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 FOOD INTOLERANCE NETWORK FACTSHEET

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Fibromyalgia and diet

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Introduction

What causes fibromyalgia?
What you can do

  • diet
  • brain retraining
  • medication

Reader reports

Notes, references, more info

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    What causes fibromyalgia?

Experts do not know.

Symptoms of fibromyalgia

  • widespread muscle and joint pain
  • fatigue
  • non-restorative sleep or insomnia, restless legs
  • foggy brain

Other conditions also known to respond to diet that can co-exist with fibromyalgia (1)

  • IBS (irritable bowel symptoms)
  • headaches or migraines
  • sleep disturbance including insomnia, restless legs
  • depression
  • asthma, and many others
What you can do


Diet

A 2019 review of five different diets - gluten-free, raw vegetarian, FODMAPs , hypocaloric, and free of monosodium glutamate (MSG) and aspartame - found that all diets showed some improvement (2).

Below are 15 reports from failsafers whose fibromyalgia symptoms have improved on diet. As is usual with food intolerance, everyone is different.

Which foods?

  • Any or all of the usual: salicylates, amines, glutamates/MSG, additives, dairy, gluten
  • Some people also have MCS (multiple chemical sensitivity) and fragrance sensitivity

Time to improve?

  • some people start to improve within one week
  • some say a full 6 weeks or even longer
  • "it didn't work for me until I was strict and df/gf” and “Once I went onto strict elimination, my health improved quickly and dramatically” - Melanie and Shireen from story [1449]

We recommend the RPAH elimination diet - supervised by an experienced dietitian - because it is science-based; covers so many possibilities and is designed as a 3-part diagnostic tool (elimination-challenges-reintroduction), to identify exactly which foods or food chemicals are causing the problem (3).  For chronic fatigue/fibromyalgia, RPAH dietitians suggest a 4 week trial of the strict diet including gf/df.

Vitamin D deficiency has been linked to fibromyalgia (4).  RPAH guidelines for Vitamin D3 include adequate exposure to sunlight on skin as per local recommendations.

Neuroplasticity and brain retraining

According to the exciting new principle of neuroplasticity, chronic conditions can be due to cross wiring in the brain that can improve with brain retraining (NOT the same as “all in your head” or “just think positively”).

Journalist Alice Haine wrote about her DNRS experience (5):

“…diagnosed with chronic fatigue syndrome and fibromyalgia … Bedridden with chronic exhaustion and pain, I was unable to work … Just 10 weeks after the devastating diagnosis, however, I returned to full-time work, and today, 11 months on, I am almost fully recovered … the most significant (treatment) was to rewire my brain … “

Two failsafers – myself included – report that this brain retraining course from Canadian Annie Hopper who originally had fibromyalgia herself - helped immensely with MCS (6,7). 

Medication

Lyrica (pregabalin) is probably one of the most commonly prescribed drug for fibromyalgia, but there are increasing warnings about adverse effects including depression, addiction and overdose (8).

A reader wrote to warn others:

“I have osteoarthritis … lots of nerve pain & damage - and was put on Lyrica to which I reacted and hated being on. After coming off it, I developed skin rashes … diagnosed as very late onset (I’m now 68) eczema which I have never had before. I have heard of (via FB) several others who have also had major skin problems coming off Lyrica.” – Barb, story [1521]

Since 2010, the most popular class of antibiotics – fluoroquinolones including Ciprofloxacin (Cipro) and Levofloxacin (Levaquin) - have had to carry a warning about a possible link with fibromyalgia (9).

Other prescription drugs may also cause problems, particularly when used in combination. See this useful article (10): Think twice before taking drugs for fibromyalgia by medical journalist Steven Findlay https://medshadow.org/your-meds/think-twice-before-taking-drugs-fibromyalgia/

RPAH guidelines regarding medication during a diet trial (11):

  • don't take anything containing aspirin (or cross-reacting - including NSAIDs such as ibuprofen)
  • avoid colours, flavours, preservatives
  • avoid non-essential medications

    Reader reports

At my absolute worst, with a diagnosis of fibromyalgia, chronic fatigue and IBS, with speech issues, constant headaches, psoriasis, untold medications and a very real chance of having to use a wheelchair, I can easily say FS saved my life.  I'm now fit and active, run a business, teach belly dancing and thoroughly enjoy life -  Sue from [1273]

My mother and I have known for years that we are allergic to aspirin. We both react with ringing in the ears, nausea, vertigo, lethargy … We have had doctors mystified for years with strange and debilitating health issues … Now they have decided that we both have fibromyalgia. None of my doctors have ever mentioned that salicylates are in foods … Now that I am on the right track (with diet), we have both been improving so drastically that everyone is asking us what is going on -  from story [559]

For years I have been in and out of the doctor’s office and all tests ran negative … so the multiple diagnoses began - arthritis, mental illness, fibromyalgia … Removing sal-full products and food from my life relieved all of my symptoms - from story [557]

I have fibromyalgia and MSG/glutamates cause horrific pain through my whole body, but I'm ok with amines – from story [1479] (See scientific study The effect of dietary glutamate on fibromyalgia and irritable bowel symptoms. https://www.ncbi.nlm.nih.gov/pubmed/22766026)

I’m 58 with severe salicylate intolerance. Thankfully, my avoidance of sals over the last 7 months has "cured", or put me in remission, for ulcerative colitis … My roseacea is also cleared after 3 years of a dermatologist trying to fix it.  My fibromyalgia is gone – Kathy from story [1473]

I have had asthma for nearly all of my life and in more recent years have also suffered with insomnia, an inflammatory-state throughout my body manifesting as fibromyalgia-type pain, loss of energy, rhinitis and head-pressure at times …   After starting my low salicylate/amine/glutamate, additive-free diet, the first miracle was being able to sleep again ... My pain has left and I have far more energy - from story [1505]

I have multiple chemical and food intolerance, chronic fatigue syndrome and fibromyalgia. I've been on the low chemical diet for many years - makes a huge difference to my fibromyalgia and also to CFS brain fog - Lesley from story [1487]

One liners

I went on this diet for gut issues but my fibromyalgia & arthritis is sooo much better & I haven't had a migraine in 3 years now!! - Sharyn from [1476]

My fibromyalgia pains disappeared inside a week (wheat and dairy in my case)... I was furious that nobody had mentioned it to me before – Susanne from [1211]

[1449] Pain from fibromyalgia – facebook thread (July 2017)

Has anyone had any success with fibromyalgia as my best friend is really struggling with chronic pain and depression and her sons have allergies and ASD? - Jen

I haven't formally had a diagnosis of fibro but I do suffer all over chronic pain, headaches and severe fatigue which was ruining my life. After 6 weeks failsafe, df and gf and although It's not completely gone it's 80% better than it was... I have tried all sorts of meds, nothing has worked better than this diet and I've tried a lot of different ones and doctors didn't know how to treat me or what was actually causing my illnesses so I gave up on them.. so this diet was a desperate resort and don't regret it.. tell her give it a go for 6 weeks if no changes then stop... got to do it strict tho it didn't work for me until I was strict and df/gf.. so good to not be in bed sleeping for days or not able to do anything because of the constant pain I couldn't explain because it is invisible to others they think it's in your head. . It kind of messes with your mind because you know it's not normal but nothing I did helped. Like I said I still suffer chronic pain and fatigue but it's controlled now when I never thought I'd find anything that would work - Melanie

I have CFS (Chronic Fatigue Syndrome), previously accompanied by FM (Fibromyalgia). The FM pain disappeared with the fs diet. It was excruciatingly painful all through the night for the sals challenge and now only comes back if I eat the wrong foods – Elaine

I went on this diet for other symptoms but have found my FM pain has significantly reduced - Sharyn

I've had a great help with my pain through this - Bianca

My mother had fibromyalgia for years (undiagnosed for most of it). At dietician’s advice she went off dairy and wheat and a few vegies and became a new person, she had energy, pain went. Amazing. The last few years she has been able to have small amounts of wheat and dairy without symptoms returning - Jasmine

Another fibromyalgia, chronic fatigue success story here. Getting started was so difficult as I was really unwell, so I spent a month gradually working my way up to it. Once I went onto strict elimination, my health improved quickly and dramatically. It's very surreal. I never considered that all my symptoms could be intolerances (I did the diet to support my daughter) and I have found very little about chronic, widespread pain being a possible sign of intolerances. Within 24 hours on my sals challenge I could barely walk again, due to pain... is this a really abnormal response, or just not talked about much? I'm 8-9 months down the track now and amines in particular give me fatigue symptoms and salicylates give me fibro-type pain. Sorbate preservatives also gave me pain throughout my body, but of a slightly different sort - Shireen

    Notes and references

1.Other conditions  known to respond to diet, see our factsheets:

2. Diet - 2019 diet review - Silva AR et al, Dietary interventions in Fibromyalgia: a systematic review, Ann Med, 2019;Feb 8:1-29.  Seven clinical trials were reviewed:  gluten-free diet (n = 1), raw vegetarian diet (n = 2) FODMAPs diet (n = 1), hypocaloric diet (n = 2) and monosodium glutamate- and aspartame-free diet interventions (n = 1). All diets showed some improvement.  https://www.ncbi.nlm.nih.gov/pubmed/30735059   

3. RPAH Elimination Diet -  Loblay RH and Swain AR "'Food intolerance'. In Wahlqvist ML, Truswell AS, Recent Advances in Clinical Nutrition. London: John Libbey, 1986, pages 169-177. https://www.fedup.com.au/images/stories/LoblaySwain1986.pdf

4. Vitamin D deficiency - de Carvalho JF et al, Vitamin D Supplementation Seems to Improve Fibromyalgia Symptoms: Preliminary Results, Isr Med Assoc J, 2018;20(6):379-381. https://www.ncbi.nlm.nih.gov/pubmed/29911760

Brain retraining

5. The road to recovery: a first-hand account of beating chronic fatigue syndrome by Alice Haine, The National, July 31st, 2014. https://www.thenational.ae/lifestyle/wellbeing/the-road-to-recovery-a-first-hand-account-of-beating-chronic-fatigue-syndrome-1.473784

6. Annie Hopper’s DNRS https://retrainingthebrain.com/  Annie Hopper herself originally suffered from chronic fatigue, MCS and fibromyalgia https://www.youtube.com/watch?v=QoJb5JQcXVw 

7. Brain retraining for MCS, failsafers report  https://www.fedup.com.au/news/blog/brain-retraining-for-fragrance-sensitivity-and-mcs-three-failsafers-report)

Medication

8. This popular drug is linked to addiction and suicide. Why do doctors keep prescribing it? by Liam Mannix, The Age, Melbourne, December 18, 2018 https://www.theage.com.au/national/victoria/this-popular-drug-is-linked-to-addiction-and-suicide-why-do-doctors-keep-prescribing-it-20181129-p50j1x.html 

9. Popular Antibiotics May Carry Serious Side Effects by Jane E. Brody, September 10, 2012, NY Times, https://well.blogs.nytimes.com/2012/09/10/popular-antibiotics-may-carry-serious-side-effects/

10. Think Twice Before Taking Drugs for Fibromyalgia by Steven Findlay, independent medical journalist, on MedShadow :balancing drug risks and benefits October 26, 2016. https://medshadow.org/your-meds/think-twice-before-taking-drugs-fibromyalgia/

11. RPAH medication guidelines, from RPAH Elimination Diet Handbook, page 115 https://www.slhd.nsw.gov.au/rpa/allergy/resources/foodintol/handbook.html also available from dietitians, see our list

12. Holton KF and others, The effect of dietary glutamate on fibromyalgia and irritable bowel symptoms, Clin Exp Rheumatol, 2012. In this study, 57 fibromyalgia patients who also had irritable bowel syndrome (IBS) were placed on a 4-week diet that excluded MSG (flavour enhancer 621) and aspartame (artificial sweetener 951). Subjects who improved on the diet were then randomised to a 2-week double-blind placebo-controlled crossover challenge with MSG or placebo for 3 consecutive days each week. The MSG challenge, as compared to placebo, resulted in a significant return of symptoms, a worsening of fibromyalgia severity and decreased quality of life in regards to IBS symptoms http://www.ncbi.nlm.nih.gov/pubmed/22766026

More information

Introduction to food intolerance factsheet

How to start failsafe eating

Blog on fibromyalgia

www.fedup.com.au

The information given is not intended as medical advice. Always consult with your doctor for underlying illness. Before beginning dietary investigation, consult a dietician with an interest in food intolerance. You can see our list of experienced and supportive dietitians http://fedup.com.au/information/support/dietitians

© Sue Dengate March 2019

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Sue's Blog

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Food intolerance

Some of the many symptoms of food intolerance that can be helped by diet:

Airways: Asthma, Stuffy blocked or runny nose/ nasal polyps, Frequent nose bleeds, Catarrh, chronic throat-clearing, Sinusitis, Frequent ear infections, Frequent tonsillitis, Frequent colds and flu, symptoms of Samter's Triad, hayfever, allergic rhinitis Skin: Eczema, Urticaria (hives), Cradlecap, Other skin rashes, Angioedema (swollen lips, eyes, tongue), Geographic tongue, Pruritis (itching), Rosaceae, Allergic shiners (dark circles under eyes), Pallor (pale skin), Flushing, Excessive sweating, Body odour, Sore vagina in children, Alopecia (patchy baldness) Digestive system: Irritable bowel symptoms (IBS), Recurrent mouth ulcers, Indigestion, Nausea, Bad breath, Vomiting, Diarrhea, Stomach ache, Bloating, Reflux in babies, adults, Constipation, Colic in babies, adults, Sluggish bowel syndrome (feeling of "more to come"), Encopresis, Soiling (sneaky poos), Dairy intolerance, Gluten and wheat intolerance, Eating disorders (ed), anorexia nervosa, bulimia nervosa, binge eating disorder (BED)  Bladder: Bedwetting, Daytime incontinence, Urinary urgency, Recurrent inflammation (cystitis) Skeletal: Growing pains, Gout, Arthritis, joint pain, arthralgia Eyes: Nystagmus (involuntary movement), Blurred vision Muscles: Low muscle tone, Myalgia (muscle pain), Tics (involuntary movement), Tremor, Leg 'jiggling', Heart: Rapid heart beat, Heart palpitations, Cardiac arrhythmias, Pseudo heart attack (feeling of impending doom, chest pressure, pain down arm), Tachycardia (fast heart beat), Angina-type pain, HHT Central nervous system: Headaches or migraines, unexplained tiredness, Chronic fatigue, Feeling 'hung-over', Confusion, Dizziness, Agitation, Tinnitus (noises in ear), HyperacusisAuditory sensory processing disorder (ASPD), Paraesthesia (pins and needles), Dysaesthesia (numbness), Hypoglycemia, Salicylate-induced hypoglycemia, Epileptic seizures, Fits, Sensory symptoms of multiple sclerosis, Scents and perfume sensitivity, Symptoms of lupus Anxiety: Panic attacks, Depression, Obsessive ruminations (repetitively focusing on bad feelings and experiences from the past), Self harm, Suicidal thoughts, actions, teeth grinding (bruxism) Impaired memory: Vague or forgetful, Unable to concentrate, Won't persevere, Unmotivated, Disorganised, Easily distracted, Difficulty reading and writing Speech: Loud voice (no volume control), Speech hard to understand, Speech delay, Selective mutism, Stuttering, Repetitive noises, Talks too much (empty chatter) Coordination: Poor handwriting, Poor coordination, Frequent accidents, Vertigo Sleep: Difficulty falling asleep, Restless legs syndrome (RLS), Persistent night waking, Insomnia, Nightmares/night terrors/sleepwalking, Sleepless babies, Sleep apnoea Mood: Brain snaps, Mood swings, Premenstrual tension, Grizzly or unhappy, Cries easily or often, Irritable, Uncooperative Oppositional defiance: ODD, Loses temper, Argumentative, Refuses requests, Defies rules, Deliberately annoys others, Blames others for own mistakes, Touchy, easily annoyed, Angry, resentful Other behaviour: ADHD, ADD, Autism, Aspergers, Inattentive, easily bored, unmotivated, 'Unable to entertain himself', Restless, fidgety or overactive, Head banging, Hyperactivity, Fights with siblings, Difficulty making friends, Destructive, aggressive, Unreasonable, Tantrums, Demanding, never satisfied, Disruptive, Discipline is ineffective, Pervasive Development Disorder

Some causes of food intolerance:

Food additives: Artificial colours: (food dyes, artificial colors) tartrazine 102 (E102, FD&C Yellow No.5), quinoline yellow 104 (E104), sunset yellow 110 (E110, FD&C Yellow No.6), azorubine, carmoisine 122 (E122), amaranth 123 (E123), ponceau, brilliant scarlet 124 (E124), erythrosine 127 (E127, FD&C Red No.3), allura red 129 (E129, FD&C Red No.40), indigotine, indigo carmine 132 (E132, FD&C Blue No.2), brilliant blue 133 (E133, FD&C Blue No.1), green S, food green, acid brilliant green 142 (E142), fast green FCF 143 (E143, FD&C Green No.3), brilliant black 151 (E151), brown, chocolate brown 155 (E155)  Natural colours: (colors) Annatto (annatto extracts, bixin, norbixin, 160b, E160b) Preservatives: Sorbates: (sorbic acid 200, E200, sodium sorbate 201, E201, potassium sorbate 202, E202, calcium sorbate 203, E203) Benzoates, hydroxybenzoates, parabens: (including benzoic acid 210, E210, sodium benzoate 211, E211, potassium benzoate 212, E212, calcium benzoate 213, E213, ethyl para-hydroxybenzoate 214, E214, sodium ethyl para-hydroxybenzoate 215, E215, propylparaben 216, E216, propyl 4 hydroxybenzoate 217, E217, methylparaben 218, E218) Sulfites, bisulfites, metabisulfites: (200-228, sulphites, sulphur dioxide, sulfur dioxide 220, E220, sodium sulphite 221, E221, sodium bisulphite 222, E222, sodium metabisulphite 223, E223, potassium metabisulphite 224, E224, potassium sulphite 225, E225, calcium sulphite 226, E226, calcium bisulfite 227, E227, potassium bisulphite 228, E228) Nitrates & nitrites: (249-252, potassium nitrite 249, E249, sodium nitrite 250, E250, sodium nitrate 251, E251, potassium nitrate 252, E252 Propionates: (bread preservative, mould inhibitor 280-283: propionic acid 280, E280, sodium propionate 281, E281, calcium propionate 282, E282, potassium propionate 283, E283, 'natural' preservatives in bread, cultured wheat, cultured dextrose, cultured whey) Synthetic antioxidants: Gallates 310, 311, 312 (E310, E311, E312), tBHQ 319, E319, BHA 320, E320, BHT 321, E321 Flavour enhancers: (flavor enhancers) glutamic acid and all glutamates, MSG monosodium glutamate 620-625, yeast extract, hydrolysed vegetable protein HVP, disodium guanylate 627 (E627, DSG, GMP), disodium inosinate 631 (E631, DSI, IMP), ribonucleotides 635 (E635, I&G, nucleotides)  Flavours: (flavors)  Natural food chemicals: Salicylates: salicylic acid, sodium salicylate, acetylsalicylic acid Biogenic amines: vasoactive amines (tyramine, phenylethylamine, histamine and others) Glutamates:  Natural foods: Dairy: milk, yoghurt, cheese, butter, lactose-free milks Wheat or Gluten: (wheat, rye, barley, oats) Soy: Sugar free sweeteners:Sugar free sweeteners: polyols, sorbitol, mannitol

On this website, failsafe refers to foods that are Free of Additives and Low in Salicylates, Amines and Flavour Enhancers. Note that copyright applies to the commercial use of the term "failsafe" in the food and health context so as to control inappropriate use by the food and health industries.