What is the Fibromyalgia Diet?

In This Article

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Fibromyalgia can be difficult to manage, but research has shown dietary changes may have benefits for some people with the condition. Changing what you eat may be one of the first approaches your doctor asks you to try to help treat pain and other fibromyalgia symptoms.

There isn’t one fibromyalgia diet that works for everyone with the condition, but many people find avoiding certain food groups or eating more of certain types of food helps them manage symptoms.

The research on fibromyalgia and diet is limited and often contradictory, but more studies are being undertaken each year. Hopefully, as more thorough high-quality research is done, meaningful connections between fibromyalgia and diet can be explored with the goal of finding new treatments.

As you and your health care team (which may include doctors and a dietician or nutritionist) begin creating a personalized fibromyalgia diet, the available research may provide a helpful guide as you look for ways to address your specific dietary needs and preferences. 

Some people with fibromyalgia begin with an elimination diet, which provides a clean slate to start from as you try to identify “trigger foods” or beverages. Your experiment will also help you figure out if there are particular food groups that improve your symptoms. 

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Benefits

The exact cause of fibromyalgia is not known, but it’s likely due to more than one factor. Certain diet and lifestyle factors, such as being overweight and obese or eating a high-fat diet, can increase your risk for developing a number of chronic health conditions. If you have fibromyalgia, your weight, activity level, and diet can impact on your quality of life

While you may not have control over potential factors such as genetics and certain aspects of your environment, you can influence your health by changing how you eat. 

Researchers have cited oxidative stress as a potential contributing factor to the development of fibromyalgia. Studies on antioxidants seem to support the theory. Antioxidants are substances in foods that protect your cells from the damaging effects of oxygen. Examples of antioxidants include vitamins C and E, beta-carotene, as well as polyphenol and resveratrol.

A 2016 study published in the International Journal for Vitamin and Nutrition Research suggested people with fibromyalgia who ate antioxidant-rich diets (specifically food high in polyphenols like coffee, red fruit, pears, and dark chocolate) reported fewer tender points and a better quality of life. 

Another study from 2016, published in Biological Research for Nursing, looked at the effects of extra virgin olive oil (EVOO) on oxidative stress. In the study, EVOO performed better than other types of olive oil, possibly because the different oils contain different antioxidants. Researchers concluded that EVOO may help reduce oxidative stress, improve function, and boost health-related mental health for people with fibromyalgia.

Other studies have indicated certain foods or ingredients may cause or exacerbate pain and other fibromyalgia symptoms, including:

A 2016 review of research published in Expert Review of Neurotherapeutics found that while people with fibromyalgia may have increased pain when they ate these foods, they didn’t necessarily feel better when they cut them out of their diet. Some people with fibromyalgia felt better excluding these ingredients from their diet, but others did not. 

It’s important to note that much of the research is still inconclusive. For example, while one study found caffeine reduced fibromyalgia pain, another study suggested it made the pain worse. 

Depression and other mood disorders are common in people with fibromyalgia. They may be symptoms of the condition but the disorders can also cooccur. Researchers think there could be a connection between nutrition and mental health symptoms. One study showed that people with fibromyalgia who had low levels of vitamin D were more likely to experience anxiety and depression. 

A 2017 study published in the Journal of the Academy of Nutrition and Dietetics followed 486 women with fibromyalgia for more than a year. The goal was to determine how each person’s diet influenced their mental health. The study specifically looked at each person’s levels of optimism and depression.

According to researchers, fruits, vegetables, and fish were tied to better mental health in the study’s participants. The findings seemed to support the benefits of antioxidants, as produce contains these compounds and fish contains omega-3 fatty acids, which may also be beneficial for people with fibromyalgia. 

Conversely, heavily processed cured meat and sweetened beverages were linked to depression. However, the exact relationship between diet and mental health for people with fibromyalgia is not clear. It’s likely a very complex one and may not represent clear cause-and-effect. 

It’s not clear if eating these foods improved mood or if a person’s mental state makes them more likely to choose certain foods. For example, a person who is depressed may be more likely to rely on processed, packaged, foods and snacks whereas someone who is feeling well mentally would be more likely to have the energy and resources to shop for fresh produce and prepare healthy meals.

How It Works

People with fibromyalgia often begin making changes to their diet on their own, even before a doctor suggests it. While experimenting with adding or removing certain foods is usually not harmful, if you are considering eliminating entire food groups or drastically reducing your intake of a certain food, talk to your doctor first. 

You may be motivated to create a fibromyalgia diet to manage your symptoms, but you’ll find that the overall goals of these eating plans would be recommended even for people who don’t have the condition. 

Most people can benefit from a diet that focuses on fresh, nutritious food and limits those that are heavily processed, at least in terms of reducing their risk for certain conditions later on. If you have fibromyalgia, you may feel the impact of making changes to your diet more directly.

Research and case studies have indicated people with fibromyalgia may be more likely to have vitamin and mineral deficiencies, which could contribute to the development of the condition. Low levels of vitamins such as B12 can cause symptoms well known to people with fibromyalgia, such as muscle pain and fatigue. 

People with fibromyalgia often have gastrointestinal symptoms and may be diagnosed with irritable bowel syndrome (IBS). There are several different diet plans that have been suggested to manage IBS and you may choose to try adding elements of them to your fibromyalgia diet. 

Duration

Everyone with fibromyalgia will respond differently to making changes in their diet. Some people notice a difference in their symptoms right away. For others, it can take time. 

Once you figure out what foods make your symptoms better or worse, you may find you can manage your fibromyalgia as long as you continue to stick to your diet. You may find that even a small amount of a trigger food is enough to cause symptoms. Or, you may be able to have these foods on special occasions without much of an issue. 

Just like the content of your meal plan, the timing of your fibromyalgia diet will probably take some trial and error. You may find that at certain times in your life you need to pay more attention to what you’re eating, such as when you are under stress

If you are trying to become pregnant, have developed another medical condition such as type 2 diabetes, or plan to start a weight loss plan, you may need to make adjustments to your fibromyalgia diet to accommodate these changes.

What to Eat

The specifics of your fibromyalgia diet will depend on the results of your own dietary experiments. However, there are some particular foods and beverages that people with fibromyalgia often report worsen their symptoms. You can use these general dietary recommendations as a guide, but remember that what works for someone else with fibromyalgia may not work for you. 

Compliant

  • Fresh fruits and vegetables (organic)

  • Fatty fish (salmon, tuna)

  • Lean poultry (skinless) 

  • Nuts (walnuts, almonds, pecans)

  • Flax, chia, sunflower seeds 

  • Extra virgin olive oil

  • Beans, legumes, lentils

  • Whole-grains (bread, cereal, crackers, pasta)

  • Nut butter (almond, cashew)

  • Eggs or egg alternatives (as tolerated)

  • Low-sugar, low-fat Greek yogurt or dairy-free yogurt

  • Dairy-free milk alternatives (rice, almond, oat)

  • Brown rice, quinoa 

  • Veggie burgers/meat substitutes

  • Fresh herbs and spices 

  • Dark chocolate (in moderation) 

Non-Compliant

  • Refined white flour bread, pasta, crackers 

  • Sugary boxed cereal, granola, bars

  • Red meat

  • Fried food, fast food

  • Dairy products (milk, cheese)

  • Processed meat (sausage, bacon, hot dogs, lunch meat) 

  • Cookies, cakes, pies, baked goods

  • Ice cream, pudding, custard

  • Frozen meals and snacks

  • Packaged snack foods 

  • Instant noodles, pasta mixes

  • Oatmeal packets with added sugar 

  • Dried fruit 

  • Vegetable oils 

  • Potato chips, pretzels, microave popcorn 

  • Butter, margarine, shortening, lard 

  • Commercial salad dressing, marinades, seasonings

  • Doughnuts, muffins, bagels, croissants

  • Soda, energy drinks

  • Fruit juice with sugar

  • Candy

  • Caffeinated beverages (coffee, tea) 

  • Artificial sweeteners (aspartame)

  • Food additives (MSG) 

  • * Wheat and gluten 

  • * Soy products (tofu, tempeh) 

*You may choose to reduce or eliminate certain allergens in your fibromyalgia diet, including wheat, gluten, and soy. However, it is a personal choice and not required.

Fruits and Vegetables: Some people with fibromyalgia try to choose organic produce when they can, as they prefer to avoid certain chemicals. Even if they are not certified organic, fresh fruit and veggies are a fiber-rich and nutritious part of a fibromyalgia diet. If you have GI symptoms, you may want to try different methods of preparing produce, as cruciferous vegetables that are high in fiber can be more difficult to digest raw. 

Dairy: You may choose to limit or eliminate cow’s milk and other dairy products from your diet. There are many non-dairy options such as rice, soy, almond, and oat milk. You can also find yogurt and even creamy frozen desserts made with dairy-free alternatives. Low-fat, low-lactose cheese may be suitable in moderation, but if you are looking for non-dairy alternatives, try “cheese” products made from nuts or tofu. 

Grains: Choose whole grains rather than refined white flour bread, cereal, crackers, and pasta. Try making veggie “noodles” with a spiralizer for a low-carb pasta alternative. In general, avoid cakes, cookies, muffins, and other baked goods that are high in carbs and sugar. Recipes that use whole grains, dairy substitutes, and nutritious ingredients like flax seeds can be a healthy choice in moderation. 

Protein: If you choose to include animal-based protein in your fibromyalgia diet, look for lean cuts of poultry and fatty fish, such as salmon or tuna. In addition to limiting red meat consumption, avoid any processed meat such as hot dogs, sausage, and lunchmeat. Not only are these foods usually high in salt and trans fat, but the additives in processed meat may also worsen fibromyalgia symptoms. Nuts and nut butter, tofu or other vegetarian meat alternatives, beans, and legumes are other sources of protein you may want to experiment with. 

Desserts: You may want to prioritize avoiding sugar in your fibromyalgia diet, meaning most sweets like cakes, cookies, brownies, and ice cream would not be approved. If you find sugar doesn’t worsen your symptoms, you may want to enjoy treats in moderation. Those made with whole grains, fruits, and nuts are healthier options than pre-packaged desserts made with refined white flour, butter, and oil. You may also want to avoid certain sugar substitutes, such as aspartame.  

Beverages: Caffeinated beverages like coffee, tea, and soda may be irritating for some people with fibromyalgia. Though, some research has found a cup of coffee in the morning may be beneficial for some people with the condition. Herbal teas may be a better option for you if you find caffeine to be a problem and seltzer water, coconut water, and fruit juice without sugar can be alternatives to soft drinks.

If you drink alcohol, you may want to cut back or stop to see if your fibromyalgia symptoms improve. If you do want an occasional alcoholic beverage, avoid sweet cocktails or high-carb brews. An occasional small glass of red wine may contribute some beneficial antioxidants.

Recommended Timing

You may find it helpful to try different meal times and sizes to see which routine feels best for you. If you have digestive symptoms related to fibromyalgia or IBS, you may be more comfortable eating smaller more frequent meals throughout the day as opposed to sitting down to three large meals. 

Some dietary changes require a little more long-term planning. Elimination diets usually take weeks and you may need to do more than one as you experiment with different food groups. Talk with your doctor or nutritionist before you get started to ensure your plan is manageable and provides adequate nutrition. 

Cooking Tips

Fresh food is a staple of many diets, including most fibromyalgia diets. Lean meat and vegetables can be a nutritious part of your diet, depending on how you prepare them. Frying meat with butter and oil can make a fibromyalgia-friendly meal into one that may promote inflammation. Instead, try grilling meat and steaming your veggies. 

Avoid adding salt when cooking, including when preparing pasta. There are many tasty and versatile herbs and spices you can use to add flavor to your meals. Olive oil is a rich source of nutrition that can be drizzled on veggies and pasta. 

Instead of frying eggs, try microwaving, poaching, or even baking them. Egg whites and egg alternatives can also be used as a base for a healthy veggie omelet or breakfast quiche. 

Many fresh herbs and spices are full of antioxidants and several have anti-inflammatory properties including turmeric, garlic, cumin, and ginger. If you have GI symptoms, adding spice to your meals may be irritating. Start with just a dash of one spice at a time and see how you feel. 

Modifications

When you find a fibromyalgia diet plan that works for you, it might seem daunting to think about adjusting it. However, there may be times when you need to make a few changes to accommodate other health needs. For example, if you become pregnant or are breastfeeding, your nutritional needs and tastes may change (though it may only be temporary).

If you have another health condition that requires certain dietary changes, such as high blood pressure or diabetes, you may also need to adjust your fibromyalgia food choices. 

Food sensitivities and allergies also influence your diet. If you have GI symptoms from fibromyalgia, you may already be limiting dairy, meat, eggs, wheat, or other common food allergens

Talk to your doctor before making any changes to your diet, such as reducing or adding a type of food. If you eliminate more than one food group, you may be at risk of becoming deficient in key nutrients. Your doctor may want you to add vitamins or other nutritional supplements to your fibromyalgia diet to help prevent deficiencies, which can cause or worsen your symptoms. 

Considerations

The choices you make about your diet are impacted by and can have an effect on, all the different aspects of your life. Food is a part of life at home, socially at work, school, or with friends, and relates to your physical and mental wellbeing. When you make changes to your diet, it’s helpful to think about how other aspects of your life might affect them. 

For example, having support from your friends and family when preparing meals can make it easier to stick with your fibromyalgia diet, while responsibilities at work, such as frequent travel, might make your dietary needs more challenging.

Other factors, such as your overall health and the cost of eating a certain way, also have an effect on how well you can manage your fibromyalgia diet. Thinking about how these different factors could affect your diet before you start gives you time to seek guidance and prepare with help from your support system. 

General Nutrition 

A diet that focuses on whole foods and avoids those that are heavily processed will generally be a healthy one. The specific nutrition of your fibromyalgia diet will depend on the foods you choose to include and how much you eat. 

If there are certain food groups you want to avoid to better manage your fibromyalgia symptoms, make sure you are making up the calories and nutrition elsewhere in your diet. Your primary goal should be eating a balanced, nutritious diet that meets your body’s energy needs. 

Safety

Your doctor may prescribe medications for you to help with fibromyalgia symptoms, including those used to treat pain, trouble sleeping, and depression. 

Food and beverages can interact with medications and change how they work. For example, some foods you eat might make your medication less effective. Combining certain foods and drinks with your medications may also cause side effects—some of which can be dangerous.

If you are starting a new medication, you may need to adjust your fibromyalgia diet to reduce or eliminate foods or drinks that should not be mixed with it. In some cases, you may be able to continue to have a food or drink as long as you time your meals and medications to allow for a few hours in between. 

If you want to try herbal supplements and natural remedies for fibromyalgia, be sure to check with your doctor before you start taking these products—especially if you are on prescription medications or have other health conditions. 

Flexibility

Certain ways of eating are less healthy options whether you have fibromyalgia or not, but you may be more sensitive to overly sweet or salty meals if you have the condition. 

If you look at a typical fast food or casual dining menu, you’ll find that many of the meals would fall under the “non-compliant” list of foods and drinks for a fibromyalgia diet, including fatty, fried, food, desserts made with white flour, and alcohol. 

That being said, you may be able to enjoy a meal out once in a while. You’ll have to experiment with your personal fibromyalgia diet to see what you’re able to tolerate. 

It can be helpful to look at the menu before dining out to get a sense of a restaurant's typical portion sizes and the ingredients used to prepare dishes. You may be able to make a meal that’s more fibromyalgia diet-friendly by asking for substitutions or splitting your entree with a friend. 

Support and Community

Living with fibromyalgia is often an emotional journey as much as a physical one. Even though your doctor and nutritionist can answer many of your questions, you may feel like talking to others who have been through what you’re going through. 

There may be in-person fibromyalgia support groups in your community, but if not, you'll also find many online resources. Patients often use social media, websites, blogs, and message forums to communicate. 

While there isn’t one fibromyalgia diet plan that works for everyone, you might find it helpful to talk to other people with the condition and hear about their experiences. Talking to others can inspire your own ideas, help you feel supported and understood, and keep you motivated.

Side Effects

When you’re making dietary changes it’s not uncommon to experience bowel changes as well. If you increase or decrease the amount of fiber in your diet, you may experience digestive discomfort even if you don’t typically have GI symptoms related to the condition. 

If your fibromyalgia diet transition causes constipation or diarrhea, talk to your doctor. It may be helpful to add a fiber supplement or follow the easy to digest BRAT diet until your body adjusts. 

Fibromyalgia Diet vs. Other Diets

There is no set fibromyalgia diet, therefore many people with the condition combine elements from several different plans to manage their symptoms. The most popular diet plans for people with fibromyalgia are those that reduce elimination, are high in antioxidants and omega-3 fatty acids, and reduce or eliminate certain food allergens, such as dairy. 

Low FODMAP Diet

A 2017 study led by A.P. Marum, MD looked at the possible benefits of a low-FODMAP diet for people with fibromyalgia. 

FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols— types of sugar or sugar alcohols that are broken down by bacteria in the colon. FODMAPs are naturally found in some foods and commonly used as additives in others. 

Researchers have been interested in low-FODMAP diets for fibromyalgia because studies have shown it can be effective for another condition that often overlaps with fibromyalgia: irritable bowel syndrome (IBS).

In one study, 38 women with fibromyalgia were followed for 10 years. While the sample size was small and additional research is needed, the initial results were encouraging: researchers found that the women with fibromyalgia who followed a low-FODMAP diet had fewer symptoms and less severe symptoms (including pain), as well as a decrease in weight, body mass index, and waist circumference. 

If you’re considering trying a low-FODMAP diet, let your doctor know. Even if there are benefits, it may be difficult to follow this type of diet if you have other dietary restrictions. It can also be harder to get balanced nutrition, as many high FODMAP foods are also very nutritious, including:

  • Apples
  • Peaches
  • Barley
  • Wheat
  • Ice cream
  • Margarine
  • Milk
  • Soy
  • High-fructose corn syrup
  • Honey
  • Sweeteners ending in –ol
  • Celery
  • Cauliflower

Low-FODMAP foods you may want to add to your fibromyalgia diet include:

  • Bananas
  • Blueberries
  • Grapes
  • Brown sugar
  • Table sugar
  • Butter
  • Almond milk
  • Broccoli
  • Carrots
  • Potatoes
  • Brown rice
  • Oats
  • Sunflower seeds

Gluten-Free Diet

The role of gluten has been researched in relation to many conditions, including fibromyalgia. Some people with fibromyalgia report symptoms similar to Celiac disease

If a person has Celiac disease and is allergic to wheat and/or gluten, they must avoid these ingredients. People with fibromyalgia may choose to reduce or eliminate gluten and wheat from their diet, but it is not required. There is evidence that following a gluten-free diet when you don’t have a gluten allergy is, at best, not beneficial and in some cases may have negative effects. 

Researchers have proposed a form of gluten sensitivity could be linked to fibromyalgia, but it’s not yet clear if following a gluten-free diet is a beneficial treatment for people with the condition. Interestingly, several studies have suggested that people with fibromyalgia may be more likely to be gluten intolerant, in which case reducing their intake of wheat and gluten could help manage symptoms. 

If you find these ingredients tend to make your fibromyalgia symptoms worse, talk to your doctor about ways to reduce them in your diet to see if your pain improves. 

Plant-Based Diets

Several studies have shown that people with fibromyalgia who follow a vegan or vegetarian diet may experience less pain. When balanced, plant-based diets can be antioxidant-rich and high in fiber, which may help improve fibromyalgia symptoms. 

There are several variations on vegan and vegetarian diets you can explore, including: 

A Word From Verywell

If you have fibromyalgia, you may find making changes to your diet can help manage pain and other symptoms. It’s important to keep in mind that the research is still limited. Dietary changes that work for some people with fibromyalgia may not benefit others. You can work with your doctor and/or a registered dietician or nutritionist to experiment with increasing, reducing, or eliminating certain foods and beverages in your diet. As you make these adjustments, keep track of how the changes make you feel physically and mentally. Together with the available research, these findings can guide you as you create a fibromyalgia diet of your own. 

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Article Sources

  1. Rus A, et al. Extra virgin olive oil improves oxidative stress, functional capacity, and health-related psychological status in patients with fibromyalgia: a preliminary study. Biological resources for nursing. 2016 Jul 21. pii: 1099800416659370.​

  2. Armstrong DJ, Meenagh GK, Bickle I, Lee ASH, Curran E-S, Finch MB. Vitamin D deficiency is associated with anxiety and depression in fibromyalgia. Clinical Rheumatology. 2006;26(4):551-554. doi:10.1007/s10067-006-0348-5

  3. Ruiz-Cabello P, Soriano-Maldonado A, Delgado-Fernandez M, et al. Association of Dietary Habits with Psychosocial Outcomes in Women with Fibromyalgia: The al-Ándalus Project. Journal of the Academy of Nutrition and Dietetics. 2017;117(3):422-432.e1. doi:10.1016/j.jand.2016.09.023

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