How to Do an Elimination Diet

Photo credit: Kristen McElveen, ND

Photo credit: Kristen McElveen, ND

We have already talked about food allergies versus food sensitivities, so how do we find out what foods we react to? 

Well, you can do a test:

  • a skin prick test will show you full blown allergies (IgE immune reaction)
  • a blood test will show you allergies or sensitivities (IgE or IgG immune reactions)

Problem #1 with blood/skin testing: What happens if the allergic reaction is vague?

Remember, a food allergy or sensitivity can be as vague as a chronic runny nose or brain fog and as severe as anaphylactic shock. The more vague reactions may not show on a skin or blood test, or if you have other immune issues going on, they will either react to everything or nothing. 

Problem #2 with blood testing: What if I haven't eaten something in months?

For example, if you've been avoiding gluten like the plague and then do a blood test to see if you have an immune response, it won't show anything because you haven't had an exposure in so long. This can obviously skew the test. 

This is why, for people who choose to do the blood test for sensitivities, I recommend trying to eat all the foods we will be testing during the week prior to drawing their blood (as long as they aren't allergic) to make sure that they have had a recent exposure and therefore will have a better chance of showing an IgG reaction. 

So, what's the best thing to do? An elimination diet. 

An elimination diet removes potential problem foods from your diet for 6-8 weeks (I prefer 8 weeks) so that your body has a chance to recover from your chronic exposures.

Your sensitivity may not be a big deal here and there, but over time, constant (daily) exposure to something that causes inflammation can significantly affect your immune system and contribute to leaky gut which can in turn affect all kinds of things for both mental and physical health

I can't tell you how many times people fought me tooth and nail to keep their daily cream in their coffee because it was "so little" or they couldn't bear to be without it for 2 months, only to find out it did have a huge effect on their body.

So how do you do an elimination diet?

Start by making a list of foods you suspect you may be sensitive to (usually it's the ones you crave), or simply remove the common sensitivities:

  • cow dairy (milk, cheese, ice cream, cream - purified butter or ghee is ok as it is lactose and casein-free, Tin Star Foods actually tests their ghee post-production to ensure purity)
  • eggs
  • wheat and/or gluten (gluten is in wheat, spelt, barley and rye and many people react to wheat but do ok with the other gluten-containing grains - still, I recommend cutting out ALL gluten and then when you re-introduce, start with the non-wheat grains first to see if you can have those)
  • tree nuts and peanuts
  • soy
  • fish
  • shellfish

I usually recommend adding the following potential allergens/sensitivities as they are becoming more common as well:

  • corn
  • strawberries
  • citrus
  • nightshades (tomatoes, potatoes, peppers, eggplant)

Remove these from your diet for 6-8 weeks - NO shorter, as your body will need a chance to heal.

You may not feel any different during this part, this is common. But don't let it rationalize ending early or cheating here and there or you will need to start over. 

Now comes the interesting part:

Start a journal to help you through this phase (you can't remember everything) and SLOWLY...that is S-L-O-W-L-Y...reintroduce the foods that you cut out, one at a time, once every 3 days (as it can take up to three days for a reaction). 

For example, on Day 1 of your reintroduction, don't eat a pizza, because that will have gluten, dairy AND nightshades and you won't know which one was causing an issue if you have a reaction.

Instead, try this as you continue your elimination diet:

Day 1: drink one 8-ounce glass of milk and record any symptoms over the next 3 days while continuing to avoid ALL of the elimination foods, including any more dairy (symptoms can include headache, phlegm, runny noise, itching, eczema, stomach upset and/or diarrhea)

Day 4: eat one hardboiled egg and record any symptoms over the next 3 days 

Day 7: eat approximately 4-6 ounces of edamame or minimally processed tofu and record any symptoms over the next 3 days

Continue to do this until you have worked your way through all of the foods you had eliminated and review your journal for any potential symptoms. 

When in doubt, continue to keep it eliminated. 

Now that you are armed with all of your very scientific data, you may now start eating the foods you had ZERO reaction to in moderation. It is still best to not eat these foods daily and keep to a rotation diet as rotation diets reduce your risk of developing an allergy or sensitivity. You can rotate your meal plans weekly or every 2 weeks, just not daily so that you avoid eating the same thing each day.

If you reacted to any of the eliminated foods, continue to stay off of those for 4 more weeks and reintroduce...continue doing that until you have no reaction. 

You now know what food(s) affect you and how, so you can judge when it is worth it for you to eat those foods or not. 

How empowering is that!?

WAY better than reading the results of some test that may or may not be very accurate!

Yes, it's a lot of work, but there's a lot of help out there for you. 

If you haven't signed up for our newsletter yet, you get a great, free healthy meal guide to help you create simple, healthy meals that basically qualify for an elimination diet.

The Anti-Inflammatory Diet and Recipe Book by Dr. Jessica Black is one of my favorite resources for doing an elimination or anti-inflammatory diet.

You can also check out the Whole30 community and books. This is basically an elimination diet (though, it's designed for only 30 days, which can still give you some information). This community is amazing and there are tons of wonderful recipes, inspiration and personal cheerleaders if that's what you're looking for. I've personally done the Whole30 program twice and even though this is my specialty, I still learned a lot about myself and my health!

Many Paleo, GAPS, SCD-diet and autoimmune diets also avoid the common allergens and are great resources for recipes and meal plans. 

It's really all about the prep, so if you plan well and get some support, it really isn't terrible. It's 2 months of your life, which is like a teeny blip in the grand scheme of things. 

Imagine if it only took 2 months to figure out why you body acts the way it does? 

Food can have a LOT to do with your general health, even if it seems unrelated.

No one has ever died from latte withdrawal, so after the initial crankiness wears off and you fend off the saboteurs, you'll be so glad you did it. 

If you try it, don't forget to tell us how it went in the comments below!