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If single-food dieting has been inconclusive or confusing, or if you appear to have multiple food sensitivity, the next step recommended by doctors is often a special exclusion diet. It is a halfway stage between single food testing and a total exclusion diet.

There are two basic kinds of special diet. The first type is a so-called low-allergen diet in which all the major foods that commonly cause allergy or intolerance are omitted. The second type is a much more specific type of diet, in which a specific range of foods is suspected of causing allergy or intolerance. These only are omitted, often leaving some common allergens in the diet. Specific diets of this kind include gluten-free, anti-candida, mould-free and low-salicylate diets.

Before a doctor chooses which diet to put you on, you will usually be asked to keep a Foods Diary, noting down absolutely everything you eat, swallow or ingest, and monitoring the timing and nature of symptoms. The doctor will then choose the specific range of foods according to your particular pattern of symptoms and food habits.

The principles of low-allergen diets are to leave out all foods commonly causing allergy and intolerance, to leave out processed and manufactured foods, and to eat foods which are as free of additives and chemicals as possible. The best known of the so-called low-allergen diets is the Stone-Age Diet pioneered by Dr Richard Mackarness.

It is usually recommended that you follow this type of diet for five days to a week, giving time for your symptoms to clear. You may, as with the single-food diet above, find you feel worse at first and have withdrawal symptoms. However, if you have excluded the foods that upset you, you should begin to feel much better after five days.

The benefits of a special exclusion diet of this kind are primarily for people who have had confused results from leaving out single foods, or who can identify no obvious candidates for single-food exclusion, or who have other multiple allergies or sensitivity with competing symptoms. It is a less rigorous approach than a total exclusion diet, and more balanced nutritionally, but more rapid and effective than single-food dieting.

Two major drawbacks of a special exclusion diet are that it is expensive and inconvenient. You have to rely on being able to eat mainly at home, or carry packed foods with you. It is also eccentric and makes you conspicuous. You often feel ravenous and empty, although these can be withdrawal symptoms. A final drawback is that, if you really have very severe problems with multiple sensitivity, it will not be adequate to sort them out straightaway. Only a total exclusion diet on a rotation basis will do that.

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Symptoms are only partly helpful as an indicator of the cause of reactions. It used to be thought that the site where your symptoms occurred was the route or the place where the substance causing the reactions had entered the body. On this basis, only things you inhaled could cause nasal and breathing symptoms; only things you swallowed could cause gut symptoms; only things you touched could cause skin symptoms, and so on. Many doctors no longer accept this, since there is evidence that molecules travel in the bloodstream and can trigger allergic and other reactions at sites in the body other than those where the substance entered. Some doctors, however, still hold firmly to the original belief that symptom = site of reaction = cause of reaction.

Nonetheless, it is true to say that certain symptoms do have prime suspects as causes, and they are a good place to start. Nasal and breathing symptoms are most likely to be caused by things you breathe in, especially house dust mites, pollens, moulds, fibres, feathers, animal hair and chemicals. Start with these, perhaps, but remember that other things, such as foods, do cause such symptoms. Gut and digestive symptoms are most commonly caused by things you eat or swallow, such as foods, drinks and drugs, but they are also very often caused by chemicals you inhale. Mental symptoms are most likely to be caused by inhaling chemicals, but are often caused by intolerance of foods, drinks or drugs.

Skin symptoms are commonly caused by things you touch, such as chemicals, but they are equally likely to be caused by things you eat or swallow, such as foods, drinks and drugs; or by things you inhale, such as house dust mites, pollens, moulds, fibres, feathers, animal hair or chemicals. Itchy eyes, headaches, joint pain, nettle rash and water retention have no real prime suspects as cause.

So use the nature of your symptoms as a partial guide only. The Pattern of your symptoms – when and where they occur – is a much better guide.

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If you would like full information on fibres and how to detect allergy or sensitivity to them. For a short guide to detection, read on.

There is a relatively cheap and easy way to test at home whether you are allergic or sensitive to specific fibres – the Pillow Test. Washing the cloth with sodium bicarbonate and drying thoroughly before use will minimise the possibility of sensitivity to laundry agents, chemicals or moulds interfering with the test.

You will get clearer results from the test if you are able to avoid totally the fibre you are planning to test for at least a day, preferably several days, before you do the test. You can then confirm the results of the Pillow Test by avoiding totally (or as far as is practicable) the fibre or fibres you suspect for a period of a week and then reintroducing it – by wearing or using it again. Monitor any symptoms for the period of avoidance and on reintroduction.

If you have multiple allergies or sensitivities and have to avoid many fibres, you may simply have to choose your safest options and stick to them. Some people with sensitive skin find that they can tolerate a fibre to which they usually react, provided they do not wear it next to the skin. So try wearing a vest or shirt of a different fibre next to your skin under other garments. If this works, you may not have to replace large parts of your wardrobe.

You can also try rotating fibres (wearing one specific fibre per day or one per week), to give your system a rest. Don’t shun anything – you may react, say, to nylon or wool, but they could be better than any other choice you have. Stay flexible and keep varying your options until you find the one that suits you best.

Take precautions if you borrow clothes to test them out. Check out what soap powder or conditioner has been used. Sniff for any perfumes that might cling to them.

Take great care if you buy clothes secondhand or from charity shops. Ask about soap powders and conditioners. Look out for dust, cigarette smoke or animal hairs which might cling.

Avoiding your worst culprits may make you able to tolerate them again after a while. You could be able to wear them occasionally or even regularly. Never throw anything away.

Do not have a massive clearout and replace everything at once. You can sometimes tolerate something well for a while, then find it comes to upset you. Take one step at a time.

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If buying new, buy whatever you can of natural fabrics, materials and metal – cotton, wood and metal have many advantages. Avoid foam padding on chairs, mats and mattresses if you are able, or air well and wash before using. Avoid new chipboard veneered furniture if you can.

If you have to buy things of synthetic materials, (such as a buggy or pram), buy well in advance and let them air before use. If buying secondhand or using equipment passed on to you.

For waterproofing a cot, bed or pram, waterproofing sheets of plastic are well tolerated if washed several times before use, which disperses the fumes. Wash just in water or in a solution of sodium bicarbonate or Borax – one tablespoonful per bowl or machine.

Most baby goods suppliers sell wood and metal cots and chairs. It is also possible to find pure cotton baby carriers, and bouncing chairs. Kiddycare sell a pure cotton babies’ sleeping bag with a pure cotton lining.

Do not put a newborn baby into a newly decorated room. Decorate and air the room well in advance of the birth, using relatively trouble-free materials if possible.

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Animal allergens can disperse throughout the whole environment around them. It is not necessary to touch or handle animals or birds to be allergic to them. Pet allergens can waft through the home and, even if the animal or bird is confined to a limited area, traces of allergens can be found in other parts. If you are not very sensitive to them, this will be no problem; but if you are highly allergic, then it can be a cause of difficulty.

If a cat or dog sleeps in your bedroom at night, it could be the cause of reactions. If you allow them to sleep on a bed during the day, they can leave traces of allergens which can upset you later when you go to bed.

Pet allergens are also found in house dust and if you react to this, animal allergens may be the cause. They can also cling to clothing or surfaces where an animal has been, such as car seats, furniture, the animal’s bedding, carpets and rugs, so visiting other people’s homes or travelling in their cars may cause trouble. Even if you do not have a pet, people who come into your home can bring animal allergens in with them on their clothes. Again, if you are exceptionally sensitive, this can be a problem.

Animal allergens can also be an occupational hazard, depending on your type of work. Laboratory workers using animals or birds in experiments are known to develop allergy, as are zoo or circus employees, kennel workers and dog handlers. Blind people can develop an allergy to their guide dogs.

Hobbies and leisure pursuits, such as horse-riding, which bring you into contact with animals can also be troublesome. Birdkeeping is a known hazardous hobby. If you are exceptionally sensitive, even inhaling animal allergens at a distance can trigger reactions. Going to the races, visiting a circus, or watching a gymkhana, have been known to cause reactions in people allergic to horses, for instance.

If your problems started on moving house, or soon after, animal allergens from previous owners may be a cause. These can be very persistent.

If you sit next to someone wearing clothes with cat or dog allergens clinging to them, even invisibly, this can upset you. This may be the cause of problems at work, at school, at leisure activities, or even on public transport.

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