransmitters.

2. EAT MORE TURKEY! That’s because turkey contains tryptophan, an essential amino acid that can help combat chronic fatigue and depression, which are common FM symptoms. In a large NFA 2007 survey of 2,596 FM patients, about 40% of the group complained of energy loss. Tryptophan is only acquired through food as our bodies cannot make it or convert it from other substances. Tryptophan is needed by our body to make serotonin (the “happiness hormone”) which improves our mood and makes melatonin, the chemical that helps us sleep deeply. Hence, to fight fatigue, avoid the food triggers mentioned in #1 and increase tryptophan, which can be found in certain protein rich foods such as cold-water fish (salmon, tuna, anchovies, and mackerel), nuts and seeds, soy (soymilk, tofu, and soybeans), turkey, and yogurt. Many of these foods also contain tyrosine, which increases levels of brain neurotransmitters dopamine and norepinephrine. These brain neurotransmitters help with cell messaging, alertness, and reduce cognitive “fog,” often described by FM sufferers. Also consider taking melatonin if sleep is an issue.

3. EAT MORE SARDINES! Okay, turkey is more “palatable,” but sardines have the ability to reduce muscle pain, of which, according to the NFA survey, 63% of FM sufferers experience. This is thought to be due to coenzyme Q10 (CoQ10) deficiency, essential for muscle function and found in sardines and organ meats. Of course, if these natural food approaches don’t appeal to you, a CoQ10 supplement may be easier. In two studies, FM patients were found to be 40% deficient in CoQ10, and 30% experienced less muscle pain and fatigue after taking 300mg/day for 9 months.

Stay tuned next month for the last 4 nutritional “tips.”