1. Current scientific evidence: Fibromyalgia and intestinal flora

According to scientific studies, fibromyalgia is related to the intestinal flora of your body.

Mcgill University scientists in an ongoing 2019 study confirm this association.

In this study, researchers have observed that in people with fibromyalgia there is an alteration of the intestinal flora.

These alterations of the microbiota that were found in patients with fibromyalgia are related to the presence of pain, fatigue and cognitive problems of the disease.

Especially they have proven that people with fibromyalgia experience a reduction of beneficial, butyrate-producing species.

Together they found that subjects with fibromyalgia experience a decrease in the bacterial diversity of the intestinal flora.

According to the research, low proportions of species related to healthy intestinal flora were found in individuals with fibromyalgia.

Some of these bacteria are Bifidobacterium, Eubacterium and Lachnospiraceae.

In turn, other species that are reduced in fibromyalgia, Faecalibacterium prausnitzii, Bacteroides uniformia, Prevotella copri and Blautia faecis, were found.

Particularly the researchers observed that in people with fibromyalgia the bacterium Faecalibacterium prausnitzii is depleted.

This is an important fact because Faecalibacterium prausnitzii is the most abundant butyrate producing bacterium in the human intestine.

It fulfills anti-inflammatory functions and improves intestinal function in healthy people.

In patients with fibromyalgia, on the other hand, high levels of bacteria Intestinimonas butyriciproducens, Flvonifractor plautii, Butyricoccus desmolans, Eisenbergiella tayi are identified.

Recently, in turn, abundant amounts of Eisenbergiella massiliensis have been identified.

The researchers were alarmed to note that the severity of fibromyalgia symptoms is related to the abundance of bacteria. 

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2. Previous research: Intestinal Flora and Fibromyalgia

However, this is not the first study that investigates and analyzes the relationship between intestinal flora and fibromyalgia.

Previously numerous investigations have shown that there is a relationship between the intestinal immune microbiota and the nervous system through an axis called the intestine-brain.

In 2015, the relationship between the immune system and the central nervous system was discussed using the term neurogenic inflammation.

The scientists used this term to refer to the interactions of the immune system with the nervous system in people with fibromyalgia.

At first, the researchers attributed the symptoms of fibromyalgia only to the presence of inflammation.

It was later understood that the origin of pain had its starting point in the nervous system and investigated its relationship with the intestinal flora.

This is how scientists from University Hospital Wuerzburg showed that fibromyalgia patients had bacterial overgrowth in the small intestine.

This was associated with an increase in intestinal permeability and the risk of developing an immune response to bacteria.

Bacterial overgrowth was defined as the passage of bacteria from the colon to the small intestine.

The increase in intestinal permeability is attributed according to research to over bacterial growth, infections, intestinal inflammation, medications, stress, and trauma.

3. Bad Food and Intestinal Flora

Poor nutrition in people who have developed fibromyalgia also results in risk and causes bacterial overgrowth and increased permeability.

Researchers at the British Journal of Medical Practitioners have linked intestinal flora disorders with the presence of food allergies, overweight and metabolic syndrome.

An inadequate diet increases the risk of infection and hormonal disorders, other causes of the alteration of the intestinal flora in fibromyalgia.

A new study by Doctors from Donostia University Hospital found that alterations in the intestinal flora increase the interaction between bacteria and the immune system. 

This occurs because the intestinal barrier is broken. Intestinal rupture leads to the release of molecules causing inflammation.  

Interestingly, inflammatory substances increase the permeability of the blood-brain barrier, that is, the barrier that separates the nervous system.

Greater permeability of the blood-brain barrier could allow, for example, that some substances cross the barrier and influence pain.

Scientists say that to maintain the strong intestinal barrier, intestinal production of butyrate is necessary.

This is where the problem arises, the bacteria that produce butyrate are those that are reduced in people suffering from fibromyalgia.

These bacteria that are reduced in fibromyalgia are important for the conversion of glutamate into GABA, an important process for pain control.

As a result of the reduction of bacteria, glutamate rises and leads to the development of pain through neuronal connections.

This would explain the role of the microbiota on the control of pain in fibromyalgia by having an important action on the nervous system.

4. Drugs, Healthy Diet and Intestinal Flora

Another discovery in relation to intestinal flora and fibromyalgia is the influence of diet and drug use.

It has been identified that antacids, lithium, opioids, and psychotropics that are used by people with fibromyalgia reduce bacterial diversity and beneficial bacteria. 

In contrast, a relevant scientific investigation states that a plant-based diet is effective in fibromyalgia by stabilizing the immune system which is related to the intestinal flora.

As a result of the diet, an increase in immunoglobulins A was found in the stool that is associated with improvements in the intestinal immune system.

Probiotics have been investigated by scientists from the University of Almeria who revealed the mechanisms by which they regulate intestinal flora.

These mechanisms include competing with negative bacteria, improving barrier function, inhibiting the growth of pathogens and increasing the production of immunoglobulins.

The results of the study are surprising considering the benefits that come with the life of people with fibromyalgia by reducing their limitations in daily life.

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5. Intestinal flora and other Fibromyalgia Symptoms

As we know, along with pain, fibromyalgia is associated with anxiety, depression and emotional stress that are related to alterations in the intestinal flora.

In this sense, the bacterial balance improved cognitive processes and emotions affected by depression and anxiety in fibromyalgia.

This happens thanks to the fact that probiotics improve the production of GABA, serotonin and dopamine, important substances for the control of emotions.

In turn, they reduce the inflammatory substances that cross the blood-brain barrier and produce changes in emotions and psychological state.

The knowledge of the intestinal flora is useful to focus on the effective treatment for fibromyalgia.

Modifying the intestinal flora allows controlling fibromyalgia symptoms naturally and in the near future will ensure a rapid diagnosis. 


Categories: Fibromyalgia


Diane Shepherd · May 22, 2020 at 4:21 pm

I was seen by my primary care physician for stomach pain and referred to specialists for further review. I told the provider I had fibromyalgia (recently confirmed by testing) and that I knew fibro patients may have problems with intestinal flora. In one ear and out the other. They did not find anything in their tests but I was prescribed Protonix. I never filled it due to side effects. Patients just want to be listened to as we have had to be our own advocates. (I have had fibro for 40+ years.)

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