Thursday, September 3, 2015

Fibromyalgia and Diet


If you’re suffering from fibromyalgia and most interventions didn’t work and left you frustrated and in pain, you might look for other solutions and diet may be one of these. The internet is full of dietary advice for fibromyalgia sufferers. So, why not try it?
Fibromyalgia cannot be cured by diet, but quite a lot of patients tell without wanting to promote dietary hoaxes that some dietary changes alleviated their pain. Though there aren’t study to prove this, I think that one might try to find out, what in the diet helps and what increases pain or other discomforts.

Nightshade Vegetables
Nightshade veggies like potatoes, tomatoes, bell peppers, eggplant etc. are said to increase pain. I’m sceptical that these foods are doing this as it’s also thought that inflammation in rheumatoid arthritis is increased and evidence for both claims are only anecdotic. On the other it doesn’t take much effort to refrain from these veggies for a little while to determine whether it has an effect on pain or not.

Food additives
Food additives like monosodium glutamate, food colours, aspartame and a galore of others might not be called healthy, therefore even if it refraining from eating these additives don’t reduce your pain, it might still be a good idea to leave these out of your diet.
There’s a blog post on monosodium glutamate  and aspartame on this blog: http://rheumatologe.blogspot.de/2013/07/monosodium-glutamate-msg-and-aspartame.html; sadly: “The discontinuation of dietary MSG and aspartame did not improve the symptoms of fibromyalgia.”

Simple Carbohydrates
Sugar / simple carbohydrates might also not be the solution of your pain problem, but refraining might make you feel better, which might also influence pain.

Dairy products
It is normal to be intolerant to lactose, only the descendents or herders have developed to produce lactase beyond early childhood. If you’re lacking lactase to digest lactose of milk, you might still be able to eat some dairy products. But actually, why eat/drink the milk of another species? If you find out that your pain level decreases with avoiding milk / dairy products, then go ahead. Vegan options have become abundant.

Caffeine
Maybe I’m not so eager to tell you to refrain from coffee and tea as I also like to drink both coffee and tea. But it’s strange that caffeine should increase pain levels. I know enough pain medications that include caffeine. Headaches often get better with caffeine alone and therefore we were urged in medical school not to use combination drugs that contain caffeine. But as it is easy to try out, design a phase where you look at labels if the drink contains caffeine and leave out tea and coffee. Then decide if it worked.

Curcumin
Curcumin is found in turmeric, which is a plant from the ginger family, used both in Indian condiments and Ayurveda preparations. It is an antioxidant, but … There’s always a but. It isn’t easily absorbed be the body. Maybe the route of action is via the gut, for instance working on the intestinal flora. I’d rather see a possible use in inflammatory diseases, but fibromyalgia doesn’t belong to this group. I’m a vegetarian and therefore I cook quite often Indian dishes and use turmeric. You can work it into you diet. If it doesn’t help with the pain, it enriches your culinary endeavours.

Vitamin D
The US is far better off than European countries like Great Britain, the Netherlands, Germany or the Scandinavian States. Look at a map and see how far up in the North we live. Even in the US you would have to go to Southern California or Florida during winter to get enough Vitamin D by sunshine. Any milk or non-dairy milk in the US is fortified with Vitamin D according to the law. In Germany the law forbids adding Vitamin D to milk- strange isn’t it. Really low levels of Vitamin D are associated with muscle pain – these people get off their pains quickly after substitution. With subnormal levels the success of substitution hasn’t been so overt. Nevertheless I think working on a high level of Vitamin D is a good idea.

Iron
No! Please be careful with iron. Only substitute if you have a known deficiency (low iron and low ferritin in the lab testing). The body shields itself against too much iron. Iron is aggressive and excess might produce free radicals, which means increased oxidative stress.

Omega-3 Fatty Acids
Omega-3 Fatty Acids (ω-3 FA) are studied in rheumatoid arthritis (especially in Adelaide, Australia), but these new developments won’t explain any effect on pain in fibromyalgia patients. I had the luck to ask Sir John Vane on ω-3 FA. He discovered the mechanism of the enzyme cyclooxygenase (converting arachidonic acid into prostaglandins) and inhibiting this mechanism by NSAIDs. The better the ration of ω-3 FAs (alpha-linolenic acid, and others) is to ω-6 FAs (linoleic acid, arachidonic acid, and others) the less pain and inflammation. Yes and no – pain isn’t dependent only on this system. Especially central pain like fibromyalgia doesn’t work this way – and therefore NSAIDs like aspirin, ibuprofen, and others aren’t convincing in the treatment of chronic pain. Nevertheless, it’s a good idea to slightly increase the intake of alpha-linolenic acid, which is found in flaxseeds.

Magnesium
Only 43% of the population in the US meet the recommended dietary allowance (RDA) of magnesium (http://www.ars.usda.gov/Services/docs.htm?docid=15672). Symptoms of magnesium deficiency: muscle soreness, pain, fatigue, and more. Food sources of magnesium include leafy green vegetables, fruit (bananas!) soybeans, nuts, and more. So, with looking on magnesium intake you might work on symptoms you know from fibromyalgia. If these symptoms are magnesium dependent then you will experience a reduction of symptoms.

Vitamin B12
Vitamin B12 is necessary in very small amounts, but plays crucial roles. A deficiency should be treated. As it plays a role in the integrity of nerves, there might be a chance that adequate intake will help you.


Summing up, there is a rational for dietary changes in fibromyalgia, though the problem itself needs other therapeutic approaches.


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