Is Your Microbiome Fueling Fibromyalgia Symptoms?

Unraveling the Mystery

For quite some time now, researchers have struggled to understand the mechanisms behind fibromyalgia — a seemingly mysterious condition that involves widespread pain and tenderness, fatigue, cognitive impairment, sleep disruption, and more. It impacts between 2-4% of the US population — or about 6-12 million people.³ While the symptoms never fully disappear, they can cycle between varying periods of intensity. Beyond the discomfort, fibromyalgia often causes mobility issues and significantly affects quality of life. Because the condition has been poorly understood, it can also cause difficulty with family, friends, and medical professionals who may be at a loss as to how to help. But a 2022 study from McGill University may shed light on why the disorder arises and insights for treatment options, giving new hope to fibromyalgia patients.

The Correlation Between Gut Bacteria and Pain

In 2019, researchers first established a link between bacteria in the gut microbiome and fibromyalgia (FM). Their findings were published in the journal Pain.¹ The study involved 77 women with FM and 79 control participants; stool samples were taken to measure the composition of their microbiomes using 16S rRNA gene amplification and whole-genome sequencing. The team discovered those with fibromyalgia had fewer butyrate-metabolising bacterial species and lower serum levels of butyrate compared to the control group.

Then, in 2022, the same team performed another experiment that compared 42 healthy women with 42 women struggling with fibromyalgia to further explore how different compositions of gut bacteria can influence the condition.² The researchers collected both stool and blood samples for analysis. They also had each group fill out questionnaires that rated their pain, fatigue, sleep quality, and cognitive issues. The participants described their symptoms — such as morning fatigue, physical functioning, work difficulties, muscular stiffness, as well as depression and anxiety. At the conclusion of the study, the team found that those with fibromyalgia had significant alterations in their serum concentration of specific bile acids — including ” a secondary bile acid called alpha-muricholic acid (aMCA) that was on average five times less present in fibromyalgia patients than in healthy participants.” This was negatively correlated with the full spectrum of symptoms — such as pain, fatigue, unrefreshing sleep, and cognitive complaints.

“Our findings show a strong relationship between patient microbiome composition, bile acids and the severity of fibromyalgia symptoms. Understanding the biological mechanism of fibromyalgia is critical, because it shows that this condition is real, and because it brings us closer to developing an effective treatment for these women and men in pain,” says lead researcher Dr. Shir.

Likewise, a 2020 review published in BMC Musculoskeletal Disorder examined 4771 studies spanning seven countries found a correlation between gut bacteria with fibromyalgia.⁶ Interestingly, the researchers discovered a strong association with higher glutamate levels (an excitatory neurotransmitter) and lower GABA levels (a calming neurotransmitter) in the brain led to increased risk of fibromyalgia pain signaling.^4,5 The gut bacteria involved in altered glutamate and GABA metabolism for the studies include Bifidobacterium and Lactobacillus (for glutamate) and Akkermansia muciniphila and Parabacteroides spp (for GABA).

The team concluded:

“The findings of this review suggest the relationship between the gut microbiome and the pathophysiology of fibromyalgia is a largely underexplored area. Despite the limitations of the included studies, there are several indications that associations between the composition and metabolism of the gastrointestinal microbiota and fibromyalgia may exist.”

Cultivating A Balanced Microbiome: The Foundation of Health

Gut health is not only essential for addressing fibromyalgia symptoms, but also for immunity, cognitive health, and less depression and anxiety. Needless to say, tending to the microbiome is a major factor for overall well-being. Eating a diet with plenty of insoluble fiber, vegetables, and resistant starch can help ensure we have robust and thriving beneficial bacteria that produce plenty of health-enhancing butyrate. See this post for more information.

Several herbal remedies are also helpful for promoting gut health. These include reishi, lion’s mane, and turkey tail medicinal mushrooms, along with plantain, slippery elm, and marshmallow root. Here’s why.

Reishi — often called the “mushroom of immortality” — is celebrated for its powerful anti-inflammatory effects, which are a vital step in repairing a leaky gut. Lion’s mane has an abundance of antioxidants that help calm the body’s inflammatory response. Turkey tail adds an additional layer of support by providing prebiotics that nourish beneficial gut bacteria, while keeping candida overgrowth in check. This helps to encourage a balanced and resilient microbiome.

In addition to these mushrooms, several additional herbs help to promote gut restoration. Plantain — long valued as a digestive tonic — soothes mucous membranes and eases inflammation, bringing relief to leaky gut symptoms. Slippery elm and marshmallow root further enhance this healing process by forming a protective coating along the gut lining, giving it the chance to regenerate and restore integrity.

Each of these effective botanicals can be found in our powerful Balanced Gut Blend. Are you ready to heal your gut, support a robust microbiome, and build a foundation of true health? Visit my apothecary today and learn more about how our gold-standard extracts can help you achieve your wellness goals!

Nicole Apelian

Nicole’s Apothecary Products in this Post

References

1. Minerbi, Amir et al. “Altered microbiome composition in individuals with fibromyalgia.” Pain vol. 160,11 (2019): 2589-2602. doi:10.1097/j.pain.0000000000001640
2. “Another secret of fibromyalgia discovered in the microbiome” McGill University University Health Center, July 12, 2022. https://muhc.ca/news-and-patient-stories/research/another-secret-fibromyalgia-discovered-microbiome
3. “People with fibromyalgia have different gut bacteria” by Catharine Paddock, Ph.D. | Fact checked by Isabel Godfrey, June 24, 2019. https://www.medicalnewstoday.com/articles/325535
4. Foerster BR, Petrou M, Edden RAE, Sundgren PC, Schmidt-Wilcke T, Lowe SE, Harte SE, Clauw DJ, Harris RE. Reduced insular gamma-aminobutyric acid in fibromyalgia. Arthritis Rheum. 2012;64(2):579–583. doi: 10.1002/art.33339.
5. Zunhammer M, Schweizer LM, Witte V, Harris RE, Bingel U, Schmidt-Wilcke T. Combined glutamate and glutamine levels in pain-processing brain regions are associated with individual pain sensitivity. Pain. 2016;157(10):2248–2256. doi: 10.1097/j.pain.0000000000000634.
6. Erdrich, Sharon et al. “Determining the association between fibromyalgia, the gut microbiome and its biomarkers: A systematic review.” BMC musculoskeletal disorders vol. 21,1 181. 20 Mar. 2020, doi:10.1186/s12891-020-03201-9