Two decades after the World Health Organization recognized fibromyalgia (FM) as a clinical entity in the International Classification of Diseases, and despite updating the diagnostic criteria, its differential diagnosis and effective treatment remain challenging and little defined. Recognized as one of the most common chronic pain diseases, it is estimated that FM affects between 3% and 6% of the world population and approximately 10 million people in the United States, disproportionately affecting more women than men.
FM is characterized by widespread chronic pain and extreme sensitivity, its unknown etiology is often accompanied by various associated symptoms including fatigue, sleep disturbances, headache, cognitive decline, morning stiffness, depression, and gastrointestinal disorders.
Nutritional deficiencies in fibromyalgia
Deficiencies or imbalances in certain essential nutritional components have been proposed to cause dysfunction of pain inhibitory mechanisms, including fatigue and other symptoms of FM.
In fact, deficiencies in certain amino acids, magnesium, selenium, and vitamins B and D are associated with increased muscle pain, and the benefits of specific diet and nutritional supplementation have been studied in patients with FM.
Recent efforts have attempted to improve understanding of the relationship between FM and nutrition.
Specifically, the relationship between metabolic status and muscle pain and the role of vitamins, metals, and antioxidants.
For example, a diet rich in antioxidants, foods that can increase the level of nitric oxide, and specific vitamins that include vitamin B 12 / folic acid and creatine supplements are associated with an improvement in FM symptoms.
Specific nutritional deficiencies are also seen, most often in individuals with FM, including deficiency of vitamin B and D, magnesium, iodine, iron, melatonin, selenium, and branched chain amino acids.
It has been suggested that a diet rich in protein and vegetables may have a beneficial effect in reducing muscle pain, possibly due to higher concentrations of specific amino acids that provide energy for muscle function and strength and increased intake of antioxidants from vegetables.
However, not all amino acids are beneficial because elevated levels of homocysteine in the cerebrospinal fluid are associated with FM-related musculoskeletal pain.
Obesity worsens pain
Studies have also examined the effects of physical exercise, body weight, and obesity on the development or exacerbation of symptoms of FM. A recent systematic review found that people with FM generally have a sedentary lifestyle, have a higher body mass index, and are more likely to be overweight or obese.
Furthermore, obese people show a greater sensitivity to pain, a lower quality of life and a higher prevalence of fatigue. These symptoms have also been linked to reduced consumption of protein-rich foods and vegetables, a poor sleep pattern, and depression.
The link between nutrition and FM can provide a viable approach to explain the variation in FM symptoms in each individual directly linked to personal nutritional habits and may present a potential approach to individualize disease management.
Achieve proper nutrition. The end of pain?
When optimal levels of nutrition are reached, FM pain levels are generally reduced.
Although, the research supporting dietary intake and FM is premature to categorically link cause and effect and allows the formulation of specific nutritional recommendations for the management of FM.
However, based on current evidence, there is a clear correlation between FM symptoms and a healthy diet, physical exercise, and maintaining a healthy body weight.
Among people with FM, guidance should be provided to improve eating habits, which may include supplements to achieve optimal nutritional status and interventions to maintain a normal body weight, so this may contribute to better control of FM symptoms.