Fibromyalgia is chronic arthritis-related condition with symptoms that may include widespread musculoskeletal pain, fatigue, depression, headaches, mental fogginess, and bowel and bladder problems. A type of central sensitization or central pain syndrome,fibromyalgiais believed to result from a problem in the way the brain processes pain signals.
Although the cause of fibromyalgia is not well understood, scientists are finding that certain nutrients or food additives may worsen symptoms for some people. Similarly, consuming or eliminating particular nutrients may lessen symptom severity.
Here are three nutrients that may play a role in fibromyalgia and what researchers are learning about them.
Food Additives & Fibromyalgia Symptoms
多年来，研究人员一直怀疑被称为兴奋毒素的食品添加剂可能会加重一些人的纤维肌痛症状。兴奋毒素包括三种氨基酸——谷氨酸、天冬氨酸和l -半胱氨酸——它们通常作为风味增强剂和糖替代品在许多杂货店的主食中发现。
Some of the earliest evidence of a fibromyalgia-excitotoxin connection was seen in 2001 in a small case study published inAnnals of Pharmacotherapy. Four people with fibromyalgia who had not responded well to other treatments became totally or mostly symptom-free within months of removing monosodium glutamate (MSG) or aspartame from their diets. All had symptoms return when MSG was reintroduced.
More recent and slightly larger studies have had conflicting results. In a study published in 2012 inClinical and Experimental Rheumatology, 57 patients with fibromyalgia and irritable bowel syndrome (IBS) symptoms were put on a diet that excluded MSG and aspartame. After four weeks on the elimination diet, 84% of those completing the diet reported their symptoms improved by more than 30%. Adding MSG back into the diet resulted in a significant return of symptoms.
A 2014 study published inRheumatology International,however, showed no relationship. In this study of 72 women with fibromyalgia, half of them stopped eating monosodium glutamate (MSG) and aspartame, while the other half continued their regular diets. There were no significant differences between the groups on pain ratings before or after the elimination diet. The researchers concluded that discontinuing the additives did not improve fibromyalgia symptoms.
Researchers say larger studies are needed to better understand the potential role of excitotoxins on fibromyalgia symptoms and whether some patients may benefit from eliminating them.
Vitamin D
You need vitamin D to absorb calcium. Your body makes it when your skin is directly exposed to the sun. Vitamin D is also found in fatty fish, beef liver, egg yolks, mushrooms, and fortified milk and cereal products.
Research has shown a connection between low blood levels of vitamin D and several chronic health problems including osteoporosis, high blood pressure, autoimmune diseases and chronic widespread musculoskeletal pain.
It’s not known whether supplementing vitamin D in people who are deficient will help pain or other symptoms of fibromyalgia. A small Austrian study published in 2014 in the journalPain表明它可能。在这项研究中，30名患有纤维肌痛且血液中维生素D水平较低的女性分别服用维生素D补充剂或安慰剂。治疗组在身体机能、晨乏和疼痛方面都有改善，而安慰剂组没有变化。
While the data presented in the study are promising, study author Florian Wepner, MD, an orthopaedist at Vienna’s Orthopaedic Hospital Speising, notes that the study was small and larger studies are needed to better determine the potential role of vitamin D in fibromyalgia treatment. He believes, however, that vitamin D is a safe supplement that can be used along with medication and other non-medication treatments for fibromyalgia.
Gluten & Inflammation
Shop the aisles of almost any supermarket and you’ll find a wide array of gluten-free products. Gluten – a protein found in wheat, rye and barley – triggers damaging inflammation in the small intestines of people with celiac disease. More recently gluten intolerance has been suspected to play a part in a host of other ailments including digestive problems, fatigue, headache, skin rash and possibly fibromyalgia.
Spanish researchers wondering whether gluten contributed to fibromyalgia sought the answer in a study published in 2014 inRheumatology International.
The study examined 20 patients who had fibromyalgia and a suspected gluten sensitivity while not fully meeting the criteria for celiac disease. After transitioning to a gluten-free diet for 16 months, all patients reported improvement in the level of widespread chronic pain. Fatigue, gastrointestinal symptoms, migraine and depression also improved.
“This report shows that remarkable clinical improvement can be achieved with a gluten-free diet in patients with [fibromyalgia], even if celiac disease has been ruled out,” the authors wrote.
Another 2014 study published inArthritis Research and Therapy评估了97名同时患有纤维肌痛和肠易激综合征的女性一年无麸质饮食的效果。没有一个女性符合乳糜泻诊断的标准。然而，58人的淋巴细胞性肠炎(LE)检测呈阳性，LE是一种小肠炎症，常见于食物过敏、自身免疫性疾病、细菌感染和服用非甾体抗炎药物的人。
The gluten-free diet produced slight improvement in symptoms of both IBS and fibromyalgia in the LE group, but not the group without LE. This suggests that LE might be useful for identifying patients who are most likely to benefit from eliminating gluten, the authors said. One important limitation of this study is the lack of a control group.
The Takeaway
尽管有关于营养和纤维肌痛的研究，但没有确凿的证据表明添加或消除任何营养或一组营养会帮助每个人。你想要尝试的任何饮食改变都应该咨询你的医生，根据你的情况量身定做。
Fibromyalgia expert Daniel Clauw, MD, professor of anesthesiology, rheumatology and psychiatry at the University of Michigan in Ann Arbor, says the data supporting vitamin D as a reliever of fibromyalgia pain is inconsistent, but its other benefits are a good enough reason to try it. “It helps strengthen bones and has a host of other benefits.”
虽然还需要更多的研究来确定我们饮食中的不同元素是如何影响纤维肌痛的，但专家们一致认为，吃健康的天然食品无疑是朝着正确的方向迈出的一步。
Authors: Kerry Ludlam and Mary Anne Dunkin for the Arthritis Foundation
Related Resources:
- Learn more about fibromyalgia
- Learn more about ahealthy arthritis diet
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