Whether a person is checking nutrition labels at the grocery store or asking a restaurant server detailed questions, careful monitoring is needed to avoid triggering sensitivities to food ingredients.

See What You Need to Know About Fibromyalgia

Gluten, caffeine, lactose and food additives such as monosodium glutamate (MSG) and aspartame are often used in surprising ways.

Avoiding Gluten to Relieve Symptoms

People with fibromyalgia have a heightened sensitivity to the environment at large, which includes food and food additives. Gluten intolerance affects a large number of people, both with and without fibromyalgia.

See How Gluten Can Cause Joint Pain

Gluten is a protein in wheat, rye, and barley. It is also used in a number of other food products and medications. One small research study of people with fibromyalgia showed improvements in symptoms when study participants changed to a gluten-free diet. 1 Isasi C, Colmenero I, Casco F, et al. Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia. Rheumatol Int. 2014;34(11):1607-12.

See An Anti-Inflammatory Diet for Arthritis

Major reductions in widespread pain were noted in all participants, and a majority experienced significant improvement in other fibromyalgia symptoms. A few participants who had been taking opioid medications stopped taking them because their symptoms had eased. In some cases, the improvement was clear after a few months.

See Medications to Ease Fibromyalgia Symptoms

Participants in the study had non-celiac gluten sensitivity, a condition in which a patient has symptoms consistent with celiac disease, but test results do not show celiac disease. Checking food labels carefully is crucial to completely eliminate gluten from the diet, since gluten is used so widely.

See Celiac Disease and Low Thyroid vs. Fibromyalgia

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Other Ingredients to Watch

The following ingredients can also have a major impact on fibromyalgia symptoms for some individuals:

  • Aspartame and monosodium glutamate (MSG). The artificial sweetener aspartame (brand names NutraSweet and Equal) prompts an inflammatory response in the body and has been associated with triggering fibromyalgia-type problems, though research has been mixed. 2 Ciappuccini R, Ansemant T, Maillefert JF, Tavernier C, Ornetti P. Aspartame-induced fibromyalgia, an unusual but curable cause of chronic pain. Clin Exp Rheumatol. 2010;28(6 Suppl 63):S131-3.

    One study suggested that both aspartame and the flavor-enhancer MSG, which also promotes inflammation, may contribute to fibromyalgia and irritable bowel symptoms in people with both conditions. 3 Holton KF, Taren DL, Thomson CA, Bennett RM, Jones KD. The effect of dietary glutamate on fibromyalgia and irritable bowel symptoms. Clin Exp Rheumatol. 2012;30(6 Suppl 74):10-7. MSG is common in Asian cooking, but is also used in many other foods.

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  • Caffeine. Getting deep, restorative sleep is crucial to easing stress and minimizing the pain of fibromyalgia. Caffeine is well known for interfering with sleep, however. If a person feels too fatigued to skip caffeine completely, it is best to limit it to the morning.
  • Ingredients in milk. Lactose and other ingredients in milk and other dairy products cause digestive problems for some people with fibromyalgia. Lactose-free milk, milk alternatives, and kefir may be helpful substitutes. When lactose intolerance is not severe, aged cheeses and yogurt that includes live active cultures may be tolerated.

See The Ins and Outs of an Anti-Inflammatory Diet

If a major source of nutrients, such as gluten, is removed from the diet, other healthy options should be added to avoid nutritional deficiencies. Rice, corn, and products specifically designed to be gluten-free, for instance, can compensate for the lack of gluten.

See What Are Anti-Inflammatory Foods?

Nutritional supplements are sometimes recommended to make up for any potential lack of nutrients when these foods are dropped from the diet. It is ideal, however, to find food sources whenever possible rather than rely on supplements.

See Dietary Supplements for Treating Arthritis

  • 1 Isasi C, Colmenero I, Casco F, et al. Fibromyalgia and non-celiac gluten sensitivity: a description with remission of fibromyalgia. Rheumatol Int. 2014;34(11):1607-12.
  • 2 Ciappuccini R, Ansemant T, Maillefert JF, Tavernier C, Ornetti P. Aspartame-induced fibromyalgia, an unusual but curable cause of chronic pain. Clin Exp Rheumatol. 2010;28(6 Suppl 63):S131-3.
  • 3 Holton KF, Taren DL, Thomson CA, Bennett RM, Jones KD. The effect of dietary glutamate on fibromyalgia and irritable bowel symptoms. Clin Exp Rheumatol. 2012;30(6 Suppl 74):10-7.

Dr. Vijay Vad is a sports medicine specialist at the Hospital for Special Surgery in New York, where he specializes in back pain, knee arthritis, frozen shoulder, and general sports medicine. He previously served as a physician for the professional men’s tennis circuit and on the Westchester Classic of the PGA Tour.

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