The ultimate purpose of elimination diets is to identify hidden food allergens that may be causing symptoms. During the elimination diet, common allergens are completely eliminated for two to three weeks. After symptoms improve, foods are added back one at a time to determine which foods provoke symptoms.

The most common and important foods to eliminate are: Dairy products, wheat, corn, soy products, citrus fruits, caffeinated and sweetened beverages, refined sugars, food additives, tap water and existing known allergens.

Early Considerations

Once you begin the elimination protocol, it’s important to note any signs or symptoms that arise when foods are reintroduced. Or symptoms that cease after elimination. Common symptoms include occasional gas, bloating, fatigue, heartburn, and more.

Upon reintroduction, if one of these occasional symptoms should occur, discontinue the food and make note of the change.

Retesting foods: Do not test foods you already know cause symptoms.

Food Sources For Testing: Test pure sources of food. Example: Do not use pizza to test cheese, because pizza also contains wheat and tomato. Do not use bread to test wheat, as it usually contains other ingredients (though flat breads might be just flour, water, and salt).

Organic sources are the best to use for testing, as you will not experience interference form pesticides, hormones or other additives, which may be used in conventional preparations.

Testing Protocol

Be aware that food Intolerance effects usually occur within 10 minutes to 12 hours after ingestion. However, certain effects may be delayed by as much as 48 to 72 hours.

You’ll want to eat a relatively large amount of each test food. For instance, on the day to test dairy, add a large glass of cow’s milk at breakfast. If after one serving, your original symptoms return, or if you develop a occasional bloating or fatigue, do not eat any more and place it on your “Intolerant” list.

If no symptoms occur, eat the food again at lunch and supper and watch for occasional symptoms. If the food is well tolerated on the day you ate the test food, wait another 2-4 days until adding it to your “permitted” foods list.

Begin testing on a day you are feeling well (without colds, unusual headaches, flu-like symptoms, etc.). Review the list of symptoms to watch for and keep a journal of how you feel.

Reintroduction of foods: You can start reintroduction after completing a period of food elimination, commonly lasting 3-4 weeks.

If severe symptoms occur, stop the challenge. Do not start the next challenge until you have had one full day free of symptoms. Do not re-introduce the offending food for at least 90 days. Lastly, record your symptoms: When you challenge, keep a record of both your physical and behavioral symptoms.

How accurate are food intolerance blood tests?

Blood tests are not the end all be all for food intolerance testing, but they are quite helpful in giving us insight into the condition of one’s microbiome. For example, if a patient’s FAP results come back revealing a significant amount of allergens, particularly in a variety of food categories, this often times indicates that the intestinal lining has been compromised.

Another example would be if sugar intolerance comes back elevated along with brewer’s yeast, that often can be indicative of the presence of candida. It’s critical to look at the whole picture of a patient’s panel rather than just the individual foods that come back reactive.

There can also be an underlying histamine component that needs to be addressed so that intolerances can improve and the patient is able to digest and absorb various foods without these negative reactions.

With that said, as practitioners it’s important to be mindful of the naturopathic principal of “Removing the obstacle to cure”. It’s often the intolerance that is prohibiting healing to take place.