What Is an Elimination Diet…and Why Your Mental Health Needs One

What Is an Elimination Diet?

The foods you eat can have a major impact on your moods, anxiety, stress levels, thinking, behaviors, and cognitive function. Subtle but important food allergies may result in brain inflammation that contributes to many issues that people view as “mental health” problems. And it’s more common than you may think with over 20% of the population suffering from a food intolerance issue or food allergy, according to research in The Differential Diagnosis of Food Intolerance.

These food allergies can be delayed, in the sense that bodily reactions to the food items may occur up to several days after consuming the item. Because of this, many people don’t make the connection between something they ate a few hours or days ago and mental or cognitive issues.

Conventional medicine has tended to ignore these reactions to foods. However, a growing body of evidence, as well as over three decades of clinical practice at Amen Clinics, shows that food allergies/sensitivities create a metabolic disorder that can lead to many “mental” symptoms, including:

Over 3 decades of clinical practice at Amen Clinics show that food allergies/sensitivities create a metabolic disorder that can lead to many “mental” symptoms. Click To Tweet

To find out if food allergies may be involved in your issues, it’s a good idea to follow an elimination diet.


An elimination diet temporarily removes potentially allergenic foods and beverages from your diet. After a specific period of time, the foods are re-introduced one at a time to see if they trigger reactions. Foods that cause unpleasant physical, mental, cognitive, or behavioral issues can be eliminated permanently to avoid those problems.

The concept of elimination diets isn’t new. Dr. Doris Rapp, a pediatric allergist and environmental medicine specialist, began describing the benefits over 25 years ago when her pediatric patients with ADHD, aggression, and even autism saw remarkable improvements when they eliminated these foods. Since then, elimination diets have emerged as one of the most important weapons against brain health and mental health issues. It’s part of what has led to the development of an entirely new field of nutritional psychiatry that uses food and supplements as interventions for mental illness.

At Amen Clinics, when patients try an elimination diet for just one month, it often makes a dramatic difference. At this time, food allergy lab tests remain unreliable. The best way to see if you (or your child) are sensitive to certain foods is to eliminate all the potential culprits and add them back one at a time.

(See instructions below detailing how to follow an elimination diet.)


An increasing number of studies are emerging that show elimination diets can be helpful. An example of how effective an elimination diet can be comes from researchers from the Netherlands, who showed a highly restricted diet brought about rapid, lasting improvement in ADHD and oppositional defiant disorder (ODD) in children. The children ate only rice, turkey, lamb, vegetables, fruits, tea, pear juice, and water. No milk products, wheat, or sugar products. No food additives or artificial colors.

In the study, 85% of children who followed the diet showed an improvement of 50% or more and no longer met the criteria for ADHD, and 67% who had ODD no longer met the criteria for that condition. They repeated this study and found similar results. In another study in the European Journal of Pediatrics using the same diet, physical symptoms (headaches and bellyaches) and sleep also improved.

Food additives and colorings can cause hyperactivity in children with no history of the problem, according to a study in the prestigious journal The Lancet (and the neuropsychiatrists at Amen Clinics have found that adults may be affected, too). The study, involving nearly 300 children, found that additives caused symptoms of hyperactivity in both young and older children. These effects occurred not just in children diagnosed with ADHD but also in those with no overt behavior problems.


Here are the steps to follow an elimination diet.

  1. Cut out the following potential food allergens for one month: sugar, gluten, soy, corn, and dairy, as well as artificial sweeteners, dyes, and additives.
  2. After a month, slowly reintroduce food items one at a time every 3-4 days. Eat the reintroduced food at least 2-3 times a day for 3 days to see if you notice a reaction.
  3. Look for symptoms, which can occur within a few minutes or up to 72 hours later. (If you notice a problem right away, stop consuming that food immediately.) Reactions to foods to which you have allergies can include:
  • brain fog
  • difficulty remembering
  • mood issues (anxiety, depression, and anger)
  • nasal congestion
  • chest congestion
  • headaches
  • sleep problems
  • joint aches
  • muscle aches
  • pain
  • fatigue
  • skin changes
  • changes in digestion and bowel functioning
  1. If you have a reaction, note the food and eliminate it for 90 days, or in some cases, permanently.

If you or your child are struggling with issues that aren’t responding to traditional treatment, it’s important to investigate further. The neuropsychiatrists, functional medicine physicians, and nutritionists at Amen Clinics can help.

At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.


  1. My Cholesterol is totally under control, with medication from my Physician…..and has been for many years.

    Comment by Marvin Negrin — December 6, 2020 @ 11:46 AM

  2. Another allergy elimination treatment to try would be N.A.E.T.
    Nambudripad Allergy Elimination Technique…!!!

    Comment by John Szewczyk — December 7, 2020 @ 3:27 AM

  3. Ever since I read dr. Amen’s book, Change Your Brain, Change Your Life, I have been a follower and refer has practice and his books too many of my clients as I am an addictions psychotherapist. Keep up the good work and I love these newsletters.

    Comment by D.J. Diebold, CAC, LISAC — December 7, 2020 @ 4:36 AM

  4. What if medications you are taking cause the brain fog and you have to have them as in hypothyroidism?

    Comment by Paula — December 7, 2020 @ 8:09 AM

  5. Allergy Associates of LaCrosse ,Wisconsin have been treating these sensitivities for years, as an outgrowth of Dr. Rapp’s work. They test each antigen one at a time sublingually to assess for a response, in addition to recommending the elimination and rotation diets. This changed my 4 year-old daughter’s life,. She had multiple sensitivities, and her behavior and thinking were extremely disordered . Instead of special ed, she was an honor student without behavior challenges. It takes consistent effort to maintain a special diet, but it’s worth it. With desensitization (again sublingual drops) , she was able to gradually re-add foods and was eating normally by the time she was in junior high. This is worth it!

    Comment by C. Swanson — December 7, 2020 @ 8:16 AM

  6. Wouldn’t it be easier just to take a food allergy test to determine heard you are allergic to?

    Comment by Russell Motter — December 7, 2020 @ 3:51 PM

  7. For Paula: There is a thyroid medication which has ONLY levothyroxine, (T4) no colors, additives, preservatives. It is in a capsule. It is called Tirosint. My patients who have not tolerated the various levothyroxine tablets have done well with Tirosint. Otherwise, some people seem to do well with one brand and not another (Synthroid, Levothroid, etc.) Hope this helps!

    “Tirosint is the brand name for a form of levothyroxine designed for people with allergies to fillers and dyes found in standard formulations. The soft gel capsules contain no dyes, gluten, alcohol, lactose, or sugar. Besides T4, Tirosint contains only three inactive ingredients: gelatin, glycerin, and water.”

    Comment by Kristin — December 8, 2020 @ 8:54 AM

  8. Heart racing or palpitations can also be a symptom of food allergies.

    Comment by Butterfly — December 8, 2020 @ 7:08 PM

  9. I was diagnosed with Bipolar over thirty years ago. I also suffer from SADS in the winter although I live in South Texas! I am about to turn 60 and have realized in the past few years that I must also have ADD. After watching your show, I suspect that it is the "ring of fire" type of ADD. I have done by best to stay off of sugar and use honey as well as eliminate non gmo wheat and processed foods for the past few years but I have not been perfect. I can tell by ankle pain when I do eat sugar that I need to stay off of it. I am ready to try the elimination diet. I do take Buproprion and carmabazepine. The Buproprion pill is pink. Will this effect my elimination diet? I am going on a trip in mid July so I feel that I need to start now instead of waiting for my summer break to start. ( I am a school counselor). Also i
    I have always struggled with my weight. I have recently just lost twenty pounds but it has been twenty pounds I lose and gain every year. I need to loose thirty five more pounds to reach my goal weight. By continuing on Buproprion, can I still discover what other foods are affecting my brain? Thanks for all yall do to help get our brains healthy!

    Comment by Kathleen Winwright — April 22, 2023 @ 6:46 AM

  10. Regarding food allergy testing, there is quite a lot to choose from out there. Some panels are a few hundred dollars, some panels are very comprehensive and test for hundreds of substances. Basic food allergy testing tests for IGG (delayed) reactions that may not be obvious at first, but can show up later as mentioned in this article. The thing they don't tell you before your fasting blood draw is that in order to identify what you may be allergic to (frequently the things we love the most and eat most frequently) is that you have to have consumed that substance within the last two weeks. So…if you are going to have that kind of allergy testing done, find out what they are testing for and if you ever consume any of those substances at all, do so in the two weeks prior to the test. Then you will know for sure if it provokes a response and to what degree.

    Please don't listen to the people who say that ONLY severe IGE food reactions (ie: something that may be serious enough to cause anaphylaxis) are true food allergies, merely sensitivities or intolerances. Not true! One can be sensitive and intolerant to something and still be "allergic" eg: causes an immune response. It just might not be so immediate or dramatic so you don't know that it was a food that caused your headache 3 days later. Conversely, it may also be "just" a digestive issue in which case there may not be any delayed allergic response but one should listen to one's body and avoid it anyway.

    An elimination diet is actually easier than food allergy testing…and all that stuff you get rid of in an elimination diet isn't good for us anyway, so there's that. I imagine lots of people feel better just by getting rid of those tings in general. The advantage of food allergy testing is that it's specific to the person. It may be something totally innocuous to many that is causing that stuffy nose or eczema flare up. You won't know until you check it out.

    Adrenal weakness can influence food intake response regarding inability to control inflammation but that's a whole separate subject.

    Comment by Fiona — June 30, 2023 @ 12:27 PM

  11. I have worked in direct care mental health for about 6 years. The diets that we feed people in psychiatric hospitals and residential treatment facilities are, with rare exception, atrocious. I have tried to steer people to Dr. Amen's book The End of Mental Illness, and Dr. Naidoo's book This is Your Brain on Food among others. Dr. Tom O'Bryan has done tremendous work on brain inflammation and gluten consumption. Gluten sensitivity can show up anywhere in the body… most gluten problems are NOT intestinal but neurological! With all the information that is out there I am disheartened that we are so far behind in helping people with mental illness.
    It's still all about "take your meds" and behavioral interventions. They have their place but it's not a long term fix, it's symptom management. Necessary, yes, but not an endgame just a starting point.

    When I worked at the state hospital in my state I noticed that sometimes the cooks would put out raw walnuts in little paper portion cups. The patients loved them! They knew they needed the omega 3s. I will say that fish oil and other nutritional supplements have made their way onto the med lists of our patients but many are in forms that are not well absorbed or just plain outdated. Ferrous sulfate? Really? Why make your patient feel like they have been run through with a brillo pad when you could give them the bisglycinate form and avoid all that unpleasantness? We have a long way to go, I hope I live long enough to be part of the solution.

    Comment by Fiona — June 30, 2023 @ 12:39 PM

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