If you are one of the 10 million Americans who suffer from fibromyalgia, what you eat and a few lifestyle changes may help you decrease some of your symptoms.

Nutritional neuroscientist Kathleen Holton, PhD, an assistant professor of health studies at the American University in Washington, DC, has studied the effects of a variety of nutrients and foods on the brain. Holton developed guidelines to help fibromyalgia sufferers better manage their condition through what they eat. Her guidelines include Washington University School of Medicine professor of psychiatry, pathology, and immunology Dr. John Olney's research on excitotoxins, a term he coined for substances that overstimulate then damage or kill brain cells.

Read on to find out what excitotoxins may be in your food and what you should avoid eating as well as what you should include in your diet to get some relief from your fibromyalgia symptoms.

Glutamate

Glutamate is a neurotransmitter that occurs naturally in the body and in some foods, but it is also added to foods to enhance their flavor. The most common form of added glutamate is monosodium glutamate (MSG). It is an excitotoxin often found in Chinese foods, canned soups and vegetables, some types of chips or crunchy snacks, and processed meats. Fibromyalgia patients should avoid MSG. Ingredients that include terms such as "hydrolyzed," "autolyzed," "protein concentrate," or "protein isolate" likely contain naturally occurring MSG, which should also be avoided.

Sugar and Artificial Sweeteners

After the initial rush of sugar in your system, the effects of sugar actually increase fatigue, which is a common symptom of fibromyalgia. Too much sugar also increases the risk of weight gain, diabetes, inflammation. Artificial sweeteners such as Sweet 'N Low, Splenda, NutraSweet and Equal, Sweet One, and Newtame (saccharin, sucralose, aspartame, acesulfame potassium, and neotame, respectively) are several times sweeter than sugar and often cause a flare-up of fibromyalgia symptoms, particularly pain. NutraSweet and Equal are made from aspartame, an excitotoxin. According to case reports published in the Annals of Pharmacotherapy, patients suffering from fibromyalgia reported reducing or eliminating their pain when they discontinued using aspartame (NutraSweet and Equal).

Gluten

While people with fibromyalgia may not have celiac disease, many have sensitivity to gluten. Studies have found that fibromyalgia patients that eliminated gluten from their diets had less irritable bowel symptoms, better sleep quality, less overall pain, and less moodiness.

Whole Foods

Processed foods such as frozen dinners, packaged food, and snacks have more additives and contain less fiber and nutrients than whole foods. Refined carbohydrates such as white flour and white rice are examples of processed foods. When eating carbohydrates, choose whole grains such as quinoa, amaranth, or brown rice.

Mediterranean Diet

The Mediterranean diet includes foods such as lentils, chickpea, kidney beans, unrefined barely, millet and couscous, vegetables, fruit, fish, olive oil, and some cheese and yogurt.

The Mediterranean diet has been shown to lower blood pressure and cholesterol as well as help reduce inflammation. The omega-3 fatty acids in foods such as salmon, sardines, walnuts, and flaxseeds may alter the expression of inflammatory genes.

Vitamin D

Those with fibromyalgia may also have a vitamin D deficiency. It is estimated that one billion people worldwide have low levels of the vitamin in their blood, so it’s a good idea to have your vitamin D level checked. If you are lacking in vitamin D, a good supplement and increasing your vitamin D food intake will help with other fibromyalgia symptoms such as fatigue, bone and back pain, depression, and muscle pain. Fatty fish such as tuna, mackerel, and salmon are good sources of vitamin D and are part of the Mediterranean diet. So, too, is cheese, which should be eaten sparingly.

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Magnesium

Magnesium citrate may reduce symptoms of fibromyalgia. Magnesium is also helpful for preventing the excitotoxicity caused by glutamate. Magnesium is found in lentils, raw almonds, sunflower seeds, avocados, bananas, kale, chard, and spinach.

In addition to foods to avoid and foods to increase, researchers have also found that exercise, mindfulness/meditation, cognitive behavioral therapy, and massage have had many positive effects on fibromyalgia patients.

Exercise

Even walking just 20 minutes a day can help. It will increase stamina, decrease pain, and improve sleep. For those with severe fibromyalgia pain, it may seem counterintuitive to exercise, but studies show that low-impact exercise will help reduce pain. An exercise buddy or a dog is a great way to make that commitment to exercising every day.

Mindfulness/Meditation

In a 2014 study published in Annals of Behavioral Medicine, female fibromyalgia patients, of which the majority of fibromyalgia sufferers are, spent 45 minutes a day doing both formal and informal mindfulness practices that included attentionfocusing, sitting in meditation with deep breathing, doing a series of simple yoga positions, and participating in instruction/discussion on being mindful. Compared to the control group, the group that utilized mindfulness/meditation had less stress and overall fibromyalgia symptoms.

Cognitive Behavior Therapy

In many studies, the use of cognitive behavior therapy (CBT) to help treat fibromyalgia has been found to result in better life management, less depression, stress, pain, and fatigue. CBT was effective for those patients who also experienced depression and anxiety along with their fibromyalgia.

Massage

Massage therapy has a beneficial effect on improving pain, anxiety, and depression of fibromyalgia patients. It is suggested that massage be continued long-term for five weeks or more for continued improvement. Also, massage therapy can help relieve sleep disturbances, improve mood, and even decrease fibromyalgia patients’ levels of substance P, a neuropeptide that coexists with the principle excitatory neurotransmitter glutamate in the transmission of pain.