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Can an Elimination Diet Help Improve Your Fibromyalgia Symptoms?

Plus 6 reasons elimination diets sometimes don't seem to work
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Elimination diet for fibromyalgia symptoms

When I became serious about healing from chronic illness, the first thing that made the biggest difference in my fibromyalgia symptoms was going on an elimination diet. I started in 2015 by cutting out gluten, soy, processed foods and most processed sugar. Within 30 days, I experienced a noticeable reduction in my pain.

A few years later, I added dairy to my do-not-eat list after I tested positive for a casein sensitivity. Within two months of making this change, my pain levels dropped yet again.

Given those results, I’m a huge believer in the power of food to heal or hurt depending on what we eat. However, I know not everyone has experienced my level of success with making dietary changes. When the subject of elimination diets comes up in online fibromyalgia support groups, there’s always a long list of people who proclaim, “That didn’t work for me!”

6 Reasons an Elimination Diet May Not Work for You

Over time, I’ve figured out several reasons why doing an elimination diet makes a big difference for some of us and does nothing for others. Below are a few reasons why elimination diets fail.

#1 – You’re on the wrong diet

I personally had this issue when I started my first elimination diet in 2015. At the time, I was following what I would classify as a ketogenic diet. I did see a noticeable improvement in fibromyalgia symptoms when I gave up gluten; however, the biggest change came when I finally went dairy free a few years later.

I didn’t realize the body sometimes cross reacts to both gluten and dairy, so if gluten triggers inflammation for you, then dairy likely does, too. In order to get the best outcome, some of us have to give up both food categories (and these other foods that cross react to gluten, too: corn, millet, oats, rice and yeast).

This is one explanation of why the keto diet, which typically promotes full-fat dairy, doesn’t work for everyone.

There’s actually very little quality research to guide us in choosing the best fibromyalgia diet. And the truth is, even if the research existed, it wouldn’t be very meaningful anyway because our bodies are all different.

Some people feel better eating low carb whereas others need a higher carbohydrate intake. Some people’s energy skyrockets on a plant-based diet, but for others, it sends them running to the toilet.

The only real way to figure out which diet is best at reducing fibromyalgia symptoms is to experiment with a few and see what happens. Unfortunately, that would be very time and money intensive.

But, as a starting point, paleo and keto are the most common diets that I consistently see working for people in online fibromyalgia support groups.

Research supports plant-based, gluten free and low FODMAP diets for fibromyalgia.

#2 You’re still eating problem foods without realizing it

It’s imperative to carefully read every food label and google ingredients that you don’t recognize so you can know for certain that every food you’re eating adheres to your elimination diet guidelines.

For example, when people give up gluten, they’re usually pretty good at avoiding all of the obvious foods like bread, pasta, cereal and baked goods. However, food manufacturers are super sneaky! They add gluten (and also dairy, corn and soy) to almost everything – even foods you’d never expect such as salad dressings, coffee creamer, seasoning spices, lunch meat, hot dogs, tomato sauces and so many others.

If you aren’t reading the ingredients list of every single food item before it gets tossed into your grocery cart, then you are likely still being “glutened” without realizing it.

One hidden source of troublesome ingredients that people almost never think of is their prescription drugs and supplements. A few years ago, a friend and I did the Whole 30 diet together. At the time, I hadn’t given up dairy yet, so I was extremely proud to get through my first 30 days dairy free.

However, I didn’t feel as good physically as I thought I should. A few days later, I figured out one potential reason why: A recently added supplement contained soy, one of my known food triggers. In that moment, I was crestfallen when I realized all of my hard work and willpower had been for nothing because my body was still likely reacting to the soy in that supplement.

#3 You didn’t give it enough time to work

With the advent of the internet and social media, we’ve been brainwashed into wanting everything to happen right away, right now, three days ago.

But healing takes time. Regardless of the elimination diet you choose, you’re not going to feel better in three days, or a week, or even two weeks. It generally takes at least 30 days of strict adherence to an elimination diet meal plan to begin to feel subtle positive effects in fibromyalgia symptoms. It takes about 60 to 90 days to experience the full impact.

The lesson here is this: Elimination diets are a marathon, not a sprint. In order for an elimination diet to work, you’ve got to stick to it and give it an honest chance.

#4 You threw in the towel too early because you felt worse

It’s not unusual to experience withdrawals or a detox reaction within the first couple of weeks of going on an elimination diet. That makes sense when you consider at least one research study found sugar is as addictive as cocaine, and food industry scientists are paid big bucks to develop foods that are “craveable.”

If you’ve eaten processed foods and processed sugar for years, then your body is going to rebel when you suddenly cut those out. You’re going to feel like you’re coming down with the flu, and your mood is likely going to nosedive without the crutch of processed sugar. These feelings will pass.

Feeling worse before you feel better while on an elimination diet is normal. While it’s not fun to go through withdrawal symptoms, it’s necessary to get to the other side of better health. If you give up too soon, you’ll never feel the full benefits of what an elimination diet could offer.

#5 You ate out

It’s extremely difficult to eat out without wrecking your elimination diet. Sure, there are some restaurants that cater to vegan and other dietary lifestyles, and more restaurants are now offering gluten-free menus.

However, when you eat out––either at a restaurant or someone else’s home––you give up control over your food’s ingredients and preparation. Restaurant food is notorious for including all of those good ingredients that are off limits on an elimination diet, like the flour used to thicken gravy or the butter sauce drizzled over that salmon filet.

Even if you’re lucky enough to find something on the menu that meets your specific dietary requirements, there’s also the issue of cross contamination. Sure, those french fries are technically gluten free, but if the restaurant prepares them in the same oil as their breaded chicken nuggets, then you’re still getting a dose of gluten. Sure, you told the cook to leave the seasoning off of your steak, but if he cooked it alongside other customers’ steaks on the grill, then you’re still getting trace amounts of that off-limits food.

If possible, it’s best to avoid eating away from home while doing an elimination diet to determine food sensitivities. That way you can fully control what you’re putting into your mouth.

#6 You have other food sensitivities that need to be addressed

I touched on this issue earlier, but it bears repeating: We are all individuals!

Most elimination diet meal plans focus on cutting out the biggies: gluten, sugar, dairy and soy. However, sensitivities can go well beyond those food categories!

Here are some other common food sensitivities:

  • Nightshade vegetables (tomatoes, potatoes, peppers, etc.)
  • Corn
  • Tree nuts (almonds, cashews, etc.)
  • Peanuts and other legumes
  • Eggs
  • Yeast (beer, cheese, processed/cured meats, etc.)
  • Citrus
  • Artificial sweeteners (diet sodas, yogurt, frozen desserts, chewing gum, etc.)
  • Food additives (artificial colors/flavors, monosodium glutamate, nitrates, etc.)
  • Caffeine (coffee, tea, energy drinks, chocolate, etc.)
  • Sulfites (wine, citrus and tea drink mixes, seafood, etc.)
  • Lectins (nightshade vegetables, beans/legumes, etc.)
  • Oxalates (dark green vegetables, dried fruit, nuts, etc.
  • Salicylates (tomato sauce, dried fruit, certain spices, coffee, etc.)
  • High histamine foods (alcohol, fermented foods, aged cheeses, etc.)
  • FODMAPs (garlic, onions, tea, sweeteners, etc.)

Overwhelmed yet? The sad fact is the list above isn’t even all inclusive. I’ve likely missed some categories of offending foods.

This is where food sensitivity testing can be helpful in parsing out troublesome foods. Even if testing results in a long “foods to avoid” list, it still provides a starting point for guiding future dietary choices.

Just be sure to choose the right test! Dr. Ginevra Liptan, author of The Fibro Manual, and a fellow fibro warrior, recommends the ELISA/ACT test offered by ELISA/ACT Biotechnologies and IgG food sensitivity testing from Genova Diagnostics, U.S. BioTek or Great Plains Laboratory.

Now it’s your turn: Have you ever done an elimination diet? If so, did you find it helpful for identifying food sensitivities? Share in the comments!


Donna Gregory Burch was diagnosed with fibromyalgia in 2014 after several years of unexplained pain, fatigue and other symptoms. She was later diagnosed with chronic Lyme disease. Donna covers news, treatments, research and practical tips for living better with fibromyalgia and Lyme on her blog, FedUpwithFatigue.com. You can also find her on Facebook and Twitter. Donna is an award-winning journalist whose work has appeared online and in newspapers and magazines throughout Virginia, Delaware and Pennsylvania. She lives in Delaware with her husband and their many fur babies.

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