Fibromyalgia

Why it works: Serotonin pathway rationale. People with fibromyalgia have repeatedly been reported to show lower serotonin activity (e.g., reduced CSF 5-HIAA, the main serotonin metabolite). Beca...

Instructions: Dose used in the best-known fibromyalgia trial. • 100 mg, three times daily (TID) by mouth for 30 days. This double-blind, placebo-controlled study in 50 patients reported signific...

Warnings: 1) Serotonin syndrome (drug interactions) — major caution. Do not combine 5-HTP with SSRIs, SNRIs, M...

Studies: Randomized controlled trial (1990). Caruso et al., J Int Med...

Why it works: TRPV1 activation → desensitization of pain fibers. Capsaicin activates TRPV1 on nociceptors, causing an initial burning, then “defunctionalization” (reduced function) of these nerv...

Instructions: Over-the-counter creams/gels (0.025%–0.1%). • Where/when: Apply a thin layer to painful areas 3–4 times daily for 3–4 weeks before judging benefit; wash hands after use. Do not exc...

Warnings: Common reactions: Burning/stinging, redness, itching at the application site (usually lessen over se...

Studies: Fibromyalgia-specific studiesDouble-blind, vehicle-controlle...

Why it works: Antioxidant / anti-inflammatory effects. Standardized ginkgo extracts (e.g., EGb 761) contain flavone glycosides and terpene lactones that can reduce oxidative stress and modulate...

Instructions: There’s no FM-specific dosing protocol because evidence is insufficient. If you and your clinician decide on a monitored trial, general usage of standardized leaf extract looks lik...

Warnings: Bleeding risk / drug interactions. Ginkgo may increase bleeding, especially with anticoagulants (e.g...

Studies: Open, uncontrolled pilot (2002): 36 people with FM took 200...

Why it works: Magnesium’s pain + stress biology. Magnesium modulates NMDA receptors (involved in central sensitization), supports neuromuscular function, and low magnesium status has been report...

Instructions: Form & label reading. “Magnesium malate” is a salt; labels list the elemental magnesium per serving (what matters for dosing). Many forms of magnesium are used in supplements; abso...

Warnings: Kidney disease: People with chronic kidney disease (CKD) can accumulate magnesium and are at higher...

Studies: Randomized, double-blind pilot (1995). Super Malic® tablets...

Why it works: Targets central sensitization & pain modulation. FM is understood as a disorder of pain processing (heightened central sensitization with impaired descending inhibition). Experimen...

Instructions: Frequency & duration per session.. • Once weekly, ~20 minutes per session for 9–10 weeks (used in a multicenter RCT in primary care). ResearchGate. • Alternative regimens in other...

Warnings: Common, usually minor effects: transient soreness, small bruises/bleeding, lightheadedness. (NCCIH s...

Studies: Cochrane Review (ongoing updates; core review CD007070).Find...

Why it works: Tai chi and gentle yoga combine low-impact physical activity, breath regulation, mindfulness/relaxation, and graded movement. Together these address core problems in fibromyalgia —...

Instructions: These recommendations draw from clinical trial protocols (what worked in studies) and from patient guidance (how clinicians advise starting/progressing).. A. General principles (bo...

Warnings: Tai chi and gentle yoga are generally safe, but people with fibromyalgia have special issues (reduce...

Studies: Randomized controlled trialsBMJ (2018) — Effect of tai chi v...

Why it works: PEA is an endogenous fatty-acid amide with anti-inflammatory, mast-cell-stabilising and neuromodulatory effects (via PPAR-α and “entourage” effects on endocannabinoid signalling)....

Instructions: Common study doses. • 3 × 400 mg/day (total 1200 mg/day) – used in a randomized double-blind crossover mechanistic study in healthy volunteers (4 weeks) assessing pain modulation....

Warnings: General tolerability: PEA is generally well tolerated in clinical trials; reported side effects are...

Studies: Randomized / controlled trialsSalaffi F. et al., Clinical an...