Case Study: Developing a Nutrition Protocol for Fibromyalgia

Ally is a 30-year-old female with a diagnosis of fibromyalgia and chronic pain. Her past medical history included attention deficit hyperactivity disorder, anxiety, urinary tract infections, yeast overgrowth, and migraines. 

When I met Ally, she said she thought nutrition therapy would improve her wellbeing, energy, and strength. She was experiencing balance issues, fatigue, myofascial pain, tingling hands and feet, numbness, constant cold sensation, neck and back pain, dizziness, and migraines. These symptoms began when she started college. At one point she had been misdiagnosed with multiple sclerosis. Testing for rheumatoid arthritis, Sjogren’s syndrome, Lyme disease and lupus were all negative. She was finally diagnosed with fibromyalgia.

At the time of our initial assessment, Ally already avoided gluten, dairy, alcohol, soda and processed foods, but consumed an extreme amount of coffee. She drank four to six glasses of water per day and reported carbohydrates as comfort foods. She admitted to skipping breakfast due to feeling rushed in the mornings and stated she snacked mostly in the evenings instead of eating dinner due to feeling tired after work.

Her initial weight was 135 pounds, but she had lost 15 pounds over the past year. Her self-reported typical body was 120 pounds and she desired to return to that weight. Physical activity was limited due to pain and Ally reported significant stress related to work and family. She rated her sleep as fair and she admitted to feeling hopeless and discouraged related to her diagnosis and the lack of answers.

I suspected stress and nutrient deficiency as significant factors, so her initial nutrition plan included:

1. Daily stress relief practice, including 15 minutes of meditation in both early morning and afternoon
2. Supplements, including a multivitamin with CoQ10 daily; magnesium glycinate, 200 milligrams before bed; an herbal supplement for inflammation, one capsule twice per day between meals; adrenal formula between meals; buffered vitamin C, 1,000 milligrams per day; methylated B complex, one capsule twice per day; and omega-3, 2,400 milligrams per day 
3. Salivary cortisol testing related to suspected adrenal dysregulation and her results indicated phase three adrenal dysfunction 
4. Stool testing was recommended, but the patient 
5. Restorative yoga daily for 20 minutes
6. Full elimination diet for four weeks
7. 64 ounces of water per day

At the four-week follow-up, Ally said she felt much more energetic, but she continued to feel excess stress related to work and family. She lost eight pounds and indicated her hairdresser reported her hair was thicker and seemed healthier. She reported no issues related to the elimination diet, but she did miss coffee and ice cream.

The follow-up nutrition plan included:

• Continue all previous goals, but transition to a long-term mitochondrial food plan with at least nine servings of vegetables per day, at least one of those being cruciferous. 
• Six to eight-minute meditation in the car immediately after work due to reported stress when speaking with her family member on the drive home from work 
• Consider journaling to help with stress management 
• Chamomile smoothie before bed to promote restful sleep 
• Mocha matcha smoothie in the morning using decaf coffee and continue to avoid regular coffee 
• Avocado ice cream recipe provided as an alternative to regular ice cream

Editor’s Note: This text was originally published in the e-book, Components of a Successful Nutrition Protocol. To access the full text, click here.