5 Steps to Personalizing Your Autoimmune Paleo Protocol | Chris Kresser
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5 Steps to Personalizing Your Autoimmune Paleo Protocol

by Chris Kresser

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A strict Autoimmune Paleo Diet isn’t necessary for many people with an autoimmune disease. Find out why.

This is a guest post by Laura Schoenfeld, a Registered Dietitian with a Masters Degree in Public Health, and staff nutritionist for ChrisKresser.com. Click here to learn more about her nutrition consulting services.

The Autoimmune Paleo Diet has been getting a lot of attention lately, even in the mainstream media. Some question if the diet is a legitimate way to manage autoimmune disease, asserting that “a lot of it doesn’t make much biological sense.”

Advocates of the diet, particularly Dr. Sarah Ballantyne (known as The Paleo Mom) and Dr. Terry Wahls, have provided heaps of evidence, both peer-reviewed and anecdotal, that the diet does indeed help those with autoimmune disease not only manage their symptoms but even begin to reverse the disease, or at least halt its progression.

As a dietitian, I’ve seen incredible results with patients who were able to successfully implement the autoimmune protocol and eliminate many of their symptoms, whether they were suffering from Hashimoto’s disease, Sjogrens, psoriasis, rheumatoid arthritis, multiple sclerosis (MS), and more. It’s amazing to see a person’s health turn around after implementing the diet change, especially when the disease they’re dealing with had been taking so much of their quality of life away from them.

While the Autoimmune Paleo Diet is a fantastic way to start seeing a vast improvement of symptoms, the major issue I see frequently is that once someone has seen success on a strict autoimmune Paleo protocol, they’re often afraid to try adding back in any foods that are eliminated from the diet.

One thing that many people don’t understand about the Autoimmune Paleo Diet is that not everyone with an autoimmune disease will need to be on this diet indefinitely.

In fact, there are few people with autoimmune diseases that would need to strictly and permanently avoid all the foods eliminated from the diet, as not everyone with autoimmunity is intolerant to all of these foods.

My goal when I work with clients is to get them on the least restrictive diet that provides the most amount of health and vitality. While those with an autoimmune disease generally have less wiggle room than the average healthy person, it’s important to remember that the Autoimmune Paleo Diet need not be followed strictly for the rest of one’s life.

A strict Autoimmune #Paleo Diet isn’t necessary for many people with an #autoimmune disease. Via @AncestralizeMe

In this article, I’ll briefly cover the five major steps to personalizing your Autoimmune Paleo Diet, in order to have the most flexible and health-promoting diet possible.

1. Start with a 30 Day Reset

In Chris Kresser’s book The Paleo Cure (formerly Your Personal Paleo Code), he suggests that everyone looking to discover their ideal diet start with a 30 day strict Paleo protocol. This means following the standard Paleo guidelines: no grains, no dairy, no legumes, no industrial seed oils, no alcohol, and so on. I believe that someone with an autoimmune disease who is currently eating a standard American diet should start with the normal Paleo 30-day reset.

There are many people with autoimmunity who will do just fine following a Paleo diet, and adding in the autoimmune diet restrictions shouldn’t be necessary in this situation. Going immediately from a standard American diet to an autoimmune protocol can be overwhelming for many people, and that’s why I generally suggest starting with the standard Paleo approach if you haven’t yet.

That said, if you have already given the standard Paleo 30 day reset a try, or perhaps you’ve been strict Paleo for many months, and your autoimmune symptoms haven’t decreased significantly, consider trying another 30 day reset. This time, I recommend adding in the standard Autoimmune Paleo Diet restrictions as well. This means additionally eliminating eggs, nightshades (e.g. potatoes, tomatoes, eggplant, peppers), nuts and seeds.

Sticking to the diet for a minimum of 30 days gives your body a chance to begin calming the autoimmune response, healing the gut lining, reducing inflammation, and repairing damaged tissues that were subject to the autoimmune attack.

I generally recommend extending the reset to a minimum of 60 days for people with severe autoimmune conditions that affect neurological function, or cause symptoms that have a noticeable impact on daily life. I’ve found that most people see enough improvement within the first 30 days that extending the reset another 30 days is no problem for them.

And remember: every time you eat a food that triggers an immune response, such as gluten, dairy, eggs, etc., your body will produce antibodies that incite an attack on your immune system for days, weeks, even months if the intake was significant enough. Committing 100% to the reset time period is crucial for a person with autoimmune disease to see the improvements they’re looking for.

It’s important to acknowledge that an Autoimmune Paleo diet is not a cure, and it may not be enough to put a disease into full remission or heal damaged tissues. Further support such as medication or targeted supplementation may be necessary to maintain the body’s optimal functioning.

That said, if you can remove the foods and toxins that are contributing to the autoimmune response and provide adequate nutrients to fuel the healing process, you can significantly reduce symptoms and even possibly put the disease into remission.

2. Optimize Your Nutrient Intake

Speaking of adequate nutrients, removing foods from your diet isn’t enough to heal from an autoimmune disease. You need to be purposeful about adding certain foods into your diet to provide the nutrients and building blocks your body needs to repair damaged organs, modulate the immune system, and heal the gut lining.

In addition to removing the common autoimmunity triggers listed above, it’s essential to add in nutrient dense foods like liver, bone broth, copious amounts of colorful vegetables, high quality meats and fats, fatty fish and shellfish, and fermented foods.

I’ve worked with patients who were following the Autoimmune Paleo restrictions beautifully, but they’d forgotten to add in some of these nutrient dense foods, which meant that their ability to heal wasn’t optimally supported.

Nutrients in liver, fatty fish and shellfish such as vitamin A and D, zinc, choline, and various B-vitamins are essential for modulating the immune response (particularly the t-regulatory cell response), supporting mitochondrial energy production, and supporting the healing of damaged tissues, especially the gut lining. (1, 2, 3, 4, 5) Liver is especially important to eat when on a strict Autoimmune Paleo (AIP) Diet, as it contains nutrients that would otherwise come from eggs, which are removed on the AIP diet.

Since the current theory of autoimmune disease is that a “leaky” and inflamed gut is required for the development of autoimmune disease, eating a diet that supports healthy gut integrity is of unmeasurable importance. (Discussing leaky gut in detail is outside the scope of this article, but if you’re looking for a program to help you through the recommended diet and supplement protocol for intestinal permeability, check out Solving Leaky Gut.)

Fermented vegetables not only provide beneficial probiotics, but also fermentable fibers that can feed the flora that are already in the gut. A healthy gut microbiome is crucial for maintaining a healthy gut lining, thanks primarily to gut bacteria’s ability to produce butyrate, which is important for t-regulatory cell production and differentiation, and can help further balance the immune system. (6)

Bone broth contains gelatin, a protein that contains the amino acids proline, glycine, and glutamine. These amino acids can help heal the gut lining, reduce inflammation, and promote healthy gut integrity. (7) Glycine in particular is known to inhibit immune activity and act as an anti-inflammatory. (8) That’s why bone broth is one of the major dietary staples of a gut healing, anti-inflammatory diet that is ideal for a person with autoimmune disease.

While many of my autoimmune patients are doing great at avoiding the foods on the AIP protocol, they still often struggle with adding in nutrient dense foods like liver, shellfish, fermented vegetables, and bone broth. These foods should be considered an integral part of an effective AIP approach, and I strongly encourage those with autoimmune diseases to make the effort to add these foods in regularly.

3. Reintroduce Foods Systematically

The benefits of reintroducing non-AIP foods are three-fold. First, you may be able to tolerate nutrient dense foods like eggs and dairy, which may improve your body’s ability to heal. Second, you’ll have a better understanding of which foods are more crucial to avoid than others, which can give you freedom in your food choices. Third, having a more broad diet can significantly improve your ability to enjoy food both at home and when out to eat, which provides important quality of life benefits.

Bonus: If you’re able to tolerate dairy, you can enjoy the nutritional benefits of grass-fed dairy. In fact, raw milk may have special benefits to those with autoimmune disease, as drinking raw milk can boost glutathione levels substantially, and glutathione is another nutrient that can modulate the immune response. (9)

Reintroducing foods is probably the most challenging part of personalizing your AIP diet. As I mentioned before, it can take hours, days, or weeks for an immune response to kick in to the point where symptoms are returning. While some people get an immediate and strong reaction to foods they eat that they have immune activity against (gluten is a big culprit here), others only have minor increases in symptoms that they may not realize are attributed to a particular food.

The best way to construct a reintroduction protocol for an autoimmune diet is to first choose which foods are the most important to you to try reintroducing, and then work systematically to bring them back into your diet. I rarely suggest trying to reintroduce gluten if you have an autoimmune disease, but other excluded foods like dairy, eggs, nightshades, and/or nuts and seeds can frequently be tolerated by those with an autoimmune disease.

Certain food groups need to be reintroduced in a particular order. The best example of this is dairy, where you start by reintroducing ghee, which contains the least amount of milk proteins, then continue with other dairy types in this order: butter, heavy cream, fermented dairy (yogurt and kefir), cheese, and fluid milk.

Other examples include eggs, which should be introduced yolk first, and nightshades, which need to be introduced one-by-one (e.g. potatoes, then tomatoes, then eggplant, and so on.) You can also reintroduce non-Paleo foods like white rice and other gluten-free grains if desired.

Chris lays out the instructions for the reintroduction phase in his book The Paleo Cure, but the most important thing to remember is to only reintroduce one food at a time, and to give yourself at least 3 solid days per reintroduction to notice any exacerbations in your symptoms.

This can be a return of your specific autoimmune symptoms such as joint pain or skin inflammation, or it may be an “unrelated” symptom like gastrointestinal distress or fatigue. If you’ve eaten the food consistently for three days and you don’t notice any negative side effects, you can generally assume the food is okay for you to eat.

4. Get Tested For Sensitivities

Sometimes the reintroduction protocol isn’t enough to discover which foods are causing you to have immune system flares. If your symptoms aren’t improving on a strict AIP diet, or if you’ve gone through the reintroduction protocol and your symptoms start to come back, you may still be eating a food that’s inciting an immune response.

In this case, getting food sensitivity testing is a good option to determine exactly which foods are the culprit. I typically see most autoimmune patients getting their testing done through Cyrex labs, which test for both IgG and IgA antibodies and can detect intolerances to a wide variety of foods.

They’ve recently released a test called Array 10 which covers a great deal of foods in both cooked and raw form, and I’d imagine this test would be beneficial to a person on the AIP diet that’s not seeing the improvements they were hoping for. Array 4 is another Cyrex test that I frequently use for patients who are unsure of whether they’re intolerant to dairy, eggs, or other foods that are commonly associated with a gluten cross-reactivity response.

It’s important to note that these tests are only accurate if you’ve eaten the food in question within the past 4-6 weeks. So if you’ve been dairy-free for 6 months, testing for a dairy sensitivity likely wouldn’t give you a positive result, even if you are truly intolerant. The testing option is more suited to people who have been eating some of the questionable foods recently and have experienced a return or exacerbation of symptoms.

If you feel that you need to get testing done to determine which foods might be an issue for you from an immunological standpoint, I strongly recommend working with a qualified practitioner who can help you navigate the testing options and interpret the results of your tests.

5. Focus on Your Lifestyle

Even though I’m a dietitian, I find that lifestyle habits other than diet often play an important role in my clients’ health outcomes. It’s always interesting to have someone come to me expecting to take on a diet change, and by the end of our first session we’ve skipped the diet and gone straight to the exercise, stress, and sleep recommendations.

Unhealthy lifestyle practices can completely undo the benefits of a healthy diet, and examining your habits is an important next step once your diet is under control.

Exercise isn’t just great for weight loss and cardiovascular health, it’s also crucial for healthy immune function. Research shows that exercise is important for T-regulatory cell production, and it can also reduce inflammation in people with autoimmune disease. (10, 11, 12, 13)

Daily exercise at a low to moderate intensity is what I’d typically recommend for people with autoimmune disease. This means avoiding excessive or overly intense exercise, allowing for adequate rest between workouts, aiming for daily low intensity movement, and limiting sedentary behavior.

As Chris explains in The Paleo Cure, chronic stress has been shown to reduce gut barrier integrity (remember the leaky gut connection?) and can trigger or worsen autoimmune disorders including multiple sclerosis, Crohn’s disease, psoriasis, and rheumatoid arthritis.

One study even found that chronic psychological stress is associated with the body losing its ability to regulate the inflammatory response. (14) The researchers even theorize that the stress connection may explain why women have a higher prevalence of autoimmune disease than men do.

I completely agree with Chris when he says:

If you’re not doing some form of regular stress management, you will sabotage all of your best efforts with diet, exercise, and supplements. 

Minimizing stress is a non-negotiable for my autoimmune clients. There are dozens of different ways you can manage stress, from yoga, to meditation, to planned social occasions with loved ones. Petting a dog, getting a hug from a significant other, or a monthly massage can all be stress relieving activities as well.

In the 14Four program, we’ve compiled a list of resources for managing stress appropriately, so check out that program if you need some assistance finding a stress management practice that works for you.

Sleep is another non-negotiable factor in my clients’ autoimmunity management plans. Chronically poor sleep is not only a source of stress, but also a source of inflammation. (15) When circadian rhythms get misaligned from weeks or months of inadequate sleep, inflammatory immune cells are produced excessively, leading to an increase in “friendly fire” against the body’s own tissues.

If you’re concerned about your sleep, check out the recommendations we provide in the 14Four program, and read Sarah Ballantyne’s excellent post on the role of circadian rhythms in regulating hormone cycles and how to get your rhythms back on track.

Sunshine is the best source of vitamin D, and good vitamin D levels have been shown to directly influence the activity of the immune system. In fact, not only has vitamin D deficiency been connected with a higher risk of developing autoimmune disease, but it also is used as a treatment for reducing the symptoms of autoimmune disease. (16, 17, 18, 19)

So don’t be afraid of the sun, particularly if you live far from the equator and/or have darker skin! And if regular sun exposure isn’t an option, you may benefit from supplementation. (Work with a professional to determine your optimal dose.)

Finally, avoiding toxins in everyday life can reduce the burden on your immune system. As an example, one study in mice showed an increased risk of developing autoimmune disease when exposed to pthalates. (20) Phthalates are relatively common chemical “plasticizers” that are found in everything from detergents, building materials, plastic food and beverage containers, and cosmetics.

You can minimize your exposure to chemical toxins by using natural products for cleaning your house and laundry, drinking out of glass bottles instead of plastics, and minimizing your use of industrial cosmetics. A great resource for DIY cosmetics is Liz Wolfe’s Skintervention Guide, and there are dozens of blog articles about how to clean without using toxic chemicals.

Get Help When You Need It!

By following these 5 tips for personalizing your autoimmune paleo protocol, I believe the majority of people with an autoimmune disease will see significant improvements in their symptoms.

That said, there are those who will need additional tweaks, deeper testing, and personalized changes to their diet, supplement, and lifestyle plan before they see the improvements they’re looking for.

This is especially true for people with severe gut issues, longterm neurological involvement, or compounding issues like surgical intervention or pharmaceutical dependency.

For those who need in depth testing and/or pharmaceutical intervention, I strongly recommend finding a qualified integrative doctor or naturopathic physician to work with.

And for those who may simply need more advice about how to tweak their diet, supplements, and lifestyle to optimize their results on the Autoimmune Paleo protocol, I’d be happy to help guide you in the right direction.

Have you overcome your autoimmune disease using any of the recommendations I described above? Share your story in the comments below!

About Laura: Laura uses her knowledge of traditional and biologically appropriate diets to improve her clients’ health. Growing up with a family that practices Weston A. Price principles of nutrition, she understands the foods and cooking practices that make up a nutrient dense diet.

With her strong educational background in biochemistry, clinical nutrition, and research translation, she blends current scientific evidence with traditional food practices to help her clients determine their ideal diet.

You can find her at AncestralizeMe.com, on Facebook, and Twitter!


Join the conversation

  1. Anyone have severe stomach pains and diarrhea?? I am in week 3 of AIP and cannot get rid of the severe stomach pains unless I just do not eat. Every time I eat, it causes the pain and diarrhea. I am mostly eating grass-fed beef and lots of veggies. Because of the stomach pain, I have been eating bananas instead. Bananas are the only thing that do not cause the pain. My doctor said to add in more fermented foods which I have added. I added kombucha and Gut Shot to my diet for the last 24 hours and still have not seen improvements in the stomach pain. Any suggestions? Did anyone else experience this?

    • Is it possible you are sensitive to beef? Maybe try chicken or fish and see if that helps. The other obvious thing I can think of is that maybe you are eating too many raw veggies and should try just cooked ones for awhile. I am by no means an expert, but those are the two things that jumped out at me. I would keep up with the fermented foods as long as they aren’t causing you pain, but I have found that I can no longer tolerate fermented foods, so went to a high quality probiotic in pill form instead for now.

  2. Hi, My husband is coeliac. he was so ill about three years ago, losing loads of weight and having exhaustion to the point he had a long time off work. he obviously gave up all gluten and went on a vegan diet of quinoa, rice, millet, mung beans and veg. He has recovered fairly well but still gets exhausted sometimes, tired a lot and bloated. So we decided to try the AIP. This morning he had his first bone broth and an hour later, he crashed. He suddenly became exhausted and had diarrhoea. Not sure whether this is normal or whether to continue? Please, any advice would be appreciated. Many thanks

  3. I am just finishing up my 30 days on the AIP diet. I’m not sure whether to keep on with it or start reintroducing things.
    I started the diet because I have lichen planus everywhere, and it does seem less active and is diminishing somewhat.
    One thing I have noticed is that I don’t have a lot of extra energy to burn. It seems like I run out of steam in my body if I am physically active for over an hour (just walked around at a trade show, for ex., and my energy got low quickly). I don’t really like that as a side effect.
    Anyone with the same issues or with lichen planus on how long you proceeded with the diet?

  4. Great article! One exception to the rule would be for people with histamine intolerance or mast cell activation disease. Fermented food and bone broth can cause major reactions. I was confused as to why my symptoms got worse on Aip but after making it low histamine I improved a lot.

    • Besides eliminating fermented foods, what else did you eliminate? I feel like between aip and histamine reduction, there will be nothing left to eat .

  5. I have been diagnosed with Grave’s Disease, but I have very few symptoms — the only symptoms I have had are the elevated antibodies, lumps visible only by an ultrasound, and a TSH that indicates hyperthyroidism. I do not have a racing heart, nor do I have bulging eyes — which seem like the most obvious external type of symptoms of Grave’s.

    My next blood test and visit to the endocrinologist is scheduled for 3 months from now. So if I use an AIP diet for 30 days, or even 60 days, and then start reintroducing foods — one every three days, what immune symptoms should I expect to see?

    Possibly I should follow an AIP diet simply to help my thyroid. How will I discern which foods contribute to the immune response that has led to the Grave’s Disease and lumps?

    I have always had hay fever-type allergies, and very occasionally eczema — but both are so minor that I wouldn’t consider them related to the Grave’s Disease or thyroid at all. Or even if they are related, my symptoms are so so minor that if I discerned a food allergy after reintroducing a food because of a topical skin reaction, for example, I would still need a TSH, T3, T4 and antibodies testing to see the impact the AIP diet produced a change in my Grave’s symptoms. So the reintroduction of foods after the diet seems almost like it would not really help me.

    Admin, what do you recommend? Thank you.

  6. Unfortunately a doctor for Functional Medicine is VERY expensive in my country, and i have to pay it all on my own. I am already saving up money, but it will take a time till i can make an appointment. Life sucks.

  7. Hi

    i Have been struggling from a disease named Lichen planus , and now its increasing very rapidly , i am trying AIP now , my question is whether i can drink milk or not ?

  8. Hi!
    I find your website filled with useful information.
    I started with AIP 7 weeks ago and I do not feel any better. I still keep cutting and cutting food from my (now very short list) and I am confused about getting no result. I can’t eat dark green vegetables like kale, broccoli or spinach. I also have issues with bananas and apples. I buy only organic food (vegetables and meat). I need to eat sweet potato or butternut in the evening for getting a good night sleep. Still have bloating, brain fog, skin issues, tired, weak muscles… Every day. Do you have any suggestion for me?

    • Hi, I am not a professional but only have the same experience as you. First I would advice you stop eating meat and meat products for a period of time and see how you feel, allow 7 to 30 days to notice any difference. With apples and bananas, I believe it is because of the carbohydrate and sugar content. May be that is why sweet potatoes and butternut makes you fall asleep, both have a bit high sugar and carbohydrate content as well for someone with food sensitivities. I have slowly transition to raw food, because cooked food barely gives me any energy. It may not be the food, but major inflammation and gut permeability in the gut, causing food sensitivities that you may not react to other wise. Seek a professional to find out your food sensitivities for now. Doing a juice cleanse for a body reset also helps. Also your body needs time to heal, and less food in the gut for it to process helps. I hope this helps and you find the best way to heal, it is a difficult journey, keep you spirits up and have fun.

  9. Hi I was diagnosed with autoimmune thyroidism disease last year. I am on 75g of eltroxin. I have started paleo reset diet. My tongue swells out with indentation on side and I was wondering if this is an indicator of inflamation in the throat. I find my memory not ss good as before. Would I continue reset diet on till indentation is gone or will I just start reintroducing foods after 30 days and stay gluten free. Hoping you can help.

    • I have the same thing. I ate aip for a year for my hashimoto thyrd and attack on my joints. I have reAlized i have strict sensitivity to gluten of course and soy. When i was strict paleo the tongue inflammation was better but Must’ve added the wrong things in. Now I have gallbladder issue going on partly attributed to my strict paleo): I need to eat lowfat diet till gallbladder is removed and better.

  10. I thought I had it bad…Having to lose 60% of hair on my head (AA) and to have itchy, scaly and bleeding from scratching constantly on my back (eczema).

    So many pepole suffer from much worse conditions everyday.

    But each of is suffering in agony just as much as others, just in different ways.

    For me, I know I need to be on AIP but it just sounds like a lot of work. So I’m very discouraged. I’m sure it’ll get easier as you put in more days.

    Good luck to everyone suffering… Hopefully, you’ll regain your health in the near future.

    And remember, don’t get frustrated (from pain or condition/severety of your disease) and take it out on your family or friends. Because they’re suffering, too. (From not having “you” as in real, healthy you.)

  11. Hi. I am only about a week into the AIP diet but every SINGLE time I look up a designated AIP recipe, it includes eggs, nuts or something else that is NOT on the AIP list. I am so confused. I have avoided certain foods like the PLAGUE and then see “AIP” recipes that include the forbidden items. Just completely confused. Thanks.

    • Sounds like the recipes are Paleo ,that’s what comes after The AIP 30 day . Just reread the recipes ,a lot of them tell you what to leave out to make it AIP .

    • Dear Rachel, please look up Autoimmune AIP, or autimmune protocol. These recipes cut out eggs, dairy, nuts, seeds etc. I can’t tolerate any of the other stuff either, including fermented things and long cooked broths (histamine issues). Don’t give up. There are many of us.

  12. Hi Laura,

    I’ve had eczema for 40 years, but in the past 1 1/2 it has been the most severe it has ever been. After several doctors prescribed steroid creams again and again, I found a doctor that specializes in autoimmune diseases (I also have graves & alopecia). She asked me to try the Autoimmune Protocol. I’m 3 weeks in and although I feel good, my skin is still struggling to heal. I know it’s different for everyone, but how do I know if this is the right answer for me? Or could it be some food in the protocol that I should try to eliminate? Seafood, citrus? It’s not an easy task following the protocol, but worth it if the outcome is living without having to wear long sleeves everyday to cover the unsightly rashes all over my arms.

    • Hey! I just wanted to chime in, because I did the AIP for six months, and the first few weeks for me I started to feel better, but it wasn’t until I had been following it for about three months that I noticed that every single one of my symptoms was gone, and even then, I was having digestive issues which a year later I’m still trying to correct. I’ve read in forums that for some people it took a lot longer than it did me. I’m not a doctor or anything but I just wanted to chime in and say hang in there! 🙂

      • Thank you for responding! I just made it through week 6 and each week has been continuing improvement. I’m guessing for me it will be several months before I’m rash free for more than a couple days at a time. You mentioned you did it for 6 months. At anytime during the 6 months, did you add any food back into your diet?

        • hey!
          yes, I did add food back in. That was a whole process that was very frustrating, because I also have anxiety (which almost went completely away while I was on AIP) that made it so I couldn’t tell if I was having a reaction to the food, or having anxiety about having reaction to the food.
          I was successfully able to add back in some nuts and seeds and some dairy, and then eventually my doctor just did a food intolerance test on me and I gave up the AIP diet and just removed those foods. All my symptoms came back, so I’m planning on starting it again in a couple of weeks. 🙂

  13. Can I ask what the best options are I terms of carbohydrates for a toddler would be we generally eat starchey tubers sweet potatoes, white potatoes, etc. is yuca flour a good option? Also what are good alternate forms or calcium for a toddler if lactose sensitivity is present? Also wondering if there is a difference between Chris’ paler “code” and paleo “cure”? I have the former. Do they cover a lot of the same material? Thanks so much very informative article as always

  14. Hi! I am on week 2 of the AIP diet and suddenly have terrible heartburn! I’ve only suffered from heartburn previously during pregnancies, occasionally with bananas, and almost alway when I have an upper respiratory thing going on (post nasal drip related I believe). Why, oh why is eating AIP causing heartburn?!? History: diagnosed with “postpartum thyroiditis” 8yrs ago after first childbirth (I was VERY hyperthyroid for 3 months then crashed into hypothyroid. At the time, just followed the Drs advice and took synthroid. Wasn’t aware until later that my antibodies were though the roof and I was really suffering from Hashimotos). 5yrs ago during a period of stress (and after another pregnancy), became debilitatingly nauseous, couldn’t eat, stomach pains, lost a lot of weight. My amazing Chiro told me to take out gluten and ordered gluten sensitivity panels and those were also through the roof. At that time, I took out gluten permanently and dairy for 3 months. Over the last several years, I’ve felt OK most of the time on a gf, close to paleo diet (minus occasional GI pains that seem related to ovulation/mensturation and too-frequent gas) but wanted to try the AIP diet to see if it would help with my (self diagnosed)endometriosis and to see if it would help with the gi issues and maybe more energy (now on synthroid and cytomel) and to clear up the occasional brain fog that I can’t find a source to and just for the fact that I have autoimmune diseases myself and several in the family. Thank you!

    • Hi. Your symptoms sound just like mine. I have Hashimotos, Endometriosis and PCOS.

      I was curious how you are doing on the diet and if you have noticed any improvement?

    • I got heartburn very bad when I started AIP (I’ve been AIP for 18 months now). It wasn’t until I stated taking digestive enzymes with every meal that I finally got it to go away!

      • I have super similar issues as you, and followed aip for past year. Unfortunately one thing you dont hear about is how aip can create the deposits and i have gallbladder stones now-the heartburn /gallstone attack i had this morning, i literally thought i was having a heart attack (have svt and my mom had heart attack early in life). Anyhow, gallstones form from high fat foods and now i am stumped at what type of diet to be on. Basically listen to your body and if you start getting mote frequent heartburn or twinges after eating dont rule out gallbladder issues- below the right side of rib and my heart attack pain this morn i could also feel the heat up into my right ear. The nerve that connects to the gallbladder is there. I regret using bacon, salami so freely now and shouldve been more strict with 3 servings or vegies to one protein. Just something to be mindful.

    • Hi, I know this is a very late response and maybe not helpful. But I’ve experienced many of the same symptoms that you have and I figured out some of them which i think might help you. Or at least doesn’t hurt to try. So the acid reflux one, well after extensive research I learned that one of the possible causes is actually not having enough acid. So what I did that worked is I would drink a warm glass of water with 1-2 spoons of apple cider vinegar a half an hour before meals. It really worked and in the process I’ve also learned that it helps clear the stomach of toxins and inflammation. Now I would first suggest trying this at home and seeing how your body reacts to it because not to be gross but initially I had massive diarrhea but more of in the sense that it felt like a full colon cleanse. And I felt better after words. So don’t be scared by it. It will normalize. And so worth it. Also suggest drinking it with a straw because I learned recently that it can be corrosive to tooth enamel and again it works. Also I know for sure it’s getting rid of the toxins just by the fact that my adult cystic acne is even going away.

      Now for the brain fog, which bothered me the most and actually freaked me out. I discovered multiple things with this that you can try one at a time to see what really works for you since I don’t know exactly what was the true solution or if it really was all of the above. So one of the things I discovered along with my Hashimoto’s is that I’m vitamin D deficient. You would be surprised how common that has become now a days. Vitamin D is known to not only improve bones and help with joint pains, but it is also a mood elevator somehow. And i did feel a little clearer the more corrected it got. I also started taking fish oil tablets to reduce inflammation and it was found to really help with Hashimoto cases. Finally, I tried magnesium supplements. Now how I got to trying this is because I heard that sometimes vitamin d deficiencies could actually be due to magnesium deficiency because it aids in the absorption. After taking this I felt a lot better. I felt way more clearer. But the thing is that I’ve also started becoming more compliant with everything else around the same time. That’s why i say try and see what works for you. Another huge factor is having a consistent sleep and a morning schedule. I think it really matters for thyroid problems especially Hashimoto’s. I learned this because I’m also suffering from idiopathic hypersomnia, and saw a difference when I forced myself to wake up at 6/6:30 every morning and take my thyroxine right away as well as force myself to sleep early. It was definitely hard but i felt a huge difference and now my fatigue has cut down by A LOT and in general I feel better. Now I try not to let anyone interfere with my sleep schedule.

      Also of course cutting out things like eggs, dairy, refined sugars, fruits, processed foods, rice, and white bread helped. I discovered that I crash hard after those and/or get really bad brain fog. Now I haven’t gone full AIP diet, because its super hard especially breakfast. But I’m working on it! I actually came on here to see if anyone knows whether you can have lactaid milk on it or not. Do you happen to know by any chance? Oh and the whole menstrual cycle thing i get it. If you figured it out, please tell me! I noticed I also get a little word forgetful the closer to my period and I don’t know why. I’ve just been trying to record all my symptoms on this app called flo to see if any symptoms have correlation with my period and if so how can I fix it. Wow I wrote a lot. Well I hope this was helpful in any way for you or that you got it all figured out now. Good luck!

  15. Thanks for this article! I have Hashimoto’s and have been strictly gluten free for 2 1/2 months. I’ve also had absolutely no refined sugar and only minimal fruit. I have been so strict about this diet that I prepared every bite of food in my own home to avoid cross contamination. I have avoided possible cross contaminated foods entirely as well. I just had my labs done and there is no improvement in my antibodies and my TSH actually INCREASED! I was so frustrated until I came across your article and now I have hope that further restricting my diet may bring the change that I need. I do have a question though. I am naturally very thin (5’4″ 112lb. female) despite having an elevated TSH. After cutting out gluten and sugar, I dropped to 104lb which is definitely not a good thing. I have deliberately eaten more healthy fats to try to make up for my reduction in carbs, but apparently it didn’t have the same affect. I’m really afraid of losing more weight by restricting my diet even more…especially cutting out all grains as those are the biggest source of carbs for me. So how can a person like me implement the AIP diet or even just the regular Paleo diet without losing more weight?

    • Hi Katy, I just discovered the AIP approach a couple of days ago and am trying it myself but much like you I’m VERY concerned about my weight…I burn calories just thinking about it 🙂 I’m 5’1 100 pounds soaking wet! Did you get a response from anyone on your concern? I’d be so happy to hear any advice, I hope this fins you doing well and on the road to recovery. Thanks much. Warmly,


    • I lost 20 pounds on AIP (didnt want to). Now ive gained back almost all of it.

      The big culprit for me was going too low carb. Adding in a bit more cassava/plantains and a lot of fat (tallow, avocado, olive oil etc) helped. I also started eating 4-5 times a day.

      I guess when you eat cookies and stuff, its easy to maintain weight by eating 3 times a day cause you get snacks all the time. Up your meals, carbs and fat and most people on AIP should be fine.

    • I am in your same boat! 5’6” and 112 lbs. I’ve been gluten free and dairy free except for butter and occasional piece of far chocolate. I am dreading doing this diet because it seems no fun and actually stresses me out about it which isn’t good. I have hashimotos and alopecia and need to fix this hair loss. Just want to be guaranteed that I will get my hair back if I do the AIP diet!

  16. Hi Laura

    Great article – Can you say any more about what you would do with positive Array 10 markers? Would you still reintroduce these into the diet? After how long?

  17. Hi there! Man can I use some help. I recently read how gut issues can cause brain issues, as the two are closely linked. I’ve been negative, stressed out, and fearful for the past 20 years, which opened my gut/brain up to a slew of problems (including an inability to gain weight). The worst is this: When I eat the wrong thing, my head/brain becomes tangibly inflammed… it feels like a burning, tight band sensation all around my head; sometimes it’s mostly around my temples… It seems to move all over the place. It remains all day until I wake up the next day… and even then, they symptoms remain, though at a much lower level.
    I’ve held closely to a Paleo diet for a few years, but more recently the autoimmune Paleo diet (but probably not rigorously for a full 30 days). My problem is that it seems like EVERY single food I eat provokes my head symptoms… some less than others. So even though I’m on the strict paleo diet, I still struggle with the head symptoms. Is it possible that my gut is so compromised that my head will continue to react to all foods (at least until I’ve removed the most offensive foods for a full 30 days)? Or is it more likely that even though I’m eating the ‘right’ foods now, I will continue reacting to some degree until my gut heals?
    Like I said, I don’t think I’ve gone a full 30 days on the ‘strict’ diet. Eggs and nuts were usually in the mix somewhere… but now they’re out!!!
    Your advice would be greatly appreciated! I’m now adding mindfulness and meditation to the mix as well.

    • Hi Steve,
      That sounds so rough! As a Craniosacral therapist I’d say you may try to see an osteopath or Craniosacral therapist. It.’s interesting that it happens with every food you eat. It makes me think there could be an issue with a previous head injury that’s flaring. The worst that could happen if you go to a Cst or DO is that you’d feel relaxed and more clear headed.
      Best of luck!

    • Hi Steve, You are the first person ever that I have heard describe the exact same symptoms as myself. Every food, particularly any kind of starch, gets my head ‘buzzing’, or like pins and needles. Disrupts sleep etc. Did you ever find a solution? I’d love to hear your experience.

  18. Hi Chris,
    I’m wondering what your thought on the Swank diet is since you mentioned MS in this blog post. I looked at the study published in 1970 and it did seem like an anecdotal/correlational study, but the correlations were strong. I have the impression that the patients in the study didn’t experience full remission as did Dr. Wahls. But how do we reconcile this conflict? Could saturated fats cause MS?

    • I have MS also and I’m having a hard time reconciling the Paleo Diet with Swank. With all the restrictions there’s really nothing left to eat but leafy green vegetables.

    • Be careful with supplementing with iodine with Hashimoto’s. Absolutely ask a well informed doctor about this before you consider taking the supplement of iodine as an excess of iodine can cause lots of issues with the thyroid gland. Taking an iodine supplement wreaked havoc on my body and thyroid.

  19. Thanks for the comprehensive article Laura!

    You might like to have a look at the research of Dr George Jelenik (Australia) regarding multiple sclerosis. He is on the same page as you regarding lifestyle, stress management and whole foods diet however his research indicates eating meat should be avoided for people with MS, no matter how high quality. I personally know of many people who say their saw a great decrease in symptoms by following his recommendations.

    • I had ms i was a mess…. Then with diet i had a total recovery 100 percent and i forget of ms. I play rugby and have a totally normal life. I has a longgg history i did 1000 of therapies but paleo was the cure and drank bone broth too…. Litres a day

  20. I have had Hashimotos for over 18 years. I am 50 years old and have recently been diagnosed with a vitamin D difency and am in week 4 of a prescribed dose of D2 1.25mg (50,000 unit) once a week. I feel no difference on this medication, in fact worse.
    I have suffered with weight gain for the past 8 years or so, increasingly suffering from fatigue, headaches, sleeplessness, lack of concentration and so on which I read could be related to the vitamin D difenciey.
    I am not sure where to begin but I now I can’t go on like this.

    • Vitamin D2 is less effective with more side effects than D3. Get your doctor to tell you how much over the counter D3 to take and throw the D2 away.

      • I am about to complete my prescription and will go back in for labs.
        I will mention the D3 instead of D2. Things have leveled off but I am having muscle cramps in my calves from time to time.
        I read an article on magnesium – which is something that could need added to the D3/D2 deficiency.

      • Thank you Erin. I read the article – Epsom salt soaks, that is easy.

        shouldn’t my PCP track this or do I need a specialist and if so – what type

    • I too have Hashi. I highly recommend joining a group(s) on Facebook for help in this area as well.
      It is my understanding that it is Vitamin D3 that one should take to increase levels if one must supplement.
      Again, join Stop the thyroid madness (this one has a great website) or Hashimoto 411 as a suggestion. There are others as well

      • I was member of Hashimotos 411 FB and found it extremely helpful early on. I went Paleo first and the AIP and my antibodies dropped. and then I had to go back to regular eating for several months and they continued to drop. I am now in normal range and not strict paleo at all. Hashimotos 411 Facebook page would not let me post my story. They said it would confuse people. I said it would give them hope. They deleted my post and I was kicked off the site. Eating gluten is a no no to them and you can’t even mention that you do it. Ever.

  21. I was diagnosed with Ankylosing Spondylitis. I’m looking for a more natural approach to healing. First question do you know how to find a good holistic type dr in the Pittsburgh PA area? Second question… I’ve been thinking about trying the low carb or paleo diet but have some concern on how I could do that if I don’t eat meat. Do you have any suggestions?

    • Dr Jaison Golijuh…(I am fairly certain I have misspelled his last name) . Is in Butler/Renfrew area and Tracy Yautz is in Harmony. They are both naturopaths.

  22. Hello, I have recently been thrown in the BFS camp. Do you think this would help someone like me? And my biggest question is, how do I know if I can or cannot tolerate something? At this point, I don’t have many issues except for constant twitching all over my body.

  23. Hello, I have recently been thrown in the BFS camp! I have done other testing and am so far clean that way. But I would love to reset my body! Do you think this would work for someone like me?

  24. Not to be off topic BUT I have searched high and low for blogs and websites focused on Sub-clinical Hyperthyroidism Grave’s Disease and haven’t found any. I seem to be the opposite of what is described in many hypo sites except for the fatigue, exhaustion, hair loose and other yada yada symptoms.
    I know not as many suffer with hyper vs hypo diagnosis but it can be just as debilitating.
    If you have any advise for a nearly nonexistent TSH yet high T3, T4 people please pass it along to me..I am a poster child!
    Thanks Dana. …aka mother of 6 🙂

    • Hi Dana,

      I have been struggling with the same issue as you for the past 8 years. And unfortunately, I have found little information for sub-clinical hyperthyroidism or good explanation for low TSH and high T3 / T4. While I don’t have any advice for you, I would like to say that I understand what you’re going through and if I come across anything I will post it to this thread.

      • Thank you! I have found a good doctor who finally listens to my symptoms and through deeper tests…I have been diagnosed with Graves Disease. I am being treated with anti-thyroid meds. and feel much better.
        I am a self proclaiming workout addict and I knew something was seriously wrong…my heart rate would go through the roof and all I did was walked up a flight of stairs….so anaerobic became my everyday nightmare and all that it causes. That is so much better….
        Here’s is a little info and a website I found… 🙂

        Graves’ disease is an immune system disorder that results in the overproduction of thyroid hormones (hyperthyroidism). Although a number of disorders may result in hyperthyroidism, Graves’ disease is a common cause.

        Because thyroid hormones affect a number of different body systems, signs and symptoms associated with Graves’ disease can be wide ranging and significantly influence your overall well-being. Although Graves’ disease may affect anyone, it’s more common among women and before the age of 40.
        Symptoms include….
        Common signs and symptoms of Graves’ disease include:

        Anxiety and irritability
        A fine tremor of your hands or fingers
        Heat sensitivity and an increase in perspiration or warm, moist skin
        Weight loss, despite normal eating habits ( personal note here…I gained weight due to anaerobic fatigue and needing to eat everything, including the kitchen sink, to feel better) lol
        Enlargement of your thyroid gland (goiter)
        Change in menstrual cycles
        Erectile dysfunction or reduced libido
        Frequent bowel movements
        Bulging eyes (Graves’ ophthalmopathy)
        Thick, red skin usually on the shins or tops of the feet (Graves’ dermopathy)
        Rapid or irregular heartbeat (palpitations)

        Hope it helps! Blessings Dana 🙂

  25. Hi Laura – thank you for this weath of information. I have been suffering for 2 years now with eczema, extremely itchy and swollen yets, anxiety, food interolerances (eggs, gluten, dairy), high levels of mercury abd high levels of B12 and B6 which all presented after the birth of my son. I’ve been strictly GF, egg free and DF now for 2 years and while my syptoms have significantly improved I do get flairs at least twice per year. I also take an array of supplements daily inlcuding: Betaine/HCL, Krill Oil w/Evening primrose, muilt vitamin, Vit D3, l-glutamine, zinc, probiotics, B12 (methylated) and methylfolate (I was also taking Milk Thistle but stopped 6 months ago). I’ve recently gone Paleo (2 weeks) to see if this will help and have noticed I have so much less energy (especially around 3pm). My intergrated dr thinks that healing the gut is key. My question is – how long does this typically take to heal and are you suprised that I am not fully healed after almost 2 plus years? When can I start to re-introduce foods like eggs?

  26. I have tried an elimination diet before under medical advice but go into severe withdrawal from carbohydrates all together is there any suggestions for helping with this and getting through it………I experience vomiting shakes and weakness symptoms which often leads me to going off the diet

    • Um. Don’t go off all carbs?
      If your Drs are advocating a ketogenic diet then the brutal fact is you can’t do it, but there’s no reason in the world that you can’t do a reasonably high-carb version of AIP. Taro, plantain, malanga, sweet potato, fruits, cassava. I get 150-200 g carbs a day from those sources, and if I needed to I could hit 300.
      What kind of “elimination diet” have they been trying to put you on that you were not able to get enough carbs?

      • I get ny carvs from sweet potatoes and plantains. They are excellent. You can try butternut squash, too.
        My symptoms are all gone!
        I have 3.5 years grain and gluten free and feel awsome.

  27. Would taking a liver supplement (dried liver in a capsule sold as a supplement) be just as effective as taking it in as a whole food ? Thank you!

  28. First question: I’ve left this comment at a couple other AIP types, but so far no one has responded.
    Part of the AIP philosophy seems to be a horror of seeds. You can’t even sprinkle a little cumin on your food, according to some interpretations. And yet everyone recommends eating seedy fruits with impunity. Figs, raspberries, you name it.
    So… Is there some kind of theory that no one is telling us as to why fruit seeds are different from other seeds? Or has not a single other person in the AIP blogosphere noticed that those lumpy things in fruit are seeds?
    Second question: I can see the argument for “keep doing it until you get results” if you have a confirmed auto immune condition, but what I have is moderately-debilitating chronic fatigue. I’ve been doing it for 3 weeks and am if anything more tired because I spend all of my previous resting time preparing meals. How much longer should I wait for results before I fold?

    • An update, as long as I’m here. On day 28 I got a burst of energy. Not huge, but I no longer need to lie down for 15 minutes after my leisurely walks of the neighborhood, so I’m keeping with it for a while longer.
      I got another big bump in energy when I decided to start prioritizing sleep. Before I was prioritizing not getting hooked on sleeping aids, which meant I got 3 hours several days a week. And since I didn’t seem to have any less energy those days than the days I got 10 hours of sleep, and since the relationship between how long I spent in bed and how long I spent asleep was pretty casual, I didn’t try that hard.
      But I’ve been being more aggressive and wide-ranging in my sleep aids, and just take something when I get up in the night, instead of lying there waiting to fall asleep until it’s too late to take anything else. And more conscientious about being in bed at a decent hour. And I’m feeling better again.
      Still nothing like what I was before I got sick. But certainly more functional.

      • Yay! Yay! and, Yay!!!

        I now, am on that EXACT SAME ROAD to better, more consistent and healing sleeping patterns…Your post is an inspiration! Thank You!

    • Alicia, I had the same question about seeds. I asked on two different websites (The Paleo Mom, and Phoenix Helix), and then later did find the answer in Paleo Mom’s book. Here is the answer from Phoenix Helix: “Seeds within fruits and veggies are fine to eat on the AIP. The reason is two-fold: (1) They are moist and digest more easily than dried seeds. (2) They are a small part of the vegetable/fruit, and if you saw my AIP Food Pyramid, you see that its foundation is vegetables. We don’t want people to exclude them unnecessarily, because their nutrition is very important for healing. The woman who commented above is the exception. Most people tolerate seeds in fruits and vegetables with no problems, so eat them without worries.” – See more at: http://www.phoenixhelix.com/2013/05/19/what-is-the-paleo-autoimmune-protocol/#comment-29922
      The answer from the Paleo Mom was basically the same, but also mentioned that the small edible seeds of fruits tend to pass through undigested.
      Hope this helps!

      • That explains why to eat raspberries, which are easily 30% seeds by dry weight, or figs, which are 60% seeds by volume, even if at least some fruit seeds are loaded with the phytate and lectins that are supposed to be the number one cause of death in the US, according to the more science-impared end of the paleosphere.
        But why shouldn’t I use cumin in a dish that will be 0.5% seeds by weight? Especially if I cook it for a while and then let it hang out in the fridge over night so that it is ‘soft.’
        I think I wrote my question inside out. The question was less “if I can’t eat spices why can I eat fruit” than “if I can eat fruit, why can’t I eat spices,” at least if I use a light hand with them.
        As far as I have seen on any AIP website, the only rationale for eliminating seed based spices is that their very seed-ness makes them devil spawn, so that even a quarter teaspoon once a day would render your entire AIP experiment a waste of time. To me that doesn’t make sense, and triply doesn’t make sense when eating fruit seeds by the tablespoon, and I’m still waiting for someone to explain to me why it would make sense for me to do that.

          • The blogs I’ve read have said to eat no seed spices. No pepper, no fennel, no fenugreek, no nothing. And I have not seen any blogs that list cumin as a night shade. In fact, many list it specifically as a non-nightshade safe spice.

              • Seed based spices tend to be common allergens for autoimmune people and can cause systemic inflammation. I have eliminated most seed based spices from my diet because of reactions I have had to them, and later found out I am allergic to many of them and also the autoimmune protocol recommends eliminating them–but AIP is supposed to be temporary, not forever, just to allow the body to calm down and start healing and get to a point where it doesn’t react to everything.

    • Sarah Ballantyne answers this question in her book in Chapter 2 I believe. Small seeds like strawberrys are meant to be eaten whole, it’s when they are broken up that the phytates are released? Any seed that needs to be chewed should be avoided (so she recommends seeding cucumbers). Spices are different, many are nightshades I believe.

    • I will pipe in and respond since nobody else has. If you were looking for answers from Sarah Ballantyne aka the “paleo mom” (supposedly the expert on the protocol), you likely won’t receive much, since she seems to have gone AWOL amidst a flurry of questions. Not very professional IMO, considering her all-or-nothing approach with this whole AIP thing.
      My guess as far as seeds go is that it’s mature seeds that have been given a chance to fully develop, dry and form irritating compounds that are off-limits during the 30-day elimination. But that said, Ballantyne doesn’t allow unripe leguminous vegetables during the elimination phase (snap peas etc), and they’re not ripe. So who knows.
      As for feeling worse during the AIP, I’m in the same boat. I was constipated, worn out and depressed during most of it. I developed mild skin patches on my face that were never there prior, anf when I caught a cold it took me three weeks to heal – which has never happened tome – not even close.
      The bloggers will tell you that it’s you that’s doing something wrong, but as a skilled cook, I was preparing very good meals that were very nutritionally sound, as per their recommendations – plenty of veggies, leafy greens, fruits and carbs in moderation, healthy fats, offal, bone broth, sauerkraut and more.
      Like you, my main issue has been some moderate fatigue along with poor mood. I wonder if perhaps this diet is ok but too difficult emotionally as well as stressful and draining. I also wonder if it’s lacking stimulating foods. Sure, you can eat ginger/cinnamon/cloves/turmeric, but maybe all in all our diets, especially when paired with so much protein, should have more compounds that get you going. I say this because when I reintroduced black pepper, I got mild gut issues, but my bowels went completely back to normal. Maybe the gut “issue” was just peristalsis getting kickstarted, and perhaps reintroducing any stimulating food after strictly omitting it for a month can cause a “reaction” that is natural.

    • Realized after posting (whether it will be reviewed or not I don’t know) that others had replied, just further down. However, I still find the whole seed thing a bit dodgy, and the AIP in general seems to have a lot of loose ends…but if it helps some people, that’s great. I’m always open to improving health through diet/lifestyle, but am skeptical of sef-proclaimed “experts” on the internet.

  29. Laura, if i were to start an herbal round to treat sibo (Dysbiocide and FC Cidal (by Biotics Research)), would I take probiotics or only after the 4 weeks of treatment is over? Are there certain strains to avoid or certain strains that are preferred, i.e. Saccharomyces Boulardii? Thanks!

  30. Thanks for all your info and the excellent presentation.
    Regarding liver: I am in my late 70’s and when I developed pernicious anemia at the age of 4, the “cure” was raw steer (not calf) liver bathed in red wine. It was harder on my Mom than it was on me, but now I CANNOT eat liver plain. However I can eat it in pates. How much nutritional punch am I losing? I have vitiligo, by the way.
    Thank you so much again.

  31. Hi Laura,

    Great post! It’s super in-depth and a truly informative read. Curious as to your opinion – if someone gets a food sensitivity test done and it shows that they’re intolerant to foods, do you treat that the same as a food allergy (i.e. complete avoidance)? Does that most likely mean that you body isn’t designed to tolerate that food, and quite, possibly never will be?

    • Thanks Kayla!

      Food intolerances are different and if leaky gut is completely healed, a person may be able to tolerate those previously intolerable foods in the future. Usually it has more to do with gut integrity, than “not being designed” to handle that food. Allergies that produce IgE antibodies generally cannot be overcome, particularly if they cause an anaphylactic reaction.

  32. Thanks for the great article. Quick question: can taking gelatin as a supplement cause headaches and if so why and can anything be done to prevent them while still taking gelatin? I can eat homemade chicken soup without a problem, but when I have supplemented with pure beef gelatin, after a while, I get daily headaches. The company says there is no hidden MSG, which was my first suspicion. I spend a lot of time cooking already and homemade bone broth just becomes too much…I’d like to cut that corner by taking gelatin but can’t seem to due to the headaches. Any ideas? Thanks!

    • Are you using hydrolyzed gelatin? Either way, powdered gelatin is somewhat high in glutamate (an amino acid) which is the same thing that’s in MSG. So if you’re super sensitive to MSG, you may not be able to tolerate powdered gelatin unfortunately.

      Have you tried eating it in the form of homemade jello? I’m wondering if some of the free glutamate gets bound to other proteins in that situation. It’s worth a try! (And it’s delicious too!)

      I make mine with herb tea and honey.

    • Let your crockpot do the work. I make my bone broth in a crockpot, pour into a muffin tin, freeze, then tip out into a zip lock bag or put in ice cube trays for ease of measuring. I pour out and add water every day for 3 days, then replace the bones. I find I don’t have to monitor the bone broth this way.

  33. Hi Laura,
    My daughter and I did an elimination diet last year. I have Hashimotos, and my daughter struggles with a myriad of minor health complaints (head-aches, stomach aches, acne, bad periods, etc.) We had just bone broth for three days, and then re-introduced foods from there. I am not sure we waited three whole days before trying our next foods, and I did not think to worry about nightshades.
    Nothing conclusive resulted with me, but immediately my daughter reacted to eggs and to peanuts with gastrointestinal symptoms. I have two questions.
    1) While my daughter complied with eliminating eggs and peanuts for a time, she re-added them to her diet without gastrointestinal problems. I do not understand this. How could the symptoms be so immediate and obvious one day, and then almost like a mind over matter, not be evident at another time?
    2) My daughter still has all the same health issues. I suspect that she has a dairy issue that may cause her headaches on subsequent days. She has agreed to do some blood tests to put the matter to rest. I had previously heard of Alcat tests. Are these a similar test? What would you prefer and why? We are outside Toronto, in Ontario, Canada.

    • Hi Jean. I would suspect that foods like eggs and peanuts are contributing to some gut permeability (aka leaky gut) and when she avoids the foods for long enough, the gut heals and can tolerate an occasional exposure more easily. Your daughter may benefit from one of the food intolerance tests. ALCAT is one that many of my colleagues recommend. I personally like Cyrex’s Array 4 and/or 10, and other RDs that I know offer something called LEAP testing that has given their clients good results.

      It really just depends on what you’re able to get done. I’m not sure which of those tests would be available to you in Canada.

      But I’d focus on getting her on a gut healing diet, which may require eliminating dairy for at least 30 days. It sounds like she has some hormonal imbalances which can be exacerbated by poor elimination.

      And I’d suggest finding a practitioner to work with so you’re not spinning your wheels for months on end!

  34. I have CD and Hasimoto’s. I’ve been off of gluten for a couple of years but still have issues. I am also UNDER weight so I have to be careful on elimination diet. I tried a couple of years ago and was weak and lost too much weight. Last week, I just started the 30 day reset and I’ve been off all dairy, legumes, grains, chocolate, nightshades, corn. I am still eating eggs at this point because I was tested once and it came up negative. Also, I don’t seem to have a problem but if after 30 days, I’m still not feeling a lot better, I may consider it. I have to be very careful not to lose weight like last time. I am also cutting back a lot on sugar intake. No refined sugars. Some fruits and some blueberry bread that I make out of coconut flour adding a TBSP of raw honey. I’m going to see how I feel after 3 more weeks on this diet.

  35. Just curious, do most of us still say we’re on AIP even after successfully reintroducing some of the eliminated foods? I left an AIP online group because there was so much contention about whether AIP was only the elimination phase (no reintroduced foods) or included “thereafter” for those who were later tolerating eggs, nuts, etc. Those who mentioned eating those foods were reminded that it’s not AIP. I wanted encouragement to pursue my personal modification after reintroduction.

    • I’m not sure if you should say you’re on AIP specifically but perhaps saying that you went through the AIP protocol is more accurate.

      For the sake of not confusing newbies, I’d be sure to make a note that foods you reintroduced were not strict AIP.

      PS – I’m not sure why people would not be encouraging to those who went through the whole process… but the online world is often weird to me. 🙂

  36. it’s just an elimination diet. maybe there wouldn’t be so much confusion if you would just call it that instead of trying to come up a brand name.

    • or maybe she would like to differentiate it from other “elimination” diets so as not to be confused with said diets because it undoubtedly has aspects that are unique. surely you have something better to do with your time than nitpick the name of a diet?

    • Like Jonathan said, it’s a specific type of elimination diet geared towards those with autoimmune diseases.

      Similar to a Low FODMAP diet which is still an elimination diet but it’s geared towards people with IBS and other GI issues.

      Not sure why naming it in a way that helps people pick the right foods to try eliminating is an issue.

  37. Thank you so much for this article! I am going to start Paleo ASAP. I was diagnosed with Chronic Fatigue, Fibromyalgia, IBS, and severe idiopathic neuropathy. Psoriasis has been part of my life since my teen years (30 yrs), so I know I have had AI problems most of my life. I have been on disability for about 4 years now after trying desperately to continue working for a few years. I am still mostly bedridden due to the severe neuropathy and fatigue. My journey has lead me to natural health and the hopes of complete healing. Every day I try to search and learn more about health and what I might do to heal. Fibromyalgia symptoms have been in remission for a little while. I am just beginning some fermented foods- mostly kombucha and kefir. I have lost a significant amount of weight due to a cdiff infection and though the infection is gone, I’m continuing to lose weight in my effort to reduce portions and eat high protein/low carb. (I still have a lot to lose… though my main concern is complete health.) Neuropathy is the most difficult part of my life… the pain is daily and can be excruciating. So my question… have you worked with anyone with idiopathic neuropathy and had success in remission? Do you believe Paleo would help me??

    • Hi Brenda

      Just a few tips that might help.
      Your FM is likely related to low thyroid hormones and you need to get a full thyroid function test including reverse T3 done. Check out this article by Dr John Lowe who did a lot of research on the connection

      You really need to find yourself an integrative medicine doctor to do the full thyroid test but you can also test your basal temperature (your temperature when you first awaken and before you move around) in your armpit. If low, it is an indicator of low thyroid hormones or inability to use them effectively. See this article on how to do it but I do recommend doing it in the armpit only and preferably using a mercury thermometer

      Also, I strongly suggest taking Magnesium Citrate for your peripheral neuropathy which BTW, may also be caused by low thyroid hormones. Not only will the magnesium help reduce the inflammation but will also relax your muscles and improve your energy. You can order Life Extension Magnesium Citrate inexpensively from iHerb. (This form is the most efficiently absorbed and really is worthwhile getting as opposed to other forms – don’t get tablets as your digestion is bound to be very poor and you will waste your money). Start slowly with 1 capsule morning and night and increase every few days by 1 cap up to 4 caps per day – you can put it in your water bottle to reduce the risk of loose stools. If you do get loose stools then back the dose off to the highest you can tolerate without that happening. Another way of possibly increasing your magnesium level faster is by using magnesium “oil” which is not really an oil at all, however Professor Vormann, a world renown magnesium expert denies that we can absorb magnesium through the skin. He does however say that it may help to reduce the body’s acidity if you soak in an epsom salts bath (use 1-2 cups in a bath).

      Also, peripheral neuropathy is sometimes caused by vitamin B12 deficiency. If you do have an autoimmune thyroid problem you possibly also have autoimmune destruction of your parietal cells that line your stomach and you should speak to your doctor about being tested and trialling B12 injections if you are deficient.

      • Thank you for responding to my comment!
        I have had several thyroid tests, including rT3 and rT4. My MD and my NMD did not find the results significant. However, I was on NaturThryoid for a couple years, with no results. I do continue to have a low basal temp.
        I discovered, while fighting Cdiff, that I am extremely mineral deficient… especially in magnesium. Now that Cdiff is gone, I continue to need large doses of magnesium (I’m using Natural CALM) day and night just to keep my heart healthy. One day without it and I have migraines, racing/pounding heart, worsened pain, and no sleep. Clearly there is a mineral problem, but as I have changed my diet severely, I can not figure out why my body will not hold minerals- especially magnesium. I did find that my digestion won’t process capsules, so I must take it in liquid. I also do Epsom baths and magnesium oil… both are not enough to function properly. I did take B12 for a long time too, with no results. I’m thinking that if my body won’t absorb the magnesium then perhaps it isn’t absorbing the other supplements either. I have not found a reason that my body isn’t absorbing nutrients. Any ideas?

        • Hi Brenda,

          Leaky gut, which is increased permeability of the intestinal wall, can cause poor nutrient absorption, and has been found to co-exist with most autoimmune disorders.

          I also have Fibro and small fiber neuropathy, and I’ve found that Magnesium Malate helps some and doesn’t give me gastrointestinal issues like Magnesium Citrate does. I’ve also heard good things online about benfotiamine for neuropathy.

    • One more thing Brenda – have you been tested for H pylori? That could be another cause of low B12, and low stomach acid, which in turn hampers your protein digestion and mineral absorption, as well as other aspects of your digestion and can set you up for a whole range of problems in your small and large bowel (bacterial imbalances, infections, parasites etc).

      Hope this helps.

    • Psoriasis became a nightmare for me at age 14, the same time I was diagnosed with Ulcerative Colitis. Now I am 58, have been doing Paleo AIP, low fodmap for about 2 years now. Each time I try to add food back in I seem to return to the psoriasis on my face pretty quickly or I get joint pain when I try to add nightshades. I have come to the conclusion I will probably be on a pretty strict diet for the rest of my life. Am I unhappy, NO! I am thrilled to have found a space to be comfortable in. Another benefit is I no longer have bloody diarrhea, so I am betting my next colonoscopy shows healing as long as I behave myself on the diet. The new recipes I have discovered far surpass the old recipes in flavor, so I have new comfort foods. My cranberry upside down cake is wonderful, non AIP friends have no clue and I don’t tell them because they think the cake tastes great. I make homemade coconut milk and horchata ice cream folks also love. Might take awhile to find recipes for yourself, but I think you will be delighted when you do.

  38. Hi Laura, thank you for a great article. I was diagnosed with Hashimotos in March and got a functional doc that diagnosed me with an h. Pylori infection last May. Based on my history it is possible I have had the h. Pylori infection since I was a teenager (I am in my 40s now) I went through a treatment of antibiotics for the infection in May, and then again recently and am having a tough time getting rid of the infection. It is hard to tell which if my symptoms are from Hashis and which are from h pylori. I had leap testing last May done by a nutritionist and some of my highly reactive foods were chicken, beef, shrimp, peppers, cucumbers and some of my extremely low reaction foods were eggs, tomatoes and cocoa. Dairy fell mid range. I have been off Gluten for a year and off soy protein since April. What would you do under these circumstances? I feel like my h pylori has my intestinal system so messed up that everything I eat makes me sick.

    • Are you using HCL or digestive enzymes? You may have low HCL which means you’re not fully digesting proteins as well as you should be. That’s a common symptom of h. pylori because it shuts down your stomach acid production.

      There are also some natural supplement options for reducing h. pylori.

      Please feel free to get in touch with me if you think nutrition counseling might benefit for you. You can sign up for a free consult and we can discuss your case: http://lauraschoenfeldmphrd.satoriapp.com/book

    • Have a look at the diets that were ranked ahead of paleo and then ask who would benefit from these diets being higher ranked? Clue: not the sweet potato, fermented food and bone broth providers.

    • When you read the description of the “paleo” diet that they used to judge it, it becomes clear why it tested so badly. I don’t remember the details, other than that it was aggressive IF, which isn’t good for everyone, but it was pretty crazy. I don’t remember if it was low cal or low fat or didn’t mention veggies or what, but it really was a terrible diet. Just it wasn’t, you know, what anyone in the paleosphere means by “a paleo diet.”

  39. Hi Laura,

    I’m really stunned what the Paleo diet has to offer.. I have a great passion for food and cooking. I’m always thinking of what i am cooking tonight.. The Paleo cookbook has definitely helped me finding out new (and more importantly) healthy recipes!

  40. “It’s important to note that these tests are only accurate if you’ve eaten the food in question within the past 4-6 weeks.” This is the first I’ve heard of this. I was planning to take Cyrex Array 10, but now I’m wondering what the point is, unless I eat most of the food items on the test within 4-6 weeks of testing. I’ve been on an elimination diet and was hoping to bypass the lengthly reintroduction stage. Your thoughts?

    • Have you looked at the variety of food antibodies that Array 10 tests? I’d be surprised if you weren’t eating many of the foods on that list.

      Usually if I have a patient who wants to bypass the reintroduction protocol entirely, I’ll suggest they get the testing done before doing any eliminations. But testing is expensive and not 100% conclusive, so many of my patients opt to do the elimination and reintroduction protocol. It’s a highly personal choice.

      • I took the food sensitivity testing and it was completely inaccurate. I took it because I was trying to get to the root of my GI symptoms. It said I was not sensitive to many things that I know cause me severe GI upset. I would caution anyone taking these results too seriously. The naturopathic physician I currently work with has had the same problems of inaccuracy that I experienced.

  41. Hi Laura

    I am currently on a low-carb diet to treat my acid reflux, but i also suffer from a leaky gut, so have been doing the reset diet aswell.

    My reflux has calmed down heaps, i hardly get it following this diet, however, i do suffer from bad psorasis, which is disappearing after taking a bio-candid supplement, but its quite persistent. I’m wondering if this is due to having still too many carbs or is could it be eggs? because im only eating whole foods, and eggs are the only inflammatory food left in my diet that i think it could be.

    also , how low is a low carb diet for reflux anyway, and how long should you adhere to it?

    Thanks a million!


    • I’d try removing the eggs for a couple weeks and see if the symptoms improve. I find that eggs tend to be a big culprit for skin related autoimmunity.

      As far as carbs go, I’d need more information about your specific dietary needs to tell you if your carb intake was appropriate!

      • Thanks so much for your reply. If the skin clears up without eggs, could i reintroduce them at a later stage?

        And what sort of info would you need specifically? just approximate would do fine. I’m 6’1 , 71-2 kg, 25, moderately active. I feel fine on a low carb, but im also very mindful of losing weight. and it seems to just fall of me on a low carb diet. So its knowing how necessary it is, and whether having maybe a sweet potatoe accompanying meals would hinder or halt my progress.

        • Unfortunately I can’t give out personalized advice (i.e. medical nutrition therapy) in a comments section of an article, but there may be some good carbs to reintroduce into your diet if you tolerate them. I’d look into low FODMAP carbs to start with.

          Also if you think you might need more one-on-one help with this, don’t hesitate to sign up for a free consult and we can discuss whether nutrition counseling would benefit you: http://lauraschoenfeldmphrd.satoriapp.com/book

  42. have you heard of the protocol for reintroductions where you take your pulse before you eat the food then again afterwards and if your pulse increases you are still sensitive to that food? is it a valid way? Also, when testing as sensitive to a food on
    Cyrex array 4 test, does it mean I have to stop eating it for life, or, can I reintro the food after a period of months?

  43. I have Hashimoto’s as do 3 of my 5 siblings. I thought it is hereditary. Can going extreme Paleo eliminate it? I have been qusi paleo for 2 years meaning I follow it 80% of the time and consume some dairy. I have asked this question repeatedly on forums but no answer – is hashimotos both hereditary and diet? Can I eliminate hashimotos with very strict paleo despite genetics?

    • Autoimmune disease in general is partially hereditary/genetic in nature. Essentially, certain people are predisposed to developing AI disease, and our environment causes the disease to be triggered, whether that be diet, stress, gut issues, toxins, etc. It is possible to significantly reduce antibody production with an appropriate diet and attention to gut health. However AI diseases can not be “cured” as of yet, just managed or put into remission (i.e. no symptoms.)

  44. Hi I often read about the nutritional benefits of liver, and gelatin. I don’t eat much animal food but I do eat fish. Would Cod liver oil be a substitute for beef liver? Also I don’t know if I’m prepared to make fish bone broth, but if gelatin is the main component, is there another way to get it?

    • Cod liver oil is an okay substitute for liver, though it will be lower in the water soluble vitamins like folate and B12. Fish broth does contain gelatin, and you can also buy fish gelatin (though it’s way more expensive than beef gelatin.)

      If you’d consider eating regular beef gelatin, you can get a high quality product with Great Lakes Gelatin.

  45. Thanks for this article. I’ve just started the 30 day reset diet. I’ve been off gluten, dairy, grains and legumes as well as garlic and onions for years but am now doing without nuts, seeds, dark chocolate, night shades and coffee as well. We’ll see how it goes. I have Hashimotos and Graves and recently developed Sjogrens. I would like to know if you have any nutritional alternative to Fermented Foods. I cannot do them because of an inability in my system to process acetaldehyde and any kind alcohol? Also, do you have any information that might help me understand what it is that makes some people on thyroid hormone unable to metabolize alcohol? I have no desire to drink alcohol but my body’s inability to process the alcohols that occur naturally in some metabolic processes mean that I experience hang over symptoms almost daily.
    Thanks again.

    • Hi Cris, have you gotten a stool test to see what your overall gut health is like? There may be some supplements that would help balance your gut flora and improve your intestinal lining’s integrity. I would definitely work with someone to get your gut in shape, especially if you can’t tolerate fermented foods.

  46. Thank you for this awesome article! I have had Hashimoto’s disease for at least 15 years and just learned about dietary influences about three years ago. Since then I’ve followed several protocols including GAPS and AIP. I think the idea of personalizing the protocol after the initial elimination phase is very important since we all have such different food tolerances and reactions.

    One question I have had is this. If we reintroduce potentially problematic foods and have no observable reactions or responses, can we assume that nothing damaging is happening silently on the inside? I seem to do fine with nightshades, but since they cause problems with so many people I wonder what might be quietly happening in my body.

    • Your best bet to ensure that there’s no asymptomatic damage happening would be to get the Cyrex testing I mentioned, as that will pick up any high levels of antibody responses to foods that you’re currently eating even if you’re not getting symptoms. I wouldn’t worry TOO much about this if you’re feeling good and your thyroid antibody levels are fairly low, but if you’re still having Hashi’s symptoms (or any health issues in general) or you have high antibody levels, you may benefit from further testing.

  47. HI Laura–great article! Thanks for clarifying some stuff for me. Any thoughts on someone who has autoimmune AND SIBO? No nightshades, eggs, nuts with the AIP and the addition of no FODMAPS..needless to say, pickings are slim! No improvements in psoriasis even after nearly a month. Could there be something more to eliminate? Holding on to the hope this won’t be forever..

    • If you have SIBO still, that’s definitely going to keep your gut from fully healing, which might be allowing larger proteins to enter into your bloodstream and aggravating your psoriasis.

      I’d focus on treating the SIBO first, because as long as that’s still an issue I wouldn’t expect the psoriasis to improve much. Check out Dr. Alison Siebecker’s work on http://www.siboinfo.com

  48. Excellent article. Thank you. I’m working my way through resolving Hashimoto’s and while not specifically following AIP, most of it is consistent with how I eat. The one area I have challenges with is liver and fermented foods in the nutrient intake section. Maybe someone can offer some suggestions / insight for me related to me specifically:

    1) Fermented foods: I have histamine intolerance (self-diagnosed, but all of the symptoms are there and eliminating high histamine foods alleviates the symptoms) and fermented foods are on the list of “no-no’s” for histamine intolerance. Are there other foods that would have the same nutritional value for AIP but not cause the histamine response?

    2) Liver: I just cannot bring myself to eat liver. If it was the last food source on the planet, I would have to eat it, but I would still have to choke it down. Any suggestions for something that would be almost as beneficial? I do eat buffalo meat for some of the nutritional value that I suspect would be similar to liver.


    • Try calves liver with some caramelized opinions. Find a friend who will cook it properly for you including letting it marinate in milk and then cooking in grass fed butter. Do not use beef liver because it is not tender.

    • I’m not at all an expert of any kind, just wanting to learn and improve my families health. I read this article on fermentation

      and also spoke with the owner of pickl-it jars. I learned that histamine is an issue in ferments not fermented long enough or anaerobic. Supposedly, if I’m remembering correctly, histamine reaches a peak around day 7. So many WAPF recipes and others suggest fermenting for 7-10 days, and the store bought brands only ferment that long too! ( I’ve called a few companies and asked). Apparently if you ferment In a good anaerobic vessel like pickl-it or something similar, AND, you ferment long enough (like a month) then histamine content goes way down! I have to say my ferments in pickl-it jars have been awesome! SOOO much better than the mason jars! We tolerate them better too!

      • Lisa, thanks for your post on fermented foods. I read website by Donna Gates and want to make some of her fermented recipes. I was going to buy mason jars, but wonder where you buy the pickle it jars you recommend? I live in Ontario, Canada.

  49. I started the reset diet 21 days ago and I have been so tired I an not functionning, napping during the day and sleeping 11 hours at night. I am finding it extremely challenging. I had Graves disease so I am on the AIP. I googled “fatigue on Paleo Diet” and all the hits related to getting enough carbs. I am hypoglycemic which indicates I should limit carbs, but I also have hypothyroidism now so need moderate carbs to address that. I am sensitive to sweet potatoes, plantains and bananas and squash wasn’t doing the trick to fill me up or give me energy. Out of desperation two days ago I added a small amount of white rice and immediately my energy improved noticeably. I am eating nutrient dense foods, having bone broth most days, and I eat lots of veggies. I have a histamine intolerance so can’t eat fermented foods. Is the rice going to drastically affect the results of the diet? Is there any reason other than insufficient carbs that I should feel this bad? I was eating paleo plus limited rice and potatoes before I started the reset. The main change for me is the introduction of the AIP which resulted in all joint pain stopping on the 4th day.

    • Sometimes those with hypoglycemic do better with a small amount of carbs at each meal. If you’re not sensitive to rice, then it shouldn’t affect the outcome of the diet. I have many patients and friends with a variety of autoimmune diseases that do just fine with white rice.

  50. I am wondering how to manage a paleo diet with a severe metal allergy that restricts nuts, seeds, legumes, whole grains, and dark leafy greens. I have been reluctant to do the AIP because I am already so limited. I do not have a diagnosed autoimmune disease but I have severe skin issues, particularly where I have had metal implants. I am hypothyroid but not Hashimotos-no antibodies. Any suggestions would be welcome.

  51. Laura, I think people may be afraid to add foods back in because for the first time in a long while, they actually feel good, and they don’t want to lose that. At least that’s exactly the way I feel right now. I’m recovering from a leaky gut and Hashimoto’s currently.

    Also, I think it’s great that you re-affirmed what I have learned from Sarah and Mickey, that this is AIP protocol is a starting point. Once you feel better, you are more able and motivated to making other changes that can benefit your overall physical and mental health.

    I think that maybe what others have taken offense to is the lead in comment: “Some question if the diet is a legitimate way to manage an autoimmune disease, asserting that “a lot of it doesn’t make much biological sense.”

    By the way, who decides what makes biological sense? I hope that no one thinks they actually know all the answers…

    Seems to me that researchers such as Dr. Fasano are still working to figure these things out in regards to the root causes and treatment of auto-immune diseases. I think that comment quoted above was maybe a bit misleading and not representative of your presentation that followed…

    Many thanks to you Laura and of course Sarah and Mickey too!!!

    Heather M.

    • Hey Heather, if you click the link in the sentence that starts with “some question” – you’ll see who I’m referring to when I say that some people in the mainstream media question the validity of the autoimmune protocol.

  52. Any other options for testing other than Cyrex? I live in Canada and it’s frustrating to keep hearing Cyrex as the go-to testing lab, yet Cyrex will not accept samples from Canada.

    • Through the Integrated Health Clinic in Fort Langley, BC,
      the MRT food Sensitivity test by Oxford Biomedical Technologies which is based in Florida

  53. So where was this advice 4 years ago when I needed it? Have somewhat reversed a lifelong autoimmune condition, only to find a second or possibly third one!! (Yes, still tweaking this) I suspect everyone suffering from autoimmunity strongly consider seeing someone highly knowledgeable, and not try to do it all on your own (except if recently presented).

    Felt great for a few months after eliminating foods but slipped far backwards as my adrenals could not handle more stress. Others seem to slip for other gut-related reasons. On no account is rebuilding any system an easy proposition, especially from a lifetime of undiagnosed damage.

    My so-called paleo/primal protocol is based more on trial and error of what works, but decisions I made have been far more complicated than the above presentation would lead anyone to believe. Finally getting round to grass-fed liver. Yes, it may be easy for some people, but not in advanced stages. If you can catch leaky gut BEFORE it starts its downward spiral, that will be much preferred.

  54. “A strict Autoimmune #Paleo Diet isn’t necessary for many people with an #autoimmune disease.” — You cannot go through the elimination phase without being strict, that’s the point of that stage. The tweet prompt makes AIP sound like a life sentence, which is likely to deter people from trying the autoimmune protocol and bettering their health/life incredibly.

    • I strongly disagree. If people know that the strict AIP diet is NOT a life sentence, I believe they’ll be more likely to commit to a couple of months of being strict. I’ve had clients tell me before that they didn’t want to start the AIP diet because they didn’t want to have to be on a strict diet forever.

      I don’t know where the confusion is coming from but the point of this article is to teach people that a strict AIP diet is a starting point, not an end point.

    • It can definitely be helpful but should only be done for a limited period of time. I’ve had clients come to me with exacerbated health issues from staying on the GAPS diet for too long. This is something you’d probably want to work with a certified GAPS practitioner on.

  55. Laura,

    I’m a little confused by your presentation here, as it seems like you are misinformed about the reintroduction process. I’m deeply a part of the AIP community, and the topic of why it is important to reintroduce foods to regain balance following the elimination diet has been a major discussion as of late. As far as I know, there isn’t anyone promoting the elimination diet as a lifelong prescription for autoimmune disease. In fact, most AIP bloggers go out of their way to squash this misconception.

    I find it curious that you mention Sarah Ballantyne’s work, but not that she covers, in detail, all of the recommendations in your post.

    My life was personally changed by using the autoimmune protocol after the diagnosis of Celiac and Hashimoto’s disease. I was on the elimination diet for three months before being able to tolerate nuts and seeds, nine months before being able to tolerate eggs, and two and a half years before being able to tolerate nightshade vegetables (I still can’t do tomatoes). Before I changed my diet I was so fatigued I had lost my job, was housebound and could only get out of bed a couple of hours a day, and had started exhibiting worsening neurological and connective tissue symptoms. To say that this protocol, as outlined in Sarah’s book, saved my life is an understatement.

    Mickey Trescott

    PS–“autoimmune paleo” is the name of my blog and book. I believe the correct term for AIP is “autoimmune protocol,” and some people use “the paleo approach” as referenced in Dr. Ballantyne’s work.

    • Hi Mickey, thanks for sharing your thoughts. Can you explain which part of the reintroduction process you believe I’m misinformed about? If it’s because I mentioned that many of my AI patients are afraid to try reintroducing new foods, I’m not suggesting that there are bloggers promoting the permanent adherence to an AIP protocol for the rest of people’s lives. (As you said, Sarah Ballantyne does a great job at explaining the reintroduction process as well.)

      I’m just describing my experience with patients who have come to me afraid to add any foods back in after being on the strict protocol for months or even a year or more. If anything, I feel my article is simply reconfirming the advice to reintroduce foods after trying the elimination protocol for 30-60 days or longer.

      • Hi Laura!Could you please tell e from your experience of people with scleroderma have good results after being on the AIP.Thank you!great article.

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