Fibromyalgia consists of a complex array of symptoms that include widespread muscle and joint pain along with overwhelming fatigue. And none of it goes away, no matter how much rest you get. Fibromyalgia affects up to 4% of the population — mostly women. And there is still no known cause or recognized treatment that works for everyone. That’s one reason, say experts, that so many people have turned to diet as a way to relieve some of the symptoms.
Kent Holtorf, MD, is the medical director of the Holtorf Medical Group Center for Endocrine, Neurological and Infection Related Illness in Torrance, California. He says, “We’re at the point now where we know diet plays a role in this disease — it’s just not the same diet for everybody. And not everybody is helped in the same way.”
Fibromyalgia and diet: Can what you eat help you?
Rheumatology experts like Alex Shikhman, MD, believe the diversity of dietary approaches may have less to do with the impact on fibromyalgia, and more to do with treating a secondary, possibly undiagnosed illness. Shikhman believes that sometimes fibromyalgia may even be the wrong diagnosis. That’s another reason, he says, we can sometimes see such dramatic and immediate response to so many different dietary measures.
“Sometimes, if you carefully note which foods a patient responds to,” Shikhman says, “you can actually get a significant clue as to the true nature of their underlying health problems. And it might not always be fibromyalgia.”
Fibromyalgia: Seven foods to avoid
While there may not be a single set of dietary guidelines that are right for all fibromyalgia patients, there are certain foods, or food groups, that appear to make a difference for a significant number of people. But remember, avoiding these foods is not a guarantee that your symptoms will change. Also, avoiding one group may offer benefit while another may make no difference at all. Nevertheless, the agree that eliminating at least some of these foods is worth a try.
1. Aspartame (NutraSweet).
All the experts WebMD talked to agree that for a large majority of people with fibromyalgia, foods sweetened with aspartame could exacerbate fibromyalgia symptoms. “There is a pain receptor in the nervous system known as NMDA,” says McNett. “When pain turns from acute to chronic, it involves opening the NMDA pain receptor. Aspartame, which is classified as an excitotoxin, helps to stimulate this event.” He also says people with fibromyalgia appear to already have overly active NMDA pain receptors, making them more susceptible to the stimulation.
In one study published in the Journal of Rheumatology in 2006, experts found patients with fibromyalgia did have an increased expression of NMDA receptors in their skin. This indicated a general increase in activity of peripheral nerves.
Holtorf says aspartame may play a role in stimulating those nerve pathways. Then he adds that for some people, “cutting it out of their diet can have a dramatic impact on pain.” That appeared to be the case for patients in one small study published in the Annals of Pharmacotherapy in 2001.Researchers found that, when patients with fibromyalgia avoided aspartame as well as the flavor enhancer MSG they felt better overall.
Other other artificial sweeteners such as Splenda, and stevia do not appear to have the same effect as aspartame.
2. Food additives including MSG (monosodium glutamine) and nitrates.
MSG is an additive or flavor enhancer that’s found in many processed and frozen foods and in some Asian cuisines. Experts say it can intensify pain symptoms in many individuals. Like aspartame, MSG is classified as an excitotoxin and has the same potential for affecting NMDA receptors.
The same is true, says McNett, for foods containing preservatives such as nitrates, commonly found in lunchmeats like ham or polony/balony/bologna or in bacon. “A lot of people who don’t have fibromyalgia can’t tolerate nitrates or MSG very well. But one of the hallmarks of this condition is that it amplifies unpleasant reactions,” McNett says. “So a stimulus that some people would find mildly unpleasant becomes very unpleasant in those who have fibromyalgia.” Cutting these ingredients out of the diet, he adds, usually helps.
3. Sugar, HFCS, and simple carbohydrates.
There is no clear evidence that cutting out simple carbohydrates — like sugar, cake, or white bread — will have an impact on fibromyalgia. What it can do, though, is reduce symptoms of chronic yeast infection — a fungus that thrives on sugars and may be a secondary condition contributing to the pain of fibromyalgia. “Cutting out sugary foods, particularly high fructose corn syrup, can make a difference in these patients,” says Holtorf
Shikhman adds that cutting out carbonated beverages sweetened with high fructose, corn syrup (hfcs) may yield even more noticeable results. That’s because the carbonation, he says, causes a metabolic reaction. This reaction results in much more sugar pouring into the blood much more quickly.
“It’s this quick rise in blood sugar,” Shikhman says, “followed by the subsequent fall that exacerbates the fatigue element of fibromyalgia. That, in turn, creates more cravings for sugar, followed by still more fatigue — allowing a vicious cycle to develop.” Cutting out the sugar, he says, particularly soda, can result in better, more even control of blood sugar. Better control will help reduce fatigue and at least some of the related pain.
4. Caffeine – including coffee, tea, colas, and chocolate.
Because it is considered a stimulant, many fibromyalgia patients turn to caffeine-rich beverages as a source of energy. But McNett says the boost you get is false — and can quickly exacerbate fatigue. “The problem with caffeine is that the ‘up’ is relatively brief and transient,” he says. “And it’s followed by substantially longer and deeper sedative effect.”
Because people with fibromyalgia are already tired, McNett cautions, those sedative effects can be much more powerful. “They are starting off from a point of fatigue, so the sedative qualities are amplified — leading to a much deeper and long lasting sense of fatigue.” The good news is that cutting out caffeine can make a difference within less than a week. “Most patients begin to see a difference in their fatigue level almost right away,” he says.
5. Yeast and gluten.
Although these are two separate food substances, they frequently appear together — particularly in baked goods like cake, donuts, and bread. For this reason, cutting out one, usually means you are cutting out both. That can actually yield two separate benefits for people with fibromyalgia.
In the case of yeast, some doctors say it fosters the overgrowth of the yeast fungus in the body. This overgrowth may cause or exacerbate much of the joint and muscle pain experienced by people with fibromyalgia. Research, though, has yet to confirm this link.
“I have seen people with and without fibromyalgia experience enormous positive changes in their health by simply cutting out gluten products,” Shikhman says.
Be they low fat or high fat, some experts say, dairy products — particularly, milk — have been known to drive the symptoms of fibromyalgia. Avoiding these products may help some people turn their health around.
7. Nightshade Plants: Tomatoes, chili and bell peppers, potatoes, and eggplant.
There are over 2,000 species of plants that that can be listed under the category of “nightshade.” Those which are edible comprise a group that some say can trigger flares of various types of arthritis, including fibromyalgia.
“I have seen patients who do much better when they cut these foods out of their diet,” says Holtorf. We’re not sure why, but it seems to work in a significant percentage of fibromyalgia patients.” At the same time, these vegetables are among the most nutritious. So if they don’t trigger your fibro pain, don’t ban them from your fridge.
A final word – Nutrients and the power of a healthy diet
Avoiding certain foods may help individual patients better cope with their disease. One small study published in the journal Complementary and Alternative Medicine in 2001 found that patients who ate a vegetarian diet consisting of mostly raw whole foods did see a reduction in their fibromyalgia symptoms.
Holtorf also believes that sticking to a heart-healthy diet may yield some specific helpful effects. “Patients with fibromyalgia have documented mitochondria dysfunction,” he says. “This is the area of the cell where energy is made.
Consequently, it’s necessary to have high levels of nutrients to get the mitochondria to work and for energy to be produced.” So, Holtorf adds, the higher your level of dietary nutrients, at least theoretically, the better off you might be. What can also help, he says, is supplements containing omega 3 fatty acids, they have shown to improve inflammation. Omega 3 fatty acids — which are also found in foods such as, flax seed, walnuts, chia seeds — are the “good fats” that we need.
“For some fibromyalgia patients,” Holtorf says, “they work extremely well.” Then he adds, “It is definitely worth a try.”
What I have found in the last 30 years of helping others is that excluding the first 6 foods is essential as is following a high raw food diet. One of the most powerful natural immune boosters which is also anti inflammatory besides flax oil is Forever Freedoms’ Aloe Vera Gel. It contains MSM, chondroitin and glucosamine. If for any reason you cannot have these, Aloe Vera from the Barbedensis plant is naturally anti – inflammatory, so any of the other 3 would benefit as well. I have seen phenomenal results in fibromyalgia & arthritis and for that matter any inflammatory condition, including gout.
If you do nothing else, go gluten-free and low animal protein plus aloe for starters!
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