The Chronic Fatigue Syndrome & Fibromyalgia Diet

Eating for Symptom Management

Woman sitting on bed, holding fruit salad, mid section
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A healthy diet plan is important for managing fibromyalgia (FMS) or chronic fatigue syndrome (CFS or ME/CFS). While it's not a "cure" and there is no magic diet that works wonders for everyone with these conditions, eating right can help you feel better, have more energy and support your immune system.

As important as eating right is not eating wrong -- certain foods and drinks could be worsening your symptoms.

It will take some trial and error to find what works best for you, but the information here is a good place to start.

While improving your eating habits might help you lose weight, keep in mind that your first goal needs to be feeling better. FMS and ME/CFS can make it especially hard for you to lose weight, but to properly address that problem, it's important for you to first get your symptoms to a more manageable level. Once you feel better, you'll be more able to increase your activity level and to face the specific challenges that keep you from dropping extra pounds. DO NOT TRY EXTREME OR "FAD" DIETS. Make dietary changes one at a time so you can gauge their effect on your health. Sudden or extreme changes -- even beneficial ones -- can temporarily make your symptoms worse.

A lot of websites advertise "cures" or treatments in the form of diets and supplements. Some of these are reputable, while others are not, so it's important to research the claims they make.

Some diets may not provide proper nutrition, while others may require you to spend a lot of money on proprietary products that might not work and could potentially damage your health.

A "Balanced Diet"

You hear it all the time -- "eat a balanced diet!" With so much contradictory information around, it's hard to know exactly what "balanced" means.

According to About.com's Calorie Count page, eating a balanced diet is defined as "choosing a wide variety of foods and drinks from all the food groups," while practicing moderation when it comes to saturated or trans fat, cholesterol, refined sugar, salt, and alcohol.

The healthy food groups are:

  1. Grains
  2. Fruits
  3. Vegetables
  4. Protein (poultry, fish, lean meats or dried beans)
  5. Dairy (low-fat milk, cheese or yogurt)

Protein

Getting enough protein in your diet is especially important, because your body needs it for growth and maintenance. Protein is directly responsible for about 20% of the material in your cells and tissues, and it's also necessary for hormones, antibodies and enzymes that keep your body going. Animal-based proteins (such as milk, meat, fish, poultry and eggs) will give you the amino acids your body needs to build protein.

Things to Avoid

Some people with FMS and ME/CFS find that certain foods make their symptoms worse. To see how they effect you, try eliminating them from your diet for several days.

Then reintroduce one food at a time (with a few days in between) and see how it makes you feel. The most common symptom triggers are:

  • High-calorie foods
  • Fried foods or those with high saturated fats
  • Refined sugar
  • Nutrasweet (aspartame) and monosodium glutamate (MSG)
  • Cigarettes and other tobacco products

Other factors can disturb your sleep, which will make you feel worse. You should try to avoid:

  • Caffeine
  • Alcohol
  • Candy/sugary foods

A note on caffeine: While many people with these conditions believe caffeine is essential for helping them wake up and have energy, it's important for you to look at it as a possible barrier to better sleep. While you may have withdrawal symptoms and feel more tired for a little while, if eliminating caffeine helps you sleep better it will be well worth it in the long run.

You can find a lot of claims online that a gluten-free diet may alleviate symptoms. This may be true for some people, but research hasn't given us definitive answers about how effective it is (or isn't.) See what we do know: Should You Be Gluten Free?

For more on finding food sensitivities, see The Elimination Diet for FMS & ME/CFS.

Raising Available Serotonin

Serotonin is a neurotransmitter that's involved in several processes in your brain, including pain perception, sleep regulation and feelings of well being. Abnormal serotonin levels are linked to both FMS and ME/CFS, as well as depression, which is a common result of any chronic pain condition. (Neither FMS nor ME/CFS is caused by depression.)

To raise serotonin levels through food, you can try eating:

  • Carbohydrate-rich foods, especially before bed
  • Complex carbohydrates (grains, beans and many starchy foods)
  • Dark chocolate (considered healthy only in small amounts)

As with everything else, you'll have to experiment to see what works best for you.

Also See:

  • (Up next - controlling inflammation.)

Inflammation

The medical community hasn't considered fibromyalgia an inflammatory condition, but more and more research suggests that inflammation -- possibly low-grade but widespread inflammation -- may play an important role in our pain and other symptoms. Chronic fatigue syndrome is believed to have an inflammatory component as research shows an association with pro-inflammatory cytokines. Further, many of our comorbid conditions do cause inflammation, which in turn causes more pain.

A lot of people with these conditions take NSAIDs (non-steroidal anti-inflammatories) such as Advil (ibuprofen) and Aleve (naproxen), but these drugs can have negative long-term effects on your health and may interact with other medications you're taking. Instead, you can reduce inflammation by adding foods containing natural anti-inflammatories to your diet. The best researched ones include:

  • Flavonoids: Apples, grapes, cranberries and strawberries
  • Carotenoids: Carrots, citrus fruits, tomatoes*, peppers*, dark leafy greens, corn, pumpkin and beets
  • Turpenes: Citrus, spinach, tomatoes*
  • Allyl sulfides: Garlic, chives, leeks and onions
  • Isothiocyanates: Cabbage, cauliflower, broccoli, bok choy, kale, turnips, mustard greens and chard

*These foods are in the nightshade family, which have long been suspected of increasing the symptoms of arthritis. This belief has carried over into FMS and ME/CFS has well. While we lack conclusive evidence that they're harmful in any of these conditions, some nightshades (also called solanaceae) contain acetylcholine. Limited evidence suggests that acetylcholine may worsen cardiac symptoms of ME/CFS.

Fish oil and the spices ginger and turmeric can help fight inflammation as well, and fish oil has the added benefit of being a natural antidepressant.

Getting Started with Good Nutrition

If you're feeling overwhelmed and don't know how to get started, here are more resources that can help you:

  • Look up foods and get help planning your diet with About.com's Calorie Count.

Don't forget that your doctor is an important resource when it comes to nutrition. Talk to him/her about any changes you make and what results they have. You might also want to see a nutritionist who can help you plan meals and change your eating habits for the better.

Sources:

Ciappuccini R, et al. Clinical and experimental rheumatology. 2010 Nov-Dec;28(6 Suppl 63):S131-3. Aspartame-induced fibromyalgia, an unusual but curable cause of chronic pain.

Khan S, Spence V, et al. Clinical physiology and functional imaging. 2003 Sep;23(5):282-5. Prolonged acetylcholine-induced vasodilatation in the peripheral microcirculation of patients with chronic fatigue syndrome.

Liptan GL. Journal of bodywork and movement therapies. 2010 Jan;14(1):3-12. Fascia: A missing link in our understanding of the pathology of fibromyalgia.

Smith JD, et al. The Annals of pharmacotherapy. 2001 Jun;35(6):702-6. Relief of fibromyalgia symptoms following discontinuation of dietary excitotoxins.

2008 National Fibromyalgia Association. All rights reserved. "Nutritional Treatments for Fibromyalgia" and "Eat Your Pain Away!"

2007 The Trustees of Columbia University. All rights reserved. "Serotonin and foods?"

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