Step 3: The Elimination Diet – The first 14 days

After seeing the food intolerance specialist, a friend put me onto a doctor who advocates an elimination diet as a diagnostic tool to see which foods cause your symptoms. I can let you know how to contact him if you want to see him yourself. The idea behind elimination diets is to cut back to the real basics of diet, with a totally natural approach to food to allow your stomach to ‘clean out’ everything else and almost reset itself. Your stomach then becomes hyper sensitive to help you discover your intolerances (as you reintroduce foods in the next phase).

During the elimination diet, you need to avoid smoking, over the counter medicines, tap water and any other things that you usually put into your body but that might have subtle things in them that can affect your symptoms. It is really severe but, if you’re going to do it, you need to do it properly. You also need to be aware that in the first 4 or 5 days, you may get withdrawal symptoms from sugars, carbohydrates, caffeine etc. The initial exclusion must last for 14 days.

Let’s start with the depressing bit. The things you must avoid in these 14 days:
All processed foods – things with additives etc. Even processed meat is not allowed and nor are sauces, gravies out of a packet/pot etc.
Diary – milk, cream, cheese, yoghurt, eggs, goat’s milk etc.
Grains and cereals like oats, corn, rice, wheat.
Yeast
Soya and vegetable oil
Chicken, beef, pork
Nightshade vegetables, beetroot, sweetcorn
Citrus fruits
Caffeine
Spices

So what can you eat?!?!
Lamb or turkey
Duck eggs (Tescos sell them)
Fresh or frozen plain fish (I’d never eaten anything but cod and how my eyes were opened! Hake is wonderful!)
Fresh fruit – but try not to have too much because the sugar can feed the bad stuff in your stomach if you’ve got that as a problem (which you’re unlikely to know so best to play it safe). I stuck to blueberry, blackberry, passionfruit, papaya and sharon fruit because they have low sugar content.
Fresh vegetables – sweet potatoes and parsnips are filling
Beans and lentils – also very filling and go with everything
Pure sunflower spread or olive oil spread (check the label)
Salt and herbs
Seeds and nuts if you don’t suspect them already
Sunflower, rapeseed and olive oils for cooking
Mineral water. Tap water boiled for teas.
Herb or fruit teas
Homemade fruit and vegetable smoothies and juices
Quinoa – grains or flour
Amaranth – grains ideal for cooking up for breakfast with fruit
Buckwheat, gram and coconut flours – recipes to follow
Coconut milk or hemp milk

THE IMPORTANT BIT – If any of these foods that are permitted already feature regularly in your normal diet, that is more than twice a week, you must avoid them altogether for the initial 14 days. So for example, I ate peas with most evening meals and had to give these up for the 14 days. I replaced them with sugar snaps, kale, asparagus, runner beans and other vegetables that I had never eaten before.

THE OTHER IMPORTANT BIT – The whole thing I’ve learnt about diet and autoimmunity is that it is over-familiarity with a food that leads to intolerance. During the 14 days, you must follow the rule that ‘If I had quinoa on Monday, I can’t have it again until Wednesday’. However, make the most of it on Monday and Wednesday and have it for lunch and dinner!

So what are the options for your meals?

Breakfast: fruit, buckwheat pancakes, quinoa, amaranth, cooked up buckwheat groats. I even made turkey burgers out of turkey mince to have with mushrooms, ducks’ eggs and haricot beans – my version of a full English!

Lunch: Homemade soup with buckwheat pancakes to dip; sweet potato with tinned tuna (in spring water) and side salad; gram flour wraps with mashed avocado, turkey and spinach; roasted stuff butternut squash; vegetables with quinoa.

Dinner: Generally I ate meat and vegetables or fish and vegetables. Roasted butternut squash and courgettes go well together. Tinned beans are filling and quick. You can make a nice shepherd’s pie with lamb mince, fennel, mushrooms and lentils, topped with mashed sweet potato and sprinkled with almonds.

Snacks: This is harder. A handful of nuts if you’re allowed them. Carrot and cucumber sticks in a mashed avocado dip. Use up some left over mix for a gram flour wrap or buckwheat pancake. Left over roasted veg. To be honest, I got addicted to butter beans!

During the 14 days of elimination, keep a detailed diary of your food and symptoms. This will be good to look back on and reflect on, and it gets you in the habit of doing it and of being more aware of your body and what you’re eating, which you’ll need properly in the reintroduction phase. Also be aware that your symptoms may get worse at first because your body is going through a big change and you are having withdrawal problems. Remember too to monitor your weight. I lost a lot during this whole process and ended up going to the doctor about it after 3 months and it was really good to have accurate facts about the rate of losing it. (It wasn’t a major issue but I’ll do a post on it at some point.)

The hope is that after the 14 days, your body has had a really good clean out of all the problem foods and toxins and your symptoms will be noticeably improved. My doctor said they should be gone entirely but they weren’t, so bad was the condition of my body. It took months for me to realise the diet approach really was working. However, it had improved enough to go on to the reintroduction phase, which is where we’ll go in Step 5.

 

 

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Step 2: Digestive supplements

My intolerance test in October 2015 showed up some real problems with foods and lacking vitamins and minerals. My intolerance tester was one of the first people to really talk me through the link between gut health and autoimmunity. There are plenty of books on the matter but a basic, child-language explanation is that powerful and unnatural things in your digestive system (like antibiotics for example) can punch little holes in your gut lining. This allows things like undigested foods to seep through into your blood system. Your immune system doesn’t recognise these invaders and starts attacking them, just as it should do. And then, as in my case with the RA, the immune system then gets confused between the proteins in this undigested invader and the proteins in your joints, so it starts attacking the joints too. If you can reduce the invaders getting through into your system, then you can reduce the anger of your immune system and thus its attacking nature.

My intolerance tester advised some supplements for helping to ‘heal the gut’ and some digestive supplements to help make sure the food was being digested properly. Now, I’m not a ‘health food shop nut’. I don’t like all of these way-out methods and am not going to waste my money on expensive, latest-things. So I was a bit overwhelmed with the list of things she wanted me to try. I decided to forget the ‘heal the gut’ idea (which just sounded a bit weird at that time) but the idea of aiding digestion sounded good. I know I eat too fast and don’t chew properly, so this was action I was willing to take.

So from that time, I started taking a digestive enzyme with every meal (I don’t necessarily now but for the first 6-8 months, I took them all the time). I use Quest Enzyme Digest with peppermint oil, which gives you 90 tablets for about £8 from Holland & Barrett. The idea of this is that it just gives your stomach extra enzymes to what it’s already producing, in order to help break down the food properly. I have the idea in my head that we don’t all produce the same amount of digestive enzymes as everyone else, so we autoimmuners may well be lacking here. I can’t remember if I read that somewhere or came up with it as my own theory, so don’t quote me on that one.

The other supplement she recommended was Acidophilus (20 billion – ultra maximum). This is just a ‘friendly bacteria’ tablet. Admittedly, it was sold to me as an ‘improve your gut health’ tablet but since I’d heard of pro-biotic yoghurts and such-like that boast ‘friendly bacteria’, I didn’t think it was too way-out! In a bottle you get 60 tablets (one a day) for about £18 from Holland & Barrett. Expensive, yes. But I do think this one’s worth it. These days I take it maybe 5 days a week.

I would ultimately come back to the ‘heal the gut supplements’ and they are important. I wonder if I’d started them at this point, in October 2015 rather than February 2016, my journey may have been a little quicker…?

Step 1: Food intolerance

The first thing I did was come off my medication. I did this gradually over the summer, as it was making me feel worse and worse. By the end of September I was off it, in pain and aware my RA condition was getting worse. My RA nurse was well aware of what I was doing and was hoping that my condition would become so bad in the coming 4-6 weeks that I would qualify for the next level of treatment, which I didn’t want as it was more severe for me and more expensive for the NHS (I was told £10,000 per patient per year).

I then went for an food intolerance test. I went to Penny Livingstone in Birmingham. She uses a Vega-test machine to work out which foods your body doesn’t like. It’s not scary at all. It looks like a sewing machine on the table but has a wire coming out with a cylindrical metal thing on the end which you hold in one hand. Then she holds something that looks like a pen (which is also connected to the machine) and gently prods your other hand. As the circuit is completed, the machine makes a buzzing sound. A high-pitched, steady sound is a good noise. If it dips low, then that shows a potential intolerance. The food she is testing is contained in a mini-test-tube, which is slotted into the machine. She takes it out to replace it with the next food.

There is *much* debate over the validity of the results from these machines. Some say they are totally unreliable and money wasters. I am not completely free of skepticism myself but, having been through this process three or four times now, I have to admit there is something in it. If you avoid the foods it highlights for 2 or 3 weeks, you generally do notice an improvement. If you really needed to cut out all of those foods or just some of them, you never can tell, but I definitely think this machine gives you a good indication of what to try.

I did go to the doctor’s and ask what intolerance tests they could do via blood tests. She tested me on dairy and gluten but with no problems arising. The Vega-test machine would contradict this numerous times over my various visits, so make of that what you will.

My first intolerance test highlighted a lot of problem foods: dairy, rice, eggs, caffeine, random vegetables, preservatives, alcohol and apples. It also brought up problems such as diesel, animal hair and pollens. Worst of all was the vitamins and minerals test, which showed how low I was in so many areas. This was put down to the mess and the state my body was in from all of the heavy drugs I had been on. I wanted to take drastic action.

The day after the test, I cut out all the problem foods and drink – I haven’t had an English breakfast tea since! I don’t remember noticing an instant change in my pain and mobility levels this first time (especially as they were so bad at this point) but it was definitely the start and a step in the right direction. It helped me to be aware of my problem foods for when I started the elimination diet 2 or 3 weeks later.

However, clearly I needed to sort out the vitamins and minerals too. See Step 2: Digestive supplements.