Health Condition
Fibromyalgia
5-HTP
Supplementing with 5-HTP may ease symptoms.Dose:
100 mg three times per day5-HTPPeople with fibromyalgia often have low serotonin levels in their blood.4,5,5 Supplementation with 5-HTP may increase serotonin synthesis in these cases. Both preliminary7,8 and double-blind trials9 have reported that 5-HTP supplementation (100 mg three times per day) relieves some symptoms of fibromyalgia.
Acetyl-L-Carnitine
Supplementing with acetyl-L-carnitine may improve musculoskeletal pain, depression, and general health in people with fibromyalgia.Dose:
1,500 mg daily for ten weeksAcetyl-L-CarnitineIn a double-blind trial, supplementation with acetyl-L-carnitine in the amount of 1,500 mg per day for ten weeks was significantly more effective than a placebo in improving musculoskeletal pain, depression, and general health in people with fibromyalgia.9
Coenzyme Q10
In a preliminary trial, headaches and overall symptoms in people with fibromyalgia significantly improved after supplementing with coenzyme Q10.Dose:
Refer to label instructionsCoenzyme Q10In a preliminary trial, supplementing with coenzyme Q10 (100 mg three times per day for three months) resulted in significant improvements in headaches and overall symptoms in patients with fibromyalgia.10 In another study, cellular levels of CoQ10 were significantly lower in women with fibromyalgia than in healthy women. In the same study, ten women with fibromyalgia received 300 mg of CoQ10 per day for three months. Significant improvements were seen in symptoms such as fatigue, pain, depression, and anxiety.11 A placebo-controlled trial confirmed that CoQ10, in the amount of 100 mg 3 times per day, can improve depression in people with fibromyalgia.12SAMe
Supplementing with SAMe may increase serotonin levels in the blood and help relieve symptoms.Dose:
800 mg dailySAMeIntravenous SAMe (S-adenosylmethionine) given to people with fibromyalgia reduced pain and depression in two double-blind trials;13,14 but no benefit was seen in a short (ten-day) trial.15 Oral SAMe (800 mg per day for six weeks) was tested in one double-blind trial and significant beneficial effects were seen, such as reduced pain, fatigue, and stiffness, and improved mood.16
Vitamin D
In a double-blind study of women with fibromyalgia who had low or moderately low blood levels of vitamin D, supplementing with vitamin D improved pain, compared with a placebo.Dose:
Refer to label instructionsVitamin DIn a double-blind study of women with fibromyalgia who had low or moderately low blood levels of vitamin D (25-hydroxyvitamin D), supplementing with vitamin D for 24 weeks improved pain, compared with a placebo. The amount of vitamin D used was 1,200 to 2,400 IU per day, depending on the blood level of vitamin D. The amount given was adjusted during the study, to maintain blood levels of vitamin D between 32 ng/ml and 48 ng/ml.17Magnesium
A preliminary trial found that a combination of magnesium and malic acid might lessen muscle pain in people with fibromyalgia.Dose:
Refer to label instructionsMagnesiumIn a preliminary trial, supplementing with 300 mg per day of magnesium (as magnesium citrate) improved symptoms in women with fibromyalgia.18 Another preliminary trial found that a combination of magnesium and malic acid might lessen muscle pain in people with fibromyalgia.19 The amounts used in this trial were 300–600 mg of elemental magnesium and 1,200–2,400 mg of malic acid per day, taken for eight weeks. A double-blind trial by the same research group using 300 mg magnesium and 1,200 mg malic acid per day found no reduction in symptoms, however.20 Though these researchers claimed that magnesium and malic acid appeared to have some effect at higher levels (up to 600 mg magnesium and 2,400 mg malic acid per day), the positive effects were not demonstrated under blinded study conditions. Therefore, the evidence supporting the use of these supplements for people with fibromyalgia remains inconclusive.Malic Acid
A preliminary trial found that a combination of magnesium and malic acid might lessen muscle pain in people with fibromyalgia.Dose:
Refer to label instructionsMalic AcidA preliminary trial found that a combination of magnesium and malic acid might lessen muscle pain in people with fibromyalgia.21 The amounts used in this trial were 300–600 mg of elemental magnesium and 1,200–2,400 mg of malic acid per day, taken for eight weeks. A double-blind trial by the same research group using 300 mg magnesium and 1,200 mg malic acid per day found no reduction in symptoms, however.22 Though these researchers claimed that magnesium and malic acid appeared to have some effect at higher levels (up to 600 mg magnesium and 2,400 mg malic acid), the positive effects were not demonstrated under blinded study conditions. Therefore, the evidence supporting the use of these supplements for people with fibromyalgia remains weak and inconclusive.
Melatonin
In one study, supplementing with melatonin reduced tender points and improved sleep in people with fibromyalgia.Dose:
Refer to label instructionsMelatoninMelatonin supplementation may be useful in the treatment of fibromyalgia. In a preliminary trial, 3 mg of melatonin at bedtime was found to reduce tender points and to improve sleep and other measures of disease severity, though pain and fatigue improved only slightly.23
Tart Cherry
Tart cherries contain antioxidants and anti-inflammatory substances that may reduce muscle pain.Dose:
80 mg anthocyanins, the equivalent of approximately 100–120 cherries, 16–24 ounces tart cherry juice blend, 1 ounce of liquid concentrate, or 400 mg of concentrate in tablets or capsulesTart CherryTart cherries contain antioxidants and anti-inflammatory substances that may reduce muscle pain,24,25 and double-blind research in athletes has shown pain-reducing properties of tart cherry preparations.26,27 In a small double-blind study, women with fibromyalgia drank 10.5 ounces twice daily of either tart cherry juice (equivalent to 100 to 120 cherries or 80 mg of anthocyanins per day) or a placebo juice for ten days prior to performing a session of intense elbow flexion exercise. While about one-third of the women reported significantly less elbow muscle pain when using tart cherry juice before exercise, the average effect in the overall group was no better than with the placebo.28Vitamin B1
People with fibromyalgia may be deficient in vitamin B1. Supplementing with the vitamin may correct the deficiency and improve symptoms.Dose:
Refer to label instructionsVitamin B1Some studies have found low vitamin B1 (thiamine) levels and reduced activity of some thiamine-dependent enzymes among people with fibromyalgia.29,30 The clinical significance of these findings remains unknown.
Vitamin E
Vitamin E was used in one early study with beneficial and sometimes dramatic results.Dose:
Refer to label instructionsVitamin EOne early preliminary study described the use of vitamin E supplements in the treatment of “fibrositis”—the rough equivalent of what is today called fibromyalgia. Several dozen individuals were treated with vitamin E using amounts ranging from 100–300 IU per day. The results were positive and sometimes dramatic.31 Double-blind trials are needed to confirm these preliminary observations.
Holistic Options
Stress is believed by some researchers to be capable of aggravating fibromyalgia symptoms. Stress-reduction techniques, such as meditation, have proven helpful in preliminary research.32
Acupuncture may be useful for short-term relief of fibromyalgia symptoms. In one preliminary trial, acupuncture produced a significant decrease in pain and point tenderness along with related biochemical changes measured in the fibromyalgia patients’ blood.33 Another uncontrolled trial used electroacupuncture (acupuncture with electrical stimulation) treatment in people with fibromyalgia who were unresponsive to conventional medical therapies. After an average of seven treatments per person, 46% claimed that electroacupuncture provided the best relief of symptoms when compared to all other therapies, and 64% reported using less medication for pain relief than prior to electroacupuncture.34 A double-blind trial compared fake acupuncture to electroacupuncture and reported significant differences in improvement in five of eight outcome measurements among people with fibromyalgia.35 Short-term pain reduction in people with fibromyalgia has been reported in other studies, some of which were at least partially controlled; however, long-term benefits have never been investigated in a controlled clinical trial.36 Long-term controlled trials are necessary to conclusively determine whether acupuncture is a useful treatment for fibromyalgia.
Joint manipulation, chiropractic, and related treatments may be helpful for relieving some of the symptoms of fibromyalgia. A preliminary study37 found that almost half of people with fibromyalgia who received chiropractic care had “moderate to good” improvement. A small preliminary trial38 evaluated the effect of four weeks of chiropractic treatment (three to five times per week) consisting of soft tissue massage, stretching, spinal manipulation, and general advice and information. Treatment resulted in a significant decrease in pain and an increase in range of neck movement, but there was no improvement in tender points or in ability to function in daily life. Another preliminary trial39 evaluated a longer treatment period (30 sessions) consisting of spinal manipulation and deep pressure massage to tender points in the muscles. More benefit was reported by this study, as 60% of the patients experienced significant pain reduction, reduced sensed of fatigue, and improved sleep. These benefits persisted one month after the treatment was completed. People who did not feel better after 15 treatments were not likely to benefit from this type of treatment. No controlled research has evaluated manipulation therapies for fibromyalgia.