Probiotics for Fibromyalgia: Help Your Gut Help You to Boost Immunity and Relieve Anxiety

Can probiotics help treat fibromyalgia? According to science, probiotics can strengthen the immune system, which is compromised in people with fibromyalgia. Probiotics may help relieve stress, anxiety and depression– which are common symptoms in fibromyalgia. In other words, take care of you gut, and it will take care of you!

Probiotics for Fibromyalgia: Help Your Gut Help You

Can probiotics help treat fibromyalgia? Despite all the research being done on friendly gut bacteria, there are actually no studies to date that directly answer that question. But when you dig into the science a little deeper, you can find a wealth of studies that support the use of probiotics to treat fibromyalgia symptoms. In other words, take care of your microbiome (the ecosystem of gut bacteria), and it will take care of you!

Probiotics Can Get Your Immune System into Fighting Shape

Ever since I developed fibromyalgia, I dread getting sick. Infections trigger flare-ups at best and relapses at worst. Many people with chronic illnesses report getting sick more frequently than when they were healthy, and believe that their immune systems are compromised.

This is supported by the science. In the case of fibromyalgia, researchers were able to develop a test for diagnosing the illness by examining cellular immunity. The study proved that people with fibromyalgia have disregulated immune function at the cellular scale. Participants with fibromyalgia were found to have increased chemical messengers called cytokines, which are involved in activating inflammation in the body (Sturgill, et al. 2014).

Strengthening the immune system using different means, including by taking probiotics, seems like a really good idea in the face of this kind of evidence. Up to 70% of the immune system’s activities occur in the digestive tract. There are more than 400 species of bacteria in the gut, which altogether add up to more than 100 trillion bacterial cells. So how do probiotics help keep your immune system in fighting shape?

  • Probiotics protect the lining of your intestines from harmful germs and toxins (Yan et al., 2011). They promote the health and integrity of the cells that line the barrier wall of the gut, keeping germs and toxins from being absorbed into the bloodstream. In the intestines, friendly bacteria compete with harmful bacteria, preventing them from growing out of control. Some probiotics even produce substances to kill harmful bacteria – this is a take no prisoners kind of fight!
  • Probiotics communicate with the immune system to strengthen its response to infections and enhance its repair of intestinal damage. (If the nerd in you wants to know, probiotics interact with intestinal wall cells in complicated ways, such as by releasing signalling proteins that stimulate the immune system). Friendly bacteria can act like guards calling for backup, priming the immune system to prevent and treat diseases, like allergy, eczema and viral infections.

Probiotics May Help Relieve Anxiety and Depression

As people living with fibromyalgia and know all too well, the challenge of living with chronic pain on a daily basis is very stressful and raises difficult emotions. Depression commonly occurs alongside chronic pain (Holmes, 2012). Research has demonstrated that anxiety disorders are more common in patients with chronic pain conditions like arthritis, fibromyalgia migraine and chronic back pain (Asmundson, 2009).

What does this have to do with friendly bacteria? Scientists are beginning to uncover a fascinating gut-brain connection. There is exciting preliminary research on the potential benefits of probiotics for mental health. Researchers call these types of friendly bacteria “psychobiotics.” One study looked at the effect of consuming probiotics on depression versus a placebo. After eight weeks, participants who took the probiotic had significantly lower scores a depression inventory test, as well as lower levels of inflammation (University Health News). If you’re interested in knowing which strains were used so you can pick a similar supplement for yourself –this study used 2 billion CFUs each of Lactobacillus acidophilus, Lactobacillus casei and Bifidobacterium bifidum.

How can probiotics act like “chill pills”?

  • Some probiotics are able to produce the same kind of compounds that the nervous system uses as chemical messengers. For example, gut bacteria can produce serotonin, which is a feel-good neurotransmitter released in the brain and nervous system when we are happy.
  • Probiotics can help regulate inflammation in the body. As you may know, excessive inflammation is linked to many chronic diseases, including depressive disorders.
  • Friendly gut bacteria interact with our hormones, and may help to turn off the response of the stress hormones cortisol and adrenaline.

Take Care of Your Microbiome And It Will Take Care of You

It’s important to remember that research has only studied a few strains of probiotics, among the many thousands that make up the human microbiome. It’s clear that each type of bacteria causes different effects in the body. Some of these effects are contradictory – some probiotics turn up the activity level of the immune system, while others turn it down. The sheer complexity of it all makes it difficult to draw any hard and fast conclusions. What is clear, however, is that having a diverse and replenished microbiome improves overall health.

The best way to take care of your microbiome is to regularly consume fermented foods rich in probiotics, and to take a probiotic supplement. It’s also vital to consume foods that help to “feed” the probiotics in your gut. After all, friendly bacteria need to eat too. Some foods help to nourish probiotics more than others, and these foods are called prebiotics. Some of the best prebiotics to regularly include in your diet are: dandelion greens, garlic, onions, leeks, asparagus, unripe bananas, barley, oats, apples, flax seeds, wheat bran, seaweed and cocoa. Prebiotics are often better consumed raw and cooked.

The best fermented foods to incorporate into your diet are:

yogurt: preferably a natural yogurt without the high sugar content of flavoured yogurt

  • kefir: a fermented milk product like drinkable yogurt
  • kombucha: tastes like a fruit flavoured ice tea, and is a fermented black tea and sugar drink
  • sauerkraut or kimchee: both are types of fermented cabbage
  • miso: a savoury fermented soybean product, usually used to make soup
  • tempeh: a fermented soybean product with a nutty flavour


Asmundson, G. and Katz., J. (2009). Understanding the concurrence of chronic pain and anxiety: state-of-the-art. Depression and Anxiety (26)888-901.

Healthline (The 19 Best Prebiotic Foods You Should Eat)

Holmes, A., Christelis, N., and Arnold, C. (2012). Depression and chronic pain. MJA Open Suppl (4):17-20.

Psychology Today (Do Probiotics Help Anxiety?)

Psychology Today (The Gut-Brain Connection, Mental Illness, and Disease)

Sturgill, J. et al. (2014).Unique Cytokine Signature in the Plasma of Patients with FibromyalgiaJournal of Immunology Research.

University Health News (The Best Probiotics for Mood)

Yan, F., and D. B. Polk (2011). Probiotics and Immune Health. Current opinion in Gastroenterology 27 (6): 496-501.


Find other fibro blog posts on the Fibro Blogger Directory Friday Link-up

Digestively Challenged: Overcoming G.I. Tract Problems when you have a Chronic Illness

Digestively Challenged: Overcoming G.I. Tract Problems when you have a Chronic IllnessIs eating well with chronic illness a luxury? When I first got diagnosed, I thought so. The significant pain I was experiencing in the muscles around my shoulder blades made it impossible for me to chop, stir, or sauté a whole meal – basically, to cook. My partner was more than happy to help (as long as I showed him how!), but it felt unfair. After all, he was now supporting me financially and doing the majority of the housework – since laundry, vacuuming, scrubbing and dusting were similarly impossible for me. We tried to eat the healthiest convenient foods we could. Unfortunately, convenience isn’t healthy, at least when it comes to eating. In a previous post, I wrote about how my processed diet failed me, even though I was making supposedly healthy choices. In one year, I gained about 20 pounds, ate four times the daily recommended allowance for sugar, was woefully short on fruits and vegetables, ate too many servings of grain and too few servings of protein.

I also had hypoglycemic attacks if I did not eat on time. I remember that panicky feeling of being on transit, far away from a convenience store, and starting to feel shaky and sweaty.  I also developed a number of food intolerances.  I felt anxious about eating out or trying a new recipe for fear of having an ‘episode’.  Not only did I have unpleasant digestive symptoms but also strange neurological ones – sweating, pulse racing, excessive salivation, skin crawling, restless legs, and others.  It was these two problems that made me feel like I needed to understand what was going on in my body and to regain control over my eating. It’s important to begin with a good understanding of digestive problems that affect spoonies (people living with chronic illness).

Firstly, we need to avoid food intolerances (also known as food sensitivities). Food intolerances are defined as a physical reaction to eating certain foods, such as digestive symptoms like bloating, gas, diarrhea or constipation, or stomach cramps.[i] These reactions do not occur because of an immune response to a particular food – that would be defined as a food allergy. In the case of a food intolerance, some people may be able to eat a small amount of the trigger food without having a physical reaction, up until they reach a threshold level. Food intolerances may occur because of the absence of a necessary enzyme (such as lactase to break down lactose sugar in dairy), having irritable bowel syndrome, having a sensitivity to food additives, having a problem digesting certain carbohydrates (acronym FODMAPS), or for no known reason. Food sensitivities may be more common among people living with fibromyalgia and CFS/ME because of the overall sensitization of the central nervous system associated with these conditions. Research indicates that at least half of people with FM or CFS/ME experience significant relief by eliminating certain foods.

How can you figure out what foods you are sensitive to? Naturopathic doctors, integrative doctors and nutritionists can offer tests that pinpoint sensitivities. However, the least expensive way is to do an elimnation diet. You begin by cutting out the most common foods that cause intolerances and any foods that you are suspicious of for a period of time, usually 2 to 4 weeks. These foods may include: dairy, gluten, eggs, soy, corn, sugar, citrus, peanuts, shellfish, and coffee. Then you gradually reintroduce one food type at a time to notice your physical reaction. If your symptoms reappear, then you know you are sensitive to that type of food. In my case, I am intolerant of eggs, red meat, and to a lesser extent, wheat. I am also sensitive to high concentrations of fiber or resistant starch. The elimination diet is best done with the guidance of your healthcare professional.

A second problem associated with the digestive system and chronic illness is the development of Leaky Gut Syndrome. Essentially, leaky gut occurs when the lining of the intestines becomes more permeable, which allows particles of partially digested food or waste to leak into the bloodstream.[ii] Increased permeability occurs because of damage to the tight junctions between intestinal cells. When the immune system encounters foreign particles in the bloodstream, it launches a response, including inflammation. Symptoms of leaky gut syndrome include digestive symptoms, gas, bloating, diarrhea, fatigue, joint pain and rashes. In addition to chronic inflammation, leaky gut syndrome affects the ability to digest food and to absorb nutrients. Furthermore, it compromises the immune system by tying it up responding to foreign particles in the blood, which leaves it less able to respond to actual pathogens. The intestinal lining actually is a significant site of immune activity, but when it is damaged, overall immune function is impaired. How does the intestinal lining become damaged? Through food intolerance, stress, medication, flora imbalance and autoimmune disease. Emerging research shows that several autoimmune diseases share increased intestinal permeability as a characteristic[iii].

In terms of diet, the usual recommendations include treating Leaky Gut Syndrome through clean eating; in other words, avoiding commonly allergenic/intolerant foods, inflammatory foods, pesticides, herbicides, additives, or sugar and rebalancing intestinal flora by consuming probiotics. For autoimmune diseases in particular, some experts recommend the paleo diet, which emphasizes protein and vegetables, while cutting out grains and legumes. For example, Dr. Terry Wahls has written a book on how she reversed her MS through a nutrient dense paleo diet. Supplements that can help to repair the damaged intestinal lining and reduce inflammation include l-glutamine and DGL.

When it comes to diet recommendations, I think the most important thing to remember is that we are all genetically diverse. We will all have unique responses to different foods and there is no one-size-fits-all diet. For example, I feel terrible after eating eggs or after eating a large portion of cruciferous veggies (broccoli, cauliflower, etc) because I have a food intolerance to eggs and  am sensitive to large portions of insoluble fiber. The paleo diet isn’t for me. However, a high-protein vegetarian diet keeps my digestion happy, hypoglycemia at bay, and generally gives me more energy. The only universal truth when it comes to nutrition is that nobody benefits from eating a diet high in processed foods, sugar, sodium or fat. We all feel better on a whole foods diet. It can seem overwhelming to change your diet when you are dealing with the multiple, uncertain symptoms of chronic illness. The potential to improve your quality of life is worth the effort in experimenting to find what works. Here are a few resources to help you get started:

  • 100 Days of Real Food is a resource for transitioning to a diet free from processed foods (includes blog, meal plans, challenge, cookbook)

Read other great blog posts by writers with FMS on the Fibro Blogger Directory




Trying to Digest

Stomach Pain

I thought that I would blog about something that is very close to my, …er, stomach. During the course of the last year, I’ve had to come to terms with adding irritable bowel syndrome (IBS) to my list of conditions. This isn’t all that unusual; according to the Chronic Pain Research Alliance, several chronic pain syndromes often co-occur in patients, and these include chronic fatigue syndrome, endometriosis, fibromyalgia, interstitial cystitis, irritable bowel syndrome, temporomandibular disorders, and vulvodynia. The CPRA points out that none of these conditions are understood well, and the relationships between them are equally unclear. Consequently, many physicians are inadequately trained to treat chronic pain syndromes, resulting in the misdiagnosis or incorrect treatment of patients.

In my case, the first gastrointestinal problems began about two years ago when I started having severe cramps when I had to ‘go’ to the bathroom during my menstrual cycle (I’m trying to keep this as non-graphic as possible, but any post on IBS is going to have TMI). My gynecologist thought it was most likely endometriosis and put me on the birth control pill, which did significantly reduce the pain. Over the next year, my fibromyalgia symptoms blossomed, so I was put on long-acting tramadol (synthetic opioid). One of the downsides of narcotics is constipation. Other than that, I have had the regular IBS symptoms of bloating, abdominal pain and irregularity. The usual culprits are whole grains, cruciferous veggies (broccoli, cauliflower, brussels sprouts), some beans and too many citrus fruits. Finally, last summer (2012) I started having episodes that are similar to stomach flu. They typically last for about 24 hours and include frequent urges to ‘go’, sleeplessness, sweats and chills (but no fever), and skin tingling or crawling. These are probably among the worst experiences I’ve ever had. In total, I’ve had about five of these episodes. The triggers seem to be eggs and beef. A naturopath did a food sensitivity test for me once and I have a food intolerance to eggs. The beef I can’t explain.

The most relevant article I’ve found to explain these episodes is called ‘Food intolerance is linked to different disorders’ by Science Nordic. The article focuses on research by Arnold Berstad and colleagues at Lovisenberg Diaconale Hospital in Oslo. Berstad conducted a study with 84 participants who had unexplained digestive problems that they attributed to food intolerances. The research team administered a provocation test in which the patients were given a non-digestible carbohydrate called lactulose to eat. The provocation test re-created the symptoms of digestive distress experienced by the patients, proving that their complaints were not psychosomatic. Researchers suspect that the indigestible carbohydrates were not absorbed in the small intestine, but fermented by intestinal microbes in the large intestine, resulting in the digestive problems. One result of this study was that patients were observed to get chills as part of their reaction to the provocation test, in addition to digestive upset (bloating, gas, and pain). This is the only mention in all of my research to food intolerance reactions which includes both G.I. tract distress and body wide symptoms like chills. Significantly, the researchers found that all but one of the participants were symptomatic of IBS, 84% were symptomatic of chronic fatigue syndrome and 71% were symptomatic of fibromyalgia. The authors of the study suggest that an imbalance in intestinal microbes might be part of a common disease mechanism for all three overlapping conditions. Other researchers dispute the claim that the cause of the three chronic pain diseases is intestinal, but agree that it might play a role.

This article was significant for me to understand the confusing and extremely unpleasant symptoms that I was experiencing. I still believe that some of my episodes result from eggs, not only difficult to digest carbohydrates, just because often the only food preceding an episode that differed from my usual diet has contained eggs – like lemon meringue pie or ranch dressing. My solution has been to focus more on taking care of my fussy intestines. I’ve been taking a probiotic called Align which is specifically formulated for IBS. It has a patented bacteria called Bifidobacterium infantis 35624, which has been clinically proven to reduce IBS symptoms. It’s a little bit pricey, so taking generic probiotics that include Bifidobacterium might also be helpful. I think eating foods rich in probiotics are beneficial. I like yogurt the best, but some people swear by miso and other fermented soy products. You’re probably better off with supplements though if you have a sensitivity to dairy or soy. I’ve also been feeling much better eating a high soluble fiber diet. There are two kinds of fiber – soluble and insoluble. Soluble fiber creates a gel in the intestinal tract, made up of the unabsorbed fiber dissolved in water, which helps with both kinds of irregularity. It slows down the transmission time of food in the gut but also creates enough bulk to ensure passage. In contrast, insoluble fiber just pushes through the gut, and can create problems with loose digestion, and also cause bloating or gas. High soluble fiber foods include oatmeal, squash, carrots, apples, oranges, flaxseed, potatoes, some beans/lentils and (according to some) French bread and white pasta. Also Metamucil (without irritating artificial sugars) is very helpful because it contains psyllium husks that are high in soluble fiber. Of course avoiding trigger foods is also key. IGG Food sensitivity tests, although critiqued by some, can help give you an idea. For me, the test that helped identify a food intolerance to eggs was totally right on.Lastly, I eat a plant-based diet that is focused on high nutrition, created by Dr. Fuhrman, and adapted to accommodate my IBS. I’ll write more about that another time, but the focus is on phytochemicals, antioxidants, micronutrients, anti-inflammatories and all the other benefits of fruits, veggies, grains, nuts and seeds, to give my body a fighting chance. I’m also big advocate of moderation, and not obsessing too much over rigidly following supplements and diets – I love food too much (even though we have a complicated relationship) to kill my enjoyment with dogmatism!


About Bifantis. 2013. Retrieved May 7, 2013 from

Chronic Pain Research Alliance. 2009. Retrieved May 7, 2013 from

Feinmann, J. 2010. Eating Fibre May NOT Be So Good For Your Stomach. In Mail Online. Retrieved May 7, 2013 from

Spilde, I. (2012). Food Intolerance is Linked to Different Disorders. In Science Nordic. Retrieved May 7, 2013 from

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