The Elimination Diet


Update: After taking the Mediator Release Test, I have found some of the foods I was eating during the elimination diet were making me sick.  This is most likely a personal thing since those particular foods don’t contain fructose, but if you are concerned with any of the foods listed below, please look into the Mediator Release Test!

The Elimination Diet: “Blech”–need I say more?  I suppose I should.

The Reason

The purpose of an elimination diet is to cleanse your system of the fructose that is causing you harm and let your body heal so you can identify exactly what foods affect you.

How To Do It

Start by eating foods that are almost completely fructose free for the cleansing phase. I’ve read many different opinions on how long, but it seems 4-6 weeks is standard.  (If your symptoms persist, go back to the doctor before moving on.) Then, begin testing out one food at a time.  Some people say add a new food in as soon as every 3 days, others say give it 2 weeks.  Personally my symptoms can be immediate, but it seems they can be cumulative as well, so 2 weeks is probably a good idea.

Since someone with FM can usually handle 5-25g of fructose a day, make sure you start off small, and if you can handle it, maybe try a little more.
This also means that when you find foods you can handle, it doesn’t mean that you should eat them while trying out new foods, since a combination of two foods might be more fructose than you can tolerate.  Start the first few days of a food trial just introducing the new food on its own.

This whole process is going to be frustrating and long.  If you try a new food every other week (and that would be a good amount)–that’s only 26 foods a year!  You could spend 3 years on spices alone!!!
I’ve found that a lot of the time things aren’t cut and dry.  It’s not like, Eat Strawberries: Get Sick.  For the most part I will get vague symptoms and then have to prolong my test of that food to another week and still not have a solid answer.  So it’s all about how you feel.  Just make sure you get your system ready first:

Foods For the Cleansing Phase

Make sure to read all labels first!

  • Milk***
  • Butter***
  • Sour Cream***
  • Cheese***
  • Unsweetened Yogurt***
  • Potatoes
  • Potato Chips (make sure they aren’t made with corn oil)
  • White rice/white rice noodles/white rice flour
  • Spinach (uncooked)
  • Celery
  • Lemons
  • Limes
  • Plain meat that is untreated, unglazed, or mixed with spices
  • Seafood
  • Eggs
  • Dextrose
  • Smarties
  • SweeTarts (not the chewy kind!)
  • Peanuts (be careful: these can cause gas.  Try starting with 1/4 cup a day.)
  • Olive oil
  • White rice vinegar (found in the Asian foods aisle usually)
  • Salt

***I recently found out I am dairy sensitive (different from lactose intolerant), so if you’re still having problems perhaps it’s dairy!

Small amounts of:

  • Pepper
  • Basil
  • Rosemary
  • Thyme


When you begin to add foods back in, make sure you know the fructose to glucose ratio. If there is more fructose than glucose, you should probably leave it alone.  Unless it is a very small difference, that’s where dextrose comes into play.  Adding dextrose in will help balance the fructose to glucose ratio, sometimes enough to where foods otherwise eaten alone can be tolerated. (This trick doesn’t work with fructans, or fruit containing polyols.)

So if a peach has 1.6g of fructose and 1.5g of glucose, normally you shouldn’t eat it because then you have this lone fructose bit inside you, ready to cause you trouble.  But if you sprinkle some dextrose on it, that will help you digest that extra fructose. Just make sure that you don’t exceed your allowed grams of fructose per day.

Where To Get Dextrose:

You can buy dextrose on Amazon, but it’s cheaper to get it from a brewery online.  Here is a site for an old fashioned country store, where you can buy a 50lb bag:

Here is some organic dextrose, which is a bit more expensive but a good option if you’re worried about GMOs:

Some people are worried about/sensitive to corn.  This site offers organic dextrose made from tapioca.  It is more expensive for sure, and I think the Barry Farms dextrose tastes better, but this is what I use:

Food Journal

Keep what you eat well documented.  Including the amount of food will help you figure out how much fructose is in what you eat throughout the day.

Your reaction to a food can differ depending on what else you’ve had that day, and even the day before, so keep track of what symptoms you have and when they occur.


4 thoughts on “The Elimination Diet

  1. How do you manage to eat ENOUGH through the elimantion phase if you can’t have milk products? Having a history of anorexia and being underweight+doing quite a lot of weightlifting atm I really need to avoid undereating.

    • That’s definitely a legitimate concern. Can you have goat milk? Usually people with milk allergies/sensitivities tolerate that pretty well. If you check out my recipes page all the ones that are safe on the elimination diet are marked with a *** and it’s not as hard as it seems. It’s certainly more of a challenge when you need to avoid any type of dairy, but there should be enough there to keep you alive for that phase. I’m sorry I don’t have a lot of knowledge about weight lifting dietary needs but your weight troubles do worry me. Do you have a doctor or dietician you can work with while on the elimination diet? If you need someone my dietician is amazing and she works via Skype:

  2. I’ve noticed that if I cook certain foods on the no list for a long time it seems to cook the sugar out. For instance tomato sauce that cooks for four hours, fire roasted peppers, etc. have you found the same to be true?

    Also, do you find that the fructose can build up over time? I can have a small amount (about five grams a day) but if I have five grams every day for three or more days I get sick. Does that happen to you? I’m just curious about other people.

    I’m glad I found this blog. I love the recipes.

    • It’s true some people have better luck with some foods raw and some cooked, although I’m surprised at the tomato sauce, since I would think that would just concentrate the sugar…but if it works then why question it?!

      Fructose can definitely build up over time! That’s one of the first things I learned after getting diagnosed. It’s not just you.

      Thanks for reading and commenting! I love to hear from people!

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