What Is a Fibromyalgia Diet?

Feel better after finding your food sensitivities

In This Article

Technically, there is no such thing as a medically-approved diet for treating fibromyalgia, a disease characterized by widespread muscle pain (myalgia), muscle tenderness, and fatigue. Though the research is limited when it comes to the connection between diet modification and fibromyalgia pain, following certain dietary guidelines may help to improve quality of life for the roughly four million people living with the disease in the United States.

Woman in a kitchen at a counter next to a pile of fruit writing on a pad of paper
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These guidelines include avoiding foods that appear to increase the excitability of neurons that trigger fibromyalgia symptoms. These triggers can vary from one person to the next but often can be identified with an elimination diet to pinpoint individual food sensitivities.

Conversely, there are foods that may help temper neuron excitability and reduce the frequency of symptoms. Identifying which foods to eat or avoid can take time but, with persistence, you will find an eating plan best able to prevent or minimize fibromyalgia flares.

Food and Fibromyalgia

Fibromyalgia is characterized by a phenomenon called central sensitization in which pain receptors in the central nervous system (called nociceptors) become hyperreactive. This greatly amplifies sensitivity to pain and can be triggered by things like illness, infection, injury, stress, and, for some people, food.

A 2017 review in the Journal of Human Nutrition and Diet suggests food intolerance and hypersensitivity affects around half of all people living with fibromyalgia.

Fibromyalgia's relationship to food intolerance is unclear, but some scientists believe allergy plays a role. In a 2013 study in Clinical and Translational Science, no less than 49% of people with fibromyalgia had at least one food allergy, while 50% tested strongly positive for a milk allergy. Intolerance to wheat, another common food allergen, also occurred.

It is possible that a hypersensitive food reaction can trigger fibromyalgia symptoms as the body releases pro-inflammatory compounds, called cytokines, into the bloodstream. Cytokines not only help instigate food allergies but are linked to the onset of fibromyalgia symptoms, most especially hyperalgesia (increased pain sensitivity).

Other experts contend that any food intolerance can provoke fibromyalgia by triggering inflammation in the gut that can "spill over" to the nociceptors in the brain. These include common causes like gluten (associated with celiac disease and gluten intolerance) and FODMAPs (fermentable sugars linked to irritable bowel syndrome, or IBS).

Goals

An individualized fibromyalgia diet aims to:

  • Identify food intolerances and sensitivities so foods that cause gastrointentinal symptoms and trigger fibromyalgia flares can be avoided
  • Avoid foods and additives known to stimulate nociceptors in the brain. These include those high in an amino acid known as glutamate. Glutamate functions as a neurotransmitter and is found in abnormally high concentrations in the brains of people with fibromyalgia.
  • Compensate for nutritional deficiencies common in people with fibromyalgia. These include deficiencies of magnesiumseleniumvitamin D, and vitamin B12, all of which are linked to myalgia.

How It Works

Although some specialists will recommend specific diets for people with fibromyalgia, there is no set group of foods that affects all people in the same way. For that reason, developing a fibromyalgia diet starts with the process of identifying the foods you are sensitive to and the ones you can eat safely. It may also involve eating more foods that are high in magnesium, selenium, vitamin D, and vitamin B12 to maintain control over hyperalgesia.

Identifying Food Triggers

An effective way to figure out which foods are troublesome is with the type of elimination diet used to diagnose things like IBS, food allergies, and gluten sensitivity. To do an elimination diet, it's best to work with a doctor or dietitian to prevent malnutrition or nutritional deficiencies that could lead to new problems as you follow these steps:

  1. Make a list of the foods (for example, eggs or nuts) or food groups (dairy, wheat, etc.) you suspect may be causing problems.
  2. Avoid everything on the list for two weeks. Do not eat these foods whole or as an ingredient in a prepared dish.
  3. If your symptoms don't improve after two weeks, your doctor or nutritionist may advise you to stop the diet and consider other possible food and non-food triggers.
  4. If fibromyalgia symptoms resolve after two weeks, introduce one food group back into the diet every three days.
  5. On the day a food is reintroduced, eat a small amount in the morning. If you don’t have symptoms, eat two larger portions in the afternoon and evening. You should then stop eating the food for two days to see if you develop any symptoms. If you don't, the food is unlikely to be a trigger.
  6. If a food is reintroduced and triggers symptoms, make note of it in your diary and tell your doctor. Wait another two days before re-challenging yourself with another food group on the list.

A fibromyalgia diet is intended to be safely followed for an entire lifetime. Therefore it should be meet the daily recommendations for protein, fats, carbohydrates, vitamins, and minerals as outlined in the 2015-2020 Dietary Guidelines for Americans issued by the Office of Disease Prevention and Health Promotion.

What to Eat

Although the fibromyalgia diet can vary from person to person, there are a number of triggers that people with the disease commonly react to. Even if you don't undergo a formal elimination diet, you may be advised to avoid these foods to see how doing so effects you. These include foods that are high in glutamate, FODMAPs, or gluten as well as common food allergens.

Some specialists also recommend following specific diets that focus heart-healthy foods, as these often are unlikely to spur systemic inflammation, such as the DASH diet for managing high blood pressure and the Mediterranean diet, which is rich in magnesium and fatty acids.

Compliant Foods
  • Vegetables

  • Fruits (especially low-fructose fruit like melons, apples, and bananas)

  • Lean unprocessed meats and poultry

  • Oily fish like tuna, mackerel, or salmon

  • Eggs*

  • Rice

  • Soy and tofu*

  • Milk substitutes

  • Flaxseed and chia seeds

Non-Complaint Foods
  • Processed or cured meats

  • Fried or deep-fried foods

  • White bread and baked goods

  • Wheat, barley, rye, and oats

  • Dairy products

  • Shellfish

  • Sweetened drinks, including fruit concentrates

  • Desserts and sugary foods

  • Artificial sweeteners like asparatame

  • Peanuts

  • Monosodium glutamate (MSG) and packaged food seasonings

* - Unless you suspect you suspect you have a food allergy

The compliant foods are those that are less likely to spur food intolerance yet able to deliver the quality nutrition you need. The non-compliant foods are those more likely to induce intolerance by exposing you to excess gluten, FODMAPs, or glutamate.

  • Fruits and vegetables: Note that low-fructose fruits are lower in FODMAPs and less likely to trigger IBS symptoms.
  • Meats and poultry: Beef, pork, chicken, and turkey are great sources of protein, but always buy the leanest cuts. Fatty meats, fried meats, and processed meat can increase the inflammatory burden in the cardiovascular system and beyond.
  • Dairy: Dairy products are something of a conundrum in a fibromyalgia diet. On the one hand, they are a rich source of vitamin D and may reduce hyperalgesia and depression in people with fibromyalgia. On the other, dairy may be problematic in people with undiagnosed lactose intolerance or milk allergy. To maintain nutrition, considered a vitamin-D fortified milk substitute like almond, cashew, or soy.
  • Wheat: Wheat, high-gluten grains like rye, barley, and oats, and foods made with these ingredients can trigger gastrointestinal symptoms in people with gluten sensitivity. With increasing evidence that fibromyalgia is linked to celiac disease and non-celiac gluten sensitivity, it's advisable to steer clear of gluten and opt for corn, millet, rice, and sorghum.
  • Oily fish: Fish like herring, mackerel, and tuna are rich in omega-3 fatty acids, a group of polyunsaturated fats that are good for the heart and can aid in the modulation of inflammation in the body.
  • Food additives: Monosodium glutamate (MSG) is one of the most concentrated forms of glutamate in food. The relationship between MSG and fibromyalgia remains unclear but some studies have shown reducing glutamate can decrease nociceptor hyperreactivity and alleviate pain. MSG can also be found in certain packaged food seasonings.

There are other foods that can trigger fibromyalgia symptoms. Beyond the common food triggers, consider any food you eat on a regular basis as a likely suspect.

Recommended Timing

Whatever diet plan you embark on, keep to a regular schedule of at least three meals per day unless your doctor tells you otherwise. Skipping meals can lead to overeating, which not only causes stomach upset and fatigue but induces inflammation.

If you feel hungry between meals, keep to healthy snacks like fruits, vegetables, canned tuna (unseasoned), and hummus (100% natural).

Cooking Tips

A fibromyalgia diet focuses largely on whole foods prepared simply. Frying or deep-frying should be avoided and replaced with grilling, broiling, or steaming. If you decide to pan-fry, use a spray bottle to add as little oil as possible to the pan (ideally extra virgin olive oil).

Some studies have suggested that the less you cook your food, the better. This includes research suggesting that a raw vegetarian diet may reduce hyperalgesia in some people with fibromyalgia.

Considerations

A fibromyalgia diet should be approached strategically and rationally: Making sudden or extreme changes—even healthy ones—can trigger a fibromyalgia flare.

Some food sensitivities are easier to deal with than others. If you find you're sensitive to gluten, for instance, you may benefit from speaking with a dietitian or nutritionist to learn about the many foods you'll need to avoid and how to replace lost nutrients with "safe" foods.

A Word From Verywell

As with any diet, support from family and friends is vital. This is especially true if you are embarking an elimination diet or have to make significant changes in the foods you eat. By letting your loved ones understand more about fibromyalgia and how certain foods affect you, they can better support your choices and avoid undermining your efforts.

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