This is based on this April 24,2035 paper: The gut microbiota promotes pain in fibromyalgia. There are two interesting finings:

• “transplantation of a healthy microbiota [FMT] is associated with reduced pain and improved quality of life. ” This option is rarely available since FMT is only authorized for  recurrent Clostridioides difficile infections
• And  “Since mice transplanted with the FM gut microbiota showed reduced levels of specific bile acids (e.g., ursocholate) and bile-acid-metabolizing bacteria (Lachnoclostridium scindens [sic: Clostridium scindens] ), we treated mice that received FM FMT with UDCA, a host-derived primary bile acid metabolized in the mouse gut into various secondary bile acids.^57,58,59 “

This post is running from this data into a model and thus a theoretical protocol (not tried in any clinic) if there is evidence to support a model.

Ursocholate Deficiency

This is available as a prescription drug: Actigall, Urso 250, Urso Forte. More details from WebMD. This is not always possible to get prescribed. This leads us to look for production by bacteria. We find that we have information about it on the KEGG: Kyoto Encyclopedia of Genes and Genomes. Going though databases, we do not find any known bacteria (including probiotics) that produces it 😦 . Going to a secondary data resource we get some bacteria involved in production:

Bacterial Species	Role in Ursocholate Production
Blautia obeum	Initiates conversion of cholic acid
Collinsella aerofaciens	Converts intermediate to ursocholic acid
Clostridium limosum/absonum	Can perform full conversion in one species
Eggerthella sp.	May contribute relevant enzymes
Ruminococcus gnavus	Produces related bile acids (UDCA)

Checking against published literature on National Library of Medicine Citations for Fibromyalgia we see:

• Several blautia species are identified but the above is not cited.
• Collinsella, Clostridium, Ruminococcus gnavus is not reported
• Eggerthella is reported high
• [Clostridium] scindens is high which is contrary to expectations

This is less than ideal. We really want

We have a secondary resource: Bacteria by Symptoms by Lab that are high or low. By lab for Fibromyalgia, we found:

• No matches for Biomesight data
• No matches for uBiome data
• No matches for Thryve data
  • One Blautia species was low

Lachnoclostridium scindens encouragement

We have the list of known items that impacts this species on this page. We note that 80% of the items listed decreases it — we want to increase it.

• High-fibre diet {Whole food diet}
• Rheum × hybridum {Rhubarb} & Rhubarb x Peony {Rhubarb Peony Decoction}
• bacillus subtilis {B.Subtilis }
• Coffee (Caffeine)

Bottom Line — No evidence confirming the proposed mechanism

Science is endless iteration of tossing out hypothesis and then testing them. Revising as needed. In the study, it is probable that FMT does help; the speculation as to the cause appears unsupported and suspect.

No theoretical protocol will be produced.