Metabolismo de grasas (deficiente)

5-HTP is a serotonin precursor that has been studied in both double-blind placebo-controlled and open-label trials specifically in fibromyalgia patients. A 1990 double-blind RCT (n=50) found all clinical parameters — tender points, pain intensity, morning stiffness, sleep, and anxiety — were significantly improved versus placebo. A 90-day open study confirmed sustained efficacy. Low serotonin metabolism is a recognized feature of fibromyalgia pathophysiology.

FM may be associated with carnitine deficits affecting mitochondrial energy metabolism. A double-blind multicenter RCT (Rossini et al., Clin Exp Rheumatol, 2007) in 102 FM patients found acetyl-L-carnitine improved musculoskeletal pain, depression, and quality-of-life scores versus placebo over 10 weeks. Additional RCTs comparing acetyl-L-carnitine with duloxetine and as add-on to standard care have supported modest benefit for pain and mood.

Alpha-lipoic acid is a potent antioxidant investigated in FM because of the documented role of oxidative stress in FM pathophysiology and ALA's proven efficacy in painful neuropathy. A double-blind, randomized, placebo-controlled crossover RCT (IMPALA Trial, registered ISRCTN58259979) was designed to evaluate ALA at 1,800 mg/day in FM patients. A second RCT (CADENCE) studied ALA in combination with pregabalin. A 2025 systematic review specifically listed ALA among nutraceuticals explored for FM.

D-ribose at 15 g/day was studied in 41 fibromyalgia/CFS patients (2006 pilot) and 257 patients (2012 multicenter trial), both reporting significant improvements in pain, energy, sleep, and well-being. Both studies were open-label without placebo controls. Fibromyalgia is associated with impaired cellular energy metabolism, which provides a mechanistic rationale.

Topical capsaicin (0.025%) has been identified in dietary supplement reviews as having evidence for joint tenderness relief in FM. A review of dietary supplements for FM treatment noted topical capsaicin showed benefit for joint tenderness, though not for overall FM pain. The Arthritis Foundation notes many studies showing capsaicin effectively reduces pain from FM among other conditions. Capsaicin depletes substance P from sensory nerve endings, reducing nociceptive signaling.

Pilot RCTs have evaluated topical capsaicin as adjunctive therapy for fibromyalgia pain. A pilot study by McCarty et al. (Semin Arth Rheum, 1994) demonstrated pain relief. PubMed identifies capsaicin as a topical pain reliever evaluated in RCTs for fibromyalgia. Evidence is preliminary but qualifies as scientific.

A pilot clinical study assessed topical capsaicin for fibromyalgia pain and found improvements in pain scores, providing preliminary clinical evidence for this application. The mechanism — substance P depletion in sensitized central and peripheral nociceptive circuits — is pharmacologically plausible.

Topical capsaicin has been studied for fibromyalgia-related muscle pain in controlled trials. A pilot study published in Seminars in Arthritis and Rheumatism (McCarty et al., 1994) and several subsequent double-blind trials showed significant pain reduction from topical capsaicin application in fibromyalgia patients.

A pilot double-blind, placebo-controlled RCT at Virginia Commonwealth University evaluated chlorella in 55 fibromyalgia patients and found potential for symptom relief and quality-of-life improvement, with authors concluding that larger trials are warranted.

CoQ10 deficiency and mitochondrial dysfunction have been documented in FM patients, with tissue CoQ10 levels reportedly 40–50% below normal. A randomized double-blind placebo-controlled trial in 20 FM patients found 300 mg/day CoQ10 for 40 days significantly reduced FIQ scores, pain, fatigue, and tender points versus placebo. A separate randomized crossover study in 22 female FM patients showed CoQ10 improved pain-related outcomes by 24–37% and reduced sleep disturbance by ~33%.

A 16-week randomized, double-blind, placebo-controlled trial demonstrated that creatine supplementation improved muscle function in fibromyalgia patients, with an 80.3% increase in intramuscular phosphorylcreatine. An earlier open-label study reported improvements in pain, quality of life, and sleep. Evidence base is small but clinical in design.

Curcumin (from turmeric) has been listed in multiple recent systematic reviews and narrative reviews as a nutraceutical investigated for FM symptom management, primarily via anti-inflammatory and antioxidant mechanisms. A 2025 narrative review (PMC) cited curcumin among supplements potentially improving FM symptoms, and a 2025 Drug Topics review identified curcumin among key nutraceuticals for FM pain. Preclinical neuropathic pain models show curcumin alleviates pain behaviors and restores neuronal integrity.

FM patients have been hypothesized to have altered muscle adenine nucleotide metabolism, depleting cellular ATP. An open-label pilot study (Teitelbaum et al., J Altern Complement Med, 2006) in 41 FM and/or chronic fatigue syndrome patients treated with D-ribose 5 g three times daily found significant improvements across all five VAS categories: energy, sleep, mental clarity, pain intensity, and well-being, with approximately 66% experiencing significant improvement and average energy increase of 45%. A case report also documented symptom reduction in an FM patient.

Multiple studies show fibromyalgia patients frequently have lower magnesium levels, and supplementation has demonstrated benefit in some trials. A 2021 literature review (Boulis et al., Sage Journals) surveyed multiple correlational and interventional studies. A 2022 double-blind RCT found magnesium significantly reduced mild/moderate stress and pain severity in FM patients versus placebo. Magnesium citrate combined with amitriptyline has also been evaluated as adjunct therapy.

FM patients have documented lower nocturnal melatonin secretion. A 2019 systematic review of four controlled and uncontrolled studies in 98 FM patients concluded all studies reported positive effects of melatonin on FM symptoms including pain, sleep, fatigue, and tender point count, with no major adverse events. A 2010 double-blind placebo-controlled RCT in 101 FM patients found melatonin alone or combined with fluoxetine significantly reduced total FIQ scores.

An open pilot study (Edwards et al., J Nutr Environ Med, 2001) investigated CMO in 13 fibromyalgia patients over 21 days. Ten patients completed the study; mean pain, fatigue, and sleep disturbance scores improved meaningfully, with five showing good response. Wikipedia confirms this pilot study as evidence of potential benefit, though notes low evidence quality and the absence of a follow-up placebo-controlled trial.

PEA is an endogenous fatty acid amide that acts on the endocannabinoid system and downregulates mast cell and glial cell activity implicated in FM pathophysiology. Observational clinical investigations in FM patients found micronized and ultra-micronized PEA reduced pain intensity and improved quality of life. A 2025 retrospective comparative study in 86 FM patients found ALC+PEA as add-on therapy produced a significant FIQR reduction of 19 points (p<0.001) versus no change in standard-care-only controls.

Pregnenolone has been proposed as a neurosteroid relevant to fibromyalgia via its analgesic and anti-fatigue properties. One case study documents significant fibromyalgia pain relief with hormonal support including pregnenolone. Its analgesic RCT results in chronic low back pain support its broader candidacy for neurosteroid-mediated pain conditions.

SAMe is among the most historically studied nutraceuticals for FM, with a review of seven clinical trials finding benefit for FM-related depression and tender point pain severity. A 1987 double-blind crossover study in 17 FM patients found SAMe significantly reduced the number of trigger points (p<0.02) and improved depression scores versus placebo. Additional randomized trials, including intravenous and oral administration studies, supported these findings.

Serratiopeptidase is listed in clinical prescribing references as an indicated agent for fibromyalgia, based on its anti-inflammatory and analgesic mechanisms. It is included among SRP clinical applications in the AJPCR review and RxList. However, no dedicated fibromyalgia RCT has been identified in the peer-reviewed literature; evidence is based on indication listings and mechanistic extrapolation from anti-inflammatory data.

D-series resolvins reduced pain and depressive symptoms in a preclinical fibromyalgia model. A human clinical trial of SPM precursors showed significant improvements in pain and quality of life in adults with chronic pain including fibromyalgia-type symptoms. Fibromyalgia is among conditions for which SPM efficacy has been documented in preclinical models.

Vitamin D deficiency is commonly found in FM patients and correlates inversely with pain severity and FIQ scores. A 2025 systematic review and meta-analysis found vitamin D supplementation significantly reduced pain levels compared to control, with effect sizes of SMD −0.85 on NRS/VAS (p=0.0148) and SMD −0.87 on FIQ scale (p=0.0115). A 2017 meta-analysis also concluded vitamin D is a determinant factor in FM.

Vitamin D3 (cholecalciferol) is the form most commonly used in clinical studies evaluating vitamin D supplementation for FM. Evidence base is the same as for vitamin D: meta-analyses confirm association of deficiency with FM symptom severity and significant pain reduction with supplementation in deficient patients. The 2025 systematic review and meta-analysis found significant FM pain reduction (SMD −0.85 to −0.87) with vitamin D supplementation.

Cat's claw is listed in modern herbal medicine references as a remedy for fibromyalgia, attributed to its anti-inflammatory and analgesic properties. Multiple integrative medicine sources recommend it for chronic conditions involving neuroinflammation such as fibromyalgia. No clinical trials specifically for fibromyalgia exist.