Fibromyalgia is an elusive and life-altering disease that is poorly understood as it lacks clear diagnostic markers. It is experienced as widespread pain, chronic fatigue, and often poor memory and depressed mood. Researchers have gathered evidence suggesting that previous infections and nervous system dysfunction may contribute to the onset of fibromyalgia (1).
But what about fibromyalgia and gut health? Are they connected? Let’s take a look!
A small number of studies examining the link between fibromyalgia and gut health have found that fibromyalgia coexists with altered gut microbiota (1), reduced diversity of gut microflora (2), and increased intestinal permeability, aka leaky gut (1,3).
The gut of someone with fibromyalgia may have less of the beneficial bacterial genus Bifidobacterium (2). This altered gut microbiota affects the creation of neurotransmitters. Amazingly, gut microbiota play a big part in neurotransmitter metabolism, creating a large percentage of these important chemical messengers. Interestingly, more glutamate may be produced within the gut of those with fibromyalgia (1, 2). Glutamate is the primary facilitator of pain perception (2).
81% of those with fibromyalgia have gut health problems like irregular bowel habits, and at least 32% of fibromyalgia patients are diagnosed with IBS.
However, one study found that we may be overlooking another gut disorder in those with fibromyalgia—small intestinal bacterial overgrowth (aka SIBO) (4).
When researchers tested a group of folks with fibromyalgia for SIBO, they found that ALL of them tested positive. This alone is significant, but more remarkable is that the worse the bacterial overgrowth, the more pain they experienced (4). Although this is just one study, it may be a big red flag that connects gut health, specifically SIBO, and fibromyalgia.
You may be surprised to learn that one risk factor for fibromyalgia is antibiotic use. Fluoroquinolone antibiotics have been linked to fibromyalgia and even include a black box warning on the label (5). Researchers think this link could be due to the infection for which the antibiotic was prescribed and that infection predisposes to fibromyalgia. But it is also theorized that because antibiotics kill good gut bacteria, this could increase the risk of fibromyalgia (5).
The good news is that taking good care of your gut before, during, and after antibiotic use can help protect your good gut bacteria! Learn more about how I help people heal their gut here!
We know that probiotics are generally good for gut health—can they also help fibromyalgia?
Only one study has looked at this so far, but the results are promising. Supplementation with a probiotic containing Lactobacillus rhamnosus GG, L. casei, L. acidophilus, and Bifidobacterium bifidus improved fibromyalgia symptoms (6). It’s worthwhile to note that the placebo supplement also improved fibromyalgia symptoms, although the benefits were not as long-lasting as those from the intervention probiotics. The placebo effect is common, and this finding is more than likely a great demonstration of the healing powers of the mind.
Mindfulness, meditation, and stress reduction techniques are great tools for both fibromyalgia (7) and gut health problems like IBS (8).
Mindfulness is the practice of being present and aware but remaining in a neutral state of mind. This helps reduce overwhelming emotional states and promotes feelings of calmness. Meditation and yoga are two practices that help increase mindfulness. Exercise is also a treatment strategy often used for fibromyalgia (9,10). Exercise reduces stress, improves physical conditioning, and lowers inflammation. Regular exercise also benefits gut health by increasing good gut microbes (11) and improving microbial diversity (12).
Based on the available evidence, fibromyalgia and gut health are closely related. In addition to probiotic supplementation, mindfulness, and exercise, a nutrient-dense diet is essential for both fibromyalgia and gut health. Those with fibromyalgia are often deficient in vital micronutrients like vitamin D and magnesium, and supplementation may alleviate symptoms (13). Increasing antioxidant-rich foods such as olive oil and colorful plant foods and avoiding refined grains and gluten (13) are also helpful in reducing symptoms.
Fibromyalgia is one of the conditions that responds really well to a nutrient-dense, anti-inflammatory elimination diet, like the one we use in The Good Poopers Club™!