The Autoimmune Protocol

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TPA as a bookThe Paleo Approach is now available!   If you want the nitty gritty details (explained in an approachable way!), the diagrams and illustrations, the scientific citations, all of the information in one place, FAQ, information on supplements, help troubleshooting, practical implementation tips,  food lists, it’s all in my book:

Buy Now!

Note:  I will always keep this cliff notes version of the autoimmune protocol here for free for everyone to see.  That’s right.  I’m not holding this information hostage.  While my book goes into far more detail and explains the detailed WHYs behind these recommendations, you don’ t need to buy it to start making positive changes that can help regulate your immune system and heal your body.

Interested in learning even more about The Paleo Approach? This video from my YouTube Channel is just a quick tour (the book is so big that giving you a broad overview takes 13 minutes!) but you get to see just how comprehensive and detailed this book is.

My original research into the dietary guidelines for those with autoimmune disease started with the recommendations in The Paleo Solution, The Paleo Answer, and various podcast and YouTube interviews with Robb Wolf, Prof. Mat Lalonde and Dr. Terry Wahls (author of Food As Medicine and Minding My Mitochondria). These are all great sources for more information while you wait for my book to be released. However, as I have delved into thousands of scientific studies (1200 of which are referenced in my book) evaluating the roles of nutrients, hormones, and the bacteria in your gut in the development or prevention of autoimmune disease, I have refined these recommendations to reflect my new-found (very thorough) understanding of how the foods we eat interact with our gut barriers and influence our immune systems.

Autoimmune disease is caused by the immune system losing the ability to differentiate proteins belonging to your own body with proteins belonging to a foreign invader (like a bacteria, virus or parasite). What causes symptoms is the build up of damage to cells, tissues and/or organs in the body–damage caused by your own immune system attacking those cells. Which proteins/cells are attacked is what separates once disease from another. In Hashimoto’s Thyroiditis, the thyroid gland is attacked. In Rheumatoid Arthritis, the tissues of your joints are attacked. In psoriasis, proteins within the layers of cells that make up your skin are attacked. However, the root cause is the same.

Genetic predisposition to autoimmunity makes up about one third of your risk of developing an autoimmune disease. The other two thirds of your risk come from environmental factors, which include: diet, lifestyle, infections (both prior and persistent) exposure to toxins, hormones, weight, etc. While you cannot control your genetics or whether or not you had mono as a kid, you do have an immense amount of control over your diet and lifestyle (and the extent that these affect hormones and weight and even toxin exposure). By removing the foods that contribute to a leaky gut, gut dysbiosis (the wrong numbers, relative quantities, or types of microorganisms typically growing in the wrong locations in your gut), hormone imbalance, and that stimulate inflammation and the immune system, you can create the opportunity for your body to heal. By addressing important lifestyle factors and changing your focus to eating nutrient-dense foods that support optimal gut health (and optimal health of your gut microorganisms), that restore levels of important nutrients and provide all of the building blocks that your body needs to heal and properly regulate the immune system, that help resolve inflammation and support organ function, you create an environment in your body conducive to healing.

This is not a cure (once your body learns to attack itself, it can never un-learn this), but you can put your disease into remission, often permanently. Depending on how long you have had your disease and how aggressive it is, there may be permanent damage (which might, for example mean that you need to take organ support supplements such as thyroid hormone in the case of Hashimoto’s thyroiditis for the rest of your life), but you can stop your immune system from attacking your body and heal substantially.

This diet is appropriate for everyone with diagnosed autoimmune disorders or with suspected autoimmune diseases. It is very simply an extremely nutrient-dense diet that is devoid of foods that irritate the gut, cause gut dysbiosis and activate the immune system. You will not be missing out on any nutrients and this diet is absolutely appropriate to follow for the rest of your life. If you have a specific autoimmune disease that causes extra food sensitivities, those should be taken into account with your food choices. Because I get asked this question more than any other question: yes, this diet will help you.

One of the most important contributors to autoimmune disease is nutrient deficiency (which of course, is built right into the Standard American diet, which while being rich in energy is very poor in actual nutrition). Even if you have been following a paleo, primal, GAPS, SCD, or WAPF diet for a while, it is likely that you have not corrected nutrient deficiencies (if you had, you probably wouldn’t be reading this page).

Gut dysbiosis and a leaky gut are believed to be involved in all autoimmune diseases (and are present in every autoimmune disease which has been tested). The presence of gut dysbiosis and a leaky gut are directly related to diet and lifestyle (the foods you eat, the foods you don’t eat, how much sleep you get and how stressed you are). The diet recommendations of The Paleo Approach are all designed to help heal the gut, to restore normal/healthy gut microorganisms, to reduce inflammation and to regulate the immune system both through healing the gut, regulating hormones and addressing micronutrient deficiencies.

My understanding of autoimmune disease goes beyond diet. The Paleo Approach will go into great detail about exactly why prioritizing sleep, managing stress, protecting circadian rhythms, and incorporating plenty of mild to moderately-intense activity (and avoiding strenuous activity) into your day is also exceptionally important. In fact, if you ignore these lifestyle factors, you might completely undermine all of the efforts you are making with your diet.

The first dietary recommendation for those with autoimmune disease is to adhere to a strict paleo diet with no cheating. To be clear, this means: no grains, no legumes, no dairy, no refined sugars, no modern vegetable oils, no processed food chemicals. While other people may be able to enjoy the occasional bowl of rice or corn chips or even ice cream, if you suffer from an autoimmune condition you are not one of these people. Gluten should be banned for life. Grains and legumes should never be consumed. Dairy of any kind (even grass-fed ghee which can still have trace lactose and dairy proteins!) should be avoided initially. This may be true for the rest of your life but some people may be able to reintroduce many foods after their diseases are in remission.

In addition, if you have an autoimmune condition, you should completely avoid:

There are a variety of reasons these are omitted, including: causing gut irritation, causing gut dysbiosis (overgrowths are most common), acting as carrier molecules across the gut barrier, acting as adjuvants (stimulating the immune system), increasing gut permeability, causing inflammation. In addition, you should ensure that your blood sugar levels are well managed (this should happen naturally but for those with a history of diabetes, obesity, and/or metabolic syndrome, using a glucometer may be helpful). This does not mean low carb. It just means not high carb.

There is also some evidence that hormonal birth control can contribute to hunger and digestive hormone dysregulation, leading to inflammation and immune activation.

Perhaps even more importantly than removing foods that negatively impact gut health or stimulate the immune system, is eating a nutrient-dense diet. Micronutrient deficiencies are the strongest diet-related factors contributing to increased risk of autoimmune disease. If you have autoimmune disease, it is highly likely that you are deficient in one or more of: fat soluble vitamins (A,D,E,K), several minerals (zinc, iron, copper, magnesium, selenium, iodine, etc.), B-vitamins, vitamin C, antioxidants and other non-vitamin nutrients (like CoQ10), omega-3 fatty acid (in relation to omega-6 fatty acid intake), certain amino acids (like glycine), and fiber.

So, just as some foods should be eliminated, there is also a focus on eating more of the following:

  • organ meat and offal (aim for 5 times per week, the more the better)–read more here.
  • fish and shellfish (wild is best, but farmed is fine) (aim for at least 3 times per week, the more the better)–read more here and here.
  • vegetables of all kinds, as much variety as possible and the whole rainbow, aim for 8-14 cups per day
    • Green vegetables
    • Colorful vegetables and fruit (red, purple, blue, yellow, orange, white)
    • Cruciferous vegetables (broccoli, cabbage, kale, turnips, arugula, cauliflower, brussels sprouts, watercress, mustard greens, etc.)
    • Sea vegetables (excluding algae like chlorella and spirulina which are immune stimulators)
  • quality meats (grass-fed, pasture-raised, wild as much as possible) (poultry in moderation due to high omega-6 content unless you are eating a ton of fish)
  • quality fats (pasture-raised/grass-fed animal fats [rendered or as part of your meat], fatty fish, olive, avocado, coconut, palm [not palm kernel])
  • fruit (keeping fructose intake between 10g and 20 g daily)
  • probiotic foods (fermented vegetables or fruit, kombucha, water kefir, coconut milk kefir, coconut milk yogurt, supplements)–read about them here and here.
  • glycine-rich foods (anything with connective tissue, joints or skin, organ meat, and bone broth)

You can also improve your intake of important trace minerals by switching to Himalayan Pink Salt or “dirty” sea salt. Other tips like eating locally-grown organic produce can make a big difference (both in terms of micronutrients and in terms of probiotics). It is also very helpful to drink plenty of water between meals and to make sure you are consuming enough food. The body is not very efficient at healing itself when you are running a caloric deficit (you shouldn’t have to gain weight to heal, but losing weight may be a competing goal for now). If you are underweight or worried about losing weight, see this post.

Fruits and vegetables may be consumed raw or cooked. I recommend eating the rainbow and including something green with every meal (or at least most of them) and as much variety as possible. The only fruits or vegetables that are restricted on The Paleo Approach are nightshades and legumes. Dried fruit are high sugar and should be reserved for occasional treats due to their potential impact on blood sugar. All other fruits and vegetables are low or moderate glycemic load (which is more relevant than glycemic index in terms of impact on blood sugar) and the vast majority of people will be able to sufficiently regulate blood sugar levels without limiting or counting fruits or vegetables at all. In fact, eating a large amount of vegetables is really important and I think that there are so many fears about which vegetables might be bad (starchy vegetables for SIBO, FODMAPs, Salicylates, histamines (teaser excerpt from The Paleo Approach on this coming soon), goitrogens, insoluble fiber, high sugar from fruit, etc.) that people under-eat fruits and vegetables to the detriment of their healing. While some of these are certainly worthy areas to explore should you not experience dramatic improvement in 3-4 months, unless you have diagnosed fructose malabsorption or diagnosed histamine or salicylate sensitivity, that isn’t where you should start. Don’t like vegetables? I don’t care. Eat them. Eat liver, fish and oysters too.

Some quick myth-busting and FAQ:

  • Starchy Vegetables (GAPS, SCD): Avoiding starchy vegetables for SIBO has not been validated in the scientific literature (but eating low FODMAP has been proven very effective for people with IBS, IBD and SIBO). Many people do anecdotally find symptom relief from starving overgrowths with these very low carb approaches, but the low carbohydrate/fiber intake can be stressful on the thyroid and cause dysregulated cortisol (and both of those are bad!). The two diet factors that have been shown in the scientific literature to have the most dramatic corrective impact on gut microorganims is high omega-3 fatty acid intake (lots of fish!) and high fiber intake (from vegetables and fruit), both soluble and insoluble. If you do have confirmed SIBO or strong gastrointestinal symptoms, you may want to combine the autoimmune protocol with a low FODMAP approach or you may wish to save low FODMAP for troubleshooting a month or two down the road.
  • Insoluble fiber: While insoluble fiber gets a bad reputation as being an “irritating” fiber, recent studies actually show that higher insoluble fiber intake speeds healing in models of colitis and diverticulitis. Also, the higher the intake of insoluble fiber, the lower the chances someone will have high c-reactive protein (implying that it reduces or prevents inflammation). Soluble fiber reduces the chance of having high c-reactive protein too, but not as much as insoluble fiber. Insoluble fiber also reduces risk of cancer and cardiovascular disease. I can’t find a single scientific journal article that actually shows that insoluble fiber irritates the gut and I have a feeling this is myth. Instead, I can find evidence that it reduces bile acid loss (which ultimately improves digestion), is an essential signal for ghrelin suppression after meals (which has a ton of different important effects in the body), that it improves insulin sensitivity, and helps to remove toxins from the body. I can’t find a single reason why insoluble fiber should be limited. If you have intact pieces of high insoluble fiber vegetables in your stool, add digestive support supplements (especially plant enzymes) and try limiting yourself to cooked vegetables until your digestion improves. For more information, see Part 1, Part 2, Part 3, Part 4 and Part 5 of my Fiber Manifesto series.
  • Goitrogenic vegetables for thyroid disorders: Again, there is no scientific evidence for their exclusion even for those with thyroid disorders. I explain in detail in this post.
  • Fruit: Many people avoid fruit because it is high in sugar. If you have FODMAP-intolerance, you will want to avoid high fructose fruits and everyone will want to keep their fructose intake below 20g per day, but fruit in moderation is endorsed and is actually a great source of vitamins, minerals, fiber and antioxidants. Depending on which fruit you choose, and how you define a serving, you can typically enjoy 2-5 servings of fruit per day and stay below 20g of fructose.
  • Omega-3 intake is very important: Aim for between 1:1 and 1:3 ratio of omega-3 fatty acids to omega-6 fatty acids. If you eat grass-fed, pasture-raised meat, not too much poultry, and some fish, this will be natural. If you eat more conventional meat or more frequent servings of poultry, you will need to increase your intake of oily cold-water fish (like salmon, mackerel, sardines, herring, kipper, anchovies, trout, fresh tuna, and carp). Rendered animal fats used for cooking should always come from grass-fed or pasture-raised animals. Omega-3 fatty acid intake is one of the most important factors for correcting gut dysbiosis. It is better to get your omega-3 fats from fresh fish rather than fish oil. Plants-based omega-3s are predominantly ALA, which is not as usable by your body as the long chain DHA and EPA in fish and pasture-raised/grass-fed meat. Increasing omega-3 fatty acid intake has been shown to dramatically reduce the need for NSAIDs in patients with Rheumatoid Arthritis.
  • Protein is important: You can heal your body by limiting your animal-based foods to fish and shellfish, but you need protein. The protein in fish and shellfish is more digestible than meat (and meat protein is more digestible than any protein from plants), which may be relevant for those with severely damaged guts.
  • Vegetables are important: don’t skimp on the vegetables. If you are a person who has a very hard time eating large servings of vegetables, smoothies or vegetable juices might be consumed in moderation as part of a meal (and not as a meal replacement because chewing is an important signal for digestion). If you have trouble digesting large amounts of vegetables (if you have any gastrointestinal symptoms or can identify intact vegetable particles in your stool), try taking digestive support supplements with your meals and limiting yourself to cooked vegetables initially (plant enzymes are especially helpful for breaking down fiber).
  • Gray Areas: egg yolks, legumes with edible pods (such as green beans and snow peas), walnut oil, macadamia nut oil, grass-fed ghee, and gluten-free alcohol when used in cooking are gray areas. I suggest omitting them in the beginning, but can typically be reintroduced much earlier than other foods. Whole coconut products (coconut butter, coconut cream concentrate, creamed coconut, coconut flakes, coconut chips, fresh coconut) should be consumed in moderation (due to being very high in inulin fiber and moderately high in phytic acid). Coconut milk and coconut cream (not to be confused with creamed coconut or coconut cream concentrate) should be guar-gum free and limited to 1 cup per day. Coconut oil is fine if well-tolerated.
  • FAQ Foods:
    • carob, rooibos tea, black and green tea in moderation, DGL, apple cider vinegar, wine vinegar, balsamic vinegar, coconut water vinegar, coconut water in moderation, vanilla extract (if cooked), pomegranate molasses in moderation, maple syrup and maple sugar very occasionally, honey very occasionally, dried fruit very occasionally, dates and date sugar very occasionally, molasses very occasionally, unrefined cane sugar (sucanat, evaporated cane juice, muscovado, very occasionally, coconut aminos, are okay.
    • algae (chlorella, spirulina), wheat grass (contains wheat germ agglutinin), barley grass, brown rice protein, pea protein, hemp protein, licorice root (except DGL), aloe, slippery elm, chia, flax, lemon balm (tea is probably okay but avoid in supplement form), commercial egg replacers, decaf coffee, herbal sleep aids that contain oat seed, some adaptogenic supplements (ashwagandha is a nightshade), are not okay.
  • Meal FAQ: It is better to eat larger meals spaced farther apart and not snack, unless you have a very damaged gut that can not handle digesting large amounts of food all at once. If you are used to grazing, transition slowly. You should not intermittent fast if you have autoimmune disease. You should not endeavor to be in nutritional ketosis if you have an autoimmune disease (teaser excerpt from The Paleo Approach on this coming soon). You should not eat when under duress. It is better to avoid excessive liquid with your meals, chew your food thoroughly and not rush to the next activity when you eat. You should not eat within 2 hours of bedtime (disrupts sleep). Meals should always include animal foods and plant foods (within the guidelines above), including a quality fat source, and some carbohydrates. There are not firm guidelines for proportion of your meals that are protein, fat and carbohydrate (make sure you get “enough” of each, and then just eat what makes you happy).
  • Useful Supplements:
  • Quality Matters (but it isn’t everything): the better quality food you can source, the better. But if you just can’t afford all grass-fed/pasture-raised meat, wild-caught fish, and organic locally-grown produce, just do the best you can. My post on the importance of grass-fed meat contains some suggestions for incorporating it into your diet in a budget-conscious way. This post ranks different animal proteins to help you prioritize which ones to buy. Whole9Life has a wonderful chart on when fruits and vegetables are in season including which fruits and vegetables are important to buy organic and which aren’t, if budget is an important concern.
  • Your body knows best: If you know that a food that is omitted from The Paleo Approach works very well for you (such as raw grass-fed dairy) or if you know that a food normally recommended on The Paleo Approach does not work well for you (such as coconut oil), then it’s find to modify accordingly. If you aren’t sure or aren’t seeing success, go with the above recommendations. If you find something that truly works for you, whatever it is, stick with it.
  • Reintroductions: Ideally, you should wait until your disease is in full remission before attempting reintroductions (which are discussed in this post). If you are feeling very deprived, you may choose to attempt some reintroductions once you are no longer taking DMARDs or steroids and can see substantial improvement in your disease symptoms. If you do not feel deprived, there is no compelling reason to reintroduce any foods.

Don’t forget the crucial importance of: getting enough sleep (at least 8-10 hours every night), managing stress (mindful meditation is very well studied in the scientific literature and universally shown to be beneficial), protecting circadian rhythms (being outside during the day, being in the dark at night and avoiding bright lights in the evening), nurturing social connection, having fun, making time for hobbies, relaxing, and getting lots of mild to moderately intense activity (while avoiding intense/strenuous activity).

I know from experience that this is a very challenging task. I also know from experience that, in many cases, 90% is not good enough (and the more serious your condition, the more important compliance is until your body has healed). I know from experience that this increases your food budget (although perhaps this can be negated by decreasing your medical expenses). I try to focus on the delicious foods that I do get to eat (yes, there are lots of them!). I try to focus on the fact that I have a strategy for improving my health that is far more powerful than any prescription medication (Note that in many cases you will still need to be on prescription medications, especially those that support organs attacked by your disease, although you may be able to reduce your dose. Please work with your doctor on this one!). And, compliance gets much easier once you start to see improvement (how long this takes will be different for everyone, but typically anywhere from a couple of days to a couple of months). It’s only effort until it’s routine.

Additional Resources

Autoimmune Paleo CookbookWant a great cookbook to help you get started (and while you wait for my cookbook to be released)? The Autoimmune Paleo Cookbook was written by my friend Mickey Trescott.  The print version which was just released contains 150 recipes and the e-book version contains 110 autoimmune protocol-friendly recipes including some wonderful treats (and only 3 or 4 are similar to recipes in the e-book version and about a dozen in the printer version as what will be included in my book, so it’s a great compliment to The Paleo Approach). Read my full review of the e-book version here and see preview recipes here and here.

My friend and functional medicine specialist Anne Angelone has written a set of very handy guides to help you get started, including:

These are great additions to your paleo autoimmune library. And, you can actually get all three and a bunch of other great stuff in Anne’s The Autoimmune Paleo Breakthrough Kit.  This is definitely worth checking out.

newkit2

Consulting Services

Finally, if you find yourself needing help and 1-on-1 support throughout this journey, then I encourage you to check out my new consulting company:

Consulting Logo

Whether you are just beginning your wellness journey or are a seasoned traveler on the wellness path, you may find you need help getting started, troubleshooting roadblocks, optimizing health, figuring out which labs to request from your doctor, or just need support during this major life change. Our consultants can help!

When you work with one of our consultants, you can expect:

  • A thorough review of your health history to establish goals while recognizing obstacles.
  • A fully customized plan tailored to meet your individual needs so that you can reach your goals.
  • Expert guidance to help you navigate your unique challenges.
  • Frequent communication to answer your questions, to adapt recommendations, or optimize your approach as needed, and to provide compassion and encouragement.
  • Concrete strategies to help you succeed.
  • Support every step of the way.

Click here and read the consultant bios to find out how you can get a FREE 10-minute informational consult to help you determine the best choice for you.

Comments

I cannot find anything on pregnancy and leaky gut. if you are doing AIP protocol due to leaky gut and an autoimmune disease (hypothyroidism), what happens if you get pregnant? is it dangerous for baby? I asked my ND but she made it seem like it was a personal decision. I’m not on any type of bc method but i don’t want to hinder progress and haven’t been able to find any information on the subject.
Also, if you have a large majority of food intolerances, how does your body not develop an intolerance to what you are “permitted” to eating? For instance, I can only eat red meat, pork and seafood so how does my body not develop a sensitivity to these things if I’m still trying to heal my gut?

Thanks for your help!

The AIP should be fine during pregnancy, provided you are eating enough variety, including organ meats. Many women find that they are able to tolerate other foods just fine during pregnancy, due to the change in the immune system. The AIP-approved foods are less likely to cause allergies or sensitivities than the not-allowed foods and contain nutrients that promote gut health. It is unlikely to develop sensitivities to them, again, provided you are eating enough variety. – Christina, Sarah’s assistant

Have you ever heard of Biofilm in an Immunocompromised person? I remember having this arthritic condition back in high school called Costchondrities…what healthy person would have this condition…right?
Anyway I have had numerous MD’s screw up on me with the bacterial/fungal overgrowth 5 years ago…diagnosed first with candida in 1991, when diagnosed with EBV, Chronic Fatigue, and Cytomegalovirus…never breast fed…put on antibiotics over the course of my life….Mitral valve prolapse diagnosed after 1991…put on Clindomycain and Cipro for the CMV…never been the same. I knew I was struggling with something from an early age with anxiety, depression, hypochondria and pulling out my hair….severe allergies at the age of 9.
Allergic to tomatoes with hives. Given sulfa antibiotics for tonsillitis at the age of 4. I am so mad at Dr. Spock for not recommending breast feeding….how screwed up is this world. I am on the AI Gaps diet…but I have this film over my intestinal lining…I took some interphase that has egg whites in it and it released a bunch of bad bacteria, yeasts into my system…How am I going to heal my gut when there’s this film lining my gut/intestines? I used to drink alcohol in excess unknowingly from 1995 to 2005….damaged my gut lining too. Trying to heal myself but its incredibly difficult….I feel so lost in this world due to how I came into the world at a deficit. Please if you can offer me any suggestions.

Look up “The Hungry Microbiome” on youtube. It is a short video on resistant starch and butarate. Not saying resistant starch is your answer but butarate’s job is protecting and healing the impereamable intestine lining that when damaged is a cause of leaky gut. Potatoes starch is one of the best sources of resistant starch. Bobs Redmill Potatoe Starch

I started the AIP last week. I am having an issue with healthy fats, and I would like to know if this is common. I was having some minor heartburn from my green smoothies when I would add a 1/2 avocado. I then had a whole avocado yesterday with a can of tuna fish, as well as some veggies and spices (a quick lunch). Within an hour I was extremely ill (will leave out the details). I didn’t eat anything else the rest of the day. For lunch today, I had some ground turkey with mushrooms, onions, broccoli, cauliflower, kale and sauerkraut (cooked with coconut oil). Within an hour or so, I was having severe GI issues again. Is this normal when you are new to the AIP?

Have you looked at foods high in histamine being an issue for you (histamine intolerance)? Some very healing foods can be high in histamine so even though avoiding them completely may not be the answer at least introducing them in slowly might help your symptoms. Canned fish, sauerkraut, avocado, mushrooms…..

Rachel, I have never heard of histamine intolerance, but it is definitely something I need to look into, as well as the fodmap intolerance Christina mentioned above. This is all very new to me. I was recently diagnosed (within the last few weeks) with Celiacs Disease after over 6 years of going to the doctor every 6 months saying “I am a runner and I know my body, something is not right. I should not have to train for a marathon just to maintain my weight ” I am quickly learning here that I may have done a lot more damage to my gut and system during this 6-year time period than I ever could have anticipated.

Dear Paleo mom,

I am writing you out of great need for your advice and opinion. I am an eczema suffer I have been for many years some years have been worse than others. The last 6 years have been hell. At one time 80% percent of my body was affected by acne and or eczema In 2013 I made great dietary changes I went completely vegan, gluten free, dairy free, soy free and grain free about 50 percent of my eczema went away as long as I stayed away from these things and my acne vanished. I started taking various supplements like zinc, slipper elm, drinking oolong tea but caffeine causes problems so I removed it. I was taking mega flora probitics for a while but I decided I’d make my own milk kefir and water water kefir. I tried goats milk but I have an extreme allergy to goat and sheep milk I mean is I touch the milk and a drip gets on my hands it swells and breaks out in white bumps the same thing happen with cows milk now as well. I don’t eat any nightshades because they cause reactions as well. I recently stopped having buckwheat flour. I don’t eat sugar unless it’s in the former of fruit I have cut fruit to for now with the exception of blackberries, or a granny smith apple very sparingly. I thought that maybe going paleo would help me finish healing since I can tolerate grass fed beef and now chicken (occasionally chicken use to send my body in a massive attack.) I can also tolerate shell fish but I can not eat fish I am high allergic is i’m in the room with fish my eczema goes insane so you can only imagine what happens if i happen to touch fish by products or fish. I tried adapted krill oil but right now I can’t take it with out an reaction now I can’t have probitics like garden of life primal defense with breaking out. I started incorporating meats back in my life grass fed steak and now liver daily or every other day when I’m low on cash and supply. I have started drink around a cup and a half of water kefir since I don’t react to this. I have started drink large quality of bone broth like 5 cups or more almost daily when I don’t drink 5 cups or more I still mange around 2 or 3 cups. I also slowly incorporated great lake collagen. My eczema has worsened it has actually came back and covered my stomach it is now started to come under my armpits and my patches in the bends of my elbow are constantly itching again all these places would give me occasional problems especially the week before my time of the month and during my time of the month. My eczema is constantly enraged between my thighs behind both knees on my upper and lower thigh and calf’s. My eczema has been relentless for around 3 and half years now. I’m starting to get depressed again it doesn’t look like this is ever going to be resolved I have prayed about it, changed my eating habits, went on fasts, taken all kinds of supplements sought he help of dermatologist and naturopaths I have spent the last 3 years in constant research trying to get rid of this stuff I have no idea how much money I’ve spent I can’t afford to keep this up I have maxed out credit card blow through my saving and I still can’t shake it. At this point there appears to be only 1 way out and that’s death I’ve been considering the last option very seriously life is not worth living if I have to keep living this way. My skin is always itching, bleeding, burning, stinging, or something I don’t even care if the areas are discolored for the rest of my life I just want the pain and itching to stop! I would give my life for one day with out all this! I can’t sleep at night anymore because of this! I’m going insane more and more daily I can’t get through meditation, I can’t exercise any more I’m afraid to go any where or to do anything now because of this. I use to be a group fitness instructor and a very active person. I just want a piece of my life back. The week before and during my time of the month are even worse it covers places on my body that doesn’t usually have eczema and makes my active eczema patches even worse! I really can’t make it through another menstrual cycle like this I’ve told my family this. I’m not sure if they understand what I meant by this exactly but the last option looks like the way out. If you can please be of any help it would be beyond appreciated! I sincerely mean this! By the way congratulation on you book I look to by it at the end of the month when I get paid again. Thanks and wishing you all the best!!

I am so sorry to hear that you are continuing to struggle. Have you tried the full autoimmune protocol (http://www.thepaleomom.com/autoimmunity/the-autoimmune-protocol)? Sarah’s book can absolutely help you troubleshoot (there is a thorough troubleshooting guide in the back). In the meantime, perhaps this post can shed some light on areas you can improve: http://www.thepaleomom.com/2013/04/how-do-i-know-when-its-working-a-quick-troubleshooting-guide-to-paleo.html. It is also possible you are over-doing foods like liver or bone broth if you have them every day (depending on how large your servings are) or may be having a histamine reaction: http://www.thepaleomom.com/2013/06/teaser-excerpt-from-the-paleo-approach-histamine-intolerance.html. – Christina, Sarah’s assistant

Thanks Christina,
I do believe that I am histamine sensitive at this point I really appreciate the links you posted. Yes I have tried the full autoimmune protocol but I think I need to go through the trouble shooting and histamine protocol as well.
Thank you very much!!

-Nicole

My daughter gets eczema, on eyelids, tummy, back, arms etc. She was told to drink apple cider vinegar every day. That she did for a month, and it’s gone away.. She started with 1 tablespoon in half glass water and upped the amount of vinegar as she could handle it. After about a week of taking it, it gets easier to swallow. Good luck.

Hi, im so sorry about your skin troubles. Are you/were you using steroid creams or oral steroids? If that is the case you could be suffering from TSW – red skin syndrome. You can find more info about it at itsan.org.

Just received my copy of “The Paleo Approach” and congratulate you on a job very well done! I haven’t read every word yet (to say that this book is comprehensive is a complete understatement), but I’m having trouble finding any info/suggestions regarding mushrooms. Can you point me in the right direction…?

I have Hashimoto’s and vetiligo and I was also advised by a relative of mine (an Endocrinologist that does these tests) to have my blood tested to get an enzyme profile to see which foods I should eliminate from my diet. While I was aiming for the Paleo diet and way of life, I stumbled upon the AIP which made sense to try. I started two weeks ago, gradually changing the fool AIP, while it is a bit hard to avoid some tasty foods, so far I’m sticking to the diet. About a week ago, I caught a really bad case of diarrhea, but I don’t understand why. I eat plenty of vegetables and fruits along with red meat, organ meat (liver and heart so far), and fish. With the hormonal replacement therapy I’m taking for my thyroid, I’m also taking SSRI (Paroxetine) for my anxiety – after trying different types of SSRI, this one didn’t have major side effects – such as diarrhea like previous ones I took, and actually made my excrement more solid for a change. I was once told that I might have IBS, but I try to keep away from stress and I work out. Is it a passing phase until I adjust or should I try something else? except for the minor discomfort in my stomach I feel fine. Thank you for your help and knowledge!

If it doesn’t happen again, then it is probably nothing to worry about. It may have been something you ate (or some kind of contamination on something you ate). Many people find after some time on the AIP that they need less medication, so that is something to look out for too. – Christina, Sarah’s assistant

I meant that since last week when it started, it hasn’t stopped and I don’t see any sign of improvement. Could it be the fruits? before the diet I barely touched fruits.
I was told about the medication and I’m looking for it eagerly.

I would recommend limiting fruit intake to 20g of fructose per day or less. If you’ve significantly increased the amount of produce you’re eating, that may also play a role. At this point, I would recommend seeing your doctor about it. – Christina, Sarah’s assistant

I’m 58 and lost 80 pounds years ago – twenty five years ago. It seems that when my weight drops below a certain number – around 135, and I’m only five feet, but not small-boned – I get sick. A cold, sore throat – that kind of thing. It seems to have nothing to do with diet. I’ve been eating very cleanly for quite awhile, and was thrilled to have dropped a few pounds, and suddenly I’ve got a sore throat. A trigger will be getting too cold – in air conditioned spaces, for instance. It’s so frustrating!

Does anyone have any thoughts on this?

I’m thinking probably a link with leptin. There’s a whole lot of information in The Paleo Approach about its link to diet and to the immune system. But, there’s other possibilities too, like toxins stored in your bodyfat released when you drop below a certain bodyfat percentage, or that you’re undereating and missing some key nutrients, or the hormonal effects of undereating…

Thanks so much for responding. I was a much lower weight when I first lost the weight, and I remember then too I got sick constantly, and also had zero energy – which also happens now when I go below that 135 number. It’s so clear – I don’t have the energy to walk briskly, I’m just dragging myself. This is separate from getting sick. When I find myself feeling so much zippier and able to walk miles easily I think I’m finally getting “better” but then realize I’ve gained weight!

I haven’t tried digestive enzymes and HCL. I’m always bloated with a history of constipation – which has been greatly helped using Dr. BG’s protocol with homemade kefir. I’m also going to give eliminating FODMAPS a shot. As you say, it could be so many things. It’s just so frustrating.

Thanks again for the response, and if you have any thoughts about how to “cure” this, of course I’d be very interested!

I went on AIP for 2 months, only to screw up and hasten the reintroduction process of the AIP. I have found out some of the food I am very intolerant to, but I know I have more food intolerances and I don’t know what they are.
So I’m doing the AIP again, and this time I am going to do it right. Been on cellcept, prednisone and hydroxychloroquine for months now for SLE and I have recurrent boils from Hidradenitis Suppurativa. I have found out (fortunately) that pork is the food that causes me to break out in those boils. It’s no wonder that when I started the AIP, I had boils breaking out all over my body and it was really painful. Wonder why I’m intolerant to pork though…

Just a question, is arrowroot starch/flour allowed on the AIP?

Quick question about starch- you mention in myth busting facts that it hasn’t been proven that starch affects sibo but is there any reason to avoid it with IBD? For example, sweet potatoes, tapioca, arrrowroot, plantains etc. I’m trying to gain weight and it’s really hard to do without a lot of starch but am hesitant because of the warnings from scd and gaps. Thanks for your help!

Can you tell me why someone on AIP cannot have aloe, slippery elm, lemon balm and licorice? Also, are there any other herbs that are nightshades that need to be avoided, other than ashwagandha?
Thanks so much!

Can I start this while nursing? My babe is 11 months old and we do extended breastfeeding but I’m suffering from horrible arthritis in my knees and want to change this. I’m extremely overweight and not sure if this would be advised during nursing. I figure if I start this I will start losing weight but don’t want anything to come through my milk and not be good for baby.

I have an unspecified auto-immune disease – after suffering recurring bouts of iritis, I was tested and found to have the genetic marker HLA B27. I used to have lots of episodes, now I have maybe one outbreak every two years, usually brought on by stress.

I just learned that I probably have leaky gut syndrome. I have been vegetarian for more than 30 years and also been a yoyo dieter (yep, the high carb / low fat diet) but have slowly introduced fish and seafood. I started Paleo a few months ago (although I eliminated wheat and sugar about 2 years ago) and now eat fish and eggs, dairy, nuts and seeds, plus lots of veggies. Now I read that I should eliminate most of these foods because of my auto-immune disease. How do I find out what foods I have a sensitivity to? Do you recommend I get allergy tested? I feel totally overwhelmed by all the information I have read recently! After 30 plus years, I don’t think I could go back to eating meat…

The elimination diet described in this post is the most effective way of determining what foods you are actually sensitive to. Sarah recommends trying it for 30-90 days before troubleshooting with things like food allergy testing, which is not 100% reliable. – Christina, Sarah’s assistant

Hi! I am hoping to begin the AIP diet soon, but I am taking some fertility supplements (OvaBoost and FertilAid for Women) that contain “rice flour.” Would I need to discontinue these supplements while on the diet?

Also, I have been trying to cut back on coffee and would like to use gluten-free Teeccino, an herbal coffee, instead–but it is made partly from ramon seed, so I assume that would definitely be off limits while on AIP? Here are all the ingredients of the French roast variety: Roasted organic carob, organic chicory, organic dandelion root, organic ramon seeds, natural coffee flavor.

Thanks in advance! I so appreciate the website! The information has been very, very helpful for me as I seek to overcome a thyroid issue.

My story is pretty extensive and I believe I may have an MS type disease even ALS. I have tremendous muscle weakness in my upper left leg, left numbness and toe stiffness. I have been on both broth, grass meats, organic vegetable diet for over a year and a half. I have extensive food allergies and rotate 5 different types of protein (meat) over a 5 day period. I am not digesting my food now and I have many gut infections, yeast and bacterial infections. C Difficile too. Blastocystis Hominis. I have excess mucus in my digestive tract and stomach which I believe is biofilm…not sure how much longer I have. but wanted to know if DGL is ok for healing the gut lining.
Years ago I used to drink wine excessively as I had much anxiety and depression and stress from my job…I know now that I have had a leaky gut since birth as I had terrible allergies starting when I was 9 years old.
The Biofilm is eating my nutrition and preventing me from digesting my food. Not sure what to do anymore….I have had numerous functional//integraive MDs who didn’t help me much…I am so sad right now and I don’t even have a diagnosis for why I am going to die. Mainstream medicine can’t seem to find an autoimmune condition which is baffling to me…when I have nerve pains and numbness in my legs, arms, feet and dramatic muscle weakness.
I am concerned about the Glutamate in the bone borne and lead contributing to my further demise and symptoms. ALS-Lou Gehrigs syndrome talks about the Glutamate problems.
Please if you can let me know what gut lining products are not irritating to the immune system so I can tell my functional medicine practitioner who has never read your book…go figure…what a joke!

Whew, there’s a lot going on here and I’m not a medical professional so I can’t give you medical advise. But, I can say that DGL is very good for restoring intestinal barrier function (so is L-glutamine, both of which are discussed in The Paleo Approach), along with adequate nutrition, digestion support, stress management, adequate sleep, protection of circadian rhythms and appropriate activity levels. There’s lots of information in The Paleo Approach (pay special attention to the Troubleshooting chapter) and you may also benefit from reading The Wahls Protocol by Dr. Terry Wahls. I also think that a functional medicine case review with Anne Angelone at http://www.ThePaleoMomConsulting.com would be extremely beneficial if that’s manageable for you (if not, you can try finding a FM doctor through http://www.paleophysiciansnetwork.com). I think the most important thing though that I can tell you is to have hope. Autoimmune disease can be extremely challenging to diagnose, and definitely gut dysbiosis makes healing harder, but there are competent medical professionals who can help you.

Hi, I contacted you a while back regarding bad breath – nothing was working to fix it and I had had clear dental / sinus tests etc. Well, based on a recommendation of my dentist, I started brushing with diluted hydrogen peroxide ( 2 part water to 1 part HP) followed by oil pulling. I’ve been doing this for about a week and a half and it is working brilliantly. For the first time in years, I went out at the weekend and was able to engage with people without being mortified about my breath. However, since Friday, I am having pains all over my body – they move about and last a few seconds ( I possibly have MS so this new development is worrying for me ). My diet has been good so I wonder if the hydrogen peroxide is to blame? Can it cause/activate inflammation? I only use oils I know I can tolerate for the oil pulling so I don’t think that’s causing the problem. I will be devastated if the HP, the one thing that works for the breath, is causing inflammation problems.

Yes, hydrogen peroxide is an oxidant (a very powerful one), so it does cause inflammation. It surprises me though that brushing with it would be enough to cause a systemic reaction. Is it possible that you were exposed to something while you were out on the weekend?

I had fruit on Friday – fresh and dried but not a huge amount. Other than that, I can’t think of any other trigger. I think I will dilute the mixture a little more- 3:1 and see if there is a change. I’m also staying away from all fruit this week. I can’t think of any other substance that would have a similar benefit to the hydrogen peroxide without causing an inflammation – if you know of anything, please let me know. Thanks for your response, I really appreciate it

Thank you for your response….I currently see a new wonderful FM practitioner who is helping me to navigate these rough waters. She has taken me off of all the pills that I was taking that was aggrevating my immune system…and has referred me to another GAPS diet person to try and heal my gut. Yes my history is extensive and sad and have severely damaged gut and a very weak immune system. I have tried Naltrexone but get nose bleeds (4.5mg per capsule). My digestion is poor ….all of this is affecting my ability to digest my food and now affecting the muscles and nerves in my left leg and foot.
Thank you so much for any further advise and many blessings.

I’m so sorry. I suffer too. Look into oxalates that was my missing link. There is a product made from coconut that dissolves biofilm. I can’t think of it now. Bromelain may too but not like the other. Hang in there.

What’s wrong with Oxalates? I take coconut oil regularly. My problem i believe is that I am so leaky and toxic and have many nutritional deficiencies due to so many food allergies. My doctor now believes I may have MS. 20 or so years ago I came down with Cytomegalovirus, Epstein Bar Virus and Chronic Fatigue Syndrome. I was doing things that I shouldn’t have like trying cocaine and marijuana which i didn’t know was hurting me as I had a defective liver and detox pathways. I am missing the Glutathione gene totally in my liver. I only did those things a few times. I smoked Cigarettes for a very short time as they made me ill…go figure. I had a very stressful job working around radiation, had a mean boss, I was going through a divorce….plus I was already born with an incomplete immune system from not being breast fed and given antibiotics many times throughout my life…later on more so because I had mitral valve prolapse diagnosed at the age of 32.
I am really depressed and am crying all of the time…my husband isn’t supportive and mean….life just isn’t worth living at times.
I am wondering if there is a support group that can help me to stay strong for the road ahead…not sure where it will lead as I am starving because I have a candida infection that’s gone wrong…because my immune system isn’t functioning well. My PCP’s never picked up on this 20 years ago….Autoimmune disease from a leaky gut and chronic prescribing of antibiotics.

I started the autoimmune protocol a week ago and can definitely feel a difference. Thank you so much, Sara!! I loved your book! I just have a question. Am I allowed to eat sago? I couldn’t find it in the lists in your book unless I missed something.

Thank you for your reply. I made it the other day. It worked okay but I kept the servings to a minimum. I have another question. I want to make fermented vegetables with home-made whey but I’m concerned about the dairy in the whey. I also have a lacto-fermented probiotic made from whey (A Vogal Molkosan). I want to know if I can have these things while on the autoimmune protocol diet. Does the fermentation take away the effect of the dairy or should I look for another source of probiotics?

Also, no spirulina? I live off of spirulina because I cannot tolerate most vegetables and the only way to make sure I get enough of the good stuff is to supplement with a green powder. Since wheatgrass and chlorella/spirulina are off limits, what kind of green powder can I supplement with?

Any sea vegetables not listed above should be fine, though I am not aware of any particular powder supplements that are AIP-friendly. You might consider an allergen-free vitamin/mineral supplement depending on what “the good stuff” you’re missing out on is if whole foods are not an option. – Christina, Sarah’s assistant

Dear Paleo Mom
I know you are busy with your new cook book (which I have pre-ordered!) but I really need some advice! Myself and my children have been following AIP for about a month and a half having previously followed the Whole 30 program. I’ve given up NSAIDs, worked out reflux problems, felt much less pain, and have started to work on sleeping more and getting my circadian rhythms back to normal! Fatigue is my biggest remaining issue. There are two drugs I am still taking – antidepressants (Sertraline which I think is known as Zoloft in US), and an antihistamine daily. I also have a Myrena coil in place (for pain relief).

We have all made great progress but have had a terrible week and all my old symptoms have returned. I wondered if you had any advice about stopping antidepressants (I have attempted it so many times but the withdrawal symptoms are awful). I have been reducing and recently stopped mine but have started taking them again because I have been feeling so awful this week. Pain, pins and needles, flu-like and rage.And a desire to comfort eat leading to an increase in fruit (still fewer than 2 or 3 pieces a day) Visual disturbances (zaps) which have eased since starting them again.. I was convinced it must be the withdrawal making me feel so ill again but my daughter has also been feeling worse and has had awful rage tempers. They put me in mind of when she had food colourings before. (The rages had stopped since being on this protocol.) My toddler was also very bad tempered. Mid week I thought we all had a virus of some kind. But this evening when I noticed my daughter’s eczema was also back, I racked my brains for what it could be – something she ate? Then I remembered that we have all eaten gammon with nitrates in this week. It came in my meat box and I hate to waste anything so I thought as all other food we eat is clean, it couldn’t hurt to have it just this once. As it was large, we have eaten it over the course of the week (in a liver sausage). Could it affect us all so badly?

I appreciate any help given. Thank you

Weaning off antidepressants is something you should discuss with your physician. Cured meats are usually okay, but if the entire family is affected, the cause is definitely dietary or environmental — it’s possible there was something in it that caused a flare. – Christina, Sarah’s assistant

I’m a bit confused. I am interested in reducing inflammation in my body and Supporting my immune system. I have several health concerns, but not sure which ones are definitely considered “auto-immune” 2 main conditions are Fibromyalgia and lichen plumus pilaris (on the scalp with hair loss). The diets for dealing with systemic inflammation (from naturopathic and Functional Medicine sites) seem very different from AIP. For instance I saw on this site a statement saying that cured meats are fine? Do your mean cured with niitrates? What about all the mercury found in ocean fish and the concern with scavenger shellfish and toxins in animal liver? AIP diet and recommendations for a “clean” plant based diet to decrease inflammation seems to contradict each other. Am I missing something in my understanding? Also, my highly regarded integrative doctor who is treating me for fibromyalgia has recently collaborated with others’ research and discovered a connection with specific mold exposure and toxicity possibly being the actual cause of symptoms of the Fibromyalgia Syndrome. He has worked with both Fibromyalgia and other hard to resolve health issues in patients for years as well as those with illness due to mycotoxins, but the connection with Fibromyalgia and mold exposure and toxicity wasn’t made until the last 8 months or so. I have had Fibro for 30 yrs. I was tested and found to have 10xs the “expected” amounts of these specific offending molds living in my body. Apparently, your exposure to the mold can be many years or decade ago and these specific molds and stay and grow in your body. One of the mold “pulling” agents he has prescribed for me to take orally is “Prime Chlorella”.I take two 200 mg. tabs per day. They are 100% pure with “cracked cell walls”. Would this small amount of Chlorella used as a mold pulling agent make the AIP diet in-effective for me? Does the AIP diet help to elevate general health even if a person does not have a diagnosed auto-immune disorder? Oh, I also have an underactive thyroid (runs in family) for which I take Liothyronine. Would that be considered an auto-immune disorder? Sorry if this is too long and complicated. Yikes! I do appreciate any feedback you can give. Thanks so much!

Those are all conditions with a confirmed or suspected autoimmune cause. Mold can certainly compound the problem. Sarah discusses all of this in depth in her book The Paleo Approach, and answers your questions in various posts on this site. You can read about mercury and seafood here: http://www.thepaleomom.com/2012/08/the-mercury-content-of-seafood-should.html and should note that the liver does not store toxins, only filters them. – Christina, Sarah’s assistant

Thanks for your response. May I repeat 1. Question and ask another? As I said, to pull mold my doc has prescribed just 2 small tabs of Chlorella per day, would taking that slow my progress when on the AIP diet? New question: I have seen videos and read reports about the benefits of using raw freshly picked and juiced high CBD cannabis leaves and flowers for healing auto-immune and other health issues. Again this plant is used raw, and juiced, not in a heated or smoked form, thereby avoiding any “psycho-active” or “stoned” affect. Used as a food source. Apparently the cannabinoids in the plant are highly medicinal. Your thoughts on that?

I just happened to read a Facebook post about vitiligo and AIP and had no idea that there was a link between leaky gut and autoimmune diseases (i.e. vitiligo). I have vitiligo across most of my body now, it started in year 2000 and it has been steadily spreading, I would say probably 70-80% of my body is lacking pigmentation now. Is there any point in following AIP at this late stage?

hi Christina! Forgive me for being obtuse. Vitiligo has spread over most of my body. I am not sure how AIP can reverse this as I don’t think I can ever get pigmentation back again. Is that not true?

Are most precriptions gluten free and how do I find out. I have been feeling bad for the past week, and just started a new precription to a thyroid medicine a couple weeks ago. Please help… I feel so tired.

Your pharmacist should be able to tell you what ingredients are used in your prescriptions. There are a lot of factors that may affect how you do on thyroid drugs, including which drug, the dosage, what time you take it, your adrenal health, your iron and thyroid cofactor levels, and whether or not your body is converting T4 into T3. I would suggest discussing your medication and alternatives with your doctor. – Christina, Sarah’s assistant

Sarah, I have started plowing through your book and there is so much there. Thanks for putting this out. I have been eating Paleo for 14 months and just started AIP in December after I was diagnosed with AI hepatitis. After looking over the food lists for sugar and corn in your book, I started checking the supplements I am taking and was dismayed at the sugar and corn in them. I am trying to determine what I really do need to take. Are there natural options for multi-vitamins and allergy medications that have no corn/sugar in them? I haven’t noticed my allergy symptoms until now, which is really late for me. Perhaps my immune system is getting stronger. Should I be concerned about the small amount of corn/sugar in one allergy pill or multi-vitamin tablet?

You can find allergen-free supplements online. Depending on what you need, you might look at Apex, Designs for Health, or Jarrow. Sarah links to the brands she uses for specific supplements above and in other blog posts about supplements. – Christina, Sarah’s assistant

Loree, have you had a saliva test to check adrenal function….usually thyroid and adrenal and gut issues go together. If you have chronic inflammation of the gut you have worn out adrenals especially if you’re in menopause. Your ovaries aren’t making the hormones that support the adrenals anymore. Just my thoughts.

No I have not had the adrenal function test, but I might try it. Thank you for your thoughts. What can I do for my adrenal to help them function better?

Dear Sarah, Christina. Kindly help understand. What is the exact mechanism of AIP? After 30 days or more (based on initial damage stage) the gut lining recovers and no longer through the “holes” allows for food pieces to pass to blood. Thus, no further inflammation and autoimmunity does not occur? Or after the AIP protocol the body stops being sensitive to special foods and no longer produces inflammation when this food is eaten? Thank you !

Both, hopefully. By reducing inflammation, food sensitivities, and allowing the body to heal — by treating deficiencies, balancing hormones, and calming the immune system — it gives our bodies the best shot at fighting autoimmune disease. – Christina, Sarah’s assistant

What about BarleyMax AF by Hallelujah Acres? It is a dried powdered green juice from young barley plants (green part only – no gluten). Shown to be a very complete food, missing only vitamin D and B12. I don’t remember coming across that kind of green juice as excluded. It has no fillers, no spirulina or other seaweed, zip. Just dried barley grass juice.

Didn’t think to ask this but I have a nothing to lose, I’m with a rheumatologist and naturopathic dr who is certified in functional medicine. I have autoimmune issues apparently polymyositis but nothing concrete just blood work shows immune issues. My naturopath has taken every blood work possible but can’t figure out what is causing the issue. The only thing was inflammation in my urinary. I’m gluten free eat only organic and follow paleo diet. We believe this started with my digestion cause I suffered terribly from heartburn even drinking water. After heavy doses of antibiotics my body hasn’t been the same.
I also had an MRI done on my legs and it shows atrophy of the muscles and inflammation. I’m on Rituxan. I didn’t want to take medication but at this point I needed to try something.
I don’t know what else to do or try.

Since coffee is obviously not AIP, I am wondering what I can drink in the morning? I know bone broth is great but are there any kind of tea’s that I can drink?

I would like to know if anyone has any information regarding the use of AIP or GAPS to heal autoimmune ITP (idiopathic thrombocytopenic purpura). Thanks.

I am thinking of buying Sara’s cookbook. Are all the recipes for the auto-immune protocol, or do they include regular Paleo recipes as well? – Thanks

Hi there!
Hey… I just found a new Sweet Potato chip called Jackson’s Honest Chips. The ingredients are simply: Organic Sweet Potatoes, Coconut Oil, and Sea Salt. Would these be OK to consume… or are chips of ANY kind counterproductive?
Thanks a lot!
Steve

Hello Sarah and Christina,

Three weeks ago I was diagnosed with coeliac disease. At the start of 2014 I began following a Paleo diet, but towards the time of my diagnosis I had been cheating on Paleo A LOT, and had begun experiencing debilitating nausea that lead to my diagnosis after blood work and a biopsy.

During my more dedicated Paleo months I referenced your recipes frequently, but since learning I am an AI sufferer my appreciation of your website here and all of your work has increased tenfold. I am quite obsessed and have spent hours over the last week reading all your AIP articles. I greatly appreciate and respect that everything you present is backed up by the science of things.

For almost 10 years I have been experiencing extreme bloating, stomach distension, sporadic bowel movements and gasiness. I honestly can’t remember if the symptoms existed during my months of dedicated Paleo, I had come to accept the bloating as a ‘fact of life’ and usually ignore the symptoms.

Now I have learned I am coeliac and it could be gluten contributing to my symptoms. The only other symptoms I seem to have are intermittent, extreme itching of my torso and toes, and stuffy nasal passages every morning.

I don’t experience any other hardcore symptoms the way some sufferers of coeliac experience, for that I am extremely grateful.

I am now 5 days into AIP and as yet have had no relief from these minor but persistent symptoms. I’m aware that it can take months to heal, but I am trying to understand what that actually means.

I know that AIP gives my atrophied villi time to heal without the threat of, not only gluten but also cross-reactors and other foods that cause inflammation, but is it the same time-frame to experience relief from my symptoms?

My bloating/stomach distension and gasiness occur within an hour of consuming food. Is this simply because I may have a leaky gut and it will take as long as it takes to heal my gut before I stop getting bloated after almost everything I eat?

I would have thought, since the symptoms occur within such a small time frame of eating, that they should stop when I started AIP as I was no longer consuming gluten OR any cross-reactors.

But maybe not, so I need your wisdom to explain to me what is going on!

Thank you so so much for all of your tireless research and sharing it with us.

Yes, it can take a while to feel relief from your symptoms. Most people report feeling a little better within the first few weeks, with major advances taking longer. The bloating could just need more time to go away or it could be a sign of underlying problems like SIBO. It’s something you should discuss with your doctor. – Christina, Sarah’s assistant

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