Fibromyalgia: Moderate Drinking May Ease Symptoms

Janis C. Kelly

March 15, 2013

Patients with fibromyalgia (FM) who drink low or moderate amounts of alcohol have less severe symptoms than nondrinkers, and Mayo Clinic researchers suspect that alcohol's ability to raise γ-aminobutyric acid (GABA) levels might be the reason. However, the researchers note that the nondrinkers (more than half of the study population) might also have had more severe FM and avoided alcohol out of concern about possible interactions with FM treatment drugs, such as opioids.

"Our study demonstrates that low and moderate alcohol consumption was associated with lower fibromyalgia symptoms and better QOL [quality of life] compared to no alcohol consumption. The reasons for these results are unclear. Since recent studies have demonstrated that γ-Aminobutyric Acid (GABA) levels are low in fibromyalgia, and alcohol is known to be a GABA-agonist, future studies should examine whether alcohol could have a salutary effect on pain and other symptoms in fibromyalgia," Chul H. Kim, MD, and colleagues reported online March 15 in Arthritis Research & Therapy. The research team was led by Terry H. Oh, MD, from the Department of Physical Medicine and Rehabilitation at the Mayo Clinic in Rochester, Minnesota.

The study included 946 patients in Mayo's Fibromyalgia Treatment Program from May 1, 2001, through April 30, 2004. All had confirmed FM and had completed the Fibromyalgia Impact Questionnaire (FIQ) and the Short Form-36 Health Survey (SF-36).

The patients were divided into the following self-reported alcohol consumption categories: none (no drinks/week; n = 546 [58%]), low (≤3 drinks/week; n = 338 [36%]), moderate (<3 to 7 drinks/week; n = 31 [3%]), and heavy (>7 drinks/week [n = 31] 3%). These were then examined for correlation with FM-related symptoms (FIQ scores) and quality of life (SF-36 scores).

Better QOL, Less Pain

Drinkers had higher education, a lower body mass index (BMI), and a lower frequency of unemployment and opioid use than nondrinkers.

After adjusting for age, employment status, education level, BMI, and opioid use, the researchers found significant group differences in the number of tender points, FIQ total score, FIQ subscales of physical function, work missed, job ability, and pain.

"Moderate drinkers had overall lower fibromyalgia-related symptoms, and higher QOL scores than the other groups. Pairwise comparison among the four groups showed that the moderate and low alcohol drinkers had better physical QOL than nondrinkers, with significant differences for SF-36 physical functioning, pain index, and physical component summary scores," the authors wrote.

The association between low or moderate drinking, fewer FM symptoms, and better QOL held even after adjustment for social variables and BMI. This beneficial effect was not observed in heavy drinkers.

The authors concluded, "We urge caution when generalizing the findings of this study because of the relatively small number of moderate and heavy drinkers in the study. Furthermore, we do not recommend that patients with fibromyalgia start or increase drinking for their symptoms."

"GABA, an inhibitory neurotransmitter, is low in the brain in fibromyalgia, which may go some way to explain why the nervous system reaction to pain is amplified. Alcohol binds to the GABA receptor in the central nervous system which in turn may turn down pain transmission. However the effects of alcohol may also be due to improved mood, socialization and tension, and while moderate drinkers have fewer symptoms there are still many questions about how this happens," Dr. Oh said in a press release.

The study was supported by the National Institutes of Health (NIH) and the NIH Roadmap for Medical Research. The authors have disclosed no relevant financial relationships.

Arthritis Res Ther. 2013;15:R42. Published online March 15, 2013. Abstract