• Dr. Erica Oberg

FOOD ALLERGIES: ELIMINATION & RE-CHALLENGE EXPERIMENT

JULY 10, 2019

We’ve been talking about food sensitivities. The science, the testing options, and here, the “Gold Standard” prove-it-to-yourself Elimination & Re-challenge experiment. No science or testing can ever trump the wisdom of learning to listen to your body and responding by giving it what it needs for optimum health. Plan on 6-8 weeks total for this experiment.


First is a 4 week “Elimination Phase” during which you remove certain foods, and food categories, from your diet. We recommend starting with a food sensitivity blood test, but you can also start with your own list of questionable foods or the most common allergens. The most common foods that cause symptoms for N. Americans are wheat, dairy, soy, egg, corn, and citrus.

Eliminate the foods from your diet for a month, if your symptoms improve during the four week period, you’ll carefully add foods back into your diet one at a time to see which foods may be triggering symptoms. Most often, individuals on the elimination diet report increased energy, mental alertness, decrease in muscle or joint pain, and a general sense of improved well-being. Many people lose weight. However, some people report some initial reactions to the diet, especially in the first week. This can include caffeine withdrawal headaches and other “Herxheimer-type” reactions. These are hangover-like symptoms as the body metabolizes accumulated antigen. Symptoms you may experience in the first week can include changes in sleep patterns, lightheadedness, headaches, joint or muscle stiffness and changes in gastrointestinal function. If you are working with a doctor on your health, s/he will want to see you at the end of the month to evaluate the changes in your health.

📷Next, is the “Challenge Phase” during which foods are systematically added back into the diet and careful notes are made about the appearance of any symptoms. It’s best to keep a journal to track your symptoms. You will introduce a new food every 48 hours, assuming you feel well. Here’s the general process: select the food you want to challenge. Eat the test food at least twice a day and in a fairly large amount. Often an offending food will provoke symptoms quickly—within in 10 minutes to 12 hours. Signs to look for include: headache, itching, bloating, nausea, dizziness, fatigue, diarrhea, indigestion, anal itching, sleepy 30 minutes after a meal, flushing, rapid heartbeat. Sometime you won’t notice symptoms until the next morning: puffy eyes, can’t get out of bed, brain-fog, more typing errors. If you are unsure, take the food back out of your diet for at least one week and try it again. Be sure to test foods in a pure form: for example test milk or cheese or wheat, but not macaroni and cheese that contains milk, cheese and wheat!

If you find that you have symptoms after eating some foods, it is not a death sentence! Your experience during the Elimination & Challenge diet is information and with it, you are empowered to choose what you want to eat and how you want to feel. Sometimes, sharing a piece of birthday cake with someone special is completely worth gas, bloating and baggy eyes! For people whose food sensitivities are related to intestinal permeability or inflammation, they may be able to incorporate small amounts of reactive foods in 4-6 months, after they have healed their digestive system. People who have auto-immune cross-reactions to foods should minimize exposure their whole lives.Ideally, you eliminate all sources of potentially reactive foods which means you need to read all labels carefully to find hidden allergens. However, life happens – people forget to tell you what ingredients they used, waiters are wrong, etc. Don’t sweat it – do the best you can. If you are exposed to a lot of allergens, you may want to extend the Elimination Phase a little longer.Eat a wide variety of foods and do not try to restrict your calorie intake. Use the opportunity to try new ingredients and venture into new ethnic restaurants; this is a journey of self-exploration and discovery!

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© 2020 by Dr. Erica Oberg, ND, MPH