Fibromyalgia
Supplements studied for fibromyalgia.
Overview
Fibromyalgia has several reviewed supplements with medium evidence for the top entries. Coenzyme Q10 (WA 68; medium effect size, high evidence, high trust) at 300–400 mg daily for 1–3 months may reduce pain, fatigue, sleep problems, and mood in women with fibromyalgia. Vitamin D3 (WA 60, three studies) reduced pain in people with low vitamin D but not mood or quality of life.
SAMe, Acetyl-L-Carnitine, and Melatonin (WA 52; low effect size, high evidence, medium trust) show mixed low-trust results across small oral, IV, or combination trials. The heatmap and evidence reviews below detail all 10 supplements reviewed for this condition.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Coenzyme Q10 | ★★★★★ | Medium |
| Vitamin D | ★★★★★ | Medium |
| Melatonin | ★★★★★ | Low |
| SAMe | ★★★★★ | Low |
| Acetyl-L-Carnitine | ★★★★★ | Low |
| Reishi | ★★★★★ | Low |
| L-Tryptophan | ★★★★★ | Low |
| Nattokinase | ★★★★★ | Very Low / None |
| Alpha-Lipoic Acid | ★★★★★ | Very Low / None |
| Panax Ginseng | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
10 supplements for , and rated at least stars. All purchase bands. No minimum star filter.
Coenzyme Q10View supplement →
Consider purchase·★★★★★
How we scored this▸
- Taking coenzyme Q10 by mouth (300–400 mg daily for 1 to 3 months) may help lessen several symptoms of fibromyalgia.
- Studies in women show it can reduce pain, tiredness, and trouble sleeping, and improve morning energy and mood.
- Some participants also reported feeling less depressed and anxious.
Browse 7 studies
RCTCoenzyme Q10 supplementation alleviates pain in pregabalin-treated fibromyalgia patients via reducing brain activity and mitochondrial dysfunction2019
A study of 11 fibromyalgia patients (2 male and 9 females; avg. age 46) included a 2 week washout period prior to 40 day supplementation of 150 mg/day pregabalin + either 300 mg/day coenzyme q10 or placebo. At day 40, patients receiving pregabalin with placebo were switched to coenzyme q10 with pregabalin, and patients receiving pregabalin with coenzyme q10 were switched to pregabalin with placebo for another 40 days. The combined coenzyme Q10 and pregabalin group experienced a greater reduction in pain, reduced oxidative stress and increased superoxide dismutase activity compared to pregabalin plus placebo. Pregabalin alone reduced pain and anxiety but not oxidative stress and inflammation at day 0, 40 or 80.
- Effect
- Benefit
- Duration
- 40 days
- Dose
- 150 mg/day
- Population
- Heart failure patients
- Avg age
- ~46
RCTEffect of Coenzyme Q10 on Psychopathological Symptoms in Fibromyalgia Patients2017
An RCT titled for CoQ10 effects on psychopathological symptoms in fibromyalgia patients had insufficient abstract text available to report specific outcomes.
RCTRole for a water-soluble form of CoQ10 in female subjects affected by fibromyalgia. A preliminary study2017n=22
In 22 women with fibromyalgia, 200 mg twice daily of a water-soluble CoQ10 formulation for an unspecified duration improved pain-related outcomes by 24–37%, fatigue by ~22%, and sleep disturbance by ~33%.
- Effect
- Benefit
- Dose
- 400 mg/day
- Population
- Women
- Participants
- 22
RCTCoenzyme q10 regulates serotonin levels and depressive symptoms in fibromyalgia patients: results of a small clinical trial2014n=20
A small fibromyalgia trial of 300 mg/day CoQ10 reported restored serotonin levels and improved depressive symptoms, but the available abstract text was insufficient for additional outcome detail.
- Effect
- Benefit
- Dose
- 300 mg/day
- Participants
- 20
RCTCan coenzyme q10 improve clinical and molecular parameters in fibromyalgia?2013
In 20 fibromyalgia patients, 300 mg/day CoQ10 for 40 days reduced pain, fatigue, and morning tiredness versus placebo and improved inflammation and mitochondrial gene expression markers.
- Effect
- Benefit
- Duration
- 40 days
- Dose
- 300 mg/day
- Population
- Heart failure patients
RCTIncreased oxidative stress and coenzyme Q10 deficiency in juvenile fibromyalgia: amelioration of hypercholesterolemia and fatigue by ubiquinol-10 supplementation2013n=67
In 10 juvenile fibromyalgia patients, 100 mg/day ubiquinol for 12 weeks raised CoQ10 levels, improved cholesterol metabolism, and reduced chronic fatigue scores.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 100 mg/day
- Population
- Children/adolescents
- Participants
- 67
RCTOxidative stress correlates with headache symptoms in fibromyalgia: coenzyme Q₁₀ effect on clinical improvement2012n=35
In 20 fibromyalgia patients with headache, oral CoQ10 supplementation restored low blood CoQ10 and catalase levels and significantly improved clinical and headache symptoms.
- Effect
- Benefit
- Population
- Fibromyalgia patients
- Participants
- 35
Vitamin DView supplement →
Consider purchase·★★★★★
How we scored this▸
- A small study found that taking vitamin D3 (1200–2400 IU daily) helped reduce pain in people with fibromyalgia who had low vitamin D. It did not improve mood or quality of life compared to people who took a placebo.
Browse 3 studies
Vitamin D Supplementation Seems to Improve Fibromyalgia Symptoms: Preliminary Results2018n=11
In 11 women with fibromyalgia and vitamin D deficiency, 50,000 IU/week vitamin D for 3 months raised 25(OH)D and reduced pain scores (VAS 90 to 30); 72% reported very significant symptom improvement.
- Effect
- Benefit
- Duration
- 3 months
- Dose
- 50000 IU/day
- Population
- Patients
- Participants
- 11
- Ages
- 1–10
Effects of Vitamin D Therapy on Quality of Life in Patients with Fibromyalgia2017n=42
In 70 fibromyalgia patients, vitamin D replacement improved fibromyalgia impact questionnaire, depression, pain, and quality-of-life scores versus pre-treatment, though 60% had deficiency at baseline.
- Effect
- Benefit
- Population
- Depression patients
- Participants
- 42
RCTEffects of vitamin D on patients with fibromyalgia syndrome: a randomized placebo-controlled trial2014n=30
A 20-week RCT of 30 women with fibromyalgia and low calcifediol found cholecalciferol supplementation significantly reduced pain on visual analog scale versus placebo.
- Effect
- Benefit
- Duration
- 20 weeks
- Population
- Women
- Participants
- 30
MelatoninView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Early studies suggest that taking 3–5 mg of melatonin each night for up to two months may ease pain, stiffness, and the number of sore joints in people with fibromyalgia compared to a placebo.
- However, more research is needed to confirm these benefits.
Browse 3 studies
Systematic reviewMelatonin in the treatment of fibromyalgia symptoms: A systematic review2020n=98
A systematic review of 4 studies (n=98) found melatonin reported positive effects on fibromyalgia symptoms including pain, sleep, and fatigue, though evidence quality was limited.
- Effect
- Benefit
- Population
- Fibromyalgia patients
- Participants
- 98
RCTAdjuvant use of melatonin for treatment of fibromyalgia2011n=101
In 101 fibromyalgia patients, 20 mg melatonin alone or combined with fluoxetine significantly improved pain and tenderness scores versus placebo over 8 weeks.
- Effect
- Benefit
- Duration
- 8 weeks
- Dose
- 20 mg/day
- Population
- Fibromyalgia patients
- Participants
- 101
RCTThe effect of melatonin in patients with fibromyalgia: a pilot study2000
In 19 of 21 fibromyalgia patients completing a 4-week open pilot, 3 mg melatonin at bedtime reduced tender point count and improved symptom severity on visual analogue scales.
- Effect
- Benefit
- Dose
- 3 mg/day
- Population
- Fibromyalgia patients
Acetyl-L-CarnitineView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is unclear if acetyl-L-carnitine by mouth or injection helps fibromyalgia symptoms.
- One study showed that taking acetyl-L-carnitine by mouth and injection for 10 weeks reduced muscle pain and improved mood and quality of life.
- Another smaller study found acetyl-L-carnitine improved physical quality of life and depression but not pain or anxiety.
- Taking acetyl-L-carnitine combined with another supplement (PEA) helped most patients reduce pain by at least 30%, while continuing usual fibromyalgia medicines.
Browse 3 studies
RCTPalmitoylethanolamide and acetyl-L-carnitine act synergistically with duloxetine and pregabalin in fibromyalgia: results of a randomized controlled study2023n=68
An RCT in 130 fibromyalgia patients on duloxetine plus pregabalin found adding palmitoylethanolamide 600 mg and acetyl-L-carnitine 500 mg twice daily for 12 weeks further reduced pain and disease severity scores.
- Effect
- Benefit
- Duration
- 24 weeks
- Dose
- 1000 mg/day
- Population
- Fibromyalgia patients
- Participants
- 68
RCTA randomized controlled trial comparing duloxetine and acetyl-L-carnitine in fibromyalgic patients: preliminary data2015n=65
A preliminary RCT in 65 women with fibromyalgia found acetyl-L-carnitine 1500 mg/day and duloxetine 60 mg/day both improved pain and depression over 12 weeks; duloxetine improved psychological quality of life more.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 60 mg/day
- Population
- Patients with fibromyalgia
- Participants
- 65
RCTDouble-blind, multicenter trial comparing acetyl-L-carnitine with placebo in the treatment of fibromyalgia patients2007
A multicenter RCT in 102 fibromyalgia patients found acetyl-L-carnitine (oral plus IM for 2 weeks, then oral for 8 weeks) continued to improve tender points and pain scores at 10 weeks versus placebo.
- Effect
- Benefit
- Duration
- 2 weeks
- Dose
- 1.5 g/day
- Population
- Patients with fibromyalgia
SAMeView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Small studies show that taking SAMe by mouth or injection might help improve some symptoms of fibromyalgia, like pain and mood.
- Different doses have been tried, including shots or pills for several weeks.
- Giving SAMe by IV has mixed results—some studies found it didn’t help, but others showed it reduced pain and depression.
Browse 4 studies
RCTEvaluation of S-adenosylmethionine in secondary fibromyalgia: a double-blind study1998
A double-blind study evaluated SAMe for secondary fibromyalgia; published details on dose, duration, and outcomes were not available in the abstract.
- Effect
- Benefit
- Population
- Patients with fibromyalgia
RCTDouble-blind, placebo-controlled cross-over study of intravenous S-adenosyl-L-methionine in patients with fibromyalgia1997
In 34 fibromyalgia outpatients, a 10-day cross-over trial of IV SAMe 600 mg/day vs placebo found no significant tender-point improvement and no clear benefit in this short-term study.
- Effect
- No Benefit
- Duration
- 10 days
- Dose
- 600 mg/day
- Population
- Patients with fibromyalgia
Controlled trialOral S-adenosylmethionine in primary fibromyalgia. Double-blind clinical evaluation1991n=44
A 6-week double-blind trial in 44 primary fibromyalgia patients found oral SAMe 800 mg/day improved disease activity, weekly pain, fatigue, morning stiffness, and mood vs placebo.
- Effect
- Benefit
- Dose
- 800 mg/day
- Population
- Patients with fibromyalgia
- Participants
- 44
Controlled trialEvaluation of S-adenosylmethionine in primary fibromyalgia. A double-blind crossover study1987n=17
A crossover study in 17 primary fibromyalgia patients found SAMe reduced trigger points and improved Hamilton and SAD depression scores vs placebo.
- Effect
- Benefit
- Population
- Patients with fibromyalgia
- Participants
- 17
L-TryptophanView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Early research in women with fibromyalgia shows that adding small amounts of L-tryptophan and magnesium to a Mediterranean diet for about 4 months helps reduce anxiety, mood problems, eating issues, and dissatisfaction with body image.
- However, it does not appear to improve sleep.
- It's not known if the effects come from tryptophan, magnesium, or both together.
Browse 1 study
RCTPsychological and Sleep Effects of Tryptophan and Magnesium-Enriched Mediterranean Diet in Women with Fibromyalgia2020n=22
In 22 women with fibromyalgia, a tryptophan and magnesium-enriched Mediterranean diet improved psychological symptoms and sleep versus control diet.
- Effect
- Benefit
- Duration
- 16 weeks
- Population
- Women
- Participants
- 22
- Avg age
- 49±5
ReishiView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- A small study in people with fibromyalgia showed that taking reishi mushroom powder 3 grams twice a day for 6 weeks did not improve mood, quality of life, or health measures compared to a placebo.
- The study might not have been large enough to find benefits.
Browse 2 studies
RCTEffects of Ganoderma lucidum and Ceratonia siliqua on blood glucose, lipid profile, and body composition in women with fibromyalgia2021
In women with fibromyalgia over 6 weeks, 6 g/day Ganoderma lucidum or Ceratonia siliqua did not show clear metabolic benefits in this pilot RCT.
- Effect
- No Benefit
- Duration
- 6 weeks
- Dose
- 6 g/day
- Population
- Women
RCTGanoderma lucidum Effects on Mood and Health-Related Quality of Life in Women with Fibromyalgia2020n=70
In 70 women with fibromyalgia over 6 weeks, Ganoderma lucidum 6 g/day improved mood, quality of life, and fibromyalgia symptoms versus baseline.
- Effect
- Benefit
- Duration
- 6 weeks
- Dose
- 6 g/day
- Population
- Women
- Participants
- 70
- Ages
- 18+
Alpha-Lipoic AcidView supplement →
Do not purchase·★★★★★
How we scored this▸
- It is uncertain if alpha-lipoic acid helps with fibromyalgia pain.
- Early research showed that taking alpha-lipoic acid for 4 weeks did not reduce pain more than a placebo.
- Combining alpha-lipoic acid with another medicine (pregabalin) for 6 weeks also did not improve pain or mood better than either one alone, but the study might have been too small to tell.
Browse 2 studies
RCTCombination analgesic development for enhanced clinical efficacy (the CADENCE trial): a double-blind, controlled trial of an alpha-lipoic acid-pregabalin combination for fibromyalgia pain2023
The CADENCE crossover trial in fibromyalgia found no significant difference in daily pain between alpha-lipoic acid, pregabalin, and their combination (4.9 vs 4.6 vs 4.5; p=0.54), though combination and pregabalin beat ALA alone on mood and sleep.
- Effect
- No Benefit
- Duration
- 6 weeks
RCTDouble-blind, randomized, placebo-controlled crossover trial of alpha-lipoic acid for the treatment of fibromyalgia pain: the IMPALA trial2021n=27
The IMPALA crossover trial in 27 fibromyalgia patients found no significant pain reduction with alpha-lipoic acid up to 1663 mg/day versus placebo; a post hoc analysis showed men but not women favored ALA.
- Effect
- No Benefit
- Dose
- 1663 mg/day
- Population
- Patients with diabetic neuropathy
- Participants
- 27
NattokinaseView supplement →
Do not purchase·★★★★★
How we scored this▸
- There is not enough evidence to determine if nattokinase has any benefit for fibromyalgia.
Browse 1 study
RCTDietary soy supplement on fibromyalgia symptoms: a randomized, double-blind, placebo-controlled, early phase trial2011n=50
In 50 fibromyalgia patients, 6 weeks of soy shake did not differ from placebo in Fibromyalgia Impact Questionnaire or depression scores despite similar within-group improvements.
- Effect
- No Benefit
- Duration
- 6 weeks
- Population
- Patients with fibromyalgia
- Participants
- 50
Panax GinsengView supplement →
Do not purchase·★★★★★
How we scored this▸
- It is not clear if taking Panax ginseng helps with fibromyalgia.
- One controlled study found that taking 100 mg of Panax ginseng daily for 12 weeks did not improve pain, tiredness, sleep, anxiety, or quality of life compared to a placebo.
- Another non-controlled study where people took Panax ginseng daily for one month showed that many felt better in terms of energy, mood, sleep, pain, and strength, but this study was not blinded or controlled, so its results are less certain.
- Most people in this study were women.
Browse 2 studies
Open-labelAn Open-Label, Pilot Trial of HRG80™ Red Ginseng in Chronic Fatigue Syndrome, Fibromyalgia, and Post-Viral Fatigue2021n=188
An open-label trial of 188 patients with chronic fatigue syndrome or fibromyalgia taking HRG80 red ginseng (200–400 mg/day for 1 month) found 60.1% self-rated improved, with composite scores rising from 11.9 to 18.8 (p<0.001).
- Effect
- Benefit
- Duration
- 1 month
- Dose
- 400 mg/day
- Population
- Patients with chronic fatigue syndrome
- Participants
- 188
RCTEffects of Panax ginseng extract in patients with fibromyalgia: a 12-week, randomized, double-blind, placebo-controlled trial2013n=38
In 38 fibromyalgia patients, Panax ginseng 100 mg/day for 12 weeks reduced pain, fatigue, and sleep versus baseline, though group differences versus amitriptyline or placebo were not significant.
- Effect
- No Benefit
- Duration
- 12 weeks
- Dose
- 100 mg/day
- Population
- Patients with fibromyalgia
- Participants
- 38
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Coenzyme Q10 | ★★★★★68% | 7 | 0 | 25% |
| SAMe | ★★★★★48% | 4 | 0 | 14% |
| Acetyl-L-Carnitine | ★★★★★48% | 3 | 0 | 11% |
| Melatonin | ★★★★★52% | 3 | 0 | 11% |
| Vitamin D | ★★★★★60% | 3 | 0 | 11% |
| Alpha-Lipoic Acid | ★★★★★32% | 2 | 0 | 7% |
| Panax Ginseng | ★★★★★28% | 2 | 0 | 7% |
| Reishi | ★★★★★44% | 2 | 0 | 7% |
| L-Tryptophan | ★★★★★44% | 1 | 0 | 4% |
| Nattokinase | ★★★★★32% | 1 | 0 | 4% |