Some very sensitive individuals with food chemical intolerance require a diet that is restricted beyond the level required by the failsafe elimination diet. This is particularly true of individuals who have severe/chronic symptoms, autism or autistic-like traits, and of those with chronic pain, fatigue syndromes, and underlying endocrine problems like untreated hypothyroidism.
Before introducing further restrictions, it may be worth trying the following:
- Avoid taking the pill or hormone replacement therapy. Oestrogen appears to lower food chemical tolerance in some women.
- Avoid soy and other foods that contain pseudo-oestrogens (chickpeas and some other legumes). For the same reasons as above.
- Have your thyroid tested for normal function. Poor thyroid function appears to worsen tolerance in some – although food chemical intolerance symptoms often also mimic poor thyroid function, so do not make assumptions about what is wrong!
- Avoid taking all non-essential medications, particularly antidepressants and psychoactive drugs. Some (not all) psychoactive drugs affect tolerance levels. This is particularly true of MAOIs, which can induce food chemical intolerance symptoms in previously tolerant individuals. Different psychoactive drugs can improve or worsen different symptoms in different individuals.
- Avoid caffeine. Caffeine appears to exacerbate some symptoms that are related to food chemical intolerance, such as insomnia, dermatitis, rosacea, etc. It can also induce ‘manic’ happy-high reactions in some.
- Vitamins: folate and B12 in particular have differing effects in different individuals. Some people experience an improvement of symptoms, others experience a worsening of symptoms. Folate and B12 can strongly affect mood and clarity (inducing mania or clearing brain fog depending on the individual and dosage) and affecting seizure threshold. Adequate vitamin D and sunlight (both UVB and SAD lighting) appear to improve tolerance during the winter months when symptoms are at their worst, this is particularly true of those who have a poor tolerance of stress. A number of failsafers have reported both positive and negative reactions to zinc – probably because it antagonises copper, a rate-limiting factor in the monoamine oxidase (MAO) enzyme, and potentially induces angiotensin converting enzyme (ACE), an enzyme implicated in food chemical intolerance. When ACE is a problem, individuals tend to feel better when they avoid salt (sodium chloride) and/or season with lo-salt (potassium chloride) instead. Zinc may also improve symptoms as it is the “master” mineral that controls the metabolism/absorption/excretion of all other minerals and detoxifies heavy metals (lead in particular is known to affect dopamine function).
- A ketogenic diet, whilst not suitable for everyone, appears to dramatically increase tolerance and symptom threshold in some individuals, probably due to its inhibition of glutamate. It is particularly useful for mental/mood symptoms and seizures.
- Be patient! A number of symptoms associated with food chemical intolerance are due to depression of the immune system, and an infection may be present (such as in skin conditions, ear aches, thrush, some (not all) cases of digestive upset, and possibly fibromyalgia). The body may need extra time to fight off an infection or a little extra help from antibiotics or antifungals to do so.
Foods to Test
If you continue to have chronic symptoms on the failsafe diet, it is essential you try the following before giving up:
- Ensure you have double-checked allowed foods and you have examined the checklist of common mistakes on the Food Intolerance Network website
- All individuals whose symptoms do not clear up on the failsafe diet should also go gluten and casein free for at least two weeks (see the gluten and casein responders page)
- Test for reactions to eggs (some individuals have severe non-IgE idiosyncratic reactions to eggs)
- Be certain you are following amine handling guidelines correctly (most people make this mistake)
- Try cutting out sulphurous vegetables such as allowed cruciferous vegetables and garlic (some people do not tolerate garlic at all)
- Try cutting out fruit and vegetables partially or completely, as per the guidelines below:
Limiting Salicylates - Stage One (Strong Intolerance)
The following plant foods contain zero salicylates. Although some foods also contain traces of amines and also salicylate-like aromatics, it may be worth restricting allowed foods to those in this list:
- Bamboo shoots
- Beans, blackeye
- Beans, borlotti
- Beans, chickpeas/garbonzo
- Beans, lima
- Beans, mung
- Beans, soya/soy
- Green cabbage
- Iceberg lettuce
- Lentils, brown
- Lentils, red
- Maple syrup
- Peas, dried green split
- Poppy seed
Limiting Salicylates - Stage Two (Serious Intolerance)
As many fruits, vegetables, legumes, pulses, nuts and seeds contain other salicylate-like aromatics (SLAs), including colours, flavours and smells, some very sensitive people do not tolerate a zero salicylate diet. This is the next stage of restrictions for those people, based on the accumulated advice of failsafers:
- Green cabbage
- Iceberg lettuce
- Maple syrup
Limiting Salicylates - Stage Three (Severe Intolerance)
White carbohydrates only – no fruits, vegetables, legumes, pulses, nuts and seeds.
- Barley (white)
- Rye (white)
- Wheat (white)
A number of the white carbohydrates listed above contain gluten, which can be problematic in itself. Not everyone tolerates millet or oats, leaving only potatoes and rice as the safest carbohydrate foods. Please follow the potato and rice guidelines as above. People this sensitive usually only tolerate sushi rice and have to be very selective about potato consumption. Remember: only a tiny number of failsafers have to restrict their diet beyond the normal failsafe diet, and those individuals must ensure that they have accounted for all possible causes of their salicylate sensitivity, such as requesting thyroid and nutritional testing. It is absolutely essential that individuals who are on this diet for more than a couple of weeks take a full spectrum of vitamin and mineral supplements to ensure adequate nutrition.
Fine-Tuning Rice Tolerance
This is a subjective compilation of tolerance levels to different varieties and brands of rice from two severe salicylate super-responders in the UK. Listed from most to least reactive.
|Type of Rice||L’s Reaction||E’s Reaction|
|Basmati rice (any brand)||Severe fatigue/exhaustion, brain fog, fibromyalgia symptoms the following day. Worse than a regular salicylate reaction.|
|Short grain pudding rice (any brand)||Insomnia and nightmares.|
|Carnaroli risotto rice (any brand)||Insomnia and nightmares.|
|Arborio risotto rice (any brand)||Insomnia and nightmares.|
|Paella rice (any brand)||Insomnia and nightmares.|
|Kokuho Rose Sushi Rice||Very aspie/hyper - I found out this one is fortified with folic acid.|
|Nishiki Sushi Rice||Hypoglycemia, I feel high and clear temporarily.|
|Okomesan Sushi Rice||Hypoglycemia, I feel high and clear temporarily.|
|Sun Rice Sushi Rice||Very sleepy, bloated, my head feels fine.|
|Yutaka Sushi Rice||Head does not feel so clear but otherwise I’m fine.||Insomnia for an hour or two on the first night it’s eaten, then get used to it.|
|Clearspring Organic Sushi Rice||A bit sleepy but clear headed.||No reaction at all.|
Amine and Glutamate Super-Responders
Limiting Amines in Dairy Products
Dairy products listed from most reactive to least reactive.
|Type of Dairy Product||Notes|
|Strong yellow cheeses||The stronger the taste of the cheese, the higher in amines and particularly glutamates it will be.|
|Mild white cheeses||Mild brie and fresh goat’s and sheep’s cheeses are sometimes tolerable. Feta and mozzarella are not safe for failsafers.|
|Kefir||According to published analyses, kefir cultures are very variable in bacterial makeup. A variety of species found commonly in kefir are known to make free glutamate and amines. Lactococcus lactis (found in cheese and kefir) and a variety of lactobacillus and bifidus species produce amines.|
|Probiotic yoghurt||A variety of species found commonly in "probiotic" yoghurts are known to make free glutamate and amines. Lactobacillus casei, a common probiotic, forms free glutamates. A variety of lactobacillus and bifidus species produce amines.|
|Fromage frais, fromage blanc, maquée, quark||Usually safe, but should not be left in the fridge for too long after opening.|
|Cottage cheese, cream cheese, crème fraîche||Usually safe, but should not be left in the fridge for too long after opening.|
|Non-probiotic (traditional) yoghurt||Traditional yoghurt cultures are made with the species lactobacillus acidophilus, streptococcus thermophilus, and lactobacillus bulgaricus. These three species do not form amines. If the yoghurt is made in a properly controlled environment (not contaminated) it will be safe.|
|Fresh milk||Failsafers sometimes report unusual reactions to UHT milk. Raw milk does not appear to be beneficial. Regular milk is considered safe for those who tolerate dairy products.|
|Fresh cream||Safe for those who tolerate dairy products.|
|Butter||Safe for those who tolerate dairy products.|
Gluten and Casein Responders
For a full overview of how to test and limit gluten and casein, please see the gluten and casein responders page.