A disease that is linked to chronic fatigue and is characterised by aching and tender
muscles over a long period of time. Also common in fibromyalgia are insomnia,
headaches and joint pain. Low serotonin levels are a common feature in fibromyalgia
patients and the quality and amount of sleep is proportional to the amount of pain
experienced. Researchers have consistently shown that 5-HTP supplementation can
dramatically increase serotonin levels in fibromyalgia patients, and that this results in
decreased pain and fatigue. 50 patients with fibromyalgia were given either 5-HTP or a
placebo in a double blind study of the efficacy and tolerability of 5-
hydroxytryptophan. All symptoms were found to be improved in the 5-HTP group and
only mild transient side effects were noted.
St John’s Wort
Studies suggest that the combination of SJW and 5-HTP is better than using either one
on its own. SJW may help to improve serotonin levels in the brain and therefore one of
the primary benefits with St. John's wort (and 5-HTP) relates to its ability to improve
sleep quality. One of the key findings in patients with fibromyalgia is a reduced REM
sleep and an increased non-REM sleep. In addition, the deeper levels of sleep (stage III
and IV) are not achieved for long enough periods. As a result people with fibromyalgia
wake up feeling tired, worn-out, and in pain.
Magnesium deficiency is common in fibromyalgia. It is required for a variety of cellular
functions and is a co-factor nutrient in hundreds of enzymatic reactions in the body,
many of which are associated with energy production. Magnesium also supports
serotonin function. Studies suggest that magnesium may be an important factor in the
support of fibromyalgia patients, and is especially beneficial when used in combination
with 5-HTP. Magnesium in citrate or aspartate forms are the best for this condition.
Although specific research on the use of rhodiola in fybromyalgia is currently lacking,
there are a number of reasons that scientists are interested in studying it in relation to
this disorder. Rhodiola has been shown to increase levels of serotonin in the brain, a
key factor in fybromyalgia protocols. Rhodiola may also improve energy production
and its adaptogenic properties make the body more resistant to stress, a major factor in
both chronic fatigue and fybromyalgia.
Studies suggest a role for D-ribose in fatigue and myalgia. Fibromyalgia is linked to
chronic fatigue syndrome and is characterised by muscle aches and stiffness in multiple
sites around the body. Scientists think that it may be associated with a muscular
imbalance between adenosine diphosphate and adenosine triphosphate (ATP), and as a
key component of the nucleotide adenosine, D-ribose is thought to promote proper
energy metabolism and thus help restore normal muscle function.
Nutrient/Herb Typical intake range
5-hydroxytryptophan (5-HTP)1 50-100mg three times per day (empty stomach)
St. John’s Wort (0.3% hypericin)2 300 – 900mg per day
Magnesium citrate or aspartate3 200 – 600mg pare day
Rhodiola rosea extract4 250 – 750mg per day
D-Ribose5 3 - 10g per day
High quality proteins
Vegetables (esp. dark leafy green)
Nuts and seeds
Take gentle exercise
Minimise impact of stress (use stress management techniques)
1. May increase risk of scleroderma-like symptoms in susceptible individuals. May cause serotonin
syndrome if combined with antidepressant drugs that increase serotonin levels – avoid concurrent
use. Best avoided by pregnant women and nursing mothers.
2. May cause photosensitivity (increased sensitivity to ultraviolet light), especially with regular use
of high doses. Avoid using St. John’s Wort anti-depressant drugs.
3. High doses may cause loose stools.
4. Do not use during pregnancy or lactation. Concurrent use with anti-depressant medication under
medical supervision only.
5. May cause increased uric levels so should be avoided by those with gout. May cause
hypoglycaemia so diabetics should use with caution and under medical supervision. Avoid if
pregnant or breastfeeding.