Checklist of common mistakes
All of the following mistakes have been made by readers. Each one was enough the stop the diet from working, but difficult to identify because effects build up slowly. If the diet isn't working, read the list below. You can also ask your dietitian or email support group to check every item for you.
I would prefer that every family who wants to try diet have access to an experienced and supportive dietitian but a mother wrote:
I have tried to get help from a dietician and a specialist about seeing what foods exactly cause my son's behaviour to deteriorate and they were not much help and suggested I just do it myself, as my son is fit and healthy and eats a very wide variety of foods.
Some dietitians get better results than others. We have noticed that dietitians who get best results are those who use the strict version of the RPAH elimination diet. While the moderate approach or simple approaches may work for some families, if they are not working for you, you can switch to the strict approach ('for those with distressing symptoms that interfere with day-to-day life or work' - p22 of the RPAH Elimination Diet Handbook, available from www.allergy.net.au). This means you should be sticking to foods in the LOW column, e.g. the only fruit in the low column is peeled ripe pears, and you can't have moderate vegetables such as carrots or sweet potatoes until you finish your strict 3-4 week elimination phase.
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We often receive emails like the following:
We are going into the fourth week of our elimination diet. My 10 year old son's behavior is quite 'angry' at the moment and he is finding a lot of simple tasks quite hard, like getting dressed in the mornings. Is there anything in particular we should be avoiding?
The problem for this family was daily red delicious apples recommended by their dietitian. We are aware that some dietitians include delicious apples and some families benefit from an easy version of the elimination diet. However, if the diet isn't working for you, make sure you are doing the strict version of the RPAH elimination diet as set down in the RPAH Handbook . This means you should be sticking to foods in the LOW column, e.g. the only fruit in the low column is peeled ripe pears.
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Sakata plain rice crackers appear to be failsafe but we have received many complaints presumably due to flavour or MSG contamination on the line. Approach all rice crackers with caution. We don't know of any other suitable rice crackers due to other ingredients e.g. Aldi Damora plain rice crackers contain 319. Anyone who hasn't improved should AVOID all rice crackers, see reader reports below.
I just wanted to alert you to the Sakata Plain Rice Cracker - my daughter reacts to them even though the ingredients listed are safe! - Jill, by email
Regarding the sakata plain rice crackers, we have had multiple reactions from them and it took a while to put the finger on the problem, because we have always used them as an okay food. My son has had reactions with behaviour, getting very angry and turning into a"transformer" as I call it (one minute he is a car or motorbike and the next he is a monkey or a tiger). Also a rash on the faces of all three of the kids but my son's has been the worst lasting for a week or more after having them. Also my sister's little girl has had really bad nappy rash and rash on the face from them. A friend's little boy also had the rash on his face and whingeing etc after just a few sakatas. All the problems have settled since we stopped having the sakatas. - Tina, by email
I have been doing an elimination diet for 6 weeks now and not getting the results I wanted. I did do the diet last November with my son and it was brilliant but this time there seemed to be something wrong. I checked all the mistakes, I saw a dietician and still he is having terrible outbursts and I am beating myself up about it, thinking maybe it is just him. Last Tuesday I left my son with his grandparents with a bag full of food. The next day he was absolutely out of control and I questioned my daughter who was also there if nanny and pa gave him something he wasn't supposed to have. She said they both ate what I supplied. It was doing my head in all day wondering what had set him off. Then I realised that the only addition I gave him that he doesn't normally have is the Sakata plain rice crackers. He would have had about 10 of them with dip. I read on your website that some people react to these. - Belinda, by email
My three year old is extremely sensitive to amines - defiant, disruptive and hyperactive. More than 5 plain Sakatas send her off the planet. - from story 
We've been failsafe for over a year now, though we are tolerant of sals so we eat those. We are also GF, being allergic to wheat. My children haven't eaten sakata rice crackers (plain) for at least 10 months. On Monday, I let my 3 yo have a few at a meeting. She hasn't had a rash of any sort at all since having thrush as a baby but the next day she had a redness across her mons veneris. It wasn't obvious, wasn't nasty looking at all. It just resembled a slight reaction to her wee from her night nappy. The next day, I wiped the area clean with a face washer and her skin peeled off. There was still no obviously bad (visual) problem. She also said it really hurt. The following day you could see the peeling off skin - it resembled our skin after we've been badly sunburnt. Yesterday the skin was hanging off her.- Bronnie, by email
If you have just started your diet or recently dropped more items from your diet, your problems could be due to withdrawal symptoms as in the following example:
I have been on the diet successfully for months but have been experiencing troubles of late, so I went over my diet with a finetooth comb and found the probable causes, including canola oil with anti-oxidants. It has been about 5 days since I have been completely failsafe, and I am now feeling depressed, unmotivated, teary, irritable, etc, would this be the side effect of eliminating the last of the food chemicals from my diet?
Withdrawals can occur any time within the first two weeks. For behavioural symptoms, withdrawals most often occur on days 4 & 5 but in some cases can last up to the end of the second week. For temporary relief, adults can take ENO regular antacid powder, children can take soda bicarb baths, see Shopping List. If frequent colds, flu or infections such as tonsillitis are part of your symptoms, they can occur now as part of withdrawal symptoms. If you have to use pain relief or take antibiotics, see the Shopping List.
Your problems could be due to withdrawal symptoms if you have dropped even one item or food group from your diet within the last two weeks, see example above.
Well done. The whole aim of an elimination diet is to get it right – it's only for 3 weeks. After challenges you can choose what you want to eat, knowing how it can affect you.
Deliberate mistakes such as one or two serves of hot chips, takeaways, Vegemite or any other mistakes per week can be enough to prevent improvement. One mother wrote:
My three boys have been avoiding a number of additives for many years now because of obvious effects on their behaviour and health. Last year my 8 yo was diagnosed with Chronic Tic Disorder which is one step before Tourettes Syndrome. He could not sit still, having tics in his face, neck, shoulders and arms. After a period of time, I realised that this behaviour coincided with an increase in eating hot chips. I stopped my son eating hot chips and the tics went away. – from Story 
Accidental mistakes can prevent the diet from working. One mother wrote:
I am about to embark on the strict elimination diet for the 3rd time, but I am trying to pinpoint what went wrong the 2nd time round - was consistently bloating but not as severely as normal - versus the 1st time round when I felt fantastic. Using your salicylate and amine mistakes information sheets and the shopping list on the fed up website, I have so far picked up the following errors: Coles Pears in Syrup snackpacks (contained pear juice), Simply Wize Crusty Bread (maize flour), Dovedale Rice & Chia Bread (Chia seeds), and the wrong Cenovis multivitamin (Once Daily Women's Multi, contains evening primrose oil). Thanks for all of your help and detailed knowledge, I think I would have been doing many more things wrong in the diet without having the fed up site to look at.
Are you sure? One mother said:
We tried the diet unsuccessfully three times. It turned out our daughter had been eating coloured sweets at school nearly every day. We only found out when we saw how much she improved over the long weekend – because it was the longest she had stuck to her diet.
• See hints in Chapter 10 of Fed Up "How do you get difficult children to eat failsafe?"
• You can start the diet during school holidays
• Some supportive schools will ban lunch swapping
• One mother of a teenager took 2 weeks annual leave to stay at home with her son and cook for him
• Some children do better on home detention for three weeks while doing the diet, which is how Superintendent Peter Bennett achieved success with juvenile offenders in the UK
We did the elimination diet for our son's migraines. He managed his diet and reduced symptoms but didn't ever completely eliminate salicylates. Years later when he developed depression and hives we thought he had multiple health issues rather than multiple symptoms. It wasn't until a week or so ago I read the Wikipedia list of salicylate intolerance symptoms that I thought "My God this has been staring us in the face for all of this time" – Ann by email.
Salicylates affect more food intolerant people than any other food chemical - approximately 75% of children with behaviour problems, 70% of people with irritable bowel symptoms, 60% of people with migraines, headaches or urticaria and 50% of people with eczema - so it is important to take them seriously. If the diet isn't working, it is worth rethinking salicylates. I know many families who thought they had passed the salicylate challenge, but hadn't given high enough dose, as this mother wrote:
We did not do the elimination diet correctly the first time. We made the usual mistakes - not enough commitment, cheating, coming off it too quickly – and were misdirected in our conclusions - thought salicylates were fine and amines were the baddies. We decided to put our daughter back on the elimination diet after she failed to improve when we removed amines. This time we are 100% committed and the results are clear. Our daughter was fine the first day of the salicylate challenge, a bit iffy the second, and by day 3 she was back to pre-diet days, even resorting to deliberately (in front of me) urinating on the lounge room floor. Add to this a constant headache, tummy pains and a small rash on both legs. I promptly cleaned out the fridge, and removed all salicylates from the house. Two days on and we are gradually improving, but what a shock! An even bigger shock was my son's reaction. - From Story 714
The problem with salicylates is that everyone expects a quick reaction like artificial colours but instead there is usually a slow build up. It doesn't mean the effect is any milder, it's just that the reaction takes longer.
Many people write I think we can manage moderate to high salicylates. If the diet isn't working, it is usually worth cutting right back on salicylates. Expect a slow build up of effects, not an immediate big reaction.
When the diet isn't working, it is vital to check for too many salicylates. Beware the advice 'an apple a day can't hurt you' – it can! People rarely notice an immediate reaction to salicylates in foods but you won't get the improvement you want - or you will see an improvement but after a while the effects will build up and you'll be back where you started. Stick to low salicylates during your strict elimination diet. There are many dodgy salicylate lists on the internet – ignore them. The only salicylate tables we recommend are the revised figures in the 2009 RPAH handbook.
Some extra sensitive people have problems with low salicylate items such as pears, shallots, leeks, golden syrup or brown sugar. According to RPAH, an intolerance to pears suggests an intolerance to sorbitol (avoid or reduce your intake of pears). Problems with shallots, garlic, leeks, chives, cabbage or Brussels sprouts suggests an intolerance to sulphur compounds which can double after 5 minutes of cooking. (To avoid this problem, you can eat these vegetables raw, or quickly steam or stir fry). For sweeteners, white sugar and maple syrup are much safer than golden syrup and brown sugar, which are at the high end of the low scale.
Reader report: Every time I use golden syrup (CSR) both kids react (itchy & rashy) yet they both tolerate maple. I just read on the Salicylate mistake list about the golden syrup. Wow! I don't use it often & not in large amounts. Usually just in the Big Anzacs but have seen a pattern of both of them reacting after eating the anzacs. Thanks!
NO or haven't done it yet
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If you have failed your salicylate challenge, RPA trained dietitians usually recommend reintroducing salicylates gradually to find your level of tolerance (e.g. using foods that are moderate in salicylates such as carrots, butternut pumpkin or other moderate vegetables, start with half a cup every second day for two weeks, the day for two weeks). Some people add in a lot of salicylate-containing foods in a hurry and say "my child is only sensitive to high salicylates". Lots of moderate salicylates can equal the same dose as high salicylates. Six months later, they say 'the diet isn't working any more'. Effects can sneak up on you, see reader comment below.
Thought I would let you know I am a lot better. Seeing RPAH Allergy Clinic directly made the difference and now I am having symptom free days. The key was the chart they gave me that showed how to add foods back in. That has made the difference. Every time my symptoms increased I had been going back to elimination and I was becoming more and more reactive. I started with 1/2 serve of amines (salmon or banana) every second day. Then introduced half a serve of sals once a week ... then I stuffed up and had to go back BUT NOT to the beginning (one step back) so you build up the base no matter how small it seems to be. I am now on 1/2 serve of moderate sals or amines each second day ... and I am so much better The problem is with rushing ... you can't help it ... you end up further back but not at the beginning.
If the diet isn't working as well as you'd like, you can try systematic reintroduction and keep the rest for holidays when your tolerance is higher due to lack of stress.
Most people can tolerate 2 pears per day. According to RPAH, a reaction to pears is likely to be due to sorbitol intolerance.
• Pears are limited to 2 pears per day or equivalent
• Pear juice is not failsafe because commercial pear juice contains the peel and is therefore moderate in salicylates
• Pears canned in juice instead of syrup are not permitted (including snackpacks with syrup AND juice, see Shopping List)
• Pears must be ripe, soft and peeled
• Pears must be soft and pear shaped, not crisp an apple shaped like Nashi and Ya (moderate in salicylates)
If the diet is working, it is okay to have a little bit sometimes.
Artificial and natural flavours, fruit flavours and even vanilla can cause problems. Vanilla essence used to be limited to 2 drops per day but even that can be too much for some children. If your child is not improving, reduce or avoid 'flavours', 'vanillin' or 'vanilla' in commercial products such vanilla flavoured yoghurt, custard, ice cream, soymilk, caramels, biscuits, carob and sweets. Home cooking is safer but avoid vanilla in that too.
Citric acid is permitted on the elimination diet but some people react to it especially to large amounts. If the diet isn't working, limit or avoid magic cordial and other citric acid containing failsafe foods. You also need to avoid commercial flavourings in moderate products such as preservative free lemonade and tonic water (in gin & tonic) – previously listed as low.
Even if eating small amounts, you may need to drop it until you get the improvement you want, then try again later.
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Eat meat as fresh as possible - fresh meat that has been hung by your butcher for a week or two is acceptable but supermarket meats are usually now vacuum packed for up to three months, avoid if possible.
Fermented products contain amines - wine, beer, soy sauce, tempeh, miso, chocolate, cheese, sauerkraut, and even sourdough bread and yoghurt, which has now been upgraded to moderate, not suitable for your strict elimination diet. As well, despite seemingly failsafe ingredients (eg flour, water, salt), yeast free bread can be made by a long rising process which encourages fermentation and can be a problem for the extra sensitive - bakers' yeast is failsafe and yeasted bread can be safer than yeast-free bread for this reason
Fetta cheese is not failsafe.- bland fresh white cheeses such as preservative free cottage, ricotta, quark, mascarpone and cream cheeses are failsafe, sharp fermented white cheeses are not.
Cashew paste must be made from raw cashews. Commercial cashew paste from lightly roasted cashews is not okay, make your own (see recipe, the option with maple syrup is particularly good).
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Cold pressed canola, sunflower and safflower oils can contain small amounts of salicylates – otherwise removed by refining - that can build up slowly to cause symptoms.
• Cold pressed soy oil is failsafe.
• Cold pressed ricebran oil is failsafe but there has been been a report of a slow build up of symptoms from a family who are known to react to wholegrains (see wholegrains below).
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Technically, carob powder is failsafe. Beware of added flavours in carob products, and milk powder if you are sensitive to dairy foods. Every so often, a batch of carob powder appears to cause problems, not linked to any particular supplier, if the carob has a bitter taste, or is a particularly dark colour, or has dark flecks in it. Howard feels there could be a problem with the processing (e.g. over-roasting, that could perhaps lead to the development of amines) or possibly contamination (e.g. with leaves, that may contain salicylates). If you suspect a problem – as with the report below – try a different brand as they do vary. Look for a pale rather than dark colour with a mild, sweet flavour.
We started the elimination diet on a Monday and saw results pretty much straight away. Our 3 & 4 yo sons had their withdrawal symptoms on the Friday (I remember this day because I thought that the diet was no longer working & I didn't think I had the strength to stick with the diet). By Sunday morning both of them were back to normal & from then on they have been like perfect lil angels until I made a carob birthday cake on day 12. Within 1 hour of eating a piece of the cake alone without icing, they turned absolutely wild and it was exactly like pre-diet days!!! It lasted until lunchtime the next day. I went back through all the things that they had eaten that day and the only thing that kept coming up was the carob. The carob powder (it was organic) had a bit of a bitter after-taste, definitely not sweet.- thanks to Clare
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White sugar, icing and caster sugars and light brown sugar are failsafe; dark brown sugar if very dark can be moderate in salicylates; raw sugar is now rated as high in salicylates; honey is very high in salicylates.
Even white sugar appears to affect children and adults sometimes. If this is happening, are you sure you have eliminated all salicylates? Salicylate-induced hypoglycaemia can cause sugar reactions, see reader story below.
We're just trying to start an elimination diet but over the last few weeks my 8 year old's behaviour just seems to have gotten worse! I've looked back on his food diary and nothing really sticks out. I made some home-made marshmallows from the failsafe book and he reacted badly to them (two small pieces and licking the whisk!) (crying, sad followed by hyper then on to the humming and repetitive singing, ending after three days as usual) …. My husband is convinced it's the sugar. The only possible thing I can think of that is new is that we have had the chia bread from bakers delight … thanks to Kate
In this case, the salicylates in the chia seeds probably caused the sugar reaction. People who are failsafe 'but not 100%' and swear they react to sugar have almost certainly failed to reduce their salicylate level enough. For more information, see Salicylate-induced hypoglycaemia in the index of my books such as Fed Up.
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Corn and maize can be terribly confusing.
• cornflour or cornstarch is okay because it is highly processed but corn or corn flour (i.e. ground corn in bread and tortillas, see reader report below) is not okay. Similarly, refined maize flour called maize starch is okay but maize flour is not.
• corn oil (no added antioxidants) is moderate in salicylates therefore not failsafe
• all other corn – fresh cobs or kernels, creamed corn, canned sweetcorn, cornmeal, polenta, corn chips, taco shells, cornflakes and other corn cereals such as Nutrigrain - are now classified as high because corn contains some glutamates as well as salicylates, definitely not suitable for your elimination diet
• popcorn was not tested but I would assume it is high
• corn syrup was not tested but could be low because it is highly processed
• small amounts of corn in gluten free pasta are technically not failsafe
• if you are gluten free, check that the corn starch is not made from wheat, see our Shopping List
• cornflour may contain residual sulphites (about 30 ppm) that can affect the extra sensitive
Readers report: My son is a salicylate sufferer. He has had major reactions the last 4 weeks to something and I finally phoned Naturally Gluten Free to confirm the ingredients in their Classic Naturally Gluten free bread and they told me it is ground corn. However, the Oriental loaf is failsafe because it uses rice flour instead of corn. - thanks to Melissa
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Annatto 160b natural yellow colour is used in many dairy foods such as yoghurt and icecream, as well as biscuits, breakfast cereals, cheese slices, frozen or crumbed products, croissants and a wide variety of other processed foods. It is often in products labelled 'all natural, no artificial colour, flavours and preservatives'. Since annatto usually causes a next day reaction, people don't realise when it affects them, they just see a slow build up of problems, as in the following report:
My 2 yo son has been an angel since starting the elimination diet however took a backwards step at about 2.5 weeks. We discovered we had been giving him soy yoghurt with 160b in it. We took him off it and his symptoms (irritability, huge tantrums) cleared again. – thanks to Greg
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Bread is one of the major causes of diet failure because it is a seemingly healthy food eaten many times a day every day and there are so many ingredients to avoid (e.g. vinegar, seeds except poppy seeds, wholegrains, preservatives such as 282, sorbates 200-203 or sulphites 223, honey, fruit, synthetic antioxidants such as 319 or 320, possibly unlisted, cultured whey powder and the newer incarnations of 282 such as cultured wheat and cultured dextrose).
Remember that wraps often contain more preservatives than loaves of bread.
See the Shopping List for more about bread – what to look for, what to eat and what to avoid. If in doubt, plain unflavoured rice cakes such as Sunrice or Pureharvest (no corn, no sesame, no flavours) are one of the safest foods on the market.
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A mother wrote:
We've lived failsafe since Christmas which up until recently has made our house a calm, lovely environment (thank you for that!) but over the last few weeks it just seems to have gotten worse! I've looked back on his food diary and nothing really sticks out. The only possible thing I can think of that is new is that we have had the chia bread from bakers delight . .. LATER … I called my husband after I got your email and he said he'd bought two loafs on saturday and they were all gone by monday morning. As bread is the one thing we thought of as safe, we let our son make himself toast or bread and nuttelex as a snack without really monitoring how much! He must've had about one loaf over the two days - thanks to Kate
Chia seeds are not permitted on the RPA elimination diet. Chia is a member of the mint family. Mint is very high is salicylates and there have been numerous reports of gastrointestinal symptoms due to chia seeds from salicylate sensitive people overseas http://nutritionalconcepts.blogspot.com/2008/03/caution-regarding-chia-seeds.html and several reports from failsafers in Australia. Some people with food intolerance are also affected by wholegrains, see next paragraph.
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People with food intolerance, including many children with behaviour problems, can be affected by wholegrains in wholemeal bread and wholegrain cereals such as Weetbix or Vitabrits.
You can switch to white bread and limit cereals (eg 2 Weetbix every second day) or if no improvement, avoid. White bread is not as nutritionally unsound as parents have been led to believe. I agree with the quote below from dietitian Sharon Natoli:
"Many parents feel guilty about feeding their children white bread - yet often it's the only thing kids will eat. Ordinary white bread provides a range of B vitamins, is a source of fibre and a good source of carbohydrate - vital for growing, active bodies. It is better nutritionally than many of the other foods commonly found in kids' lunchboxes." http://www.femail.com.au/white-bread-bakers-delight.htm
But if you don't like the idea of white bread you can switch to gluten free, e.g. Naturally Gluten Free Oriental loaf with quinoa.
Perhaps you need to reconsider. In my experience families are often extremely reluctant to avoid dairy but research shows about 25% of children with behavioural problems are affected by dairy foods and the figures are similar for most other symptoms - about 25% of people with irritable bowel symptoms and about 20% of people with eczema are affected by dairy products.
One mother wrote:
When eating dairy foods, my daughter is not just bad, she is impossible to live with. I just can not understand how a food can affect her in this way. Her oppositional defiance is incredible …. Since she has been dairy-free she listens, talks more quietly and without intensity, she lets me cuddle her, she does not get locked into bad behaviour … from Story 
If the diet doesn't seem to be working, it is probably worth cutting out all dairy foods as part of the elimination diet, and doing the dairy challenge (1-3 glasses of milk per day for at least a week, I prefer ten days as reactions can build up very slowly). If you don't want to cut out dairy from day 1, you can cut it out from the beginning of the 3rd week.
Parents often say 'but I can't ask my kids to stop drinking milk'. Failsafers say an easy way to do it is to switch to A2 milk first for two weeks – in some cases that is enough - then switch to oat milk (not for gluten free diets), rice milk, soy milk or Dari-free, see Shopping List.
When avoiding dairy foods you need to avoid not only milk but also yoghurt, ice cream, cream cheese, butter and milk powder in bread, biscuits and other foods. You can switch to a milk substitute such as oat milk, Nuttelex margarine (not with olive oil) and ice cream substitute such as Sanitarium So Good Vanilla Bliss or Icey Ricey, see Shopping List for more information.
While people with physical problems such as rashes, rhinitis, irritable bowel or migraines may do well on A2 milk (www.A2milk.com.au) but it is often not helpful for children with behaviour problems, except as a stepping stone to milk substitutes such as soy, rice or oat milk.
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Some people are affected by soy not only in soymilk but in numerous common products including most breads, and also in some otherwise harmless additives. The effects can be extremely difficult to recognise, see story below:
 Diet not working 100 per cent - another soy intolerance story (November 2008)
We have had a major breakthrough with my nine-year-old daughter. Over a year ago we did the elimination diet for her and worked out what her intolerances were - severe for dairy, moderate to severe for salicylates, mild for amines and reacted to all the additives. I wrote to you some time back noting that my daughter who had finally started drinking soy milk (in fact she was guzzling it down), was bed wetting again and old behaviours were returning. You asked if she was OK with soy. So we removed soy (or so we thought) and the bedwetting stopped, unless she consumed anything with soy flour in it. For the next year we lived with a much improved daughter but it niggled at me that she still didn't seem 100 per cent and I thought she could be better ... See the full story in Success Stories
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Ricemilks are probably the safest of all milk substitutes but children or adults with nut or soy allergies may be affected by brands which add chickpea flour for extra protein. Ricemilks alone are not suitable for infant feeding. For babies with milk problems you need to consider a prescription only formula such as Elecare or Neocate - ask your dietitian or doctor.
When the diet isn't working, you may need to reconsider gluten. Fewer people are affected by gluten than any other food chemical (e.g. for irritable bowel symptoms, 70% react to salicylates compared to only 20% to gluten). However, gluten is eaten many times a day every day, so if you are affected, it is important for you. If you have a coeliac diagnosed relative, a genetic test can tell which relatives are at risk, see page 16 of the RPAH handbook. Even if you aren't diagnosed a coeliac, you can still have problems with gluten, including behaviour.
Coeliac disease was previously regarded as unusual and glaringly obvious but is now seen as more common and difficult to diagnose. It can be implicated in a range of low key diarrhoea and abdominal complaints, neurological dysfunctions, Down Syndrome, schizophrenia, unexplained anaemia, osteoporosis, teeth enamel defects and other nutritional deficiencies, unexplained infertility, alopecia, insulin dependent diabetes, dermatitis herpetiformis and possibly psoriasis. Traditionally, coeliacs were thought of as small and skinny with a life-long sensitive stomach. Now it is known they can be tall, overweight, and have no abdominal symptoms. See the following story:
Eliminating additives and low amines as suggested by your book provided the answer my son's problems for some time. Then at nearly nine, out of the blue, he had some sort of breakdown. The teacher suggested Asperger's but he soon became worse - quite autistic, wild and extremely violent. He was off school for three months. The doctors I approached turned their backs on me … Without medication it was like living with a drunk - he could be fun sometimes, but more often silly and tiresome, and aggressive too often … Then, by chance ("Mum, I don't want Rye bread this morning, I want Rice cereal") we realised it was the GLUTEN. I never suspected it, because I'd known a baby who nearly died of coeliac disease and the symptoms were quite different from my son's. I followed up your footnote in Fed Up and read Professor Duggan's article in the Aust. Med. Journal. My son was diagnosed with Coeliac disease a month ago and I am absolutely delighted by his response to the gluten free diet. From story 
In my experience, gluten is by far the most difficult dietary component to avoid in Western societies. Here are some of my mistakes:
• malt is a minor source of gluten so check labels on puffed rice cereals, soymilks etc
• assume cornflour in confectionery, baking powder and other products is wheaten cornflour unless otherwise specified
• avoid contamination e.g. from family members' toast crumbs in the Nuttelex or jam
• when eating out, avoid gravies, sauces and anything with thickeners that may be wheat based
Some items that may contain residual gluten: beverage whitener; dextrin in adhesive (don't lick postage stamps); maltodextrin; thickeners 1400-1450 (see page 70 of the RPAH handbook)
• Oats and oat milk are not permitted on the gluten free version of the RPAH diet; overseas the debate rages about whether oats are gluten free and it now appears that some Australian varieties of wheat may contain gluten, see the GF section of the Shopping List.
• Spelt flour is not gluten free although some people with non-coeliac gluten intolerance say they can tolerate it
WARNING: When switching to gluten free, don't assume that gluten free products such as bread and cereal are failsafe. Most of them are not, due to flavours, honey, fruit etc. See reader story below.
I have a 6 yo son who is going through a tourettes type attack at present - we are reassessing his diet to find out what has happened and back being really strict, he was doing so well, so this has been upsetting. We have also switched to gluten free. We started using healthy bake plain gluten free bread, is this bread failsafe?? Also the freedom foods GF tropicO cereal. I saw this cereal on the yahoo forum and someone said it was safe, perhaps not, what they say is natural is not always the case as we know.
Healthy bake plain gluten free bread turned out to contain olive oil, not failsafe. At the time of writing, Freedom foods GF tropicO cereal contained 'maize (corn) flour' which is not permitted due to moderate salicylates – maize starch would be okay; also 'natural colours turmeric, gardenia flour extract, sweet potato extract' not permitted because natural colours are listed as high in salicylates when concentrated; also 'natural fruit flavour'. Fruit flavours are NEVER failsafe. This product may be okay for some kids but not for failsafers.
Plain unflavoured rice cakes are some of the safest products in supermarkets – perhaps it would be safer and easier to stick to those as a bread substitute and crumbled with milk as a cereal when first going gluten free, see Shopping List.
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Sometimes a change in diet, including too much fibre too quickly cause cause bloating, stomach aches and diarrhoea especially in people with irritable bowel symptoms. Fibre intake should be slowly increased in foods such as vegetables, raw rolled oats (can be more digestible if well cooked), and dried beans. RPAH recommends starting with e.g. just a few chickpeas at a time. Vegetable gums such as guar gum 412, tragacanth gum 413, acacia or gum Arabic 414 and xanthan gum 415 in many processed foods known to contribute to this effect, and sugar free sweeteners such as sorbitol and mannitol must have a warning on the label "excessive consumption may have a laxative effect". See our sugar free sweeteners factsheet. For some people with food intolerance, wholegrains such as All Bran, wholemeal bread and wholewheat products such as Weetbix and Vitabrits can be a problem and refined products such as white bread are safer.
Psyllium is recommended on the RPAH elimination diet - but as with any form of fibre - including chickpeas and other legumes such as lentils - start with a very SMALL dose and work your way up slowly, otherwise you could be causing any or all of the symptoms of irritable bowel just by eating large frequent doses of fibre as in this reader story:
After reading your website about too much fibre possibly irritating the gut I cut out the chickpeas that I was eating every day and just switched to a small amount of psyllium for fibre instead. Almost straight away that cramping feeling that I was getting several times a day and other sensations disappeared almost entirely. I'm just going to very slowly build up the psyllium to a point that keeps me regular.
More information : http://fedup.com.au/factsheets/symptom-factsheets/constipation-and-psyllium
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Product changes occur frequently - read labels especially with a packaging change. Bread, vegetable oils, soymilk, lemonade, pastry, margarine, blended butters, cream cheese, cooking oils and rice crackers have been some of the most changeable in the past. You can read about changes in Product Updates in our newsletters or check the Shopping List, see the following example:
I have noticed that in the Coles brand diced pears in syrup tubs (sold in 4 packs), on the failsafe shopping list, have concentrated pear juice in them – is this still okay? My daughter has been taking one tub a day to school over the last three weeks and is suffering quite a bit with sinus. Nothing else in her diet has changed, although she is has environmental triggers too, so can't decide whether the diced pears are to blame! I don't want them to be a problem as we have just discovered them, and it is wonderful that she can take some fruit to school!! As these pear tubs have been mentioned in the shopping list on your site and in the RPA handbook's shopping list, I wonder if the concentrated pear juice is okay....or alternatively, whether the recipe has changed recently … LATER … Thank you very much for your response re: Coles pear tubs. I did miss the product warning. I suspected they weren't good for my daughter, but did not want to believe it! – thanks to Carol
Some recent changes include:
• McCains frozen potato products have finally removed unlisted antioxidant BHA 320 so the Healthy Choice chips are failsafe (good news!!!)
• Darryl Lea white jelly beans with vanilla flavour appear to have changed again and should now be avoided.
• There are now no brands of lemonade suitable for the elimination diet. Some Schweppes lemonade or other brands might be preservative-free but avoid them altogether if you are not improving because they are now rated as moderate in salicylates.
• Sakata plain rice crackers appear to be the only failsafe rice crackers but we have received many complaints presumably due to contamination on the line, approach all rice crackers with caution and avoid for anyone who has not improved
• We also receive many complaints about reactions to plain unflavoured chips, again presumably due to contamination on the line. Discard any product with a flavour that tastes wrong. For people who are not improving, home cooking is safer.
• Philadelphia cream cheese is now free of sorbate preservatives in all products except the extra Lite (more good news)
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A government survey found 58% of samples of mince (ground beef) in NSW contained illegal sulphites, now supposed to be improved due to better monitoring. It is safest to buy your mince always from the same place and test it once (on a Friday afternoon) with our sulphite test strips. See sulphite test kits in the sulphites factsheet. Or make your own mince.
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Unlisted additives can occur in any product (both illegally or legally due to the 5% labelling loophole). If you think a product is affecting you, avoid it and reintroduce, if convinced, contact us. We frequently find illegal ingredients labels and we were once caught for months by an illegally unlisted additive in softened butter.
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It is extremely difficult to find additive free food when eating out except in expensive restaurants with quality ingredients or organic cafes – see some suggestions in the Shopping List. Most food is preprepared and often contains additives – e.g. you can buy an additive free butter cake mix for home cooking in the supermarket, but the food service version of that product for sale in cafes will often contain additives as you can see by doing an online search, and it is the same with pastries, desserts, treats and cooking oils. Look for places where the staff are friendly and prepared to answer your questions about what's on the label.
• It is not okay to eat the meat and avoid the skin of BBQ or roast chicken with seasoning or stuffing
• Beware of stuffed fresh chickens in supermarkets, the stuffing is not failsafe
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Synthetic antioxidants in oils are often unlisted - due to mistakes or the 5% labeling loophole - in any product that contains vegetable oils or margarine, for example biscuits, snack foods, breads, pizza bases, frozen potato products and fudge
• check our Shopping List for safe products
• for unlisted products, check to see if the oil is less than 5% of the product
• if the 5% labeling loophole applies, the only way to find out whether oil contains nasty antioxidants is to phone the manufacturer and ask 'are there antioxidants in this oil?'
• natural antioxidants 300-309 are safe
• synthetic antioxidants 310-312 (gallates) and 319-321 (TBHQ, BHA, BHT) are nasty
• if no improvement, avoid any commercial product containing any kind of vegetable oil or vegetable shortening (such as hot chips) unless you are absolutely certain they are OK
Changes in products with antioxidants in oils can occur without warning and there will be nothing on the label to indicate the change, for example, Arnotts biscuits previously contained unlisted 320 but are now okay (except for a few flavoured varieties that are not failsafe anyway), but with other brands you do not know unless you phone the manufacturer
• home cooking oil in Australia is generally pure with a few exceptions, always read the label
• commercial oils usually contain nasty antioxidants so assume that any hot chips and other fried takeaway foods contain these additives
• bread can contain these nasty additives, unlisted (Bakers Delight and Brumbys do not use them)
• reactions are likely to build up slowly over several days or more
• In New Zealand nearly all supermarket oils, commercial oils, margarines and products such as bread, biscuits and fudge contain nasty antioxidants in NZ – if visiting NZ, ask our Christchurch contact for the NZ shopping list
In 1995 I gradually developed CFS and was invalided out of work a year later. In late 1999 I began the RPAH elimination diet. Ten days later my brain fog and fatigue were greatly diminished. Challenges confirmed intolerance to dairy and gluten – which I had eliminated years previously – and indicated intolerances to salicylates, amines and glutamates.
In the following years I had a few relapses, usually lasting for no longer than a couple of weeks. The exception was a six months relapse, which ceased five days after I decreased my intake of vegetable oil and changed from canola to sunflower. (Both oils had no additives listed on the label).
In January 2007 I was feeling quite well and had no significant CFS relapse for a couple of years. At the beginning of February my energy plummeted. I needed to spend at least twelve hours a day lying down, instead of eight hours. Physical fatigue and brain fog returned in force. Six weeks later I bounced back, and was quite well for a few weeks, then I plummeted again. These irregular fluctuations continued throughout the year, but the highs got lower and the lows got lower. I became much more sensitive to amines.
In early February 2008 I went to Woolworths for grocery shopping. I picked up a bottle of sunflower oil and glanced automatically at the contents. In a way, I was not really looking because I 'knew' that nobody put additives into sunflower oil in Australia. But there it was: 'Sunflower Oil, Antioxidants E319, E320'. I squeezed my eyes tight, reopened them, and read the same thing. Then I grinned and imagined myself leaping into the air and clicking my heels. Yes!
I phoned Woolworths and was told that their sunflower oil had E319 and E320 since the beginning of 2007. But sometimes my wife bought sunflower oil from Coles. No, Coles had never put antioxidants into their sunflower oil. We take about six weeks to consume a one litre bottle of sunflower oil. I looked back in my diary and found that the length of my ups and downs were in multiples of six weeks. We swapped to Coles sunflower oil. Eighteen days later I was fully well again. – thanks to Ian, from story 
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Remember that sweets are limited – e.g. for white marshmallows limit 4 per day of the Pascall's small white marshmallows. It is NOT okay to eat the white ones from a mixed bag of pink and white as contamination from the pink marshmallows – both colours and flavours - can cause a reaction.
We receive many complaints from parents whose children have reacted to the Natural Confectionery Co sweets. These products are not suitable for your strict elimination diet because they contain strong natural fruit flavours (salicylates and amines) and strong natural colours which are rated as high in salicylates by the latest RPAH Handbook.
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Sulphites (220-228) are widely used in unlabelled foods such as sausages and prawns. These products are not failsafe but can sometimes be eaten by people who have passed salicylate and amine challenges and are unaware of the sulphite content, see story below.
Just purchased my Xmas prawns and thinking to avoid any additives, I always buy 'Australian' uncooked prawns. As I purchased 2Kg they came in the original box and shock, horror, I see preservative ticked, and then 223 (sodium metabisulphite). This product was labelled 'Wild caught Australian frozen prawns' from Hervey Bay - all sounds so pristine!
I rang the fish man morning and he informs me that all prawns are treated with 223 to prevent discolouring. This is common practice across the industry, the only difference being that imported prawns may not declare the preservative on the packaging. I phoned the Health department who were completely unaware of this practice. I suggested that as processed foods have to have labelling of ingredients what of the 'fresh' product?
An asthmatic with sensitivities to the sulphur group of preservatives may well react to prawns and then assume this is a seafood allergy, as preservative would not be considered a factor. Imagine if all those wonderful sea food displays at this time of the year were labelled 'contains sulphur metabisulphite'! – thanks to Judy - from story 
Most failsafers can tolerate the small amounts of sulphites in gluten free flours but failure to improve on diet or worsening of symptoms including asthma and eczema when gluten free may be sulphite-related, see the gluten free section of the Shopping List
High levels of sulphites (220) are permitted in gelatine but dissipate due to heat and storage – make sure you follow directions about heating when cooking with gelatine.
If you are an asthmatic avoiding only sulphites, see How to Avoid Sulphites in our Sulphites Factsheet.
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A. According to the RPAH Handbook (p37), some vegetables - including shallots, garlic, leek, chives, cabbage and Brussels sprouts - contain sulphur compounds which double after 5 minutes of cooking. To avoid this problem, you can eat these vegetables raw, or quickly steam or stir fry.
Reader report: I was finding I was developing headaches every time I ate shallots with my homemade soup. I observed my reaction each time I added shallots, and there is this definite link. As shallots may be used by many failsafers, I just thought I would pass this info on, as I always saw shallots as a safe food.
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You may need to exclude more foods. People with severe symptoms or extra sensitivity may need to avoid some of the following • dairy foods • wheat or gluten • soy • citric acid • gelatine (see below).
Some people notice problems with sulphur containing vegetables including garlic, leeks, shallots, chives, cabbage and Brussels sprouts. After 5 minutes of cooking, the sulphur compounds become more accessible and can cause problems for the extra sensitive. To avoid problems, RPAH suggest eating raw or quickly steam or stir fry (page 37 of the handbook).
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The development of allergy is a combination of inherited susceptibility and exposure to allergens. You may want to avoid cashew nuts for children under five and also cochineal natural colouring (120) as allergies to both are increasing – consult your dietitian, and be aware that true allergies as well as food intolerances can be responsible for skin rashes especially in young children.
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Challenges can be more difficult than people expect. It is important to follow the RPAH recommendations for challenges from your dietitian because challenge can be inconclusive if you don't get the dose right. The worst case scenario is doing a challenge and still being uncertain. Some mothers find they are much more confident after doing a challenge twice. Seeing the same reaction twice makes it feel more real. For more information about challenges, see
• challenge recipes in the Failsafe Cookbook
There are some RPAH recommended supplements and medications if required that can be used during your strict elimination diet.
Anything you put in your mouth can affect the elimination diet. RPAH guidelines say take only essential medications (e.g. for asthma, epilepsy, but consult your dietitian) and avoid unnecessary medication during your elimination diet
• Do one thing at a time - do not try to combine other diets (e.g. candida) or therapies with failsafe eating - your efforts are much more likely to be successful if you get failsafe 100% right
• it's best to avoid optional visits to GPs, specialists, naturopaths, optometrists and dentists while doing the elimination diet because preservatives, flavours or other additives in most medications and supplements will interfere with the diet
• aspirin and other salicylate containing medications e.g. other painkillers such as Nurofen, anti-inflammatory drugs and skin remedies such as wart remover - are absolutely not permitted on a low salicylate diet, see Shopping List for alternatives
• colours, flavours, preservatives and active ingredients in syrups, capsules or lotions, herbal remedies including Echinacea and supplements including fish oils may cause problems
• you can ask for white tablets or powdered capsules, mix contents with syrup, jam or icecream, or see the Vitamin Icypole recipe
• non-recommended supplements etc can be reintroduced as challenges after you have achieved success on your supervised elimination diet.
• flavours or preservatives in vitamins or children's syrup medications such as paracetamol, cold medications, antibiotics, chewable vitamin tablets or iron supplements don't have to be listed on the label but will appear on the Consumer Medication Information sheet • do a Google search for 'name of product' and 'ingredients' • ingredients listed as 'superarome' literally mean strong flavour, see more on the Shopping List and Supplements Factsheet
• preservatives and colours from diagnostic or therapeutic eyedrops and some preserved contact lens solutions are easily absorbed through the eye and can cause problems.
• for dental treatment • you can take your own toothpaste • plaque disclosing tablets contain artificial colours. Beware, treatments your dentist may use or recommend can contain nonfailsafe ingredients
• the contraceptive pill can cause problems for female failsafers
• absorption through the skin can increase your daily load: salicylates and additives such as benzoate preservatives in skin creams, wart ointment, arthritis rubs and acne wipes can be absorbed through the skin and if used every day can stop the diet from working – effects can build up slowly
• beware of inhaled salicylates from Vicks Vaporub, Deep Heat, and similar liniments
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Because you don't swallow toothpaste, people think they won't be affected. Wrong!! Mint flavoured or herbal toothpastes such as fennel are not failsafe because herbs contain salicylates, and coloured children's toothpaste - even pale pink - is definitely not okay!!! The wrong toothpaste can be enough to ruin the whole diet, especially for children who like sucking on toothpaste tubes. See Shopping List for alternatives and story below
Three years ago I started the RPAH elimination diet and discovered I was suffering intolerance to dairy as well as other food chemicals. Although other symptoms cleared up, there were a few niggling things, particularly the blocked and running nose, always having my sleeve or back pocket loaded with tissues, ready for the inevitable moment. I had always suffered this morning and evening ritual of a running nose so 'just lived with it'. Trying the diet again 3 years later, after a week of full elimination, the runny nose persisted. I read and re-read through your checklist of common mistakes and decided to try plain toothpaste which I never did 3 years ago as my dietician at the time said, 'oh you don't have to give up toothpaste if you don't want to - everything else though' and I never really considered it could cause me such suffering. Well well well. A truly amazing change has occurred for me. No more nose blowing at breakfast time or when I'm settling into bed at night. The tap has officially been turned off! – from story 
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On the surface of all chlorinated pools, especially indoor pools, there's a gaseous layer of chlorine and its metabolised gases called chloramines that are formed by heating chlorine or by reactions of chlorine with perspiration or urine. Although not mentioned by RPAH, these chloramines can cause the same reactions as food chemicals in some children, including behaviour, hives and asthma.
• saltwater pools generally contain some chlorine but not as much
• some families find they can minimize the effects of chloramines by children wearing goggles and showering in fresh water immediately after swimming
• outdoor pools are safer than indoor, home pools are generally better than public pools
• some children do better avoiding swimming lessons and smelly chlorinated pools at least until they have finished their elimination diet, see story below:
After 4 weeks on the elimination diet I was still scratching my head trying to work out what I was missing with our daughter. Our dietitian couldn't fault me how I was following the diet but seemed to suggest that she felt our daughter was possibly one of these children that just diet was not going to fix. She strongly suggested we give the diet another 4 weeks without doing any challenges and see how our daughter went, but to be realistic about the fact that she may not get any better and that we look into getting her psychologically assessed. I felt as though her swimming lessons were impacting on her behaviour so pulled her out around the same time. Well I am pleased to tell you that most days for the past 13 days particularly the later of these, we have had a calm, happy, relaxed, loving, caring, mostly compliant beautiful little girl. She seems to be more in control of her actions and I am not getting the "I don't know why I did this mummy, my brain can't help it". She is very excited about receiving her readers from school and proudly comes home and reads them to us with no problems at all.- thanks to Mel
For people who have a frequently used backyard pool, see this solution from the tropics below.
My 6 yo son's chlorine reactions are similar to his salicylate reaction except that he skips the usual initial silliness and hyper behaviour and goes straight into tantrums/anger/out of control behaviour. The first one we noticed (his first swimming lesson) was delayed 12 hours, he woke up the next day grumpy and irritated and was like that for a couple of days and settled down. A week later with the next lesson, grumpy again the next day but during that week descended into tantrums/swearing. The next few weeks followed the same pattern, but the behaviour got worse with no good days at all in the end. Obviously it was building up with each lesson and when he stopped it took another week for him to settle. We now have a salt water pool, where the chlorinator runs in the middle of the night only, so that by the time he swims during the afternoon, there is no smell (the filter is set up so that we can run it when we are actually in the pool during the day without the chlorinator being on).- thanks to Jenny H
• One third of the Australian Olympic swimming team have asthma. For more about chloramines as a cause of asthma, see http://www.smh.com.au/articles/2007/11/23/1195753262186.html
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Some people are more sensitive than others. Consider exposure to perfumed products and other smells, industrial chemicals and heavy metals and see Shopping List for alternatives:
• perfume in toiletries, cosmetics, after shave, washing powders, shampoo, conditioners, aerosols, deodorants, sunblock for all family members and household cleaners
• essential oils, incense and 'naturally fragranced' products
• scent sprayers, air fresheners and toilet deodorisers
• bubble baths, finger paints, preschool paints and glues, food dyes in playdough (see Playgroup factsheet)
• paints, solvents and other renovating fumes
• petrol, diesel, engine degreaser and other traffic fumes
• smells of new or newly cleaned soft furnishings, upholstery, carpets, new mattresses, furniture, ('new' smells mean chemical exposure)
• shopping malls, hairdressing salons - alternatives include fast cuts or home hairdressing services
• pet shops, cigarette smoke
• workplace chemicals
• chemical smells of new cars, electrical appliances including computers and CD players – display or second-hand models are safer
• strong smelling plants e.g. herb plants, strongly fragrant flowers and trees e.g. eucalypt, camphor laurel, pine, particularly freshly cut as in a Christmas tree
• freshly sawn timber, sawdust (especially camphor laurel bark chips) and new timber for renovations
• the smell of wood and smoke from wood fires
• lawn clippings and mower fumes
• the smell of strongly spicy food - don't cook it for others
• fumes are generally worse in hot conditions
• and see story below:
My daughter's sinus headache problem is certainly affected by food chemicals - it has improved quite a lot on the elimination diet, but a whole range of environmental allergens seem to trigger it too. The grass being cut affects her. Walking through the detergent isle in the supermarket affects her. The smell of perfume and cosmetics affects her. Household chemicals affect her … see story 
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Too much stress for whatever reason including confrontational parenting or teaching styles can increase food intolerance. A mother wrote
Sue, I am really hoping that this will work because our lives have been very stressed. I am finding though that I seem to be swapping one stress for another as it is hard to stick to this diet and I was cross that he ate some crumpets that were offered to him! – thanks to Sandra
It is common for mothers to write me on days 4 & 5 of the diet feeling exceptionally cross and irritable, and complaining that the diet is too hard due to withdrawal symptoms – this will pass.
However, to reduce stress and make life easier for everyone, see the following suggestions:
* make some very kid-friendly food, such as homemade chicken and chips and a favourite dessert like pavlova or failsafe icecream. It is okay to eat homemade chicken and chips frequently during the first three weeks. One mother who was at her wit's end and about to abandon the diet during the first week broke the diet in a tiny way by doing chicken & chips with green peas (green peas, sugar snap peas and snow peas are all moderate) with a favourite family comedy DVD, the evening was so successful it broke the tension and the rest of the diet went well.
• reduce demands on your children and yourself during the first three weeks. Treat each other with respect and kindness
• avoiding confrontations, the 1-2-3 Magic DVD or book (from Amazon or www.parentshop.com.au in Australia) can show how to do this
• have some fun family time, e.g. schedule a regular family night with a good comedy DVD because laughter therapy really works - it actually boosts the immune system and makes the kids less food sensitive
• for adults, highly effective laughter yoga classes developed by a doctor are now available http://www.youtube.com/watch?v=2EGTETc5oFU (Howard and I go to a regular fortnightly class) or see http://www.youtube.com/watch?v=kKnY8tBLG3g
• go through old photo albums to relive the good times and encourage positivity
• schedule family walks, bike rides or camping holidays - preferably with no shops or advertising, e.g. in a national park
• relaxation – you can play relaxing music while preparing dinner or at other times e.g. http://www.youtube.com/watch?v=TuLg9TOzfm0&feature=related
• for adults, meditation is considered to be the single most effective stress reduction method. It is now called mindfulness and recommended by psychologists and the UK public health service. http://www.youtube.com/watch?v=ejruLy2Cf_o&feature=fvwrel
Non-food factors such as an absent parent, a new baby, moving, house renovations, illness, changes in medication, a new school, bullying, criticism, punishment or lack of friends can contribute to problems - children on the diet need a failsafe house, support, love, praise, exercise and time with parents.
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You are very welcome to send me a complete list of everything that goes in your mouth, on your skin and up your nose (e.g. inhaled fragrances and chemicals such as flame retardants in new furniture) in a typical day, so I can check for anything obvious, see more details below.
- what are you (or your children) consuming for breakfast, lunch, dinner, snacks, drinks? (have you excluded dairy and gluten?)
- what brand of soap, shampoo & washing powder are you using?
- which toothpaste?
- which medications (full name please) & supplements if any? (this is very important)
- do you live in a new or newly renovated house?
- do you have new furniture, carpet, drapes?
- do you wear fragranced cosmetics and hair products?
- do you (or your children) swim in a chlorinated pool?
Reader question: I have seen a dietician and have been doing the RPAH elimination diet for 3 weeks (now starting my 4th week). There are not enough improvements to convince me to follow the diet long term. Is it possible that my symptoms are not related to chemical sensitivities? I will stick with the diet for another week, but would assume that after that (4 weeks), if I have not seen any improvement, that food chemicals is not my problem?