If you’re one of millions of Americans living with fibromyalgia, then you already know how insidious fibro flares can be. Not only must you endure chronic muscle pain, fatigue, “brain fog,” difficulty sleeping, and more; sometimes, for no obvious reason, the number of symptoms increase or existing symptoms become increasingly intense. These “flares” or “flare ups” can last from only a day or two to weeks or even months. Worst of all, it’s hard to prepare for them: first, because it’s extremely difficult to figure out what your individual triggers are. Second, because even if you can determine your individual triggers, they’re often things that are difficult if not impossible to avoid: things like stress, traveling, illness, or changes in weather.
Still, just because you have fibromyalgia doesn’t mean you have to live in fear of symptom flares. Instead, there are several steps you can take in order to prevent your flares—or at least, to significantly decrease their length and intensity. Here, I’ll discuss a few of the most effective proactive steps you can take.
1.) Diet and Nutrition
As indicated above, one of the reasons fibromyalgia is so difficult to understand and to manage is that it affects just about every part of your body in some way or other. Symptoms and causes are interrelated; drugs that help one symptom end up worsening another, and so on. Still, there is hope: because fibromyalgia tends to affect your whole body, managing you whole-body health can help to reduce symptoms and fend off flares. According to Lynne Matallana, founder and president of the National Fibromyalgia Association, “With fibromyalgia, one of the most important things is to improve your overall health and well-being.” Granted, that’s rather vague advice—but, one of the easiest ways to improve your overall health and wellbeing is through a combination of the psychological techniques mentioned above, and the maintenance of a healthy diet and exercise regimen.
Now, when I talk about “diet,” I don’t mean that you have to go on a diet diet (although if you are overweight, losing just a few pounds can put less stress on your body—something doubly important for people with fibromyalgia—and potentially decrease the intensity of your symptoms). For the most part, losing weight shouldn’t be the primary focus of the fibromyalgia diet (though note the caveat just mentioned). This is especially worth noting if you’re on one of several of the most common non-narcotic prescription medications for fibro (e.g., Cymbalta, Lyrica), as these drugs can make losing weight next to impossible without compromising your health. When you have fibromyalgia, it’s especially important to think of food not in terms of calories, but in terms of what that particular food will do for your body.
First, and probably most importantly, focus on filling your diet with fruits and vegetables. Fruits and veggies tend to contain more fiber, nutrients, and antioxidants than any other foods. According to some studies, fibromyalgia is caused (at least in part) by the destruction of muscle and mitochondrial tissue by free radicals—and antioxidants found in certain fruits and veggies can destroy these free radicals and even repair their resulting damage. In addition, fiber can help with IBS—a common though unwelcome companion of fibromyalgia’s.
In addition, be sure to eat plenty of lean proteins: after all, there’s evidence that fibromyalgia actually damages muscle tissue (at least partially responsible for widespread muscle pain), and protein can help to build that tissue back up. In addition, protein tends to stabilize your blood sugar, helping to resist fatigue by preventing a sugar crash. Relatedly, avoid foods that do tend to cause sugar crashes (or any rapid bodily changes): for example, sugary foods, sugar substitutes, simple carbs (e.g., highly processed white bread), caffeine, and alcohol. As discussed above, people with fibromyalgia can’t cope with quick changes in body function; these quick changes can even cause flare ups. By avoiding these foods, you actually reduce the risk of fibro flares.
2.) Vitamins and Supplements
There are some important vitamins and nutrients that you can’t get from food alone, however—perhaps there’s not enough of that nutrient available, or perhaps that nutrient, in its food-based form, has a low bioavailability (meaning that it isn’t digested well and as a result can’t be used by your body). In these cases, it’s beneficial to take vitamins and supplements in order to help your body and reduce your symptom flares.
In fact, recent studies have shown that people with fibromyalgia tend to have multiple vitamin deficiencies. Though it isn’t clear yet whether these vitamin deficiencies actually cause fibromyalgia, there’s increasing evidence that treating these deficiencies can greatly improve your symptoms and even help to avoid flare ups. Some of the most important supplements you can take to balance out your body’s store of nutrients include alpha lipoic acid, a combination of magnesium and malic acid, omega 3 fatty acids, Acetyl-L-Carnitine, Coenzyme Q10 (CoQ10), SAM-e, a B-vitamin complex, and vitamin D. There are multiple homeopathic remedies recommended as well, especially in combination with the vitamins, antioxidants, and other nutrients listed above—these include turmeric, cat’s claw, rhodiola, and more. Though individual mechanisms of action have been discovered for some of these supplements, trials show that the greatest effect is in combination.
Fortunately for those people with fibro attempting to sort their way through these myriad supplements, there’s finally an alternative solution to multiple nutrient deficiencies and incomplete information. The Fibromyalgia Treatment Group—after multiple clinical trials on individual supplements as well as multiple supplements in combination—has developed a sort of fibromyalgia-specific multivitamin that includes the nutrients listed and more. They’ve also made sure to include the preferred dose of each nutrient for fibro treatment in that nutrient’s most bioavailable form. It’s a revolutionary way for people with fibromyalgia to receive guaranteed doses of all necessary nutrients without purchasing an entire medicine cabinet’s worth of products! (The Fibromyalgia Treatment Group even offers a one-year, 100% money back guarantee, just in case this all sounds too good to be true.)
In any case, whether you take a multivitamin or multiple vitamins, adding supplements to your healthy, fibromyalgia-geared diet can help to balance out your body’s store of nutrients. This balance both reduces symptoms and dramatically decreases flares.
3.) Stress and Emotional Well-being
It shouldn’t be surprising that mental and emotional health can have a serious impact on physical health, and vice versa. This is especially true of people with fibromyalgia, who often demonstrate abnormal levels of certain hormones and brain chemicals. For example, some people with fibromyalgia have abnormally low levels of serotonin, a brain chemical that is associated with feelings of wellbeing, decreased sensitivity to pain, deep sleep—and other important functions that are severely lacking in fibro sufferers. Similarly, many people with fibromyalgia have abnormal levels of the stress hormones norepinephrine and cortisol. When these hormone levels are low, it’s much harder for your body to respond to stressors—both psychological and physical. Low levels of these chemicals can also contribute to depression and sleep troubles.
Before continuing, however, please note: I don’t intend to suggest that stress, anxiety, depression, and so on actually cause fibromyalgia, nor do I intend to suggest that fibromyalgia is nothing more than a psychological problem! Though some doctors still subscribe to such myths, unfortunately, these misconceptions have been definitively disproven. Still, psychological factors—especially stress—can make already existing fibromyalgia worse, meaning that keeping your stress levels in check can help you avoid a flare up.
Of course, avoiding stress is easier said then done—especially when you’re trying to deal with a chronic disease on top of an already full life! Many fibromyalgia researchers note that people with fibro tend to put too much pressure on themselves. You don’t want to appear incapable, so you focus all your energy on your career, or your family, or both. While the following advice is important for everyone, it’s doubly so for those suffering from fibromyalgia, as your body simply isn’t capable of dealing with stress: you have to take some time for yourself. Set aside some amount of time every day, and don’t let anyone or anything take this time away from you. Use this time to do something that makes you feel good, no matter what it is: curl up with a book and some tea, go for a walk in the woods by yourself, take a long, hot bath, watch your favorite guilty pleasure show… etc.
In addition, some light exercise—especially yoga, tai chi, and swimming (all of which help stretch out sore muscles without putting too much physical stress on your body)—can increase endorphins and serotonin, evening out your brain chemicals naturally and decreasing stress as a result. In addition, treatments such as cognitive behavioral therapy (CBT), relaxation therapy, and biofeedback therapy can help you re-learn your stress responses. By decreasing stress, you might notice changes in your symptoms (as well as decreased flare ups!): lowered stress can improve sleep and daily fatigue, decrease depression, and more.
Finally, one of the most important things you can do in order to control your flares is to keep a journal. Write in it every day, no matter how trivial your entries might seem: write down everything you did, everything you ate, anything that was worrying you, any weather changes, dietary changes, medication changes, and so on. Over time, you’ll be able to track relationships between symptom flares and things like weather, diet, stress, etc.—all of which will be carefully tracked in your journal. Note that flares don’t necessarily occur immediately after being triggered; it can take up to 48 hours for a trigger to cause a full-blown flare. Still, if you’re careful with your journal, you should start to notice patterns like this over time. Once you know what your triggers are, you’ll have a better chance of avoiding (or at least preparing for) those triggers, which means you’ll have an even better chance of avoiding a fibro flare up.
Even if you never determine a clear pattern between triggers and flares (which isn’t unusual, since there are so many factors involved and so many interrelated symptoms in every individual case of fibromyalgia), keeping a journal will enforce accountability. For example, if you know that you have to write down everything you eat in your journal, maybe you’ll stray less frequently from a fibro-friendly diet. Similarly, you might be more likely to go for that walk, to restock your supplements, to go to bed early, etc. After all, it’s harder for people with fibromyalgia to deal with change: even seemingly insignificant things like a slightly altered sleep schedule or one day of missed supplements can throw your body into turmoil. Keeping a journal regularly can help you maintain regularity in the rest of your coping mechanisms as well.