The No-Pain Diet: Foods to fight fibromyalgia

Remember the last time you had the flu? Most likely, you felt exhausted, sore, achy, and muddled. You couldn’t think straight, it was a task just to drag yourself through the day, and the four days you were sick seemed like a month. If you have fibromyalgia, that’s how you feel almost every day, but unlike the flu, your symptoms don’t go away. And while there’s no cure for the condition, dietary changes can make life easier, even pain-free, for people with fibromyalgia.

Though it seems to be the health news of late, fibromyalgia was first recognized in the 1800s, when it was termed rheumatism. Aches, pains, and flu-like feelings aren’t the only signs: Other symptoms include extreme fatigue, sleep disturbances, difficulty concentrating, and other manifestations that dramatically affect quality of life.

Fibromyalgia is widespread: Almost 10 million people in the United States have the condition, and women are much more likely to develop fibromyalgia than men. According to the NFA, between 75 to 90 percent of those with fibromyalgia are women; that may be because women experience hormone fluctuations which could play a part in the condition.

Or it may be simply that men are less likely to seek help for the vague, flu-like feelings of fibromyalgia, and thus are underdiagnosed. Despite the prevalence of the disorder, causes of fibromyalgia remain unknown. Certain people may be genetically predisposed to developing fibromyalgia, which can also be triggered by extreme stress, physical or emotional trauma, or even another health condition. New research also suggests that a defect in the central nervous system can lead to abnormal sensory processing; in other words, people with fibromyalgia may have a heightened degree of pain perception, so a a sensation that goes unnoticed in the general population may cause them pain.

Because the causes are uncertain, the condition is difficult to diagnose. There’s no blood test or X-ray used to identify fibromyalgia. The characteristic symptoms‹muscle pain, fatigue, sleep disturbances are common to many disorders, and many patients with fibromyalgia frequently have concurrent conditions like arthritis or chronic fatigue, further confounding doctors and making a diagnosis challenging. Generally, fibromyalgia is diagnosed by symptoms alone.

Once fibromyalgia is diagnosed, treatment is usually symptomatic‹that is, there’s no cure for the disorder. As a result, many people have turned to complementary therapies, including hydrotherapy, homeopathy, mindfulness meditation, acupuncture, osteopathy, and magnetic therapy, all of which have been shown to help alleviate pain in people with fibromyalgia, according to a recent study. And like most health conditions, diet is also essential to reducing symptoms.

Dietary changes, especially when they involve eliminating foods that  trigger inflammation, and emphasizing nutrients that are key in  treating fibromyalgia, can be very effective in reducing symptoms of fibromyalgia.

In most cases, finding a specific eating plan is as baffling as diagnosing the disease itself, since no single diet is effective for everyone: Some people can¹t touch fruit or grains, for example, while others do just fine with them. In other words, while we know diet works to help alleviate symptoms in fibromyalgia patients, we just don’t know what that diet is.

Most experts recommend eliminating trigger foods that have been shown to aggravate fibromyalgia symptoms. Aspartame, an artificial sweetener found in Equal and many popular sugar-free products, stimulates pain receptors in the brain. So does monosodium glutamate (MSG). Sugar and white flour can upset blood sugar, increase fatigue, and encourage yeast overgrowth. Caffeine exacerbates sleep disturbances and stresses the adrenal glands. And some people with fibromyalgia react strongly to wheat,corn, and soy, probably from hidden food sensitivities.

The best approach is to learn how your own body responds to suspicious foods. To do so, eliminate potential triggers, then reintroduce them one at a time to see if they provoke a reaction (see “Pulling The Triggers,” below).

Though trigger foods vary from person to person, some foods and nutrients have been shown to be beneficial in helping lessen pain and the other symptoms of fibromyalgia in most people with the condition. People with fibromyalgia almost always have inflammation, so it’s crucial to include anti-inflammatory foods, like ginger and turmeric, in the diet. Same goes for protein-rich foods, like beans, fish, and lean meat, which help to keep blood sugar levels steady. In some cases, increasing the amount of food containing these nutrients is sufficient to improve symptoms; in other cases, supplements may be necessary. Start by eating more of the following nutrients, then add the following supplements if necessary:

Omega-3 fatty acids reduce inflammation, help brain and joint function, and can relieve pain. In one study, people with back and neck pain who used non-steroidal anti-inflammatory drugs (NSAIDS) took 2,400 mg of omega-3s along with their regular NSAIDS for two weeks, and then took 1,200 mg of omega-3s instead of NSAIDS. At the end of the study, 60 percent of the patients reported a reduction in their pain levels, and 59 percent stopped using NSAIDS altogether. The omega-3s reduced pain by inhibiting inflammation, which is central to the treatment of fibromyalgia.  Find omega 3 fats in: salmon, tuna, sardines, mackerel, anchovies, herring, flax, walnuts, hemp, and eggs fortified with DHA.

Magnesium acts as a muscle relaxant to help ease pain; the nutrient also encourages sleep. Most people with fibromyalgia have low levels of magnesium, because stress, hormonal disruptions, and sleep disturbances‹all common symptoms in patients with fibromyalgia‹deplete magnesium levels. Magnesium deficiency is also associated with increased inflammation and increased levels of substance P, a neurotransmitter produced in response to stress that makes the body more susceptible to pain. In fact, a lack of magnesium is often the single, biggest factor in exacerbating the symptoms of fibromyalgia. People with fibromyalgia should get 400 to 1,000 mg of magnesium per day. Find it in: halibut, pumpkin seeds, white beans, black beans, spinach, beet greens, lentils, lima beans, cashews, almonds, and leafy greens.

Vitamin D deficiency has been linked to fibromyalgia and other immune-system disorders, including lupus, multiple sclerosis, and chronic fatigue syndrome. About 90 percent of people with fibromyalgia have low vitamin D levels. It’s unknown if that’s a cause of the condition or a result, but vitamin D does work as an immune modulater, meaning it prevents the immune system from becoming overactive and attacking other cells, which can improve symptoms.

In any case, vitamin D is crucial for treating lowered immunity and osteoarthritis, both of which are common in people with fibromyalgia, in addition to improving overall general health. In the winter, it’s hard for the body to make enough of the nutrient from exposure to the sun; in the summer, 10 minutes outside in the midday sun is enough for most people. Find it in: salmon, tuna, sardines, fortified juices, fortified milk alternatives like rice milk, and dairy products. Note: dairy is a common trigger; if you suspect that you have any dairy sensitivities, eliminate it as a potential trigger.

Vitamin B12. Low levels of Vitamin B12 have been shown by research to worsen fibromyalgia pain. For this reason and also because vitamin B12 deficiency can lead to fatigue and diminished cognitive function, adequate intake of the nutrient is crucial for people with fibromyalgia to avoid compounding symptoms and to help prevent deficiency. Vitamin B12 also decreases levels of homocysteine, an inflammatory amino acid that is often found in elevated amounts in people with fibromyalgia. Aim for 1000 mcg of B12 a day for fibromyalgia. Find vitamin B12 in: clams, oysters, sardines, trout, brewers yeast, turkey, and eggs and dairy.

Antioxidants fight oxidative stress and can help reduce inflammation. Studies specific to fibromylagia have shown that people with the disorder often have reduced levels of common antioxidants vitamin C and E. Other antioxidants have similar effects. In one study, for example, cherries, which are packed with anthocyanins, a potent class of antioxidant that’s also found in berries, lowered blood markers of inflammation by 18 to 25 percent. Find antioxidants in: Dark leafy greens, beets, sweet potatoes, cherries, berries, and green tea.

SIDEBAR

Pulling the triggers

Trigger foods can worsen fibromyalgia symptoms, but what causes pain for
some people may not affect other individuals. The best way to identify your
triggers? Eliminate the following suspicious foods for 10 days to two weeks
to see how your symptoms respond.  If the food is a trigger, you should start to notice a lessening of pain and some improvement of sleep within a week. If symptoms haven’t changed in two weeks, that food probably isn’t a trigger, and you can add it back to your diet.

Red meat
Dairy products
Fried foods
Nightshade vegetables (tomatoes, potatoes, peppers and eggplant)
Raw crucifers, such as broccoli, cabbage, and kale
Citrus
Sulfites (found in wine, dried fruit, and some preserved meats)
Additives, including sugar, artificial sweeteners, and MSG
Coffee and caffeine
White flour and processed foods
Wheat, corn, soy, peanuts, eggs and other common allergens

Sources: Ellie Krieger, MS, RD, author of The Food You Crave: Luscious
Recipes for a Healthy Life (Taunton Press, 2008), and Susan Levin, MS, RD,
director of nutrition education at the Physicians Committee for Responsible
Medicine.