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RPAH/Failsafe Diet for Migraine & Headache

The low histamine and salicylate diet that seems to be helping me is referred to as either the RPAH diet or the Failsafe diet. Originally developed by the allergy unit of Royal Prince Alfred Hospital in Australia (that’s the RPAH part), the diet was popularized under the name Failsafe by a woman whose daughter was helped by RPAH. The name Failsafe comes from the diet being free of additives and low in salicylates, amines (including histamine and tyramine) and flavor enhancers.

Calling the diet “flavor-free” sounds snarky, but it’s an easy and accurate summary. Naturally occurring food chemicals are responsible for the flavor in foods. Without them and without artificial flavors and chemicals, the diet is pretty bland. However, it is not a permanent dietary change. The idea is to cut out all these possible food chemicals for two to four weeks, then slowly add them back in, testing to see which ones are problematic for you.

This diet was developed for treating behavior problems in children. You’ll find people online saying the diet has helped them with a wide variety of health issues, from eczema to migraine and headache to heart palpitations. All the evidence is anecdotal, but if you’re really sick and no conventional or alternative treatment seems to help, it is worth a try.

The diet is drastic: check out this two-page list of allowed foods (PDF). This list, which I printed and keep on my coffee table, includes common pitfalls and mentions other chemicals in allowed foods. Even though potatoes are allowed, I discovered this week that I react to them, perhaps because they have naturally occurring nitrates. Working with a nutritionist is the best way to maintain proper nutrition without losing your mind.

Where to learn more:

Failsafe WordPress Blog: This blog is a superb resource and is where the aforementioned two-page list comes from. It is really all you need to get started on the diet.

RPAH on Food Intolerance: The original source, which doesn’t have a ton of information online, but the overview is particularly helpful. You can order the diet handbook from them for about $80 (including shipping from Australia), but it doesn’t seem necessary.

Food Intolerance Network: This website is run by the woman who coined the name Failsafe. The amount of information is a bit overwhelming, but the site answers a lot of questions. Check the US shopping list (PDF) for specific allowed foods.

Allergy Friendly Food: I ordered this book used from Amazon (much less expensive than ordering it directly from RPAH) and reference it a lot. This and the Failsafe WordPress blog are my go-to resournces.

The Failsafe Cookbook is good if you’re looking to get the most flavor possible while on the diet. I bought this book, but haven’t used it because many of the foods (like nuts and dairy) are ones I’m avoiding for other migraine-related reasons.

Keep in mind that I haven’t started the “challenges” yet. Once I begin testing which foods/food chemicals I can tolerate, my list of recommended resources may change. Also, most of the information is from Australia, so product information isn’t always relevant and you may need to do some translating.

After writing this all up, I’m struck by the fact that I’m not following the RPAH/Failsafe diet, although it was my starting point. Because of a stomach virus, the results of an ELISA food allergy test, and foods I’m pretty sure are migraine triggers for me, I’ve eaten mostly chicken and rice for the past week. My head feels better than it has in a decade, but this is not a healthy diet for the long-term. I’m definitely scheduling an appointment with a nutritionist.

P.S. In your reading about the diet, you’ll see toiletries mentioned. Many body and beauty products contain salicylates and histamine and it is recommended that you avoid those as well. I’m working on another post about that.

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Self-Care or Alternative Medicine?

I’ve blogged a lot about meds and medical devices, but haven’t really discussed “alternative” therapies. There are two reasons for this. The first is that none of the alternative treatments that I have tried have worked for me, so I don’t think to recommend them. The more important reason is that much of the advice of alternative practitioners is what I think of as simply taking care of myself. I do employ many of the strategies of alternative medicine; I just don’t think of them as alternative.

The non-alternative alternative therapies that I try to follow:

Eat simply prepared produce and meat
Frozen veggies make this much easier and Penzeys Spices make it tastier; both make preparation a snap. I also eat a lot of organic produce and organic free-range meat. Living in the northwest give me an advantage with this; organic is easy to come by and isn’t outrageously expensive.

Avoid inhaling potentially harmful chemicals or substances
Since most artificial scents or offensive odors trigger headaches for me, this is pretty easy. Most of my cleaning products are homemade or from Seventh Generation and candles are beeswax or soy. And, as I’ve already complained, I am careful to find home furnishings that don’t off-gas much.

Avoid potentially harmful food additives
Avoid all forms of MSG, nitrates, nitrites, sulfates, sulfites, and artificial sweeteners, flavorings or colorings. This means skipping almost all convenience foods, sauces and dressings.

Exercise and relax
My beloved yoga is out, but I try to take a short walk every day, even if it is just to my favorite coffeehouse (.8 miles round trip!). Meditation is beyond my grasp, but I do try to lie down, breathe deeply and relax all my muscles for about 10 minutes each day. This is usually when I lie down to go to sleep, but I figure every little bit counts.

Use aromatherapy
Maybe essential oils help my headaches, maybe not, but I love smelling lavender, mint and orange. I smell them straight from the bottle, rub them on my temples, burn them with a candle or put them in a spray bottle with alcohol (is that a harmful-to-inhale substance?) and use them as air fresheners.

Don’t mistake me for a whole health goody goody. These are all steps I try to do, which means that I do them most of the time unless I want to go out for dinner, get my shower really clean, take advantage of high energy days or be lazy. But I do feel better when I follow the “rules.” The days I give in to reading a book and eating cookie dough all day are indulgences that I pay for with more headaches.

(P.S. Many of the foods and products I mention are more expensive than conventional varieties. I stock up on frozen vegetables when they are on sale, burn fewer candles than I used to, and remind myself that meds are expensive too.)