Fibromyalgia and the link to gut health

If you’re one of the 3.5 million people in the UK living with fibromyalgia¹ you’ll know how much this condition can affect every aspect of day-to-day life. Fibromyalgia is not a degenerative disease and does not cause long-lasting damage to the body. However, widespread pain and fatigue, amongst other symptoms, can significantly affect a person’s ability to work, social life, sleep, mobility and mental well-being.

Current treatments such as pain medication, physical therapy, and CBT provide only basic management of this chronic condition; however, emerging research shows a link to the health of the gut, which could be a potential area of treatment. This article explores the connections between the gut microbiome and fibromyalgia.

Diagnosis and Symptoms

A diagnosis of fibromyalgia is based on symptoms of chronic pain in multiple areas of the body for more than three months (where other possible conditions have been ruled out).²

Symptoms vary from person to person and range from mild to severe. Some people also experience flare-ups and periods of remission.

Symptoms include:

Fatigue, low tolerance to exercise
Stiffness
Headaches
Poor sleep
Food intolerances, digestive issues, IBS
Depression, irritability, feeling low
Cognitive dysfunction (forgetfulness or poor concentration, “brain fog”)
Anxiety, increased stress, worrying
Increased sensitivity to cold, sound and touch
Pins and needles/numbness

Causes of Fibromyalgia

There has been much debate about the cause of fibromyalgia. Primarily, it has been linked to dysfunction within the central nervous system, causing disturbances in how the brain processes pain and other sensory information³⁴.

The NHS describes the origins of fibromyalgia as ‘abnormal pain messages’ and ‘chemical imbalances’ to explain symptoms of chronic pain, sleep problems, fatigue and digestive issues.⁵

However, scientists are looking at the gut as an area of focus –

Links with the gut

Gut bacteria influence many areas of human health, including the immune system and the brain. A balanced microbiome has a positive influence, however, imbalances in this delicate ecosystem (gut dysbiosis) can have wide-ranging effects on many systems throughout the body.

Recent research points towards the immune system in general and, more specifically, antibodies as the likely cause of fibromyalgia. Scientists have identified certain antibodies that “increase the activity of pain-sensing nerves throughout the body, resulting in increased pain sensitivity, muscle weakness, and reduced movement“.⁶.

A review carried out by the Institute of Pain, published in 2020, noted an altered composition of gut bacteria in patients with fibromyalgia and the subsequent effects that a loss of microbial balance has on the immune system, metabolism and cognitive health. They found “significant differences in the overall composition of the gut microbiome between fibromyalgia patients and healthy controls“.⁷.

As a result of this research, some scientists believe that fibromyalgia is a condition of the immune system and, indeed, the gut microbiome. 70% of the body’s immune cells are located in the lining of the gut therefore these two systems are intricately related.

Friendly gut bacteria interact constantly with the immune system, signalling when and how it should respond via their production of short-chain fatty acids such as butyrate.⁸⁹ Certain bacterial species may affect pain, fatigue, mood and other symptoms due to these short-chain fatty acids, bile acids, neurotransmitters and bacterial antigens entering the bloodstream.¹⁰ The review by the Institute of Pain found that fibromyalgia patients had a lower level of butyrate-producing bacteria such as Faecalibacterium p.¹¹

There is a scientifically accepted link between the gut and the brain. Gut microbes help produce neurotransmitters like serotonin, dopamine and GABA, all of which have an effect on mood, energy levels, pain perception and digestive function. This bidirectional communication pathway between the gut and the brain, enables gut bacteria to influence the function of CNS circuits.¹²

How do you bring back balance to the gut microbiome?

The aim is to replenish the gut with an abundance of friendly bacteria, increase microbial diversity and prevent the growth of harmful bacteria. The goal is to build a resilient community of microbes that can withstand the effects of modern living. To do this, we recommend a gut-health protocol – Kefir, Prebiotics and Collagen:

Eat fermented foods each day such as Kefir, kimchi, sauerkraut, miso, tempeh, and probiotic yoghurt. Kefir contains numerous strains of Lactobacillus, which produce lactic acid – a substance that inhibits the growth of pathogenic bacteria.
Reduce intake of sugar and processed foods – these can damage the gut lining and encourage the growth of pathogenic bacteria.¹³
Eat a diverse range of fibre-rich plant foods (pulses, legumes, nuts, seeds, whole grains, fruits, vegetables, herbs and spices). Prebiotic fibres provide the fuel for beneficial bacteria to thrive.¹⁴
Include as many different colours as possible: plant nutrients such as polyphenols also help to encourage the growth of good bacteria.
Take collagen, which has been shown to support a healthy gut lining.