What’s an Elimination Diet?

Eliminating all identified IgG-positive foods after testing can reduce stress on the immune system, decrease inflammation (helping to heal “leaky gut”), resolve food cravings, and reduce the potential for eating disorders.

Many people suffer from what are commonly called “food sensitivities.” Food sensitivities are reactions to certain foods that one may be eating and are likely due to an immune response to those foods in the GI tract or throughout the body. It is believed that the immune protein immunoglobulin G (commonly called “IgG”) is the culprit behind food sensitivity reactions. IgG is one type of antibody made by the immune system, and it can create delayed responses to foods. IgG food sensitivities may play a large role in many common health complaints, such as:

  • Irritable Bowel Syndrome (IBS)
  • Major Depressive Disorder
  • Migraine headaches
  • Skin rashes such as eczema
  • Joint aches
  • Autoimmune disease
  • Crohn’s Disease
  • Obesity

IgG food sensitivities can be difficult to detect because symptoms can occur up to several days after consuming a particular food.

This makes it challenging for individuals to make the connection between consuming a particular food and the adverse reaction that follows. One of the most common ways to test for food sensitivities is to measure the level of IgG response to certain foods via a blood test.

When food sensitivities are uncovered your doctor may suggest an elimination diet. This therapy involves the removal of certain foods for a specific period of time to allow for a reduction in the immune response and to help the GI tract repair.

Food allergies versus sensitivities:

Although the terms “food allergy” and “food sensitivity” are often used interchangeably, they are not the same. Food allergies are not related to IgG antibodies, but rather are caused by IgE antibodies. IgE antibodies are responsible for causing true allergic reactions such as allergies to dust, cat/dog dander, and ragweed. Similar to environmental allergies, food allergies can cause immediate, and sometimes life-threatening, reactions. The most well-known example of this type of food allergy is the common peanut allergy, though humans can have allergies to many different types of foods.

When people consume foods that trigger an allergy, they are more likely to experience a sudden onset of symptoms. These symptoms include throat or tongue swelling, itching, skin rash, rapid heartbeat, nausea or vomiting, dizziness, fainting, shortness of breath, or difficulty breathing. Even though some food allergies can produce life-threatening symptoms (such as anaphylaxis), it is also possible to have a food allergy that results in milder symptoms. Due to the potential life-threatening reactions that are associated with IgE-allergies, it is best to avoid these foods and discuss this further with your healthcare provider. Together you can decide the best options for management of food and/or other IgE-allergies.

Food sensitivities:

There is some debate regarding the exact mechanism of how foods can trigger this type of immune reaction.

The most common hypothesis is that food sensitivities are caused by a dysfunctional gut lining. In a healthy GI tract, the gut lining acts as a wall to protect us from the outside world. This barrier is made up of tiny cells that are held together by what are called “tight junctions.” As their name suggests, tight junctions keep the GI tract’s cells locked together, which maintains a strong gut barrier. However, in some situations these junctions can open, allowing the GI tract to become more permeable. When the tight junctions forming the barrier in the gut remain permeable for longer periods of time, substances can “leak” through. This is known as “intestinal permeability” or “leaky gut,” and it is can cause an immune response to those proteins that leak through the gut wall. This immune response may result in the production of IgG antibodies to foods. There are multiple dietary and lifestyle factors that can contribute to increased intestinal permeability. These factors include alcohol, stress, chronic non steroidal anti-inflammatory drug (NSAID) use, Western-type diets (high consumption of red meat, animal fat, and sugar), as well as prolonged strenuous exercise.

The elimination diet:

An elimination diet is a common treatment strategy to address IgG food sensitivities. An elimination diet is an eating plan whereby foods that are suspected of causing adverse reactions are temporarily removed from the diet. These foods are then carefully reintroduced at a later date. Elimination diets can pinpoint symptom-triggering foods that may cause or worsen chronic health issues you may be experiencing. This diet is specific to food sensitivities caused by IgG-mediated reactions, and not food allergies (IgE-mediated reactions). Because an elimination diet may significantly alter your overall food intake, we encourage the oversight of a healthcare provider to ensure that your nutritional requirements and caloric needs are adequate.

Stage # 1:

A person’s individual symptoms are combined with the IgG Food Antibody Assessment results to determine which food(s) to temporarily remove from the diet. Additional foods that were not tested can be included in the elimination diet based on your clinical history. Your healthcare provider will assist you in deciding which foods to eliminate. The average time frame for an elimination diet is 1 to 3 months. Planning for a successful elimination diet includes making appropriate preparations. Important preparation steps include:

– Removing offending foods from the home and adjusting grocery needs accordingly.

– Reviewing resources to assist with meal preparation, such as recipe books or reputable websites.

Many clinicians recommend their patients record what foods are consumed in a food journal to help track the progress of the diet. This includes what foods are eaten, what date/time these foods are eaten, and any notable changes in your symptoms. A sample journal is provided at the end of this handout for your own use. You may wish to make several copies of this page to use throughout the elimination diet. Lastly, it is important to determine a start and end date with your healthcare provider.

Stage # 2:

It is essential that you completely avoid the foods your healthcare provider recommended you eliminate and/or that elicited a strong reaction via IgG Food Antibody Assessment. If you are unable to eliminate all reactive foods from the diet, focus on the foods that elicited a stronger reaction.

Review ingredients in prepared and prepackaged items to ensure minimal or no exposure to reactive foods. There may be alternate ways that some foods are listed on ingredient labels. For example, some food products may list eggs as mayonnaise or albumin. If you are instructed to avoid eggs for the elimination diet, you should also avoid mayonnaise and products listing albumin.

Stage # 3:

Eliminated foods are reintroduced one food at a time while monitoring for any adverse food reactions.

You are encouraged to consume the test food several times throughout the day for one day.

Meanwhile, keep track in your journal which food is being reintroduced and any adverse reactions over the following three days. It is recommended you consume pure sources of the food. For example, if you are reintroducing eggs, eat scrambled eggs rather than mayonnaise which has been processed and contains other ingredients. If you experience an adverse reaction, the food should be immediately removed for the duration of the elimination diet.

Your clinician may want you to wait until the adverse reaction resolves before moving on to another food.

Common symptoms that may indicate an IgG food reaction include headache, itching, bloating, fatigue, diarrhea, constipation, joint pain, indigestion, or worsening of your chronic health complaints. If the food does not cause symptoms during the reintroduction phase, it can be added back into the diet. Continue the process with each food that was previously eliminated.

Caution: It is NOT recommended that you reintroduce a known food allergy.

Ask your healthcare provider to discuss the signs and management of immediate hypersensitivity reactions prior to food reintroduction following an elimination diet.

If reintroduction of a food causes an immediate allergic reaction (i.e. swelling of face, mouth, tongue, etc.,; wheezing, rash/hives, or other allergic symptoms), it is imperative that you be treated as soon as possible. Following resolution of the immediate hypersensitivity reaction, consult with your healthcare provider on how to proceed with food reintroduction.

Stage # 4:

An elimination diet based on food sensitivity testing is part of a comprehensive approach to overall gastrointestinal health. Based on your test results and symptoms, a long-term plan is usually developed utilizing the results of the reintroduction phase. Your healthcare provider may also consider treating increased intestinal permeability based on the results of your immunology food profile. The goal of addressing intestinal permeability is to strengthen the gut barrier. This will reduce the amount of partially digested food proteins that enter the bloodstream, causing an adverse immune reaction. There are several nutrients that have been found to support intestinal barrier function and decrease inflammation, including:

  • Glutamine
  • Essential fatty acids (omega-3)
  • Zinc17,18
  • Probiotics
  • Vitamin A
  • Butyrate
  • Vitamin D

Botanicals that can also assist with intestinal health are slippery elm, deglycyrrhizinated licorice (DGL), aloe vera extract, and marshmallow root. Your healthcare provider should provide further instructions.

Dietary Recommendations for Common Food Sensitivities

Dairy, wheat, and eggs commonly cause food sensitivities (IgG-mediated reactions) in humans. These foods are difficult to eliminate from the diet because they are found in a wide variety of products. If you are reactive to any of these foods, be careful to avoid the items containing them while maintaining a balanced diet with a healthy intake of essential nutrients and vitamins.


Test results may vary depending on your age, gender, health history, the method used for the test, and other things. Your test results may not mean you have a problem. Ask your healthcare provider what your test results mean for you. 

The information on is NOT intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

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