How to Do an Elimination Diet for Food Sensitivities (Step by Step)

When I was a kid, I knew chickpeas didn't agree with me. Nobody had a name for it, and nothing showed up on a standard allergy test. Years later, when I trained in food sensitivity testing and ran it on myself, the result made sense of what I'd felt all along: I react to peas in general, not just chickpeas.

That's what food sensitivities are like for a lot of people. The signals are subtle, they show up hours later, and they're easy to blame on something else. An elimination diet is the simplest way to connect the dots.

In this article, I'll cover how food sensitivities differ from allergies, the most common symptoms, why new sensitivities can develop, what testing can and can't tell you, and exactly how to do an elimination diet, step by step.

In this article 10 sections

Food Sensitivity vs. Food Allergy vs. Intolerance

These terms get used interchangeably, but they're not the same thing:

• Food allergy. An immune reaction (usually IgE) that happens fast, often within minutes. It can cause hives, swelling, vomiting or trouble breathing, and it can be life-threatening.

• Food intolerance. A digestive problem, not an immune one. Lactose intolerance is the classic example: you're missing the enzyme to break down milk sugar, so it ferments and causes gas, bloating or diarrhea.

• Food sensitivity. A looser term for delayed, non-life-threatening reactions that don't fit neatly into either category. Symptoms can show up hours to a couple of days after eating and are often dose-dependent.

It's common to mix these up. In a survey of more than 40,000 U.S. adults, 19% believed they had a food allergy, but only about 10.8% had symptoms consistent with a true allergy [1]. Many of the rest are likely dealing with intolerances or sensitivities, which is exactly where an elimination diet helps.

Important: if you've ever had hives, swelling of the lips or throat, wheezing or trouble breathing after eating something, that's a possible allergy. Don't do a reintroduction test with that food on your own. See an allergist.

Common Food Sensitivity Symptoms

Because the reactions are delayed and can show up anywhere in the body, they're easy to miss. Common ones include:

• Bloating, gas, belly pain, constipation or diarrhea

• Fatigue or brain fog after meals

• Headaches or migraines

• Skin flares like eczema, rashes or itching

• Joint aches

• Congestion or a runny nose after eating

From talking with thousands of people, I've noticed a pattern linking skin issues like eczema, and histamine flares, with gut problems like leaky gut. When I see skin issues, I always look at gut health and stress first.

Why New Food Sensitivities Develop

Many people tell me they used to eat a food for years without a problem, and then suddenly couldn't. One pattern I've noticed, and other practitioners see it too, is that new sensitivities tend to develop when intestinal permeability has been compromised for a long time. Your gut lining is supposed to be a selective barrier. When it's under strain from overgrowths, chronic stress, poor diet or repeated antibiotics, more partly digested food can reach the immune system than it should. The research connecting leaky gut to food sensitivities is still early, but it's a big reason I focus on rebuilding the gut, not just avoiding foods.

A close friend of mine is a good example. For years he kept telling me he was developing random food sensitivities, at an age when you don't expect that. Then he suddenly started reacting to eggs, something he'd eaten all the time. I brought up leaky gut, and we ran a DAO-to-histamine ratio test. There's also a test that measures zonulin, a marker tied to how tightly the junctions in the gut lining are holding. The pattern I see is that when you eat a food all the time and the gut lining is letting more through than it should, that's often the food you become sensitive to. These are functional tests, not standard diagnostics, so I treat them as pieces of the picture. Our article on leaky gut and candida goes deeper.

What about wheat?

Wheat is one of the most common foods people react to. One theory I find interesting is that some people tolerate wheat in Europe but not in the U.S., possibly because of differences in how it's grown, including glyphosate use. It's a theory, not something that's been proven.

It's also worth knowing that gluten isn't always the culprit. In a blinded trial of 59 people who believed they were sensitive to gluten, fructans (a type of carbohydrate found in wheat, onions and garlic) caused more symptoms than gluten did, and gluten didn't cause more symptoms than placebo [2]. That's one reason a careful reintroduction beats guessing. More in our guide to bread, gluten and bloating.

Food Sensitivity Testing: What It Can and Can't Tell You

MRT (Mediator Release Test)

I'm trained in the MRT, a blood test that measures how white blood cells react when exposed to different foods and food chemicals. It's what showed me I react to peas in general, which matched what my body had been telling me since childhood. To be transparent about the evidence: MRT isn't part of conventional allergy testing, and there's limited independent published research on it. I treat any test result as information to confirm with an elimination diet, not as a final answer.

MRT panels also include food chemicals, not just foods, and that's where it gets interesting. My results showed I'm sensitive to artificial food dyes, the ones listed on labels as a color and a number, like Red 40 or Yellow 5. Most people would never connect those to how they feel. I've cut them out of my diet since.

IgG food sensitivity tests

These are the at-home kits you see advertised everywhere. The European Academy of Allergy and Clinical Immunology has recommended against using IgG testing to diagnose food sensitivities, since IgG antibodies to foods can simply reflect that you've been eating them [3]. If you use one, don't cut a long list of foods based on the results alone.

Test for celiac disease before going gluten-free

If you suspect gluten, ask your doctor about celiac testing first. The blood test needs you to be eating gluten to be accurate, so cutting it out beforehand can hide the result.

Listening to your body

No test replaces paying attention. I'm a big believer in listening to your body, and a structured elimination diet is the most practical way to do that. Self-diagnosing from a social media video is one of the most common mistakes I see. It's rarely one thing.

How to Do an Elimination Diet, Step by Step

Step 1: Choose what to remove

There are two common approaches:

• Targeted. Remove one or two foods you already suspect, like dairy or gluten. This is simpler and a good place to start.

• Broad. Remove the most common triggers at once (see below), then bring them back one by one.

The foods I see come up most often with clients are dairy, gluten, eggs, soy, peanuts, lentils, artificial food dyes and black pepper. Soy is a huge one. Other triggers worth including are corn, added sugar and alcohol, plus other legumes or nightshades if you suspect them.

Black pepper surprises people, since it's in almost every savory dish. It comes up often enough that in our Liposomal Turmeric Curcumin Tonic we use fenugreek instead of the black pepper most turmeric products rely on to help absorption.† Artificial dyes are easy to miss too: check labels on candy, sports drinks, cereals, sauces and even some supplements.

If your main symptoms are bloating and IBS-type gut issues, a low-FODMAP elimination diet is the best-studied option. In a controlled crossover trial, people with IBS had about half the overall gut symptoms on a low-FODMAP diet compared with a typical diet [4]. Our SIBO diet guide covers low-FODMAP foods.

I consider FODMAP reactions a different type of sensitivity. They have a real connection with your gut bacteria, which ferment these carbohydrates, so they say more about the state of your gut than about the food itself. In my experience, with proper terrain work on the gut, people can heal and become less sensitive to FODMAPs over time. That's why I see a low-FODMAP diet as a temporary tool, not a permanent way of eating.

Step 2: Eliminate for three to four weeks

Remove the foods completely, including hidden sources. Read labels: wheat, soy, dairy and corn turn up in sauces, dressings, snacks and supplements. Most elimination diets run about three to four weeks, which gives symptoms time to settle.

What to eat instead: build meals around whole foods. Quality protein, lots of vegetables (I aim for half the plate), fruit, rice, potatoes and sweet potatoes, quinoa, olive oil, avocado, nuts and seeds you tolerate, and bone broth. Keep it simple so it's easy to stick with.

Step 3: Keep a symptom journal

Write down what you eat and how you feel each day: digestion, energy, sleep, skin, mood and headaches. Patterns are much easier to spot on paper than from memory.

Step 4: Reintroduce one food at a time

This is the most important part, and the one people skip. Bring back one food, eating it a couple of times in a day. Then go back to your elimination diet for about three days and watch for symptoms. If nothing comes up, that food is probably fine. If symptoms return, note them, take the food back out and wait until you feel normal before testing the next one.

Step 5: Build your long-term diet

The goal isn't to eat as few foods as possible forever. It's to find the specific foods that cause trouble and bring everything else back. Long-term restriction can lead to nutrient gaps and a more fragile relationship with food. Some sensitivities may ease as your gut heals, so it's worth retesting problem foods every few months.

What About the Carnivore Diet?

I'm not a carnivore diet fan. But I do think a lot of the benefits people report come from the fact that it works as a very effective, if extreme, temporary elimination diet. You're removing almost every common trigger at once. A structured elimination diet can get you the same information without cutting out vegetables, fiber and everything else your gut needs long term.

Support Your Gut While You Eliminate

Finding your trigger foods is half the job. The other half is rebuilding the gut lining so you're less reactive over time.

The foundation is getting short-chain fatty acid production going: healthy bacteria eat prebiotic fiber and make short-chain fatty acids like butyrate, which feed and help repair the gut lining. When that process isn't working smoothly, I use arabinogalactan (a gentle prebiotic), a calcium-magnesium butyrate, colostrum, L-glutamine and bone broth. In my experience, these work better for this than herbal options like slippery elm. Our GI Health and Gut Lining Support Protocol combines Butyric Acid, Arabinogalactan, Colostrum and our Multi-Strain Probiotic Complex, and our butyric acid guide covers the food side.†

Digestion matters here too. Food that isn't broken down well is more likely to cause trouble. I'm a huge fan of digestive enzymes for people who feel heavy or bloated after meals; our Digestive Enzyme Complex is a vegan blend of 14 enzymes taken with meals.† If digestion feels slow overall, low stomach acid is worth ruling out; see our guide to low stomach acid symptoms.

And don't forget how you eat. You can't digest well when you're stressed. Sit down, take a few breaths before your first bite and be present with your food. Our list of the best and worst foods for gut lining health is a good companion while you rebuild.

Common Elimination Diet Mistakes

• Skipping reintroduction. Without it, you never learn which foods were the problem, and you end up avoiding foods you don't need to.

• Cutting too much for too long. Restriction is a short-term tool, not a lifestyle.

• Reintroducing several foods at once. If symptoms come back, you won't know which one caused them.

• Going gluten-free before celiac testing. It can make the test inaccurate.

• Assuming food is the only issue. If bloating persists on a clean diet, look at stomach acid, overgrowths and stress. Start with our guide to why you might always be bloated.

When to See a Doctor

Get emergency care for swelling of the lips, tongue or throat, trouble breathing, wheezing or fainting after eating. See a doctor promptly for unexplained weight loss, blood in your stool, persistent vomiting or diarrhea, or symptoms that wake you up at night. Children, pregnant women and anyone with a history of disordered eating should do elimination diets only with professional guidance.

The Bottom Line

Food sensitivities are common, subtle and easy to miss. An elimination diet is the most practical way to find yours: remove suspected foods for a few weeks, track how you feel, then bring them back one at a time. Use testing as information, not a verdict, listen to your body, and put just as much effort into rebuilding your gut as into avoiding foods.

References

1. Gupta RS, Warren CM, Smith BM, et al. Prevalence and severity of food allergies among US adults. JAMA Netw Open. 2019;2(1):e185630. doi:10.1001/jamanetworkopen.2018.5630

2. Skodje GI, Sarna VK, Minelle IH, et al. Fructan, rather than gluten, induces symptoms in patients with self-reported non-celiac gluten sensitivity. Gastroenterology. 2018;154(3):529–539. PMID 29102613

3. Stapel SO, Asero R, Ballmer-Weber BK, et al. Testing for IgG4 against foods is not recommended as a diagnostic tool: EAACI Task Force Report. Allergy. 2008;63(7):793–796. PMID 18489614

4. Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014;146(1):67–75. doi:10.1053/j.gastro.2013.09.046