A Fibromyalgia Diet

Foods to Eat (and Eliminate) to Ease Symptoms

Many people with fibromyalgia find certain foods can trigger a flare-up. Sugar, gluten, dairy, and fried or processed foods can lead to symptoms like widespread muscle pain (myalgia) and fatigue.

The connection between the foods you eat and fibromyalgia pain is not well understood. Some evidence suggests food allergies or intolerances may be to blame. Other research links fibromyalgia symptoms to nutritional deficiencies, such as iron, vitamin D, and B-complex vitamins.

There is no one-size-fits-all fibromyalgia diet plan. The overall goal is to avoid foods that increase neuron excitability that triggers fibromyalgia symptoms. At the same time, you want to add anti-inflammatory foods that help prevent fibromyalgia flares.

Woman in a kitchen at a counter next to a pile of fruit writing on a pad of paper
BreatheFitness / GettyImages

This article discusses the principles behind the fibromyalgia diet plan. It includes what foods to avoid if you have fibromyalgia and foods that may relieve symptoms. It also explains how to pinpoint your personal food sensitivities with an elimination diet, plus tips for cooking for the fibromyalgia diet.

Food and Fibromyalgia

Fibromyalgia is characterized by a phenomenon called central sensitization, in which pain receptors in the central nervous system (called nociceptors) become hyperreactive. This greatly amplifies sensitivity to pain and can be triggered by things like illness, infection, injury, stress, and, for some people, food.

A review Journal of Human Nutrition and Diet suggests food intolerance and hypersensitivity affects around half of all people living with fibromyalgia.

Fibromyalgia's relationship to food intolerance is unclear, but some scientists believe allergy plays a role. In one study in Clinical and Translational Science, no less than 49% of people with fibromyalgia had at least one food allergy, while 50% tested strongly positive for a milk allergy. Intolerance to wheat, another common food allergen, also occurred.

It is possible that a hypersensitive food reaction can trigger fibromyalgia symptoms as the body releases pro-inflammatory compounds, called cytokines, into the bloodstream. Cytokines not only help instigate food allergies but are linked to the onset of fibromyalgia symptoms, most especially hyperalgesia (increased pain sensitivity).

Other experts contend that any food intolerance can provoke fibromyalgia by triggering inflammation in the gut that can "spill over" to the nociceptors in the brain. These include common causes like gluten (associated with celiac disease and gluten intolerance) and FODMAPs (fermentable sugars linked to irritable bowel syndrome, or IBS).

Goals of a Fibromyalgia Diet

An individualized fibromyalgia diet aims to:

  • Identify food intolerances and sensitivities so foods that cause gastrointestinal symptoms and trigger fibromyalgia flares can be avoided
  • Avoid foods and additives known to stimulate nociceptors in the brain. These include those high in an amino acid known as glutamate. Glutamate functions as a neurotransmitter and is found in abnormally high concentrations in the brains of people with fibromyalgia.
  • Compensate for nutritional deficiencies common in people with fibromyalgia. These include deficiencies in iron, iodine, magnesiumseleniumvitamin D, and vitamin B12.

Planning Your Fibromyalgia Diet

Although some specialists will recommend specific diets for people with fibromyalgia, there is no set group of foods that affects all people in the same way.

For that reason, developing a fibromyalgia diet plan starts with the process of identifying the foods you are sensitive to and the ones you can eat safely. It may also involve eating more foods that are high in magnesium, selenium, vitamin D, and vitamin B12 to maintain control over hyperalgesia.

Fibromyalgia Elimination Diet

An effective way to figure out which foods are troublesome is with the type of elimination diet used to diagnose things like IBS, food allergies, and gluten sensitivity.

To do an elimination diet, it's best to work with a healthcare provider or dietitian to prevent malnutrition or nutritional deficiencies that could lead to new problems as you follow these steps:

  1. Make a list of the foods (for example, eggs or nuts) or food groups (dairy, grains, etc.) you suspect may be causing problems.
  2. Avoid everything on the list for two weeks. Do not eat these foods whole or as an ingredient in a prepared dish.
  3. If your symptoms don't improve after two weeks, your healthcare provider or nutritionist may advise you to stop the diet and consider other possible food and non-food triggers.
  4. If fibromyalgia symptoms resolve after two weeks, introduce one food group back into the diet every three days.
  5. On the day a food is reintroduced, eat a small amount in the morning. If you don’t have symptoms, eat two larger portions in the afternoon and evening. You should then stop eating the food for two days to see if you develop any symptoms. If you don't, the food is unlikely to be a trigger.
  6. If a food is reintroduced and triggers symptoms, make note of it in a diary and tell your healthcare provider. Wait another two days before re-challenging yourself with another food group on the list.

A fibromyalgia diet is intended to be safely followed for an entire lifetime. Therefore, it should meet the daily recommendations for protein, fats, carbohydrates, vitamins, and minerals as outlined in the 2015-2020 Dietary Guidelines for Americans. Working with a dietitian can help ensure this.

What to Eat

Although the fibromyalgia diet can vary from person to person, there are a number of triggers that people with the condition commonly react to.

Even if you don't undergo a formal elimination diet, you may be advised to avoid these foods to see how doing so affects you. These include foods that are high in glutamate, FODMAPs, or gluten, as well as common food allergens.

Some specialists also recommend following specific diets that focus on heart-healthy foods, as these often are unlikely to spur systemic inflammation. Examples include the DASH diet for managing high blood pressure and the Mediterranean diet, which is rich in magnesium and fatty acids.

Foods to Choose
  • Vegetables

  • Fruits (especially low-fructose fruit like melons, apples, and bananas)

  • Lean unprocessed meats and poultry

  • Oily fish like tuna, mackerel, or salmon

  • Eggs*

  • Rice

  • Soy and tofu*

  • Milk substitutes

  • Flaxseed and chia seeds

Foods to Avoid
  • Processed or cured meats

  • Fried or deep-fried foods

  • White bread and baked goods

  • Wheat, barley, rye, and oats

  • Dairy products

  • Shellfish

  • Sweetened drinks, including fruit concentrates

  • Desserts and sugary foods

  • Artificial sweeteners like asparatame

  • Peanuts

  • Monosodium glutamate (MSG) and packaged food seasonings

*Unless you suspect you suspect you have a food allergy

The compliant foods are those that are less likely to spur food intolerance yet able to deliver the quality nutrition you need. The non-compliant foods are those more likely to induce intolerance by exposing you to excess gluten, FODMAPs, or glutamate.

  • Fruits and vegetables: Note that low-fructose fruits are lower in FODMAPs and less likely to trigger IBS symptoms.
  • Meats and poultry: Beef, pork, chicken, and turkey are great sources of protein, but always buy the leanest cuts. Fatty meats, fried meats, and processed meat can increase the inflammatory burden in the cardiovascular system and beyond.
  • Dairy: Dairy products are something of a conundrum in a fibromyalgia diet. On the one hand, they are a rich source of vitamin D and may reduce hyperalgesia and depression in people with fibromyalgia. On the other, dairy may be problematic in people with undiagnosed lactose intolerance or milk allergy. To maintain nutrition, consider a vitamin-D fortified milk substitute like almond, cashew, or soy.
  • Wheat: Wheat, high-gluten grains like rye, barley, and oats, and foods made with these ingredients can trigger gastrointestinal symptoms in people with gluten sensitivity. With increasing evidence that fibromyalgia is linked to celiac disease and non-celiac gluten sensitivity, it's advisable to steer clear of gluten and opt for corn, millet, rice, and sorghum.
  • Oily fish: Fish like herring, mackerel, and tuna are rich in omega-3 fatty acids, a group of polyunsaturated fats that are good for the heart and can aid in the modulation of inflammation in the body.
  • Food additives: Monosodium glutamate (MSG) is one of the most concentrated forms of glutamate in food. The relationship between MSG and fibromyalgia remains unclear, but some studies have shown reducing glutamate can decrease nociceptor hyperreactivity and alleviate pain. MSG can also be found in certain packaged food seasonings.

There are other foods that can trigger fibromyalgia symptoms. Beyond the common food triggers, consider any food you eat on a regular basis a likely suspect.

Cooking Tips

A fibromyalgia diet focuses largely on whole foods prepared simply. Frying or deep-frying should be avoided and replaced with grilling, broiling, or steaming. If you decide to pan-fry, use a spray bottle to add as little oil as possible to the pan (ideally extra virgin olive oil).

Some studies suggest that the less you cook your food, the better. This includes research suggesting that a raw vegetarian diet may reduce hyperalgesia in some people with fibromyalgia.

Prepare Ahead for Success

A common challenge with trying to follow an elimination diet like this is having healthy food at the ready. If you don't have a lot of time to cook during the work week, consider prepping ahead of time. Make several fibromyalgia-friendly meals in advance, and freeze in individual serving sizes. That way you will be able to stick to your eating plan when short on time.

Considerations

A fibromyalgia diet should be approached strategically and rationally: Making sudden or extreme changes—even healthy ones—can trigger a fibromyalgia flare.

Some food sensitivities are easier to deal with than others. If you find you're sensitive to gluten, for instance, you may benefit from speaking with a dietitian or nutritionist to learn about the many foods you'll need to avoid and how to replace lost nutrients with "safe" foods.

Recommended Timing

Whatever diet plan you embark on, keep to a regular schedule of at least three meals per day unless your healthcare provider tells you otherwise. Skipping meals can lead to overeating, which not only causes stomach upset and fatigue but induces inflammation.

If you feel hungry between meals, keep to healthy snacks like fruits, vegetables, and hummus (100% natural).

A Word From Verywell

As with any diet, support from family and friends is vital. This is especially true if you are embarking an elimination diet or have to make significant changes in the foods you eat. By letting your loved ones understand more about fibromyalgia and how certain foods affect you, they can better support your choices and avoid undermining your efforts.

Frequently Asked Questions

  • Can fibromyalgia be reversed with diet?

    Not entirely, but many people find a combination of diet and exercise helps to reduce fibromyalgia symptoms and improve their quality of life. In addition to avoiding trigger foods, getting regular exercise relieves muscle aches and fatigue.

  • Do any foods make fibromyalgia worse?

    Some people find certain foods cause a flare-up of fibromyalgia symptoms. Common foods fibromyalgia patients may want to avoid include:

    • Dairy products
    • Fried foods
    • Food additives like MSG
    • Gluten
    • Processed foods
    • Sugar and sugar substitutes
  • What is the best fibromyalgia diet plan?

    The best diet for fibromyalgia varies from person to person. Start by eliminating all of the common fibromyalgia triggers for at least two weeks. Slowly add foods back in and watch for symptoms.

  • Can vitamin D supplements help fibromyalgia?

    They might. Fibromyalgia makes you more more likely to be deficient in vitamin D—a nutrient that plays a role in pain and inflammation. If you are found to be vitamin D deficient, your healthcare provider may recommend supplementation.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Additional Reading
Adrienne Dellwo

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.