A Different Approach to Fibromyalgia

Updated: April 24, 2020

Drugs That Cause Osteo

I’m a fighter. I use the word ‘suffer’ not only because trauma and chronic pain have changed my life, but because they are keeping me from living a normal life.”

Lady Gaga, the pop star and actress, wrote that to her fans on Instagram after fibromyalgia forced her to cancel the remainder of her 2018 tour.

And she’s just one of an estimated 10 million people in the U.S. who suffer from the chronic pain disorder. But despite its prevalence, and its new-found limelight, there remains no known cure.

And it gets worse…

The drugs commonly prescribed by doctors to ease the symptoms of fibromyalgia can have serious negative effects on your bones.

But there is some good news. Research is starting to look at identifying the potential causes of fibromyalgia. Not just the symptoms.

And we’ve sifted through the research to present you with the latest information to consider regarding the causes of fibromyalgia. We’ve put together a list of natural options that could help ease the symptoms of fibromyalgia too…

What is Fibromyalgia?

Fibromyalgia is an autoimmune disorder characterized by pain in many parts of the body.

75-90% of fibromyalgia sufferers are women, but it also occurs in men and children. In fact, fibromyalgia is commonly seen among mothers and their children, or among siblings. This points to a possible genetic aspect to the cause. (I’ll cover some of the other theories on the causes of fibromyalgia a little further down).

Common fibromyalgia symptoms include:

  • Tender points
  • Extreme fatigue
  • Muscle stiffness
  • Paresthesia (tingling)
  • Headaches
  • Irritable bowel syndrome (IBS)
  • Skin sensitivity
  • Increased sensitivity to noises, bright lights, smells
  • Memory problems, difficulty concentrating
  • Restless legs syndrome (RLS)
  • Dizziness
  • Hemorrhoids
  • Anxiety
  • Depression

Doctor in a consultation for drugs that cause osteoporosisConventional Treatments

Research on the causes and treatment of fibromyalgia is starting to gain traction. But it’s still in its early stages. We still don’t have a standard set of treatment options, and even diagnosing fibromyalgia has its problems.

Diagnosis of fibromyalgia is usually made between the ages of 20-50. But incidence rises with age. By age 80, approximately 8% of adults meet the American College of Rheumatology classification for fibromyalgia.

And the worrying thing is, 73% of people with fibromyalgia remain undiagnosed.

You see, it’s hard to fix something if you can’t figure out how it’s broken. That’s the case with the conventional approach to fibromyalgia. It focuses on proximate causes and symptom suppression. Not curing the root problem.

What do I mean by proximate causes?

Proximate causes are the factors that immediately precede the occurrence of a symptom. They’re very rarely the reason that the symptom (or in this case the condition) develops or continues to persist.

The real reasons, also called the distal or ultimate causes, occur before the proximate cause. Distal factors cause the proximate factors to appear. And you must treat distal factors to restore health and cure the condition.

Here’s an example that illustrates the difference between proximate and distal/ultimate causes:

Your smoke alarm starts shrieking, alerting you to the possibility that your house is on fire (proximate cause).

(a) You turn off the smoke alarm and go back to sleep. This is the equivalent of taking a drug that will suppress your symptoms (temporarily) but won’t put out the fire!

(b) You call 9-1-1. The firemen arrive, douse the flames and determine faulty wiring in your kitchen caused the fire (distal cause). You fix the faulty wiring (curative action). No more fires.

The key point here is that focusing on proximate causes may, at best, provide temporary symptom relief. It won’t restore your health.

Your doctor wants to help you. But without an understanding of the real underlying causes of the condition they can’t. All they can do is prescribe one of many drugs in hopes of providing symptom relief. And as I mentioned earlier, some of these drugs can cause bone loss.

Proximate Causes of Fibromyalgia

There are many theories on the causes of fibromyalgia. But as I touched on earlier, they all focus on proximate causes. With one, recently added exception; genetics…(discussed shortly). Theories on the causes of fibromyalgia include:



In 2017 the Journal of Pain Research published a study that’s since been dubbed the “most extensive inflammatory profiling study of fibromyalgia patients to date.” It examined the levels of 92 inflammatory proteins in fibromyalgia patients.

Researchers found extensive inflammation, particularly in the central nervous system, of participants with fibromyalgia compared to a healthy control group. This research supported earlier findings that people with fibromyalgia have elevated levels of certain inflammatory cytokines. (Cytokines are messenger molecules produced primarily by the immune system.)

Now, in conventional medicine, these findings will be used to help identify drugs to suppress the production of these cytokines. Can you see why this is like turning off a blaring smoke alarm rather than putting out the fire?

Fortunately, the same information can identify a natural means of restoring health. And that would be balancing your immune function. Promoting healthy balance in the immune system will reduce inflammatory cytokine production. So how do you promote a healthy immune system? Well, your diet plays a big role as you’ll see in the ‘A Different Approach to the Causes of Fibromyalgia‘ section a little further down. In fact, I’ll go over three nutrients that lower production of inflammatory cytokines specifically.

Brain Chemistry

Brain Chemistry

Abnormal levels of certain neurotransmitters (chemical messengers) is common in fibromyalgia sufferers. In particular, levels of serotonin tend to be low, and levels of substance P tend to be high.

Now, serotonin handles mood regulation, sleep cycles, and pain perception. And substance P transmits pain signals to the brain. So you can see why these would affect common fibromyalgia symptoms. But low serotonin and elevated substance P are both proximate causes of fibromyalgia. Not ultimate causes.

The conventional approach is to prescribe drugs that extend serotonin’s availability. Drugs do this by preventing the cells that produce serotonin from reabsorbing and recycling it.

But if you’d prefer a natural approach to producing more serotonin, there’s another option… supplementing with the active form of vitamin B6- pyridoxal-5-phosphate (P5P). You see, P5P is a required cofactor for producing serotonin.

For about 30% of us, including myself, our genetic inheritance compromises our ability to produce serotonin. Single nucleotide polymorphisms (SNPs) are the most common form of genetic variation. And they can cause people to produce an underperforming version of the enzyme pyridoxine 5′-phosphate oxidase (or PNPO for short). And it’s this enzyme that’s responsible for converting vitamin B6 to its active P5P form.

P5P is also required to bring magnesium into your cells. It’s functions here include relaxing tight or cramping muscles. People who have inherited a SNP that produces a slow PNPO also have problems absorbing magnesium. This further exacerbates the muscle pain experienced by those who have fibromyalgia.

Nervous System Issues

Nervous System Issues

Your nervous system regulates how your body responds to stress and stress-related hormones. Some researchers theorize that people with fibromyalgia release these hormones differently when stressed. And they believe this release is what alters how they perceive pain.

But as you’ve probably guessed, the abnormal release of stress-related hormones is another proximate cause. The real question is “what’s causing it?”Well, one of the primary enzymes responsible for eliminating stress hormones is catechol-O-methyltransferase. Or COMT for short.

And once again, our SNPs could be the problem. Twenty-five percent of Caucasians, including myself once again, inherit a SNP that causes us to produce a slow COMT. Fortunately though, we can boost our COMT activity. And it’s as simple as ensuring that we’re getting optimal amounts of magnesium, several trace minerals, and s-Adenosyl methionine (SAMe for short).

COMT is most active when it uses magnesium as its cofactor. (A cofactor is a substance whose presence is essential for the activity of an enzyme). But COMT can also use copper, manganese, zinc, and iron.

I’ll go into detail on why people with fibromyalgia may be lacking these minerals in just a moment. Plus, I’ll show you how to get enough of them.

As for SAMe, it’s one of the principal compounds COMT works upon (it uses it as a substrate). And a fundamental law in biochemistry is that supplying more substrate increases the activity of the enzyme that acts upon it. In this case, that means increasing the activity level of a slow COMT.

But there are no food sources of SAMe. You can up your SAMe intake by taking a supplement, though.

SAMe supplementation has added benefits too. Research shows it increases serotonin and dopamine activity in the brain, which in turn relieves depression. And it doesn’t have any bone-health side effects either!



As we’ve seen, when you dig a little deeper into the ’causes’ of fibromyalgia there’s often an underlying genetic issue. In particular, our SNPs. And a growing number of studies identify increased susceptibility for fibromyalgia in individuals who share certain SNPs.

To recap, SNPs are variations in how our genes are expressed. Your genes contain the instructions for the production of every molecule in your body. Metabolism, cell structure, you name it. Your genes provide the code for how it’s made. If you’ve inherited a SNP that codes for a slightly altered set of instructions, what you produce will also be slightly altered.

Sometimes these alterations are beneficial. Like helping you to be more resistant to disease or to environmental toxins. A prime, although rare, example of this is the 100-year-old smoker who credits his long life to cigarettes and alcohol. In reality, he won the genetic jackpot and inherited liver enzymes with stellar detoxification abilities.

Some SNPs, however, increase your needs for certain nutrients. Or they decrease your ability to detoxify and eliminate toxins in your diet or environment. (Same with potentially damaging compounds your body produces too). Think back to the nervous system and how COMT SNPs can make you less able to clear stress hormones.

For example, there are at least four SNPs that affect the formation of the vitamin D receptor. I’ve inherited the worst versions of all four and produce a very malformed vitamin D receptor. This is the main reason everyone in my family before me died prematurely from osteoporosis.

Fortunately though, we can compensate for SNPs that impact our nutrient needs. In my case, by supplying plenty of vitamin D, so some manages to stick to the receptor.

I’ll cover this in more detail in this next section…

A Different Approach to the Causes of Fibromyalgia

Research is finally investigating the initiating, ultimate causes of fibromyalgia. And it’s uncovering a number of factors which have lead me to make the following evidence-based hypothesis:

It appears that Fibromyalgia is caused by nutrient deficiencies (vitamins, minerals, essential fatty acids), plus exposure to environmental toxins (heavy metals, endocrine-disrupting chemicals in our foods, water supply, air, cleaning products and health and beauty aids) in individuals whose genetic inheritance increases their needs for certain nutrients and/or decreases their ability to effectively clear toxins.

It’s tough to imagine we’ll ever identify one “root cause” of fibromyalgia. It appears there are several complex factors at play that make each case of fibromyalgia a little different.

And each of us has a unique profile of genetic susceptibilities that impact both our nutrient needs and our ability to deal with the environmental toxins to which our diet, lifestyle, and environment expose us.

But research into fibromyalgia is starting to look in a different direction. Instead of focusing on the proximate causes and symptom suppression, it’s starting to look at the potential underlying causes.

Here’s a roundup of the latest research:



Glutamate is a non-essential amino acid. That means you don’t need to get it from your diet because your body can produce it by itself.

Glutamate is the most abundant neurotransmitter in the brain. And in appropriate amounts, it’s essential for brain development and function. Glutamate stimulates neurons (brain cells) to communicate messages. That’s why it’s called an “excitatory neurotransmitter.” As the expression “bored to death” indicates, you (and your brain cells) require a bit of excitement. But too much is not a good thing.

An imbalance between glutamate and GABA (a calming neurotransmitter that counters the effects of glutamate) is increasingly being seen in conditions involving the brain. The theory is that a brain that’s constantly wired (too much glutamate / too little GABA) can’t efficiently process information. And the result, over time, is lasting injury to delicate brain tissue.

Normally, glutamate can only enter the brain through specific receptors in the blood-brain-barrier (BBB). The BBB is a layer of cells surrounding most of the brain that, when healthy, regulates what’s allowed in. Think of it as the bouncer if your brain were a nightclub.

However, a number of conditions, including fibromyalgia, produce a state of chronic low-grade inflammation. This makes the gut lining “leaky.” So pro-inflammatory agents get into the bloodstream and travel throughout the body to the brain, where they make the BBB leaky too. And a leaky BBB can’t do a good job of controlling how much glutamate enters the brain.

Elevated concentrations of glutamate are known to trigger migraines. And researchers propose hypersensitivity to glutamate as a contributing factor in Huntington’s Disease, autism spectrum disorder and ADHD, as well as fibromyalgia.

Good Glutamate vs. Bad Glutamate

Research shows that dietary glutamate aggravates fibromyalgia symptoms too. One study examined the effects of dietary glutamate on irritable bowel syndrome (IBS) symptoms in fibromyalgia sufferers. Fifty-seven fibromyalgia patients began a 4-week diet that excluded monosodium glutamate (MSG) and aspartame– two food additives known to be excitotoxins.

Of the 37 people that completed the diet, 84% reported that over 30% of their symptoms resolved. These individuals then participated in a 2-week double-blind placebo-controlled crossover challenge. They took MSG or a placebo for three consecutive days during the first week. The following week, they took whichever compound they didn’t take initially, for three consecutive days.

When those who took the placebo first got MSG, they reported a significant worsening of fibromyalgia pain and severity. They also reported increased IBS symptoms and decreased quality of life.

In whole foods, glutamate is bound up in proteins. That means it’s released slowly as it’s digested, and is therefore absorbed slowly. For this reason, the glutamate in whole foods is rarely a problem, except possibly for individuals highly sensitive to it.

Free glutamate in the form of food additives is another story though. The glutamate here isn’t bound to other amino acids, so it’s digested quickly and rapidly absorbed. This causes glutamate levels in the bloodstream to skyrocket.

Free glutamate additives are abundant in nearly all processed and packaged foods. You’re probably familiar with free glutamate as MSG (monosodium glutamate), a synthetic chemical used to add a savory taste to processed foods. But don’t think if MSG isn’t present, you’re home safe. Free glutamate hides in processed foods under many names.

Get out your magnifying glass and scan the label. If you see any of the following ingredients, free glutamate is present:

Ingredients That Contain Free Glutamate
Anything “hydrolyzed” like hydrolyzed protein Corn starch, corn syrup, and modified food starch Monosodium glutamate
Anything “protein fortified” Fish sauce Pectin
Autolyzed yeast “Flavors” or “flavoring” (i.e. natural vanilla flavor) Soy protein (including isolate and concentrate)
Bouillon and broth Gelatin Soy sauce
Calcium caseinate (a protein derived from the casein in milk) Maltodextrin Stock
Carrageenan Milk powder Whey protein (including isolate and concentrate)
Citric acid Monopotassium glutamate Yeast extract

If you suspect glutamate could be playing a role in your fibromyalgia symptoms, stop consuming anything with added free glutamate for several weeks. It’s a good idea to keep a daily diary to track your symptoms too.

If symptoms persist, try eliminating natural sources of free glutamate as well for a few more weeks. When your symptoms have lessened or resolved, try slowly adding back some natural sources of free glutamate. Then see if these foods still trigger a reaction.

Natural sources of free glutamate:

Natural Sources of Free Glutamate
Bone broths and meats cooked for long times, generally using moist cooking methods such as braising. Foods matured, cured, or preserved, such as matured cheeses (Parmesan and Roquefort) and cured meats Ripe tomatoes
Broccoli Grape juice Soy sauce
Dairy casein Malted barley used in bread and beer (barley contains gluten, so you may want to avoid barley even if glutamate isn’t an issue for you) Soy protein
Fish sauce Mushrooms Walnuts
Peas Wheat gluten

Aspartame is added to such a huge number of processed foods and over-the-counter drugs that a bulleted summary would go on for several pages! Check the list of ingredients on a product’s label to be sure this excitotoxin isn’t present. This list and tips on how to identify aspartame-containing products is a good place to start.

Gluten Sensitivity

Gluten sensitivity is becoming more and more common. It’s a treatable condition with a wide spectrum of symptoms that overlap with those of fibromyalgia. In particular, chronic musculoskeletal pain, a lack of energy, and irritable bowel syndrome. And here’s the interesting thing; recent research is showing that fibromyalgia sufferers have intestinal lesions (like the ones caused by celiac disease) even though they don’t have celiac disease.

A 2014 paper reported on 246 patients diagnosed with severe fibromyalgia. They were referred to a chronic pain rheumatology unit and, after a pathology report ruled out celiac disease, were given the option to participate in an open gluten-free diet trial.

Study participants also agreed to undergo a biopsy of their small intestinal lining to check for intraepithelial lymphocytosis. That’s a condition where an increased number of lymphocytes (white blood cells) appear in the lining of the duodenum (the first section of the small intestine) when a biopsy is examined microscopically. All 246 patients had intraepithelial lymphocytosis.

So they started to follow a strict gluten-free diet. In cases where lactose intolerance was suspected, a lactose-free diet was also recommended. The average follow-up period was 16 months, but the length of time to date has ranged from 5 to 31 months. And patient-follow up is continuing.

When the research was published in 2014, 90 of these 246 patients showed excellent clinical responses. Clinical response was defined as the achievement of at least one of the following:

  • A return to normal life as judged by the patient
  • A return to work
  • Discontinuation of opioid medications
  • Remission of fibromyalgia pain criteria

For 15 patients, the widespread chronic pain was no longer present. That indicates relief from fibromyalgia altogether! Fifteen patients returned to work or normal life. And three patients who took opioids for their pain before stopped taking them altogether. Fatigue, gastrointestinal symptoms, migraine, and depression improved together with pain.

For some patients, the clinical improvement after starting the gluten-free diet began after only a few months. For others, the improvement was slower but definitely occurred over months of follow-up.

Environmental Toxins

Environmental Toxins

Fibromyalgia is one of a number of syndromes now being labeled as idiopathic environmental intolerances. That means multiple symptoms arise in multiple organ systems. And they’re caused by a variety of chemical substances or toxins.

These syndromes have become the subject of research on the ways in which environmental toxins impair metabolism and detoxification.

This is leading researchers to believe that individuals whose genetic inheritance includes slower, less effective versions of the enzymes responsible for detoxifying environmental toxins are more susceptible to developing fibromyalgia.

In these individuals, exposure to heavy metals and other environmental toxins (e.g. pesticides, PCBs, plasticizers, and the hundreds of other endocrine-disrupting chemicals that flood our world today) further impairs their ability to eliminate these toxins and produces the symptoms many of these conditions share.

A Lack of Trace Minerals

A Lack of Trace Minerals and/or Magnesium

Trace minerals play a crucial role in combating oxidative stress. (Oxidative stress is when your body has too many free radicals and too few antioxidants to neutralize them.) And a number of studies show people with fibromyalgia have high levels of oxidative stress.

In one study, 85 female patients with primary fibromyalgia were evaluated for their oxidant and antioxidant balance. Meanwhile, 80 age-, height-, and weight-matched healthy women were evaluated too. There were two markers used:

  1. Malondialdehyde – a toxic compound produced when free radicals damage fats.
  2. Superoxide Dismutase – an antioxidant enzyme that lives in our mitochondria.

Pain and number of tender points were assessed. Malondialdehyde levels were significantly higher in the women with fibromyalgia compared to controls. And superoxide dismutase levels were significantly lower too.

These results led researchers to suggest fibromyalgia may occur when free radical production in the mitochondria outstrips the available antioxidants. The mitochondria are your cells’ energy production factories. The majority of the free radicals your metabolism generates are produced in the mitochondria.

Here’s the important thing to note though. While that study is interesting, oxidative stress is another proximate cause. The real question is, “what’s causing the oxidative stress?”

Well, remember those inflammatory pain-causing cytokines I mentioned earlier? The ones that are commonly elevated in fibromyalgia patients? Well, superoxide radicals ramp up their production. And superoxide radicals form in every cell in the very first step of energy production in the electron transport chain in your mitochondria.

Now, your body is prepared for this. But only when it gets all the minerals it needs. When this is the case, you produce an enzyme called mitochondrial superoxide dismutase (MnSOD). This neutralizes these superoxide radicals. This enzyme, however, can’t work without manganese, which is MnSOD’s cofactor.


The way we produce food has changed a lot over the last 50 years or so. Farmers now grow produce using increasing amounts of chemicals. And that has negative consequences on the nutritional value of the produce. One particular herbicide, glyphosate, could be especially troubling for fibromyalgia sufferers.

You see, glyphosate blocks a plant’s ability to absorb manganese from the soil. And research shows that fibromyalgia sufferers often lack manganese. And remember, without manganese, your MnSOD enzymes can’t neutralize superoxide radicals.

And here’s the kicker. The cells that need to produce the most energy, (and so have the most mitochondria), are your brain and muscle cells. So when MnSOD isn’t working effectively, they produce the most free radicals. And these are the two areas where most fibromyalgia symptoms occur.

As I mentioned before, elevated oxidative stress and increased inflammatory cytokine production are proximate causes for the chronic pain of fibromyalgia. The ultimate cause here is a lack of manganese (plus some other minerals and vitamins, which I’ll get to shortly).

There are two things you can do to lower oxidative stress and inflammatory cytokine production to potentially ease the chronic pain of fibromyalgia:

  1. Don’t eat conventionally grown, manganese-deficient foods! Eat organically grown whole foods wherever possible. Gluten-free oatmeal is an excellent example. Just ½ cup of cooked oatmeal will give you 3.84 milligrams of manganese!
  2. Take AlgaeCal Plus. It’s a plant-based calcium supplement primarily geared for building strong bones naturally. But get this: a daily serving provides you with all 13 essential bone supporting minerals. Including 0.32 milligrams of manganese.

Zinc and Magnesium

Like we saw with manganese, research shows that fibromyalgia sufferers often lack both zinc and magnesium too.

In one study, researchers compared 32 patients with fibromyalgia (mean age 42.9) to 32 healthy controls (mean age 41.3). The researchers examined the association between serum trace elements and fibromyalgia-like symptoms. These included; sensitive tender points in the body and fatigue amongst others.

The participants recorded their symptoms in daily logs and questionnaires. The results showed the lower the level of zinc, the greater the number of tender points. And as magnesium levels declined, fatigue increased too.

So why is not having enough zinc a problem?

Zinc is the catalyst for over 300 enzymes involved in cellular metabolism. In addition, 2,500 transcription factors (more than 8% of the human genome) require zinc. Without it, neither these 300+ enzymes nor 2,500 transcription factors can operate properly.

Not surprisingly, not having enough zinc harms your health in numerous ways. In relation to fibromyalgia, the most relevant are the adverse effects on immune and thyroid function. Plus, zinc insufficiency is strongly linked to depression.

Why might not having enough magnesium cause fibromyalgia?

Magnesium deficiency is another very common finding in fibromyalgia sufferers. So common in fact, physicians often recommend magnesium supplements.

Magnesium stabilizes cellular membranes. This provides a calm, organized environment in which the job—actually its 300+ jobs—gets done. You see, magnesium activates more than 300 cellular enzymes. And it’s necessary for the production of ATP, the energy currency of the body, which we make in our mitochondria.

When your magnesium levels are sufficient, your muscles relax. And the environment in your brain becomes one of calm too. So if your muscle or brain cells are having a hyper-reactive, fibromyalgia kind of day, they settle down. No cellular road rage or temper tantrums when magnesium is in charge. Just efficient energy production with a minimum of free radicals allowed.

But when magnesium levels are low, your body slips into a nervous state. And America is a pretty nervous place apparently…

A 2018 review on magnesium concluded that more than half of the American population aren’t getting enough magnesium!

This nervous state affects your brain in three ways. Brain cells become trigger happy, hyperactive, and prone to a special kind of neuronal depression called “spreading depression.” This initiates migraine attacks too.

So why does this happen? Because a low magnesium state triggers cells to release stress hormones and other substances that increase inflammation. Remember how one of the proximate cause theories of fibromyalgia was too many stress hormones? Well, not getting enough magnesium is a very significant cause of it!

Vitamin A and/or Vitamin D

Vitamin A and/or Vitamin D

As we saw in the inflammation section earlier, lots of people with fibromyalgia have immune system issues.

Specifically, their levels of the anti-inflammatory signaling molecules (the Th2 cytokines) are abnormally low. Since the Th2 cytokines promote immune tolerance, low Th2 skews the immune system into a trigger-happy state in which “evil” is seen lurking everywhere. The result is chronic chemical warfare,  a.k.a., chronic inflammation.

Now, the conventional treatment for a hyperactive immune system is immune suppressant drugs. But these medications don’t deal with WHY the immune system is out of balance.

So, the real question is, “What’s causing the immune system to be out of balance?”

The answer is far from simple. But here’s what we do know. You need both vitamin A and vitamin D for proper immune tolerance. And these two vitamins are commonly deficient in fibromyalgia patients.

Specifically, Vitamin A decreases the production of proinflammatory cytokines. And vitamin D helps prevent a hyperactive immune response.

Now, you may be thinking, “But I’ve read that vitamin A promotes bone loss and increases the risk of osteoporosis!” Yes, vitamin A can promote bone loss. But only when it’s not in balance with vitamin D. When these vitamins are in balance, studies show that vitamin A is beneficial to bone. Not harmful.

And when I say balance, I mean vitamin A and vitamin D should be consumed in approximately equal amounts.

A Lack of the Omega 3s

A Lack of the Omega 3s- EPA and DHA

Omega 3 fatty acids are crucial for your overall health. Especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). They help with the prevention and management of a wide variety of health conditions. These include inflammatory joint pain, chronic spinal pain, autoimmune diseases, cardiovascular disease, depression, and low bone density.

To date, only small human studies have been conducted looking at the effect of supplemental EPA/DHA on fibromyalgia syndrome. But the results of these studies are quite positive.

Why might EPA/DHA be effective?

A significant factor in neuropathic pain is the activation of the nervous system’s immune cells in the spinal cord. They’re called glial cells. When the glia are excessively activated, more are produced. And they all ramp up their production of inflammatory cytokines – the ones that, as mentioned earlier, are commonly elevated in fibromyalgia patients.

That’s where omega 3s come in. EPA and DHA lessen the production of these cytokines. What’s more, EPA and DHA are also used to produce metabolites called resolvins. As the name suggests, resolvins resolve or put an end to the inflammatory process.

One study followed 12 female fibromyalgia sufferers for four weeks. During that time, they were treated with high doses of EPA and DHA. The women showed significant beneficial changes from the baseline scores for tender point counts, chest expansion measurements, pain severity, fatigue, and depression scales, using the Fibromyalgia Impact Questionnaire.

In another human study, five participants were treated with high oral doses of omega 3 fish oil for different conditions causing neuropathic pain. These included cervical radiculopathy, thoracic outlet syndrome, carpal tunnel syndrome, and burn injury as well as fibromyalgia. The dosage of fish oil ranged from 2,400 to 7,200 mg/day of EPA and DHA.

Outcome measures were obtained before and after treatment. These included several validated surveys (short-form McGill Pain questionnaire, DN4 neuropathic pain scale, Pain Detect Questionnaire), objective clinical tools (Jamar grip strength, Lafayette dynamometry, tender point algometry) and EMG Nerve Conduction studies.

All participants experienced significant pain reduction and improved function. The improvements were documented with both subjective and objective outcome measures and continued up to 19 months after treatment started. Plus, not a single serious adverse effect was reported. So EPA/DHA shows promise for lessening the pain and depression of fibromyalgia — by correcting its ultimate cause —  with no adverse effects. Win-win!

Remember when I mentioned omega 3 fatty acids are important for bone health, too? Well, you can read all about it in the “Why Omega 3 Fatty Acids Are Crucial for Healthy Bones” post.

Natural Symptom Relief for Fibromyalgia

So, that was a roundup of the latest research into what might be the underlying causes of fibromyalgia, with information on what you can try to address them. It’s a start, but there isn’t a one-size-fits-all remedy, unfortunately.

While you digest that information and decide on your next steps, I’d like to share some natural methods that may help ease the symptoms of fibromyalgia.

Tai Chi

Tai chi is a Chinese mind–body practice. It’s the combination of physical, emotional, spiritual, and mental elements in a single practice. The practice of tai chi focuses on meditation and slow, gentle movements combined with deep breathing and relaxation techniques.

Because it connects the mind and body, people with musculoskeletal conditions like fibromyalgia often practice tai chi. And there’s research to support its effectiveness.

A randomized controlled trial looked at the effectiveness of tai chi compared with aerobic exercise (a current core standard treatment in fibromyalgia patients). It also tested whether the effectiveness of tai chi depends on its duration or dosage.

Two hundred and twenty-six adults with fibromyalgia participated. One hundred and fifty-one were assigned to one of four tai chi groups. And 75 were assigned to an aerobic exercise group. The aerobic group exercised twice weekly for 24 weeks. The tai chi groups completed 12 or 24 weeks of supervised tai chi once or twice weekly. Participants were then evaluated for 52 weeks and were encouraged in-person and by telephone to promote adherence.

The primary outcome was a change in the revised fibromyalgia image questionnaire at 24 weeks compared to baseline. Secondary outcomes included anxiety, self-efficacy, coping strategies, physical function, sleep, and health-related quality of life in the patients’ global assessment.

Questionnaire score improved in all five treatment groups. But, the combined tai chi groups improved significantly more than the aerobic exercise group. And several secondary outcomes like anxiety, self-efficacy, and coping strategies improved as well.

When comparing tai chi or aerobic treatment with the same intensity and duration, tai chi had greater benefit. The groups who received tai chi for 24 weeks showed greater improvements than those who received it for 12 weeks. And there was no significant increase from receiving tai chi twice weekly compared to once weekly.

Tai chi’s mind-body approach may be a valuable therapeutic option for the management of fibromyalgia.

There are many other benefits to tai chi, including bone loss prevention. If you’re curious about how tai chi can benefit your health in other ways you can read more here.


Acupuncture is a technique-based practice used in traditional Chinese medicine. The belief is that points all across the body connect with other points. So stimulating one can help with another.

A trained technician will stimulate a specific point, typically by puncturing the skin with a very fine needle. This stimulates another area connected to the patient’s symptoms and health issues.

Several randomized controlled trials have been conducted on acupuncture. One study published in Acupuncture in Medicine involved 153 individuals in Spain.

All participants had fibromyalgia and were randomly assigned to one of two groups. One group received real acupuncture treatment. The other group received a placebo treatment.

Both groups received a 20-minute session every week for 10 weeks, and recorded the severity of their symptoms.

The results were promising. The group that received real acupuncture had a greater decrease in pain intensity at 10 weeks compared to the placebo group. And what’s more, the positive effects were still present a year later!

The latest research corroborates these findings too. A study published in Pain Medicine in February 2018 recruited 30 women with moderate to severe pain levels of fibromyalgia. In fact, 78% of those women reporting symptoms for longer than 10 years!

Participants were randomly assigned to one of two treatment groups: Either 20 treatments of acupuncture over 10 weeks, or group education over the same duration (both 900 minutes total). The participants completed a weekly Fibromyalgia Impact Questionnaire (FIQR) and Global Fatigue Index at baseline, five weeks, 10 weeks and a four-week follow up.

In the group receiving acupuncture, FIQR total, pain, and Global Fatigue index all showed significant improvements by the end of treatment and four weeks post-treatment, compared to the education group.

Natural Symptom Relief for Fibromyalgia


There are two studies that show promise in using yoga as a natural treatment option for fibromyalgia.

The first study involved 22 female participants. They completed two 75-minute yoga sessions each week for two months. Each participant filled out a questionnaire before the eight-week program began, another halfway through, and a third at the end of the study.

The questionnaire focused on their pain symptoms, including details about the intensity, quality, and location of their pain. The participants also noted their levels of anxiety, depression, and mindfulness.

Researchers measured their cortisol levels too, by taking saliva samples three times a day. This was on both the day before and the day after a yoga session.

The results were encouraging. Participants reported a 30% improvement in their overall symptoms. The outcome of the study suggests that a yoga intervention may reduce pain, increase mindfulness, and alter total cortisol levels in women with fibromyalgia.

This sample size was small, so let’s look at a larger study now.

This study was conducted on 53 female fibromyalgia patients. Remember, fibromyalgia is far more prevalent in women.

Of these 53 women, 25 were randomly selected to participate in an 8-week yoga awareness program. The yoga awareness program consisted of gentle poses, meditation, breathing exercises and yoga-based coping mechanisms and group discussion.

The other women who were not selected for the yoga program were waitlisted for standard care.

At the end of their treatment, women who were in the yoga program showed significant improvement regarding pain, fatigue, and mood. They also reported having greater coping capacity and coping strategies. The researchers concluded these results showed promise for the potential benefits of yoga to treat fibromyalgia in women.

So as you can see, these two studies show the benefit of yoga on fibromyalgia symptoms. And that’s not all. Yoga can have positive effects on bone mineral density too!

If you want to learn more about it, read our ultimate guide to yoga. It’s a free guide to help you start practicing yoga.

You can also try our gentle detoxifying yoga by watching this YouTube video.


Another beneficial treatment for fibromyalgia symptoms is massage. But not all massages are equal. For fibromyalgia treatment, manual lymph drainage therapy (MLDT) is the most beneficial.

MLDT works by stimulating the lymphatic system. It’s all down to specific hand movements by the masseuse. So make sure to seek out a professional.

MLDT also helps to redirect and enhance the lymphatic flow. When the lymphatic system flows properly, it helps the body remove toxins. It also reduces stress, improves circulation and reduces inflammation and pain. People who suffer from fibromyalgia often cannot fully relax their muscles, but MLDT helps them do just that.

One particular study showed MLDT to be more effective than another type of massage (connective tissue massage or CTM). Fifty women with fibromyalgia were randomly assigned into two groups. One group of 25 were given MLDT five times a week for three weeks. The other group received CTM for the same duration.

While both groups showed improvement in pain intensity and pain pressure threshold, the MLDT group showed greater improvements. This was only a small sample size, but it shows the promise of MLDT as a natural treatment option for fibromyalgia.


Research and medical thinking toward fibromyalgia are starting to turn a corner. They’re starting to look at the underlying causes of fibromyalgia rather than focus on the proximate causes and only dealing with symptom suppression.

The information I’ve put together for you here is based on the latest scientific research. But it’s still early days as far as finding a definitive cure for fibromyalgia is concerned. And there’s no one-size-fits-all solution. But the ideas suggested in this post can’t harm you and could potentially cure, or at least significantly reduce, your symptoms.

Avoiding toxins, including potential dietary triggers (like gluten, aspartame and glutamate), and optimizing your intake of key nutrients (like manganese, zinc, magnesium, vitamin A, vitamin D and the omega-3 essential fatty acids), are all viable options that could greatly reduce or even completely clear your symptoms. These are steps you can safely take that have no adverse effects and will improve your overall health as well as that of your bones.

So don’t give up… and DO stay hopeful!

And while you’re working on those root causes, there are palliative remedies to help relieve your fibromyalgia symptoms: Tai chi, yoga, massage therapy, and acupuncture, for example. Now, they may not cure your fibromyalgia, but they can help to make you a lot more comfortable.

I’m rooting for you and would really like to hear about your experiences! Let me know what you learn that helps with your fibromyalgia. Your successes could just be the inspiration someone else needs, too.

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    August 25, 2018 , 11:55 am

    I suffered with Fibro for 8 years from 1994 to 2002. I finally found several products that helped to heal my damaged nerves and they were MSM (Methylsulfonylmethane),
    Wobenzyme, and powdered Bovine Colostrum. Several years ago, I switched to fresh or frozen goat colostrum. I no longer need the Wobenzyme and discontinued that in 2002. After discussing the pain symptoms of Fibro with others who have this auto immune problem as well as those who suffer from PPS (Post polio Syndrome), I have come to the conclusion that they are one and the same. Or, Fibro is a little brother of Post Polio. I firmly believe that those with PPS suffer nerve damage from Polio and those with Fibro suffer nerve damage from having gone through an adverse reaction to the Polio vaccine. My own symptoms leading up to Fibro began soon after a reaction to the OPV with hair falling out, extreme dry skin, followed by Mono (twice), allergies, and then on to CFS and Fibro. I have since been diagnosed with Hashimotos and Celiac. I seriously believe all of this is related to developing autoimmune issues, due to the poisoning by the OPV.

  2. Lara Pizzorno

    August 29, 2018 , 9:39 am

    Hi Catryna,

    You are VERY insightful! What I’m hearing at the latest medical conferences on autoimmune diseases is that ALL stem from the same issues, which present in different individuals differently due to the person’s genetic susceptibilities and specific environmental triggers. For an outstanding discussion of this, I suggest you read Dr. Susan Blum, MD’s new book, The Immune System Recovery Plan.

  3. Sheila Gholson

    August 25, 2018 , 3:31 pm

    This is an outstanding article Lara.
    I don’t have fibromyalgia, but do have migraines and osteoporosis. Many of the recommendations are the same as those for migraines. Thank you!

  4. joyce broyles

    September 8, 2018 , 10:07 am

    So you are suggesting that if you suffer ftom osteo. and fibro..We must take All the different supplements you offer?..There is not one supplement that you can take that helps both ..build bone and help painful fibro?

  5. Jenna AlgaeCal

    September 12, 2018 , 11:21 am

    Hi Joyce,

    Unfortunately, supplementation isn’t always a one stop shop! In this case, AlgaeCal Plus is excellent for bone health because of the bone-building nutrients it provides, and for fibromyalgia because of its trace mineral content and vitamin D. Like we discuss in the post, omega 3s EPA and DHA are also beneficial for both fibromyalgia and bone health – and we do carry a fantastic omega 3 product called Triple Power Fish Oil.

    We would love to incorporate both supplements into one, however it’s simply not possible! For the best deliverability, AlgaeCal Plus needs to be taken in a powder form, and Triple Power must be an emulsified liquid form.

    If you have any questions or feedback feel free to let us know! You can email [email protected] or call 1-800-820-0184 🙂

    – Jenna @ AlgaeCal

  6. Joyce

    September 21, 2018 , 11:19 pm

    I appreciate you answeri g my first question.Iam purchasing your algae cal. I would like to read negative T numbers 9f consumers that report an i crease i stead of just saying what increase alone they have seen.Also do you see any difference in anyway after taking it awhile ..i stead of havi g you next year bone density test..my spine alone is -3.7. .. and I have had fibro for 25 years..hope to hear and thank you for research and responce.

  7. Jenna AlgaeCal

    September 25, 2018 , 3:54 pm

    Of course, Joyce! You can see actual DXA scan (bone density scan) results on our AlgaeCal Reviews page here. Simply click ‘See More’ on the review to see them.

    We would also love to share with you Annette’s story, she suffers from fibromyalgia and is nearly 100% pain free since starting AlgaeCal! See her story here.

    Some customers do report back a noticeable difference after starting AlgaeCal — such as stronger nails, reduced pain, and increased energy. These changes can happen if you had any mineral deficiencies before starting AlgaeCal, and varies from person to person. However, the best indicator of an increase in bone mineral density is through a DXA scan!

    If you have any questions or would like more information please feel free to call us at 1-800-820-0184 🙂

    – Jenna @ AlgaeCal

  8. Shirley Ross

    October 4, 2018 , 2:45 pm

    We hear a lot about Fibromyalgia , and very little about Polymyalgia which I was diagnosed with over a year ago.There seems to be a close connection between the two , but I was told they are different because of the auto-immune effect Polymyalgia has. I would be interested to know why Polymyalgia isn’t mentioned in this report and whether the advice give for Fibromyalgia would be of equal benefit to PMRheumatica sufferers.

  9. Jenna AlgaeCal

    October 11, 2018 , 3:55 pm

    Hi Shirley,

    Glad you reached out. We don’t currently have a post covering Polymyalgia, although this is certainly something we’ll consider for the future! I reached out to Lara Pizzorno about Polymyalgia and her best suggestion is to reach Susan Blum, MD’s book, The Immune System Recovery Plan. She believes Blum’s protocol may be extremely helpful to you.

    We wish you all the best!

    – Jenna @ AlgaeCal

  10. dorit

    January 25, 2019 , 3:19 pm

    Hi. I’ve been diagnosed with FM in 2014. The year before my CRP blood count was high (out of range). They made some US and such but couldn’t find the cause of inflammation. Is CRP now considered related to FM and if so is there some general antibiotic or another medication that can lower it and reduce some of the FM symptoms? THANKS ♥

  11. Jenna AlgaeCal

    January 30, 2019 , 10:11 am

    Hi Dorit,

    I reached out to Lara Pizzorno with your comment for some suggestions! Here’s what she said:

    Causes of high CRP include pro-inflammatory diet, environmental toxins, nutrient insufficiencies. (CRP (C-reactive protein) is a marker of inflammation – it’s not a type of bacteria, which are what can be treated by an antibiotic.)

    Re Diet: Key components that promote inflammation are gluten (wheat), excessive consumption of conventionally raised beef and processed meat products, refined carbohydrates, soda, high fructose corn syrup, etc. Eating a whole foods, organically grown, Mediterranean type diet is essential.

    Re Environmental Toxins: Plasticizers, pesticide exposures, heavy metals (lead, cadmium, mercury) are major causes of high CRP. Avoiding plastic and eating organic will greatly lessen these exposures. The most important nutrient insufficiencies are those of the omega-3s (because EPA, DHA actively resolve inflammation, so you should definitely be taking Triple Power) and the B vitamins, without which levels of a highly inflammatory intermediate product of the methylation cycle called homocysteine, rise, and homocysteine triggers production of CRP. [Source]

    You should be evaluated for rheumatoid arthritis, which can be misdiagnosed as fibromyalgia. [Source]

    I hope this info is helpful for you, Dorit! ❤️

    – Jenna @ AlgaeCal

  12. Katie

    September 2, 2019 , 1:39 am

    I’ve been thinking about taking AlgaeCal for a while now. One thing that has been stopping me, however, is that the source is seaweed, which tends to be high in free glutamate. Do you know what levels of glutamate are in AlgaeCal, or rather the specific seaweed that it comes from? I have a very sensitive nervous system and get some pretty nasty symptoms from anything that is high in free glutamate.

  13. Megan AlgaeCal

    September 3, 2019 , 2:10 pm

    Hi Katie, good question!

    We have a great article on Algas calcareas, the red ocean algae used in AlgaeCal. You can read this here.

    Hope this helps! If you have any questions or need clarification please feel free to email [email protected] or call our Bone Health Consultants at 1-800-820-0184! ?

    – Megan @ AlgaeCal

  14. Jen

    May 20, 2023 , 9:34 pm

    Great information! Can you recommend a
    functional provider that is available to answer some questions and make a recommendations ?
    Thank you

  15. Brianne AlgaeCal

    May 23, 2023 , 10:02 am

    Great question, Jen! Although we don’t have any specific recommendations for Functional Medicine Practitioners, you can use this handy tool to find one in your area!

    I hope this helps!

    – Brianne @ AlgaeCal

This article features advice from our industry experts to give you the best possible info through cutting-edge research.

Lara Pizzorno
MDiv, MA, LMT - Best-selling author of Healthy Bones Healthy You! and Your Bones; Editor of Longevity Medicine Review, and Senior Medical Editor for Integrative Medicine Advisors.,
Dr. Liz Lipski
PhD, CNS, FACN, IFMP, BCHN, LDN - Professor and Director of Academic Development, Nutrition programs in Clinical Nutrition at Maryland University of Integrative Health.,
Dr. Loren Fishman
MD, B.Phil.,(oxon.) - Medical Director of Manhattan Physical Medicine & Rehabilitation and Founder of the Yoga Injury Prevention Website.,
Prof. Didier Hans
PHD, MBA - Head of Research & Development Center of Bone Diseases, Lausanne University Hospital CHUV, Switzerland,