STEP 1: PLANNING

It is common for your provider to recommend not starting this journey until after an upcoming holiday or vacation.

• Choose a start date. Try to pick a time that you are confident that you won’t have any tempting events that will prevent you from successfully completing the diet.
• Take up to 2 weeks for planning and shopping for your elimination diet.
• Give away or eat up foods at home that will tempt you.
• Use the food guide to create your shopping list and meal plan.

STEP 2: ELIMINATE FULL LIST OF FOODS FOR 3 WEEKS

Once you have picked a time and have prepared, then begin your elimination diet!

• Remove all instances of Gluten, Dairy, Soy, Eggs, Peanuts, Corn, Pork, Beef, Shellfish, Caffeine, Sugar (refined).
• Focus on eating high quality and nutritious colorful foods throughout the month, and be sure to eat enough to avoid making poor decisions from hunger.
• Stay hydrated as many people report going through significant detox-like reactions while on the elimination diet.

What You Might Experience

It is common for a person to have a period of “withdrawals” that will typically peak in week 2 of the diet, with most people feeling back to their baseline by week 3, and significantly better than their baseline by week 4.

Stick with It for 3 Weeks!

Remember that since every exposure to these foods can restart the inflammation process it is imperative that for the 3 weeks you stick to the diet plan as close to 100% as possible. Every slip up can “reset the clock” and undo all the hard work that you have put in so far to decrease those inflammation levels.

STEP 3: REINTRODUCTION—ONE CHALLENGE AT A TIME

Once you have reached the 3-week mark and you feel an improvement in your symptoms—it is time to start reintroducing foods! When you are reintroducing a food, it is critical to do this in a very structured way. Some people reintroduce too many foods at once, and then aren’t able to determine which of them is making them feel ill which undoes all the hard work that they just put in. Remember these tips for reintroducing foods:

• The order is not important—we recommend reintroducing which ever food/food group that you miss the most.
• Make sure that you only introduce that food, and that food in its purest form.
• Use a food diary or symptom tracker to notice if you have any symptoms. It can prompt you to think about symptoms in body systems that go beyond the GI system, such as headaches, brain fog, or joint pain.
• If you have a history of anaphylaxis, do not reintroduce these foods.
• Wait 3 full days before reintroducing another eliminated food/food group.
  • If you notice no symptoms after 3 days, then you can continue eating that food—you have no sensitivity to it!
  • If you do begin to notice symptoms within that 3 days, then stop eating that food and wait for those symptoms to go away before reintroducing the next food.
• If no symptoms after the above food introduction, move on to reintroducing another food.

Examples of focused reintroduction of one food or food group

Eggs: Many people reintroduce eggs first. Begin with 2 eggs in the morning for breakfast and then another 2 eggs later in the day around lunch time, and potentially again for dinner. Sounds like a lot of eggs, but this way we get enough of the exposure to generate a response (if there will be one).

We want to be certain that we are only testing our body’s reaction to eggs. If you start with a pastry that contains eggs then there may not be enough exposure, and there may be other ingredients that might set off your system. The preparation of the eggs isn’t important – hardboiled eggs vs poached vs baked, but it is important not to introduce other eliminated ingredients, like dairy.

Gluten: For gluten try using a whole wheat bagel or bread (no butter!) or shredded wheat cereal (no dairy milk!).

Dairy: For dairy try using a plain yogurt or cottage cheese.

Once you have reintroduced all of the foods you can...

• Try to reintroduce this food again to confirm your reaction if you aren’t 100% sure that it was causing issues.

Once you are sure that a food is causing symptoms...

• Please avoid this food.
• Bring this information with you to your next appointment with your provider.

Typically, you can reintroduce those foods again in a few months after some gut-healing work and they will be tolerated just fine. The goal of the elimination diet is never to restrict your diet long term.

ELIMINATION DIET: TIPS, CAVEATS, AND CAUTIONS

• You may get worse before you get better. If this is going to happen it will get worse at 2 weeks but you should feel much better by week 3!
• This is not a calorie restriction/weight loss diet. This is not a diet aimed at dictating how much you eat—it is purely aimed at changing what you eat to assess impact.
• Be sure to read labels! This diet promotes awareness/label reading/curiosity. You will likely learn a lot about the foods that you eat in the 3 weeks, and you may be surprised where you find the eliminated foods hidden (i.e. gluten in soy sauce).
• An elimination diet doesn’t have to be expensive! Staples like rice and beans are extremely cost-effective ways to incorporate gluten-free grains.
• No improvement? If you haven’t noticed any improvement in 4 weeks, then you may need to wait an additional couple of weeks, or you may need to talk to your healthcare provider to consider more in-depth elimination, such as histamines, tryptamines, or nightshades.