In the naturopathic world, the chronic pains associated with fibromyalgia are symptoms of a deeper, more complex problem. While we are still unsure of the exact cause of fibromyalgia, the latest research is showing a connection between chronic pain and the serotonin neurotransmitter.

What Is Fibromyalgia?

According to the American College of Rheumatology, it is the widespread pain in all four quadrants of the body for a three-month minimum duration. The newest criteria of diagnosis includes the associated symptoms of fatigue, and problems with sleeping and thinking clearly. Often, fibromyalgia is associated with anxiety and/or depression as well. It is therefore not surprising that the research is showing its connection with low serotonin, which is one of many chemicals found in the brain and digestive tract that contribute to happiness and well-being.

Causes of Fibromyalgia  

While the current cause is unknown, there seems to be a strong genetic disposition to genes associated with serotonin. Like with most genes, these genes must be “turned off” by physical or mental stress to cause a decrease in serotonin. From a naturopathic standpoint, this could mean a range of causes, from a poor diet to an emotional trauma. But this also means that there are ways to sway the gene to work properly. This can be done by providing the nutrients the body needs to make serotonin, even going so far as to skipping steps in the pathway to making it.

Fibromyalgia and Serotonin

Thanks to the common and widespread use of SSRIs (selective serotonin reuptake inhibitors), most people are aware of the connection between serotonin and depression. However, few people are aware of its connection with chronic pain and fatigue. How does serotonin help with pain? Serotonin has analgesic, or pain-relieving, effects directly on the nervous system; it also works together with opioid receptors to modulate pain.

Since the 1980s, studies have been showing a connection between low serotonin in spinal fluid and fibromyalgia. The studies have also shown a connection between poor sleep and a low influx of serotonin. This might explain why fatigue is now associated with the diagnosis of fibromyalgia. It is a vicious cycle though, as we ask if the poor sleep is causing the pain or if the pain is causing poor sleep.

Boosting Serotonin Naturally
Tryptophan is the essential amino acid necessary to make serotonin. Most people know they can get tryptophan from turkey; it can also be found in pumpkin seeds, bananas, red meat, fish, oats, beans, nuts and other foods. Eating an anti-inflammatory diet—low on sugar, caffeine and alcohol—with plenty of green veggies and whole foods rich in tryptophan can help with fibromyalgia symptoms.

For chemical reactions to occur in the body, our body uses enzymes—little protein catalysts—to help make one thing become another. These enzymes need nutrients like vitamins and minerals, or what we call cofactors, to make them work. To make serotonin, tryptophan is converted into 5-Hydroxytryptophan (5-HTP) to serotonin. For this specific reaction to occur, the body needs the cofactors folic acid, vitamin B6 and magnesium.
What’s great about using food as medicine is that foods have combinations of nutrients and amino acids to help support the body’s utilization of them. It is, of course, possible to supplement amino acids and vitamins through a nutraceutical. There are many supplements out there that combine 5-HTP—which skips the step of making tryptophan to 5-HTP—and its cofactor B6 to help in supporting healthy serotonin levels.
It is important to consult with a naturopathic doctor when deciding on which supplement is right. They can ensure that a lack of serotonin is the cause of the disease. They will also look to see if we are properly absorbing nutrients from food, and that we are taking the right supplements for us at the right amount with its supporting cofactors.

Dr. Sara B. Frawley, a naturopathic physician in Wallingford, is the founder of Ground Force Supplements. Connect at or