The Elimination Diet for Fibromyalgia and Chronic Fatigue Syndrome

Feel better after finding your food sensitivities

asian woman looking at fruit and vegetables and writing

Food sensitivities are a real problem for a lot of people with fibromyalgia (FMS) or chronic fatigue syndrome (CFS or ME/CFS). Experts believe that, because of the central sensitization involved in these conditions, you can develop sensitivities to foods that then aggravate your symptoms.

The best way to figure out what, if any, foods are a problem for you is an elimination diet. It's not easy, but it is mercifully short compared to most diet plans. You start out by eliminating broad categories of foods that are the most likely one to cause problems. Then, you re-introduce one at a time and see how you feel.

Research shows that at least half of the people with FMS or ME/CFS get significant relief from symptoms—including pain, fatigue, headaches, bloating and breathing difficulties—by eliminating certain foods. While sensitivities vary from person to person, the most common problem foods are:

  • Corn
  • Wheat
  • Dairy
  • Citrus
  • Sugar

Before you get started, it's a good idea to make sure this is the right time for you to try the elimination diet. Is a holiday or special event that centers on food coming up? Do you anticipate any major changes or stressors in your life? If so, it's probably best to wait. If not, here's what you need to know:

The Elimination Diet

Even without mental fog, it can be hard to remember what you ate on any given day. That's why a food diary and symptom journal are important for the success of an elimination diet. You'll be comparing the two of them to see what effect your diet is having.

Your food diary doesn't need to be complicated. A simple list of what foods you eat each day is probably enough. A symptom journal can be that simple as well, or you can go to Tracking Your Symptoms to find several sample logs.

Once you start the elimination diet, give it at least five days. If you notice a reduction in symptoms that last for a couple of days, you're ready to start adding foods back in. If you don't notice changes, give it another five days. If you still don't notice any difference, it's tempting to give up, but if you stick to the diet, you may notice subtle changes as you add things back in that can point to food sensitivities.

Foods You Can Eat

Initially, you'll want to limit your foods to the following (remember, it's temporary!):

  • Vegetables (except for corn, peas or beans)
  • Fruit (except citrus or any that you currently eat two or more times a week)
  • Meat (except for bacon, sausage, hot dogs or lunch meat)
  • Rice
  • Grain alternatives such as amaranth, quinoa, and buckwheat
  • Bottled or distilled water
  • Herbal teas

While it's uncommon, it is possible for people to feel worse when they switch to this diet, probably because they've introduced a new food to replace something they've eliminated. If this happens to you, try eliminating anything new you've introduced to see if that helps.

Foods to Avoid

  • Dairy products (rice milk is an acceptable alternative)
  • Caffeine in any form
  • Alcohol
  • Soda
  • Chocolate
  • Sugar and aspartame (NutraSweet)
  • Wheat, oats, barley, and anything containing gluten
  • Eggs
  • Bacon, sausage, hot dogs and lunch meats
  • Peanuts
  • Peas, beans, and corn
  • Citrus fruit
  • All processed foods
  • Anything containing monosodium glutamate (MSG)
  • Food colors and dyes
  • Any food you currently eat more than twice a week

IT'S ONLY TEMPORARY! Keep in mind that some people with FMS and ME/CFS see pain and fatigue drop significantly when they eliminate certain foods. If you find something that helps, it'll be worth it. If not, it's still valuable knowledge.

Reintroducing Foods

Once your 5-10 day elimination period is over, it's time to start adding foods back in. You'll want to add one category at a time, then wait 2-3 days before adding another one. Eat a lot of the re-introduced foods, at least three servings a day.

Depending on the foods and your body, you could notice an increase in sensitivity-based symptoms within minutes or hours, or possibly the next day.

If you find a sensitivity, eliminate that category again and wait until your body has recovered from the increased symptoms before you add another food.

This is a tedious process and it may seem like it takes forever. Just do your best to stick with it and remember that it could make a major difference in how you feel.

Life After the Elimination Diet

Some food sensitivities are easier to deal with than others. If you find you're sensitive to gluten, for instance, you may want to see a nutritionist to find out the broad range of foods you'll need to avoid and learn about alternatives. 

If you don't discover any sensitivities, you might still want to maintain the healthier eating habits you adopted for the elimination diet.

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Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Campagnolo N, Johnston S, Collatz A, Staines D, Marshall-Gradisnik S. Dietary and nutrition interventions for the therapeutic treatment of chronic fatigue syndrome/myalgic encephalomyelitis: a systematic reviewJ Hum Nutr Diet. 2017;30(3):247–259. doi:10.1111/jhn.12435

  3. Lattanzio SM, Imbesi F. Fibromyalgia Syndrome: A Case Report on Controlled Remission of Symptoms by a Dietary StrategyFront Med (Lausanne). 2018;5:94. Published 2018 Apr 30. doi:10.3389/fmed.2018.00094

  4. Bora S, Rindfleisch JA. The Elimination DietIntegrative Medicine. 2018. doi:10.1016/b978-0-323-35868-2.00086-4

Additional Reading

  • Copyright 2008 Celiac Disease and Gluten-free Diet Information Since 1995. All rights reserved. "Elimination Diet May Ease Fibromyalgia"