Guidance for patients undertaking particular treatments: patient information sheets

• Stay on your exclusion diet for at least three months reasonably vigorously, unless your doctor has advised you otherwise.  The initial phase of the diet will mean that you will often make a mistake and frequently have quite a big reaction to the food.  This is the ‘hyper-reactive phase’.  It is a good sign and the intensity of the food reactions will almost invariably settle.
• Usually after three or four months, you are often into the ‘active tolerance stage’ and you will probably cope with the odd amount of the identified excluded foods.
• If you have reached ‘active tolerance stage’, you can move on to the next phase whereby you can have the identified food socially, i.e. once every two to three weeks, but not too excessively.This is extremely useful for children and adults in helping to maintain a more normal social life.
• If you seem to tolerate the foods socially, i.e once every 2 or 3 weeks, then you can now think about odd bits of the foods here and there in your regular diet.  However if you reintroduce similar amounts of the identified food back into the diet, you are likely to get a return of symptoms within one or two months.  You will need to consider how much of that food you need and how much you can avoid.  This will vary between individuals and may also be dependent on other factors, for example fatigue, illness, and stress where you are more vulnerable and physically less able to cope with food reintroduction and achieve tolerance.

However, as a general guide start with approximately a tablespoon quantity of the food being reintroduced, or half a slice of bread, a small piece of cheese or butter, milk in tea once every two weeks and, if tolerated, once a week.  If tolerated, you may find you can increase the frequency of these amounts to two or three times per week, or a slightly larger quantity once or twice a week; for example, a sandwich or milk on cereals.

There are no definitive rules for food reintroduction as we are all individuals, only guidelines, therefore take things carefully and observe the effects.  You will become expert on what amounts you can tolerate and at what frequency.  It is likely that you will overstep the mark along the way, but trial and error is the only way to find your personal tolerance.

• At any point in your reintroduction programme, if you continue to have reactions after three or four months, particularly if it is due to minor exposure to the foods during social events, you will need to return to your doctor for reassessment and further treatment options, such as nutritional support, classical homeopathy, desensitisation for example – Isopathy, Miller, or EPD (Enzyme potentiated desensitisation).
• The most effective guidelines to reintroduction will invariably be explained by your doctor as he/she will have an understanding of you and your symptoms as an individual and will guide you more specifically and successfully.