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Functional Medicine Approach To The Management Of Fibromyalgia

Written by 

Deborah Freudenmann 

Fibromyalgia is a chronic syndrome that often causes severe and recurring body aches. It is often accompanied by other physical and emotional symptoms including severe mental distress and even depression. Hence, there is a need to understand the pathogenesis of this condition and seek appropriate treatment to overcome the symptoms.Here is a brief discussion about what fibromyalgia means and the functional medicine approach to the management of this condition.

What is Fibromyalgia?

Fibromyalgia is a chronic condition characterized by pain all over the body, severe fatigue, sleep problems, and emotional distress. Patients with fibromyalgia are often more sensitive to pain. It is estimated that nearly 5 million adults above 18 years of age in the United States suffer from fibromyalgia.

Correcting imbalances in the functions of the vital organs and the different systems of the body such as the HPA axis, gastrointestinal system, brain-gut axis, inflammatory and detoxification pathways, and mitochondrial functions is expected to help patients derive relief from fibromyalgia.

Signs and symptoms of fibromyalgia

  • Pain and tenderness all over the body, especially in the soft tissues
  • Pain is worse with activities, exposure to cold, anxiety, damp weather, and stress
  • Pain originating from the tender points in the shoulders, back of the neck, chest, hips, shins, lower back, elbow, and knees
  • Pain is felt deep in the tissues and is shooting or burning in nature
  • Fatigue
  • Mental and emotional disturbances leading to depression, poor concentration, mood swings, forgetfulness, and irritability
  • Disordered sleep patterns with a lack of restorative non-REM sleep
  • Tendency to wake up from sleep with severe pain and stiffness
  • Waking up in the morning feeling sleepy or unrefreshed
  • Other symptoms such as headaches, palpitations, numbness and tingling, and irritable bladder

Root causes of fibromyalgia

Gluten intolerance SIBO / leaky gut

Digestive disturbances that occur due to food sensitivities such as glucose intolerance, SIBO (small intestine bacterial overgrowth), and leaky gut can lead to gut microbiome imbalances due to which the vital functions of the immune system are affected.

This could contribute to widespread inflammation and an increased secretion of neurotransmitters like prostaglandins due to which the patient’s sensitivity to pain is increased. As a result, the patient experiences severe pain all over the body.

Parasite or pathogenic bacteria overgrowth

Previous co-infections such as Lyme disease, candida, EBV, and mold exposure as well as the adverse effects of medications used to treat these diseases could contribute to the overgrowth of harmful bacteria in the intestine. As a result, the gut microbiota is adversely affected.

This would create imbalances in the immune system functions and the gut-brain axis putting patients at risk of chronic inflammatory conditions like fibromyalgia.

Traumatic event / chronic stress / HPA axis dysregulation

Traumatic stress events and chronic mental stress could lead to the disruptions in the levels of hormones resulting in the dysregulation of the HPA (hypothalamic-pituitary-adrenal) axis.

Hormonal disturbances play a key role in triggering inflammation and lowering the person’s pain threshold. Restoring the balance of hormones, especially stress hormones like cortisol and thyroid hormones, through effective stress-relieving techniques such as medication could inhibit the dysregulation of the HPA axis thereby preventing the risk of fibromyalgia.

Restoring a healthy adrenal response and resetting the body’s circadian rhythm by improving the sleep-wake cycle would also reduce stress, and enhance the normal bodily functions thereby allowing a person to derive relief from the symptoms of this condition.

Mitochondrial dysfunctions

Mitochondrial dysfunctions can trigger fibromyalgia by reducing the availability of a source of energy to the organs at the cellular level. Supporting mitochondrial functions could offer an effective strategy to reduce pain and prevent fibromyalgia.


Inflammatory reactions and oxidative stress play a major role in causing widespread chronic damage to the healthy tissues making patients vulnerable to developing fibromyalgia.

Toxicity due to heavy metals like mercury and lead can contribute to inflammation and oxidative stress. Similarly, MTHFR mutations and immune dysregulations can also trigger inflammatory damage and weaken the body’s defense mechanisms against inflammation. These factors can trigger the development of fibromyalgia.

Nutritional deficiency

Deficiency of nutrients such as vitamin D, B vitamins, magnesium, and glutathione can make the immune system less efficient at fighting infections, inflammation, and oxidative stress due to which the risk of fibromyalgia may worsen. It may also prolong the recovery of patients even after the treatment has started.

Functional medicine understanding

Dietary changes

Fresh foods, especially plant-based, anti-inflammatory, alkalizing, whole foods having natural antioxidant properties, could help to provide relief from the symptoms of fibromyalgia.

A Mediterranean diet that comprises fresh fruits and vegetables, fish, legumes, nuts, seeds, and olive oil could also help to prevent nutritional deficiencies, restore hormonal balance, reduce inflammation, and relieve the symptoms of this condition.

Identify and eliminate food allergens

Minimizing your exposure to food allergens and pro-inflammatory foods such as sugars, refined carbohydrates, commercially raised meat, trans fats, omega-6 fatty acids, alcohol, and caffeine is highly recommended for reducing inflammation and relieving the symptoms of fibromyalgia.

Emphasize anti-inflammatory foods

Eating a diet containing natural antioxidant-rich foods like berries, turmeric, fruits, green tea, and vegetables would promote tissue repair and relieve body pain and stiffness.

Patients should also include probiotic and prebiotic foods like high-fiber foods, kefir, yogurt, fermented vegetables, and kombucha in their regular diet to boost immunity and prevent immunological dysfunctions. 

Functional testing

Functional testing should be performed for choosing the most effective supplements that could prevent nutritional deficiencies and correct imbalances.

Supplements that could benefit patients with fibromyalgia include:

  • Vitamin C and bioflavonoids to reduce inflammation and oxidative damage and support adrenal health
  • Bromelain to reduce systemic inflammation
  • Omega-3 fatty acids to reduce inflammation, repair mitochondria, and support healthy functions of the neurotransmitters
  • B-complex to support healthy neurotransmitter synthesis and energy output
  • Magnesium for reducing muscle spasms and supporting mitochondrial energy output
  • N-acetyl cysteine for reducing inflammation and oxidative stress and improving endothelial functions
  • Coenzyme to support mitochondrial functions and improve oxygenation at the cellular level
  • GABA for down-regulating pain signals in the nervous system and managing stress and depression
  • Acetyl-l carnitine for supporting ATP production
  • Vitamin D3 for supporting immune response
  • D-ribose for supporting ATP synthesis, boosting energy, increasing muscle recovery, improving exercise tolerance, and relieving pain and fatigue
  • Probiotics

Lifestyle / Physical measures

  • A gentle and progressive exercise plan may be introduced into the patient’s routine for accelerating the recovery. Regular exercises are crucial for improving energy and moods.
  • Stress management with the help of yoga, relaxation exercises, and tai chi
  • Regular exposure to sunlight
  • Epsom salt bath to soothe painful and stiff muscles
  • Aromatherapy with essential oils of lemon balm, rosemary, jasmine, and clary sage
  • Therapeutic massage for improving circulation, reducing stress-related symptoms, and increasing the general sense of well-being

PEMF therapy

Pulsed electromagnetic field (PEMF) therapy has been very beneficial for patients with fibromyalgia. It is a safe and non-invasive treatment that would help relieve the symptoms of this condition by promoting mitochondrial repair and improving the oxygen-carrying capacity of the cells. 

PEMF would also reduce hypoxic damage and restore healthy functioning of the vital organs thereby providing significant relief from the symptoms.

Ozone therapy

Ozone not only up-regulates the healing functions of the body, it also reduces pathogenic overgrowth, increases mitochondrial activity, increases ATP production and energy and brings patients with fibromyalgia faster into a recovery.


Treatment of fibromyalgia through the functional medicine approach could help to eliminate the root cause and enable patients to recover faster. Functional medicine would also help control widespread inflammation and reduce the risk of recurrence of symptoms.

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