A recent study published in Current Rheumatology Reviews found that high dose omega 3 supplementation significantly improved fibromyalgia pain measures and was associated with increased serum magnesium and calcium levels. These findings align with preclinical evidence demonstrating multiple biological pathways through which omega 3 fatty acids exert analgesic effects. EPA and DHA modulate inflammatory responses by competing with arachidonic acid metabolism, thereby reducing the production of proinflammatory mediators such as prostaglandin E₂ and leukotriene B₄. They also serve as precursors for specialised pro resolving mediators, including resolvins, protectins, and maresins, which actively promote the resolution of inflammation. Within the central nervous system, omega 3 fatty acids have been shown to attenuate neuroinflammation and central sensitisation, partly through suppression of microglial activation involving the SIRT1 HMGB1 NF kappa B pathway. These mechanisms support the potential for omega 3 fatty acids to alleviate pain through complementary peripheral and central actions.
The randomized, double blind, placebo-controlled trial included 120 patients assigned in a 1 to 1 ratio to receive either omega 3 supplementation or placebo for 8 weeks. Clinical assessments, including the Widespread Pain Index, Symptom Severity Scale, Visual Analogue Scale, and Fibromyalgia Impact Questionnaire, were performed at baseline and at week 8. Serum calcium and magnesium levels were measured at both time points to examine potential biochemical correlates of treatment response.
The omega 3 group demonstrated significantly greater improvements across all clinical outcome measures compared to placebo (P < 0.001). After 8 weeks, serum calcium levels showed negative correlations with Widespread Pain Index (r = –0.308), Symptom Severity Scale (r = –0.28), Visual Analogue Scale (r = –0.311), and Fibromyalgia Impact Questionnaire (r = –0.348) scores (P < 0.001). Serum magnesium levels also showed inverse correlations with Symptom Severity Scale (r = –0.212) and Visual Analogue Scale (r = –0.231) scores after treatment.
Emerging evidence supports a neuronutritional approach to fibromyalgia management, as dietary factors and specific supplements may influence pain, inflammation, neurotransmitter regulation, and mitochondrial function. Interventions such as vitamin D, magnesium, iron, vitamin B12, coenzyme Q10, probiotics, omega 3 fatty acids, melatonin, S adenosylmethionine, acetyl L carnitine, and curcumin have shown potential benefits for pain, mood symptoms, sleep, cognition, and gastrointestinal disturbances, while plant based diets, low FODMAP diets, and weight loss have been associated with reduced inflammation and improved quality of life. Overall, nutritional strategies appear promising as complementary treatments, highlighting the need for further research to establish evidence based dietary guidelines and optimise holistic management of fibromyalgi
Overall, the study suggests that high dose omega 3 supplementation provides meaningful pain reduction in fibromyalgia, potentially mediated by associated increases in serum magnesium and calcium concentrations. The inverse relationships between these mineral levels and symptom scores indicate that higher serum electrolyte concentrations may contribute to reduced symptom severity and improved functional outcomes in fibromyalgia patients.
References
- Fattah MAA, Morsi S, Fattah SA, A Moneim NH, Tawfik MG. High-dose Omega-3 Alters Serum Magnesium and Calcium Levels and Affects Fibromyalgia Symptoms: A Randomized, Double-blind, Placebo-Control Study. Curr Rheumatol Rev. 2025;21(4):446-454.
- Xie L, Wang X, Chu J, He X, Bao J, Xi Y, Wei X and Zhou Q (2025) Effects of omega-3 fatty acids on chronic pain: a systematic review and meta-analysis. Front. Med. 12:1654661.