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!

The Paleo Approach Cookbook is also now available! It provides expert tips on how to make the switch to The Paleo Approach easily and economically. It explains how to stay within your food budget, how to make the best use of your time in the kitchen, and where to shop for what you need. Complete food lists, shopping guides, meal plans, and over 200 recipes take the guesswork out of eating to maximize healing.

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.


Also, my assistant Christina Feindel has released an e-book called 28 Days of AIP which contains a 28-day autoimmune protocol meal plan (including several new, exclusive recipes) to help you get started, stay on track, and illustrate that the AIP is a flavorful diet full of variety. Check it out here.

Another great resource for reintroducing foods into your diet safely is Reintroducing Foods on the Paleo Autoimmune Protocol by Eileen Laird. Eileen walks you through the process of reintroducing foods one at a time and gives you pointers on when to start reintroducing foods, keeping a food journal, and how to know if you have a reaction. She also provides recipes appropriate for various stages of reintroducing! Get the e-book here.

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.


Absolutely and psoriatic arthritis. I have both. Psoriasis symptoms disappeared when I converted to a paleo diet.

I have a severe allergic reaction to seafood. I do eat meat and it is all grass fed, free range, organic. I currently use flaxseed and walnut oil to supplement my Omega-3s. Would these still be allowable in this case?

Buenas tardes. Ante todo felicitarte por tu trabajo, por tu libro y tus artículos. Me estoy empapando de ellos y la verdad estoy aprendiendo mucho. Soy una chica española, de Madrid. Soy nueva en esto, pero dados mis síntomas de múltiples intolerancias alimentarias, depresión, cansancio, malas digestiones, hinchazón abdominal, estreñimiento, hipotiroidismo. .tengo qe intentar poner solución a todo este caos. Estoy empezando con tu protocolo y no me está resultando fácil. He eliminado muchas cosas de mi dieta pero faltan. Lo qe se me resiste es el cafe. Tomo dos al día por la mañana y por la tarde, pero yo creo qe no le viene bien a mi tripa. A veces me despierta, otras me parece qe me da depresión, qe me duerme, a veces me duele la cabeza…lo tomo con leche de arroz y tampoco creo qe me vaya bien. Pero por la mañana necesito espabilarme con algo, además de qe si no lo tomo no voy al baño. Me gustaría qe me ayudaras para ver como lo puedo eliminar o sustituir, así como si pudieras darme algunas pautas para dar un empujón a mi estado de salud qe está muy deteriorado y cada día más. Muchas gracias de antemano y enhorabuena por tu trabajo. Eres genial! ! 

I’m wondering in order for someone to know for sure they have to eat the AIP way, do they have to go to a specialist to get tested for all autoimmune diseases? Thank you.

my hashimotos antibodies test is 3579 date Jan 26 2015, TSH 6.6, T3 T4 were in range.. My test April 2014 antibodies were 2200.
My doctor is a wait and see protocol.. I had reactions to Armour and Synthroid so was taken off meds Nov 2013 when synthroid put me in hospital w 200/112 BP. I was going to 2 different doctors being passed back and forth (Endo said see Internal, Internal saying see Endo ) labs every visit sometime 2 to 3 times a month.
What does 3579 antibodies mean..!!!!!!!!!!( I know normal range is 9.)

Find another doctor. I had to keep searching until I found the right. One is into functional medicine or is an nd.


With possible AS, I’m going to try the AIP. You mention in the post NOT to limit starch and that it is not proven to reduce SIBO. I was wondering if you changed your view on starch considering the research done on its connection with Klebsiella and proven ability to feed pathogens in gut. I would assume that a bacteria food source like starches could easily feed pathogens in small intestine just like undigested fructose with sibo.


Can aloe be taken when it is topically applied? Can you explain what the issue is with aloe? It’s in so many alternative/more natural beauty products.

My husband has ulcerative colitis. he keeps bleeding when he trys to have a bowel movement. and alot of sticky mucous.(not ever hardly any stool). what can he do to stop bleeding…….

My ND has recommended licorice but not specifically DGL. Can you explain why DGL is preferred over non-DGL?

DGL is licorice that has had the glycyrrhizin removed, and therefore is unlikely to cause the blood pressure problems you’d risk by taking regular licorice.

No, BUT pickles are almost always pickled with a spice blend including seeds, nightshades, etc, so you’ve got to be watchful with your pickles unless you make your own.

Hi, I recently saw your post on facebook about breakfasts and was wondering whether you could post more ideas for AIP breakfasts. Any ideas for alternatives to protein other than eggs or breakfast sausage? Thanks!

Why are spirulina and pea protein not allowed? I’m on the low-FODMAP diet and it’s been insanely difficult to manage that diet and the AIP diet in my condition (extreme fatigue and severe neuropathic pain in lower legs), while taking care of two energetic boys (5 & 7 years old). I have turned to pea protein with spinach and raspberries for breakfast and lunch sometimes. I also can’t eat much in the morning before I do yoga, but I need to take my morning medication with food. I take prednisone and an immunosuppressant to control my autoimmune illness and four different nerve pain medication. I’ve been trying to manage the two diets for a year now. I’ve long since run out of willpower to stay on both diets. Spirulina was recentle suggested by a third naturopath I’ve seen since my ordeal has begun to try and support my liver in eliminating all the toxins in my body.

I forgot to mention I’m also taking mefenamic acid which is a milder NSAID than ibuprophen. I can’t survive without the medication I’m on, and it seems like a lost cause to try to stick to the diets when I’m damaging my gut with all these meds. Sorry I think I’m just venting now, because there might not be an easy answer.

It’s because spirulina and other algaes boost the immune system. I struggle with that one too- spirulina is probably my favorite supplement, makes me feel like a superhero, and was a dynamite substitute for coffee (for energy, not taste, obvs). I’ve given it up, but boy, do I miss it.

Can the AIP diet address type 1.5 diabetes? It is an autoimmune condition, similar to type 1 diabetes, where the body is attacking the pancreas.

It is so nice to be reading this and finally getting some backing for what I’ve been advocating over the past 10 years.

Ever since I can remember I have had autoimmune issues. These changed over the years in intensity and nature but never went away completely until a few years ago. Even though I was never officially diagnosed with anything, I would say that that the peak was at around 23 y.o. when I was abroad studying for my Bachelors degree. By the end of 2003 I was going to the hospital to get cortisone shots at least once a month and in 2006 when I started my first job, I had to bandage my hands because I was scratching them so much they were bleeding. I would feel sick after pretty much every meal I ate to the extent that I would have to throw up for no apparent reason. I would break out into hives as big as dinner plates that were scattered all over my body and I would have trouble breathing especially at night. Other symptoms where frequent urinary tract and yeast infections, headaches, fatigue, a constantly irritated throat and runny nose, swollen glands – you name it. Basically, I was a complete mess.

And no one was able to help. All that doctors offered were cortisone creams and shots, which repressed the symptoms for a short while only so they could come back even worse once the cortisone wore off. And not only did the medicine not help, it actually brought on other health issues, such as kidney problems.

Luckily I’ve always been able to listen to my body pretty well and figure out what it needs. So I somehow new that my problems had to be related to my diet, even though everyone around me was calling me crazy when I finally announced that I was through with doctors and that I wasn’t going to take anymore of their cortisone and instead take matters into my own hands.

I started out cutting out the obvious. Alcohol went first, then all processed foods, especially foods containing yeast and any kind of flavour enhancers. I went on to omit first wheat and later all grains except rice, buckwheat, corn and quinoa. I limited dairy to a minimum and cut out all sugar for a while (this was probably the most difficult). Last to go were eggs and nuts, as I was always suspicious about them but could never really put my finger on why (nuts now work fine for me btw, I actually eat quite a lot of them w.o. having problems).

This all sounds easy enough, but I had never heard of Paleo and had no regime to follow, so it took me almost 6 years to find out what works and to heal completely (I would say that I was in control by the end of 2009). I am now at a point where I can have the occasional cheat (such as eat some rye, yeast free bread for breakfast or dark chocolate for dessert) without falling apart again.

Having said all this, the thing that is still most frustrating to me is that my family and friends, who’ve been through this ordeal with me and have seen the changes in my health still look at me like I’m crazy when I tell them that it’s all mainly related to my diet.

It’s good to see that there are people out there who have gone through a similar experience. Makes me feel a little less crazy : )

Wow, Sarah, what a story! Amazing that you figured all that out on your own. So glad you are better now. With the Internet and so many experts turning out great information every day, someone with AI disease today has a great advantage…if they can just stumble on the first lead and follow it.

Maybe you’ve already been tested for Hashimoto’s, but if not, you might try. I think it’s the most common AI disease. It was definitely the first to be identified. If you had Hashi’s, you’d need to be gluten-free for life…and are most likely gluten-intolerant.

Anyway, again, it’s so good to read a story like yours with a happy ending!! You have amazing perseverance.

I have a question – are all autoimmune deseases go together with leacky gut syndrom? Because seems like AIP diet heals only LGS. I have Hashimoto’s, but I’m not sure if I have leacky gut, so I’m not sure if this AIP dieting will help me at all.
Thank you

Yes, all AI diseases indicate leaky gut. If you google “autoimmune leaky gut” you’ll get lots to read. I’m in the Hashimoto’s 411 Facebook group and we are constantly discussing leaky gut and using AIP as the first step toward healing.

Hi Sarah,

I have Type 1 Diabetes and have been struggling to stay focused while following this diet. I constantly feel like I’m in a fog. Is this because I am no longer eating complex carbs? Are there any resources or websites I could visit that you know of for more information on AIP with T1D?


I could greatly use resources and help with type 1 diabetes and the AIP. Has anyone been successful with type 1 with this? Any advice on lowering insulin doses with adapting the protocol? Grateful for any help!

I have symptoms of Sjogren’s syndrome. Loss of tears, saliva and swallowing difficulties. The diagnosis was not confirmed. Can AIP help? Thanks.

” It is better to avoid excessive liquid with your meals, chew your food thoroughly and not rush to the next activity when you eat. ”

This is impossible to follow when your autoimmune condition is Sjogren’s Syndrome.

I am looking into this for my adult son who is disabled as a result of an unspecified autoimmune disease. He’s a committed vegetarian (going on 17 years). Is there any way to do this diet without any animal protein? I’m pretty sure he could not be convinved to eat any kind of meat or seafood. Beans and tofu are his protein staples.

In relation to probiotic consumption already a few months straight, kefir, pickles, sauerkraut, beet kvass (now discovered a Russian drink and easy to do). More to wanting to stop a while with probiotics and stay only in the resistant starch feeding my bacteria. Can I do this or we need to continue with probiotics?

Hello thank you for posting all of this great info! I have been diagnosed with adrenal exhaustion and was thinking of trying out licorice root (not DGL). I see that the whole licorice is not recommended, cab I ask how come? Also I’ve heard citrus fruits (lemon lime) are problematic too, do you know anything about that? Thanks:)

I have been on the AIP since mid January this year and am feeling much better. My issue is hot flashes. I have heard that a lignan supplement which contains only the hulls of flax seeds can be very beneficial for hot flashes/hormone imbalance. Is there any reason why I shouldn’t take it on the AIP diet?

OK, so i reading this, and I want to absolutely do it with utmost compliance, buttt I work nights, so circadian rhythm is kind of screwed, I cant quit anytime soon, any suggestions? I still do sleep well, but obviously my circadian rhythm will suffer. Any suggestions?

Hi there Sarah! Big thanks for your detailed page on the AIP. Would really appreciate if you could get back to me your view on my problem!

I purchased your books and learned the importance of consuming organ/offal meats. I understand why we should eat them, however, what if we can’t find good quality organ/offal meats? In my country, it’s a challenge to purchase organic, grass-fed, pastured or even free-range meats, and of course, that applies to organ meats as well. There’s a strict law regarding the imports of these pastured meats and hence, most butchers and supermarkets don’t sell them. I refuse to eat those organ meats from conventional animals after knowing how what goes into their body and how they are treated. What’s your take on this?

Also, I’m taking Great Lakes Beef Gelatine everyday with my meats during dinner. Is that considered offal or is that just considered glycerine?
What about bone broth? Are they considered offal since we do put many bones (which are offals) and slow cook them together?

Thank you so much for all your information. It is great to finally have info that is clear: what to do, what not to do. I have several auto-immune diseases and know that by changing my diet, it will improve my health too. My problem is that I am a Pescatarian and only eat limit fish: salmon, cob, blue-grenadier. At the moment my fatigue level is rock bottom and my inflammation level high. How can I incorporate AIP as a vegetarian? Most of the foods I eat are disallowed on AIP? Also I enjoy gluten free weetbix with LSA and soy milk for breakfast. I am struggling to find alternative ideas for breakfast: green smoothies, Paleo granola, what else, seeing that no eggs are allowed on AIP? Thank you.

In your readings you mention that Spirulina and some chlorella plants stimulate the immune system. My daughter has Sjogrens. Can she have wheat grass? Thank you

I’ve been strict paleo for over 2 years and have been cutting back a lot of the foods restricted on AIP for about 6 months (just to see if I felt any better). I was thinking of trying a 30 days strict AIP however I wondered why strawberries, figs etc were allowed but seed based spices not allowed. Should seedy fruits be avoided then too (blackberries, strawberries, figs….)?

Dear Sarah,

I desperately need your advice!

I’ve started the autoimmune protocol in January after I have been diagnosed with Hashimoto,and since startting to eat like that,my hair started to fall a lot,like never before,and didn’t stop! I don’t know what to do,I’ve always had thin and rare hair but it was never falling.. My daily menu looks like this: I eat for breakfast smoothie for example with beeries,orange,avokado(that’s the only fruit through the day), for lunch and dinner I eat meat or fish with vegetables(raw or cooked) and a salate of green veggies, and eat 1,2 or 3 spoons of coconut butter per day. Also I drink a lot of water.

I really don’t know what I’m doing wrong.. :( And I don’t have stress now in my life.. My hair started falling when I adopted this diet. :(

I would be very thankful if you could give me some advice.

Thank you a lot!!

Hi Joanna,

I have my hair thin and falling out easily; turns out I was low on thyroid test, but the doctor I saw said, “your number is lower than I like, but it’s not low enough to give you thyroid medication.” So what should I do? “Nothing you can do.”

WRONG! You’ll probably are very low on iodine; I finally found a naturapath healer, who put me on the Standard Process Prolamine Iodine (just 1 tablet a day at bedtime). I also include kelp seaweed and laver in diet, but it’s hard for me to eat it every day.

You need to go to your doctor and get tested.

What a Great article..I wish more questions were answered. Having 3 autoimmune conditions, i’ve noticed foods high in histamine, oxalate, gluten., dairy, yeast etc bother me greatly… I’m recovering from adding trigger foods back in my diet >> grains, chocolate, cane sugar, GF bread, rice, etc back in my diet..puffy eyes, fatigue, foggy thinking, always feel hung over and i don’t even drink!! sore joints head to toe… Paleo in past helped, so this article will help me get back on track. It also helped having my genes tested at 23andme.Com and a functional Doc review results, for knowing foods & supplements affect me.

If I had food sensitivity testing through Cyrex Labs and it found I was ok with all legumes and dairy – do I still need to avoid those on the AIP? I wanted to do the testing so that I wouldn’t be cutting out foods that I was tested to NOT have a sensitivity to. I have Hashi’s.

How can I gain weight on the AIP? I’m down to 96 pounds (from 106). I’ve been on AIP for 2 months. I eat all day and am still losing! I have celiac and with this diet my symptoms are greatly improved but I am thinking of quitting due to so much weight loss. Any suggestions?

What is your protein and calorie intake? Do you supplement at all? I have to supplement my AIP diet, as well, although no one has been able to say exactly why.

I think it’s because we are so nutritionally deficient. If I don’t supplement, I don’t even have enough energy/clear headed to go to work! Supplements help give me the extra nutrition I need until my body can catch up after healing.

I’ve been eating gluten-free for about 5 years and wondering why I still wasn’t healed. After reading this article and buying the book and reading it, I’m doing gluten-free all wrong. I was substituting GF breads, GF cakes, GF cookies, etc instead of real vegetables and fruits. I have no problems eating lots of animal proteins, so I thought I was doing great. Nope. Have to eat the 8-14 cups of cooked veggies, then a bit of fruit and my large quantities of protein.

And NOT eat rice, corn, GF soy sauce, GF miso, kefir, kimchi (with chili peppers), peanut butter, peanut sauce, asian sweet beans dessert, and ice cream. After looking through the avoid list, I can see why my gut isn’t healing.

After this last severe skin rash (like celiac rash) from a tobramycin eye drops for an infection, I decided to fully commit to the AIP. I want every second of my life to be free, healthy, happy, no itching, no bleeding, no weeping wounds. My healthy destiny still awaits! That is worth living for.

I’ve searched and searched and can’t find any answer to my question. Wondering if on the AIP diet can I eat dairy free, casein free, soy free rice cheese?

Thank you for all the free info available! I am in remission since 1 year! never have felt better! thank you so much. I was sticking to the AIP for around 6 months (plus histaminerich foods avoidance), before introducing many foods again. I was integrating many detox supplements too. later on I started doing green smoothies instead of supplements. Since 3 months I am vegetarian and therefore started with quinoa, lentils, chick peas and some goat yoghurt and cheese. works great for me. But what brought me to this point of health that i enjoy now is the strict AIP. cannot thank you enough!

Hello and THANK YOU for all of this information!! I’m about 3 weeks in and realized I never asked about medication. I take synthroid, and various antihistamines: xyzal, ranitidine, and ketotifen. Bi-weekly injections of xolair, Xanax occasionally, and a probiotic and pre-natal vitamins with DHA. Are any of these on the naughty list for my 30 days? I have noticed already that I can go longer without my antihistamines. Also, I’ve seen a lot about gelatin in cans, etc. is this ok? Also, baking soda?

Last August I started this journey with my new nurse practitioner at an integrative wellness center and have been very happy with how I have been feeling. I have been doing an elimination diet modified for SIBO and candida but not always perfectly strict as I should. However, a lot of my chronic symptoms like fatigue, acid reflux, and sinus problems have improved immensely and I know my major trigger foods are sugar, gluten, and dairy. However, I just had labs done again for the first time since August and my TPO-AB is almost TRIPLE what it was when I was initially tested. My TG-AB is down but not in normal range. My ferritin has dropped, my folate has dropped…still awaiting other test results. I am very discouraged. I know I wasn’t perfect about the diet but I was pretty darn good! We’ve had an enormous amount of stress in our life in the last 4 months so I’m wondering how much that plays a role. I’m willing to try the AIP but just looking at the food list makes me want to cry. This is going to be very hard for me, especially with a spouse that has a terrible diet and won’t change it. It was hard enough to do what I was doing all this time. Is there an online support group of some kind for this? Facebook maybe? Thank you. I’m amazed by your dedication to your work and all you have done in this field.

Have any of you experience with healing peptic ulcer through diet?
Duodenal and gastric ulcer due to extended treatment with NSAIDs (Mobic (meloxicam) and Celebrex) for chronic back pain.
Doc gave steroids by IV to reduce inflammation. Also took 2 rounds antibiotics for strep. Combo wrecked gut health, in spite of Diflucan. Steroid worsened carb cravings, which I satisfied by eating maltitol-sweetened foods-a lot. Especially chocolate candies. Caused stomach pain, so quit. But ulcer appeared, so quit NSAIDs. Now using probiotics, digestive enzymes, Paleo/SCD diet.
Doc wants to treat ulcer with Prilosec, Nexium, Xantac, Pepcid combinations. If biopsy shows h. Pylori, wants to add Amoxycillin and Biaxin (?) to the mix. Definitely afraid of antibiotic. Not excited about other drugs either. Any advice, experience, information would be so appreciated!

Can I be healed through nutrition? Thank you for help/education!

After two years into paleo and two weeks into the AIP with daily diarrhoe I quit and went back to normal diet, including cheese, bread, rice and stuff. You know what? My digestion is better than ever. I am not sure at all if AIP is really the solution for my Vitiligo.

ps. i cured my autoimmune related Ankylosing spondylitis with almost normal diet: lots of vegs but no fruit , no pepper or other spicy herbs, no sugar; grains well chewed.

Although I have had positive ana results suggesting multiple autoimmune disorders are present, I am still in the process of diagnosis. I am trying to control what I can of my symptoms including anxiety, chest tightness, dizziness, leg heaviness and stomach pain to name some. I’ve started AIP for about a week and have noticed much less bloating and had some weightloss. I still am struggling with inflammation and sever migraine and have to take asprin to stop the aura before the pain becomes debilitating.

My question is, is there any anti inflammatory OTC med that can help me that does not conflict with AIP? My hopes is that being on the protocol for a month or more I may have some results, but in the meantime I have to work and be functional for my other obligations. How do I manage the pain and feel full?

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