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Some Common Food Sensitivities

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The following information comes primarily from these sources, sometimes copied verbatim for small sections: The ME Association: Diet and Nutrition in ME/CFS and Long-COVID (2024); and Diet – American ME and CFS Society (ammes.org).

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Some types of foods and ingredients that many ME/CFS and Long-COVID patients with sensitivities find particularly problematic include: 

Stimulants
(coffee, tea, caffeinated sodas, cola, some herb teas, including mate, and ma huang)

  • Stimulants cause the adrenal glands to work harder, so they may exacerbate fatigue in some patients. 

  • Some patients also find that using stimulants makes them expend too much energy, exceed their daily energy envelope, and crash. 

  • Caffeine also produces insomnia, which is a perennial problem for ME/CFS patients.

Sweeteners
(sugar, corn syrup, sucrose, glucose, dextrose, brown sugar, fructose, aspartame, saccharin)

  • Many people with ME/CFS crave sweets. Researchers have proposed that sugar-craving is due to faulty carbohydrate metabolism and subsequent low levels of ATP and blood glucose.

  • It is suspected that carbohydrate metabolism is disturbed in patients, and not enough glucose is formed from carbohydrates to maintain blood sugar levels. After the temporary elevation caused by a flood of sugary food, blood sugar levels plummet. The result is a vicious cycle of physical and mental exhaustion.

  • For some people, even dried fruits, especially dates, and starchy vegetables may even cause an issue.

Alcohol
(wine, beer, hard liquor)

  • Alcohol intolerance, even sometimes from one drink, is very common among ME/CFS and Long-COVD patients. 

  • The reasons for alcohol intolerance may include:

(1) alcohol acts on the central nervous system, already in dysfunction for patients,

(2) alcohol is toxic to the liver,

(3) alcohol interferes with the methylation cycle,

(4) alcohol is a vasodilator, which will exacerbate vascular symptoms (such as POTS). 

  • It is usually recommended that alcohol be avoided. Those who are especially sensitive should also avoid herbal tinctures and alcohol-based mouthwashes.

Additives
(artificial colors, artificial flavors, preservatives, MSG)

  • Sensitivities to petrochemicals and their by-products (found in many food additives) are common in ME/CFS patients. Reactions such as inflammation, itching, pain, insomnia, depression, hyperactivity, and headache can occur. A couple of additives to watch out for, based mainly on anecdotal (not scientific) evidence are:

    • Artificial colorings (tartrazine, AZO dyes, FD&C, or “coal tar colors”). These are derived from petroleum.

    • MSG and MSG-containing substances (monosodium glutamate, monopotassium glutamate, hydrolyzed vegetable protein [HVP], hydrolyzed plant protein, sodium caseinate, calcium caseinate, and Flavorings). Some people note sneezing, itching, hives, rashes, headache, acid stomach, bloating, restlessness, balance problems, chest pain, joint pain. But note that there are studies that question MSG sensitivities as well.

Some food groups you might consider thinking about if you still feel you have a food sensitivity you have not identified among the ones above (always work with your doctor!):

Nightshade family
(eggplant, pepper, tomato, potato)

All members of the nightshade group contain atropine, an alkaloid that is an anticholinergic (inhibits acetylcholine) and produces inflammation.

Gas-producing food

(onions, cabbage, Brussels sprouts, broccoli)

People with gastrointestinal problems should avoid gas-producing foods.

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Raw foods  

Even though salads provide necessary fiber, many ME/CFS patients experience discomfort after eating raw vegetables. Eating well-cooked vegetables and grains usually reduces digestive problems.

Acid foods

(fruits, tomatoes, vinegar)

Patients with interstitial cystitis or recurrent gastritis should avoid acidic foods, as these can exacerbate symptoms.

Animal fats  

  • Liver and gallbladder function, which are vital for breaking down fats, can be impaired in ME/CFS patients, especially those with low blood volume. ME/CFS patients have also been shown to have deficiencies in the transport molecule acylcarnitine, which enables the body to use fats at the cellular level. 

  • If you can tolerate animal fat, then continue with your current diet. But if not, start by eating animal fats in moderation and avoid rich foods and sauces. If you eat meat, use very lean cuts and remove the skin from chicken and other fowl. Work with your doctor to determine if you require a fully-plant-based diet, but be sure to add in foods that replace the nutrients you may be missing.

Milk products  

Many patients, especially children, have sensitivities to milk products. Lactose intolerance can produce bloating, gas, and discomfort.

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Spicy foods

(black pepper, curry, garlic)

Many people with food sensitivities seem to do best with a bland diet, especially in the acute phase and during relapse. Avoid spicy foods if you have gastrointestinal problems.

Yeast-containing foods

(brewer’s yeast, fermented products, mushrooms, aged cheese, some B vitamins)

Molds, in general, can produce strong reactions in some patients.

Soy products  

Soy products sometimes provoke reactions such as headache or gastrointestinal pain in sensitive individuals.

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