Fibromyalgia is a complicated and multiple symptom syndrome that is difficult to treat, but alternative medicine may help immensely

Fibromyalgia (FM) is a disorder characterized by widespread muscle and joint pain accompanied by fatigue, sleep, memory and mood issues. Painful sensations are amplified as FM affects brain and spinal cord processing of signals. While there is no cure for fibromyalgia, medical experts have developed strategies to control symptoms including the use of pain relievers, antidepressants, steroids and antiseizure drugs.^[i],[ii]

Researchers have investigated 11 natural treatment options for FM from magnesium, calcium, probiotics and vitamin D supplements, and use of cannabis, homeopathic, melatonin and serotonin treatments to yoga and hyperbaric oxygen therapies. Natural substances may be safer and more effective than conventional drugs with fewer adverse effects.

1. Magnesium

Patients with fibromyalgia often have symptoms of chronic pain, fatigue, depression and sleep disturbances, which can affect their quality of life. Having a deficient magnesium level has been associated with FM.^{[iii],[iv],[v]}

Twenty-four female patients diagnosed with fibromyalgia were provided with a spray bottle containing a transdermal magnesium chloride solution to apply four sprays per limb twice daily for four weeks and asked to fill out questionnaires on their quality of life and fibromyalgia symptoms. All patients had significant quality of life and symptom improvements after increasing their magnesium chloride levels.^[vi]

Thirty-two patients diagnosed with FM and 32 healthy participants were included in a study of three natural substances ​ -- selenium, magnesium and zinc. Serum levels of zinc and magnesium were significantly decreased in the FM group, whereas there were no differences in selenium levels between groups. Zinc level was associated with the number of tender points on the body and magnesium level was highly associated with fatigue severity in the FM patients.^[vii]

2. Vitamin D

Hypovitaminosis D is a vitamin D deficiency defined as a 25-hydroxyvitamin D level of less than 20 ng/mL. An adequate vitamin D level is important for maintaining normal muscle and immune function and low vitamin D has been associated with FM symptoms.^[viii]

In a study of 74 FM patients with vitamin D deficiency, subjects were randomly assigned into group A -- 25 milligrams (mg) of the antidepressant Trazodone at bedtime and 50,000 IU of vitamin D weekly -- and group B -- 25 mg of Trazodone at bedtime and placebo. Significant improvements in widespread pain index, fibromyalgia symptoms and sleep quality scores were found in both groups.

However, the combination of vitamin D and Trazodone resulted in significant improvement in quality-of-life scores compared to Trazodone therapy alone. Therefore, a combination of vitamin D and a conventional antidepressant, when given to vitamin D-deficient fibromyalgia patients, provided the most significant improvement in physical and psychological symptoms of FM.^[ix]

To study 30 women with FM whose serum vitamin D levels were less than 32 ng/mL, patients were randomly assigned to a treatment group with vitamin D supplementation or the control group with a placebo. Optimization of vitamin D levels in FM women had a positive effect on their perception of pain.[x]

In a trial of premenopausal women aged 18 to 50 years old, 40 patients with low vitamin D3 (less than 25 ng/mL) were compared to 40 healthy subjects who had vitamin D3 levels of 25 ng/mL or more (a level that many experts also believe to be too low for optimal health). The vitamin D3 deficient group showed higher pain severity, muscle weakness and pain sensitivity in tendons, ligaments and muscles as well as higher likelihood of fibromyalgia diagnosis compared to the healthy group.^[xi]

3. Homeopathy

In a meta-analysis of 10 case reports, three observational studies and five controlled trials on homeopathy for fibromyalgia, results showed positive effects of homeopathy on tender point count, pain intensity and fatigue compared to a placebo.^[xii]

Homeopathic medicinal care was added to the usual care for 22 weeks and compared to usual care treatment alone as a control group for 47 FM patients. There were significant reductions in FM symptoms, less pain, fatigue and tiredness with increased ability to function in the homeopathic care group compared to the control group, with no reported adverse effects.^[xiii]

4. Cannabis/CBD

In a clinical trial of 17 women with fibromyalgia, patients were supplemented for eight weeks with either a THC-rich cannabis oil -- 24.44 mg/mL of THC and 0.51 mg/mL of cannabidiol (CBD) -- or a placebo. The cannabis group showed a significant decrease in FM index scores in comparison with the placebo group and, in particular, had lowered pain and fatigue scores and reported feeling good and able to work.

Cannabinoids can be a low-cost and well-tolerated therapy that reduces symptoms and increases the quality of life for those suffering with fibromyalgia.^[xiv]

In a systematic review of 10 studies with a total of 1,136 patients, cannabis was found to be safe and well tolerated for treating FM symptoms, particularly chronic pain, with minimal adverse effects of dizziness, dry mouth, cough, red eyes and drowsiness.^[xv]

Among 194 fibromyalgia patients studied, medical cannabis treatment was given for six months at a clinic. Afterward, subjects answered questionnaires and reported reduced pain intensity -- from a level of 9 to a level of 5 on a 10-point scale -- with mild adverse effects of dizziness, dry mouth and gastrointestinal symptoms from the treatment.^[xvi]

In a study of 2,701 participants with FM, those who used CBD for FM-related symptoms -- most commonly pain -- reported small to major improvements across symptoms with half of the subjects reporting only minor side effects.^[xvii]

5. CoQ10

One FM treatment that is gaining a lot of interest is coenzyme Q10 (CoQ10) supplementation. The therapeutic benefits associated with CoQ10 supplementation are related to its ability to restore an underlying deficit in CoQ10 status associated with fibromyalgia, improve mitochondrial activity, restore cellular antioxidant capacity and ameliorate inflammation.^[xviii]

In a review of 10 studies of CoQ10 supplementation on fatigue, CoQ10 had better therapeutic effects in statin-related fatigue and fibromyalgia patients compared with other disease-related fatigue.^[xix]

Pregabalin is a seizure drug often prescribed to treat pain caused by fibromyalgia since it affects chemicals in the brain that send pain signals across the nervous system.^[xx] Eleven FM patients were enrolled in a trial with two weeks wash-out then randomly allocated to two treatment groups: pregabalin with CoQ10 or pregabalin with placebo for 40 days.

Then, patients in the CoQ10 group were switched to placebo, and patients in the placebo group were switched to CoQ10 for another 40 days. Pregabalin alone reduced pain and anxiety, decreasing brain activity compared with the baseline measures. Supplementation with CoQ10 effectively reduced greater pain, anxiety and brain activity, and decreased mitochondrial oxidative stress and inflammation.^[xxi]

In a comparison of 40 FM patients to 30 participants in a healthy control group, a higher level of oxidative stress markers in plasma was observed in the FM group compared to the control subjects. The CoQ10 level in plasma from FM patients was doubled compared to healthy controls and in blood mononuclear cells isolated from FM patients was found to be about 40% lower. Higher levels of ROS production were observed in mononuclear cells from FM patients compared to the control and a significant decrease was induced by the presence of CoQ10.^[xxii]

6. Calcium

Calcium is thought to be important to FM treatment as it affects muscular contraction. A study of intracellular calcium concentration was carried out on 70 patients with fibromyalgia and 40 healthy controls. In the FM patients, the intracellular calcium concentration was significantly lower than in the healthy control group.^[xxiii]

In a study of 12 FM patients and 12 healthy subjects, both hair calcium and magnesium levels were significantly higher in the FM group than the control group. Supplementing calcium with magnesium to fibromyalgia subjects was an effective treatment to reduce the number of tender points detected.^[xxiv]

7. Melatonin

Melatonin has certain properties that may be helpful for fibromyalgia. It normalizes circadian rhythms, which in turn improves sleep disorders, and it also serves as a pain reliever by involving melatonin receptors and several neurotransmitter systems.^[xxv]

In a blind study of 101 patients randomized into four groups -- group A treated with 20 mg per day fluoxetine (also known as the antidepressant Prozac) alone; group B treated with melatonin 5 mg alone; group C treated with 20 mg fluoxetine plus 3 mg melatonin; group D treated with 20 mg fluoxetine plus 5 mg melatonin. Both treatments were given once daily in the morning and evening for eight weeks.

Using melatonin, either low or high dose, in combination with 20 mg per day fluoxetine resulted in the most significant reduction of both total and different components of FM compared to the pretreatment values and treatments alone.^[xxvi]

8. 5-HTP

Serotonin supplementation, via L-tryptophan or 5-hydroxytryptophan (5-HTP), has been shown to improve symptoms of depression, anxiety, insomnia and pain in a variety of FM patient cohorts. Low serotonin or serum tryptophan levels may be markers for the effectiveness of this treatment.^[xxvii]

Clinical symptoms were studied in 50 FM patients using a serotonin pathway treatment. The number of tender points, anxiety, pain intensity, quality of sleep and fatigue symptom improvements were reported as “good” or “fair” compared with baseline in nearly 50% of the patients during the 90-day treatment with 5-HTP.^[xxviii]

9. Probiotics

Some researchers believe that the gut-brain axis may be important for diagnosis and treatment of FM since many FM patients experience altered microbiota, which has been tied to symptoms of pain, mood, anxiety and depression.^[xxix] In a recent study of 77 FM and 79 control subjects, microbiome comparisons revealed significant differences in the serum levels of butyrate and propionate bacteria in FM patients.^[xxx]

Two studies including 83 patients were included in a meta-analytical review of probiotics on FM and chronic fatigue syndrome. In the first study, administration of the probiotic Lactobacillus casei strain Shirota for eight weeks lowered anxiety scores. In the second trial, treatment with Bifidobacterium infantis probiotic, during the same period, reduced inflammatory biomarkers.^[xxxi]

In a pilot study that explored the effect of a multispecies probiotic in FM patients, results showed that probiotics improved participants' impulsivity and decision-making.^[xxxii]

10. Yoga

Hatha yoga proved to be an effective means of relieving pain in FM. In particular, a measurable improvement in scores occurred for the affective dimension of pain after only four yoga sessions and this effect remained stable throughout the two-month-long program.^[xxxiii]

A pilot study of 22 women with FM evaluated pain, psychological variables, mindfulness and cortisol levels before and after a yoga intervention of 75 minutes twice weekly for eight weeks. Scores improved significantly for chronic pain, pain catastrophizing, pain acceptance, mindfulness and altered total cortisol levels in women with FM.^[xxxiv]

A sample of 53 female FM patients was randomized to an eight-week Yoga of Awareness program -- gentle poses, meditation, breathing exercises, yoga-based coping instructions, group discussions -- or to wait-listed standard care. The yoga program group had significant improvements in FM symptoms and functioning, including pain, fatigue, mood, pain catastrophizing, acceptance and other coping strategies.^[xxxv]

11. Hyperbaric Treatment

Hyperbaric oxygen therapy (HBOT) has shown promising effects in the management of FM and other chronic pain disorders. HBOT allows breathing of 100% oxygen in a pressurized chamber and review of research showed HBOT has significant anti-inflammatory effects, which result in pain alleviation, and also influences neuroplasticity and brain function.

In addition, HBOT stimulates nitric oxide synthesis, which helps alleviate hyperalgesia -- a super sensitivity to feeling pain and an extreme response to pain -- one of FM's most debilitating symptoms.^[xxxvi]

In FM patients, HBOT reduced brain activity in the posterior cortex and increased it in the frontal, cingulate, medial temporal and cerebellar cortices, thus ameliorating abnormal brain functioning. Moreover, the lessening of pain induced by oxygen therapy significantly decreased the use of pain medications.^[xxxvii]

Sixty female patients, aged 21 to 67 years old with diagnosed FM at least two years earlier, were included in a crossover study. The HBOT protocol comprised 40 sessions, five days per week for 90 minutes. HBOT led to significant improvements of all FM symptoms, life quality and abnormal brain activity in pain-related areas.^[xxxviii]

Natural Alternatives to Treat Fibromyalgia

Fibromyalgia is still not well understood, presents many different symptoms and may result from stress, lack of sleep, genetics or trauma. Researchers continue to study the syndrome, treatments for the symptoms and diagnostic tools. Natural substances like serotonin, melatonin, CBD and CoQ10 may help relieve symptoms. Deficiencies in vitamin D, magnesium, zinc and calcium and gut bacteria imbalances can be addressed and used as diagnostic markers for FM.

Alternative therapies like yoga and hyperbaric oxygen therapy may help as well. Lifestyle changes such as a healthy diet, getting plenty of sleep and stress-reducing activities such as exercise and meditation are highly recommended to prevent fibromyalgia.  To investigate more natural alternatives, please see GreenMedInfo.com's database on fibromyalgia.

Fibromyalgia affects millions of individuals, but it remains one of the most misunderstood disorders in the world. In an online survey by the National Fibromyalgia Association, 27.8% of respondents felt that their healthcare provider did not view fibromyalgia as a legitimate disorder. 

That's why we're inviting you to the Freedom From Fibromyalgia Summit, happening May 23rd to the 30th, 2023. This summit brings together 40+ leading experts in functional medicine, pain management, nutrition, and more to guide you toward a pain-free future.

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