Fibromyalgia: Prolonged fasting can alleviate symptoms

Supervised fasting lasting an average of seven to eight days resulted in reduced pain and improved mood in patients with fibromyalgia, with effects maintained for at least the next three months, a German study showed.The experiment was carried out at the Immanuel Hospital in Berlin on 176 patients and was part of a multimodal treatment. It was combined with moderate physical exercise, patient education, an introduction to mindfulness and alternative methods such as acupuncture, acupressure and massage. This mechanism could partly be explained by “a greater availability in the brain of serotonin, endogenous opioids and endocannabinoid,” reported the study authors in Nutrients.Therapeutic fasting is therefore likely to be added to the list of non-pharmacological approaches to consider in the management of the symptoms of fibromyalgia. The daily calorie intake was first set at 200 to 300 calories. From April 2020 until the end of the study, the limit was increased to 600 calories per day, given the uncertainty of the effects of fasting on the immune response to SARS-CoV-2. Water, unsweetened tea, natural juice, soups and steamed vegetables made up the bulk of the menu.For most patients, the use of non-steroidal anti-inflammatory drugs was maintained during their deprivation diet. However, dosage was reduced in around 30 patients, while others turned to herbal remedies. Between the first and last day of hospitalization, prolonged fasting resulted in an average drop of 13 points in the Fibromyalgia Impact Questionnaire (FIQ) scale, representing an improvement of 23.5% in symptomatology. (58.3 +/- 11.1 to 44.6+/- 15.5). This result is higher than the minimum clinically important difference (MCID) of 14%, set by the FIQ. The researchers noted a significant reduction in pain, which was maintained at the three-month follow-up. Reported pain remained below baseline for up to one year after hospitalization.Effects also on well-beingQuality of life, measured by the WHO Well-being Questionnaire (WHO-5), improved by 4.9 points on average during hospitalization and remained at a high level until the end of the one-year follow-up. Participants also reported improvements in their levels of mindfulness, anxiety and depression, but these results did not persist long-term. "Considered by many patients as a drastic method, fasting requires self-control and the implementation of self-management strategies to adhere to it. This would explain why fasting also improved the quality of life and mindfulness of patients,” reported the authors. Indeed, a 2022 study revealed that self-management practices would be one of the key elements to increase the quality of life of patients with fibromyalgia. To optimize the effect of fasting, patients were then encouraged to maintain a plant-based diet and favour minimally processed foods when they returned home. “According to our clinical experience, fasting is often the starting point for patients to change their lifestyle habits and particularly their eating habits,” noted the researchers.

Fibromyalgia: Prolonged fasting can alleviate symptoms

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