Fibromyalgia is a multi-symptom and multi-system disease with widespread chronic pain that can change location. People living with Fibromyalgia experience fatigue, sleep disturbances, and cognitive symptoms, including brain fog and depressed mood.

Like chronic fatigue syndrome/ME, the cause of fibromyalgia is still poorly understood. It involves neuro-immune dysregulation, and many now consider it to be a form of autoimmune disease. With any illness which has multiple factors and symptoms, any treatment must be likewise holistic.

Sadly for people living with fibromyalgia, conventional drugs are often ineffective and can be difficult to tolerate. However, newer therapies, including medical cannabis when used in combination with a RM approach, offer hope and are shown to improve people’s quality of life significantly.


The Resilience Medicine Approach to Fibromyalgia

Diet
Supplements
Medication
mind-body
BioData + Habit Tracking

Diet

  • The Resilience Medicine diet principles
  • A Ketogenic style diet-may impact mitochondrial function and help fatigue and autoimmune component possibly due to low carbohydrate content according to a recent study but may not work for everyone. Some people find it may also worsen fatigue so it is a diet strategy to try for 6 weeks and track how you feel to see if it helps you.
  • Cut out MSG and aspartame.
  • Eliminate caffeine and alcohol due to their effect on mitochondria (especially alcohol which is a mitochondria toxin), especially if fatigue is a feature
  • Trial of a low FODMAP diet especially if gut issues suspected

Supplements

Many people living with fibromyalgia find nutraceuticals and botanical supplements can help, including:

  • CBD, cannabinoids, and terpenes from the cannabis plant, including alpha-pinene, beta-caryophyllene, and myrcene.
  • PEA (Palmitoylethanolamide)
  • Liposomal glutathione
  • High Absorption Curcumin
  • High Absorption Magnesium
  • Vitamin D3
  • Acetyl L carnitine
  • Liposomal CoQ10
  • Herbal sleep support
  • Lions Mane and other medicinal mushrooms for stress and cognition support
  • See the CFS page for help with fatigue symptoms

Cannabinoids & Medication

Medications can also help, particularly:

  • Full spectrum CBD products
  • Medical cannabis both oils (usually high CBD strains) and vaporised flower for breakthrough pain and fatigue
  • Low-Dose Naltrexone (LDN)
  • Medications to treat pain include paracetamol, SSRIs, and other classes of medication. Avoid opioids which may make pain worse over time in some people
  • Consideration of medications to treat other symptoms – such as treating restless legs syndrome if present, depression, insomnia, and pain
  • Melatonin to help with sleep and for the immune regulatory effects

Mindbody

Many forms of relaxation practices can help decrease brain and body hyperarousal and may help expand the energy envelope and reduce the ‘tired but wired feeling.’ People living with fibromyalgia may feel very fatigued and also suffer from a lack of deep restorative sleep, difficulty resting and achieving a sense of calm. Mind-body tools may include:

  • PMR – progressive muscular relaxation
  • Mindfulness-based stress reduction (MBSR) programs for chronic pain
  • Breath-focused mini-meditation minutes throughout the day – focusing on a longer exhale than inhale and experimenting with a few seconds of holding the breath at the top of the inhale. This can help check in with energy levels, decrease stress response to pain signals, and avoid overexertion.
  • Yoga Nidra recordings whilst lying down
  • Altered states experiences with a guide. Many people anecdotally have found these helpful in their healing, regaining function, reducing symptoms, e.g. holotropic breathwork, therapeutic psychedelics (where legal).

Apps, BioData and Habit Tracking

You can track your pain and related symptoms like mood and fatigue and sleep in the app and see any interventions and resilience tips you have started and if they are helping over time.

The Resilience Medicine App is a free tool developed over a decade of practice treating patients using a quality of life approach. It can help you track how you feel in the four main Resilience Medicine areas of mood, stress/anxiety, energy and mental clarity.

I have been treating patients with fibromyalgia using a RM approach for the past decade and cannabinoids are still my single most powerful tool to help improve symptoms and quality of life, especially when combined with gut healing, diet, supplements and a mindbody practice. There are not good conventional medicine drugs to treat fibro but this is a very real biological debilitating condition and is not ‘psychosomatic’ or ‘people exaggerating symptoms’ as unfortunately many patients have been told.

The endocannabinoid system dysregulation is likely involved in this condition which is why cannabinoids seem to help so greatly. Healing the gut is another important factor since the brain-gut-immune axis regulates so much in terms of inflammation, immune response and neurological function. The good news is that getting better is possible!

Dr Dani Gordon, Founder of Resilience Medicine