Chronic Migraine, Coping, Diet, Treatment

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.

7 thoughts on “RPAH/Failsafe Diet for Migraine & Headache”

  1. thank you so much for this Kerrie. After reading about this diet I realized it’s what my mom has developed out of her own trial and error for her extreme sensitivities and chronic illness, and when I showed her that it’s actually a ‘thing’ she was so happy to find out she is not alone.

    I have chronic migraine too and I am thinking of trying this diet out because I am already obviously sensitive to a lot of these foods. My headache specialist really pushes NSAIDs but they’ve never worked for me, and in fact may be more irritating than helpful. Do you use them anymore, on this diet? If you don’t use them, what alternatives have you tried?

    now if only I didn’t have to give up tea . . .

  2. Hi Ann, For me it seems like the problem with most beans is that they contain tannins. I thus can have lima beans–i.e., white beans. Similarly I tolerate eating yellow split peas but not green split peas. I plan to order some zero tannin yellow and red lentils from the Pacific Northwest. I also avoid high oxalates, which most beans also have, but the lima beans are only medium oxalate.

    Kerrie, this RPAH diet has helped me and my boyfriend immensely. Though we also avoid all gluten from the wheat family since we both have celiac and also gluten ataxia, which makes both of us severely sensitive to just cross contamination from gluten.

    Fortunately for my boyfriend he is not as sensitive to salicylates or tannins as I am. We both however are severely affected by histamines and amines.

    Similar to you I also avoid all nuts–perhaps because they are full of salicylates?? Or maybe it is due to some other factor?

    There is so much we don’t know. Nevertheless I am glad we are discovering more and sharing that knowledge with others more easily than in the past.

    Every once in a while I try something new out. A bit like Russian Roulette, but worthwhile despite the 50/50 chance I might get a migraine… Like tonight after eating red lentils that apparently are very high in tannins!

    1. Thanks for sharing your experience, Bea. I’m glad to see someone else benefiting from the RPAH info. Histamine could be another culprit with red lentils (see this fantastic chart for details on the histamine levels of certain foods: I eat them occasionally for their nutrition content and take a Histame beforehand, which seems to do the trick for me.

      Best of luck in your sleuthing. It is difficult and exhausting, but the relief is worth it.


  3. Thank you for this list. I have been struggling for years with severe migraines and had been told by my doctors to avoid certain triggers and that I may have food intolerances. This list of resources will help me greatly.

  4. I’m really glad to hear you’re improving with this. Would you mind posting what modifications you’ve made to the failsafe diet?

    I was surprised to see most beans allowed on the failsafe diet,as I think they’re migraine triggers for me. What about you?


  5. Hi Kerrie
    Thanks for info on cyprohepdadine. I started taking it and it DOES work. Will try the 12 mg. Am now on 4 mg and even that low dose helps a lot.

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