AIP Diet: What It Is and How to Personalize It for Best Results

AIP Diet: What It Is and Specific Steps for Personalizing It for Best Health Results

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Reviewed by Tracey Long, MPH, RDN

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

AIP Diet
Personalizing your AIP diet could allow you to eat foods that are typically prohibited, like peppers. iStock/vanillastring

The Autoimmune Paleo Protocol diet (also known as the Autoimmune Protocol, or AIP, diet) is a fantastic way to start seeing a vast improvement of autoimmune disease symptoms. However, the major issue I see frequently is that once someone has seen success on a strict AIP diet, 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 AIP diet is that not everyone with an autoimmune disease needs to be on this diet indefinitely.

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

My goal when I work with clients is to get them on the least restrictive and simplest diet possible 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 AIP diet need not be followed strictly for the rest of one’s life.

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

If you have an autoimmune disease, you’ve likely heard of the AIP diet. But do you know how to personalize it and, potentially, reintroduce foods that you once had to avoid? Check out this article to find out. #AIP #paleo #wellness

What Is the Autoimmune Protocol Diet?

The goal of the AIP diet is to remove foods that could trigger inflammation or harm gut health and instead eat nutrient-dense foods that promote health, like:

  • Bone broth
  • Liver
  • Fermented foods
  • High-quality meats
  • Leafy and cruciferous vegetables
  • Healthy fats from whole plants and animals

Based on a general Paleo template, the AIP diet focuses on removing foods like:

The AIP diet routinely gets a lot of attention, 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.”

However, 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 clients who were able to successfully implement the AIP and eliminate many of their symptoms, whether they were suffering from Hashimoto’s disease, Sjögren’s syndrome, 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.

But as I mentioned above, the introductory AIP diet is highly restrictive, and for some people with autoimmunity, it doesn’t need to be followed forever. That’s why it’s so important to take steps to personalize your AIP diet. 

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 suggest that someone with an autoimmune disease who is currently eating a standard American diet start with the normal Paleo 30-day reset.

Many people with autoimmunity 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 AIP can be overwhelming for many people, which is why I generally suggest starting with the standard Paleo approach if you haven’t done so 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 AIP diet restrictions, as well. This means additionally eliminating eggs, nightshades (e.g., potatoes, tomatoes, eggplant, peppers), and 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 produces antibodies that incite an attack on your immune system. This autoimmune attack can last for days, weeks, or even months if the intake was significant enough. Committing 100 percent to the reset time period is crucial for a person with an autoimmune disease to see the improvements they’re looking for.

It’s important to acknowledge that an AIP 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 AIP supplements may be necessary to maintain the body’s optimal functioning. There is no shame in using conventional medicine in addition to a dietary and lifestyle approach to healing.

That said, by removing the foods and toxins that contribute to the autoimmune response and providing adequate nutrients to fuel the healing process, you can significantly reduce symptoms and even possibly put the disease into remission.

AIP Diet
Adding nutrient-dense fatty fish to your AIP diet could help your body heal from autoimmune disease.

2. Optimize Your Nutrient Intake

Speaking of adequate nutrients, simply 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
  • Large amounts of colorful vegetables
  • High-quality meats and fats
  • Fatty fish and shellfish
  • Fermented foods

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

Another unexpected benefit of focusing on adding foods is the impact your total calorie intake will have on healing. In this interview with Eileen Laird, I explain the very common challenge many of my clients following the AIP diet face: undereating. With the number of restrictions on a strict AIP diet, it’s very easy to fall into the trap of not eating enough total calories. And no matter what your health challenges are, chronic undereating is a recipe for worsened health.

Be sure to emphasize adding more of the following foods, along with eating enough total calories, as you work to heal your body from any autoimmune disease.

Liver, Fatty Fish, and Shellfish

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 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 immeasurable importance. (Discussing leaky gut in detail is outside the scope of this article, but if you’re looking for more information on leaky gut, check out this episode of Revolution Health Radio.)

Fermented Vegetables

Fermented vegetables not only provide beneficial probiotics, they also contain 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

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 an autoimmune disease.

While many of my clients with autoimmune disease 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 disease to make the effort to add these foods in regularly.

3. AIP Reintroduction Stages: Take a Systematic Approach

The benefits of reintroducing non-AIP foods are three-fold:

  1. You may be able to tolerate nutrient-dense foods like eggs and dairy, which may improve your body’s ability to heal.
  2. 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.
  3. 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 return. While some people have an immediate and strong reaction to foods they eat that they have immune activity against (gluten is a big culprit here), others have only 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, and even non-Paleo foods like white rice and legumes, 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., first 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 three 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 a new, “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 culprits. I typically see most clients with autoimmune disease getting their testing done through Cyrex Laboratories, which tests for both immunoglobulin G and immunoglobulin A antibodies and can detect intolerances to a wide variety of foods.

They’ve 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 who’s not seeing the improvements they were hoping for. Array 4 is another Cyrex test that I frequently use for clients 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 accurate only if you’ve eaten the food in question within the past four to six weeks. So if you’ve been dairy-free for six 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 an exacerbation of symptoms.

It’s also very important to note that many food sensitivity tests are on the market these days, and most of them are questionable when it comes to their usefulness. There are many reasons why I don’t recommend most food sensitivity testing, such as lack of evidence to support their accuracy, as well as the potential for the results to create disordered eating habits in the person taking the test. Not to mention, those tests can distract a person from addressing the root cause of their food sensitivity, and eliminating those sensitivities by healing the body appropriately.

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 taken care of.

Exercise

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 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
  • Limiting sedentary behavior

Manage Your Stress

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 MS, Crohn’s disease, psoriasis, and rheumatoid arthritis. (14)

One study even found that chronic psychological stress is associated with the body losing its ability to regulate the inflammatory response. (15) The researchers 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 non-negotiable for my clients with autoimmune disease. There are dozens of different ways you can manage stress, from yoga, to meditation and prayer, to planned social occasions with loved ones. Petting a dog, getting a hug from a significant other, or getting a monthly massage can all be stress-relieving activities, as well. There are so many ways to reduce stress; the most important thing is to pick a few that work best for you and your lifestyle.

Sleep

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. (16) 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 provided in this article, and read Dr. Ballantyne’s excellent post on the role of circadian rhythms in regulating hormone cycles and how to get your rhythms back on track.

Spend Time Outdoors in the Sun

Sunshine is the best source of vitamin D, and healthy 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 the vitamin is also used as a treatment for reducing the symptoms of autoimmune disease. (17, 18, 19, 20)

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.)

Avoid Toxins

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 phthalates. (21) Phthalates are relatively common chemical “plasticizers” that are found in everything from detergents, to building materials, to plastic food and beverage containers, to 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 plastic, 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 five tips for personalizing your AIP diet, 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, long-term 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 Functional Medicine practitioner to work with, such as the ones at the California Center for Functional Medicine.

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

Some people with autoimmune disease need to follow a strict AIP diet—but for many with an autoimmune condition, that’s not necessary. They may find, while working with a dietitian or nutritionist, that they’re able to tolerate some foods, while others exacerbate their condition.

Understanding which foods help and which ones harm is just one step in the healing process. The next step? Working with a health coach who is able to help their clients implement the changes a practitioner recommends.

Health coaches are experts at offering support and empowering people to make sometimes difficult changes. Those changes could include letting go of some well-loved foods or adopting different daily habits that will better support immune health.

The ADAPT Health Coach Training Program teaches coaches the skills they need to support their clients as they make those changes happen. We also delve into core concepts of Functional Health, including the diet variations like AIP.

Health coaches are an important part of any collaborative healthcare team—which is one of the reasons why the career is continuing to grow. Learn more about what health coaches do and find out whether this could be the right career path for you with the ADAPT Health Coach Training Program.

164 Comments

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  1. “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.

  2. 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!

    Guy

    • 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

  3. 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?

  4. 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.)

  5. 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?
    Thanks
    Jillian

    • 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.

  6. 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.

  7. 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.

  8. 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

  9. 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.

    Thanks!

    • 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
      http://www.nourishingtreasures.com/index.php/2012/05/15/the-science-behind-sauerkraut-fermentation/#comment-14587

      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.

  10. 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.

  11. 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.

    • I would suggest working with a qualified practitioner, as your health issues sound fairly complex and likely need an in-depth case review to determine what might be going on in your body.

  12. 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.

  13. Excellent article Laura! This is a great intro for my AIP clients. They can start here and then move on to Sarah’s book without feeling overwhelmed.
    Thanks!

  14. 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

  15. 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.

  16. “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.

  17. I would be careful what seafood I eat since so many are high in mercury.

    So check out what you are buying.

  18. 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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