Food Sensitivity Checklist for CFS/ME

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Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) symptoms can be affected by food sensitivities. This checklist helps you:

  • Identify problem foods
  • Track symptoms
  • Try an elimination diet
  • Create a personalized meal plan

Key steps to manage food sensitivities in CFS/ME:

  1. Keep a detailed food diary
  2. Note symptoms after eating
  3. Look for patterns
  4. Remove suspect foods
  5. Reintroduce foods one at a time
  6. Develop a tailored diet plan

Common food triggers to watch:

  • Dairy
  • Gluten
  • Nightshade vegetables
  • Beans and lentils
  • Nuts and seeds
  • Eggs
  • Soy
  • Processed foods
  • Food additives
Symptom Area Signs to Monitor
Digestive Bloating, pain, diarrhea
Cognitive Brain fog, headaches
Skin Rashes, itching
Energy Fatigue, sudden tiredness
Other Joint pain, sleep issues

Work with your doctor to ensure proper nutrition while managing food sensitivities. Regular tracking and adjustments can lead to improved CFS/ME symptoms and quality of life.

What Are Food Sensitivities in CFS/ME?

Food sensitivities can affect symptoms in people with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). Knowing about these sensitivities helps manage the condition better.

Defining Food Sensitivities

Food sensitivities are bad reactions to certain foods that can make CFS/ME symptoms worse. They’re different from food allergies:

  • Food allergies cause quick, strong reactions
  • Food sensitivities can take longer to show up and may be harder to spot

Food Sensitivities vs. Allergies vs. Intolerances

Type When Symptoms Start Immune System Involved? How Bad It Can Be How Long It Lasts Common Signs
Food Sensitivity Hours to days later Maybe Mild to medium Can last a while Tiredness, headaches, stomach issues
Food Allergy Right away Yes Can be very bad or life-threatening Usually short Rashes, swelling, trouble breathing
Food Intolerance Varies No Mild to medium Varies Stomach discomfort, bloating

Common Food Triggers in CFS/ME

Some foods and drinks often cause problems for people with CFS/ME:

  • Alcohol: Many people with CFS/ME can’t handle alcohol well
  • Caffeine: Can make symptoms worse for some
  • Sweet stuff: Sugar, corn syrup, and fake sweeteners might cause issues
  • Food additives: Things like MSG, preservatives, and artificial colors
  • Gluten: Some people have trouble with foods containing gluten
  • Dairy: Milk and cheese can be a problem for some

Signs of Food Sensitivities

People with CFS/ME may notice different signs when they eat foods they’re sensitive to. These signs can show up at different times after eating.

Stomach Problems

Many people with CFS/ME have stomach issues when they eat certain foods:

  • Feeling bloated or gassy
  • Stomach pain
  • Diarrhea or constipation
  • Feeling sick or throwing up

These problems can be like those seen in Irritable Bowel Syndrome (IBS).

Brain and Nerve Issues

Food sensitivities can also affect thinking and nerves:

  • Trouble focusing
  • Headaches
  • Feeling dizzy
  • Mood changes

These problems can make daily life harder for people with CFS/ME.

Skin Changes

Sometimes, food sensitivities show up on the skin:

  • Rashes
  • Itchy skin
  • Red or flushed skin

While less common, skin problems can help spot food sensitivities.


Since being tired is a big part of CFS/ME, changes in energy can be important:

  • Feeling very tired after eating
  • Sudden drops in energy
  • Hard time waking up or staying awake
  • Feeling more tired than usual

Watching how foods affect your energy can help find what you’re sensitive to.

Other Body Signs

Food sensitivities can cause other problems:

  • Joint or muscle pain
  • Stuffy nose or breathing issues
  • Sleep problems
  • Fast heartbeat

These signs can be like regular CFS/ME symptoms, so it’s important to look for patterns after eating.

Body Area Signs to Watch For
Stomach Bloating, pain, diarrhea, constipation
Brain Trouble focusing, headaches, dizziness
Skin Rashes, itching, redness
Energy More tired, sudden tiredness, hard to wake up
Other Joint pain, stuffy nose, sleep issues, fast heartbeat

Foods to Watch

When dealing with CFS/ME, it’s important to know which foods might make you feel worse. Here’s a list of foods to keep an eye on:


Many people with CFS/ME have trouble with dairy products like:

  • Milk
  • Cheese
  • Yogurt
  • Ice cream
  • Butter

These foods might upset your stomach or make you feel tired. Try milk-free or plant-based options instead.

Gluten Foods

Gluten can be a problem for some people with CFS/ME. Be careful with:

  • Wheat
  • Barley
  • Rye
  • Oats (unless they say gluten-free)

These grains are in many breads, pastas, and cereals. Look for gluten-free choices made from rice, quinoa, or corn.

Nightshade Vegetables

Some people feel worse after eating these vegetables:

  • Tomatoes
  • Potatoes (white and red)
  • Eggplants
  • Peppers (bell peppers, chili peppers)

If you think these might be a problem, try not eating them for a few weeks and see how you feel.

Beans and Lentils

These foods can sometimes cause stomach trouble:

  • Black beans
  • Kidney beans
  • Chickpeas
  • Lentils
  • Peas

Start with small amounts to see how your body reacts.

Nuts and Seeds

Some nuts and seeds might cause problems:

  • Almonds
  • Walnuts
  • Peanuts
  • Flaxseeds
  • Chia seeds

Pay attention to how you feel after eating these.


Eggs can be a problem for some people:

  • Egg whites
  • Egg yolks

If you think eggs might be causing issues, try not eating them for a while.


Soy is in many foods and can cause problems:

  • Soybeans
  • Tofu
  • Soy milk
  • Soy sauce
  • Edamame

Check food labels for hidden soy and try soy-free options.

Processed Foods

Ready-made foods often have many added ingredients that might make you feel worse:

  • Packaged snacks
  • Fast food
  • Frozen meals
  • Sugary cereals
  • Processed meats

Try to eat whole, fresh foods instead.

Food Additives

Many food additives can cause bad reactions:

  • Artificial colors
  • Artificial flavors
  • Preservatives
  • MSG
  • Artificial sweeteners

Read food labels carefully and choose foods with fewer additives.

Food Type Foods to Watch Better Choices
Dairy Milk, cheese, yogurt Plant-based milk, dairy-free cheese
Gluten Wheat, barley, rye Rice, quinoa, gluten-free oats
Nightshades Tomatoes, potatoes, peppers Sweet potatoes, cucumbers, zucchini
Beans Beans, lentils, peas Quinoa, rice, gluten-free grains
Nuts/Seeds Almonds, walnuts, peanuts Sunflower seeds, pumpkin seeds
Eggs Whole eggs, egg whites Flax eggs, chia eggs (for baking)
Soy Tofu, soy milk, edamame Coconut milk, almond milk, tempeh
Processed Foods Packaged snacks, fast food Whole fruits, vegetables, home-cooked meals
Additives Artificial colors, flavors, MSG Natural, organic, additive-free foods

Keeping Track of Food and Symptoms

Tracking what you eat and how you feel is key to finding food problems in CFS/ME. This takes time and effort, but it can help you understand how food affects you.

How to Keep a Food Diary

To start a food diary:

  1. Pick a way to record: Use a notebook, computer file, or phone app.
  2. Write down everything: Include all food and drinks, even small snacks.
  3. Be clear: Note how food is cooked, what brand it is, and how much you ate.
  4. Add times: Write when you ate or drank each thing.
  5. Include other info: Write down things like stress or exercise that might matter.
Time Food/Drink Amount Symptoms How Bad When It Started How Long It Lasted
8:00 AM Oatmeal 1 cup Bloating 3 30 min after 2 hours
12:30 PM Chicken salad 1 plate None
3:00 PM Apple 1 medium Headache 2 1 hour after 3 hours

Rating How Bad Symptoms Are

Use this scale to rate your symptoms:

  • 0: No symptoms
  • 1: Mild (you notice but it’s not a problem)
  • 2: Medium (uncomfortable but you can handle it)
  • 3: Bad (gets in the way of daily life)
  • 4: Very bad (stops you from doing things)

This helps you see patterns and know which foods to look at more closely.

When Symptoms Start

Note when symptoms begin:

  • Quick reactions: Within minutes to a few hours after eating
  • Slow reactions: Up to 3 days after eating a problem food

Write down when symptoms start compared to when you ate. This helps you and your doctor see if food is causing the problem.

How Long Symptoms Last

How long symptoms last can tell you a lot:

  • Short: Symptoms for a few hours might mean a small problem with the food
  • Long: Symptoms for days could mean a bigger problem with the food

Write down how long each symptom lasts. This helps tell the difference between food problems and other health issues. You might need to track for several weeks to see clear patterns.

Symptom Start Symptom Length What It Might Mean
Quick (minutes to hours) Short (few hours) Mild food sensitivity
Quick (minutes to hours) Long (days) Stronger food sensitivity
Slow (up to 3 days) Short (few hours) Possible delayed reaction
Slow (up to 3 days) Long (days) Possible serious intolerance

Trying an Elimination Diet

An elimination diet helps find food problems in CFS/ME. It means stopping certain foods, then adding them back one by one to see how you feel.

Getting Ready

Before you start:

  • Talk to your doctor
  • Plan your meals
  • Choose foods that aren’t common allergens
  • Think about what you want to learn
  • Get ready for the challenge

Removing Suspect Foods

Stop eating these foods for 2-4 weeks:

Foods to Stop Try Instead
Milk products Coconut or almond milk
Wheat Rice, corn, or oats (gluten-free)
Eggs Seeds (chia or flax)
Soy Pea protein
Fish and shellfish Chicken or beans
Nuts and peanuts Seeds or avocado

Also, don’t drink coffee or alcohol.

Adding Foods Back

After 2-4 weeks:

  1. Pick one food to add back
  2. Eat a little bit in the morning
  3. If you feel okay, eat more later
  4. Watch how you feel for 2-3 days
  5. Write down any changes in how you feel
  6. If you feel fine, the food is probably okay
  7. If you don’t feel good, stop eating that food
  8. Wait until you feel better before trying the next food

Understanding Your Results

Look at what you wrote down. See if any foods made you feel bad. Remember, sometimes you might not feel bad right away. It can take up to 3 days.

When You Feel Bad What It Might Mean
Right away You might be sensitive to that food
1-3 days later You might not handle that food well
You feel fine after 3 days The food is probably okay for you

If you find foods that make you feel bad, talk to your doctor. They can help you make a good eating plan without those foods.

Dealing with Food Sensitivities

Managing food sensitivities in CFS/ME means changing what you eat. By making smart food choices and working with your doctor, you can make a plan to feel better.

Making Your Own Meal Plan

Create a meal plan that works for you. Focus on foods that don’t make you feel bad:

  • Eat lots of different vegetables and fruits
  • Choose lean meats like fish and chicken, or plant-based proteins
  • Add whole grains and healthy fats
  • Cook meals ahead of time for when you’re tired

Many people with CFS/ME find a Mediterranean-style diet helpful. It includes foods that may reduce swelling in your body.

Getting Enough Nutrients

When you stop eating certain foods, make sure you still get all the nutrients you need:

Nutrient Where to Find It Why It’s Important
Protein Lean meats, fish, beans Helps your immune system and muscles
Fiber Vegetables, fruits, whole grains Helps digestion
Omega-3 fats Fatty fish, flax seeds, chia seeds May reduce swelling and help brain function
Vitamins and minerals Different fruits and vegetables Help your body work well

Drink 6-8 glasses of water each day. Not drinking enough can make you feel more tired.

Using Supplements

Sometimes, you might need extra vitamins or minerals:

  • Vitamin D: Many people with CFS/ME don’t have enough
  • B vitamins: Help your body make energy
  • Magnesium: Might help with muscle pain and sleep
  • Probiotics: Can help your gut and immune system

Always talk to your doctor before taking any new supplements.

Working with Your Doctor

Your doctor can help you manage food sensitivities:

  1. See your doctor regularly to talk about your diet and how you feel
  2. Get blood tests to check if you’re low on any nutrients
  3. Ask about seeing a dietitian who knows about CFS/ME
  4. Tell your doctor about diet changes, as they might affect your medicine

Other Things to Know

When dealing with food problems in CFS/ME, keep these extra points in mind:

Foods That Cause Similar Problems

Some foods can trigger the same symptoms because they have similar parts:

Food Group Other Foods That Might Cause Problems
Milk Beef, goat’s milk
Wheat Oats, corn, rice
Peanuts Other beans, tree nuts
Shellfish Clams, oysters, foods with lots of iodine

Watch out for these foods when you’re trying to find what makes you feel bad.

Hidden Problem Foods

Many everyday foods have hidden things that can make you feel bad:

  • Sauces often have milk, wheat, or soy
  • Packaged meats might have wheat, milk sugar, or flavor enhancers
  • Canned soups often have hidden milk or wheat
  • Energy bars can have nuts, soy, or fake sweeteners

Always check what’s in your food, even if you think it’s safe.

How to Check Food Labels

Checking food labels is very important:

  1. Look at the list of ingredients first
  2. Find allergy info (usually in bold letters)
  3. Check how much one serving is
  4. Know different names for things that might bother you (like "casein" means milk protein)
  5. Look for "may contain" warnings about foods mixing by accident

Use measuring cups and scales to get the right amount of food based on the label.

Eating Out and Going to Parties

It can be hard to eat out or go to parties when some foods make you feel bad:

  • Look up restaurant menus online before you go
  • Call the restaurant to talk about what you can eat
  • Bring snacks you know are safe to parties
  • Tell hosts and servers clearly what you can and can’t eat
  • Think about eating before you go to events where you might not find safe food


Dealing with food problems in CFS/ME takes time and care. By finding foods that make you feel bad through careful tracking and trying different diets, you can feel better and do more. Keep in mind that how foods affect you can change, so check often. Work with your doctor to make sure you’re eating right while avoiding foods that cause trouble. With time and effort, you can make an eating plan that helps you feel better, manage your CFS/ME symptoms, and maybe get back to doing things you used to enjoy.

Here’s a quick guide to help you manage food sensitivities:

Step Action
1. Track Write down what you eat and how you feel
2. Try Stop eating foods you think cause problems
3. Test Add foods back one by one to see how you react
4. Plan Make a list of safe foods and meals
5. Check Keep watching how foods affect you over time
6. Talk Tell your doctor about any changes in your diet


  • Everyone is different, so what works for others might not work for you
  • Be patient – finding the right foods can take time
  • Keep learning about your body and how food affects you
  • Don’t give up – small changes can make a big difference

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