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Elimination Diet For Those with ME/CFS or Fibromyalgia (Update)

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ME/CFS specialist Dr. Paul Cheney reports he has documented food sensitivities in roughly 50% of cases of Chronic Fatigue Syndrome, says Clinical Nutritionist Blake Graham. And a large proportion of Fibromyalgia patients suffer from food intolerances, though many do not know it.

Graham believes an elimination diet is the best method of assessing food sensitivities, and has developed this protocol for patients with chronic illnesses that includes a preliminary step for ME/CFS and fibromyalgia patients specifically. The protocol requires time and food label detective work. But it will produce great benefits for those who identify one or more diet troublemakers.


There are many reasons why individuals react negatively to foods, and laboratory assessment methods test only for specific mechanisms of reaction and exclude others (such as IgG).**

An elimination diet, by contrast, is not reliant on a particular mechanism, covers all food reactions, and is the best method of assessing food sensitivities.

The elimination diet described below is:

Limited to unrefined/whole/fresh foods

Devoid of food additives/colorings/artificial sugars

Gluten free, casein free, and lactose free

Very low in salicylates

Very low in dietary yeasts

Very low in dietary glutamates

Very low in dietary biogenic amines

Very low in dietary solanines

Generally hypoallergenic

Devoid of caffeine and alcohol.

Adhering to the following diet for a period of time enables a person to determine if any of these key, and common, food sensitivities are present. Observing benefits in any aspect of health while on this diet indicates one or more of the points listed above are significantly related to your symptoms.

This diet provides a snapshot in time of what you may feel like while taking into consideration all the factors listed above.


CFS/FM Patients – First, Go Gluten & Casein Free For 30 Days

In the weeks before an elimination diet, eat a nutrient-rich, unrefined and varied diet. In the case of Chronic Fatigue Syndrome, this diet trial should come after a gluten- and casein-free diet trial of 30 days or more. Sources of these two dietary proteins are explained below. Sensitivity to gluten and casein can sometimes take a more extended time period to become evident than a standard elimination diet allows.

To attempt this diet you must carefully read the ingredients list of every food you eat, and truly do it 100 percent, to see real results. No lab test negates the need for this trial. Most people who react negatively to gluten do not have true celiac disease (and therefore test negative to celiac blood tests), but rather another form of gluten sensitivity.

Sources of gluten include:

Anything containing wheat, barley, rye, oats & spelt [a species of wheat grown in parts of Europe since ancient times, and now often a ‘health food’].

Anything that contains the words gluten, gliadin & glutenin.

Foods which state they may contain traces of wheat/gluten.

Maltodextrin/malt (unless it states it is derived from rice or corn).

Soy sauce (unless it states it is gluten free).

Bran (unless it states it is gluten free and/or derived from rice or corn).

Hydrolyzed vegetable protein (HVP).

Bulgur, couscous, durum, dinkle, kamut, semolina & triticale [all AKA wheat].

Sources of casein include:

Anything containing milk, yoghurt, cheese, butter, cream, icecream, goat’s milk derived products, etc.

Milk solids.

Anything that says casein or caseinate.

Choose the most convenient time to try this diet. For example not when relatives are staying over or when traveling. Ask for the support of your family.


First 7 to 10 Days Very Limited

For 7 to 10 days, consume nothing but the foods listed below. If there are any foods on this list you know or suspect you may be sensitive to, eliminate these foods also. (Aspirin should also be avoided during this period due to its high salicylate content.) Consume a varied diet, eating some [of these] fruits, vegetables, meats, and grains daily.

GRAINS – Whole grain rice (rinse before cooking)

MEAT – All unrefined (non aged/processed/smoked/seasoned) fresh meats, except beef

VEGETABLES – Cabbage, celery, green beans, iceberg lettuce, & swedes [rutabagas]

FRUITS – Peeled pears

OILS/SEASONINGS – Olive oil & sea salt

DRINKS – Water (filtered)

Keep a diary of symptoms and note any changes.

If symptoms worsen (or new symptoms appear) in the first 2 to 4 days, this may indicate withdrawal from food allergy or addiction.

If after 7 to 10 days symptoms have improved, this may indicate food sensitivities of some kind.


Add Back Food Categories One at a Time

Add back foods one at a time and in a pure form (fresh corn, for example), or with a non-eliminated food, taking note of symptoms changes. Consume plenty of the foods you are testing. (Corn at lunch and dinner, for example.)

The following order for adding foods back is recommended:

1. Dairy (in the form of whole cream or plain yogurt)

2. Eggs

3. Yeast [see below]

4. Citrus

5. Corn

6. Cocoa.

Allow about 48 hours between adding new foods.

Note changes in symptoms upon adding back foods [see list of “Common food allergy and intolerance symptoms/signs” below].

Any foods you react to should be eliminated, as you go on to test others. If you react to specific foods wait until the resulting symptoms have cleared before adding new foods.


Patterns to Look Out For

Some people are sensitive to dietary salicylates. [Found in many fruits and vegetables, often concentrated just under the skin and in the outer leaves of vegetables, such as cabbage and lettuce. Levels decrease as fruit/vegetable ripens. Discard outer leaves; peel thickly; go for ripe. For information on the relative salicylate levels of scores of fruits and vegetables, nuts and snacks, sweets, herbs/spices/condiments, coffees/teas, alcoholic beverages, and fats & oils, go to http://salicylatesensitivity.com/about/food-guide/]

Some people are sensitive to dietary yeasts. [Found in many foods including yeast raised breads; fermented beverages; vinegar; fruits eaten with skin, from berries, cherries, and grapes to prunes and raisins; olives; peanut butter. To print out a small chart of “permitted” and “not permitted” foods in a yeast-free diet, go to http://www.Nutritional-Healing.com.au/content/Yeast%20free%20diet.pdf]

Some people are sensitive to dietary glutamates. Glutamates are contained in MSG, hydrolyzed vegetable protein, anything that contains the word glutamic or glutamate, and foods including roquefort cheese, parmesan cheese, soy sauce, walnuts, fresh tomato juice, grape juice, peas, etc. [For more on foods containing glutamates, and other names for glutamates used in labeling, see "List of Foods Containing Glutamates." As this article notes, the soy protein used in so many prepared foods contains high amounts of glutamates, peanuts are high in glutamate, and the artificial sweetener Aspartame converts to glutamate in the digestive system.]

Some people are sensitive to dietary amines. Amines are contained in chocolate, cheese, fish, aged/processed meats, bananas, oranges, avocados, tomatoes, wine/beer, etc. [For a more complete food list with relative amine content levels, see "Amine Content of Foods]

Some people are sensitive to solanine containing foods. Solanines are contained in tomatoes, potatoes, peppers, eggplant. [They function as the plant’s natural defense against pests and fungus.]


Common Food Allergy and Intolerance Symptoms/Signs


Increased mucus production in throat, regularly clearing throat, coughing

Irregular flattened patches on tongue or mottled tongue

Dark areas and/or blue, black or pink circles around eyes

Nose rubbing/Itchy nose

Nasal/sinus congestion or postnasal drip

Headache, migraine

Puffy eyes, nose, face

Abnormally red cheeks/nose and/or flushed appearance

Ears turn red for no apparent reason

Inner corners of eyes itch

Skin problems (eczema, rash or pale ring around mouth, dermatitis, itching, ‘burning’ feeling of skin, ‘creepy crawlies’ under skin feeling, numb skin, etc.)

Diarrhea or loose stools or constipation

Abdominal pains, bloating or nausea after meals

Increased frequency of stools

Feel/act best when don’t eat

Strong particular food likes (cravings) and dislikes

Unexplained intermittent +/- sudden irritability, depression, hyperactivity, anxiety, anger, crying, giggling, hiding in dark places, rage, vulgarity, not wanting to be touched

Unexplained intermittent +/- sudden changes in walking, reading, writing, speaking



* Blake Graham specializes in nutritional and environmental treatments for patients with CFS, FM, and other chronic conditions. He is an associate of the Australasian College of Nutritional and Environmental Medicine in Perth, Western Australia (AACNEM). This article is reproduced with permission from his website Nutritional-Healing.com.au

** [For example, IgG-specific antibody tests look for the immunoglobulin G antibodies associated with non-atopic or ‘delayed’ food reactions to specific foods that can worsen or contribute to many different health problems. These tend to be frequently eaten foods that are hard to avoid, including milk, corn, and wheat. Another type of test – the IgE antibody assay – addresses less frequent but more immediate, high-profile atopic food sensitivities, such as those to peanuts or shellfish.]

Note: This information has not been evaluated by the FDA. It is not intended to diagnose, cure, treat, or prevent any illness, disease, or condition. Importantly, you should never make any change in your health care plan or health support regimen without researching and discussing it in consultation with your professional healthcare team.

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2 thoughts on “Elimination Diet For Those with ME/CFS or Fibromyalgia (Update)”

  1. jsjefferson says:

    NAET is an Allergy Elimination Technique which I have used for about 8-9 years off and on (as $$ was available). It is a form of energy medicine which uses a combination of acupressure and/or acupuncture to clear the resistance in the body to a specific allergen. It can be very effective against food allergies if used properly. The first time I used it I did not notice that much difference in my overall allergies except that there were 3-4 anomolies which told me that it was doing something and encouraged me to come back to it again at a later date. Now, I can eat pretty much whatever I like except that once in a while a particular food will sour on my stomach and I know that there is a resistance developing which will eventually need treatment. It is not cheap but works much better than the 5 years of shots that I had in the 1980’s.

    Janet J

  2. Shirley33Anne says:

    I did this with a doctor in Florida. I sent blood which was tested for delayed food allergies and specific foods were positive and I had to eliminate them from my diet for six week. I did this one food at a time. After six weeks I reintroduced the foods. If I showed a symptom within an hour I had to continue eliminating for another six weeks and check again. I had GREAT success with this process and MAY symptoms are gone and remain gone eg irritable bowel, headaches,sinus, asthma, skin rashes etc. It is absolutely amazing and has encouraged me tremendously. I would recommend this for anyone suffering from fibro.

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