Fibromyalgia and Nutrition, part 1

Hi everyone,

I have recently completed a nutrition certification, for which I have written a thesis about fibromyalgia. Because good nutrition habits can help people with this condition to improve their well-being, I have decided to share the content of my thesis with you.


Fibromyalgia is a syndrome with unknown etiology, characterized by diffuse pain throughout the body, digestive and cognitive disorders, up to depression[51].

There is currently no clinical diagnosis, the diagnosis is by elimination, when any other pathology that can induce similar disorders has been ruled out, and often after a long medical wandering of people with fibromyalgia syndrome[60].

To date, there is no treatment to treat fibromyalgia, apart from medications intended to relieve symptoms, such as analgesics, antidepressants and sleeping pills[60]. However, it has been shown that the use of natural therapies, including nutrition, may have a greater beneficial effect than drugs[51].

This thesis aims to take stock of the current state of research and nutritional recommendations whose positive impact on the quality of life of people with fibromyalgia has been demonstrated.


Fibromyalgia comes from the Latin word Fibra (“fiber”) and Greek myos (“muscle”) and algos (“pain”) [80].

Fibromyalgia was recognized as a disease by the World Health Organization in 1992[6]. According to the American College of Rheumatology[60], fibromyalgia syndrome is a chronic neurological disease that causes pain throughout the body and other symptoms. Although fibromyalgia is a syndrome traditionally considered rheumatology, it is not a disease of the joints as such, because it causes inflammation or tissue damage. However, it affects the daily lives of those affected by fatigue and the chronic pain it causes.


Fibromyalgia syndrome causes diffuse pain that travels throughout the body[51]. Other symptoms are:

  • paresthesia of extremities
  • feeling of swelling of the extremities
  • iritable bowel syndrom (IBS)
  • tension headaches or migraines
  • anxiety, depressive disorders or depression
  • urinary disorders
  • dry syndrome
  • Raynaud’s syndrome
  • hearing and visual disorders visual
  • memory and concentration disorders
  • chest and pelvic pain
  • palpitations, restlessness, cramps in the lower limbs
  • dysfunction of the temporo-mandibular joint


To date, there is no screening test for fibromyalgia. The diagnosis is made on the basis of criteria retained by the American College of Rheumatology[60], when any other track was discarded:

  1. Pain experienced in the last week in a number of areas listed (Figure 1)
  2. Presence and severity of the following symptoms in the past week:
    • Fatigue
    • Unrefreshing sleep
    • Cognitive disorders (memory and thought)
  3. Persistence of symptoms in the last three months
  4. No other health problems that may explain the pain and symptoms.

Since fibromyalgia induces functional disorders similar to those of other diseases, it is common that the patient, in search of diagnosis, consults many specialists before fibromyalgia syndrome is diagnosed[55].

Widespread_Pain_Index_Areas - update - Légende ENGLISH
The 19 painful areas involved in fibromyalgia syndrome. Modified after Jmarchn[69] and Mt Sterling Chiropractor[73].


The causes of fibromyalgia syndrom are unknown, there is no consensus on this in the medical world[35]. Abeles et al[1] suggest the involvement of genetic factors that would induce dysregulation of dopaminergic, catecholaminergic and serotoninergic systems. Other researchers believe that external factors such as infections, trauma and stress are involved[13].

Fibromyalgia has recently been described as a central nervous system pain signal treatment disorder, resulting in pain amplification, rather than tissue dysfunction where pain is perceived [35]. Stress, by disrupting communication between the nervous system and other cells, seems to play a major role in the onset of the disease[60].

At-risk people and aggravating factors

Fibromyalgia affects about 4 times more women than men[51]. If it is possible that this difference comes from many men suffering from fibromyalgia without having been diagnosed, the researchers think that the sex hormones influence the appearance of this disease, by the way they modulate the expression of the genes in case of stress[67].

For example, people with a family member who has fibromyalgia or depression have a higher risk of developing the syndrome as well. It is not yet clear whether this is due solely to genetic factors, or whether exposure to a similar environment plays a role[29].

Research by Walker et al[44] has shown a correlation between the occurrence of fibromyalgia and an experience of child abuse and / or sexual abuse in adulthood. Other studies have revealed the occurrence of a physical and emotional shock – accident, fall, surgery or difficult childbirth. The disease is thought to be a consequence of post-traumatic stress, which increases the emotional response to pain[46].

People with autoimmune or rheumatic diseases are more likely to have fibromyalgia, as well as those with an infectious disease, such as Lyme disease, brucellosis, infectious mononucleosis, or HIV[46].

The metabolic syndrome – overweight, diabetes, high blood pressure, hypercholesterolemia – seems to favor the onset of fibromyalgia: 50% of women with fibromyalgia have a metabolic syndrome[6 ;46]. It has also been shown that the presence of symptoms of hypothyroidism increases the risk of the occurrence of fibromyalgia[43].

Oxidative stress could be an aggravating factor: research has shown that people with fibromyalgia have deficiencies in antioxidant nutrients, such as magnesium or selenium. However, it is not known whether this deficiency is a cause or consequence of the disease[6]. Finally, the fact that the person is not listening to his needs, does not allow himself to feel his tiredness or discomfort and put his entourage before itself, seems to promote the onset of fibromyalgia[49].

Dietary deficiency and oxidative stress

Free radicals are toxic substances produced by the metabolic activity of the body and brought by our environment: UV rays, air and water pollution, pesticides, medicines… They produce what we call ” oxidative stress “, which attacks our body by inducing cellular destruction, which can cause organ dysfunction if aggression continues[46]. Free radicals attack the body as a whole, especially muscles, tendons, joints and nerve cells, which may explain musculotendinous pain, memory and concentration disorders, and depressive disorders in fibromyalgia, as confirmed by  Janet Travel and David Simons study, who have established the link between food deficiencies and tendino-muscular and hormonal problems[57]. Antioxidants, the substances that neutralize free radicals, are often deficient in people who have fibromyalgia, as well as iron, magnesium, calcium, potassium, zinc, vitamins B, C and D, acids Omega-3 fats, iodine and sulfur[49].


There is currently no pharmaceutical treatment for fibromyalgia, conventional medicine advocates drugs to relieve symptoms, such as analgesics, nonsteroidal anti-inflammatory drugs, anti-depressants and sleeping pills[46]. However, research has shown that exercise, relaxation and cognitive behavioral therapies have a beneficial effect[49]. Nutrition has also been suggested as a factor to consider in the treatment of fibromyalgia[7].

The aspect of nutritional care in fibromyalgia will be explored in the second part of my thesis.



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