A plethora of factors can upset bacteria balance in the body, including a sugar-rich diet or antibiotics. This can have many adverse effects, including interrupting the ability to absorb and digest nutrients such as vitamin B12. Poor gut health can have negative effects on the body as a whole. In some cases, bacteria from the colon can overgrow and enter the small intestines, a condition called SIBO. Some research suggests that SIBO is more common in people with fibromyalgia and that people with fibromyalgia and SIBO experience more pain, but a clear link between the two conditions has not been firmly established.

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