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What is Fibromyalgia?

Fibromyalgia syndrome (FMS) is a composite of related syndromes, which includes myofascial pain syndrome (MPS), chronic fatigue syndrome (CFS), and chronic fatigue immune deficiency (CFIDS).   With fibromyalgia, energy is used up much faster than it can be produced, leading to cellular energy depletion, resulting in fatigue and increasing muscle pain.   Although pain and/or fatigue are common characteristics in all four conditions, it is unknown as to whether they are different conditions or manifestations from related influences. (Murphree, 2010) MPS mainly involves pain with possible triggers being injury and repetitive use. CFS and CFIDS are largely triggered by an infectious illness, while FMS triggers are considered to be stress and/or trauma related.

How common is Fibromyalgia?

Fibromyalgia affects nearly 10 million people* (70-90% are women according to the CDC, 2010) in the United States, and accounts for 1.8 million visits to the doctor’s office each year.

Often times FMS goes undiagnosed for many years due to the fact that most patients tend to have a healthy outward appearance or they do not exhibit all the symptoms associated with this complex syndrome.   (Murphree, 2010) Furthermore, and most unfortunate, it is not uncommon for symptoms to be mistaken for those of hypothyroidism or hyperthyroidism in some individuals, due to the fact that they mimic or overlap those of FMS as well as other diseases. (Bauman, 2012)

Diagnosis of classic or pure fibromyalgia is determined by widespread pain and allodynia (pain from stimuli that does not typically cause pain) with symptoms being present for at least a 3-month period, and tenderness on 11 out of 18 pressure points when light pressure is applied. (Only two percent of FMS sufferers will actually exhibit 11 tender points. Clauw & Crofford, 2003) In addition, there must be pain in all four quadrants of the body in individuals with FMS; they are, above and below the waist and on the right and left sides.   (ACR, 1990)

In 1993 The World Health Organization (WHO) expanded the definition of fibromyalgia as a syndrome that may also include non- restorative sleep, headache, spastic colon, colitis, irritable bladder, temperature sensitivity, painful menstrual periods, numbness or tingling, depression, and persistent fatigue. These parameters have made it much easier to establish a diagnosis of fibromyalgia. Nevertheless, it is always good practice to seek a practitioner who is familiar and up to date with the complexities of the condition.

3 Key Nutrients:

  • Folate
  • B-12
  • Magnesium

Folate and B-12 function together in a variety of body processes. Without folate cells do not divide properly, most affected is the gastrointestinal and genital tract. Deficiencies of folate in pregnant women may lead to birth defects such as spina bifida. Rich sources of folate can be found in a wide variety of plant foods and is sensitive to heat, and light. Alcohol, and prescription drugs also impair folate.

Food Sources of Folate:

(Milligrams per 100 grams (3 1/2 oz) edible portion)

  • Brewer’s yeast= 2,022
  • Black-eyed peas= 440
  • Rice germ=305
  • Beef liver= 295
  • Wheat bran= 195
  • Soy beans= 225
  • Asparagus= 110
  • Walnuts= 77
  • Kale= 70

The RDA for folate is 200 micrograms for males and 180 micrograms for females, and can be supplemented in capsule form if needed.

B-12 also known as cobalamin, works with folate in the synthesis of DNA. B-12 reactivates folate, therefore a deficiency of B-12 will likely result in a deficiency of folate. B-12 deficiency is very common among the elderly and may be mistaken for dementia. Other

symptoms of B-12 deficiency include; numbness in the extremities, depression, and anemia.

Food Sources of B-12:

(Milligrams per 100 grams (3 1/2 oz) edible portion)

  • Liver, lamb= 104.0
  • Liver, beef= 80.0
  • Sardines= 17.8
  • Salmon= 5.0
  • Eggs= 2.0
  • Swiss cheese= 1.8
  • Cottage cheese= 1.0
  • Halibut= 1.0
  • Swordfish= 1.0

The RDI of B-12 is 2.0 micrograms and can be found in animal foods. Supplementation is recommended in methylated sublingual form (metylcobalamin), for individuals with digestive disorders.

Magnesium is a critically important cofactor involved in more than 300 enzyme reactions throughout the human body such as energy and neurotransmitter production, blood sugar control body temperature regulation and bone health.

Food Sources of Magnesium:

(Milligrams per 100 grams (3 1/2 oz) edible portion)

  • Kelp=760
  • Wheat Bran= 490
  • Almonds= 270
  • Tofu= 111
  • Beet Greens= 106
  • Spinach= 88
  • Dried Figs= 71
  • Avocado= 45
  • Shrimp= 51

The recommended daily intake (RDI) for magnesium is 350 mg for adult males and 300 mg for adult females. It is best taken in the chelated form along with 25-50 mg of B6. Magnesium taken in doses of 600 mg or more may result in diarrhea. Toxicity can prove to have more severe symptoms such as drowsiness, lethargy and weakness. (M. Murray. N.D. 2005)

Additional Foods, Herbs and Supplements for Fibromyalgia

Vitamin D

  • More of a hormone due to its action. It regulates calcium and phosphorus absorption in the intestines.
  • RDA- 2000 IU daily-although best obtained through sunlight.
  • Vitamin D is fat-soluble. Sources of good fats in the diet would include, wild salmon and mackerel, cod liver oil and leafy green vegetables


  • Produced from glucose helping the body to produce energy
  • Supplementation can help build ATP and increase energy by 45% in individuals with FMS.
  • Recommended intake- 5 grams 3 times daily for 3 weeks; then 5 grams twice daily for a total of 6 weeks. (Teitelbaum, 2009)


  • May improve sleep quality and reduce the occurrence of nighttime awakenings.
  • Replenishes serotonin levels
  • Improves FMS symptoms such as depression, morning stiffness, fewer tender points, improves mood, and anxiety. (Murphree, 2010)
  • RDI – 50 mg in daily increments until sleep occurs within 30 minutes and lasts throughout the night.       Take with magnesium and B-6 (40mg) for increased efficacy.


  • Increases oxygen delivery to tissues and has antioxidant properties.
  • RDI-100-200 mg daily. (Teitelbaum, 2009) For FMS symptoms the recommended dose is 300 mg per day for 9 months. (Cordero et al., 2011)


*http;//;Neumann&Buskila, 2003.

Therapeutic Nutrition Part Two Ed Bauman, M.Ed., Ph.D. & Jodi Friedlander, N.C

The Encyclopedia of Healing Foods M. Murray N.D. 2005

Teitelbaum, J. (2009). Pain free 1-2-3! Eliminating fibromyalgia pain. Townsend Letter, 316, 102-107.

Murphree, R. (2010, Nov). Treating and beating fibromyalgia. Townsend Letter, 328, 52-57.

Claw, D.J. & Crawfford, L.J. (2003, Aug) Chronic widespread pain and fibromyalgia:What we know, and what we need to know [Abstract] Clinical Rheumatology, 17 (4) : 685-701. DOI: 10. 1016/S1521-6942 (03) 00035-4

Cordero, M>D> Alocer-Gomez, E., de Miguel, M., Cano-Garcia, F.J. Luque, C.M., Fernandez-Riejo, P.










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