Low sulfur diet

A low sulfur diet or sulphite-restricted diet or sulphite elimination diet involves reducing or eliminating foods and drinks containing either sulfites or all causes of sulfur. A sulphite elimination diet has been suggested for people with sulphite sensitivity, which is relatively rare; a general low sulfur diet has been proposed to reduce some gastrointestinal problems in people without sulphite sensitivity.

Sulphite sensitivity
People with sulfite sensitivity do not need to avoid sulfates or sulfur. Sulphite sensitivity does not normally cause an allergic reaction, asthma symptoms are the most common response in people with sulfite sensitivity.

Medications containing sulfates e.g., morphine sulfate, and soaps or shampoos containing sodium lauryl sulfate (SLS) do not need to be avoided.

Some people experience allergic reactions to sulfonamide medications, but this is a separate allergy and not caused by sulfite sensitivity.

High sulfur foods and drinks

 * Processed meats, mince, although other meats may have sulfite used as a preservative
 * Crustaceans, e.g. crab or shrimp
 * As an additive or preservative, e.g., in soup mixes, pickles, commercially prepared baked goods including bread and biscuits, dried fruits, canned vegetables, gravy, condiments e.g. ketchup, relishes, or tomato puree, bottled lemon or lime juice, grapes, pizza dough, pies
 * Foods containing gelatine or pectin, e.g., jams or marmalade and jellies
 * Coconut
 * Wine, cider, beer, apple juice, cordials, instant teas, drinks with added sulphites or sulphates
 * Foods labeled as containing sodium sulphite or sulphate, sodium thiosulphate, sulphurous acid, sulphur dioxide, sodium or potassium metabisulphite, sodium or potassium bisulphite, or sodium dithionate
 * European additives including E220, and E221 to E228
 * Supplements or medications may contain sulfur, including MSM or those containing gelatine.

Low sulfur diet

 * Most plant-based or vegan foods except coconut, soy and foods with added sulphites.

Theory
Sulfite elimination diets aim to reduce symptoms caused by sulphite sensitivity.

A general low sulfur diet is not linked to a particular medical hypothesis for ME/CFS.

Evidence
Jason et al. (2016) reported on a single patient with ME/CFS involving significant post-exertional malaise who reported significant improvement in overall health and reduction in brain fog after switching to a low-sulfur diet at the advice of her doctor. The patient followed a vegan diet both before and after the change in diet, and self-reported her symptoms using an online tool for 70 days before and 70 days after switching from a high sulfur to a low-sulfur diet.

No particular diet is recommended or shown to be effective in ME/CFS. The International Consensus Criteria Primer states that most patients do best on a diet that containing sources of low-fat protein, and a range of fruit and vegetables.

Costs and availability
Suitable foods are widely available and inexpensive. No medication or supplements are required.

Notable studies

 * 2016, The Use of Operant Methods to Evaluate Interventions for Patients With Myalgic Encephalomyelitis - (Full Text)

News articles

 * 2020, Heard of the low sulfur diet? Eating low-protein may prolong your life, say researchers - CNN

Learn more

 * Sulphite-restricted diet - GI society
 * Low Sulphite Diet - Fact Sheet - Women and Children's Health Network, Government of South Australia
 * Sulphite sensitivity - WebMD