It's not all in your head, it's in your gut: Differences in the gut microbiome in individuals with and without fibromyalgia

Description

Abstract

Background: Fibromyalgia (FM) is a chronic pain syndrome that most commonly affects women. Given that there is no consensus regarding the pathophysiology of FM nor any known abnormalities in laboratory studies in FM, patients’ symptoms are often dismissed. There is a need for a better understanding of how and why FM occurs, and how it can be treated.

Objectives: This capstone aims to review recent literature regarding potential relationships between the gut microbiome and the symptoms of FM.

Design: Multi-study review.

Methods: The National Library of Medicine (PubMed), Embase, and Scopus databases were searched for articles published in 2025 that met the inclusion criteria. Four studies relevant to FM and the gut microbiome were selected for further analysis.

Results:

Study #1 Cai et al.: Significant increase in gut primary bile acid and amino acids, and significant improvement in quality of life measurements in patients with FM after getting fecal microbiota transplant from healthy controls.

Study #2 Hou et al.: Significant improvement in quality of life measurements and increase in bacterial alpha diversity in FM patients after receiving ozonated enema treatments.

Study #3 Durán-González et al.: Significant differences in 30 proteins and 19 bacterial taxa between FM and healthy controls in a cross sectional cohort study.

Study #4 Erdrich et al.: No significant difference in gut microbiome between FM and healthy controls in a cross sectional cohort study, however there was an association of P. johnsonii and cognitive dysfunction.

Conclusion: All four studies observed some relationship between the gut microbiome and/or metabolome and FM symptoms, however these studies were of lower quality due to small sample sizes and observational designs. Future studies are needed to conclude the relationship between FM and the gut microbiome.

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