Elemental Diet
WHAT IS AN ELEMENTAL DIET?
An Elemental Diet is a liquid only diet.
An Elemental Diet (ED) means you are consuming nothing but ingredients that are in their most pure and broken-down form to allow for rapid absorption.
It minimises the need for digestion, allowing your digestive tract to have a rest and heal.
In the case of SIBO, this rapid absorption means that little food is left behind to feed the bacteria overgrowing in the small intestine. This has two very important effects:
1 - It minimises fermentation and the symptoms caused by it, such as gas and bloating.
2 - It reduces the bacterial overgrowth (by starving the bacteria).
Most Elemental Diet ‘shakes’ or ‘drinks’ contain essential amino acids, simple sugars (glucose, dextrose, maltodextrin), and vitamins and minerals. Some of them also contain fat. They are meant to be a complete meal replacement.
Many Elemental Diet ‘shakes’ or ‘drinks’, often called a partial elemental diet, will also contain proteins like whey protein and rice protein that are not broken down into amino acids.
WHO IS AN ELEMENTAL DIET FOR?
An elemental diet could be right for you if you’ve experienced and/or are still experiencing any of the following:
- SIBO - the Elemental Diet is known as one of the most effective treatments for SIBO and can be the fastest way to reduce bacterial overgrowth – seeing visible reductions in numbers in your test results after only 2 weeks. If you have SIBO, please read the SIBO specific information below.
- Severe food sensitivities and intolerances - you’re down to 5 foods and are feeling totally fed up and overwhelmed when it comes to food. You’ve been struggling with a low FODMAP, low food chemical diet (low histamine, salicylate, oxalate, etc) for some time and feel like you’re running out of options.
- Intolerances/sensitivities/reactions to supplements and other medications - you frequently react to supplements (like antimicrobials - oregano, thyme) and medications and you want to avoid taking antibiotics and/or other prescription medications.
- Fatigue and/or emotional overwhelm - where using less energy and minimising decision fatigue when it comes to food choices/preparation would come as a welcome break and give you a chance to focus on other important things (like trauma recovery) that will help you heal.
- Ulcerative Colitis, Crohn’s, Gastritis - elemental diets are often recommended by gastroenterologist to support people with gastrointestinal conditions.
Even if you don’t have any of the above, we believe that anyone with gut health issues can benefit from giving their entire digestive tract a well-deserved break, giving it a chance to heal faster.
HOW LONG SHOULD I STAY ON AN ELEMENTAL DIET?
This will depend on why you are doing it.
Here are a few examples:
- Quick ‘Reset’: you could do an ED for 2-3 days to reset your system at any time during your healing journey (see more information in the Reset Diet section). This is also a great way to get back on track quickly whenever you feel the need.
- 1 - 2 weeks: a longer time will really allow your gut to rest and is a fantastic way to speed up healing. This will be amazing for anybody with gut issues.
- 2 - 4 weeks: if your goal is to treat SIBO, you will need to continue the ED for a minimum of 2 weeks, but longer may be needed. See more SIBO Specific information below.
WHAT TO EXPECT ON AN ELEMENTAL DIET
Die-off symptoms - like with any other treatments/diets that may lead to a reduction in bacterial overgrowth, you may experience die-off. However, not everybody does. In fact, some people feel fantastic on an Elemental Diet! If you experience die-off, try our tips and tricks in the Die-Off Rescue Kit section.
Feeling spacey, tired or fatigued - you may want to sleep more (add an extra hour to your normal sleep routine) or take a nap throughout the day. Listen to your body!
Changes in bowel movements - you may notice that your stools are strange in shape and colour. Let us assure you that this is normal. Your bowel movements will return to normal (or better than normal) once you’re back on solid foods. We recommend using water and/or coffee enemas to help flush things out, especially if you’re experiencing die-off symptoms.
Food cravings - some people experience cravings for certain foods, while others do not. Consider avoiding places/situations where foods may trigger you.
Hunger – you shouldn’t feel hungry... if you do, simply have more ‘shakes’.
Emotional releases - whilst it is not a complete fast, an elemental diet can be an emotionally cleansing and even a spiritual experience. Emotions and feelings may come up and it’s best to be prepared for this. Make sure you have some emotional support in place just in case (see below for more tips on this).
HOW TO LOOK AFTER YOUR MINDSET
Get clear on your why: You’re doing the Elemental Diet for a reason. What is that reason? Get really clear on this and write it down as a vision statement for yourself. Print this out and put it where you can see it (on your fridge, by your bed, etc).
Here’s an example: I’m doing the elemental diet because I want to be free from SIBO, heal my gut, be able to eat a wider variety of healthy foods, have more energy, be able to think clearly… AND because I want to… be a better Mum, partner, friend, learn to surf, excel in my chosen career and travel the world.
Emotional support: How will you support yourself emotionally? What do you do already that you know helps you feel calm and focused? Is it mediation, affirmations, breathwork, EFT, walks in nature, exercise? Whatever it is, be prepared to ramp up your self-care during an elemental diet. Do you have someone, or a group, like our Happy Gut Facebook Group, where you could reach out for some encouragement and emotional support?
WHAT TO PREPARE IN ADVANCE
Test the product you will be using: Start by ordering one tub of your chosen elemental diet product and try it out the week before you plan to commence the full elemental diet. Try a half serve ‘shake’ or ‘drink’ and see how you feel. Then try a full serve as a meal replacement. If you can tolerate it, then try replacing two meals on the same day. This will give you a good indication as to your tolerance levels and will also give you some confidence that you’ll be able to progress through the number of days or weeks you decide to do.
Schedule time in your calendar: Create more white space in your calendar so you can rest and have more time to support yourself throughout this process. Remember to allow some extra time for solid food reintroduction.
Reduce caffeine intake: If you drink tea and/or coffee, start to gradually reduce the amount you consume the week before you start. Trust us, the last thing you want is caffeine withdrawals while you’re trying to focus on implementing the elemental diet.
Medications and supplements: Traditionally, any non-essential medications and supplements are stopped during an elemental diet. Decide which, if any, you will need to continue to take. Please consult your doctor before stopping any medications.
Transition back to solid foods: Take a look at the section below on how to transition back to solid foods. We highly recommend preparing some meals ahead of time, freezing them until you're ready to eat them (ideally in portion sizes).
Buy and book everything you need: see lists below.
Don’t start the elemental diet the week before your period, when you may experience extra strong cravings (like chocolate) and other symptoms. A good time to start is when your period has just ended.
WHAT YOU'LL NEED TO IMPLEMENT THE ELEMENTAL DIET
ESSENTIALS:
1 - Elemental Diet product of your choice.
Make sure that you order enough for the duration you plan to do the ED for, and also some extra for the transition period (food reintroduction). We recommend ordering at least enough for 4 shakes per day plus an extra tub for the transition period. Trust us, it’s best to order more rather than less!
Each tub in our recommended products below makes 10 shakes, so will last about 2 ½ days.
So for instance, if you plan on doing the ED for 10 days, you will need 4 tubs + 1 extra.
Here are the products we recommend:
Australia:
ElementGold – Vanilla WHEY (Whey Protein Isolate, extracted using the Ion-Exchange method)
ElementGold – Caramel VEGAN (Rice Protein)
USA:
Element Heal – Whey/Dairy free
Homemade Elemental Diet:
This can be a great option, as it allows for customisation to meet your specific needs. For example, if you have a Candida/yeast/fungi overgrowth or are recovering form toxic mould exposure (CIRS), you can reduce the carb/sugar content and even use your homemade elemental diet to go into Ketosis for a while.
However, it’s important to bear in mind that the taste won’t be as good as the pre-made version.
See our separate Homemade Elemental Diet Info Handout for more information, including the main recipe and tips on how to personalise the recipe to meet your unique needs.
2 - Fat of your choice. As most elemental diet drinks don’t contain fat, we recommend that you add it in separately.
How much you add will mostly depend on how well you digest fat. You could add as little as ½ tsp per shake, to as much as 1-2 tbsps. The higher amount is recommended if you do well with fat and don’t want to lose too much weight.
We recommend the following fats. Alternating between these is best:
- MCT oil (ideally Caprylic Acid C8): this is great option as it doesn't have any flavour. If you experience nausea with MCT oil, we recommend trying Bullet Proof Brain Octane Oil and gradually increase your dose.
- Organic flaxseed oil: will affect the flavour of your shake, but tends to be well tolerated and causes less nausea.
- Organic hempseed oil: will also affect the flavour of your shake.
- Organic coconut oil: can add a nice flavour to your shake, but is temperature dependant for blending. However, you can take it by the spoonful on its own.
- Olive oil
- Fish oil - EPA/DHA: taken in as a capsule, we like the Nordic Naturals brand.
- Vitamin E oil: we like this A.C. Grace Company one from iHerb.
You can either mix your fat in with you shake, or take it separately. You can also use a combination of your preferred fats.
OPTIONAL:
1 - Candida support: The Elemental diet does contain a significant amount of carbs (even the low carb/low sugar versions). This can be problematic for some people and may cause a candida flare up. If you think this could be an issue for you, we recommend using a gentle antimicrobial during the ED. Our top choices are Allimax and Kolorex, both are available on iHerb. As previously mentioned, the Homemade Elemental Diet can be a better option, as you can personalise the amount of carb/sugar.
2 - Enema kit (including coffee if you plan on doing coffee enemas): As the amount of food that will be going through your bowels is very limited during the ED, it is normal for your bowels to slow down. However, if you experience die-off, you may feel the need to ‘flush your colon’. A water enema or coffee enema are both ideal.
3 - Epsom salts (& essential oils if your like): Taking an Epsom salt bath will feel very nurturing and may also help if you are experiencing fatigue and die-off symptoms.
HOW TO IMPLEMENT THE ELEMENTAL DIET
STEP 1: Full Elemental Diet for the duration of your choice
Once you’ve prepared yourself, it’s time to start your elemental diet.
Have your shakes spread throughout the day at your normal meal times.
Drink your shake slowly. You should take at least 15 to 20 minutes to finish your shake. See more information below under ‘Trouble Shooting Tips’.
We recommend having another ½ a shake in between meals if you feel hungry or if you have poor blood sugar balance (if you know that your blood sugar tends to drop between meals, if you feel shaky when you don’t eat often, or if you have adrenal fatigue).
Your day might look like this:
- Breakfast: 1 shake with hempseed oil
- Morning tea: ½ shake
- Lunch: 1 shake with MCT oil
- Afternoon tea: ½ shake
- Dinner: 1 shake with flaxseed oil
- Before bed: ½ shake.
Do not go hungry. If you’re hungry, simply increase the amount of shakes you have per day until you find your sweet spot... and/or have a full shake for morning tea and/or afternoon tea.
What else can I drink?
Drink lots of filtered water.
While traditionally, no food or beverages other than water are consumed during an elemental diet, you may add the following drinks without affecting the end results (although abstaining is still best):
- 1 cup of very weak black coffee or black tea. You may sweeten it with 1 – 2 drops liquid stevia. This can be helpful if experiencing symptoms of caffeine withdrawal, especially in the first few days.
- Herbal teas. This can be great if you feel the need for a variation of tastes in your mouth.
- Bubbly water (sparkling mineral water or soda water). Add flavoured liquid Stevia if desired.
Remember to gift yourself the time and space to get plenty of rest.
* Unless you are doing the ED for SIBO treatment (in which case we recommend the SIBO specific information below), you can choose to end the ED when it feels right for you and your body. Even if you decided to do it for 14 days and it feels right to stop after 10 days, stop! You will still get tremendous benefits! Don’t be disappointed if you finish early. Even just 1 day is really beneficial.
STEP 2: Transition back to solid foods
Once you have done the ED for the amount of time that you desired or that felt right for your body, you will then gradually add some solid foods back into your diet.
We recommend that you continue to substitute either one or two meals per day with your chosen Elemental Diet drink at first.
Here’s a good way to re-introduce foods slowly:
Days 1 - 2: Soft cooked meats and bone broths.
Days 3 - 4: Gradually introduce cooked low FODMAP veggies (carrot, peeled zucchini) to your broth, or to have with your soft cooked meats. The Soups from the Soup Reset Recipes would be great as well.
Days 4 onwards: Gradually continue to slowly introduce more foods, starting with foods you know are ‘safe’ for you. How long you take to re-introduce foods will depend on how long you were on the full Elemental Diet for, and also where you’re at in your healing journey. If you haven’t done our Supersafe and Safe Diets, now could be a great time to try these!
SIBO SPECIFIC - HOW TO IMPLEMENT THE ELEMENTAL DIET (FOR SIBO ONLY)
If you plan on doing the Elemental Diet to treat SIBO, you will need to stay on the Elemental Diet for a minimum of 2 weeks.
To obtain a negative SIBO test, up to 3 weeks may be needed - sometimes more!
We recommend scheduling four weeks into your calendar. This will allow for at least two weeks on the full elemental diet +/- an extra week if needed, and one week for the gradual reintroduction of solid foods.
Remember to create more white space in your calendar during this time so you can rest and have more time to support yourself throughout this process.
Things You’ll Need:
ESSENTIALS:
1 - Elemental Diet product of your choice.
We recommend you order enough for 3 weeks of full elemental diet and also some extra for the transition period - the reintroduction of solid foods. It’s best to order more rather than less! You don't want to run out of your chosen elemental diet product (or ingredients if homemade) right when you need it most - on the tail end of your treatment.
Most people will need about 4 - 5 shakes per day.
Each tub in our recommended products below makes 10 shakes, so will last about 2 ½ days.
This means that for 3 weeks, you will need 8 1/2 tubs + 1 extra for the transition diet. To be on the safe side, 10 tubs would be ideal.
Some people like to have an extra tub or two to use as they continue their low FODMAP diet for 3 - 6 months after treatment.
See above for the products we recommend, or try homemade.
Homemade Elemental Diet:
This can be a great option as it allows for customisation - like the use of less carbs/sugar. However, it’s important to bear in mind that the taste won’t be as good as the pre-made versions.
See our Homemade Elemental Diet Info Handout for more information.
2 - Fat of your choice. As most elemental diet drinks don’t contain fat, we recommend that you add it in separately.
How much you add depends on how well you digest fat.
You could add as little as ½ teaspoon per shake...
or as much as 1 - 2 tablespoons per shake.
The higher amount is recommended if you tolerate fat well and don’t want to lose weight.
See above for the fats we recommend. Remember that alternating between these is best.
You can either mix your fat in with your shakes, have it separately by the spoonful, or take it via a capsule (like for EOA/DHA, Vitamin E Oil for example).
VERY IMPORTANT:
3 - Prokinetic of your choice. This is a MUST for preventing a relapse and should be started immediately after you finish your Elemental Diet (week 2 or 3). You should stay on a prokinetic for at least 3 months post treatment.
Natural Options (available without prescription):
- Iberogast (available OTC in most countries): 30 to 60 drops at bedtime.
- Ginger root (such as Ginger Supreme by Gaia Herbs): 1000mg dry herb equivalent at bedtime.
- Motilpro by Pure Encapsulations (requires a prescription by health practitioner in some countries).
Prescription Options (although we don’t often recommend ‘drugs’, these are good options for SIBO, especially if you’ve had a relapse before):
- Low-dose Naltrexone (LDN): 2.5 mg for diarrhoea type and 5 mg for constipation type, at bedtime. This one has been life changing for some people due to its immune modulating effect.
- Low-dose Erythromycin: 50 mg at bedtime
4 - SIBO test. We highly recommend doing a SIBO test to check on your progress after 2 weeks on the Elemental Diet. It’s a good idea to pre-order your test... one less thing to think about once you get started!
You can order your test here:
Australia (also ships internationally), select 'Nourishing Therapies' when asked for your practitioner's details.
* Important note regarding enemas and colonics: you must wait 3 days after an enema or 1 month after a professional colonic before you retest with your SIBO test. For this reason, we do not recommend professional colonics if you plan on retesting.
HOW TO IMPLEMENT THE ELEMENTAL DIET FOR SIBO
WEEKS 1 & 2: Full Elemental Diet
Once you’ve prepared yourself, it’s time to start your elemental diet.
Have your shakes spread throughout the day at your normal meal times.
Drink your shake slowly. You should take at least 15 to 20 minutes to finish your shake. See more info below under ‘Trouble Shooting Tips’.
We recommend you have another ½ a shake in between meals if you feel hungry or if you have poor blood sugar balance (if you know that your blood sugar tends to drop between meals, you feel shaky when you don’t eat often enough, or if you have adrenal fatigue).
Your day might look like this:
- Breakfast: 1 shake with hempseed oil
- Morning tea: ½ shake
- Lunch: 1 shake with MCT oil
- Afternoon tea: ½ shake
- Dinner: 1 shake with flaxseed oil
- Before bed: ½ shake.
Do not go hungry. If you’re hungry, simply increase the amount of shakes you have per day until you find your sweet spot, or make your morning tea and/or afternoon tea shakes a full serve instead of half.
What else can you drink?
Drink lots of filtered water.
While traditionally, no food or beverages other than water are consumed during an elemental diet, you may add the following drinks without affecting the end results (although abstaining is still best):
- 1 cup of very weak black coffee or black tea. You may sweeten it with 1 – 2 drops liquid stevia. This can be helpful if experiencing symptoms of caffeine withdrawal, especially in the first few days.
- Herbal teas. This can be great if you feel the need for a variation of tastes in your mouth
- Bubbly water (sparkling mineral water or soda water). Add flavoured liquid Stevia if desired.
Remember to gift yourself the time and space to get plenty of rest! We can't say this enough!
END OF WEEK 2: Retest for SIBO
It’s recommended to retest for SIBO after 2 weeks on the full Elemental Diet.
Contact the lab and let them know you're on an Elemental Diet and request a fast result so you know if you can stop the ED, or need to continue for longer. Most labs should be able to offer you a fast turnaround.
WEEK 3: While you wait for your test result
If you can, continue on your ED until you get your SIBO test result back. However, adding some bone broths and soft meats would also be okay.
SIBO test still positive: If your SIBO test has improved but is still positive, we recommend you stay on the full ED for another week. However, if you have re-introduced meat only broths and soft meats while waiting for the results and feeling good, you can continue with a partial elemental diet until the end of week 3, but don’t re-introduce any other foods.
SIBO test negative: Hooray!
Start your prokinetic and gradually transition to food re-introduction.
SIBO TEST NEGATIVE: Gradually start food re-introduction
We recommend that you continue to substitute either one or two meals per day with your chosen Elemental Diet drink during the first week of food re-introduction.
Here’s a good way to re-introduce foods slowly:
Days 1 - 2: Soft cooked meats and bone broths (be careful if you have histamine intolerance).
Days 3 - 4: Gradually introduce cooked low FODMAP veggies (carrot, peeled zucchini) to your broth, or to have with your soft cooked meats. The Soups from the Reset Diet would be great as well.
Days 5 onwards: Gradually continue to slowly introduce more foods, starting with foods that you know are ‘safe’ for you.
How long you take to re-introduce foods will depend on where you were at with your healing journey before doing the ED. If you haven’t tried the Supersafe and Safe diets yet, we highly recommend you start there! Even if you’ve done these before, it would be a great idea to go back to them for a short time.
* Important note: It’s recommended to stay on a low FODMAP diet for at least 3 months post treatment to prevent a relapse. After 3 months, you can carefully test your tolerance to FODMAPs as per the section in the program Test Your Tolerance to FODMAPs