Fibromyalgia is a chronic pain disorder in which patients experience muscle aches and tender points in various locations. The cause is multifactorial with poor nutrition playing a major role.

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Fibromyalgia affects nearly 2% of the general population, with middle-aged women experiencing a higher risk.1 It is considered to be the most common cause of generalized pain in women between ages 20 and 55. Many of these patients struggle with work-related disability due to pain, fatigue, and depression.

Fibromyalgia is a diagnosis of exclusion, which means all other diagnoses causing similar symptoms need to be ruled out. Patients with fibromyalgia experience generalized aches, throbbing, burning or stiffness at three different anatomical sites for at least three months. On exam, they have multiple reproducible tender points. They can also experience generalized fatigue, sleep disturbance, neurological or psychological complaints such as mood disorders, numbness or tingling of extremities, joint swelling, chronic headaches, jaw or facial pain, bladder pain, irritable bowel syndrome, and a variation of symptoms with changes in activity, weather, or stress.

There is no single cause of fibromyalgia. It is thought to be due to a change in pain perception, known as “central sensitization.” Certain people may be genetically predisposed to this change in pain perception, and it may be triggered by various stressors, such as physical or emotional trauma, infections, poor sleep habits, hormone dysregulation, and years of eating the Standard American Diet. This low-nutrient diet causes damage to the gut lining resulting in increased intestinal permeability and small intestine bacteria overgrowth which contributes to the hypersensitivity experienced by patients. With a Nutritarian diet, patients improve and most resolve their symptoms.

  1. Chakrabarty S, Zoorob R. Fibromyalgia. Am Fam Physician 2007, 76:247-254.

Action Plan


  • A Nutritarian diet, with its high micronutrient density, includes a broad variety of vitamins, minerals, and phytochemicals to help heal the gut, regulate hormones, and boost the immune system. This diet-style has helped numerous patients resolve their fibromyalgia symptoms entirely. The addition of green juicing and/or green smoothies may aid resolution of the condition by enhancing tissue isothiocyanates and other phytochemicals that enhance cellular detox and repair.
  • Food sensitivities may play a role in producing symptoms. An elimination of gluten and dairy, the two most common allergenic foods, may be beneficial for a time period of 2-4 months.
  • Supplement appropriately following my general guidelines to assure sufficiency of Vitamin D, zinc, DHA, iodine, and B12. Probiotics can also be helpful for many with fibromyalgia and should be added for the initial period until improvements are noted.


Exercise regularly as appropriate to individual tolerance. Tai chi for example, has demonstrated benefits in patients with chronic pain syndromes through its adaptive exercise, mind-body interaction, and meditation.1


  • Aim for 7-8 hours of sleep per night, making sure to go to bed at the same time each night in a completely dark room. Expose yourself to bright light early in morning soon upon awakening.
  • Avoid stimulants like caffeine or nicotine, and do not eat 2-3 hours prior to bedtime.
  • Keep a consistent relaxing bedtime routine avoiding any stressful, stimulating activity. Use the bed only for sleeping, not for reading or watching TV.
  • Avoid naps during the day which will disrupt the sleep-wake cycle.

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  1. Peng PW. Tai chi and chronic pain. Reg Anesth Pain Med 2012, 37:372-382.

Ask The Doctor

The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)


I suffer from fibromyalgia, and my pain is really overwhelming most of the time. My doctor suggested to me that I try the drug Lyrica. I rarely agree to take meds because of the side effects, but I’ve read that this has quite good results for fibromyalgia sufferers. I would like to be free from the constant pain I suffer but wondered what you think of this medication?


Some patients experience improvement, but as you note, you risk side effects. Lyrica is a risky drug that causes weight gain and can have long-term dangers and toxicities, which is the opposite of the results you are looking for to be rid of this problem, long-term. Only nutritional excellence can enable a complete recovery, not adding more toxins to your overly toxic body. Using toxic drugs for some pain relief makes your disease more serious with time. We need to clean out the toxins in your tissues to get well, not add more.

Fibromyalgia can also be related to gut/immune dysfunction. My experience is that almost everyone with fibromyalgia recovers and becomes pain-free after adjusting to a Nutritarian diet and healing the gut. That means eating G-BOMBS—raw green vegetables, beans, onions, cooked mushrooms, berries, and seeds to improve immune function, facilitate detoxification, and support the growth of favorable gut bacteria. Taking probiotics can be helpful in the initial stages of improvement.