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Food Sensitivities & Fatigue
could be a factor
G. Crook, MD
Many clinicians who work with chronic fatigue and
syndrome (CFIDS) patients have noted that sensitivities to common foods contribute to their patients'
symptoms. I first learned of the relationship of food sensitivities to fatigue (and other symptoms) from
the mother of a 12-year-old boy almost 40 years ago. She convinced me (against my will) that her son's
fatigue, headache, muscle aches and depression vanished when she eliminated milk from his diet.
A short time later, I read several articles about
the subject published
in peer-reviewed medical journals.1-3Each described persons with fatigue and other symptoms
who improved (often dramatically) when they eliminated milk, wheat, corn and other common foods from their
After reading these articles, I began putting some
of my fatigued
patients on elimination/ challenge diets. Although it did not help all of them, I was astounded and delighted
when many of their chronic and often disabling symptoms disappeared when they stopped eating some of their
I first reported my observations on
50 children with food-related
fatigue and other symptoms in a major pediatric journal over 30 years ago.4 I published other
reports in the 1970s.
In the 1970s and 80s, other physicians
described the relationship
of food sensitivities to a diverse group of health problems in children and adults.7,8 In spite
of these reports, most allergists and other physicians continued to ignore this type of food sensitivity.
Why is this so? Here's one of the reasons:
these sensitivities are
not IgE-mediated and cannot be confirmed in the laboratory, yet they can be easily identified using an
elimination/ challenge diet. On such a diet, a person avoids a number of his/her favorite foods. When
convincing improvement is noted after one week, the eliminated foods are eaten again, one food per day,
and reactions are noted. (See "The
During the past decade, a number of observers
on health problems, including food sensitivities which develop when the gut flora is changed. In a comprehensive
review of antigen handling by the gut, W. Allan Walker of Harvard Medical School commented, "There's increasing
experimental and clinical evidence that suggests that large antigenically active molecules can penetrate
the intestinal surface not in sufficient quantities to be of nutritional importance, but in quantities
that may be of immunological importance."9
In another report, John Hunter, a British investigator,
on adverse food reactions which occur in people with migraine, irritable bowel syndrome, rheumatoid arthritis
and other disorders. In this discussion, Hunter said that patients with food intolerance have abnormal
gut flora even though pathogens are not present. And he said, "If food allergy is not an immunologic disorder,
but a disorder of bacterial fermentation in the colon, it might be more appropriately named an 'enterometabolic
disorder.' This is of more than mere terminological importance: modern microbiology has opened the way
to the manipulation of bacterial flora to allow the correction of food intolerances and thus the control
Based on my experiences in practice during the last
15 years, repeated
use of antibiotics and resulting yeast overgrowth play a major role in contributing to food allergies
and sensitivities. And many health professionals have found that a sugarfree special diet and nystatin,
Diflucan and other antifungal medications play an important role in helping people with fatigue, depression,
headache, muscle ache and other symptoms.
How is a yeast-related disorder
identified? Although stool
and blood tests may provide some useful information, the diagnosis remains a clinical one. George E Kroeker,
MD, a board-certified internist said, "Unfortunately candida remains a disease in search of a laboratory
test for diagnosis. The best test remains the history and one-month trial of antifungal medication and
a sugar-free diet. I've tried to utilize antibody assays, cultures, etc., and they all fall short of diagnostic
- Rowe AH: Allergic toxemia and fatigue due to food allergy West
- Randolph TG: Allergy as a causative factor of fatigue, irritability
and behavior problems of children. J Pediat 1947;31:560.
- Speer F: The allergic/ tension/ fatigue syndrome. Pediat Clin
N Amer 1954;1:1029.
- Crook WG, et al.: Systemic manifestations due to allergy Pediat
- Crook WG: The allergic/ tension/ fatigue syndrome. Pediat
Ann April 1974.
- Crook WG: Food allergy - the great masquerader. Pediat Clin N
- Deamer WC: Pediatric allergy: some impressions gained over a 37-year
period. Pediat 1971;48:930.
- Gerrard JW: Understanding Allergies. Springfield IL: Charles
C. Thomas, 1973.
- Brostoff and Challcombe: Food Allergy and Intolerance. Philadelphia:
WB Saunders, 1987:209-222.
- Hunter JO: Food intolerance. Lancet 1991;338:495.
- Crook WG: The Yeast Connection and the Woman. Jackson TN:
Professional Books, 1995:653-654.
Dr. Crook is author of Chronic
Fatigue Syndrome and
the Yeast Connection and The Yeast Connection and the Woman (items 3080 and 3200 on pages 63-64).
He is a Fellow of the
American Academy of Pediatrics, The American College of Allergy, Asthma and
Immunology and The American Academy of Environmental Medicine. He is president
of the International Health Foundation.
Carrying out an elimination diet isn't easy Here are some of the things you'll
need to do to succeed:
- Before beginning your trial diet, discuss it with your family.
- Carry out the diet at an appropriate time. Don't try it during a
- Before beginning a diet, keep a diary or symptom inventory for at
least three days.
- Continue the symptom diary while you're following the diet.
On the initial elimination diet, you can eat the following foods:
---any vegetable but corn, peas or beans
---any meat but
bacon, sausage, hot dogs or luncheon meat
---rice, oats, barley and the grain alternatives amaranth,
quinoa and buckwheat (available at health food stores)
---any fruit but citrus (also avoid any fruit
you currently eat more than once a week)
---bottled, spring or distilled water and herb teas
- On the initial elimination diet, avoid: milk, tea, coffee, Kool-aid,
soft drinks, eggs, bacon, sausage, hot dogs, lunch meat, peanuts, peas, beans, corn, citrus fruit, any
fruit you eat more than once a week, processed foods, sugar, wheat, chocolate, food colors, and dyes.
- Continue the diet for 5-10 days, until there is convincing improvement
in your symptoms lasting 48 hours.
To identify specific food sensitivities, eat one of the eliminated
foods per day and note any reactions. Symptoms may occur within a few minutes, a few hours or the next
Note:If you have been
bothered by asthma, severe hives, swelling or other serious allergic reactions, consult your physician
before beginning an elimination diet.
From: "Detecting Food Allergies"
by the International Health
Foundation. Available from the non-profit International Health Foundation, Box 3494, Jackson TN 38303. A long, self-addressed, stamped envelope
and a donation of $1.00 is requested. Dr. Crook provides a detailed discussion of the elimination diet
in CFS and the Yeast Connection (item 3080 on pages 63-64.)
Signs and Symptoms of Food Sensitivity
- nasal congestion
- dark circles under the eyes
- muscle aches
- abdominal pain
- memory loss