Fibromyalgia: What to Eat, What to Avoid
Eating whole foods and avoiding excitotoxins may ease fibromyalgia symptoms.
Medically Reviewed by Samuel Mackenzie, MD, PhD
Ever since Ellen Wildman was diagnosed with fibromyalgia, 20 years ago, she’s made her self-care a full-time job, and that includes eating the right foods.
For Wildman, 60, who lives in the Ft. Lauderdale area in Florida, good nutrition helps take the edge off her symptoms and reduces pain.
But what constitutes good nutrition for a person with fibromyalgia?
The nutritional neuroscientist Kathleen Holton, PhD, an assistant professor of health studies at the American University in Washington, DC, has researched the effects of a variety of dietary components and nutrients on the brain, and she’s developed specific guidelines to help people with fibromyalgia better manage their condition through what they eat.
“No drug on the market is as important to optimal health as a well-balanced and healthy diet,” Dr. Holton says. “While many people like to call nutrition ‘alternative medicine,’ in reality it is the basis of all human health. We can’t be optimally healthy without giving our bodies the nutrients they need, and that applies to anyone with fibromyalgia.”
10 Tips for Choosing Foods for Fibromyalgia
Holton’s research has focused largely on the effects of dietary excitotoxins, chemicals that “excite” neurons in the brain and that can be toxic if consumed in excess. The most common forms of dietary excitotoxins in the Western diet are food additives used to enhance or sweeten the flavor of foods.
Some early research showed that eliminating excitotoxic food additives from the diets of some individuals with fibromyalgia reduced their symptoms. While results of subsequent research have been mixed, eliminating food additives from the diet remains a low-cost treatment option with few if any side effects and the potential to help. (1)
Here, Holton shares her top tips on choosing foods for fibromyalgia.
1. Avoid Foods That Contain Added Glutamate
Glutamate is a neurotransmitter that occurs naturally in the body and in some foods, but it is also added to foods as a flavor enhancer.
The most common form of dietary glutamate is monosodium glutamate (MSG), which must be listed on the label when it’s included in foods.
Ingredients that include the terms “hydrolyzed,” “autolyzed,” “protein concentrate,” or “protein isolate” are also likely to contain naturally occurring monosodium glutamate. (2)
In a study published in 2012, 37 people with fibromyalgia and irritable bowel syndrome (IBS) — which is common in people with fibromyalgia — followed a diet free of added MSG and aspartame for four weeks. Most reported that more than 30 percent of their fibromyalgia symptoms had resolved during that time. Those whose symptoms improved then consumed either MSG or a placebo for three consecutive days per week for two weeks. The group assigned to the MSG experienced a significant return of symptoms. (3)
Foods that commonly contain MSG include Chinese foods, canned soups and vegetables, some types of chips or similar crunchy snacks, and processed meats. To avoid MSG and other sources of added glutamate, read food labels carefully, and don’t buy those that list MSG or ingredients high in glutamate.
2. Choose Whole Foods Instead of Processed Ones
Steer clear of processed foods and choose more whole foods, advises Holton.
Processed foods typically have more additives and less fiber and nutrients than unprocessed foods. Refined carbohydrates — such as white flour, white pasta, and white rice — are examples of processed foods that have been stripped of naturally occurring nutrients.
When choosing carbohydrate-containing foods for your meals, choose whole grains such as quinoa, amaranth, whole wheat berries, buckwheat groats, or brown or wild rice, or have a sweet potato or plain potato in place of bread, pasta, or rice.
“I try to eat whole, real food,” says Wildman. “That means cauliflower from a fresh head, corn from an ear, and cage-free eggs.”
3. Try the DASH or Mediterranean Eating Plan
Both the DASH Diet (dietary approaches to stop hypertension) and Mediterranean diet have been shown to have real health benefits, including lower blood pressure and cholesterol.
The two diets are slightly different in their specifics, but both are rich in fruits and vegetables, lean proteins, whole grains, nuts, seeds, legumes, and low-fat or no-fat dairy foods.
Many components of the DASH diet reduce inflammation in the body, which can be helpful in controlling many chronic conditions.
4. Avoid Cured Meats
When you buy meat, avoid processed products with added salt or preservatives or meats that have been smoked or cured. This list includes canned meat, sausage, bacon, hot dogs, ham, deli meat, corned beef, and beef jerky.
Also beware of meat products with the words “natural flavor added” on the label. An example of such a product is turkey breast infused with broth (to give it more flavor). Natural flavors are derived from natural sources such as plants, meats, and seafood and may be high in naturally occurring monosodium glutamate.
5. Eat Cold-Water Fish and Fortified Foods for Vitamin D
According to the National Center for Complementary and Integrative Health, vitamin D supplementation may reduce pain in people with fibromyalgia who are deficient in this nutrient. (4)
You can get vitamin D naturally in swordfish, tuna, sockeye salmon, and eggs, and some foods, such as orange juice and milk, are fortified with vitamin D. Vitamin D can also be taken as a supplement or in cod liver oil, which provides both vitamin D and omega-3 fatty acids.
Spending time outside also increases your body’s vitamin D levels, although too much sun exposure increases the risk of skin cancers and eye disease. (5)
6. Choose Dark, Leafy Greens, Nuts, and Seeds for Magnesium
“Magnesium is necessary for helping to prevent the excitoxicity caused by glutamate,” says Holton.
Magnesium is found in many healthy foods, including legumes (dried beans and lentils), nuts and seeds, avocado, yogurt, bananas, fatty fish, dark chocolate, and dark, leafy greens.
RELATED: 8 Foods High in Magnesium
7. Add in Fish, Flaxseed, and Chia for Omega-3 Fatty Acids
Omega-3 fatty acids may reduce levels of oxidative stress, as well as lower levels of inflammation and boost immunity. Oxidative stress takes place when the body has too many free radicals, or unstable molecules, that damage cells. It is implicated in the development of many medical conditions.
Omega-3s are abundant in wild-caught seafood, walnuts, chia seeds, and flaxseeds. It can also be taken as a supplement.
However, omega-3 capsules are not recommended since they contain gelatin, which contains the amino acid aspartate. Aspartate may active a glutamate receptor on nerve cells that’s implicated in fibromyalgia. Gelatin also contains glycine, a co-activator of that receptor. (7)
8. Include Good Sources of Antioxidants in Your Meals
To combat the effects of dietary excitotoxins on fibromyalgia symptoms, you may need more antioxidants in your diet, as excitotoxins also create oxidative stress.
“To keep this simple, look for foods that add color to your diet, in the fruits and vegetables category,” says Holton. “Focus on increasing consumption of items with bright red, green, orange, yellow, and purple hues to give yourself an antioxidant boost.”
9. Read the Labels on Packaged Foods
If the ingredients list on a food packaging label is long and complex, put the product back on the shelf, Holton advises. You won’t likely see “glutamate” on that label, but you will see other additives that may hide glutamate. Labels should be short, easy to read, and should list ingredients that you could add to a dish when cooking.
Don’t be fooled by the words “spices” or “flavorings,” since the U.S. Food and Drug Administration doesn’t dictate that manufacturers explain what those terms mean on a food label, she says.
10. Avoid Artificial Sweeteners and Limit Sugars
Holton recommends avoiding artificial sweeteners such as aspartame, acesulfame-K, saccharin, and sucralose. Use regular sugar or honey sparingly to sweeten foods.
“It’s much easier to wean yourself off sugar if you aren’t using artificial sweeteners,” she says.
“As you cut back on sugar, you’ll taste sweetness in foods more easily. Even Stevia is hundreds of times sweeter than sugar — which makes you want more sweetness in your food.”
For general good health, avoid high-fructose corn syrup. When you’re fatigued from fibromyalgia, don’t choose sugar or the corn-syrup alternative to boost energy. High sugar intake increases risk of weight gain, diabetes, and other inflammatory diseases, including heart disease and cancer.
“Sugar is my nemesis,” Wildman says. “It makes me more tired, raises my insulin levels, and makes me supersensitive to things. When I’ve had sugar, something can startle me, and I’ll jump sky high.”
“Research suggests excitotoxicity requires a great deal of energy in the body,” says Dr. Holton. “High sugar intake may ‘fuel’ this process.”
Editorial Sources and Fact-Checking
- Smith JD, et al. Relief of Fibromyalgia Symptoms Following Discontinuation of Dietary Excitotoxins. Annals of Pharmacotherapy. June 2001.
- Questions and Answers on Monosodium Glutamate (MSG). U.S. Food and Drug Administration. January 4, 2018.
- Holton KF, et al. The Effect of Dietary Glutamate on Fibromyalgia and Irritable Bowel Symptoms. Clinical and Experimental Rheumatology. November–December 2012.
- Fibromyalgia: In Depth. National Center for Complementary and Integrative Health. May 2016.
- Are There Benefits to Spending Time Outdoors? Centers for Disease Control and Prevention. April 25, 2017.
- Bagis S, Karabiber M, et al. Is Magnesium Citrate Treatment Effective on Pain, Clinical Parameters, and Functional Status in Patients With Fibromyalgia? Rheumatology International. January 2013.
- Littlejohn G, Guymer E. Modulation of NMDA Receptor Activity in Fibromyalgia. Biomedicines. June 2017.