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Important metabolic factors that affect appetite with fibro patients are sufficient levels of oxygen and the B vitamins. When there is an insufficient level of oxygen and other nutrients, the body begins to break down muscle tissues to use as fuel. At least one scientific theory suggests that this is the basic cause of fibromyalgia. Lack of Vitamin B1 (thiamine) can lead to the lack of proper oxygen in muscle tissues. Whether we have a large appetite or a small one, getting the proper types of food and the proper nutritional supplements should result in some improvement in symptoms.