CFIDS Elimination Diet

Dr. Paul Cheney, CFS Specialist, reports that he has documented over half of all CFIDS patients he studied with having food sensitivities.  Dr. Cheney, along with a nutritionist, believe that a food elimination diet is the best way to figure out what food sensitivities CFIDS patients have.  Blake Graham, the clinical nutritionist, has created a protocol for CFIDS patients to follow for the elimination diet. 


There are many reasons why individuals react negatively to foods, and laboratory assessment methods test for specific mechanisms of reaction and exclude others (such as IgG).* An elimination diet is not reliant on a particular mechanism, encapsulates all food reactions, and is the best method of assessing food sensitivities.

The elimination diet described below is:

Limited to unrefined/whole/fresh foods

Devoid of food additives/colorings/artificial sugars

Gluten free, casein free, and lactose free

Very low in salicylates

Very low in dietary yeasts

Very low in dietary glutamates

Very low in dietary biogenic amines

Very low in dietary solanines

Generally hypoallergenic

Devoid of caffeine and alcohol.

Adhering to the following diet for a period of time enables a person to determine if any of these key, and common, food sensitivities are present. Observing benefits in any aspect of health while on this diet indicates one or more of the points listed above are significantly related to your symptoms.

This diet provides a snapshot in time of what you may feel like while taking into consideration all the factors listed above.


CFS Patients First, Go Gluten & Casein Free For 30 Days

In the weeks before an elimination diet, eat a nutrient-rich, unrefined and varied diet. In the case of Chronic Fatigue Syndrome, this diet trial should come after a gluten/casein-free diet trial of 30 days or more. Sensitivity to gluten and casein, two dietary proteins [defined below], can sometimes take a more extended time period to become evident than a standard elimination diet allows.

To attempt this diet you must carefully read the ingredients list of every food you eat, and truly do it 100 percent, to see real results. No lab test negates the need for this trial. Most people who react negatively to gluten do not have true celiac disease (and therefore test negative to celiac blood tests), but rather another form of gluten sensitivity.

Sources of gluten include:

Anything containing wheat, barley, rye, oats & spelt [a species of wheat grown in parts of Europe since ancient times, and now often a health food].

Anything that contains the words gluten, gliadin & glutenin.

Foods which state they may contain traces of wheat/gluten.

Maltodextrin/malt (unless it states it is derived from rice or corn).

Soy sauce (unless or states it is gluten free).

Bran (unless it states it is gluten free and/or derived from rice or corn).

Hydrolyzed vegetable protein (HVP).

Bulgur, couscous, durum, dinkle, kamut, semolina & triticale [all AKA wheat].

Sources of casein include:

Anything containing milk, yogurt, cheese, butter, cream, icecream, goat’s milk derived products, etc.

Milk solids.

Anything that says casein or caseinate.

Choose the most convenient time to try this diet. For example not when relatives are staying over or when traveling. Ask for the support of your family.

First 7 to 10 Days Very Limited

For 7 to 10 days, consume nothing but the foods listed below. If there are any foods on this list you know or suspect you may be sensitive to, eliminate these foods also. (Aspirin should also be avoided during this period due to its high salicylate content.) Consume a varied diet, eating some [of these] fruits, vegetables, meats, and grains daily.

  • GRAINS – Whole grain rice (rinse before cooking)
  • MEAT – All unrefined (non aged/processed/smoked/seasoned) fresh meats, except beef
  • VEGETABLES – Cabbage, celery, green beans, iceberg lettuce, & swedes [rutabagas]
  • FRUITS – Peeled pears
  • OILS/SEASONINGS – Olive oil & sea salt
  • DRINKS – Water (filtered)

Keep a diary of symptoms and note any changes.

If symptoms worsen (or new symptoms appear) in the first 2 to 4 days, this may indicate withdrawal from food allergy or addiction.

If after 7 to 10 days symptoms have improved, this may indicate food sensitivities of some kind.

Add Back Food Categories One at a Time

Add back foods one at a time and in a pure form (fresh corn, for example), or with a non-eliminated food, taking note of symptoms changes. Consume plenty of the foods you are testing. (Corn at lunch and dinner, for example.)

The following order is recommended:
1. Dairy (in the form of whole cream or plain yogurt)
2. Eggs
3. Yeast [see below]
4. Citrus
5. Corn
6. Cocoa.

Allow about 48 hours between adding new foods.

Note changes in symptoms upon adding back foods [see list of “Common food allergy and intolerance symptoms/signs below].

Any foods you react to should be eliminated, as you go on to test others. If you react to specific foods wait until the resulting symptoms have cleared before adding new foods.

Patterns to Look Out For

Some people are sensitive to dietary salicylates. [Found in many fruits and vegetables, often concentrated just under the skin and in the outer leaves of vegetables, such as cabbage and lettuce. Levels decrease as fruit/vegetable ripens. Discard outer leaves; peel thickly; go for ripe. For information on the relative salicylate levels of scores of fruits and vegetables, nuts and snacks, sweets, herbs/spices/condiments, coffees/teas, alcoholic beverages, and fats & oils, go to]

Some people are sensitive to dietary yeasts. [Found in many foods including yeast raised breads; fermented beverages; vinegar; fruits eaten with skin, from berries, cherries, and grapes to prunes and raisins; olives; peanut butter. To print out a small chart of permitted and not permitted foods in a yeast-free diet, go to]

Some people are sensitive to dietary glutamates. Glutamates are contained in MSG, hydrolyzed vegetable protein, anything that contains the word glutamic or glutamate, and foods including roquefort cheese, parmesan cheese, soy sauce, walnuts, fresh tomato juice, grape juice, peas, etc. [For a more complete food list with relative glutamate levels, go to]

Some people are sensitive to dietary amines. Amines are contained in chocolate, cheese, fish, aged/processed meats, bananas, oranges, avocados, tomatoes, wine/beer, etc. [For a more complete food list with relative amine content levels, go to ]

Some people are sensitive to solanine containing foods. Solanines are contained in tomatoes, potatoes, peppers, eggplant. [They function as the plant’s natural defense against pests and fungus.]

Common Food Allergy and
Intolerance Symptoms/Signs


Increased mucus production in throat, regularly clearing throat, coughing

Irregular flattened patches on tongue or mottled tongue

Dark areas and/or blue, black or pink circles around eyes

Nose rubbing/Itchy nose

Nasal/sinus congestion or postnasal drip

Puffy eyes, nose, face

Abnormally red cheeks/nose and/or flushed appearance

Ears turn red for no apparent reason

Inner corners of eyes itch

Skin problems (eczema, rash or pale ring around mouth, dermatitis, itching, burning feeling of skin, creepy crawlies under skin feeling, numb skin, etc.)

Diarrhea or loose stools or constipation

Abdominal pains, bloating or nausea after meals

Increased frequency of stools

Feel/act best when don’t eat

Strong particular food likes (cravings) and dislikes

Unexplained intermittent +/- sudden irritability, depression, hyperactivity, anxiety, anger, crying, giggling, hiding in dark places, rage, vulgarity, not wanting to be touched

Unexplained intermittent +/- sudden changes in walking, reading, writing, speaking


* [For example, IgG-specific antibody tests look for the immunoglobulin G antibodies associated with non-atopic or delayed food reactions to specific foods that can worsen or contribute to many different health problems. These tend to be frequently eaten foods that are hard to avoid, including milk, corn, and wheat. Another type of test the IgE antibody assay addresses less frequent but more immediate, high-profile atopic food sensitivities, such as those to peanuts or shellfish.]

Note: This information has not been evaluated by the FDA. It is not intended to diagnose, cure, treat, or prevent any illness, disease, or condition. Importantly, you should never make any change in your health care or support plan without researching and discussing it in consultation with your professional healthcare team.

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  1. my husband has cfids he was diagonsed a couple of days before thanksgiving 2008 l want to know what kind of diet should he be on thank you linda m kingston lancaster ca

  2. I think it’s not as simple as cutting out sugars and simple carbs, which I’ve seen some people suggest. We’ve done the full elimination diet, and I found that salicylates make me feel much worse. Salicylates are natural plant chemicals which help plants resist disease. They also make my fibromyalgia worse – especially the aching.

  3. This is fantastic info! Exactly what I was looking for. I have been ill for many years now and it is still getting worse. Labeled by doctors with depression, ADD,CFS, PLMD, RLS to name a few…
    I have read al lot on possible diets over the years en tried a dozen of them with sometimes good results but never lasting more than a few months. I am certain food must be a key factor. I am looking for the ultimate strategie to start combining every bit of info i gathered so far. And this comes very close. It is similar to a recent dutch study on a AD(H)D diet (RED) for children with great results.
    Just one remark: For CFS, I think it’s also very important to leave every form of sugar (also high suger fruits, honey etc…)out of the 30 days caseïne/gluten free fase because of possible sugar/carbohydrates withdrawal in the very limited fase.
    Thanks a lot, now i know what to focus on the next months 🙂

  4. so what about beans? If I can’t have most grains or fruits, where am I going to get my fiber if I can’t have beans? I usually get it from black beans and such. Looking for advice here.

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