Treating Low Serotonin in Fibromyalgia and CFS

The serotonin dysregulation many of us with fibromyalgia or chronic fatigue syndrome experience can cause myriad symptoms. Now, let's take a look at what might be able to help.

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You can influence your serotonin levels in 4 ways:

  1. Drugs
  2. Supplements
  3. Food
  4. Sunlight

Drugs for Serotonin Dysregulation

You've probably heard of selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). These drugs don't add serotonin to your system. Instead, they're designed to slow down a clean-up process in your brain that keeps serotonin around longer, meaning more of it is available to your neurons (brain cells) at any given time.

SSRIs and SNRIs are primarily used as antidepressants, but in conditions involving low serotonin, studies show that they can be effective for some people. The big downside is that they create more available serotonin everywhere in your brain, and typically people will be deficient in some areas but not in others. That can lead to a host of side effects ranging from mild to life-threatening. (More on that next week.)

Some common SSRIs include Prozac (fluoxetine), Paxil (paroxetine) and Zoloft (sertraline).

We have stronger evidence for SNRIs for fibromyalgia, and two of the FDA-approved fibromyalgia drugs — Cymbalta (duloxetine) and Savella (milnacipran) — fall into this category. The other approved drug, Lyrica (pregabalin), and the similar drug Neurontin (gabapentin) are believed to influence serotonin levels as well.

Supplements for Serotonin Dysregulation

Supplements aren't likely to have as dramatic an effect as medications, but they're also less likely to have serious side effects. (That's not to say they don't cause any side effects — they often do.)

Some supplements shown to increase available serotonin include:

SAM-e and 5-HTP both provide important building blocks of serotonin so your body can produce more. Rhodiola rosea is a natural SNRI. We don't know exactly how St. John's Wort works, but it's believed to raise levels of serotonin (as well as dopamine.)

In the U.S., St. John's Wort is the best known of these supplements, but it's also the most dangerous. With any supplements, be sure you talk to your doctor and pharmacist about possible problems and drug interactions and educate yourself about their side effects. Anything we put in our bodies can have side effects, and we're especially likely to experience them.

Food for Serotonin Dysregulation

Foods aren't well researched for this, but some foods are commonly believed to contain building blocks of serotonin and therefore may raise the level of serotonin in your blood. They include:

  • Carbohydrate-rich foods, especially before bed
  • Complex carbohydrates, including grains and beans
  • Watermelon
  • Dark chocolate (which is only considered "healthy" in small amounts)

Notice that above the list I said those foods raise serotonin in the blood, where it acts as a hormone. Because of the blood-brain barrier, it's likely that very little actually reaches your brain. Blood levels of serotonin may influence blood-flow-related symptoms and serotonin-related conditions such as irritable bowel syndrome.

Sunlight for Serotonin Dysregulation

This is the most straight-forward way to raise serotonin in your brain: get more sunlight.

The reason for this is that serotonin is a crucial part of the wake-sleep cycle, which is strongly influenced by light. When light hits your eyes, especially natural sunlight, it tells your brain, "It's time to be awake," and your brain starts churning out serotonin to make you more alert.

However, it can be hard to get consistent levels of sunlight, especially when you're severely ill.

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