3

votes

Elimination diet to determine food sensitivities -- how long is long enough?

Commented on November 21, 2014
Created August 26, 2011 at 4:02 PM

Hi all --

I have a couple "mystery conditions" that might possibly be autoimmune related (chronic cough, and insterstial-cystitis type thing, thankfully both pretty mild). Since the start of the year, I've been "paleo" -- following Kurt Harris' protocol at first, then morphing into the Perfect Health Diet, with occasional weekend forays into the neolithic agents (probably about 90% compliant in terms of meals).

I had hoped that my little conditions would improve on a paleo-style diet, but they have not. So I decided to try an allergen elimination diet wherein I strictly removed the following: - all grains (or any source of gluten) - dairy - nightshades - eggs - added sugar/sweeteners - anything processed - alcohol

I'm now roughly 3 weeks into this diet, and there have been absolutely no changes or improvements to my specific conditions. And generally, I feel no difference whatsoever in terms of energy, well-being, etc.

OK, so onto the question, finally. Given that I've completely eliminated all these foods for 3 weeks and seen no change in either my symptoms nor my general feeling of well-being, I feel that I've falsified the hypothesis that I have food allergies/sensitivities. Would you agree with this, or do you think more time is needed to prove such a thing?

The reason I ask is that I know that it is typical to recommend 30 days (eg Robb Wolf, Whole30), but I get the impression that this is a catch-all recommendation that addresses things like ingraining habits and metabolic issues when transitioning from the SAD, which don't really apply here. I have heard that healing the gut lining can take a while, but I still feel that if food sensitivies were the issue, I would have seen at least some tiny change after fully avoiding all suspect foods for 3 weeks.

Thank you!

A3731c6eb531c45539eabfc0f3f85202

on November 21, 2014
at 05:17 PM

My son was gluten free for 5 years will little improvement in health.  We did blood testing and discovered he was allergic to 15 foods, including many that he ate every day, like eggs.  But also weird stuff, like pumpin, iceberg lettuce, tapioca (in all the GF stuff), etc.  We would never have discovered all these with an elimination diet.

Also, from reading the GAPS book, it sounds like 2 years is more the target for real healing...

A6b2325aefabe3e40c89646e40223f6f

on May 25, 2013
at 05:39 PM

In your case, from everything I've read a week isn't necessarily enough, but I'm really not sure. However long you choose to go, though, I would definitely recommend phasing foods back in one by one and looking for symptoms. Best of luck and I hope you are able to find relief.

A6b2325aefabe3e40c89646e40223f6f

on May 25, 2013
at 05:37 PM

I pretty much went with Rogue Nutritionist's very sensible advice. Soon after posting this, I started carefully re-introducing things one at a time following her instructions, and watching carefully for any adverse effects. FWIW I didn't find any at all, so I don't seem to have sensitivities to any of these things, but that's just me.

77877f762c40637911396daa19b53094

(78467)

on August 27, 2011
at 02:50 PM

And I'm talking about extreme elimination diets that eliminate all anti-nutrients, not ones where you're still eating a broad variety of them and therefore general sensitivity must gradually decrease. That's a different matter.

77877f762c40637911396daa19b53094

(78467)

on August 27, 2011
at 02:48 PM

Exactly how long do you think food stays in the digestive tract? Removing the anti-nutrient and switching to superfoods like scallops should nearly always show results in 1-2 days, the problem is that anti-nutrients often show a "double dip" effect over about a week which confuses attribution when self tracking. A week without improvement is definitely a sign the strategy isn't working. I would take 2 days as a very strong indicator. Faster iteration times are crucial and this "months of healing" business is poison for people trying to find a diet that works.

100fd85230060e754fc13394eee6d6f1

(18706)

on August 27, 2011
at 02:46 PM

Fascinating! So, yes, you're right, after the first month the improvement was gradual.

957a563c7e4a165663fd3c71207c39da

on August 26, 2011
at 11:05 PM

This answer is misleading and isn'tbacked up by any experience or references. A week is not nearly enough time for toxins to clear before repair can take place.

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 08:53 PM

(Though Rogue Nutritionist's approach to re-introduction may prove me wrong...)

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 08:52 PM

"it's not dietary to begin with" -- Yes, this is the conclusion I am leaning towards at this point.

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 08:51 PM

Thanks Ambimorph! FWIW I looked at the link that Ed provided, and it said that in the study, some of the kids were moved from a less-strict (gluten-including) version of the elimination diet into the full elimination diet because so many of them had no response to the less strict version after two weeks. This implies that there were observable changes resulted from the strict version within the first two weeks.

100fd85230060e754fc13394eee6d6f1

(18706)

on August 26, 2011
at 05:54 PM

I'm not sure, Pierce. My sense was that the difference was fairly dramatic, but I'll ask him.

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 05:35 PM

That is great advice. I didn't realize that the approach to re-introduction was so important, so this answer is very helpful. Thank you.

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 05:16 PM

BTW, your answers both focused on gluten... perhaps it would make sense to keep the gluten elimination going for a while but add some of the other stuff back in. It's really the dairy and the nightshades that I miss.

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 05:13 PM

Thanks Dragonfly. I have gotten tested and my Vit D is good, but I appreciate the tip.

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 05:13 PM

Hi guys -- Thanks for the answers. I understand that it might take a couple months to get everything completely squared away, but it seems strange that you wouldn't notice any difference at all from removing these things, and then all of a sudden you'd notice a big difference after some lengthy period of time. Ambimorph, is that how it went down with your friend? Or did she notice some incremental improvement before that?

6426d61a13689f8f651164b10f121d64

(11478)

on August 26, 2011
at 04:52 PM

The elimination period in the ADHD elimination diet ( http://evolutionarypsychiatry.blogspot.com/2011/02/food-elimination-diet-and-adhd.html ), which also eliminates gluten, is also 2 months.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on August 26, 2011
at 04:28 PM

Also, I found my food intolerances cleared up after being sufficient o Vitamin D for a few months. You may want to get tested.

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7 Answers

best answer

0
77877f762c40637911396daa19b53094

(78467)

on August 26, 2011
at 06:08 PM

You should feel better after a week if it was something serious.

But you should see results after 1-2 days for purely mechanical digestive symptoms.

You probably haven't eliminated your problem, or it's not dietary to begin with.

I cut down to white rice, water, and various meats with low fat/oil to get my desired result. And heavy scallops and fish.

77877f762c40637911396daa19b53094

(78467)

on August 27, 2011
at 02:50 PM

And I'm talking about extreme elimination diets that eliminate all anti-nutrients, not ones where you're still eating a broad variety of them and therefore general sensitivity must gradually decrease. That's a different matter.

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 08:53 PM

(Though Rogue Nutritionist's approach to re-introduction may prove me wrong...)

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 08:52 PM

"it's not dietary to begin with" -- Yes, this is the conclusion I am leaning towards at this point.

957a563c7e4a165663fd3c71207c39da

on August 26, 2011
at 11:05 PM

This answer is misleading and isn'tbacked up by any experience or references. A week is not nearly enough time for toxins to clear before repair can take place.

77877f762c40637911396daa19b53094

(78467)

on August 27, 2011
at 02:48 PM

Exactly how long do you think food stays in the digestive tract? Removing the anti-nutrient and switching to superfoods like scallops should nearly always show results in 1-2 days, the problem is that anti-nutrients often show a "double dip" effect over about a week which confuses attribution when self tracking. A week without improvement is definitely a sign the strategy isn't working. I would take 2 days as a very strong indicator. Faster iteration times are crucial and this "months of healing" business is poison for people trying to find a diet that works.

4
100fd85230060e754fc13394eee6d6f1

(18706)

on August 26, 2011
at 04:28 PM

I have a friend who didn't get results until 2 months. I think it was gluten in this instance. The explanation their caregiver gave was that it took a month to clear out the substance, and then a month to repair from the damage.

On the other hand, when I eliminated everything but meat, I felt fantastic within 2 weeks. So maybe it depends on the specific mechanism of the offender.

When you add things back, be sure to do one thing or one class of things at a time, and eat a lot of it to get the biggest possible reaction.

100fd85230060e754fc13394eee6d6f1

(18706)

on August 26, 2011
at 05:54 PM

I'm not sure, Pierce. My sense was that the difference was fairly dramatic, but I'll ask him.

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 08:51 PM

Thanks Ambimorph! FWIW I looked at the link that Ed provided, and it said that in the study, some of the kids were moved from a less-strict (gluten-including) version of the elimination diet into the full elimination diet because so many of them had no response to the less strict version after two weeks. This implies that there were observable changes resulted from the strict version within the first two weeks.

6426d61a13689f8f651164b10f121d64

(11478)

on August 26, 2011
at 04:52 PM

The elimination period in the ADHD elimination diet ( http://evolutionarypsychiatry.blogspot.com/2011/02/food-elimination-diet-and-adhd.html ), which also eliminates gluten, is also 2 months.

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 05:16 PM

BTW, your answers both focused on gluten... perhaps it would make sense to keep the gluten elimination going for a while but add some of the other stuff back in. It's really the dairy and the nightshades that I miss.

100fd85230060e754fc13394eee6d6f1

(18706)

on August 27, 2011
at 02:46 PM

Fascinating! So, yes, you're right, after the first month the improvement was gradual.

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 05:13 PM

Hi guys -- Thanks for the answers. I understand that it might take a couple months to get everything completely squared away, but it seems strange that you wouldn't notice any difference at all from removing these things, and then all of a sudden you'd notice a big difference after some lengthy period of time. Ambimorph, is that how it went down with your friend? Or did she notice some incremental improvement before that?

3
Ed983a42344945b1ff70fd9597a23493

on August 26, 2011
at 05:18 PM

I think three weeks is enough time, but people often don't notice feeling better...what they notice is feeling worse during the reintroduction phase...if you've been very strict for the three weeks, you should be able to get good information from your body if you don't rush the next phase. I recommend taking a full 72 hours to add each food individually, in its simplest form. Eat a lot of that food during the 72 hours, and really make note of feelings on every level. If any one particular food causes an undeniable reaction right away, don't continue eating it, but do wait the 72 hours before adding another food.

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 05:35 PM

That is great advice. I didn't realize that the approach to re-introduction was so important, so this answer is very helpful. Thank you.

3
Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on August 26, 2011
at 04:27 PM

My understanding is that gluten reactions take at least 6 weeks to clear the system, so I think that is a good rule of thumb to follow. Most allergy elimination diets I've been on have been 2-4 weeks.

Ce41c230e8c2a4295db31aec3ef4b2ab

(32564)

on August 26, 2011
at 04:28 PM

Also, I found my food intolerances cleared up after being sufficient o Vitamin D for a few months. You may want to get tested.

A6b2325aefabe3e40c89646e40223f6f

on August 26, 2011
at 05:13 PM

Thanks Dragonfly. I have gotten tested and my Vit D is good, but I appreciate the tip.

0
6cf657b6d99b1e56690e63fab0213b1a

on May 23, 2013
at 07:22 PM

I just came across this and am interested in what you decided. I am at the end of one week of the elminiation diet. i have interstitial cystisis and am desperate to heal my bladder and get out of pain. After one week, i'm not feeling any better. Still in pain. Was hoping for at least a little relief by now.

A6b2325aefabe3e40c89646e40223f6f

on May 25, 2013
at 05:37 PM

I pretty much went with Rogue Nutritionist's very sensible advice. Soon after posting this, I started carefully re-introducing things one at a time following her instructions, and watching carefully for any adverse effects. FWIW I didn't find any at all, so I don't seem to have sensitivities to any of these things, but that's just me.

A6b2325aefabe3e40c89646e40223f6f

on May 25, 2013
at 05:39 PM

In your case, from everything I've read a week isn't necessarily enough, but I'm really not sure. However long you choose to go, though, I would definitely recommend phasing foods back in one by one and looking for symptoms. Best of luck and I hope you are able to find relief.

0
Ab989680bed782967f4594a96ec2c38c

on February 08, 2013
at 06:25 PM

My sister has some issues with some kinds of foods. She needs to be on a food sensitivity elimination diet. Thanks for posting this useful information.

0
957a563c7e4a165663fd3c71207c39da

on August 26, 2011
at 11:04 PM

This answer is misleading and isn'tbacked up by any experience or references. A week is not nearly enough time for toxins to clear before repair can take place.

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