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The Hidden Cause of Fibromyalgia: A Natural Remedy for Pain

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Fibromyalgia is one of the most common pain syndromes, affecting 2-4% of the population. (1) Unfortunately, it is also one of the least understood.

The hallmark of fibromyalgia is pain. There is pain in places we carry stress: the neck, shoulders, hips, and low back. Then there is chronic pain in the arms, thighs, chest, and rib cage.

The medical community does not yet know what causes fibromyalgia or agree on how to remedy it.

Currently, if you are diagnosed with fibromyalgia, you may be told to exercise, think positive thoughts, and take an anti-depressant or muscle relaxant.

Studies Now Connect Fibromyalgia to Bacterial Overgrowth

Several studies now tie fibromyalgia back to the gut. There is a strong relationship between fibromyalgia and bacterial overgrowth in the small intestine, a condition known as SIBO, or small intestine bacterial overgrowth. (2)(3)

One study that was published in Annals of the Rheumatic Diseases in 2004 found a 100% correspondence of fibromyalgia with SIBO. (4)

Researchers have finally linked fibromyalgia to the health of the gut! One study showed a 100% connection between fibromyalgia and small intestine bacterial overgrowth, the direct result of an imbalanced inner ecosystem.

In a double blind study, participants were asked to take a lactulose breath test, the gold standard when it comes to measuring overgrowth in the small intestine, which checks the breath for the presence of hydrogen. Bacteria produce hydrogen gas or methane as they feed.

Researchers at the Cedars-Sinai Medical Center found that 100% of the participants with fibromyalgia had abnormal test results. They also found that the more abnormal the test results, the more pain a fibromyalgia volunteer was in.

The degree of bacterial overgrowth in the small intestine has a direct relationship with the severity of fibromyalgia.

The Development of Small Intestine Bacterial Overgrowth (SIBO)

When bacteria overrun the small intestine, whether good or bad bacteria, problems quickly arise. This is because the small intestine is meant to smoothly shuttle food from one end of the digestive tract to the other.

How things can go wrong:

  • Enzymes play an important role. If there are not enough of the right enzymes in the small intestinal tract, which are known as brush-border enzymes, food slows its transit time, and bacterial populations begin to grow.
  • Diet also matters. When we eat a carb-heavy meal, or if we are unable to break down certain plant fibers, this feeds resident bacteria.
  • The wrong kind of bacteria starts to grow. Whether its food poisoning or a small, resident populace of disease-causing microbes, these bad bugs can actually secrete an opiate-like substance that will slow down the wave-like motion of the small intestine. This gives food a chance to rot and microbial communities the opportunity to grow.
  • Diabetes and hypothyroidism affect digestion. In both diabetes and hypothyroidism, something known as the migrating motor complex slows down. The migrating motor complex (MMC) is a set of wave-like movements that keeps food and bacteria moving. Oftentimes, bacteria from the large intestine creep up into the small intestine. With a robust MMC in place, this is usually not a problem. When the MMC weakens or slows down, these bacteria are given the opportunity to proliferate.<

Communities of bacteria in the small intestine and throughout the intestinal tract are normal and expected. It is only when these communities get out of control that problems arise. In any healthy ecosystem, balance is key.

Bacterial Overgrowth May Lead to Fibromyalgia

Once our inner ecosystems reach a state of imbalance, the intestinal lining can become “leaky,” or permeable. This becomes a problem because bacteria produce their own toxins and waste products.

These are toxins like:

Lipopolysaccharide (LPS): Otherwise known as endotoxin, this molecule gives structural support to certain bacteria. It also elicits a strong response from our immune system.

Endotoxins contribute to inflammation in the body. We also know that in fibromyalgia patients, it leads to increased pain. (5)

Tryptophanase: Another by-product of some bacteria is an enzyme that degrades tryptophan, called tryptophanase. Tryptophan is an amino acid that may sound familiar. That is because it gets quite a bit of attention as a precursor to serotonin. Without tryptophan, serotonin (our happy brain chemical) could not be made. And without serotonin, it is pretty difficult to manufacture melatonin (our sleepy brain chemical).

Serotonin helps us feel relaxed and happy. It is also important for gut motility, the migrating motor complex that we mentioned earlier. Serotonin deficiency contributes to pain, carbohydrate cravings, and fatigue.

Melatonin helps us fall asleep easily. It also helps to reboot our energy on a cellular level.

When large amounts of the enzyme tryptophanase are busy breaking apart tryptophan, the body no longer has the building blocks that it needs to make enough serotonin and melatonin. This contributes to fibromyalgia syndrome.

4 Suggestions for Fibromyalgia Sufferers

Once we know what causes a group of symptoms, we can do something about it.

Luckily, scientists have already done the research showing that SIBO has a direct relationship with fibromyalgia.

While there is not a universal cause-and-effect relationship, we know that bacterial overgrowth can show up as fibromyalgia. If you have been diagnosed with fibromyalgia:

1. Request a lactulose breath test. This can help to determine if you have SIBO.

2. Follow The Body Ecology Diet. Even if your breath test comes back normal, it is essential to remove anything that may reduce your pain threshold. Since studies show that leaky gut and bacterial toxins can contribute to pain, use your diet to protect your gastrointestinal tract and nervous system.

3. Supplement brush-border enzymes. Assist Full Spectrum Enzymes contains brush-border enzymes that help move things along in the small intestine, reducing your chances of developing SIBO.

4. Optimize the beneficial bacteria in your gut by eating fermented foods and drinking probiotic beverages. These foods will not only improve digestion, they will also help assist in repopulating the healthy flora in the intestines.

What To Remember Most About This Article:

Fibromyalgia is one of the most common pain syndromes that affects up to 4% of the population. It is also the least understood, making it difficult to treat within the medical community today.

Several intriguing studies have connected fibromyalgia with the gut, emphasizing a strong relationship between fibromyalgia and bacterial overgrowth in the small intestine. This condition is called SIBO, or small intestine bacterial overgrowth. Researchers discovered that the degree of bacterial overgrowth detected in the small intestine has a direct relationship with the severity of fibromyalgia.

Small intestine bacterial overgrowth can occur from:

  • Not having enough brush-border enzymes to support healthy digestion, allowing bacteria to grow.
  • Eating a carb-heavy diet that feeds pathogenic bacteria in the gut.
  • Allowing the wrong kind of bacteria to grow and slow down the movement of the small intestine.
  • Diabetes and hypothyroidism that affect healthy digestion by slowing down the migrating motor complex, which keeps food moving through the digestive tract.

Although there isn't a cure for fibromyalgia yet, fibromyalgia sufferers can use the following tips to find natural relief:

  1. Take a lactulose breath test to determine if you have SIBO.
  2. Implement The Body Ecology Diet to boost your gut with friendly bacteria.
  3. Take a brush-border enzyme supplement like Assist Full Spectrum Enzymes to reduce the risk of SIBO.
  4. Eat fermented foods and drink probiotic beverages as often as possible to improve your inner ecology!

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    • Assures digestion of proteins over the entire pH range from 2.0 to 11.0
    • Fast-acting, high potency enzyme formula
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  1. D Buskila, et al. Comorbidity of fibromyalgia and psychiatric disorders. Curr Pain Headache Rep. 2007; 11 (5): 333 – 338.
  2. A Goebel, et al. Altered intestinal permeability in patients with primary fibromyalgia and in patients with complex regional pain syndrome. Rheumatology (Oxford). 2008 Aug; 47(8):1223-7. Epub 2008 Jun 7.
  3. M Pimentel, et al. Small Intestinal Bacterial Overgrowth: A Possible Association with Fibromyalgia. Journal of Musculoskeletal Pain. 2001; 9 (3): 105-113.
  4. M Pimentel, et al. A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing. Ann Rheum Dis. 2004 Apr;63(4):450-2.
  5. LC Loram, et al. Prior exposure to glucocorticoids potentiates lipopolysaccharide induced mechanical allodynia and spinal neuroinflammation. Brain, Behavior, and Immunity. 2011; 25 (7):1408-1415.


  • Leah S says:

    I suffer from fibromyalgia and, therefore, also suffer from the side effects of chronic use of pain medications. My Dr recommended Lady Soma's Probiotics supplement, but after trying a probiotic it really didn't work, but the Lady Soma Fiber Cleanse did!

    I take 2 Lady Soma Fiber Cleanses twice daily and it has definitely consistently worked. Without this product, I faced having to reduce the dose of my pain medication (tramadol) to a less effective dose. Doing that would have greatly impacted my quality of life.

    Posted on Jan 14 at 5:59 am

  • Vojtech says:

    I think that whether the cause of fibromyalgia is bacteria or chemicals or some underlying disease, increased gut permeability is a common thread of coeliac disease, fibromyalgia, diabetes, and some other autoimmune illnesses. This has been linked to the effect on increased zonulin in the gut as researched by Dr Alessio Fasano. One of the treatments to make the gut more normal by healing a leaky gut (intestinal tight junctions) according to Dr Fasano is the zonulin inhibitor AT-1001. Fortunately, there is now an ELISA test for testing zonulin levels in Coeliac and Fibromyalgia patients. Unfortunately it is not a common test used by doctors to check for the leaky gut associated with fibromyalgia etc.


    Zonulin and Its Regulation of Intestinal Barrier Function: The Biological Door to Inflammation, Autoimmunity, and Cancer
    Alessio Fasano
    doi: 10.​1152/​physrev.​00003.​2008 Physiol Rev January 1, 2011 vol. 91 no. 1 151-175

    Update on Validation and Practical Use of the Zonulin Inhibitor
    by Alessio Fasano

    Posted on Jun 13 at 4:02 am

  • Barbara says:

    I followed your above reference #2 to the actual clinical study and found this: "We demonstrated no correlation between the IP and pain intensity in the FM group. In addition, there was also no correlation between the IP and pain intensity in the CRPS patient group. In the FM group, the correlation between IP and NRS pain was −0.3 for both the S% and L/M tests, while in the CRPS group it was 0.23 for the S% test and 0.19 for the L/M test. In the subgroup of FM patients with abdominal symptoms, the IP did not differ from that for patients without such symptoms." NO CORRELATION. If you care to read the entire thing, go here:

    Posted on Feb 11 at 1:23 pm

  • Lynn says:

    Diagnoses of Chronic Fatigue Syndrome were being made, starting around 1987. It was theorized that Candidas Albicans ( also gut ovegrowth toxin issues) was very strongly linked to CFS. There were several books written about that as a strong indicator of CFS. Then years later, Fibromyalgia was diagnosed, and as with CFS, no one knows yet what are the causes, but it is often the case that if you have CFS, you also may have FMS. Again a common link between the two syndromes is gut overgrowth/toxin issues. Like the previous commentator, Ann, I suspect the colon, fermentation, constipation, gut bacteria issues, and toxins not being adequately released by the liver, et al are several of many factors involved. I'd like to see a study done with people with severe, chronic depression (often a result of too low seritonin levels) to determine what percentage also suffer from Fibromalgia.

    Posted on Jul 1 at 7:45 pm

  • Kelly says:

    Great information and I'd like to add a little more. For someone struggling with Fibromyalgia look into the possibility of a thiamine defficiency. Very common when simple carbs and or synthetic B vitamins have been excessively consumed. B's are needed to breakdown carbs, without the correct amounts an imbalance can occur as described above. Eliminate sugar and include in the health plan a whole foods based B complex for 3 - 6 months.

    Posted on Jun 29 at 8:10 am

  • JP says:

    "*The* Hidden Cause of Fibromyalgia"?
    It should be *A*, rather than *The*.
    "The" implies that this cause is the only cause. Which it isn't. There are many causes, of which this can be one is one of many.
    "A" implies that this cause is one of a number of causes, as well as only a possible cause in some people (not *all* people).
    Everyone has a different set of causative factors, & in this case, of which, this above cause is only one of many in the number of individuals tested.

    It's like trying to find a "magic pill" that will cure everything for everyone. There isn't one.

    What are the set of causes for one person won't be the exact same set of causes for another.
    What will help one person, won't help another.

    "Diet" to most people, means to go on a temporary set of eating guidelines, & then once the goal is reached, go off of the diet & go back to one's previous bad eating habits.
    It needs to be not "go on a diet", but "cultivate long-term eating habits", which is actually a slower, but more firmly habituated process than any kind of "go on a diet." plan.

    Posted on Jun 28 at 3:12 pm

  • Ann says:

    I totally agree with the idea that the Fibromyalgia is caused from the gut as is so many other illnesses. I think that pretty soon people will realize that the gut is where most disease comes from. By eliminating foods that are causing the problem and introducing foods to heal the gut... people will heal!!! It is really great when I see someone just make some simple changes in there diet and cure themselves of an ailment.
    Thank you!!

    Posted on Jun 28 at 2:51 pm

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