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The fibro-food connection

By Mara Betsch

Fibromyalgia is notoriously difficult to treat. Medication tends to reduce muscle pain, fatigue,
and other symptoms of the chronic condition by just 30% to 50%. As a result, many patients turn
to diet and lifestyle changes for added relief.

Learning which foods to avoid is a good place to start, since fibro patients often have food
sensitivities that may not show up in food allergy tests. In one survey, 42% reported that certain
foods made their pain and stiffness worse.

How does food affect pain?

Experts believe that oversensitive nerve cells in the spinal cord and brain may be involved in the
way fibro patients process pain. Certain foods may trigger the release of neurotransmitters that
heighten this sensitivity, says Daniel Arkfeld, MD, a rheumatologist at the University of
Southern California's Keck School of Medicine.
Although the research on diet and fibromyalgia is limited, experts suggest that the following 10
healthy eating rules can’t hurt, and may help people dealing with chronic pain.

Eat more fresh foods

Roughly half of fibro patients also suffer from irritable bowel syndrome (IBS). Eating a diet of
fresh foods, devoid of preservatives and additives, may ease fibro symptoms associated with
IBS, says Dr. Arkfeld. "Foods that irritate your bowel will trigger the body to send a message to
the brain that signals fibromyalgia symptoms," he explains.

Whenever possible, it’s also a good idea to buy organic food. “Some patients do better avoiding
pesticides and chemicals,” says Dr. Arkfeld.
 Don't OD on caffeine
Fibromyalgia is believed to be linked to an imbalance of brain chemicals that control mood, and
it is often accompanied by unrestful sleep and fatigue. Fibro patients may try to ease fatigue with
stimulants like caffeine, but they may end up doing more harm than good in the long run.

“Caffeine is a loan shark for energy. We recommend not using a lot,” says Kent Holtorf, MD,
founding medical director of the Fibromyalgia and Fatigue Centers, which are located across the
country.
 Steer clear of some
veggies
"For joint pains, a lot of people say avoid nightshade vegetables," says Dr. Arkfeld. Normally,
veggies are low-cal, healthy options, but the nightshade variety—including tomatoes, potatoes,
and eggplants—are believed to aggravate arthritis and pain in some people.

"The thought is that they have components that are neurotoxins," says Dr. Holtorf. "For a small
percentage of patients, cutting them out makes a dramatic difference."
 Get plenty of omega-
3s
Omega-3 fatty acids, found in salmon and a variety of fish, have been touted as a heart-healthy
food, and they may help with pain as well. "The fatty acids are great," says Dr. Holtorf. "They
reduce the inflammation and help brain function."

A 2006 survey of arthritis patients found that daily fish oil supplements reduced pain symptoms
in 60% of the patients. Omega-3s have not, however, been tested on fibromyalgia patients
specifically.
 Easy on the yeast
Yeast, along with its partner in crime, gluten, can be found in a variety of baked goods.
Consuming yeast may contribute to the growth of yeast fungus in the body, which can add to
pain, says Dr. Holtorf.

Fibromyalgia patients may also be more prone to gluten sensitivities. "Celiac disease is seen in a
subset of patients. Avoiding [yeast and gluten] can help some patients improve," says Dr.
Arkfeld.
 Don't eat too much
dairy
Some degree of lactose intolerance affects about 70% of adults worldwide, so it's not surprising
that many fibromyalgia patients have trouble digesting dairy products.

In a 1998 study, researchers tested whether blood samples taken from 40 fibromyalgia patients
reacted to substances found in various foods; the blood of 25% of the subjects demonstrated an
immune response to cow dairy products.

Fibro patients on vegan diets have also seen their symptoms improve.
 Cut back on carbs
"If I had to choose one particular diet for fibromyalgia patients, I would choose a low-carb, low-
sugar diet," says Dr. Holtorf.

"About 90% of fibromyalgia patients have low adrenal functioning," he adds, which affects the
metabolism of carbohydrates and may lead to hypoglycemia. These people crave sugar, but they
also experience the crash that follows the initial energy high. "If you're hypoglycemic, you want
to keep that sugar level as stable as possible. Try carbs with a mix of protein and fat," says Dr.
Arkfeld.
 Getting off [aspartame] can make
some pain patients feel much better," says Dr. Holtorf. The artificial sweetener found in diet
sodas and many sugar-free sweets is part of a chemical group called excitotoxins, which activate
neurons that can increase sensitivity to pain. Though aspartame isn’t dangerous to healthy people
when consumed in moderation, it may heighten fibro patients' sensitivity to pain.
 Avoid additives
Food additives such as monosodium glutamate (MSG) often cause trouble for pain patients.
MSG—a high-sodium flavor enhancer often added to fast food, Chinese food, and processed
packaged foods—is a an excitatory neurotransmitter that may stimulate pain receptors; glutamate
levels in spinal fluid have been shown to correlate with pain levels in fibromyalgia patients.

A 1995 report commissioned by the U.S. Food and Drug Administration stated that MSG may
cause short-term reactions such as headaches, and a 2007 animal study in the journal Pain
suggested that increases in glutamate in muscles may contribute to pain sensitivity.
 Say no to junk food
The National Fibromyalgia Research Association recommends limiting or eliminating refined
sugar, caffeine, fried foods, and highly processed foods—in other words, most fast food, candy,
and vending-machine products. In addition to contributing to weight gain, these foods may
irritate muscles, disrupt sleep, and compromise the immune system.

Experimenting with an elimination diet and cutting the foods in this slideshow out completely for
several weeks—either one at a time or all at once—may help you decide whether they affect
your fibromyalgia symptoms.