Fibromyalgia: which supplements can help?

What is fibromyalgia?

Also called ‘fibromyalgia syndrome’, fibromyalgia is a chronic disorder affecting around 3.3% of the global population, predominantly women. It’s characterised by widespread, persistent pain and extreme sensitivity to touch (1). Each sufferer perceives painful stimuli in their own way: some feel as if they’re being steamrollered or constantly held in a vice-like grip, while for others it’s like being pierced by thousands of needles.

While fibromyalgia is primarily characterised by pain, around 100 different symptoms have so far been recorded, including intense fatigue, difficulty sleeping, problems with memory and concentration, anxiety and brain fog (‘fibro-fog’) (2).

Classified as a syndrome by France’s Academy of Medicine in 2007, the latest medical imaging research suggests fibromyalgia is more akin to a neuro-tendon-muscular disease.

Though the cause has yet to be clearly established, fibromyalgia is believed to result from dysfunction of the autonomic nervous system, neurotransmission and pain control. One theory is that, in individuals who are probably already genetically-predisposed, exposure to various stressors (environmental, social, psychological, physiological or traumatic) overwhelms the nervous system, producing a physiologically inappropriate response.

The scientific literature also notes abnormal neurotransmitter levels, peripheral damage to small nerve fibres, as well as hormonal and immunological imbalances (3-4).

As fibromyalgia cannot be detected biologically and remains difficult to codify, many sufferers find themselves forced to ‘doctor-hop’ in search of a diagnosis, while all the time their various symptoms continue to significantly impact their daily activities and quality of life.

What treatments are available for fibromyalgia?

There is, as yet, no miracle cure. Though certain analgesics, anti-depressants and anti-epileptics can be prescribed, they should only be used as a second-line treatment (5) as they’re likely to cause side-effects and dependency.

Managing fibromyalgia should be based, in the first instance, on a non-drug, multi-disciplinary and personalised approach. As each sufferer ‘lives’ their own particular fibromyalgia, they should be free to experiment with different techniques to find what works best for them.

The most common of these techniques include:

• engaging again in appropriate physical activity in order to re-condition themselves to exercise and promote muscular and mental relaxation (6);
• balneotherapy, in tandem with physiotherapy, for the relaxing and analgesic effects of warm water, (7);
• thermal treatments (in mineral-rich fresh water), following a fibromyalgia-specific programme;
• kinesiology, a form of psycho-emotional therapy designed to remove physical and emotional blockages though ‘dialogue’ with the body (8);
• transcutaneous electrical nerve stimulation (TENS), in which a mild electrical current is passed through the skin via electrodes to alleviate neuropathic pain (9);
• psychological support, using Cognitive Behavioural Therapy (CBT) or Eye Movement Desensitisation and Reprocessing (EMDR), which helps individuals accept their illness, manage their pain better and/or process and recover from potentially-triggering past trauma (10);
• relaxation, meditation, sophrology and even art therapy, for greater serenity and well-being (11).

Doctors such as France’s Jean Seignalet consider fibromyalgia to be a ‘cell-clogging’ disease, and recommend a ‘hypotoxic’ diet based on the exclusion of ‘modern’ cereals and gluten, dairy products, sugar and refined oils, as well as foods cooked at high temperatures.

I suffer from fibromyalgia: which supplements can help with my condition?

Dietary supplements are not intended to eradicate the disease but they can support the body and provide a useful complement to a comprehensive care approach.

Vitamin D appears to have a direct relationship with fibromyalgia, undoubtedly because it supports healthy immune system and muscle function. Indeed, a 2017 meta-analysis highlighted the fact that the majority of fibromyalgia sufferers have significantly lower serum levels of vitamin D compared with controls (12). It also pointed to a correlation between vitamin D levels and perception of pain.

Similarly, a lack of magnesium may also be more common in those affected by fibromyalgia. This essential mineral contributes to normal nervous system, muscle and psychological function. Several studies indicate a correlation between magnesium deficiency and increased levels of substance P, a neuropeptide involved in pain perception (13). Other theories suggest that a lack of magnesium may affect ATP production in muscles, ATP being necessary for muscle contraction (14).

A number of findings also support the case for supplementation with probiotics, given the highly-probable link between the gut microbiome and chronic pain syndromes (15). Indeed, it’s been noted that 60% of fibromyalgia sufferers are affected by digestive problems, the most frequently-reported being irritable bowel syndrome (16).

There are also plants that can help in fighting the symptoms of fibromyalgia. Used for more than 6000 years in Asia, ginger root supports energy, vitality and immunity and also offers antioxidant properties (17). One study on mice with fibromyalgia measured ginger’s effects on allodynia (pain triggered by stimuli that don't usually cause pain) and hyperalgesia (heightened sensitivity to pain) when combined with paracetamol (18).

Neuroinflammation associated with pain (as a result of activation of non-neuronal cells of the central nervous system) has been observed in people with fibromyalgia (19). Some naturopaths therefore recommend taking extracts of plants with anti-inflammatory properties such as turmeric, blackcurrant leaves and meadowsweet (20-21).

And finally, the ancient Ayurvedic remedy Bacopa monnieri supports the central nervous system by acting as a brain and nerve tonic and by stimulating memory (22). It may thus help to clear fibro-fog.