Modifying Paleo for Autoimmune Conditions (i.e., The Autoimmune Protocol)

May 10, 2012 in Categories: , , , by

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NOTE:  This is no longer the most up-to-date version of the autoimmune protocol.  You can see the most current version here.

Autoimmune conditions and a leaky gut go hand in hand.  In fact, in every autoimmune condition that has been tested, a leaky gut is present and is a contributing factor to the illness (not all autoimmune conditions have been tested, but many in the paleo community assume that leaky gut is a factor in all autoimmune conditions).  For individuals with suspected or diagnosed autoimmune disease, additional dietary guidelines exist to help address the disease.  In many cases, autoimmune conditions can be put into full remission by following these guidelines.  There is some variability to these guidelines depending on who you ask, so I have reviewed them and compiled a comprehensive list of not only dietary restrictions but also food recommendations using information from 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.

It is vitally important to adhere to a strict paleo diet with no cheating.  While other people may be able to enjoy the occasional bowl of rice, if you suffer from an autoimmune condition you are not one of these people.  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 (most people will not be able to successfully reintroduce dairy, although some will be okay with grass-fed butter and ghee).  This may be true for the rest of your life.  In addition, if you have an autoimmune condition, you should completely avoid:

The reason is that each of these causes gut irritation and/or increased gut permeability (and in the super sensitive gut of those with autoimmune conditions, they just aren’t tolerated).  There is also some evidence that hormonal birth control can contribute to hunger and digestive hormone disregulation, leading to inflammation.  However, you may wish to address the other elements in this post before going off birth control, depending on your personal circumstances.

Dr. Terry Wahls lays out a very convincing argument for increased vegetable intake.  Her focus is on eating vegetables from four main groups:  green veggies (for the vitamin B, A, C and K content and the mineral content), colorful veggies (for the flavonoids and polyphenols; at least 3 colors per day but this includes brightly colored fruit like berries), sulfur-rich veggies (cruciferous veggies, veggies from the onion family, mushrooms and asparagus), and iodine-rich foods (seaweed).  Dr. Wahls recommends eating 3 cups per day of each of green veggies, colorful veggies and sulfur-rich veggies as well as at least once serving per week of seaweed.  Note:  If you have Grave’s Disease or Hashimotos Thyroiditis, you must also avoid goitrogenic foods, which include raw cruciferous veggies, radishes, spinach, peaches, and strawberries (cooking reduces the goitrogens; fermentation increases them).  I also recommend an extra serving of seaweed each week as well as at least three servings per week of oily cold-water fish to support thyroid function  (except in the case of Hashimotos Thyroiditis as there are mixed reports of iodine taken either as a supplement or in iodine-rich foods actually worsening the disease).

Meat quality is very important as this profoundly impacts the types of fat that you consume.  It is extremely important to be mindful of your omega-3 to omega-6 fatty acid intake ratio, aiming for between 1:1 and 1:3, as this is essential for regulating inflammation in your body.  The best way to do this is to ensure that all of your meat, poultry and fish comes from grass-fed, pastured or wild sources. Oily cold-water fish (like salmon, mackerel, sardines, herring, kipper, anchovies, trout, fresh tuna, and carp) should be consumed at least three times per week for their high omega-3 content, easily absorbed protein, vitamin D and selenium content. Grass-fed meat also contains Conjugated Linoleic Acid (CLA), known to reduce inflammation, promote healing and even fight cancer.  The nutrient profile of pastured/wild meat and fish is superior as well.   My post on the importance of grass-fed meat contains some suggestions for incorporating it into your diet in a budget-conscious way.  It is also extremely helpful to incorporate organ meat into your diet at least twice per week due to its high nutrition density (including some amino acids, vitamins and minerals that are not as concentrated in muscle meats).  Note that the high vitamin A content of liver may be contraindicated in anyone consuming foods that they are allergic or sensitive/intolerant to as it has potential adjuvant activity (it may be better to add liver into the diet after 3-4 weeks of following this protocol).   It is also more important to eat organic produce as much as possible.  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.

Autoimmune conditions are also typically associated with disruption of normal gut microflora, often including Small Intestinal Bacterial Overgrowth (SIBO).  For individuals with suspected or confirmed SIBO, avoidance of starches and sugars other than monosaccharides (like glucose and fructose) is very important (read my post Fruits and Starchy Vegetables with Small Intestinal Bacterial Overgrowth for a list of which starchy vegetables are okay and which to avoid), although this is one aspect of the autoimmune protocol which is highly individual.  Some people do extremely well with the inclusion of starchy vegetables in their diet. For those with gut dysbiosis (any condition in which the type, amount or location gut bacteria are not normal), it is also important to help repopulate the gut microflora by eating raw fermented foods (like sauerkraut, coconut milk kefir, or kombucha) or taking a dairy-free probiotic supplement. Some people may need to avoid high FODMAP fruits and vegetables (which I discuss in this post) as FODMAP sensitivities are common in those with leaky guts and/or gut dysbiosis (when the lining of the gut is damaged, there tends to be fewer fructose transporters so any sugar or starch containing alot of fructose is harder to digest).  Others will need to limit themselves to cooked vegetables, which are typically easier to digest.

Healing the gut becomes very important.  I highly recommend consuming bone broth, organ meat (note the caution against consuming liver initially described above), oily fish, and coconut oil on a fairly routine basis as well as making sure that you are getting adequate vitamin D, whether you are taking a supplement, food sources like liver and fish, or spending lots of time outside. Note that coconut oil does not contain the phytic acid or inulin fiber (both gut irritants) that other coconut products contains (a little coconut is typically tolerated, but I urge caution).  Stress management is very important and I highly recommend doing at least one of the following: go for daily walks, take up yoga or tai chi, take a class on meditation, or make time for an activity/hobby that you absolutely love.  And I cannot emphasize enough the importance of getting lots of good quality sleep.  Aim for 8-10 hours of sleep in a cool, pitch-black room, preferably waking up without the use of an alarm.  It may help both stress hormone regulation and improve sleep quality to drastically reduce your caffeine intake.  Aim for no caffeine if you can.  It is also very helpful to drink plenty of water 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).

I know from experience that this is a very challenging task.  I also know from experience that 90% is not good enough (and the more serious your condition, the more important compliance is).  I know from experience that this increases your food budget (although perhaps this can be negated by decreasing your medical expenses).  I try and focus on the delicious foods that I do get to eat.  I try and 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 although you may be able to reduce your dose.  Please work with your doctor on this one!).  And, compliance gets easier once you start to see improvement.  Are these restrictions for ever?  Some may be and others might be successfully reintroduced after you see improvement in your symptoms. What foods you can reintroduce when if highly individual and will be the topic of a future post.



Very informative post! I have Celiac Disease and I have to say that eggs and nuts are very tough to stop eating. I do buy raw nuts, then soak them overnight and roast at low heat. I do try to limit them and I am trying to limit my eggs to 6 per week, but that’s tough.

Thanks! I have a hard time avoiding them too (especially when i’m cooking for the blog and feel like I have to taste everything to know if it’s okay!). 🙂

the same as me i have to have hight fibre diet and its very hard with all the tablets i have to take..i have oasteoperosis to and a fatty liver….

I’ve been trying to figure out what’s wrong with me as my health has steadily declined the past two years. Thank you for posting all of this information on one handy site. I’ve never felt so alone in my search and this gives me hope since none of the doctors I’ve seen had any clue what was wrong.

Hi Andrea,
Sorry to hear about your health issues. You might want to read the book “Forbidden Healing” by T.C. Randall. It’s very interesting and makes a lot of sense.

Curious, if this is all aimed at healing your gut… then would you say that once it’s healed, you can reintroduce foods? Or would you say once an auto-immune disease, always an auto-immune disease? Or would it depend on the disease?

I ask, because my sister had/has Graves disease…. which I understand is hyperthyroid… it was in remission for years, then she had a baby and bam…. hypothyroid. Clearly, her thyroid is wonky. But would you say it’s because she’s got a leaky gut as a result of a particular food (and not the entire list of restricted foods in your protocol), and once that food is removed and the gut is healed… is the auto-immunity gone? Can she then reintroduce foods slowly? We are all just guinea pigs… aren’t we.

It is a spectrum and some people can add those foods back in but many can’t. In principle, your body should stop making antibodies against itself after 6 months or so (but it can take up to 2 years of strict diet to heal the gut, then 6 months after that to stop making antibodies). Unfortunately, there is no good metric for when the gut is fully healed and antibodies are no longer being made. It really is just a case of, once you’re feeling good, then try a little bit and see how you feel. I don’t believe it’s the case of a trigger food so much as a sensitive gut (genetic susceptibility clearly plays an important role).

As for your sister, pregnancy suppresses autoimmunity so it’s very common for “flare ups” of autoimmune diseases after the baby is born (and potentially another one after weaning). But I do think that if she follows the autoimmunity protocol and can get to the point of not needing any medication, then she can carefully play around a bit with small amount of nuts and eggs and see how she does.

I’m trying to figure out how to type a ginea pig squeal. 🙂 Yes, we are all n=1 experiments.

Good question! In principle, the oil from seeds shouldn’t contain phytic acid. They typically still contain unfavorable omega-3 to omega-6 ratios (and the omeaga-3s are typically ALA which isn’t easily used by the body; we really need DHA and EPA instead) so I would use them sparingly.

This is a great post compiling this important info! Thank you! I have been Paleo AIP since January and have seen encouraging progress with Ulcerative Colitis, enthesitis and liver enzyme numbers going down. I had some intentional and some unintentional forays off that track recently and I am seeing that it was too much, too soon. I hope one day to have a healed gut that tolerates Paleo-approved foods like delicious poached pastured eggs with coconut oil again… oh yum! I am still trying to figure out how to have the “ok and nutritious but not AIP foods” in my house for my hubs and daughter, and not be tempted myself. It’s a process, and I find it does cost more, but you are right- it pays off in less medical expenses! And the investment we’re making into a healthy future is priceless!
Your blog is so helpful, keep up the good work 🙂

Thank you! I have the exact same struggle with the temptation of nuts, seeds, eggs and tomatoes in my house. I still haven’t figured out how to avoid them. Sigh.

My best blood results for Hashimotos was after 30 days strict auto-immune protocol. The exception was cocoa. (I have cocoa in hot water with a little coconut milk)
I then added back some foods – a little dairy, too much wine, eggs and tomatoes. Things with my thyroid went backwards!

On the other hand all my joint issues (mild auto-immune) have gone and stayed away with the standard paleo diet.

I’ve now removed eggs, and dairy, and have the occasional 1/4 glass wine. Things are better. I spoke to Mat Lalonde at AHS last year, and he confirmed all nuts and seeds are out. I think he said alcohol may be tolerated but not more than 10 grams (that is one small glass wine)

I’d like to find a balance with having a life and keeping my thyroid healthy as possible

May I just say how jealous I am that you have met Mat Lalonde! 🙂 I definitely think there is a balance. The trick is to figure out how much of what you tolerate. For myself, it still feels like a moving target, but I hope I eventually can partake in some of these foods without paying for it immediately! 🙂

How would you know how strict you need to be? Does having more than one autoimmune disease make it more difficult to heal? Why should you avoid eggs?? I’m noticing that I need to get off hte dairy and nightshade wagon (while limiting my fruit intake to less than 2 servings and eating Primal), I don’t do a whole lot of nuts unless I’m caught out and about with my daughter (aka-easy travel food), but I do a LOT of eggs. I do 4 eggs for myself in the morning and, excepting the last 2 days, am not hungry until noon (a good 4-5hr span). I now eggs can be an issue for a lot of people but I’m curious why you recommend it across the board for people with autoimmune conditions (I have 2).

I know this isn’t the most helpful answer, but it depends. Every person’s ability to handle these foods is different and some people do really well with eggs or nuts, while other don’t. The reason that eggs are blacklisted is because the whites of the egg contain lysozyme which can increase gut permeability and also bind to proteins in the gut and “help” them across the intestinal barrier. It’s also an extremely common food sensitivity. Dr. Cordain has suggested limiting eggs to 6 per week for everyone. And it’s fairly accepted to be a problematic food for those with autoimmune conditions (since the gut tends to be more sensitive to gut-irritating foods and heal more slowly). Some people do tolerate the yolks well, though.

I would just go by how you feel. If you think you are doing well on eggs, don’t worry about it. Or you could try leaving them out for a month or two and see if you do better. I dont’ tolerate them at all (which is horrible for me because I also used to eat 4 eggs every morning). Now, I typically have meat (pastured pork sausage or leftovers) for breakfast to help keep me full until lunch.

I hope this helps!

Thank you. I suppose I will work on eliminating the other foods and focusing on trying to obtain healthier forms of meat when the budget allows for it and if I still don’t feel 100% I’ll look to eggs as the next culprit… 🙂 Your advice is awesome, btw.

I was hoping for more of the why rather than the what. Everyone is different and has different issues. Switching to pastured meats, removing sugar and getting at least 30mins of sun has done the most to relieve my symptoms. Raw milk (grass fed) also seems to help so I’m reluctant to ditch that without good reason. I tried Wahl’s diet and it caused tremendous heartburn. Apparently I don’t tolerate cruciferous vegetables in those amounts. I can only have about one serving a day not the recommended three cups. Since pain is part and parcel of my illness ditching pain meds is out of the question also. Kinda stuck between a rock and hard place on that one.

Thanks for your comment. I’m sorry I didn’t get into the why’s for you in this post. I had to lay out the foundation before I can get into the nuances and details. I will be dealing with the individuality of autoimmunity and the why’s for the various restrictions and recommendations in future posts. As for the cruciferous veggies, sounds like you may have a FODMAP sensitivity (which basically means you get alot of gas etc. from cruciferous veggies and a few other similar veggies). My husband does too which makes it tougher, for sure. Have you tried sauerkraut? Some people who can’t tolerate raw or cooked cabbage are okay with it fermented. And if raw grass-fed milk seems to help, I would definitely leave it in your diet. I’m not sure what to suggest in terms of pain killers, other than to say that it sounds like you are doing a great job finding balance. 🙂

No need to appologize. I’m so happy you are posting on this interesting topic.

I only recently heard of FODMAP. If you could do a future post on it I would love to learn more about it.

I have tried sauerkraut and I’m not a fan of the flavor. I love cabbage, brussel sprouts and broccoli I just have to keep the portions small. I want to start sneaking sauerkraut juice into my food to help with my digestion but I have to take things slow since I have to monitor changes for adverse reactions. Over the last six months I have made huge changes to my diet. Some of the experiments went really well and I’ve had a few failures. I seem to have settled into a Primal style diet as a happy compromise.

BTW, if you want to look further into gut healing diets check out the Specific Carbohydrate Diet and the GAPS (Guts and Psychology Syndrome) Diet. Quite interesting and possibly contains the links between gut health and skin and brain health.

I need to ammend that answer. I have now read some good info that cooking foods substantially decreases the goitrogenic activity of the various compounds in those foods. I’ve actually ammended the protocol to simply recommend avoiding eating them raw.

I have Graves disease and limit cruciferous veggies to maybe once or twice a month, and always cooked. That way I can occasionally enjoy them. But there are so many other tasty veggies I feel why run the risk of jacking up my thyroid?

I would really like start this diet. I have celiac’s and what my nurse calls Type 1.5 diabetes. Basically where your antibodies are destroying the cells that make insulin or something like that. Anyway, do you have any links to scientific research on if this diet really helps or whatever? I’m finding a huge opposition from my husband about how I found this article and the one about the autoimmune protocol and am going to change our diet. He wants to be told by a doctor that I need this extreme of a diet change. I just want my body to stop producing antibodies and to not ultimately have to use insulin when those antibodies kill off everything that’s helps me regulate my glucose. It’s so frustrating. Any help would be much appreciated. What kind of Naturopath or whatever should I look for that treats autoimmune diseases?

Thanks, Cathy

I think that the evidence for using paleo to effectively treat autoimmune conditions such as celiac is still mostly anecdotal (basically, thousand of people have tried it and found it helped). However, Dr. Wahl’s is conducting clinical trials using a paleo diet plus the veggie recommendations I outlined above to treat MS. As far as I know, this is the first prospective study done using paleo to treat autoimmunity.

Here’s one of Terry Wahl’s papers:

This one you have to pay for, but it’s very similar to her TedX Iowa talk on youtube:
This is the talk:

You might also want to check out her website

A really good resource for finding a physician to help is the Otherwise, call around your local NDs and Chiropractors to find one that knows about paleo.

I hope this helps!

Cathy, please tell your husband that whatever works is the goal. My health declined in 05 so much all my faculties were 80% and I feared death. No MD had a diagnosis. After I got off dairy, gluten (6 months), corn and sugar, I improved physically and mentally so much that I got off of anti depression and anti anxiety meds and was immediately happier. MD’s are not taught about diet, food sensitivities in school. Alternative medicine is where that expertise lies. This is the first time I’ve seen this website and the advice matches what my functional medicine practitioner has had me practicing. Its essential to comply with the food suggestions and I’ve been taking supplements recommended by my professional who knows me well now.
Remember how careful you what to put in your gas tanks? Industrialization and Corporatist America build our medical system which fights with what it doesn’t know. So we are on our own. If I’d stayed on the pharmaceuticals I was prescribed I’d be dead now. Hallelujah for websites like this one!!!!!!! I had to figure this out by myself after consulting with 6 gastroenterologists and etc. I’m far from alone. I wish I had committed to this version of diet from the beginning and not cheated.

How befitting! I am going Paleo for my Hashi’s! I have been reading your blog for about 5 months and now I read this :-).
I didn’t know about no eggs… which is very interesting! I am wondering now what the heck I am going to eat for breakfast! I really appreciate this article. Thank You from the bottom of my heart and Happy Mother’s Day!

Thanks! I eat sausage, either homemade or bought from a local farmer, mostly pastured pork but I’m starting to play with grass-fed beef and bison sausage. And I usually have some veggies and berries on the side. It’s quite satisfying! 🙂

I love having shrimp for breakfast. Eating fish for breakfast is common in other parts of the world. Being English kippers were always a breakfast option.

I have Hashimoto’s and am wondering if you have information regarding using nut flours in gluten free cooking. I’m just beginning to research the Paleo diet in hopes that it will improve my symptoms. Thanks!

The recommendation for Hashimoto’s would be to avoid all nuts and seeds. If you’re avoiding starches, arrowroot flour and tapioca flour are out too. I do think you could use coconut flour and I just bought some pumpkin flour to play with which should be okay. I hope this helps!

I love how informative your posts are! Questions: What about the GAPS diet protocol for gut healing? Do you personally agree with using that to determine one’s ability to handle certain foods? Also, I have severe seasonal allergies (that are now year-round). That is the only autoimmune condition I have (as far as I know). Would you consider that a reason to do the autoimmune protocol or are we talking about more severe conditions?

I’m surprised i never replied to this comment. I’m sorry. I think GAPS-intro is awesome. I have some differences in what to add in as you keep going, but I really like the combination of GAPS and paleo. I think that if you have seasonal allergies, there is a good chance you are eating something you are sensitive to. The AIP is a good start for an elimination diet to try and figure out what that is, or you could get some food sensitivity testing done. But I doubt that you need to be on the AIP long term.

Seed-based spices are more individual. I generally recommend eliminating them for the first few weeks and then trying them (staying away from hot pepper spices which are also nightshades and high in capsaicin). It is a dose issue with spices, but since you are mostly using them in small quantities, many people tolerate them. As for flax, it is not recommended. Egg yolks are often okay though. Again, I advise a period of time without but I think egg yolks are the first thing to try and add back in (they are a common sensitivity in those with leaky guts, but if you aren’t sensitive, they can provide some great proteins and fats). I hope this helps!

I have MS and just started the Paleo diet with most of the autoimmune protocol in place (I still have bell pepper and tomato). My main symptom is weakness in my left-hand, which seems to have become more pronounced since I started Paleo. Does this sound like a normal detox side effect, or a sign that this isn’t working for me? Somethings I would be willing to wait out and see if it goes away, but I’m worried about ignoring this.

I doubt that it’s a detox effect. I think it sounds like tomato is a bad idea for you (it can rev up immune responses and is the most likely food to not be successfully reintroduced).

I originally started up on the Paleo diet last September after being diagnosed with Pulmonary Fibrosis (PF). In the last seven months of being on the diet I have had some success (success in PF is in being stable) and stopped taking three major drugs (Nexium for GERD, Crestor for high cholesterol and Wellbutrin for depression) but have not been 100% but probably follow Mark Sissons advice of 80% or better. One of my toughies to give up are eggs. My wife all but went ballistic when I started having eggs fried in butter (grass fed) each morning but here I am, with a stable disease, feeling far better than I probably should, and eating eggs plus the once and a while a night shade plant of potatoes and occasionally eggplant. My question to you is should I try to go 100% if I am already experiencing some success?

Hi Bill. This is a great question! If you feel like the 80% that you are doing is sustainable for the long term (and especially if you feel like 100% would be too hard and might lead you to “fall off the wagon”) and that you like how you feel (especially if you are continuing to see improvement), then I think sticking with what is working for you makes alot of sense. That being said, pulmonary fibrosis is an autoimmune disease. You may be able to do better than “stable” and actually see some reversal of the disease if you fully adopt the autoimmune protocol. I guess my answer is that I think it’s worth a try to go 100% if it’s going to be manageable for you (and if your wife can handle it!). I think you have nothing to lose but potentially alot to gain. You could do a trial, maybe commit to one month, and see if it makes a noticeable difference for you. After that you can decide if the difference in your health is worth the extra deprivation and effort or if 80% was working well enough that you’d rather stick with that. Unfortunately, you won’t really know if it’s going to make a big difference to go 100% compared to 80% unless you try. 🙂

Nine years ago I had my thyroid removed due to cancer, once the pathology came back we discovered I had had Hashimotos as well. I been treated for years prior to my thyroid cancer for hypothyroid.
I have been eating Paleo for a couple of years. My eczema has cleared and I no longer take any allergy meds.
My question is should I be eating Paleo or Paleo with the autoimmune protocol?
I feel great on Paleo, going through menopause, though and not losing weight.

That is a fabulous question! My answer is no, if you are feeling great with how you are eating now, there is no good reason to restrict what you are eating any further. Weight loss is tough when your body is going through big hormone changes. Give it some time to adjust and if you are still not losing weight, you can play with macro-nutrient ratios and portion sizes (which might mean up or down) and see if you can get your body to lose more weight. Patience is probably the best strategy for now though. 🙂

I am just curious, what typically do you eat for breakfast if you are doing Paleo and avoiding eggs as well? Thanks!

I typically eat sausage (mostly homemade but I do buy some pastured pork sausage from a couple of local farmers) with some veggies (typically homemade sauerkraut but sometimes spinach or kale sauteed in the sausage grease). Sometimes I have berries or other fruit or a green juice on the side. I change it up by changing the seasonings that I use for the sausage (and whether or not it’s beef or pork), and changing the fruits and veggies.

I love the idea of this whole approach, sounds a little like GAPS? I would be totally on board except I’ve gotten used to my whole milk kefir and it would be really hard for me to ditch. I feel like it has a lot of good benefits and personally it seems to make me feel so good when I drink it. What is your take on doing this and still drinking kefir? Is dairy bad for all autoimmune disease or just some? Thanks!

There are definitely some strong similarities between this and GAPS intro (some foods allowed on GAPS that are not allowed here and vice versa). Dairy is not universally bad and some people tolerate it, especially raw, grass-fed, and cultured. However, those with autoimmune disease tend to be ultra-sensitive to some proteins in milk that can make it hard to heal a leaky gut (if not directly contribute to it). I suggest leaving it out until the health issue(s) you are trying to address improves and then add it back in. If you make your own kefir, the grains will grow in full fat coconut milk fairly happily for a couple of months (and then need to be refreshed in cow or goat milk for a week or two). Then you get the benefits of all those good probiotics without the potentially harmful proteins in milk. But, if you really think that kefir is helping rather than hurting, then it’s completely reasonable to leave it in your diet for now (but do re-evaluate if you are having continued health issues).

So glad you mentioned coconut milk kefir, though I’m a little confused because I was reading on the Cultures for Health website about making it and they said something like “or for truly dairy free kefir try water kefir” which made me wonder how much dairy might be leftover in process. Also do you have an opinion on water kefir on the AIP? I’ve heard it does have some fructose left over but not sure how that affects the no sugar stuff (well I guess more so the candida killing aspects of my plan). Thank you so much for all this helpful info!!!

The milk kefir grains are just an organism that likes living in a higher fat environment. You do need to refresh them in milk every so often, but rinsing will with eat before putting in coconut milk should handle any residual proteins. If you are crazy allergic, you co us throw out the first batch of coconut milk kefir too.

This all sounds great. But what about losing weight…when you don’t want/need to? Being naturally thin and eating paleo with no eggs/nuts/nightshades/sweet potatoes leaves you with meat and veggies/fruit. Veggies and fruit are basically out as I have Ulcerative Colitis and can’t handle them for the most part. Which means most of your calories are coming from meat and any oil’s you may add to foods. Coconut Oil is out if were talking Extra Virgin since it makes things flow like niagara falls if you know what I mean. The refined Organic stuff (NOT hydrogenated..Spectrum sells it) doesn’t seem to bother me gut wise…but I don’t know that it offers the same benefits as the EV stuff. Any advice?

Wow! Fabulous question! How do you handle very well cooked vegetables and fruits (thinking like applesauce, stewed berries etc.)? The other option with ulcerative colitis is green juices, because they can be much easier to digest after you remove all the fiber (and pack a nice carbohydrate punch for you to help with weight maintenance or weight gain). With naturally refined coconut oil, like Spectrum, you get the beneficial medium chain triglycerides, but not as much of the antioxidants. Still a good choice if you can’t handle extra virgin. Other good oils to try are avocado oil, olive oil and macadamia oil (the oil doesn’t have the lectins or phytic acid that make macadamias a no-no). Olives and fresh avocado are a great way to boost fat/calories too. Keeping the carbohydrates from dipping too low and making sure you are getting lots of good protein and fat is my general guideline for weight maintenance and gain. If stewed fruits and/or green juices don’t work for you, let me know and I’ll see what else I can come up with! 🙂

Wow, quick response! Thank you! Cooked veggies…well I can steam the hell out of broccoli and I seem to do ok (some excess gas). Spinach as well. When you say green juices you mean actually juicing veggies? Haven’t tried that actually! Good to know about the refined coco oil. I actually REALLY like the taste of the Spectrum refined one (even though people say it doesn’t have a taste). Olive oil is my main fat I’d say. Haven’t tried the others you mentioned (I’m generally very cautious about trying new foods. I’m just starting to improve with my colitis after 2 years of hell…still a long way to go but I’m getting there). As far as protein goes. I’m just about 6ft 145-150 pounds depending on the week. Even before colitis I was about the same. More like 148-152. (Male by the way). I’ve seen varying reports on how much I should eat. I’ve tried as much as 1 pound of Top Sirloin a day but things tend to get loose at that amount…actually I ate it all at once for dinner actually so maybe that was the problem. O and applesauce doesn’t seem to bother me much either.

Sorry I meant varying reports on how much protein I should eat…also maybe it would help I post my normal daily intake. This hasn’t changed much at all over the past year.

Breakfast – 5 pieces of Jones Sausage links (no sugar).
3 Egg’s cooked in about 1 teaspoon of refined coco oil.
Handful of blueberries (should havent mentioned these dont’ seem to bother me)

Lunch – plaintain chips cooked in palm oil. Dried apricots (just recently starting eating these). No added anything including no sulphur.

Dinner – Grass fed top sirloin 1/2lb-3/4lb. Spaghetti squash (just started recently) or broccoli/spinach. Maybe half a cup.

And that’s about it! Lunch I skimp on so that I can make it through the work day. Eating tends to get things moving (bathroom trips).

Sorry for all the typo’s! I’ll refrain from posting again until I have the time (rushing right now…haha).

Tough one. I think eating a more substantial lunch would probably do you alot of good (or finding another time of day to eat more?). Of course, not if you can’t get any work done! What about adding a couple of small snacks? How about adding a cup or two of bone broth throughout the day or with lunch? How do you do with something like jerky? And how does fish affect you (easier to digest proteins than meat). Yes, I mean vegetable juices or vegetable mixed with fruit juices (you can go to a juice bar or whole foods and try some premade ones before investing in a juicer).

I plan on making the bone broth later this week actually. Jerky I actually do fine with. The O’berto brand I’ve tried on and off with no increase/decrease in symptoms. It’s not SCD legal (sugar) but it’s not loaded with wheat/soybean oil/msg/all the other crap most store bought jerky’s have. The only grass fed jerky I’ve seen without 10,000 ingredients is on US Wellness. VERY expensive. Of course I could buy a dehydrator and make my own I guess. Fish…o how I miss it! Living in SoCal I literally ate wild salmon every single day. Great supply at Trader Joe’s! I live in VT now and the selection is just not soo great 🙁 Grass fed beef however is very easy to find here! seems to have a great selection of seafood. A bit pricey but they seem legit (sustainable..etc). As far as juicing I have a Jack Lalaine juicer but I’m not sure it handles veggies (leafy anyway). Those Vitamix blender’s seem to be the way to go…but they dont’ separate all the fiber which would proably tear me up right now! Thank you so much for all the suggestions!

Do you my breakfast is excessive with bad fats? The sausage in particular? I’ve seen Gary Taubes’s daily diet and it’s pretty much the same deal.

Well, it would be better if your sausage was grass-fed beef sausage or pastured pork sausage. Is that easy for you to get a hold of? Eggs may or may not be a problem with ulcerative colitis. It might be good to try a couple weeks with a bigger sausage serving and no eggs (maybe add some cooked veggies too?). I buy frozen wild-caught pink salmon at my local grocery store fairly inexpensively. Are you near a Trader Joe’s ? I hear the Jack Lalaine juicer is great for veggies (my favorite juice is beat, carrot, kale and lemon and I do this with a $30 juicer I bought at Walmart). There, I just saved you $600. 🙂 I also have a $40 dehydrator that works great for making jerky:

Beef sausage I’ve never seen here. Pastured pork however I could get my hands on! I eat 3 egg’s every morning which = 210 calories according to the carton info. I could just eat 2-3 more sausage links I suppose. Any reason to be concerned with eating that much sausage?

Closet’s Trader Joes is 3 hours away near Boston! My girlfriend said she saw Wild Salmon at Costco today though. I’m always skeptical about inexpensive fish…until I digg into exactly where it’s coming from…google the companies name along with “scam” “bogus” “fraud”…etc..I don’t trust them! Haha…

That is a huge savings! I’ll just found the booklet that came with the juicer and it will do some greens! I’m gonna give it a shot. Do you have a receipe for Bone Broth you’d recommend?

Thank you so much for the dehydrator link! Looks like Nesco has a bunch of models with great prices (with my amazon prime account). I remember looking into these a while ago and for some reason got turned off by it….anywho…I’m gonna give it a shot now!

Hi! Your website is an amazing wealth of information. I’ve been doing the paleo diet and am getting ready to start the autoimmune protocol for ankylosing spondylitis. I have kefir grains. My question is this: Is raw goat milk kefir ok with autoimmune conditions or should I just do the coconut milk kefir?

Thank you for your help.

It really depend on whether or not you are sensitive. Most people with autoimmune issue are sensitive to all dairy, but not everyone. You could approach this one of two ways: you could do the full AIP except leave raw goat milk kefir in your diet and see how you do (and if you aren’t happy with your progress, switch to coconut milk kefir) OR you could do the full AIP with coconut milk kefir and then have goat milk kefir be the first thing you add back in. I think which ever way makes more sense to you is fine. 🙂

I was also happy to read the post about finding patience with AIP – I feel like I’m at the end of the proverbial rope and I just started. Perhaps it’s a mistake to try to integrate AIP with a low-meat diet – beginning to feel like the only thing left is water!

Quick question for you, though – I wonder if there are more things that qualify as ‘seeds’ than we would think, particularly fruits? I read that strawberries are more seed than fruit – do they count as seeds?

Thanks in advance for your response, and for everything you post!

Berries are usually considered okay since the lectins they contain are not damaging in the way that other seed lectins are. They are also very high in vitamins and antioxidants, which can help healing. That being said, strawberries are a common food allergy which always makes me suspicious. I think berries are okay to include as a first step when starting the AIP but should definitely be kept in mind as possible suspects if symptoms do not improve (a blood allergy and/or sensitivity test might be needed).

Thank you so much for sharing all of this information. I just found your website and it has cleared up so much for me. Especially the AIP! I have Hashimoto’s. I was wondering about hemp hearts and chia seeds? Because hemp hearts have the omega fatty acids and protein are they permitted? And can we have chia seeds if soaked?

Again, I am so very grateful for your insight and sharing!

Soaking chia sees (or any nuts and seeds) reduces the phytic acid and lectin content, but it’s still there. You may be sensitive enough that that’s still a problem or you might be fine. Hemp hearts would still have phytic acid and lectins, although less because those are usually concentrated in the shell, but the omega-3 fats are ALA, not DHA and EPA which is what is really needed by the body. I would try leaving both out for a couple of weeks and then try some and see if you notice a difference. There’s lots of individuality here in terms of response to these foods.

HI, I have Hashimotos and my Endocrinologist said no special dietary requirements were necessary but I was already familiar with and have followed the Paleo diet. I dont particularly react to any foods and it’s tough cutting all those food groups, how would you tell? THe most I get is slight bloat but have always had this my whole life with things like pasta and bread like most people I know. THanks very much.

Diet changes to address disease is not really part of medical training, so it’s fairly common for doctors not to recommend any dietary interventions (other than the standard lower your cholesterol advice for cardiovascular disease). However, the autoimmune protocol (with making sure you are eating iodine-rich seaweed and/or fish and avoiding goitrogenic fruits and vetebales) should actually make it possible to reduce your thyroid hormone supplementation (and some people are even able to go off it altogether). You will want to have your thyroid hormones tested more frequently while you do this so that the levels of your medications can be adjusted. That is probably where you’ll notice a difference, rather than in any digestive symptoms. When you try and reintroduce foods again, look for the signs of hypothyroidism like fatigue.

honestly, this diet is too restrictive for kids with autoimmune issues, and too restrictive in general. Paleo is fine and can be very beneficial for autoimmune issues. But what is left to eat here? meats, veggies, fruits, fish and coconut products. You can’t even have seaweed if you have autoimmune thyroid disease either. A good option is to go Paleo and take an immune modulator like Low Dose Naltrexone, DMG or immunovir to help your messed up immune system function properly and lower antibodies.

I love your posts!! very informative! I have hashimoto’s and have been GF for over a year and still experiencing some uncomfortable symptoms like anxiety and IBS. I was wondering with the AI protocol, you say to avoid eggs and nuts/seeds and spinach and strawberries. Is that just until the gut heals or forever? I have been printing out your recipes and many of the snacks have nuts and eggs in them and I eat spinach and strawberries everyday. Is there a chance that some people with hashi’s eat them?

Many people can reintroduce these foods (I’m working on a post of how to reintroduce foods and when) or at least some of these foods (some people can’t though and it’s really individual). The idea behind avoiding these foods is that you may be able to put your Hashimoto’s into remission and go off all thyroid meds (there are many cases of this in the paleo community). I do have lots of recipes that are not appropriate for the autoimmune protocol because I cook more for my family than I do for myself. I will have more and more autoimmune friendly recipes in the next couple of months though.

Thank you for your response! I was on a gut-healing protocol for several months using supplements and of course going GF, while under the care of a functional medicine doctor. I am still having gut issues so, I wasn’t sure if I should cut out more things – like starting the AI protocol and then ease some things back in…All of this is so confusing!! I appreciate your response and feedback, thank you so much, you have put a lot of hard work into your blog to help others!~ =)

Hello – have Hashimoto’s. Would love to get off meds/get my body to stop attacking itself. My doctor told me there was nothing I could do but to take meds for the rest of my life. I specifically ask her about diet, she said it didn’t matter, but I knew that could not be true.

I first found gluten-free research, and I thought that was restrictive. Once I got used to that, I learned about Paleo when I got up enough energy to try Crossfit. I thought that would be impossible. Now that I’m used to Paleo, I learn about cutting even more foods out to heal my gut and maybe stop the AI attack. Good thing I’m learning all of this in phases!

My question is can a high-quality fish oil supplement take the place of eating the amount of fish you recommend per week? If I cut out nuts/seeds/nightshades/sweet potatoes, I am wondering about having enough energy for workouts. Any advice here?

I’ve come here in pieces too (low-carb, paleo, no nightshades, AIP). I think it was helpful for me too.:)

Yes, you could take a high-quality fish oil supplement, but actual fish would be better (the fats won’t be oxidized from storage like they may be with a supplement and you’ll also be eating all the minerals, vitamins and proteins; I actually have three posts coming about eating fish instead of supplements).

As for energy for workouts, in terms of fats, you’ve got lots of great fat sources (you’ll notice the biggest energy boost from coconut oil and palm oil/shortening). And you can include high glucose fruits like bananas, grapes, figs and apricots (I have a post coming about high glucose fruits too). I also think you can try sweet potatoes and see how you feel; they are really only an issue if you have SIBO in addition to autoimmunity. Squash should be fine with autoimmunity and still provide a little more energy. Chances are that your energy will rebound once your thyroid is happier too. 🙂

Thanks so much for the suggestions – I really appreciate you being able to explain in such depth. I haven’t read your entire site, but stumbled across this page and have looked around a little – it seems you are very knowledgeable and passionate. Please keep it up. The AI community needs more information such as yours!

I came in stages too. Gluten free for 2.5 years which is hugely better but still having breakthrough episodes of some sort of autoimmune disorder (symptomatic of fibromyalgia) so I have adapted the Paleo AIP on top of it. Feeling much better! I think it helped to start with GF before moving on. All at once would have been very scary.

I just re-read this post & got the part about seeds. Somehow, I completely missed that before. I’m not AI, but suddenly developed a bunch of food allergies last year, while I was trying to loose weight (everything whole wheat, no fat, etc). I fell into Paleo because it seems to eliminate the foods I know I react to & it is really helping. I’ve been trying to move to AIP, since I’m assuming a leaky gut is the source of the allergy problem. My question is: Are Pine Nuts considered seeds, or nuts, or are they ok to eat? I’ve been grinding them up & using them for a crust on fish.

I wonder if this would help with my psoriasis. Hmmm. Since starting Paleo, my psoriasis has calmed down but not gotten better as a whole. Still growing actually. I’m gonna try this. I train allot so I’m interested in how this will work. Must stop drinking alcohol too.

I’ve just stumbled upon one of your articles and have gone from link to link to link reading for well over an hour. I am so overwhelmed. I was diagnosed with celiac disease back in December 2010. Giving up gluten was actually fairly easy, however, all these other conditions are driving me mad. It started with dairy and soy, then eggs, then yeast. I think I’m being healthy by increasing my fruit intake, I start reacting to fruits, I start paleo and I react to nuts, I also tried to change over to coconut everything and I think I am reacting to the coconut, so I feel I live off salads and plain old meat (because I can no longer have yummy marinades or many spices) and now I read the list of veggies that may be bad for me (#1 avacado which I’ve started putting on everything)! I read one article that says these supplements are good (I started daily flax and chia seeds)….but nope, oops, those are bad for me too! It’s no wonder I’m not really getting any better but I really am wondering what’s left for a person to eat and it makes it so difficult for the rest of my family. Everyone feels guilty about eating around me and going out to dinner is a plain nightmare! How do you do this?

Oh, and I should add that even though I eat better than I ever use to, I’m up 15-18 pounds!! AND gave up coffee. Sorry…having a woe-is-me day. Just frustrating trying to figure it all out.

I know that it can feel very frustrations and very limiting. And it doesn’t help that there is so much conflicting information out there. The idea behind flax and chia is to increase your omega-3. The idea is really good, but flax and chia are not good sources of the omega-3 fats that your body actually uses (those come from fish and grass-fed meat). The part about the fruits and vegetables is very individual and most people just need to experiment and see what works for them (which it sounds like you are doing). I would recommend the book Practical Paleo for a really succinct list of supplements and foods to avoid for autoimmune disease and for digestive problems. As your gut heals, you will hopefully find that the range of foods you can tolerate increases. I know it’s hard. I wish I had a better answer for you.

Thank you for your response and I apologize for my rant, it just gets me every now and then how difficult this is. I’ve purchased the book you recommended and a couple of others to continue to learn about paleo and the AI issues. At 42 years, new habits are hard to create. Thank you for sharing all your expertise….I look forward to learning more!

You might be interested to know that a fungal problem could be at the root of all your issues….”dairy, then soy, then eggs, then yeast”…
You wouldn’t be the first person I’ve known to go gluten-free, only to find it necessary to cut out all dairy, then the next thing and the next and so on.
What do you have to lose from trying a “fungus until proven otherwise” approach? I’d bet before 30 days are up on a Phase One regimen that you’d have a good idea if it indeed IS a fungal problem. (Plus I think it would be EASIER than what you’re having to endure now 🙂
read more about it here:

Blessings to you,

I have Hashimoto’s and having to give up strawberries, spinach and eggs is going to be very difficult. What if you freeze fresh strawberries? Does that help to eliminate any goitrogenic properties at all?

I was labeled with ms in January of 12. Upon finding out what it was that ailed me, this year has been a world wind of information. I’ve read as much as I can daily sense Jan. At first I was vegan, then Wahls, and now Paleo. Thank you for all the information it is very enlightening. I wish I would have found this first off, but now that I have my diet is veggies, wild salmon, grass fed liver and some fruits and some nuts. I need to get away from nuts, but in the last two months I’ve battled getting away from tomatoes and eggs. My supplements are D, fish oil, B12 and B Complex. I think I am on a good path and I know I ate terribly for over 20 years so I don’t expect results today. My question is, have you heard of a person with ms putting it into remission and getting their balance back? I read somewhere where it is good for the brain to believe it will get better so I try to live by the motto of “reverse it”, of course only time will tell, but just curious if you’ve been around it. Thanks again. Joel

Besides Dr. Wahls herself? Dr. Wahls is actually running clinical trials right now with her version of the autoimmune protocol and the early reports are that they are seeing great improvement. Anecdotally I’ve seen many comments from people on blogs about having success reversing MS, although I do not know anyone personally who has tried this diet for MS (I am working on getting a friend to try it thoug). Actually, there seems to be abetter success rate for MS than skin-related autoimmune conditions, maybe because the brain can adapt so well?

Thank you. Yes besides Dr Wahls. She is my hero. Most people I’ve met in ms societies, seem to never think they could change it. I try to keep my mind open to the fact I got labeled with ms and I will reverse it. I guess looking for justification of that, but it dosn’t matter, either way I’m a believer and I know I abused myself for years, so i don’t expect it to be different over nite. I’m 42 now, so who knows maybe by the time I’m 50 or 60 lol, no rush, life is good.

Yes Joel! Keep that positive attitude! Surround yourself with people and information that believe the body is designed to heal. I hear you refusing to be ‘owned’ by the MS label. Good work. Blessings and vibrant health to you.

Kerry, yes you know someone who reversed their ms besides Wahls? Recently I’ve spent a lot of time reading Jack Kruse. That guy is amazing and he takes paleo to another level. Check him out if you haven’t. Paleomom is great because it lays it out simply and takes a lot of info and makes it applicable. I also like the fact she replied too my comment. The world will always need people like her.

Thanks for the Elanspantry websit, she sounds amazing and so encouraging. I will read more on her. In the meantime I did find Rosemary Fletcher off of the raw food website. Diagnosed 30 years ago, 15 in a wheelchair and couldn’t walk, now walks a mile a day and inspirational person. She had doctors tell her she better get back on her meds, she said “your fired”.

Hi, someone from a post I put on the WHOLE30 Forum recommended your post about anti inflammatory…
I have RA.. I have been gluten/dairy/corn free for years.. I only take homeopathic remedies as well. I am very athletic. All that being said I am inflamed and hurting… I have been doing whole30 for about 40 days now. I am faithful! I do eat eggs, raw nuts,sweet potatoes, and peppers… Do you really think that’s the problem? It does flair up during season changes…

It could be, especially the peppers. Since it flares seasonally, it may be that you just need to be extra strict with your diet when the polens or molds that you are allergic to are blooming. I think it’s worth a try to at least take out peppers and maybe eggs and see how you do (if you don’t have obvious GI symptoms, I think it would be fine to leave in sweet potatoes). I hope this helps!

Very nice post! Thank you. I wonder if my symptoms might be helped by a diet like this. I have chronic anxiety, acne, hair loss, cold hands and feet in the winter, gas, constipation, eczema, dandruff, muscle pains and mites allergy. I don’t know if there is some autoimmune condition (or other) that is causing all this (maybe you have an idea) but maybe this diet could help?

It certainly sounds like early symptoms of autoimmunity. These could also be explained by a leaky gut and food sensitivities too. Are you eating paleo now? If you aren’t, I’d suggest giving that a try first. If you don’t see dramatic improvement in the first three months, then doing this more restricted version would be a great next thing to try. I definitely think that this diet has the possibility to help dramatically. Sleep and stress management are also very important.

Thanks for the reply. I’ve been eating paleo (with rice) for awhile. I also tried taking the nightshades and FODMAPS out but the improvements are difficult to see. Maybe I really have to have a food diary and try these variations…

You recommend coconut oil for healing the gut. Do you mean cooking with it or consuming it by itself? If so, how much is recommended daily? Thanks! : )

Wow! And I do say that with a tear in my eye! My eldest daughter and I have gluten intolerance, I have hypothyroid, my eldest son has migraines and a (thankfully going-away) pituitary tumor, and my youngest son has extensive vitiligo and anaphylactic peanut allergy. I have recently decided to pack my family up onto the Paleo bandwagon for our health. Personally, I feel TONS better already. My eldest daughter is the ringleader/cheerleader, always checking, “Is that Paleo, Mommy?” LOL! My eldest son is the one who has had the most resistance to this new lifestyle. The other two kiddos are too little to really care (almost 4 boy and 22 months girl), though my little guy is CONSTANTLY begging for food (especially fruit).

I am wondering if going Paleo now and strict AIP later when everyone is “in the groove” would be okay. Yes, I know that we are dealing with leaky gut issues, but I just don’t think I could get everyone to give up eggs and almond butter, and me, my coffee and wine!

I am especially concerned about the little guy with the vitiligo. It’s quite extensive, and he’s also my beggar. I guess I just need some advice on “easing” into total AIP… Thanks for a great blog!

Hi Sarah

What do you think of this product: BLUE ICE Royal Butter Oil/Fermented Cod Liver Oil? Do you think that the butter oil (which adds more K2 to the blend) can be problematic? Would it be safer for me to consume just the Fermented Cod Liver Oil?

I would definitely recommend going with the straight fermented CLO and not the butter oil blend for autoimmune. My only caution is that the extra vitamin A can exaggerate a food sensitivity reaction if you are still consuming any foods that you are sensitive to. If your diet is very clean, then it’s great for speeding healing.

I am blown away. I just discovered your site (link hopping via Chris Kresser); what an amazing resource this is.

I am in the middle of a confused tangle of celiac, hypothyroid and incredibly upsetting adult acne. My diet is Paleo (and low FODMAP), but skin and gut problems persist. And painful arthritis at 40, really now?! I feel pretty lost in it all, and hence your ability to present the information so very clearly, to make this accessible to non-scientists … wow. So grateful.

I can see I have a lot of reading ahead, and the AIP to trial (given the insane amount of eggs in my diet, I wonder if a solution could really be this simple. How wonderful to think that perhaps I don’t have to live like this forever). You’re awesome!

[…] 30-ers” and those who make amazing Paleo-fied versions of non-Paleo foods. Some Paleos follow an autoimmune protocol, and others fast between meals.There are “80/20” Paleo eaters, those who eat Paleo but drink […]

Question – do you know if Pernicious Anemia falls under the same cloud as these other autoimmune disorders in relation to diet? Thanks so much for all your wonderfully informative posts!

[…] More foods not to eat are dairy, refined sugars, salt and processed foods. Although the 85:15 rule is that you can have up to three non-Paleo meals weekly. You can find more information about the Paleo Diet here . Click on the pulldown menu at the ‘Getting Started Menu’ to find the medical documentation and more breakdowns of foods that you can and can’t eat on the Paleo Diet. You can purchase his book through his website as well. If you have an autoimmune disease, you may also want to visit the Paleo Mom’s advice here […]

I’m curious as to your thoughts on food sensitivity testing. I have type 1 diabetes, and was just diagnosed with stage 1 lipedema. I’ve had chronic GI issues for many, many years, preceding anything else. Several years ago I had the IGG/IGA/IGE food sensitivity testing done, and I’ve never eliminated everything all at once that I had a reaction too (it’s a pretty long list, and that’s overwhelming). I am wondering if, instead of first trying the AIP, and removing nightshades, alcohol, etc. (everything you listed), if I should try removing my sensitivities first and see what happens. Thoughts?

Yes, that makes a lot of sense to me. If you have already tested positive to a variety of foods, eliminating those before the other foods on the AIP is what I would recommend.

Hi – Very interesting article! I was diagnosed with APS (Antiphosolipid Syndrome) recently which is an auto immune disease of the blood. I have been following a Primal Diet for the last month, Paleo most recent weeks and aside from dramamtic weightloss and feeling better than ever, i have very little symptoms of my disease.
Im still all new to the Paleo world and researching heaps but i was almost heartbroken when i read that Eggs, Nuts seeds, Nightshades should be competly avoided! I feel like i have recently rediscovered a new love in these foods to help replace/remove Dairy and Grains.
Do you think i should remove these additonal foods comepletly if i dont have other symptoms or are they complete no no’s….. Im not sure if APS falls under the same class as these other autoimmune disorders in relation to diet…

If you are experiencing vast improvement in your symptoms with a standard paleo diet, then it makes a whole lot of sense to stick with that. Just keep the idea of the autoimmune protocol in the back of your mind. Sometimes things like stress can cause a flare, and then this more restricted diet might be very helpful in dealing with that. But, if you’ve found something that works, go for it!

Will you please explain why cocoa and chocolate should be eliminated? Is it because they are seeds? You explanation about coffee helped motivate me to give that up, and I really notice a difference. I have to be very strict with this diet: no nightshades, alcohol, coffee, etc . . . in addition to strict paleo. Before finding your site, cocoa, red wine, and coffee were my cheat foods! And I was unclear about why I should avoid nightshades (tomatoes and peppers). So sad to give those up. Your site is a goldmine of information. Thank you!

There are a few reasons. Most importantly, chocolate is a gluten cross-reactor. So, if you have gluten intolerance and your body is producing antibodies against gluten, there is a good chance those antibodies will see chocolate as being exactly the same thing as gluten (this is true for coffee as well). Chocolate is extremely high in phytic acid (more than most nuts and seeds), which can be a gut irritant, especially in high quantities. It is a fairly allergenic food and it’s a seed (so the arguments against seeds generally applies, plus most of the most allergenic foods tend to be the ones with lectins that increase gut permeability, although that hasn’t been studied with chocolate). I think it’s absolutely fine for healthy people to include chocolate/cocoa in ther diets, but it’s another food with high potential to be problematic for those with autoimmune disease.

Thank you! I did give up coffee, chocolate, and red wine, and notice right away that I feel better. But I’m looking for an excuse to add chocolate back in.

I read in one of your comments that skin-related conditions may not show as much improvement on the AI protocol as MS. Do you know of any other sources with skin-specific AI protocol information?

I’ve been suffering from seborrheic dermatitis and/or scalp psoriasis (dermatologists never know what to call it) for a few years. When I was pregnant I improved quite a bit, but started getting these really weird skin issues–like all of a sudden my eyelids were extremely flaky, red, and blotchy. Now that I had my baby, I have psoriasis developing quickly on my arms–it started on my forearms but is spreading up. And just today, after a hot bath and blow drying my hair, I looked in the mirror and my face was almost maroon–it literally looked like I had a maroon mask on, with a clear demarcation line extending all the way down to my neck It went away after I cooled down. I eat 80% Paleo, but have been overindulging in coffee, dark chocolate, white potatoes, and wine.

I’m planning on implementing the AI protocol ASAP, as soon as I’m able to get back into my house once the power is back on (due to Hurricane Sandy). I’m wondering if there are any supplements I should take in addition to the dietary changes that might specifically target these weird skin issues.

The reason skin conditions can be tougher to resolve is the gut-brain-skin axis (Chris Kresser has written about this a fair bit). It even merge important to get a good source of probiotics, get alot of sleep, and manage stress. Mindful meditation can be very helpful (5 minus of sitting quietly of focussing on your brething). Also doing puzzles, cross-words, sudoku things like that can help turn off the inflammation in the brain. Getting some not too sensuous exercise is very important. And Vitamin d3, probably a fairly hefty dose (5000-1000iu daily). Also, L-glutamine can help speed healing of the gut. Plus all the other recommendations in the AIP! Good luck and let me know how it goes!

I re-read this page quite frequently (comments are helpful, they let us all know we are not alone), and, with apologies for being so immature … I have to say that sensuous exercise, above, made me laugh.

I realize it’s a strenuous auto-correct, but heck, amidst the sadness we all face recognizing the foods we need to avoid – yes, worth it, but no more espresso and choc?! – well, humour is welcome!!

I have a quick question, are flax seeds and bell peppers included on the no-go list for the AIP? And what about sweet potatoes? How come they are not excluded while while white potatoes are?

Bell peppers and white potatoes are nightshades are excluded on the AIP. Sweet potatoes are not nightshades which is why they are still included (with the caveat that those with small intestinal bacterial overgrowth don’t do well with starchy vegetables). Flax seeds are a seed and all seeds and pseudograins like chia are excluded in the AIP.

So autoimmune means no nuts, nightshades, dairy, legume, alcohol, sugars, grains, eggs, seeds, certain produce, FODMAPS & SIBO take away a lot of foods too no starchy, sweet potato, etc. So someone with all these things am I only eating meat and bone broth at this point since almost everything seems off limits? I’m really confused and so upset that my psoriasis has not gotten better after so long. I really would love a master safe foods list as I am not against narrowing food down and eating a small variety to heal, it’s just finding out what those foods are.

Woa this totally sounds like my tone is being mean, I assure you it is not intended that way at all! I appreciate any advice you may be able to give me, just having a hard time looking throu charts for each protocol and figuring out what a sick person like me needs to be eating to get on the right path. 🙂

I didn’t read mean into your comment, just frustration, which is totally understandable! It will take me a while to put something like this together (I’ve been asked by more than one person, so it’s definitely on my to do list). In the meantime, do you have a copy of Practical Paleo? Basically, sticking with non-starchy vegetables are completely fine, which still should provide lots of variety.

The skin autoimmune conditions seem to be the longest to heal. They tend to go hand in hand with bactial and/or yeast overgrowth and with gut-brain axis issues (Chris Kresser has quite a bit of information on his site about this). Eating organ meat seems very important (maybe because of the trace minerals found in organ meat, also vitamin D), having a good source of probiotics is also important, and eating fish to balance omega3 to omega 6 raio.

Do you have a good functional medicine practitioner? Food sensitivity tests, micronutrient deficiency tests, and liver detoxification support can all be very helpful with psoriasis.

I drink a lot of herbal infusions like nettle leaf, raspberry, etc which are trace mineral rich and really help my skin and body a lot. I used to take cod liver oil (the green pastures kind) and found it really helped me. I have bottles left I think I will start taking again but I take it with 1/2 tsp of ghee and I thought ghee is something I shouldn’t have so I haven’t had any since June of this year? (Shouldn’t have because I should avoid for autoimmune of is ghee fine if I have found it helps?)

I first developed psoriasis after I was put on medication for mental health issues when I was 17, I haven’t been on anything in the past 3 years though. Never took birth control but I have Interstitial Cystitis (imagine having to pee and you are crying in pain because your bladder actually has no urine in it, very painful.) For 3 1/2 years from the time I was 20 to almost 24 I could barely walk anywhere. Well that only got “cured” from the nettle actually and keeping a food diary. I have just now started to feel bladder pain again because I try to be accommodating when we visit friends and I eat their food to not offend them and I literally feel like it is reversing all the progress I have done. Been Paleo about 80% of the time for a year and a half and lost an initial 10 lbs and feel less puffy and skin has healed a little bit, but still have more work that needs done. (I am ~5′ 5″ 115 lb)

We don’t use chemicals in the home or for personal care products, no makeup either. I cook most of our food at home (organic or grass fed meats local) and organic produce. Acidic foods really bother my bladder though so onions and pork I have to be careful with. You mention yeast infections, I have had chronic infections and been on many rounds of antibiotics to combat bladder issues. My urologist put me on them 2-3 capsules a day indefinitely since he said some women just get them and that is life basically. (Ugh!) That is why I had IC so long without treatment, he was very unkind to be so I went 3 years in pain before finally seeing a female doctor this year who diagnosed me properly for IC this Feb and that I have kept the IC symptoms in check by avoiding acidic foods for the most part, drinking nettle, and making sure I am not dehydrated. For liver detox I was thinking of eating a lot of prepared burdock root and eating dandelion greens. Its ironic that you say that I need non starchy veggies because I looked up non starchy like you said and many of the foods listed my body has actually been craving lately!

I do not have my own doctor but if anyone knows of a good functional medical doc in the Atlanta, GA area I am all ears! I do have Practical Paleo but find it difficult to follow because again, no master list for someone like me in exteme cases that has to avoid SIBO/FODMAP/and autoimmune on top of acidic foods for my bladder condition AND keeping to the Paleo of no sugar, dairy, legume, grain.

Oh! As far as probiotics, I used to take goat milk yogurt but stopped since dairy. I was told that probiotics do not survive the digestive process so my option is the fecal transplant thing that I have read about several places recently if I really needed to reintroduce bacteria that I am missing or low on in my body. Any thought about this?

Some but not all of the probiotics will survive the digestive tract. It’s still a good idea to try. You mention that you’ve been 80% paleo for 1 1/2 years… have you tried the AIP yet for very long?

I looked into the Paleo Physician’s Network and see several located in my area. Thank you for pointing out this resource, I will try to see if I can find one that I will be comfortable seeing.

I have never done the Paleo AIP before. A recent flare up of psoriasis from poor quality city water (even with a nice shower filter) has really made me want to kick it into gear and figure out how to get my body functioning properly. The only monitoring of my food intake was a few months back when I was avoiding common “bladder irritant” foods, otherwise I followed paleo but allowed some diary. (Cooking with a lot of Kerrygold butter, goat milk yogurt some mornings, a sheep’s milk cheese for certain dishes I make if it called for it, occasional slice of Cheddar Tillamook cheese, and local unhomogenized cow’s milk.) Sometimes I had rice once a week too, (again, was only doing ~80% paleo) but I see now that I have to be more strict so finally going to ditch all dairy.

I hope you can find a good doctor that you like. With 2 autoimmune diseases, it’ll be very helpful to have someone who can monitor your progress and help you work through supplements and figure out food sensitivities and deficiencies. Good luck!

Hey Dawn it’s a great site and I’ve been experimenting with my condition with various diets to no avail… though I’m trying this one.

The leaky gut hypothesis for autoimmune conditions is completely discounted by modern medical science. I asked my rheumy and have searched medical journals.

Could you please point to any evidence about leaky gut. Not saying it doesn’t work, just want evidence when I discuss it with medical professionals

I would refer you to the research done by Dr. Alessio Fassano. A google search will lead you to his interviews and public appearances. A PubMed search will lead you to his research papers.

Hi- I just found your blog and am going to try the Paleo AIP protocol since after two years of food elimation for a few weeks at a time here and there, I have seen no improvement in my myesthenia gravis (manifested with a droopy right eyelid). My question for you is that if I’ve been tested for food allergies and sensitivies, and I learned I am allergic to eggs, wheat, milk, soy and some weird ones like banana and avocado, do I need to also eliminate coffee, chocolate, and the nuts that didn’t show up (peanuts did)? I eat vegan chocolate and use coconut creamer in my coffee. If I had cross reactions, they would all have shown up on my test, correct? I was tested extensively for allergies and sensitivies at quite a heafty price so I’m hoping to spare myself some of the restrictions.
Also, I really struggle with breakfast, especially as a nursing mother with an appetite! Has anyone tried protein powders? I’ve been using a great dairy free one made from peas which I suppose I will have to give up.

I think that if you aren’t seeing improvement, you have two options. First is strict paleo with also eliminating the foods you are allergic to (this makes a lot of sense to me as a first step). Second if full AIP. Either way, the pea protein powder is out. Chocolate, coffee and nuts (and everything else eliminated in the AIP) can all cause problems in ways that are separate from being allergic or sensitive, so if you don’t see improvement with the paleo less foods you are allergic to, it’s still worth a try. Also, hormones might be a factor here which may mean you are fighting an uphill battle (which would mean you need to be more strict with food now but might be able to relax on once you’re done nursing). And sleep? With young kids, sleep might not be optimal (I know mine still isn’t!).

As for breakfast, mine typically includes homemade sausage (I also have one source of nightshade-free sausage that I purchase locally) with some fruit and veggies or leftovers. Actually, lately I’ve been on a bone broth for breakfast kick, with a protein-rich snack mid morning. It takes some getting used to eating unconventional breakfast foods, but you do get used to it. I hope this helps!

Have you ever posted information about the homemade sausage you make? That sounds like a great option. We just moved to Connecticut and are just getting to know the local farms, so we have good resources nearby.

Hi there! I just stumbled across your blog and wow! I’ve never seen anyone speak of this diet and psoriasis before, it’s so great to see. Okay where do I even start? My psoriasis has gotten worse since my sons birth 3months ago (which I see in your writings is totally expected). I started doing some research and realized since its an autoimmune disease that maybe going gluten free would help. I read “Wheat Belly” and it motivated me to put a menu together and get started come the new year. But now i see there are even more restrictions that you recommend and it seems overwhelming. Should I just start with eliminating the biggest offender (gluten) for 30 days and see how I do? If not much improvement, what do I do next? Dairy? What CAN I eat? I’ll be reading more over your blog! Thank you! I’ll also add that in nursing, in case it matters.


You may end up needing to remove more form your diet, but I think doing it in pieces makes a lot of sense, both from a practical implementation point of view and from a health point of view. I would definitely start with gluten as the most likely and wrist offender. Try not to replace things with gluten with gluten-free products since these have a high likelihood of having very similar effects in your body. This really means just getting used to more Meath, fish, eggs, fish, veggies, fruit, nuts and seeds and getting away from grains. Once this feels more manageable, you can work on other grains, legumes, dairy, and start switching to better fats.

Wow, this is very interesting. I tested positive for both Hashimoto’ and Graves’ antibodies (constantly low TSH 0.005/0.01), normal FT3 and FT4 up some time ago (hyper this Summer and Fall, but hypo last Fall). I first went GF and felt better. Then my endo put me off all grains, legumes, and sugar because of my severe GI symptoms. I feel significantly better, and I have actually cut all goitrogens from my diet – but I am still having dairy, eggs, and niteshades, and cocoa, and they don’t seem to affect me. Should I eliminate those as well? I am also cutting nuts and seeds out (not that they were a staple of my diet, anyway).

If you are feeling great, then there’s no good reason to do further eliminations. However, if you think there’s room for improvement, then I definitely thing it’s worth trying.

Since many autoimmune diseases are managed with corticotherapy, the question is if the use of glucocorticoids goes hand in hand with paleo diet or they are not compatible. Is the gut healing the same?

Steroids will slow down healing of the gut, but that doesn’t mean that you can just go cold turkey if you’re on them. I suggest following the AIP for a few weeks, getting sleep dand stress management down, making sure that you’re dealing with any micronutrient deficiencies through supplementation and/or food sources and then slowly trying to wean off steroids. It’s definitely a longer process for those on immunosuppressants.

Awesome article – thanks, I found the strict auto-immune diet made the most difference to my thyroid (Hashiomtos) Recently I’ve been less strict – added in eggs, a little dairy and nuts and wine. Tests results have gone backwards sadly.
I’m not sure if you have seen this post – but I put together a chart which shows omega 6 and 3 contents of just about all foods, as a resource.

Thank you for sharing this great information! Would you recommend doing intermittent fasting while being on the autoimmune protocol?

I think doing it very occasionally, like 1-2 times per month, for a shorter window like 16-18 hours can help (there’s evidence that autophagy is turned off in autoimmune disease and this MIGHT stimulate it, which would be very beneficial). The problem is the possible stress response, which is why I don’t recommend IFing too frequently and I certainly don’t recommend it if you have trouble sleeping the night afterward or don’t feel good doing it. It may help stimulate healing, but really only something to try for someone who has already sleeping well, getting some activity and some time outdoors, and managing stress.

Thanks for your positive thoughts Sarah! when you get relief from excruciating pain and remission of your symptoms, cutting out a few foods that aren’t really missed is a small price for quality of life and to feel normal again. Wish you all the best on your journey

Hi Sarah – First and foremost I wanted to thank you from the bottom of my heart for this website. I so greatly appreciate your scientific discussion of all of these issues – it really helps me understand things as I go through my own journey to heal my gut. I’ve been doing full Paleo for about 1 month and about 3 weeks ago I began to wake in the a.m. with gas, and sometimes experience gas right after meals again. For the sake of background info, I’m celiac and have been gluten free for 12 years. This past year I experienced horrible GERD which led me to remove all grain and then potatoes and legumes from my diet. Only now with Paleo have I eliminated dairy 1 month ago (immediate clearing of my eczema within 2 days).

I’m planning to start the Autoimmune protocol in a couple of days to see if it will help eliminate whatever I’ve got going on in the digestive system, be it SIBO, some autoimmune thing going on or quite possibly very low HCL levels.

My question is, on this protocol, woudl you recommend me also eliminating green beans, cucumbers or zucchini? The beans I’m curious about because there’s some disagreement about Paleo/not paleo. The raw cucumbers and zucchini seem like maybe they make me bloat more?

Thanks so much!

Hi Corrie! I think you could probably get away with trying a SIBO modification first. Instead of the whole autoimmune protocol, you would just eliminate starchy vegetables. It might be a good idea to do this in conjunction with some digestive support (digestive enzymes with meals and either an HCl supplement or something like 1-2 Tbsp lemon juice or apple cider vinegar 10 minutes before you start eating–acid supplementation is contraindicated in anyone with ulcers or taking blood thinning medications or NSAIDs so maybe check this one with your doctor). As for the direct answer to your question, I do not recommend green beans on the AIP but I think it’s fine for standard paleo. Any food where you consume the seeds (cucumbers, zucchini, berries esp. strawberries) can be problematic if you have an already irritated gut, but you should easily be able to add those back in fairly quickly.

Hi Paleo Mom, thank you for this most informative post! I have Hashimotos Thyroiditis and have been eating a 99% paleo diet for a year now which has significantly helped me, but I’m still struggling a little with a bit of excess weight on my thighs, belly and hips. I’m not overweight, I’m quite slender but have those “trouble zones” that I’m finding difficult to shift, even with 5 days a week working out, haha! I got tested for food allergies and am apparently not allergic to things like eggs and nuts (and apparently not even to wheat, ha! Though I don’t eat it or even gluten free flours or packaged processed junk), and I do eat them almost every day as they help fulfill and sustain hunger pangs, but obviously I’m still dealing with my Hashimotos as I’m on 75mg of thyroxine daily, ugh. I’d rather do it naturally of course, but my energy levels still flag at times and even with my morning green juice/smoothie doesn’t always keep me nourished for long enough! I try not to eat too much red meat or sausages/processed meats and of course cheeses etc as they tend to make me break out into acne; the green smoothies helped me to lose weight and fix my acne I think 🙂 But I do love my full fat greek yoghurt, damn! If I’m specifically allergic to any foods, should I still avoid them? I’d be at a loss without my eggs and nuts especially… I’m also on a contraceptive pill for managing excess androgens. I was just wondering about it all anyway as it can be extremely frustrating trying to determine what I should and shouldn’t be doing, ARGH I still have a terrible sugar addiction which I try to curb by eating protein rich foods 🙂

Wow. Okay. So first, the foods restricted in the AIp can be problematic in more ways than just sensitivities. I have written a series of posts under the Whys’s of the AIP for more info. That doesn’t mean they are all problematic for you, but you don’t really know until you eliminate them and then try adding them back in. Second, sugar cravings might be due to micronutrient deficiencies air insufficient dietary fat, I would sight trying some spoons of coconut oil with or between meanly and see if that helps. Eating enough fat is also really important in getting your body to burn fat as a fuel source, which is what it needs to do to lose weight. Add some fat to your green smoothies too because fat helps you absorb many of the vitamins and minerals in them. Micronutrient deficiency is common in autoimmune disease. And while i agree with staying away from processed meat, I think eating red meat (especially if you can get grass-fed) is really important. It is righ in many vitamins and minerals that tend to be deficient in those with autoimmune disease. I also highly recommend eating oily fish and organ meat several times per week. Keeping weight around your middle is the classis sign of high cortisol, which is a stress hormone. It can be high for a variety of reasons, too little sleep, too much stress, too intense of workouts, too much sugar, too much caffeine, inflammation from your autoimmune disease, or as a reaction to food sensitivities. Pulling back on the intensity of your workouts and focussing on stress management and sleep should help. You can also look at some adrenal support supplements (GAIA makes a good series, just avoid the ones with oat seed as an ingredient).

I hope this helps!

Ahhhhh, your advice is just what I needed to hear – thank you kindly, I shall give this a go and see where it takes me!!!! Thank you 🙂 x

Sorry in advance if this is too long! But I really want to thank you for this article and the follow -ups in the comments. I have Graves Disease, and although I have no digestion issues and only very rarely stomach upset/discomfort, I do have very low energy, am still battling to lose the weight I gained when they over-medicated me early on and then more weight later due to high dose prednisone for over a year for Graves ophthalmology issues, AND I would like to get completely off the meds someday (I’m on methamazole and a beta blocker).

I think the paleo may be the way to go for me – I know I tend to feel better when I’m eating those foods. I was concerned though about the diet in relation to my autoimmune disease, and was THRILLED to find your article!

Just a side note about diet for those with Graves Disease – many people with Graves have difficulty assimilating calcium because of too much thyroid hormone, and can suffer from low bone density/brittle bones. They also tend to have low Vitamin D – which aids in absorbing. However calcium (dietary or supplemental) can also interfere with some thyroid medications. Simple solution – don’t take calcium at the same time as meds – wait at least 4 hours. But Graves patients MUST get adequate calcium and Vitamin D.

I can’t imagine making the full shift to this diet all at once (plus I cook for my elderly mother who has issues with keeping her weight up) so would cutting out breads, pastas and cereals first be helpful? Am I likely to see changes? I rarely use milk (mainly on cereal LOL) so I could cut that too. And although I LOVE nuts I know they don’t agree with me, so I have them pretty rarely. Also I don’t drink alcohol. But I would like to initially keep some starchy veggies like sweet potatoes, butter, and eggs, then try taking them away one by one and seeing how I do. Does this make any sense? Would I still see some good effects?

It makes total sense to traditions in stages. I would definitely focus on gluten first, then all grains, work on cooking fats, then dairy, then legumes, then sugars, then the extras like nightshades, eggs, nuts. You may see an improvement with each stage or you might not until you’ve finished transitioning. But, a slow transition is more sustainable for most people. I also have a post on gaining weight on the AIP, which might give you some ideas for foods you can cook for both you and your grandmother. Good luck!

Hi Paleomom, thank you so much for your amazing website, what a great resource!

I am fairly new to paleo, and I have so many questions I’m not sure where to begin. I’m from Norway, where there’s almost no awareness about paleo living, so I am so grateful and also completely depending on information found online in order to fix my health. Apologixing in advance if this gets very long and for any typos and broken english 🙂

In november I took an IgG Elisa protein intolerance test. Two weeks ago I got the results, it turns out I have a lot of food intolerances and the doctor said that there’s no doubt that I also have a leaky gut (because of the amount of foods that were a problem, both in quantity and in force/impact). My main symptoms have been skin problems almost all my life (I’m 27 by the way), fatigue, periodically joint pains, and some digestive problems and nausea. The doctor recommended me to look into paleo, and I bougt Marks Sissons book the same day. I immediately switched over to paleo, which was a complete u-turn for me who have been relying on bread and milk on a daily basis for all of my life.

So I have only been eating paleo for two weeks, but I can definately feel a difference, I’ve lost about 8 pounds without any excercise, skin is ever so slowly starting to heal a tiny bit, digestion is much better but not perfect, breathing is better, I’m more awake so coffe consumption is heavily reduced, just to mention a few things. I don’t feel much difference in energy level yet, and to be honest I’ve had some weird mood swings, but from what I’ve read I think that might be the withdrawal symptoms from milk maybe(?). I have also added some supplements, I take selenium, coq10, L-glutamine, N-acetyl glucosamine and cold-pressed seal oil every day.

But now I am so unsure of what direction I should take this, if anyone has any good advice or feedback I’d be super thankful! Should I stay on regular paleo as long as i see improvement, and then consider AIP, or should I jump to AIP right away since I already know that I have a leaky gut? How and when do I know if I should also apply IBO or FODMAP restrictions? And should I let theory or test results be my main guidlines? For instance, according to my test I react to egg yolk, but egg whites are totally fine, and bell peppers (a nightshade right?) is also fine for me. If I decide to try AIP should I still avoid them, or trust the test results?
Any advice on this would be higly appreciated!

Oh, and one last question, the hardest thing I could ever give up is chocolate. I make the chocolate myself from mostly raw ingredients, and I just wonder if all cocoa is equally bad? Would it make any difference if I made white chocolate using only cocoa buttter and not the cocoa powder? Or replaced the cocoa powder with carob?

Thanks again in advance for any feedback, and sending greetings to you all from the north! 🙂

I recommend you keep going with standard paleo for a while (yes, as long as you are seeing improvement). You might also consider including a probiotic supplement and/or raw fermented foods like sauerkraut. For now, just try and keep your chocolate to very dark chocolate.

When it comes to tackling the AIP, I do recommend doing the full version of it, including egg whites and peppers even though you didn’t show an IgG reaction to them. The reason for this is that you can be sensitive to these foods in ways that won’t show up on the ELISA tests. The proteins that can be a problem in chocolate will also be in cocoa butter, although to a lesser extent. If you do need to do the AIP in the future, you could use carob as a substitute (try mixing with coconut oil or palm shortening?), but be careful of the sugar content.

Wow, thanks for fast reply! I have just started taking some probiotics too, just forgot to mention it. Thanks for great advice, it sounds like a good idea and not too overwhelming sticking to regular paleo for a while, and then maybe do AIP when I feel I have more routine and knowledge.
Thanks again! 🙂

It will be much easier to tackle the AIP after you’re in the paleo grove. 🙂 Plus, you might find it unnecessary, so it’s worth giving standard paleo a few months first.

Hi and THANK YOU for your blog!! You have provided so much information in one spot, it makes learning about all of this so much easier! I just started reading your blog and I when I read your “about” page (I think that’s where it was) you mentioned being torn between going back to work and staying home for your kids. Not to get side-tracked here, but I think what you’re doing here is so helpful and beneficial to us, that maybe you can make it work into a paid career (consulting??) for you?? That way you can still be home, set your own hours, etc…Also, just through experience and learning from other moms, (I have an 11 year old son and have been a stay at home mom), it seems when the kids are younger, it’s not nearly as important to be home….it’s when they start to reach puberty and into the teen years where we most need to be really present!!! I thank god for my MOM friends and for people like you, who really want to help educate and share experiences with each other!!

I was diagnosed with hashimoto’s thyroiditis back in ’98. (I’m 46 y/o) I had so many symptoms before the actual diagnosis finally showed up in my blood, but I was thankful to finally have a diagnosis and thinking that taking a little pill everyday for the rest of my life would alleviate all the symptoms! (mainly depression and weight gain).

Then last year, having had bathroom issues for who knows how long….I just kept thinking that my system worked really well….constantly “eliminating” had to be good, right?!! Then I met someone with a low thyroid who had celiac and told me I should be tested. So October of 2011 I finally got diagnosed with being wheat/gluten intolerant and then other allergies showed up…strawberries, pecans (which I hardly ever consumed) and pinto beans….which has led me to find out so much more about food, and thankfully, (thanks to the nutritionist at my endocrinologist’s office), led me to the paleo/primal diet. I literally felt euphoric after giving up grains! I thought, wow, this is so amazing not to feel so sad all the time and not get so depressed over every injustice in the world!

I’ve been doing more of a primal diet, because dairy didn’t show up in my allergies and I like cream in my coffee. I’ve been consuming nuts, because we in the paleo/primal world tend to use a lot of nut flour for baking and/or snacking. I also have been consuming 1-2 (pasture raised) eggs on a daily basis because I learned how important the yolk is and that it’s a great and simple protein to have on hand all the time!!

But through all of this, my scalp issues (I think psoriasis??) have never really cleared up. Sometimes I felt it was better and then other times it would get really bad and I’d blame the sugar I had…which of course I’ve indulged a little too much on over the holiday season (maple syrup, raw honey, palm sugar). I even indulged on buttered popcorn…(I know that it’s not in the primal diet, but I just love it…it’s the ONLY thing I miss from the pre primal days!!)

I also saw you mentioned something about ibuprofen, which I’ve been popping lately for sever tooth pain, as I’m going through quite a lengthy process of redoing a lot of old dental work in this past year…and sometimes I just can’t tolerate the pain that comes and I don’t want or do well with Rx drugs…even though I know over the counter aren’t good either…the pain was just too great to sleep or be around people!

Anyway…it seems, thankfully to all of your information, that I really have to eliminate the last few staples I’ve been able to enjoy (dairy, nuts and eggs, fruit and sugar (I was going to do a sugar detox anyway) from my diet.

I feel so sad about this, mainly because living this way (knowledge about our food supply: GMO’s, CAFO’s pesticides, etc….) has made it very hard for me to eat out (I can’t enjoy it if I know it’s not orgainic, grass-fed, etc…I also contracted h.pylori last year). I feel alone and isolated so much already (my husband eats his SAD diet and makes it really hard for me to convince our 11 y/o to eat like me…thankfully he lives in Las Vegas during the week, so my son has to eat what I prepare!!)

I’m sorry this is long…I guess I just needed someone to listen to me!!

I can’t thank you enough for providing your incredible blog, sharing your experience and your recipes with complete strangers for FREE!!! I will be donating to you, PaleoMom!!! Thank you!!!

Popcorn is still the food I find most tempting and miss the most! Ibuprofen and other NSAIDs are absorbed by punching holes in the lining of the first part of your small intestine. So, in the case of autoimmune diseases, this can be a real problem. Tylenol is a safer pain killer (although I know it doesn’t work for many) from the perspective of gut health (of course your liver would prefer you not to use tylenol, but it’s like being stuck between a rock and a hard place). I understand your frustration and that sense of mourning over losing favorite foods. It does get easier, especially when everything falls into place and you start to see real healing. Hang in there! You aren’t alone!

Thank you! I knew when I looked at the ingredient list on the advil that it shouldn’t go in my body…so I didn’t buy more, just took two more and then, miraculously the pain has started to subside!! I haven’t had to take for at least 2-3 days now! I should go and buy some grass-fed bones and make some broth to start the healing….I had know idea that it punched holes in my intestine…that is just awful and it explains so much!
I feel like we have to navigate through a minefield to find our best health!
I know in the blogosphere I’m not alone, but I am alone in real life, as NO ONE I know personally, takes their health as seriously as I do and I’m often joked about!! I don’t care, but I will be seriously mad if I get some awful disease when I try so hard to avoid all the stuff they eat 😉
Thank you again for all your help and info!!

hi Paleo Mom! 🙂

I’d like to start off by saying your an amazing person for contributing so much helpful information to the world! I usually don’t post messages in the comments, am more of a reader, but since I saw you were so active in responding to comments I thought perhaps you could your advice on a dilemma I’m facing:

– In short, male 29-years old, had lifelong bloating and digestion issue but nothing major until about 5 years ago when I started getting much worse, likely due to caffeine and pre-workout supplements and years of yo-yo dieting. I started with going gluten free, then slowly made my way towards mostly-Paleo, and over the last year thought that I was doing okay on a diet on mainly steamed veggies, meat, and fat. I was consuming broccoli + cauliflower at almost every meal and didn’t realize until recently how much this could have been stalling my progress. I felt much better than I did over the years when things were pretty bad, but still had digestion issues and itching near my rectal area from the yeast most nights, constant bloating and alternating moods among other more minor symptoms.

After coming across your wonderful website, and experimenting for 3 weeks now with removing FodMaps initially, but then even finding that I am allergic to eggs, omega 3 fish oil, canned foods, dried spices etc.. so over the past 1.5 weeks I’ve cut out everything that you suggested so that I can completely heal – even black pepper! (ps. I am Indian and it has been very difficult to realize the spice box has no place in my life 🙁 )

For the past week 100% of my meals have been simply dark green salad greens/cucumbers (and herbs such as chives, coriander, and thyme) + chicken/turkey/occasional wild fish + 2-3 TBSP of olive oil + sea salt. I had been using coconut oil exclusively for the past year (4-7 TBSP daily), but after eliminating it recently and reintroducing I noticed that it made me feel anxious and nervous, and since I had been eating it for so long I think that I started to believe this anxiety that I felt mostly at work or in social settings was just part of my personality, lol 🙂 So it’s great to feel much more relaxed and calm lately.

I can go on the rest of my life eating these foods and be happy – simply because of how great it feels to have normal digestion and energy levels. My dilemma is how to cover my nutritional basis since my body is unable to handle any multivitamin supplements? Have tried several brands of multivitamins in the past month (with the lowest doses, and smallest amounts of B complex), from Rainbow Light to Raw Mens Multi, and having a bad reaction to all of them and feel major muscle weakness and overall lethargy for the entire day. Makes me fearful of even experimenting with other supplements since the whole day will literally be shot if I have a bad reaction. I seem to have developed a similar reaction to vitD but that I am able to get from the sun.

The supplements I take split up daily are calcium (600mg), magnesium glycinate (400mg), and renew life brand probiotics (15 bil) after waking up + candizyme before bed.

My conclusion from this is that I’m hypersensitive to these synthetic multivitamins and perhaps there is no place for them in my life (despite what I’ve always been taught). I’m worried what might happen after a few weeks if I become depleted in some particular vitamin which I had been receiving adequate amounts of in the broccoli/cauliflower I was eating large quantities of over the last year? Given my diet are there certain vitamins that you definitely would recommend I supplement with? I don’t eat much seafood aside from wild fish, and do not eat beef for religious reasons, and honestly don’t have the stomach for organ meats (grew up on chicken breast :).

Thank you so much for any advice you are able to offer. I’m really grateful to have come across such a knowledgeable and helpful person.


Hi Ravi,

I’m sorry you’ve had to go to such a limited diet! On the bright side, you may be able to add many foods back in after several months of healing.

You might be allergic to a filler in the supplements and not the supplements themselves, which basically means avoiding anything in a capsule or tablet and anything with fillers listed on the ingredients. That being said, you could take a magnesium supplement without a capsule (something like Natural Calm) or open up your magnesium glycinate capsules and sprinkle into some water (this would work with probiotics too, not sure about the calcium). I think magnesium and probiotics are important. Also, would you consider taking Green Pasture Fermented Cod Liver Oil (straight, not capsule, go with unflavored if you think the flavoring might not work for you). That would give you some vitamin A, D and K2 which seems to be lacking in your diet. L-glutamine may help heal the gut, but some people get a stimulant effect from it, which means you should stop. Drinking ginger tea, licorice root tea, cinnamon tea, all help digestion and healing too. Bone broth would be an outstanding addition to your diet (could be chicken or turkey) and provide the calcium among other vitamins and minerals too.

I’m wondering about other red meat. What about lamb, bison, goat, emu or pork? All of these would help round out your nutrition and, if grass-fed/pastured, provide some really good fats, vitamins and minerals. I would definitely suggest continuing to avoid FODMAPs. How are you with starchy vegetables? My guess if you think you have a yeast overgrowth, then not good. Adding whatever variety into your veggies that you can, within those limitations, is important. Cooked will probably be easier to digest, so you might want to try moving toward soups. Have you tried mixing organ meat with ground meat and hiding it that way? I’m sure you can tell from reading my blog that I’m very pro organ meat consumption.

I don’t think multivitamins are necessary. I think if you can add a little more variety to your diet while you heal, you will notice a big difference. If you do feel the need for supplementation, it would be better to seek out a Functional Medicine Specialist to test for micronutrient deficiencies and then do targeted supplementation.

I hope this helps!

Hi Sarah,

Thanks so much for your quick and detailed reply!
I should have clarified about about the supplements I’m currently taking:

Magnesium & Calcium are the 2 most important supplements for me personally, and I couldn’t imagine how I’d survive if stranded on an island without either 🙂 It’s taken quite a while to find the optimal dosage, but my routine is usually:

~8am (take this dose in bed usually) : 15 billion strand probiotic, 100mg magnesium glycinate (buffered), and 150-200mg of calcium (depending on current diet, now is at ~200mg).

~1PM & 6PM – 100mg magnesium glycinate, 200mg calcium

~12PM- 100mg magnesium glycinate, 200mg calcium, 2-3 candizyme

I haven’t had much of any reaction to these 3 supplements over the last year, although for my next purchase I will seek to find a brand of calcium citrate which doesn’t include magnesium stearate, just to be completely safe. And before bed I’ve lately started taking Candizyme (similar to Candex/other yeast fighters). All 4 of these supplements seem to be working well for me – it is specifically the multivitamins that I’ve not been able to stomach whatsoever.
I must have tried at least 5 brands of multivitamins over the last few months, and had initially thought that my reactions were due to the excessive amounts of B complex found in most multivitamins, even though I was purchasing high end vitamins which did not contain fillers or the bad forms of vitamin B. But, the last multivitamin I tried which I was very hopefully of, Raw Code Mens Multi, which is from food and not synthetic vitamins, still gave me strange feelings of spaceiness/dizziness and muscle pain along with confusion so I cut that out. I even tried it without the capsule (as recommended by the manufacturer) and even at 1/2 the dose without capsule and I still had the bad reaction, so thats what has led me to believe I shouldn’t experiment further with multivitamins.

About the cod liver oil you suggested- I’ve taken high quality fish oil almost 2x daily for the past year, and recently found that fish oil even in small doses makes me feel dizzy and lightheaded, which I think is due to its ability to lower blood pressure. I didn’t realize it was the fish oil that was causing these feelinsg and just had assumed it was part of my health condition. I do very much like the idea of obtaining those vitamins you mentioned from cod liver oil, but I also cannot consume anything containing too much vitamin D or I will feel similar pains as described above (sometimes 1/2 can of trader joes boneless wild salmon makes me feel really uneasy, i think perhaps after days when I’ve received adequate sunlight and my levels are topped off).

Regaring glutamine and bone broth, sadly both of those give me immediate reactions identical to what I would feel if I ingested a small amount of MSG (dizzy, light headed, slurred speech – some chicken krapow earlier this year caused me to pass out and fracture my hand (thankfully that was all!) so I am leary of ever reintroducing either back into my diet. I think the glutamic acid from all the protein powder I’ve consumed in my early 20’s has added to this toxic buildup. When I had the reactions to bone broth, once was after simmering for 6 hours in a slow cooker, and the other 4 hours simmer, but both gave me strange reactions.
I’ve read reports from people with similar reactions who have tried to pressure cook chicken bones for 45 minutes and still had a reaction, either due to the glutamic acid or the histamines perhaps. Would you happen to know of any alternatives to make a safe broth which won’t give me this type of reaction? I really love the idea of obtaining all those vitamins and minerals, and making full use of the animal when eating.
Also, I’m a little weary of consuming anything which can throw of my calcium/magnesium levels, since they have to be balanced so carefully otherwise I can feel really unwell and not like myself (won’t bore you with those details), and since there is no way to gauge or estimate with how calcium is in a cup of bone broth, I also thought that maybe it’s not the best idea for me even if I got past the glutamic acid issue.

I’m open to trying chicken or turkey livers perhaps – would you recommend that as a good starting point? Thats a great idea to mix it with ground meat, I would love to try that.
I don’t think I’ll ever be able to eat animal hearts though. I will go to Whole Foods tomorrow to see if they sell organic chicken or turkey livers (or whatever organ meat you suggest). I have eaten lamb twice this week to add variety, and I’m happy to hear you recommend that. I’ve read conflicting information as to whether that is best on this restricted diet. Pork I don’t love, but don’t mind eating, I’ve just always been taught to avoid it and haven’t seen organic pork for sale anywhere (although I haven’t looked).

And as for the starchy vegetables, I unfortunately can’t handle any as far as I’m aware – I’ve most recently tried green beans and zucchini on different nights, and the bloating and yeast symptoms at night came back right away.

Thanks so much for taking the time to reply to my message – it really means a lot to connect with such a knowledgeable and helpful person!


Hi Again Sarah,

I’ve re-read your posting several times and just thought I’d add in a little update before you had a chance to reply 🙂

About your suggestions for the supplements: I will take that advice and try to no longer consume and capsules or tablets. The magnesium I’m using is Doctors Best Magnesium glycinate, which from what I’ve gathered seems to be a very high quality form, but more so it is one of the only brands which provides “buffered” glycinate (as opposed to other healthier brands like BlueBonnet for example which are not buffered).
Although I haven’t had any real noticeable problems with calcium or magnesium tablets I take, I have noticed sometimes a few minutes after swallowing there is a kind of squelchy sound which comes from my throat that lasts a few second (very hard to describe, feels/sounds “yeasty” but goes away fairly quickly so I’ve never narrowed it down). Thinking more about your recommendation the last day, I think this may be a reaction to the “magnesium stearate”. Personally I’m not a fan of the Natural Calm products due to their price, and the assortment of different magnesiums and calciums used (I prefer just glycinate instead of citrate, etc).

About the calcium citrate, I have been taking a Tablet form (165mg) which contains:

Microcrystalline cellulose, silicon dioxide, cellulose, magnesium stearate, food glaze

I’ve been considering switching to another brand which is formulated for people with allergies (Nutricology), and is a Capsule which contains:

Hydroxypropyl methylcellulose, microcrystalline cellulose, L-leucine

Between these 2 forms, would you recommend I switch to the capsule, or should I avoid any types of fillers even those that are hypoallergenic? For calcium and magnesium since I need to dose 4x/day, it makes me feel much more comfortable to have the tablets/capsules in my pocket so that I can take on schedule, as they can impact my mood/feelings of well being.

And I apologize for having missed your suggestion about the herbal tea. I should tell you that I’m a tea lover, and after eliminating caffeine I switched to peppermint/ginger/roobios and have been drinking 3-4 cups daily over the last year until a few months ago when I realized these teas were causing me digestion issues, and mouth sores, and once I eliminated herbal tea I was shocked to find that stevia even makes me feel dizzy, similar to fish oil, perhaps because it is so effective in reducing blood pressure. So as of a few months ago I’ve cut out all tea and artificial sweeteners. Ginger tea is a great suggestion, I just realized that I can make a cup with fresh ginger and maybe won’t have any reactions to that!

Thanks again and look forward to hearing from you! 🙂


Hi Ravi,

Thanks for e-mailing me. You comments got lots in the hundreds of giveaway comments I’ve received this week and my late reply was unintentional! Chicken or turkey liver is a great starting point. Lamb liver is also very mild. Have you looked at US Wellness Meats They have a good selection of lamb, pork and poultry (Tropical Traditions also sells grass-fed lamb and bison, not sure if bison are too close to cows or now).

So, I would recommend staying away from broth. There’s no way to make it and not get some glutamic acid and it definitely sounds like you are having a reaction to (there’s a condition that is basically a glutamic acid sensitivity, which is sounds like you could possible have, although I have no idea what causes it or what to do about it other than avoid food sources of glutamic acid… there’s also some idea that L-glutamine can convert into glutamic acid, which might be why you have those symptoms too). It also explains alot of the sensitivities to fillers.

A sudden drop in blood pressure after eating specific foods is a type of allergy (commonly to allums but also fish and shellfish). I think you are wise to avoid any foods that you feel causes this type of reaction.

Your supplements look okay to me (I’m happy to see the probiotic in there). Between the two calcium citrates in your next comments, I would go with the second.

Are you working with a good functional medicine specialist who can help you sort all this out? It sounds like a very complex health condition and you may benefit dramatically from some tests that a good functional medicine specialist would run (like testing for overgrowths and infections, micronutrient deficiencies and various sensitivities).

So, to get back to your original question from the first comment. I think that working within the confines of your many sensitivities but still trying to increase your food variety as much as possible will help. If you can get locally-grown organic produce, that will often have more micronutrients and especially trace minerals so that may help too (you’ll probably still have to supplement with store-bought to get variety especially in the winter).

I hope this helps,

Hi Sarah,

Thanks for your reply!
I love and have just received my first order the other day 🙂
Their beef tallow is such a great fat source that I have been eating pretty much that mixed with ground beef/lamb.

I will continue to stay away from the bone broth as you suggest. I may try a 45 minute pressure cooked version in the future as I’ve read that some people with glutamate sensitivity had success with this method, but am not eager to try it myself yet.

In regards to your question, I’m not currently working with any doctors but have consulted with many natural and conventional doctors in the past. I seem to have a much better grip on my health lately now that I am close to eating ZC aside from occasional leafy greens.

I tried to eat beef liver as you suggested, and maybe consumed about 0.5oz but for the next 2 hours I felt similar to when I consume MSG or excess B vitamins — dizziness, head flushing, and just generally feeling awful like I could pass out.

I was able to find a few reports of others who are either allergic to beef liver, or cannot handle excess vitamin A doses. Do you think it was more likely one of these causes? I’m asking because if it is the vitamin A excess, perhaps I should try chicken liver since that is known to contain less vitamin A? Since i can’t consume bone broth, I’m wondering since I eat so much ground meat whether I will become deficient in any vitamins which are not obtainable outside of organ meats (none which I’ve found in my research)

Thanks again Sarah, I appreciate all your advice!

It’s possible. Vitamin A has also been shown to exaggerate food sensitivity reactions. Vitamin D should help with this, but I think chicken liver makes sense to try.

If you’re eating a variety of meats and vegetables, you should be fine even if you can’t tolerate broth.

This may sound like a weird question, but I wonder I wonder If this way of eating would apply to dogs. I have an aging boxer that has started having health issues.. The vet thinks it is some type if autoimmune disorder. She is taking steroids daily … She keeps getting gut infections too and is leaking protein there . If wonder I’d this type of eating would be good for her and if so, what I should feed her. I currently give her grain free dog food, but still give her bread to take her meds. I guess I better cut out the bread…


I’ve recently started paleo and have been experiencing some adverse affects which lead me to believe I may have a problem with my gut. I decided to follow the paleo diet after being diagnosed with M.E and after much research this seemed like a viable option. I have even eating lots of meat, fish, eggs, nuts, coconut and olive oil, vegetables and fruit but have been experiencing major bloating and weight gain. My stomach feels uncomfortable but not painful. I have since removed fruit and nuts for 2 days and that seems to of helped reduce some of the bloating but not the additional weight! I actually need to loose some not gain! My main concern is health so my question is do you think I should change my diet to the one you suggest above to help with these issues or stop paleo all together?!

Think your blogs are really helpful FYI


ME is an autoimmune disease, so I definitely think giving the AIP a try is a good idea. I do think it would be a good idea to cut out starchy vegetables and I would also suggest doing a low FODMAP trial to see if that helps too. Let me know if you are still gaining weight on the AIP and I can help you troubleshoot from there.

There are some recommendations in The Paleo Diet (like avoiding nightshades), but not the full protocol, which appears for the first time in print in The Paleo Solution. I’m not entirely sure what the origins are, but I suspect it involved discussions between the various prominent bloggers and authors circa five years ago, probably related to many questions submitted the Prof. Cordain’s original website, where a lot of these recommendations were flushed out for the first time.

Hey PaleoMom,

I am confused about greens/vegitables! I jumped on the green smoothie bandwagon a couple of months ago thinking I was “healing/aiding” my gut. Since Criss Kresser’s article I am confused since he mentions that allot of veggies contain too much insolable fibers that are very hard for the gut to digest. He mentions this mainly in relation to “Irritable Bowel Syndrome”. How is this for Leaky gut ?

Also my biggest question:

Is it alright to consume bread made of pseudo-grains like “Buckwheat’ ? (or buckwheat pancakes for that matter). I read your post about the Gluten Cross-reactivity but sadly I do not have the option to get myself tested.
What I did do is cut out on bread for 3-4 days without noticing any affect (more hungry since I did eat allot of this buckwheat bread).

The biggest issue with green smoothies for healthy people is that chewing is an important signal required for digestion. I recommend that people don’t overdo the smoothies (6-8 oz should be plenty) and always consume with a meal. Some people have issues with the fiber and some don’t. You’d probably know if you do.

Pseudograins are generally not included in a paleo diet bus some people do consume them for special treats. And if you’re worried about having a leaky gut, they would be best avoided. Have you tried any paleo bread or pancake recipes for a better alternative?

I don’t have a diagnosed autoimmune condition but have been experiencing chronic pain in my lower body for several months. I’m about to embark on an autoimmune diet to see if it will help with my symptoms but am wondering about coconut products other than oil. Is coconut milk and butter ok? The safe choice is probably just to leave them out but including them would make the rest of the diet so much easier to stick to. Thoughts?

I am so glad I found your site! This is wonderful. I am trying to follow the multiple sclerosis 30-day plan in the Practical Paleo book but eggs are included in that plan whereas you are suggesting not eating eggs. I’m not sure what to do. Also, I hate fish. Is there a way I can get the benefits of eating fish without having to actually eat it? The one fish I eat is Sole and I never see it on the recommended list of fish to eat. I just can’t envision forcing myself to eat something I hate. And how can I be sure I am getting the right balance of Omega-6 and Omega-3 in my diet? Lastly, what about snacks between meals? It looks like fruit is a no-no while trying to heal the gut – do you have suggestions for mid-morning and mid-afternoon snacks that stave off hunger.

Sorry for all the questions! I’m excited and eager to do this!

I definitely recommend no eggs. All fish is a good source of omega-3s (with the exception of farmed tilapia and farmed catfish), so if you like sole, go for it. It’s just not as high as the ones you typically see listed. Other ways to make sure you’re getting enough omega-3 is to avoid nuts and seeds (which I would recommend for MS anyway), eating pastured and grass-fed meat, limiting chicken. And even though I don’t typically recommend fish oil supplements, that is another option. As for snacks, go ahead and try fruit. Better choices would be something like jerky and same veggies. You may also want to see if you can increase the size of your meals and not need snacks (which might just not work for you, but maybe worth a try).

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Double drat…I am so addicted to coffee. But I think I need to dial in a little bit further as I have many of the issues listed. I hear you on the 90% rule being insufficient…what about 99% say like one cuppa per day??
is tea allowed? Although I do love everything about coffee the smell, sight, ritual of the whole thing ultimately I drink it for effect ie: caffeine/keep going. I may be ok w/ a switch to black tea to get over the hump.
thanks so much this blog is pretty awesome, love your wonky science woman approach 🙂

How is one cup per day 99% (do you normally drink like 100 cups per day?!)? I would try and go a good month without any coffee and then see how you do when you have a cup. Yes, tea does not pose the same issues as coffee (although it can still mess with your cortisol). I still drink black tea. 🙂

I am wondering if you have a list of all vegetables and fruit, or just foods in general that are allowed with autoimmune conditions and the ones that aren’t. I am just starting paleo and it’s quite overwhelming to understand what I can and can’t eat. A comprehensive list all in one place would be so helpful 🙂 And you may have one that I’m missing. I am wondering about juicing. I currently drink 1 to 2 Mean Green juices per day. They each consist of 1 head of kale, 2 green apples, 4 stalks celery, 1/4 lemon, and 1 english cucumber. I feel good after drinking them but I can’t buy any of this produce in organic (because I live in the middle of no where in po-dunk America and I’m lucky to even find kale at all..Ok stepping off of that soap box). Do you think I should stop juicing or cut back. I’m a little concerned after reading the list (you recommended) of veggies we should be buying organic and the ones we don’t have to if budget is an issue. Thank You so much for taking the time to share the way you do. You are impacting so many lives for the positive!!

Hi Natalie,

I haven’t put any food lists together for the blog yet, but I am working on them for the book. In the meantime, this e-book has some food lists and Anne Angelone is actually coming out with a new e-book in a couple of weeks that is essentially a very comprehensive food list with sorting out FODMAPs, starches etc. if you can wait that long.

As for the green juices, I think some juicing is okay, but they pack a pretty powerful sugar punch (when you remove the fiber from the veggies, the sugars in them are much more easily absorbed). I typically recommend limiting to a 4-6oz glass of vegetable juice with meals. As for organic versus inorganic, organic is clearly better, but if you can only stick to organic for produce on the dirty dozen list (which changes year to year, but leafy greens are typically included) then I think you’re doing well. And then for anything inorganic that you buy, if you can’t peel it (which will get rid of most of the pesticides), then soaking in salty water for 15 minutes and then rinsing well is typically fairly effective.

Thank You for the information! I ordered the ebook and am very happy with it. If you think to please post a link on here when Anne Angelones book is released and I will check it out as well. I am a little confused on the sugar content of the green juice. The green apples were all I thought was sugar. But I don’t really have any I seem to be allergic to everything and it’s random. I got so frustrated with it that I just drank green juice for 35 days. It was really nice to not have random (yes random, not because I did or did not eat) blood sugar crashes all day, to not crave food constantly, to not feel hungry all day, and to not be congested, oh AND to sleep! That was some amazing sleep. I was losing weight too which had been impossible for me. I actually lost so much weight (17lbs which I’ve gained back 10 for. no. reason.) that my skin was getting loose and I decided to start working out. Well that was the end of the juice fast. haha I could have eaten the doors off the cabinets I was so so hungry. Anyway I feel like I am back at square one and I’m really glad I found your site. I have often thought of just juice fasting again but I realize that is not a way of life that I can maintain long term. After thousands of dollars to 3 differents ND’s (who were all helpful at some level) $1200 on blood testing to find out what food I am intolerant too, avoidance diets, and the list goes on and on. I have essentially spent my 30’s fat and unhealthy. My eyelashes have nearly all fallen out and my hair is thinning. I just feel like I want to be well so badly but I don’t know what to do. We’ve spent so much money and I’m back at square one. Which is why I am really excited to do this plan. I somehow managed to carry a baby full term 2 years ago so I have a toddler I want to be able to care for energetically and not feeling like every single bit of energy I use is the very last I have.
Um this site is for venting and not just questions right?lol I’ll stop there. If there is any information that you could recommend on living with edometriosis I would be glad to read it. That is my autoimmune disease. My doctor said it’s everywhere. I had two softball size cysts removed just before I got pregnant and I want to have another baby but I can feel that the cysts are back. No more surgery for me though! I searched for endo on your site and I read one very helpful article. But any others you could recommend would be great! Thanks again!

I have a question about a few foods. One website for AIP diet said no fruits, another said in moderation, what is your best suggestion? Also one site listed green beans as OK, another said no, again what is your best suggestion? I’m just starting on this adventure after going gluten and dairy free, then took out night shades and corn. Now have decided to go AIP at the suggestion of a friend. I have something similar to your lichen planus. It also looks similar to dermatitis herpetiformis. Thank you for any information you can share.

I say fruits in moderation, 1/2-1 per meal. Regulating blood sugar seems to be especially important for the skin conditions, as is probiotics and getting enough fat soluble vitamins (basically making sure you’re eating fish, organ meat and high quality animal fats). I say no green beans (okay for standard paleo, but not for AIP) at least at first. They are a food you can play with adding back in once your symptoms are improving. Good luck!

Thanks for your help. I thought the gluten and dairy free was complicated!! Glad about the fruit because I do like it, especially the berries and peaches. I’m also hoping that this takes care of the itchy spots that I have. I take probiotics and will need to acquire a taste for organ meat….not my favorite at ALL! Do you suggest taking supplements of the fat soluble vitamins? Are there any baked goods allowed on AIP? Thanks again

I have been dealing with Hashi’s, muscle pain, joint pain, chronic diarrhea, fatigue for a few years (since having kids). Been clean-eating, all organic, doing yoga, and as chemical free as possible since having kiddos because they do so much better that way. Recently went gluten-free for me and found that all muscle pain, all joint pain, chronic diarrhea, and fatigue gone. My question: how do you know if gluten-free is enough? Is there a way to tell if your gut has healed? Do you go by symptoms alone? I’d say I’m 60% Paleo because I enjoy the recipes, but I am not auotimmune Paleo at this point (still use eggs, tomatoes). Reluctant to go autoimmune Paleo it if I don’t have to since I cook for the family and we are all very slim. I appreciate any help so much! Thanks for taking the time.

Hi Sarah,

Two questions regarding the AIP …

First, when you say “no eggs”, does that mean only hen’s eggs, or does that include all eggs, from any kind of fowl? For instance, are duck’s eggs also prohibited? My daughter tested positive for IgG/IgE sensitivity to eggs – but, from your post, it sounds like under the AIP the issue is not the food sensitivity as much as the lysozymes. Does this issue carry over to duck’s eggs as well?

Also – why are green beans prohibited on the AIP? They are definitely our go-to vegetable, and I thought that they were a non-starchy vegetable.

Your website is incredibly helpful – thank you!

I mean no eggs. But when it comes to reintroducing, you might want to try duck or goose eggs and stay away from chicken eggs completely (an IgE reaction is not likely to go away). If you are allergic to one, you might be allergic to the others but you might not. Green beans are a legume. Most people can handle legumes with edible pods, but i don’t recommend them on the AIP because people with autoimmune disease are much more sensitive to the saponins in them. They might be successfully reintroduced later though.

I’ve been reading your site for awhile and I sure appreciate all the valuable information you share and put out there for us readers. In my case, it’s my husband who has the digestive/stomach issues – heartburn, strong reactions to certain foods, especially dairy, etc. We’ve been mostly following the Paleo diet for about 8 months now. Both of us have seen great health benefits from it as far as energy, feeling good and for me, post-baby weight loss. My husband however is hitting another setback. After months of feeling great, his heartburn seems to have returned again. We are now thinking that maybe he has a sensitivity to foods we have been eating. He saw a gastro doctor and together they feel he has the SIBO (leaky gut). Therefore, we are going to try some of the modifications that you recommend here. However, in his case he is actually hoping/trying not to lose any more weight. He wants to gain weight. He is six feet tall and only weighs about 155 pounds. He has 0% body fat. Do you have any food suggestions on how he can heal his stomach without losing any more weight, perhaps even make recommendations on how he can safely gain weight? We’d sure appreciate any insight you have!

I have Hashimoto’s and have recently gone grain free and working on completely eliminating nightshades to which I discovered I am very allergic. (Thought I was in the clear with a chicken paprikash recipe and have learned about paprika the hard way.) Also cut out sugar and dairy, with the exception of butter. I was tested by an allergist and do not appear to have egg or nut allergies. For purposes of gut healing, it is essential that I eliminate eggs and nuts if I am not allergic? And why is it that I can’t eat spinach or sweet potato, they’ve become something of a staple? But as other posters here have indicated, it’s a one step at a time sort of thing so I shall inch my way along in pursuit of better health.

I am very grateful for the information you share and the time you are willing to take to share you knowledge. Thank you very much.


This website extremely helpful for someone with Hashimoto’s and Psoriasis. I have read so many books on nutrition and health and giving up gluten and dairy and plant-based lifestyles and it is all so overwhelming and confusing. I am looking forward to your book “The Paleo Approach” coming out in September. Wish I did not have to give up grains and legumes too, I feel like my diet is going to be so restricted already with no gluten, dairy, nightshades and goitrogens, there is not much left. Thanks for all of the wonderful information on your website, it is one of the most informative I have ever come across.

Can’t wait for your book to come out! To have all this amazing info compiled all in one place it’s going to be great…I Did the AIP last November/ december…didn’t see any changes…then Christmas came and although I’ve maintained a “paleo diet” it hasn’t been the AIP…New lesions of the condition I have continue to appear…Starting again, this time it will be easier because I already know what it takes, so there is not much suffering plus no major expectations, except feeling great 🙂 If my condition improves- all the better! if not, at least I know I’m getting healthier. The bone broth really does make a difference and the caffeine free lifestyle, although sad and lonely 🙁 (I love my coffee!), make a difference in cortisol stability, I definitely felt the difference when I didn’t drink coffee for six weeks. What is your take on juicing…I’ve been doing this daily since I started the AIP protocol and have continued…I usually include Kale, Romaine lettuce, celery, cucumber, carrots, dandelion roots and one apple– do you juice, is having the raw veggies a good thing? Also, do you own a vitamix? It seems to be all the hype with healthy eating, was wondering if you own one and what you use it for? Also, plan on getting the 21 day detox book…is this ok to while doing the AIP- it seems to be more or less the same idea- no sugar….veggies and protein only?

Hi Paleo Mom!

First of all thank you so much for your website! As a twenty-year-old kid, I feel like I am always the only one that is taking care of myself and eating healthy, only to constantly get comments from my family and friends that are not supportive. Your website has helped me a lot because you support everything so well with scientific evidence, I am very thankful for that.

I am currently restricting FODMAPS and following The Autoimmune Protocol. I have been very strict about it and it hasn’t been too hard for me, I am actually very excited about all the positive effects. I was already eating a high raw Paleo diet before I found your website, but I have found soooo much great new information here. I recently got a pretty bad reactive arthritis due to an infection (or so the doctors think, they are not sure) and they have prescribed me the NSAID Naproxen, though I was sad that it would be breaking my Autoimmune Protocol, I’m really hoping it will help my other health conditions which have been very bad recently.

So I have two questions: if I’m following the Autoimmune Protocol will taking the NSAIDs ruin it?
Also is there anything I can do to reverse some of the negative effects of the NSAIDs on my gut? (other than following the Autoimmune Protocol otherwise.) Possibly drinking lemon juice or raw apple cider vinegar with the NSAID?

Thank you so much for your website and your help!

Taking NSAIDS will perpetuate a leaky gut, but you may be able to wean off after being on the AIP for a while (important to work with your doctor on this one). But, you won’t be able to fully heal until you can go off of them. I don’t recommend doing any food reintroductions until you can go off NSAIDs and steroids.

Okay thank you for your quick reply! Also, because of FODMAPs and the Autoimmune Protocol, the vegetables I can eat has become very limited, so right now my vegetables consist of leafy greens, carrots, zucchini squash, green beans, and cucumber, but I read somewhere on this site that the seeds in some of those vegetables can cause GI problems. Is this true? Should I not eat them for right now?

Hi there,
Would this eating regime be considered too radical for complaints of asthma (could be considered as seasonal), hay fever and eczema (throughout the year and quite debilitating). I tried Gaps for 4 months, strictly on the intro diet for 1 month, and didn’t see any health changes other than a 15lb weight loss that I didn’t need! My known allergies are environmental; house dust mites, grasses, molds etc., not really any foods.
Would the theory be: that if I didn’t have a leaky gut, my immune system would be able to handle the environmental allergens?
Thank you so much for any advice you can offer!!

No, it would not be too radical, and if you didn’t have much luck on GAPS, it might be a really good place to start (I would normally recommend starting with standard paleo but no nightshades). I would suggest eating a good amount of quality animal fats and keeping the intake of lower starch starchy veggies like squashes up on the high side to try and keep the weight on. If you don’t see improvement in 1-2 months, I would look at liver detox supplements (typically selenium and molybdenum, talk to a functional medicine specialist for dose and brand), FODMAP sensitivities, and histamine sensitivity (see as possibilities. Good luck!

I was diagnosed with Grave’s disease after the birth of my youngest child, about 35 years ago. I was treated with radioactive iodine, and subsequently became hypothyroid. Thyroxine supplementation brings my thyroid hormones within normal range. Am I still considered to have Grave’s disease, and therefore need to avoid raw cruciferous fruits and vegetables?

I’m in the process of researching and revamping the raw cruciferous veggies recommendation for my book. The problem seems to be excessive quantities in a selenium-depleted diet, which doesn’t apply if you are eating fish or if you are eating a variety of veggies. So, at this point, no I don’t recommend avoiding them. But I also don’t recommend eating only cruciferous veggies. 🙂

Hi Dr. Ballantyne!

I’m currently following the AIP and FODMAPs. I have two questions.

I’m on prednisone due to a reactive arthritis. I saw in previous replies that you said this will interfere with the AIP, is this true and why?

Also, I have trouble not being hungry, especially because my vegetables are so restricted and I try not to eat more than 2-3 servings of fruit a day (is that necessary?). I’ve been eating at least two pounds of meat a day (either grass-fed beef or wild-caught fish), is that too much meat? Also, what can I eat to feel more full? I’m always hungry! Would plantains be okay? Anything else you recommend to feel fuller?

Thanks in advanced and thank you so much for your website. You really are improving the lives of so many people, including mine. I can not thank you enough for that.

Prednisone directly opens up the junctions between the cells that line your gut, causing a leaky gut. It’s not simple to just go off of it though and you need to make sure you are working with your doctor on that one. You’ll want to make sure you’ve got the AIP down pat before you taper and make sure you keep going with strict AIP for 1-2 months at least afterward.

Plantains are okay if you can handle the starch. That really depends on whether or not you have bacterial overgrowth and how regulated your blood sugars are. It’s worth trying.

Increasing the portion of vegetables you can eat and a good fat source will help with feeling more full. That might mean making a dressing with olive oil and lemon juice or apple cider vinegar for your veggies, or adding some coconut oil, or eating fattier cuts of grass-fed/pastured meat. Your appetite is also artificially increased from prednisone, so being able to taper off of that will help dramatically.

Hi Dr. Ballantyne!

I asked you previously about prednisone and a leaky gut, but my doctor told me that now I’m going to have to take either a DMARD (they said methotrexate) or a TNF inhibitor (such as etanercept, infliximab, or adalimumab). Will my leaky gut be able to heal while on either of those?

I asked the doctor, but they don’t even recognize that there is a connection between leaky gut and NSAIDs or steroids…

Thank you so much for your help. I feel like I should be paying you for your advice lol. I will definitely be buying your book!


One of my hopes with the book is that a patients will be able to bring it to the doctor and point to the information and all the referenced studies to be able to have a more informed and ultimately more helpful discussion. From a leaky gut standpoint, the TNF inhibitors are a better choice than methotrexate (which does cause a leaky gut). I hope this helps!

Okay thank you very much!! I’ve read somewhere that cannabis is a TNF inhibitor, and I used to smoke marijuana about 3 times a week but I quit since I got sick a month ago. In general do you think smoking weed is okay with the AIP / leaky gut? If you don’t know the answer I understand. Thank you so much for your help!

In general, I recommend no recreational drug use with autoimmune disease. I haven’t researched cannabis specifically, but I do know that it has been shown to potentially induce schitzophrenia which is a suspectd autoimmune disease.

Okay thank you so much for your help!

I just have one more question I’m sorry to ask so many, I’ve been unable to have a BM without Milk of Magnesia for the past four weeks or so. I’ve been on a strict AIP with absolutely no cheats for two and a half weeks (except for the NSAIDS I took for 3 days and the prednisone I’ve been on for 3 days), can I expect the constipation to go away soon? I’m worried I’m going to become dependent on the MoM. If I don’t take MoM I just don’t go… is this problem likely to persist until I can get off prednisone to heal my leaky gut?

Again, you’ve really been sooooo helpful in relieving a lot of my stress about my health. I can not thank you enough for the peace of mind, as it’s been a really difficult and depressing month. Thank you.

It should go away, but it’s hard to say how long since it depends on a bunch of factors. Was constipation a symptom you had prior to AIP? Are you eating enough veggies? Are you getting enough sleep? Are you drinking broth and eating organ meat?

I’m sorry I swear this is the last question! Over the past 5 days I have become completely addicted to the dehydrated kale chips I’ve been making.

Now that I think about it, it’s a bit suspicious how quickly I got addicted to them, I made sure to take the time every single night to prepare them for myself for the next day. I realized I was eating 1/2 – 1 lb. worth of raw, fresh kale every day.

I checked this on nutrition data and apparently that amount has more than 40 g of carbohydrates, which is what I’m now suspecting caused my addiction and voraciously quick eating of all of them every morning from my dehydrator.

I started wondering about the type of carbohydrate in kale. I suspect I have SIBO, and I pretty much stay under 100 g of carbohydrates every day, but if I think I have SIBO, is it better if most of those 100 g of carbs are monosaccharides, so I don’t feed that overgrowth. Or is (what I think is a complex carb) a complex carb like in kale better? (what kind of carbohydrates are even in kale?)

Sorry I started typing my question about the kale before I saw that you replied! Yes constipation is an issue I’ve been having for the past 6 months pretty badly, but always had to some degree for years. I eat a lot of vegetables and always make sure to get my sleep, but I’ll definitely get on the bone broth. (I’ve been eating sooo much organ meat, I always crave it.)

The reason why I ask about the bone broth, is it could be a melatonin deficiency (and the glycine in bone broth can help support neurotransmitters in general). Once of Chris Kresser’s recent podcasts had a discussion about supplements to support melatonin (the transcripts are all online so you can search for it fairly easily). You could try Natural Calm as an alternative magnesium supplement. I also recommend getting a squatty potty. As for the kale, you could be enjoying them because they are so nutrient dense (if you crave organ meat too). Carbs in kale are most likely short starch molecules. It does have a lot of insoluble fiber, which can be an issue for some people, but that’s usually more in the context of also eating a lot of sugar. I guess it’s a fairly easy experiment to try a week without them and see if it makes a difference…

Okay that would definitely make sense about the melatonin since I have been having sooo much trouble sleeping! I will definitely be making myself some bone broth and I will look for that podcast. I have made myself a makeshift squatty potty out of a box 🙂 Thank you so much for your help!

Hi Dr. Ballantyne,

I know I’ve been asking a million questions, I’m sorry I’m just so worried! I’ve been suffering from a reactive arthritis for about a month now. Five weeks ago I ate raw beans (sooo dumb of me) and then had diarrhea for two days, then a week later the reactive arthritis started. I have not cheated at all while on the AIP for a little more than two and a half weeks now (except for the prednisone and naproxen…)

My reactive arthritis seems to just not be improving, even though I’m on prednisone, which was supposed to shut it all down. My problem is autoimmune in nature and I have a family history of serious autoimmune problems. It’s really conflicting for me trying to decide what to do, because I’m following the AIP strictly, but I feel like the steroids I’m on are ruining it. Do you think my problem would go away if I got off the steroids and didn’t take any NSAIDs and just followed the AIP?

Thanks so much again for all your help,

P.S. I’m a 20-year-old male and I listen to your podcast! My roommate walked in the other day when you were talking with Stacy about shampoo… awkward haha. Also I actually stopped using shampoo about a year ago, I only use soap to clean my hands! It’s the way to go!

At least we weren’t talking about feminine hygiene products! lol! I would advise patience. No, you won’t be able to heal completely while on prednisone and naproxen, but you need to wean/taper and I would advise doing this with the guidance of a health care professional. But, the good thing is that you should be able to heal some now and the healing will speed up when you can get off NSAIDs and steroids. How long is your course of prednisone and what dose are you at?

And please, call me Sarah. 🙂

Okay sorry, hi Sarah! And yeah good thing that would have been much more embarrassing haha!

I’m currently on 25 mg of prednisone a day and every three days my dose is going down 5 mg. I was hospitalized 10 days ago on Monday (I probably should have gone to the hospital about 3 weeks ago, but I was stubborn about it, my parents finally convinced me) and they made me stay in the hospital until Thursday. What I was just realizing is that I started getting better within 5 or so days of starting the AIP (about 4 days before I went to the hospital) and then worse since they started me on NSAIDs and prednisone! (since starting NSAIDs / prednisone the pain in my feet has gotten worse, but the overall swelling is down.)

Realizing this I’m so mad I went to the hospital and I’m so mad how little the doctors know! I was improving up until I went to the hospital, but since they’ve put me on NSAIDs and prednisone, the swelling has gone down but the pain has only gotten worse. It’s so ridiculous that they prescribe NSAIDs and prednisone for an autoimmune problem when they perpetuate autoimmune disease!

I’ve also become really passionate about Paleo and especially the AIP (because you!), but it is soooo frustrating trying to convince my friends and family because they don’t want to believe grains are bad, “the science isn’t there”, etc… I started thinking all the time “Damn, I wish I was really rich so I could fund tons of research to show people how important it is to eat this way!” I’m currently an economics / psychology major but I’m starting to realize that it would be so much more meaningful to me to actually do that research myself. I know you have a PHD in biomedical research, would that be the ideal degree to be a researcher on nutrition / autoimmune disease? Would that mean I should major in biology in my undergrad in order to do that?

The whole point of me writing this book is to help patients have more productive discussions with their doctors and validate this approach for discussions with family. So you have about 10 days left of prednisone? You really do need to taper, so I think you’re kinda stuck for now. Hang in there.

Really, you can get at medical research from any science degree. My undergrad is actually in physics, then I did a PhD in medical biophysics, and the last research I was doing was cell biology (I just became more and more biological as I went). Biology, biochemistry, physiology, microbiology would all be great places to start. And there’s so many different angles to the research that needs to be done, you could be in a graduate program in so many different areas (biology of which there are many subfields, or something more clinical like nutrition sciences). I would recommend taking a few entry level courses and seeing what’s the most enjoyable for you and the most natural for the way you think. 🙂

Okay thank you so much for all your help and for being so responsive! I’ll probably wind up having another question in the next week, so I’ll stop promising this will be my last post 🙂 But really, thank you so much for answering me and for having such a great blog. I visit your website more than any other paleo/health blog because it is organized so nicely and so informative! I will also definitely be taking some intro science courses next semester and seeing what I like!

Has anyone posted a sample meal plan for the aip? Lots of comments so maybe I missed this somewhere. My head swirls every mealtime with all the things I “can’t” eat that I am lost on what I can! 🙂 thx

Hello, I was told that fermenting goitrenic foods actually decreases the goitrens. What is your source for fermentation increasing goitrens? It would be great to know as I have Hashimoto’s and eat saurkraut nearly every day.

I’m actually in the process of completely revamping the goitrogen recommendations (I’m going to recommend not limiting them) but I’m still going through the scientific literature on this. I will update this post once I have that 100% figured out.

Thank you for your awesome information! I have done numerous tests through Cyrex and Genova and have a slight autoimmunity and several food intolerances. However, almonds, walnuts, and eggs were VL…Am I safe to eat these or should I stay away because of my Leaky Gut and Autoimmunity? Thanks so much.

You would probably heal faster without them, but if you wanted to try keeping them in you could. I would just point out that nuts quantities should be kept very low and egg whites can be a problem even if you aren’t sensitive.

Hi Sarah!

I don’t know if you remember me but I asked quite a few questions about a week and a half ago. I have reactive arthritis (or so the doctors think, they said there is no way to confirm this), so I have swelling and burning pain in my feet and left knee, my blood tests show very high inflammation markers, and I also have an HLA-B27 genetic marker that makes me more susceptible to reactive arthritis. The past month has really been miserable, I can’t walk at all, getting up to go to the bathroom with crutches is very painful, and I cannot do any of my school work. I finally got off of prednisone, I took my last dosage on friday. I haven’t seen any improvement since then (I know it can take a while to heal a leaky gut), I’m following the AIP 100%, drinking bone broth, taking probiotics, lots of coconut oil, eating organ meat, lots of wild caught salmon, and taking natural calm.

My family is so unsupportive of my diet. They constantly are negative and they won’t take the time to look into it online. I don’t know how to convince them. I’m starting to think they’re just all idiots. The doctors wanted to put me on a TNF inhibitor, but they is known to potentially cause terminal cancer. I think I’d rather try this first… I feel sooo pressured to get better, as everyone in my family thinks that my diet is causing my problem (even though I started the diet AFTER getting sick). My sister is also suffering from a very serious auto-immune condition, she can hardly breathe, and she is on huge doses of prednisone, which I am really worried about. I’m trying to convince her to just try this diet, but my dad gets very angry at me for telling her that. I’ve showed them your website and other things but they just refuse to believe it could have merit!

Where on the carbohydrate curve do you think I should be to heal my leaky gut? I’ve been under 100 g / day, is that too low? Is it also important that I keep my fruit to only 2-3 servings a day? Also, raspberries have seeds in them, should I not eat them because of that?

I also went to an acupuncturist yesterday. He said that there is too much dampness and heat in my body. He recommended that I take an herbal concoction. I’m open to trying it, but I’m worried it could perpetuate a leaky gut. The way it’s made is all the herbs are cooked in water and then I drink the liquid. The herbs that he recommended are :
-Cassia Twig
-Peony Root
-Liquorice Root
-Fresh Ginger
-White Atractylodes Rhizome
-Common Anemarrhena Rhizome
-Divaricate Saposhnikovia Root
-Prepared Common Monkshood Daughter Root
The whole herb combination can be seen here:

Do you know if drinking those will be okay in terms of the AIP?

Thank you so much for your help. I wish I could give you a hug or something I don’t know how I can ever repay you for your help. I can’t wait for your book to come out, especially so I can show my family. Thank you so much!

I think around 100g is probably good, but really anywhere between 50g and 200g if you are eating low glycemic index veggies (anything less than about 65). This should allow you to eat a tons of non-starchy veggies, and a few servings per day of lower starch starchy veggies and a little fruit.

As for the herbs, that’s really not my area of expertise (and I haven’t even heard of half of those ingredients). You might benefit from talking to Anne Angelone at and checking out here teleclasses for the autoimmune protocol (next one starts at the beginning of April).

Hi Sarah,

I apologise in advance for the length of this mail. I will try to be as concise as possible.

I have an autoimmune condition that is, for now, not definitively diagnosed (it could be one of a number of conditions). I have known this for years but I try not to pay too much attention to it and just get on with my life. I do not take any medication and manage things through diet and lifestyle choices. My doctors and neurologists support me in what I do (their advice is “keep doing what you’re doing”).

For almost 15 years I did not eat any red meat or chicken. I have been eating fish since about 2006. From a grain perspective, for about ten years, I ate only whole grains, spelt etc and avoided overly processed products. I ate very little dairy (usually goats’ products) and lots of fruit. Recently, I started eating liver and chicken and I think I feel a positive impact of that – especially the liver. I drink about three mugs of chicken bone broth a day (usually before each meal or included in soups).

I think I may have a huge number of food sensitivities/an exceptionally leaky gut. I say this because when I eat ANYTHING I get a build-up of mucus at the back of my nose and the base of my throat. When I wake up in the morning the mucus is there. Some mornings it is more severe than others and when I blow my nose there are often traces of blood on the tissue. The mucus stays pretty much the whole day but can increase, depending on what I eat. I have had this sensation for a long time but in recent years it has gotten much worse. I know for sure, that certain foods will increase the mucus e.g. sugar, dairy, pasta (the usual suspects). However, something as simple as dill can also increase the production (I have fresh, organic dill in my kitchen and while passing it yesterday, I tore off a little branch and ate it. Almost immediately, I could feel the impact).

I thought perhaps the issue might be FODMAP or SIBO so I have eliminated these foods from my diet. However, even foods that are permissible under AIP, FODMAP and SIBO still cause problems. Today, I discovered cinnamon is a no-no (my leg gets heavy and there is increased mucus production) and dates caused so much build up I had difficulty breathing!

I get bloated quite easily, however, since removing grains from my diet this has improved a lot (but not totally). I have seen an ENT specialist and I do not have sinusitis or any other infection. He tested me for allergies to wheat, milk and eggs and all came back clear (I do not eat these products but he still tested). He did say that I have very narrow nostrils but nothing that should cause problems. His advice was to have a procedure that would widen my nostrils and increase air flow. He could not guarantee this would make a difference to the mucus build up though. I don’t think it would help – it is not addressing the root cause of the issue.

In general, I eat very healthily and my plan is to continue with AIP, FODMAP, and SIBO. However, I have one weak area in my diet. Because of the mucus, I am conscious of bad breath so I chew gum when I know I am coming in contact with people – obviously, gum is full of artificial sweeteners and other nasties (things that would never, ordinarily, make their way into my diet) and it is not something I like doing, however, I do not want to repel people :)) and I have a business to run… In recent days I have started sniffing olbas oil in an attempt to clear my nasal passages. I regularly wash out my nostrils with a salt solution. I take peppermint tablets to relax my colon (sometimes, once I’ve taken these, I can taste peppermint, indicating, perhaps, a little reflux. This does not always happen however, so I don’t think I have constant reflux). In the past, I have tried bentonite clay and psyllium husk to try to cleanse my intestines – it didn’t work so well as the psyllium husk had a lot of difficulty completing its journey 🙂 . I have been toying with the idea drinking a little bicarbonate of soda diluted in water before bed to see if it will make a difference (my father has done this all his life and swears by it for regulating digestion).

I am beginning to despair that I will never be normal! I am very outgoing but this problem is really taking its toll and making me very self conscious. I am also convinced that this issue is linked to my autoimmune situation. I think getting a handle on this would have a very positive impact on all aspects of my wellbeing.
I’m sorry for the long email; I wanted to give you as much information as possible. I’m hoping you can answer the following questions:

In addition to the AIP, FODMAP and SIBO plans, is there anything I can do to help heal the gut?

Do you have any, natural, replacement for gum that will serve the same purpose?

Can you estimate the length of time needed before an improvement is seen?

I know this is not going to be a quick fix however I would really appreciate any help you can give.
Thank you,

I’m sorry to hear about your health battles. It’s highly likely that the mucus production is linked with the autoimmune issues, but I’m afraid I have no insight into what exactly that might mean in terms of diagnosis.

As for diet changes, I suggest focusing on micronutrient density. Lots of organ meat, offal (things like trotters, cheek), fish, and vegetables (that will be mostly non-starchy vegetables for you with FODMAP and SIBO restrictions, but you should still be able to get a really good variety). Broth is great. Make sure you are getting enough fat and getting enough carbs through the higher starch low starch veggies like carrots, winter squash and pumpkins and maybe a little fruit. You might want to try digestive enzymes as a supplement and see if that helps. The baking soda doesn’t really sound like the best idea to me. But, if you don’t have a clotting disorder, ulcers, or are taking NSAIDs, you could try a stomach acid supplement (best info at A high quality probiotic may be useful (I like PrescriptAssist). And you might want to get some food sensitivity testing and avoid any highly reactive foods for a couple of months.

Also, I can’t stress enough the importance of sleep and stress management.

You should start to see some improvement within the first couple of months, but it could take even a couple of years to see full healing.

Also for the gum replacement, you could try a lemon juice and water or apple cider vinegar and water rinse or even maybe add a little food grade peppermint oil like a mouth wash and see if that helps. Liz Wolfe (from Cave Girl Eats, who I defer to for these sorts of things) recommends Basic Breath Spray from Tropical Traditions and Neem Chew Sticks from Neem Tree Farms.

I hope this helps!

Thank you Sarah for such a comprehensive response. I will let you know how I get on with the food alterations.

I do not live in the US but I will look for the products you suggest online. Do you have a preferred brand for the digestive enzyme?

Have a lovely (Saint Patrick’s) weekend.


I use the one from Tropical Traditions, but more out of convenience than because I’ve compared brands or anything. I have heard that NOW foods makes a good one.

Bien Venu!

Just wanted to let you know – I went looking for this page on the site and had a bit of a hard time finding it. I don’t see a link to it anywhere under the “Autoimmunity” menu – I finally found it under the “Eating Paleo – Paleo Modifications”. Seems like it should be at the top of the Autoimmunity page – maybe it is but I just couldn’t see it…

Thanks so much for all of the your education here – sooo looking forward to seeing in the book! 🙂

I’ve been eagerly “devouring” the info on your blog last couple of days and have decided to do the AIP Protocol, since going dairy free/gluten free has not entirely gotten rid of my psoriasis (although it has vastly improved). Unfortunately, I cannot seem to incorporate leafy greens in the amounts suggested by the Paleo diet/ AIP protocol without suffering a severe gastrocolic response. I’ll spare most the details but it causes adominal spasms which rival the most severe menstrual cramps (I’ve seriously almost fainted at times) all in an attempt to evacuate my entire digestive system whether I want to or not. Maybe this issue will clear up once I’ve adopted the AIP for a while but for right now, I’ll just stick to small amounts of leafy veggies. If however, it doesn’t clear up, what would this type reaction seem to indicate? Can people have sensitives to excess fiber in their diet?

Hi Sarah,
Thanks for your wonderful website — chock full of good info. HOPING you can answer a question that no other paleo site seems to be able to answer. Here goes:

I’m hypothyroid, recently diagnosed with Hashimoto’s. I have been gluten-free, dairy-free, soy-free for years. I am now also strictly egg-free, grain-free, nightshade-free and mostly sugar free. Zero processed foods, and get worse with all chocolate and coffee, so I stopped them too.

Started with selenium supp a few months ago which INITALLY caused incredibly positive change ( lost 5 lbs easily), but its positive effects suddenly wore off, and I had a bad autoimmune flare up…including sudden severe swelling of the thyroid/throat – AFTER trying to implement the clean, veggie laden paleo protocol that sites such as this one advocate! I cannot tolerate even highest quality meats and poultry, animal fats. It makes no sense!

I had previously found some success with a 90% raw food vegan diet and juicing. Annoying way to live, though, and I lost even more muscle tone and memory function.

Any idea why someone would be totally unable to process meats and animal fats?? Same with coconut milk, meat and coconut shreds/flakes (though coconut oil is fine). No good. My body blows up immediately, I gain weight overnight, breasts swell as if I’m menstruating.

Digestive enzymes don’t help this situation.

I cannot find any references to such a dilemma on your website or any other. Do some folks have an inflammatory reaction or intolerance to dense proteins/fats?? I desperately want to heal with food, but am at my wit’s end, being seemingly unable to go paleo.

Thank you!

There are a variety of possible causes for the flare. I could even be completely unrelated to diet and be attributable to stress, spending less time outside, not getting enough sleep. It could have been caused by a viral infection or it could also be the development of a new food sensitivity.

I think getting your iodine levels checked is probably a good idea. Both too little and too much iodine can cause problems with Hashi’s. And one of the aspects of supplementing with selenium is it changes how your body processes iodine. How much selenium were/are you supplementing with? Too much selenium can also cause problems by itself (you may have overcorrected which is why it helped initially and then stopped helping).

It is also very common to have digestive problems when your thyroid hormones are out of whack. So, the inability to digest meats and animal fats may be directly attributable to the flare. Also autoimmune thyroid diseases have a tendency to occur at the same time as celiac disease or primary biliary cirrhosis, two additional autoimmune diseases that can affect digestion. Here’s a paper about it:

I would suggest adding other forms of digestive support supplements to digestive enzymes to see if that helps. Specifically, I would add an HCl supplement (check with your doctor since these are contraindicated in people with ulcers, taking NSAIDs or other blood thinners, and people with blood clotting disorders) and I would add an oxbile supplement. Also, the proteins in fish are typically easier to digest (fish is also a natural source of selenium and iodine).

I also can’t emphasize enough the importance of getting enough sleep and managing stress.

I hope this helps,

Thank you so much for your insightful, detailed reply.

5 months ago I began supplementing (and still am) with 200mcg of a high quality selenium supplement (one by Life Extension, another by Thorne) per day, along with Magnesium, which my body seems to need. Didn’t think of fact that I maybe overcorrected

My stress levels haven’t changed and are in fact fairly well managed, and I sleep well and adequately. I am gluten sensitive, though I do not have Celiac. I do already take HCl, but have never heard of oxbile. Will check that out.

Interesting re iodine — everyone says iodine is oil on a fire for Hashi’s, but I’ve been skeptical. It does always seem to irritate me each time I try to use it.
Do you have a particular test kit/lab that you prefer for testing deficiency? The patch test is obviously unreliable.

I have always had problems processing meats and fats, especially nuts (as well as coconut flakes, cream, meat), for as long as I can remember. My younger sister is the same way, so I suspected that just certain body types were unable to handle the paleo diet. Also, I know that in MS, also an autoimmune disease, there is much controversy over consuming animal proteins and fats, as it is said by some to worsen the condition. I wondered if the same mechanism was in play here.

Deeply appreciative,

Hello, Sarah. Such an informative site, and what a supportive voice for many seeking help! Hoping to start AI protocol for family member, but I need to have something to present to the family member that will convince that it will help Hidradenitis Suppurativa, especially since it is Stage 3, and has been going on for over 20 years. Thank you!!!

Hi, I am interested in the Paleo diet for Autoimmune disorder. I have been suffering with Hidradenitis Suppurativa (HS) for over 7 years now and am at my witts end with this disease. I have read about people controlling or totally eliminating this disease with the Paleo Diet, specifically for Autoimmune disease. I am having trouble putting it all together though, and feel a little overwhelmed about not being sure of what I can eat and what I cant eat. Is there any kind of list out there that is cut and dry and what you can and cant eat for this specific diet? I want to give it 110%, but I really need to be sure of what I can and cant eat before I start. If you could help or direct me to a list I would appreciate it!!

I think a good place to start in a standard paleo diet if that’s not what you’re doing already. Hidradenitis Suppurativa is a suspected autoimmune disease, but not confirmed. If you’re really gung ho and want to get started with the Autoimmune Protocol, I recently reviewed an e-book that is a great resource.

I would also direct you to Tara Grant of who cured her HS with a primal diet.
I hope this helps!

Hi, your site is lovely. I have been very ill and am interested in doing the autoimmune protocol…have hashis. Is there a list of foods somewhere that I can eat. I saw the avoid and the general categories but am wondering if there is a more detailed list and perhaps recipes for what i can eat…and also fruit?

Thank you,

I have RA and also an ongoing battle of digestive issues that flare up periodically. The last 2 weeks have been hell. Extreme pain and bloating and I feel like my insides are going to burst like there isn’t enough room under my ribs. I bought a bottle of digestive enzymes two days ago and it has helped TREMENDOUSLY! I can’t wait to implement these additional changes and see how much better I can feel. I can actually wear pants again today without pain. Hopefully this autoimmune paleo diet will help resolve the residual inflammation inside. I think my entire small and large colon have been extremely inflammed.

Thank you, PaleoMom, for such a helpful article.
I was wondering whether you could clarify your suggestion on twice-weekly servings of seaweed? What constitutes a single serving of seaweed? A tablespoon of dulse? A sheet of nori? I know different seaweeds are widely variable in their iodine content…. How much seaweed do you suggest consuming each week?
Thank you!
Kind regards,

WOW such a wealth of info again from PaleoMom!! Thank you!! 🙂 A few weeks ago, a gave up startchy vege to see what happened! I had already removed Deadly Nightshades few years ago (I have Psoriatic Arthritis)…Also I am started the Autoimmune protocol Paleo PROPERLY- this time! I went Paleo on 1st August 2012 because I was utterly sick of being a fatigued, floppy muscled, tubby-chubby vegan with a thyroid problem!! I was never chubby until I was vegan for a while, I never had a thyroid issue either….I had been GF for many years too… Over the years I was always lead to believe that being a vegan was the best thing for Psoriatic disease, and that meat “went toxic” in the human gut (false pro-vegan claims)….Anyhow, turning Paleo fixed my thyroid issue (never used the drugs I was offered) new blood tests show normal T4, T3 TSH! I also lost loads of weight and look like my fit self again!! yay!

Polyols indeed give me horrid gas, sorbitols, things ending in ‘ols’ , low carb choc bars etc!!! Sugar free sweets OMG nooooo!

I have been only having green calm veggies..
I have stopped eating nuts too and eggs. I will re-introduce egg white and see what happens in a month..But with nuts I definately see redness increase after eating them…

If I stay really strictly to the AIP system, I may see some great results!!? The arthritis and skin flared really badly a few months after going Paleo, but I had suddenly started eating eggs again, and I was doing whey protein for the weight loss too, and even tried cheese!! …Also baking with nut butters, nut flours…So, having stopped that, I hope to see how I improve ! The flare was so bad that I was put on Chemo to stop my joints deforming. Now it is all calming and healing (even though I am left with bone deformity) I hope I can retrain my immune system to be ok.

I had noticed that is I fast/starve and dont eat anything at all, my skin is so much better, but that is just not sensible or practical! lol
I have started taking high dose L-Glutamine for gut healing too!
Seems like the joy of baking desserts is out for me…But I do jolly good savoury dishes! I love coconut, seem to be getting on with it wonderful!
Been through so many different diets in my life so far too. Though at least I got my energy back, and slimness! It is also like having to retrain your thinking, as when being a Vegan, you are brainwashed into believing certain things which are a load of rubbish. Everything I eat, I bless it with gratitude and thanks. <3

Thank you for your website! I just wanted to clarify, if I wanted to follow the auto-immune protocol, can I eat berries/fruit, corn starch, sesame oil and wheat-free soy sauce (the tamari sauce I have has water, soy beans, salt and alcohol). Some berries/fruit look like they have seeds in them, such as pineapples, strawberries, raspberries, blackberries, etc… If I can’t eat berries, can I eat blueberries since they don’t look like they have seeds in them? Thanks so much again!

Thanks so much! Just another follow-up: what about carbonated water, vinegar, pickles and cooking with alcohol (i.e. fish)? Thanks again!

It’s a common sensitivity, and if you are thinking of nutritional yeast, you need to make sure it’s not grown in wheat, but other than that, it’s okay.

Hi Thanks for all the info. I am wondering what your thoughts are on yams/sweet potatoes and autoimmune disease. I am wondering how an autoimmune disease can be healed when on these foods since according to GAPS/SCD they are dissacharides and therefore will not allow a leaky gut to heal.


I believe the gut can heal while they are in your diet and in fact, going too low carb can put a big strain on your thyroid function. That being said, I myself don’t tolerate sweet potatoes very well, I believe because they are high FODMAP. In The Paleo Approach, the only fruits or vegetables that are omitted are nightshades and legumes.

Hi Sarah– I’ve been on the AI protocol for two weeks now. A couple of things have come up that I’m wondering about:
— Why is it that once on the protocol I react strongly to foods that I (seemingly) didn’t react to before (or at least not in the same way)? For example, I was eating dairy and nuts prior. Yesterday, I mindlessly ate a spoonful of the pesto that I was making for my kids (some parm. and almonds in it). Then it tasted so good that I had another bite! About an hour after I began to have gas pain and bloating that I still have this morning. I rarely had these digestive issues prior. The same thing happened last week with alcohol. I decided to try one drink— and was keeled over in pain the next morning. I gather that this is normal, I’m just wondering why.

Sleep is a huge issue for me and one of the main reasons I started the nutritional balancing program and hair mineral analysis for my adrenal burnout. I discovered that I have heavy metal toxicity which is slowly being released through the program. I’ve been doing it a year and have had some bad sleep times. BUT it was getting better before beginning the AIP. As soon as I started the AI, I started having horrible sleep again–felt like I was wired at night. Because I’m not sleeping, I feel worse since beginning AI. My allergies are better–but I’m not sure if that’s just because some of the pollens have calmed down, or if it’s my own body. I’ve seen your recommendations for sleep and have done them all (this has been a problem for 30 years)– I’m wondering if you might have an idea about how the diet could be affecting my sleep(?)

Thank you so much for your thoughts and information!

I have a much more thorough explanation in my book, but basically, when you eat foods that your body is sensitive to, it tries to protect itself (in a bunch of ways). Once you remove those foods from your diet, your body slowly stops trying to protect itself because it doesn’t need to anymore. That’s good because it means you are healing, but if you do eat those foods, you can expect a much more dramatic reaction, since your body isn’t prepared anymore. That’s actually the whole point of an elimination diet–it makes it much more obvious to isolate problem foods. The good thing is that as your body heals more and more, eventually you will have a higher tolerance for many of those foods again.

The biggest thing I wonder with how your diet is affecting your sleep is what your carb intake is. If you are too low carb, that could be causing the issues. Try increasing your intake of starchy vegetables, and make sure to have a big meal at supper time (ideally about 4 hours before you go to bed) and see if that helps. Eating lots of fish, taking a magnesium supplement and taking a vitamin C supplement will probably help as well (these are all to help regulate cortisol).

Hello Paleomom!

Thank you so much for creating this article! I’m just about to get right into the AIP but have a few questions that I can’t figure out though.

How do I know whether a certain food is problematic for me? Since eating a very strict paleo/low fodmap diet, my IBS symptoms have disappeared, but I still flavour my food with cayenne pepper/paprika and eat roughly 6 eggs and a lot of macadamia nuts a day (I’m bodybuilding so I need roughly 2800kcal a day!!).

Basically, should I just cut out all the foods you’ve listed, or is it possible I can tolerate some of the foods. If it makes a difference – I’m 19, very athletic, and have mild asthma, acne, a leaky gut and I suspect SIBO. I don’t know how severe my condition is, so I’m not too sure how strictly I need to follow the AIP.

The next question is, I’m worried about the amount of supplements I’m taking, this list includes.

Slippery Elm Bark powder – 3 tsp 4 times a day
L-Glutamine – 3 tsp 3 times day
Betaine HCL tablet – one before every meal (usually 4)
digestive enzymes – one before every meal (usually 4)
Oregano Oil – 6 drops, twice a day (taking this for candida cleanse)
A gut health tablet, contains Lactoferrin, licorice root and glutamine – 3 times a day
vitamin b5 to reduce sebum production – 500mg tablet 3 times a day
A clear skin mixture, contains zinc, burdock and echinacea – twice a day
FIsh oil capsules – 3 with every meal (except breakfast when I have a can of salmon)
Biokult probiotic – 2 capsules, twice a day
cup of homemade bone broth with every meal, this counts as a supplement right? 🙂

Most of these are for leaky gut and I haven’t had any side effects from taking these, but it seems unnatural taking all these pills, and I’m worried so many supplements may be detrimental to my gut problem, rather than fix it.

Sorry for the all of text, and thanks for your help!

So, the first thing I will say is that if this is working for you, you should stick with it. But, I’m guessing you wouldn’t be asking me if it was working for you.

Because you don’t have an autoimmune disease, but do have some immune issues, I think you could use the AIP more like an elimination diet to figure out what you’re still eating that you are sensitive to (you mention that you eat nightshades, eggs and nuts and any one of those or all of them could be holding your healing back). I would suggest eliminating all of those foods for 3-4 weeks then adding back in one at a time. This will help you determine which foods you can handle (and it’s possible that there are many). But, there are some other culprits to think of here too. Intense exercise causes a leaky gut all by itself. Lack of sufficient sleep and unmanaged stress might be a problem. Are you eating enough carbohydrates for your level of training? Do you drink alcohol (which can hinder digestion and cause a leaky gut too)?

You are taking a lot of supplements and I think you could prune this back. Most of the supplements you are taking are designed for short term use. Some of the supplements that you are taking are immune stimulators (slippery elm, licorice root, and echinacea… Not sure about burdock). You are taking a whopping dose of glutamine. Clinical trials use .3-.5g/kg ideal body weight (there are also trials that just give a fixed dose, 30g per day is common). These studies have all been done in critically ill patients. I don’t know how much you weigh, but you are probably taking about 50% more than the top of that range. That’s a lot of oregano oil too… You might be stopping good bacteria from growing. Depending on the quality of fish oil you are buying, the fats can be damaged and could be causing oxidative stress. Fish oil has been shown to be very effective for short term use but potentially problematic for long term use for probably this reason. It’s much better to get your omega-3s from food (fish is the best source, grass-fed meat is good too). If you aren’t eating a ton of chicken, high omega-6 nuts (macadamias are okay) or really fatty conventional meat, a can of salmon a day is probably enough to balance your omega-3 to omega-6 intake.

I think digestive support supplements and probiotics are great. Other than that, I think it’s best to look to food for everything your body needs. Organ meat, fish, tons of veggies, glycine-rich foods (like anything off the bone, bone broth, organ meat) will all make a big difference. Sleep, not working out too intensely and giving your body enough of a break between workouts, and managing stress are super important too.

Thanks for your prompt response!

I’ve decided to do a strict 100% low fodmap AIP, at least for the next 6 months till I start uni. My sister and mother both have celiac disease, so I assume I’m a likely candidate for immune problems aswell, and there’s no harm in trying the full AIP.

The answer may change entirely on the person, but do you know how big of a contributor strenuous exercise is to leaky gut? I do heavy lifting 5 days a week for 45-60 mins, and I really don’t want to give it up, I’ve toned it down a bit in the meantime as I’m doing a Candida cleanse and have cut out the majority of carbs, I plan to reintroduce bananas/sweet potato (don’t think this is a nightshade?) shortly.

I’ve cut out the slippery elm bark powder for now, I think it may be a fodmap? (it’s causing gas/bloating). And thank you for picking up my L-glutamine dosage! I’m suppose to be taking 3 teaspoons split over the whole day, not 3 teaspoons, 3 times a day 🙂 I’ve also looked into Dr Chris Kresser’s research regarding fish oil supplements, and I’ve decided to trade all my O3 capsules for a single cod liver oil capsule with dinner.

Finally there are a few foods that I’m not too sure a bout. In your updated page of the AIP, shellfish are noted as okay, however these are a common allergy/irritant, and many sites claim they contain harmful toxins. (I eat frozen mussels and squid)

Also I have a Healthy Gut complex supplement that contains Dry licorice root and Lactoferrin(a milk protein from colostrum). Many sources claim these are both beneficial, but the licorice isn’t in it’s DGL form and I am allergic to casein/whey, so I’m a little unsure about them.

One final question, will The Paleo Approach be available on kindle?

Thank you again again and sorry for bothering you so much!

Most of the research showing that intense exercise causes a leaky gut is either high intensity short rest interval training (like HIIT classes or cross fit) or cardio (cycling, running). If you’re lifting with good rest periods between sets and laying off the cardio and metcon, you should be fine.

Sweet potatoes are not a nightshade, but they are a FODMAP. Some other low FODMAP starches are plantains, parsnips, taro root, and lotus root. The two diet factors that have been shown in the scientific literature to have the most profound effects on gut bacteria are fiber (basically avoiding refined carbohydrates) and omega-3s. But I do find that low starch diets for a couple of weeks can be very helpful (but then you need the starchy vegetables to help good bacteria grow).

Shellfish are extremely nutrient-dense and I think the benefits far outweigh the risks (as long as they aren’t being grown in extremely polluted waters, but most of what we get in North America should be fine). Of course, if you’re allergic, don’t eat them.

I would definitely try stopping the healthy gut complex for now.

Yes, The Paleo Approach will be available on kindle.

Hi Paleo Mom,

I’m literally at my wit’s end trying to figure out what all my health issues are. It all started when I was 14 and I started having seizures. They progressively got worse until I had the damaged part of my brain removed when I was 21. Ever since then, I’ve had gut and skin issues. In 2010 I went gluten free and noticed a big improvement in my overall health. I’ve now been Paleo for a year and a half. I’m struggling with eczema, weight gain, swollen stomach, and fatigue. I’ve cut out eggs, nightshades, and now nuts. I was tested for Celiac Disease but it was negative, maybe because I was already GF for a few months. Please offer any advice you may have. I’ve gained 10 lbs in the last 4 months.

Well, the first thing that occurs to me is to ask how your sleep is? and stress management? have you had your thyroid levels checked? are you eating enough carbohydrates and eating nutrient-dense foods? are you eating enough (you body might be gaining weight due to the stress of eating too little, especially if you have micronutrient deficiencies)? have you considered digestive support supplements? Yes, the celiac test could have been a false negative, but there are plenty of ways that you can be sensitive to gluten that are not celiac disease and even that can not be tested for.

I sleep at least 8 hours a night usually. My stress has been higher than normal lately. My intake has not been lacking. I would have a 3 egg omelet with spinach & mushrooms, 1/2 an avocado, and kraut for breakfast, leftovers for lunch which could be chicken, venison, or fish with veggies, or a spinach salad with chicken or shrimp. I would have a banana or green apple with almond butter for a snack or a LARA bar if I were on the go. I used to take a digestive enzyme but didn’t see a difference. I had all my levels check a few months ago, and everything can back normal. I’m just out of ideas here.

I love this article and the comments and am finding it very helpful and informative as I consider the idea that this might be me, and that implementing this plan might be beneficial. I have also been reading Paul Jaminet, and am curious on your thoughts on his approach (reduce protein consumption, eat safe starches and limited fruit with a limit on carb calories of 400, eat fermented veggies, bone broth, intermittent fasting, and get majority of calories through fat). It sounds above as though your experience indicates safe starches may not e well tolerated (white rice, potatoes of all varieties). Would ths be accurate?

There’s a lot that I agree with with Paul (like not being afraid of starches) and quite a lot that I disagree with, especially for those with autoimmune disease. I am quite opposed to intermittent fasting and ketogenic diets for those with autoimmune disease (and the research supports me on this–I will actually be posting a teaser excerpt from my book that discusses this in the next few weeks). There is also no evidence in the scientific literature that limiting protein or carbs is even remotely beneficial for those with autoimmune disease. In fact, I don’t like the idea of people with autoimmune disease thinking about macronutrients at all, but rather suggest a focus on micronutrient-dense foods. When you think about not eating carbs, people tend to undereat veggies, and your body needs protein to heal. You need fat too and especially fat soluble vitamins, so I’m not saying limit fat, I’m just saying nutritional ketosis is not appropriate for people with autoimmune disease (with perhaps the exception of short term nutritional ketosis for those with neurological diseases). I do not recommend rice for people with autoimmune disease, but I think starchy vegetables are fine (have a look at the updated version of this post linked above). I think fruit is fine too, as long as people keep their fructose intake in the 10-20g/day range.

Hello Paleo Mom,
Thanks for all very helpful information that you give us. I cannot stop reading your website and all comments. I am also so excited about the book and waiting the delivery in 4-5 months.

My question is….do you support the consumption of Almond milk in case of autoimmune disease?

Hi Sarah,

great website, thanks a lot for these helpful insights. I’m looking forward to your book!

I’ve recently been diagnosed with rheumatoid arthritis. My rheumatologist put me on Prednisolon and Metex. I haven’t started the Metex injections yet because I’m afraid of the side effects (Prednisolon is just as bad, but I need it to get the inflammation under control). Right now I’m looking for a holistic or integrated approach to put the RA in remission. Sadly, neither my physician nor the rheumatologist are inclined to look for “natural” ways to reduce the inflammation.

I’ve known & incorporated some aspects of the paleo diet before RA was diagnosed, and I’m now trying hard to follow the autoimmune protocol. But I do find it hard to eat a lot of meat – I’ve never been much of a meat-eater, I prefer chicken, fish, eggs and dairy products. I’ve cut dairy products and eggs from my diet, now I’m afraid that I don’t get enough animal-protein and -fat. And my rheumatologist told me to avoid meat, especially red meat, as it’s supposed to promote inflammation, so now I’m a bit lost at what to do.

What would you suggest?

Kind regards

The recommendations in the AIP are extremely thoroughly researched (there are 1200 scientific citations in my book, which is written just as much to educate doctors as it is to educate patients). Finding it hard to digest meat is typically a sign of low stomach acid, so have a look at the digestive support supplements I mention in this post. You can do this by eating predominantly fish (if you also include shellfish, this is actually a very healthy way to implement the AIP), and some chicken (it takes several meals of fish per meal of chicken to balance your omega-3 to 6 ratio).

Hi Sarah, of all the sites that I’ve found re: the autoimmune diet, thepaleomom has definitely been the most helpful for me. The winning combo is the science, practics and your availability to answer questions. Thank you so much!

My question concerns accessing protein. Until 4 weeks ago I was an ovo-vegetarian who had no idea that all my whole grains and legumes were potentially worsening my auto-immune symptoms. Since I started the auto-immune diet however, I have had allergic reactions to at least chicken and lamb and I felt really sick in my stomach after eating beef. I tried eating more nuts to get more protein but that resulted in cramps and when I added eggs back into my diet after eliminating them for 21 days, I also experienced cramping. I’m hoping fish is the answer 🙂 but I’m wondering if you have any comments about this? I ask this question because of a statement you made above about the fish in protein being more digestible than meat which you said may be relevant for those with severely damaged guts.

I should maybe also mention that until I started the auto-immune diet I relied upon legumes to stabilise my blood sugar levels which are wreaking havoc at the moment. Is there ever a time when you recommend eating legumes using the traditional/tried and true forms of cooking/preparing?

Thanks again. I look forward to hearing from you!

I definitely think fish is a good choice. I would also suggest looking into digestive enzymes to help support digestion (if you look at the updated version of this linked at the top, you’ll find descriptions of which ones I recommend). I guess if you were soaking, sprouting, fermenting and then thoroughly cooking legumes and introducing them after you’re feeling better, then I guess they’re okay. I would suggest some strachy vegetables to help with the blood sugar regulation and lots and lots and lots of sleep.

For the Autoimmune Protocol, can I eat something with carob bean gum or pectin in it? Can I chew gum with gum arabic in it? Thanks as always for all your help!

Also, can you tell me if I can eat something with sunflower oil in it (for the Autoimmune Protocol)? Thank you again!

Generally not recommended due to the high omega-6 content, but if it was only a little and occasional, it should be fine (for example, I might have a handful of dried cranberries as a treat and those are sprayed with sunflower oil).

Great site and very informative. I have had Hashi’s for 13 years and only till this year a Naturopath explained about Leaky Gut to me and the importance of diet. My biggest complaint is Fibromyalgia and food intolerance, primarily to the good foods. I’ve been on a elimination diet for 4 months but to no relief from pain. I have not eliminated all the foods on the NO list due to ignorance I guess, because not reacting to certain foods on allergy testing also. But I have not felt any improvements on my health.
I am just now starting to look into Paleo diet and realize I am eating many NO NO foods. I have been a vegetarian for 35 years and just have had to start eating fish and eggs due to too much muscle loss with my diet. What next? I don’t want to eat any other meats. Is there hope for me? How do you know your gut is healing?

I think you can heal very effectively if your only protein is seafood (if you’re just eating fish, I suggest trying some shellfish too because they are so mineral dense)–I care more that you are getting some animal protein, not weather it’s meat versus fish. You should slowly see improvements in your symptoms, increased energy, less pain, better sleep. Give it a few months before you start tweaking. If you were a vegetarian for so long, digestive support supplements are a very good idea (click on the link at the top of this post for the updated autoimmune protocol).

Thank you for your response. So for the last four months I’ve been on a gluten free and most cross reactives, soy free, sugar free, dairy free, fruit free diet and probably some other free foods too.
I am willing to be off more foods like nuts, seeds and nightshades, but if I don’t feel any better from my pain, I don’t know what else to do. I am taking supplements prescribed by my Doctor in Nutrition, they are all geared to healing the gut, but I thought as long as I am still eating tomatoes and some peppers and nuts/seeds that maybe thats whats holding me back from healing.
I can’t wait for the new cook book coming out soon. I looked in Barns and Noble but didn’t find any related to the immune system.
What are your thoughts on Brewer’s Yeast for flavoring and nutrition?

If you aren’t sensitive to yeast, I think it’s fine, but I feel a little hesitant to recommend it while you’re still dealing with pain. High omega-3 intake can be very helpful with pain. It that doesn’t help, you could look into low dose naltrexone.

Hello Mrs. Ballantyne! I have recently decided to change my diet in order to (hopefully) improve my life instead of depending fully on pharmaceuticals and doctors advice. I have been diagnosed with UC (colon removed a few years back), Ankylosing spondylitis and RA. I’ve looked into Paleo before but had never heard of nightshades or autoimmune protocol until I stumbled upon the terms tonight and googled them together to find your blog. I must say your posts are very informative. Considering I’m new to these ideas, are there any posts of yours that I should read first to get me going? There seems to be a whole lot of information on your site! I feel the need to thank you already for your blog, it seems to be exactly what I needed to find. Thank you!

I have Hashimoto’s Thyroiditis which is now in remission thanks to the AIP diet. I still ate eggs and seeds and I am ok with that. I am now about 8 weeks pregnant and vegetable and meat make me so sick I can’t even look at them. The only thing that settles ok is brown rice.. Do you think eating brown rice again will upset my gut? I don’t want to trigger an immune response, but at the same time chicken and veggies trigger my gag reflex right now and I don’t know what to do. Any thoughts? Advice?

Well, often pregnancy hormones will suppress parts of the immune system responsible for autoimmune diseases and many people with autoimmune disease will experience a reprieve during pregnancy (this often goes with a flare after the baby is born or when the baby weans). So, I think that if rice is working for you right now, then that’s okay (white rice would be better than brown rice from an antinutrient standpoint). The protein aversions that are so common with pregnancy usually go away in the second trimester, at which point you can start focusing on nutrient density to hopefully mitigate a flare after the baby is born.

That makes so much sense. I had my first really bad dyshidrotic eczema flare up after my first son was born. It took awhile to figure out what it was and I actually self-diagnosed because all the doctors I saw had their heads up you-know-where. Thanks for all this great info. My Dad just started eating AIP per my instruction (for his psoriasis) and I really want to get your book! I’ve learned so much just from your blog posts.

I’m confused about some seeds. Chia seeds and flax seeds, are they ok to consume for autoimmune diseases? Do they have harmful lectins? I’ve heard such good things about these.

I don’t recommend chia or flax for autoimmune disease. Flax is crazy high in phytoestrogens. Chia is mucogenic, and while there are not studies showing that it is an immune stimulator, other mucogenic plants like aloe, slippery elm, and licorice root are all immune stimulators. Plus, the omega-3 fatty acids in these plants are almost completely unusable by the body.

Chia seeds make me bloat. Not good for autoimmune…although I do not think I react to flax. Good to know about them being unusable to the body.

i used to eat flax seed by the gobs, as in 32 oz plastic cups filled with ground flax and water each day for weeks at a time and i noticed beneficial effects in my back (discs?) and also where the ribs attach to the sternum. I was much younger though so my absorption and conversion from ALA to longer chain omega 3’s was likely much better but now i hear that saponin content in flax may be a problem so its prob not advisable anyway. To say that the body cant use the omega 3’s in flax is incorrect though imo.

Where would you suggest starting if I have hoshimoto’s autoimmune and salicylate sensitivity to quite an extreme. I notice you offered a list of high salicylate fruits, but what about vegetables? There is so much conflicting information on how to get beyond the leaky gut / salicylate sensitivity… but conflicting “lists” of food.

I would suggest starting with the autoimmune protocol, avoiding salicylates in household products and medications, and avoiding those foods that you know you have a salicylate reaction to. Salicylate sensitivity should go away as your gut heals and it’s quite controversial in the scientific literature whether there is any benefit to avoiding salicylates in foods since medications and household products are by far the biggest sources.

Dear Sarah.
Thank you for this informative post! I’m looking forward to your book and have pre-ordered a copy. In the meanwhile, I’m trying to decide if I need the full AIP or could start with something like strict Paleo and see how things go. As far as I know, I don’t have a commonly recognized Autoimmune disorder. I do have severe environmental allergies (all developed in the last ten years), chronic sinusitis, mild food allergies and a major problem with oxalate toxicity which is most likely the result of a leaky gut and endogenous oxalate production brought on by oxidative stress and nutrient deficiencies (most likely not diet related, but my body’s inability to use the nutrients that are available). I am working with an oxalate scientist to address the endogenous oxalate production, but I’m hoping to address the rest of my issues through diet, especially the leaky gut. Does any part of this jump out at you and make you think “Start the AIP now.” Or do you think going very strict Paleo to start with the intention of adding parts of the AIP or the entire protocol if necessary might work? I am currently following a Paleo-inspired whole foods diet, with very limited grains, beans, industrial oils etc, which is how I feed my young children. It’s helped, but obviously isn’t enough.
Thanks for your time.I appreciate it.

I think it’s worth trying a very strict Paleo diet first before jumping to the AIP. I also think focusing on more really nutrient dense foods (rather than cutting things like eggs and nuts out) makes a lot of sense (so more organ meat, more seafood, tons of veggies). I’d give strict paleo 2-3 months and then see how far you’ve come before tackling the AIP.

I’m so interested in this and think it would be very beneficial for me to give this a go. Having said that, I’m a vegetarian paleo girl (too many lab pracs with cadavers!) and use nuts and seeds to make up for my lack of meat. Do you have any tips regarding the cutting out of the nuts and seeds?

I am working on healing my leadky gut and was wondering if one also has candida albicans should one heal the gut first or try to get the candida under control first or address both issues at once. Any comments are appreciated. Thanks

Both at once. The diet factors with the most powerful corrective influence on gut microoranisms is high long-chain omega-3 intake (from seafood) and high insoluble fiber intake (from vegetables). Adding in broth or other glycine rich foods and nutrient-dense foods (like seafood, organ meat, and vegetables) will help heal the gut.

Thanks ThePaleoMom. Are there any options for getting omega 3’s from non-seafood? I was recommended Cat’s Claw as a great option for healing leaky gut. Have you heard anything about this herb? Thank you.

Not long-chain omega-3s which are the kind your body needs. If you eat exclusively grass-fed and pasture-raised meat, not very much poultry and no nuts or seeds, you can get enough without seafood. All plant sources of omega-3s are ALA, but you need DHA and EPA.

Hi PaleoMom,

Yes, all the meat I eat is grass-fed without hormones and antibiotics. I do also eat a lot of chicken, turkey and some pork but it’s all-natural with no hormones and antibiotics. Should I cut down on the poultry/pork and eat more meat and add some offals? Thanks.

Hi Sarah,
I love the work you are doing and sharing.

Have ordered and anxiously awaiting both books and bought others you have recommended in the past months. Great reading.

I was following AIP to begin with, as I have life long dairy, coconut and wheat allergies. Recently I had a kidney stone pass (agony) and the urologist is doing further testing at the moment. However, the diet she recommended conflicts with what I have been doing. For example-NO meat broths, game meat, dark green leafy veggies, turnip, cabbage, fermented veggies, limited protein, organ meat, but DO eat dairy. It is the typical diet recommended for kidney stones.

On top of that, I do have gallstones and a fatty liver which adds another layer of confusion for me. At the moment, I do not know what to eat, where to begin to get healthy again and I do believe the problems are all linked.

I would be interested to hear if anyone with similar problems has successfully followed the AIP? Many thanks!

Hi PaleoMom,

I cannot tell you how grateful I am for your site. I have literally spent hundreds of hours searching the internet to help me with understanding my son’s health problems. He has been chronically ill since he was 7 years old and is now 20, never having been able to attend school, hold down a job or play sports. We have finally found a wonderful microbiologist who is now on his case but the picture is overwhelming. Your site has helped me understand so much of her report, and understanding goes a long way to helping implement major changes.

A general summary of his problems would be Histamine Intolerance, Leaky Gut, IBS, Chronic Fatigue, and Anxiety. There are several other side issues such as his liver struggling, chronic infection, etc but this was the best summary I could give from a 30+ page report!

I have read a great deal of your site already but have alot to go, and have found answers to a great deal of questions. There are two foods which we have to eliminate that have me baffled – pineapple and almonds. Can you explain why these should be eliminated from a diet? (Other nuts are apparently ok, just not almonds or cashews). I was of the understanding that pineapple can be quite soothing for IBS so until now it has been a regular part of our diet.

Strangely enough, wheat is not on the list to avoid, however from everything I have read I still plan on eliminating it. Avoiding almond flour does make it a little tricky but coconut flour is fine, so we will focus on that instead.

Any light you can shed on this would be greatly appreciated.

Thankyou again for such a wonderful resource and all the time you put into it!

Almonds are very high in polyunsaturated fatty acids and cyanogenic glycosides. The PUFA are inflammatory, and the cyanogenic glycosides cause the release of cyanide in the body which can be a stress as well, especially if your son’s liver is struggling. Pineapple can stimulate histamine production, so that might be why (it’s also full of digestive enzymes, which is why it can be so helpful). Also, sunflower seed flour can substitute for almond flour in most recipes 1:1, so that’s a good option to consider.

I have not been diagnosed with an Autoimmune Disorder, but have been following Paleo for 3 weeks now. My main symptom I am trying to get rid of is Brain fog and Fatigue. Do you think this diet will help in those areas? Thank you!

FANTASTIC article. Thank you so much for sharing this information in such a succinct way.

I just have one question – I was diagnosed with celiac and I am wondering if the precautions mentioned above are for something like that or for more severe autoimmune conditions. I mean, I gave up gluten rather easily (except for living in a foreign country at the time and dealing with that fun miscommunication) and now I am moving forward into Palo (skipping eggs as well).

But for a person like me, how critical is it that I NEVER have coffee, nut butter, or a glass of wine. I’m not interested in cutting corners – trust me, I did a mini-cheer when I read about how paying a little more for food means paying less for medication in the long run. Big fan of taking care of my body. I just want to make sure I don’t over-do it as it does indeed affect those around me to a great extent.

I’d love your feedback. Thank you in advance.

I think it’s for all autoimmune disease, but what you do is try it for a month, then reintroduce those foods and see if you have a reaction. Chances are good that if your stress is well managed, you’re getting enough sleep and activity, and your diet is nutrient-dense, that you’ll be able to add those foods back in and enjoy them without negative health consequences.

Awesome, thanks so much. Like I said, I am willing to do what it takes, but I just like to have all the information. Your blog and entire website is fantastic. I am so grateful for the high quality information you are putting out there.

Has anyone been successful at healing their underactive thyroid, completely eliminating it by following the Paleo Diet? And I get mixed lists of foods that you can & cannot eat, items in question bananas, mangos, tomatoes & bell peppers.

I do plan to follow this AutoImmune Protocol to kick start the process as I am just now linking my gluten intolerance to my underactive thyroid & am amazed at the amount of info out there.

And what about fiber drinks? I drink a fiber drink daily to help control my cravings through the day. Should I avoid those or keep drinking them?

Thank you for all of your information!!!

The AIP is discussed in detail in Sarah’s book The Paleo Approach. You can learn more abut the book here: You may also want to join our new The Paleo Approach Community group on Facebook, there are lots of great discussions on various AIP/Paleo topics. The group has over 4,000 members, you can request to join here: — Tamar, Sarah’s assistant

I am so disheartened by all of this. I have Celiacs and Hashimotos. I have been diligent about no gluten and no grains. I lost weight being sick and now I have gained 4 pounds back but my thyroid blood tests are still coming back terrible. If I cut out nuts eggs and goat cheese what is left to eat? I was eating lots of protein–servings at breakfast lunch and dinner but now my doctor said to cut back because of my cholesterol. I have a wedding in July that I can’t attend because of food issues. I feel like life is over not to mention the depression that follows cause no one understands. There are so many Paleo People out there. Does any one really know what diet actually fixes the thyroid numbers is everyone just guessing?? When I limit my carbs too much I go to bed hungry and stressed out. When does the suffering end? Has anyone seen remission with diet alone?

Yes. I encourage you to check out who saw dramatic improvement with celiacs with this protocol. And check out and Also, if you’re on Facebook, there’s a group called The Paleo Approach Community with over 4000 members all using this protocol for their autoimmune conditions. You aren’t alone.

You should check out Chris Kresser’s website, and his new book Your Personal Paleo Code. I think I read somewhere that he talks about too little carbs and hypothyroidism and that some women just need more carbs (I am one) to feel better (white rice seems to help me). Eliminating gluten put my antibody numbers in the normal range, but I did not feel much better until I got my medication figured out (taken me over 2 years and am still working on it).

Check out for some great information on thyroid related questions.

Are you aware of the “vegalicious” site, by ELena Wilkins. She cured her hypothyroidism naturally. Check it out and good luck.

Hi Sarah, I have just completed genetic testing and it turns out that I do not tolerate sulfur and I have been instructed to remove it as much as possible from my diet. I’ve read Dr. Wahls work and much of the literature of AI friend paleo eating strategies but most of these empshasize sulfur rich foods. Is there a way around this? Thanks, Ryan.

I’m confused, with auto-immune (Hashimoto and possibly IBS), if you can’t use almond flour or coconut flour, do you avoid baking altogether or what do you use? Thank you for your help!

Sarah discusses flours used in Paleo baking (including some that are nut-free) here: Sarah has a section of recipes that are Auto Immune Protocol (AIP) friendly, you can view them here: The Paleo Approach Cookbook will contain over 100 AIP recipes. You can read more about the cookbook here: — Tamar, Sarah’s assistant

I have Hashi/celiac and I’m confused on how much animal protein (ounces) is safe to consume on a daily basis? Right now I am eating protein at every meal excluding dairy and nuts due to AIP protocol. How much is too much? I’ve heard too much animal protein will deplete calcium from your body..true?

Also I’m not consuming nuts right now but when I do I was going to bake with them but a friend of mine said baking nuts alters the fat somehow and it becomes toxic. How true is that? Thanks for all you do.

No, too much animal protein can not deplete calcium from your body (that has been debunked). Eating animal protein at every meal is perfectly safe. Just make sure you’re eating veggies too.

No, cooking nut fats does not make them toxic. Cooking oils beyond smoke point does oxidize the fats which is not great. But, if you’re cooing with nut flours, the fats are very stable and not oxidized easily. Plus the internal temperature of baking is well below smoking point.

Now I have the sufficient information to do something about my autoimmunity. Thank you so much. This will help me change my quality of life for the better. I am very grateful. Your blog is the best!

I know you have addressed the use of antibiotics (if they are absolutely necessary) and how to minimize gut damage, but I have been unable to find any resources addressing what to do when NSAIDs are prescribed or necessary – for severe acute injuries, surgery or unavoidable medical/dental procedures. For those with an autoimmune disease, is it ok to take them for a short-term period of time for recovery? Are there any alternatives? Is there anything that will minimize the negative side effects and gut damage (i.e. healing foods, supplements, etc.)? Should I follow your suggestions for minimizing damage from necessary antibiotics (like you did with the burn from the bacon)?

Hi Sarah

I have decided to go for the AIP diet, I have hashimoto’s disease and a spot of arthritis in my hip – even though I am only in my early forties. It already seems clear that I am in need of the AIP. I am nervous and wonder whether I should start with Paleo and then go for AIP or just jump right in ! Any thoughts or suggestions would be gratefully received.

Thank you and best wishes
Susan in Istanbul – we don’t have access to almost anything organic or organically grown/raised unless you spend huge amounts on private farmers, which I cannot do 🙁

Reply to Sarah in Istanbul: Sarah, I also have Hashimoto’s and pain in my left hip socket and IBS. I feel like I have been to college with all I have learned online. My daughter also has Hashimoto. After taking the slow approach (gluten/dairy/soy free), in hindsight, I wish we would have just gotten on AIP RIGHT AWAY!! At first, we didn’t even know it existed, but after having a blood/food sensitivity test, the eggs, nuts, etc. showed up there anyway. GO FOR THE GOLD, the AIP diet right away! My daughter and I also have severe yeast issues and have gone on Christa Orecchio’s Yeast Diet. Take the free, at-home test and just spit a dime-sized piece of saliva in a glass of water each morning for 7 days in a row. It has to be before you eat or drink anything! Check it 3 times within 45 minutes. If it floats, you are fine. If it grows legs, you need to go on yeast diet. If it sinks, there are more of them than you!, LOL, but has some truth to it! I paid a fortune for a 1 day stool test that showed not enough yeast to do anything about, when I knew I had severe issues. My daily spit samples have sunk like a rock!! I soak all produce in white vinegar for 20 minutes to help remove pesticides, mold, dirt, etc. Also, check out Christa’s site at The Whole, she has a list of the “Dirty Dozen” Veggies and the “Clean 14” which don’t absorb as many chemicals. I am thrilled that this “Yeast Diet” will take care of the yeast, take care of leaky gut and give my thyroid, liver and adrenal glands a big boost towards healing!

I have just been diagnosed with Graves’ disease. (I also have very well controlled type 1 diabetes for 25 years). The Graves’ disease was diagnosed by a blood test since I do not exhibit any symptoms. Currently not on any medication for this disease and would like to keep it that way.

Starting the AIP, however my doctor also says to avoid foods with iodine. Now being hyperthyroid, that makes sense since iodine is what is needed to make TH. Unfortunately that means avoiding seafood, which I love. Also increasing goitrogenic foods since they inhibit the making of TH. Not sure my body knows how to find a balance of TH.

After a month of this way of eating, how do I know that it is making a difference aside from a blood test? Therefore, does this mean I can never eat food with iodine? How do I reintroduce food groups if I have no symptoms now? I cannot take a blood test every couple of weeks that a food is introduced.
Just looking for some sort of plan on how to approach things.

These topics (how to begin, food reintroduction) are all discussed in detail in The Paleo Approach. You can read more about what is included in the book here: Other posts that may interest you include: How do I know the AIP is working? and Reintroducing Foods after the AIP: — Tamar, Sarah’s assistant


Hi Melissa, I’m in Melbourne too, I have Hashimotos and would be grateful to have someone else nearby to share local resources with

Help Paleo mom! I have just found out that i am pregnant, i have been following the AIP for 50 days and have started with introductions, but should i stop that? the thought of eating this restrictive untill…well untill when? the baby is due? I have ME and have had great sucess with the diet. Would any adverse reactions to food be harmful to the baby? I have a leaky gut ( much better now thanks to you) and have been following AIP and fodmap. so greatfull for answers !

Many people find that they do not have serious food reactions during pregnancy and can eat plenty of non-AIP foods for the baby. You will definitely want to discuss any dietary changes with your doctor. – Christina, Sarah’s assistant

i have hashimoto’s. so can i eat fresh water fish like carp to maintain omega 3 ratio. is carp low enough in iodine for consuming on a daily basis?

I have a question regarding limiting nuts. I know they can be hard to digest, but I always soak my nuts and re-hydrate them to make them more digestible. Also, in the GAPS diet it does not say to avoid nuts. In the first month or so yes, but after, no. Are you saying to avoid nuts forever? I do notice that sometimes egg whites effect me and other times not….which might mean it is not even them and it is something else.

Soaking does make them more digestible but does not eliminate the problem completely. The autoimmune protocol can be, but is not intended to be, a permanent diet change. It is an elimination/reintroduction protocol to determine and heal from your unique sensitivities. You may find that you can add nuts back in. – Christina, Sarah’s assistant

HI Sarah
I live in the Uk and many of our foods are very different to America however I have followed your auto Immune Paleo faithfully for 49 days and have lost 1 stone in weight so I am very grateful to you. I have Takayasu a rare auto immune disease and for the last days following the diet I have felt better, however I have just had a hair analysis done which is showing allergys to Nickel in particular the others I have already eliminated.
However on Saturday having been so successful, I thought I would try and introduce 2 small tomatoes, wrong move I have been so ill the tummy pains, temperature spikes and muscles spasms in my legs have just set me back so badly, so I have decided to stay on Auto immune diet as I seem to cope well with that.

My question is while I am awaiting delivery of your book not arriving until May 2014 are there any supplements or tests that you could recommend that may help me further. My last PET scan was clear but my consultant wants to put me on to Ritiximab and I feel the cause and cure is most definately in my food so I would like to avoid any more drugs if possible I have just completed 9 rounds of cyclophosomide and heavy doses of Prednisilone, now down to 4 mg per day.

Takayasu has such little research therefore if I can prove that the auto immune Paleo diet has such a major contribution to holding the disease at bay then I am willing to do anything as I know from your own health issues you have done the same and it may well help many more people with this disease.

I just know there is more to my food but don’t know where to turn for advice on testing or help, so I do hope you can help me in any way.

My food is now totally organic.

Many thanks for listening and hopeful of some further guidance until I receive your book.


If the AIP in and of itself isn’t yielding the results you’d like, you may be sensitive to one of the AIP-approved foods. Some of the most common ones are coconut, FODMAPs (possibly due to SIBO, something your doctor can test for), and shellfish. It can also be that you’re simply not eating enough or a wide enough variety of certain foods like veggies, seafood, and offal. Sarah’s book goes into more depth on troubleshooting. In the meantime, this post addresses some of those topics: – Christina, Sarah’s assistant

Hi Jacqui, Have had a host of seemingly unconnected autoimmune responses for most of my life (am 55) and only recently discovered a supplement for gastrointestinal support containing L-glutamine and others and cannot recommend highly enough for repairing the gut and feeling super! Have not felt this good for decades. Didn’t know I felt so bad. Read Dr. Amy Myers in usa website. Bought my supp in a health food store, chemist had a commercial less potent version which I started on then found something stronger. It is a powder called “Intestamine” but each country will most likely have a different version. Teaspoon in small amt of water once or twice daily. There was a shellfish version which I did not buy in case I had a reaction. ps I live in Australia. Cheers. Mxo

Hi Margaret,
Thank you for posting the information on Intestamine. Can you please tell me what other ingredients other than L-Glutamine are in the product. Thanks again.


Hi Margaret, many thanks for your advice I will certainly try anything to help me. I have Takayasu although too old (61) but young at heart by medical standards but all of my aorta is inflamed, I have had 9 rounds of cyclophosomide and heavy steroids but when ever I reduce below 6mg daily the aorta flares again. I know it is from my gut but here in the uk leaky gut is not considered they only dampen down the immune system which is not good.
so Thank You most sincerely for the information I will track down tomorrow.

Kind regards

I realize this comment section is from last year, however, I just discovered it!
I have an autoimmune condition called Primary Biliary Cirrhosis PBC.
I was diagnosed 2 years ago at the age of 46. 4 years prior to that I had put on 100+ lbs. I’m sure the many starches I ate to gain that weight contributed to my condition. The only way I’ve ever been successful at losing and maintaining weight has been to eat low carb. I followed Atkins. I’ve been eating Keto/Paleo for a few months now, unaware of the AIP. I have lost over 40 lbs but seem to be stuck now. I never had a problem with my blood sugar but now when I test it, even in the morning, it’s always between 105-125. My blood ketones are between .05-1. I’m not sure what’s going on. I feel great. My liver counts are fantastic and I’ve even reversed fatty and enlarged liver!
I need to lose weight tho. I’m stuck at 202 lbs. I’m 5”3′ and would like to be at a healthy weight. HELP!! Thank you.


Thank you Christina. I’ll check it out. I found a wholistic physician close to my home. I’ll be going there as well. They believe in paleo nutrition!! Big win!

Thank you Isabelle. I listen to his podcasts as well as Robb Wolf. I’m doing what they suggest. I actually found a wellness Doctor close to my home is practices exactly what jimmy and Robb talk about! I went today.

Hi Sarah and Christina! Thank you for all the effort you put in creating all these blog posts and answering the questions!
I hope you will have time to answer my question. I have a child, almost three years old. Just a few months after her birth we realised she has several food allergies. Later blood tests showed she has these allergies: gluten, cow milk, soy, eggs, walnuts, hazelnuts, peanuts. Unfortunately, those were the only allergens she was tested on. Later we realised that she does not tolerate any milk products, tomato, peppers (paprika), origano, celery, cranberries.
From your blog posts I believe she has leaky gut and that’s why she has all those intolerances, including gluten cross reactions.
Finally, my question is: can you help me help her? Where to start as she is a child? How to look for negative symptoms – I am not sure I can always tell if something is not doing good to her body.
Best Regards!

In moderation. Because juice can spike blood sugar and doesn’t activate the important digestion signals in your body that chewing food does, Sarah recommends having juices as part of a complete meal, not a meal replacement. – Christina, Sarah’s assistant

I have Hashimoto, and currently only partially diagnosed autoimmune arthritis. Along with the endocrinologist telling me I am carbohydrate intolerant, Syndrome X/hyperinsulinemia/pre diabetes (whichever you prefer) And factor in the degenerative spinal disease.
I am a painful mess to sum it up.
This morning I have discovered this idea of autoimmune diets, whilst being very unsuccessful using ketogenic dieting. I am however a very picky eater, and combining that with this, that even eliminates things I’ve been using on keto, I am not sure what exactly I can eat. I love spicy food, :/ and I have been using almond meal, coconut flour, meat, eggs, cheese, and heavy cream as major components of my intake. That plus coffee, spinach, coconut oil, grass fed butter, mayo, Z SWEET, Stevia, chia, flax, psyllium husk powder, coconut palm sugar, pumpkin seeds, zero carb protein podwer (Gnc isopure), Brazil nuts, almonds, cashews, and occasionally pistachios. Plus light use of tomato sauces.
Can I keep any of these items?

It’s ideal to eliminate all non-AIP foods for the best results. You can ease into it by giving up/replacing one food at a time if you need to. The more non-AIP foods you hang on to, the longer it can take to see results. – Christina, Sarah’s assistant

You’ve got to get Sarah’s book! And read the website page(s) above! I also have Hashimoto and had a bad case of IBS and skin rash/issues. #1 I got off of all gluten/dairy/soy and it helped a lot, but my stomach/IBS was still way out of control until I got off of #2 Nightshades (tomato, potato, peppers, eggplant). Yes, I know, that includes most Mexican/Italian; but, it is worth it to be healed! I also did a serious Candida Cleanse for 8 weeks which at the same time healed my Leaky Gut. Now, YEAH, the IBS is completely gone and my Leaky Gut is healed. I have had a light tomato sauce on a gluten free pizza with only a barely noticable response from my stomach. I may only do that once a month or so. Everyone is different! My daughter also has Hashimoto and handles some nightshades with no big deal. All nuts and seeds really effected me too. I have also added back in goat cheese and am fine with that. After the blood test to confirm the auto-immune, the “food sensitivity” test was invaluable so that I could temporarily eliminate those items and begin healing my “leaky gut”. Sadly, you cannot really heal until your gut is healed. What also has been INVALUABLE and Sarah promotes them too have been Dr. Tom O’Bryan and Sean Croxton and Sara Olson’s Health and Thyroid Summits!! Google them too, but Sarah’s book is foundational!!

Can you point me to the right direction in helping my 4yr old? Everything is geared towards adults. She has rashes all over her body, itchy inflamed skin that is hot to the touch. She screams and cries for help all day and night. We have been looking at gaps, scd and now aip. Just wondering if a low histamine diet would be a next approach? Maybe gaps intro would be right? There is so much info I dont know which foods to cook, eat raw? We have been to the dr and that would just be a life time of antihistamines and steroid creams! No thanks. Any thoughts would be helpful at this point. Thanks.

Sarah recommends starting with the AIP and then only making additional restrictions (like histamines) if the AIP is not yielding the results you would like. Whether you eat your foods raw or cooked is a matter of personal preference (Sarah recommends mixing it up). You can find Sarah’s posts on Paleo for kids here: – Christina, Sarah’s assistant

Hi, I suffer from alopecia areata. I was wondering if you have read or know of anyone who has had improvement with this auto immune disease by following AIP? My alopecia has gotten out of control since giving birth 6month ago.

I believe it contains nightshades. Sarah recommends whole, solid foods on the AIP as much as possible, not juices or smoothies, as chewing is important for digestive health. – Christina, Sarah’s assistant

Hi, Just wondering if the autoimmune protocol diet would be useful for treating vitiligo. I feel well, the vitiligo started in 2012 and is very widespread over my body and is itchy at times. I have slightly raised tsh and high thyroid peroxidase antibodies (but not off the scale). I have become gluten free but perhaps with cross contamination as I cook for the family.
Your advice would be most helpful.

I’m so confused…Is there an in detail breakdown of what to and what not to eat on AIP diet for Hashimotos and Hypothyroidism? I sure could use it…

I don’t like any kind of seafood, which is a huge bummer because I know how healthy everyone says it is for omegas, selenium, etc.
I seem to have a hard time with eating more than 1/4 cup of coconut per day and can’t have any nuts with AIP , correct? Almonds tend to make me bloated and I overdo nuts when they are in front of me.
I’m a chocoholic!! I’m trying to cut it out completely..
I read that those who crave chocolate are low on magnesium. So, I’ve been eating bananas and avocados but can’t overdo those because of high glycemic index for bananas and too much avo makes my stomach turn…
Ugh..I can only eat so many veggies before I’m just plain craving rice.
I feel like I’m missing something…I want some kind of nut butter but can’t have sunflower butter.

Any advise would be amazing…Or even if it’s directing me to your book or an article on your blog.

Warmest thanks and SO much appreciation for your blog! I love it!! I don’t feel so alone. 🙂

PS. Have you ever heard of Kim John Payne? He’s a family and child psychologist. I use a lot of his balancing techniques in my home and it’s helped bring my child on board with my diet. We cook together and our new diet lives with us with warmth and joy. You should check him out if you have not already. Perhaps it will help your family too. 🙂

I’ve just bought your book (is on the way now) but could you tell me if inside are some API recipes? I have Hashimoto and I thought that normal Paleo is enough to heal.
thank you

I’ve been searching for a solution to my problem, I have endometriosis, would following the AIP be of help to treating my condition? I have endo but it is the rare type, bleeding spots all over my small and large intestine. Every time I’ve got my periods these spots bleed in my tummy and the blood stays there.I have been having the most painful periods for all my life. This has caused intestine lesions and if things get worse surgeons consider a removal. My issue was discovered by false diagnosis taking me for a surgery to remove my appendix (these were the symptoms and the tests results said so too – due to blood free floating in my tummy- it was dangerous). During the surgery my surgeon saw the spots and had to do another cut to open my belly from above the belly button till under it. After running tests, endo was the answer. All doctors I consulted suggested artificial menopause to make endo less severe. I went through it for 9 months (after 3 months periods came). In the meantime a homeopath told me that I do not metabolise wheat so I stopped consuming it and felt great for 2 months, no intestine pain, no constipation. Things got worse and after reading about paleo I cut out any kind of flour, potatoes and rice. After months pain came back accompaning my periods and intestine pain and problems too. I reduced sugar and coffee intake and I smoked a lot less. Only temporary results again because now my period is not regular in flow or date so I am on the pill to ballance it for three months and my doctor suggested after this I should try to get pregnant, if tha tis possible since my tummy is full of adhesions. I would realy appreciate it if you could give me some guidance. Even doctors have given up on me and are desperate because they can not find a solution which is not that radical. Please forgive any mistakes, English is not my native language.

Expecting your answer with hope

The AIP can certainly help reduce complications from endometriosis, though it’s not a cure. Angie at suffers from it as well. – Christina, Sarah’s assistant

I have Sjogren’s Syndrome, Celiac Disease, Intracranial Hypertension aka Pseudo tumor Cerebri & elevated Tryptase level. I am also allergic to seaweed in addition to almost everything that grows outside! My tongue is geographic & inflamed from my diet. I am already gluten free. How do you suggest I follow your Paleo Diet? My allergist told me NOT to eat any fresh fruits or vegetables because of my elevated Tryptase level. I am really confused…I am just getting sicker & sicker!!! I really need to help but no one has any answers…

Are cooked or otherwise prepared fruits or vegetables okay? Sarah does recommend following Paleo or, even better, the autoimmune protocol as closely as possible for the best results for autoimmune patients, but sometimes additional restrictions need to be made for other conditions. Sarah has professionals available at to help troubleshoot the diet change. – Christina, Sarah’s assistant

Just read your reply…I didn’t know where to find it! I am only supposed to have very limited amounts of cooked produce. I am really confused by all of this because from my research on the Internet even meat can have high histamine in it! My Tryptase level is bordering on Mastocysis & if it gets any higher I will have to have a bone marrow biopsy. So is this consulting a free service or I am I charged a fee? I am tapped out financial from all my medical bills!!! I was hoping for a a straight answer but thanks…even doctors are no help! Rita

Hi! Thankyou so very much for all of your information! You are so very generous with your wealth of information. My husband and myself have recently (3 weeks) transitioned to paleo. I have also purchased your book, and am wading my way through!

Have you come across people who, when transitioning, experience significant food aversions? My husband has autoimmune disorders (lupus and hashimotos). He has started to have trouble eating certain foods (that have previously been enjoyed). Sometimes it’s the smell that puts him off, other times it’s the texture, and he can’t stomach them. The aversions have been simple foods such as coconut milk, fruits, salads etc. I don’t have autoimmune issues, and I’ve transitioned quickly and well. Are his difficulties because of the autoimmune disorders and it’s just going to take longer to heal his gut?

I thought I’d ask, I couldn’t find anything specific like this in your book.

Thanks again – Nicole

What about sprouts from seeds, like for example, sunflower sprouts? And also, what about sauerkraut? A no-no for Hashimotos? Thanks!

Is sauerkraut a no no for Hasimoto? Also is almond or cashew butter not good as well considering not allowed to have nuts

Thank you for this information! I’ve been following the regular paleo diet for years now, without improvement and my doctors have never mentioned that I need to do things differently if I had autoimmune problems. One more question for you- I am breastfeeding my 3 month old. Would you recommend starting this protocol now, or wait until I’m done? I’m wondering if I will have enough to eat to keep my milk supply up. What is your opinion on that? Thanks!

To Aflores:

My dermatitis seemed to be linked to ulcerative colitis and Doctor’s aren’t sure what diagnosis to give my thyroid. I started with SCD with some improvement, moved to Paleo, more improvement, on to Paleo AIP. I was still having some problems with my skin peeling/crusting (of course happens to be on my face) and being bright red when flared. I eliminated nightshades, moved to fodmap. Once onions and garlic were gone, my flares have slowed way down and the burning, itching, set on fire feeling I have had for years is finally gone.

Along with the skin problem slowing, I no longer have diarrhea-my Ulcerative Colitis seems much improved with no rectal bleeding. I am due to have a colonoscopy soon on schedule, will find out then what I look like on the inside. I have added back a slice or two of tomato once a week and a small potato once a month. I tried corn-no luck. I have basically given up on grains totally. I seem to have found a formula which works for me.
BTW-I do not feel deprived. Feeling better is wonderful, much more wonderful than donuts or pie. Takes awhile to find alternatives, sites such as this one helps soooo much.
I am off thyroid meds and my anemia seems to be gone also. I am 58 now and no meds at all, which amazes the staff when I go in for checkups. I broke my leg a few years back, the Orthopedic Dr. was amazed I showed no arthritis-my reasoning to boot nightshades back to the wild. Nicotine is the most difficult nightshade for me to give up and I am working on. My weight is trending down (a very good thing) and my smoking is much less.

The formula which works for me-Paleo AIP, low fodmap, no nightshades (I cheat occasionally with about a tomato slice or two weekly and a once a month potato), NO ALLIUMS!

Hello. I looking for suggestions for next steps. I have done low fodmop and paleo ai for almost a year. I have made little to no progress. My testings all show normal thyroid and adrenals..though my tg..thyrogobulin was up ten times the norm. Negative for sibo and gastroparesis… I show low pancreatic and fatty acid profile from stool testing with gastritis and ulcers in my small intestine. I am not sure if I should eat any starchy veggies…they taste good and are less fiberous but I still am not shedding a pound. I have gained 18+ in a year wo food changing. Greens and sulfur veggies irritate me tremendously. I am at my wits end….just want to feel fluid again and not in joint pain fatigued and have black puffy under eyes 24-7. I did recently test positive for two MTHFR s….which i am learning about .. My point is..if I have been eating super clean for over five years shouldn’t I be better and able to lose weight and 24/7 bloat?

When you had your thyroid panel completed, did you include Reverse T3? My panels were all within “acceptable” ranges with the exception of RT3, which was extremely high. I was put on a slow release compounded T3 immediately. In addition, have you checked your cortisol and vitamin D levels? If your adrenals are wacked…you are putting extra stress on your thyroid. Balance is key. Best of luck! BTW…my traditional M.D. thought my RT3 was just fine. See an integrative M.D.


What do you recommend in place of NSAIDs? I have pain that I do not think is associated with my autoimmune conditions (hypothyroidism, rosacea, celiac and undifferentiated connective tissue disease). I have five disks in my neck and back that are subluxated, bulging or disintegrated. Most of the time life is good! However, I frequently need to take an Advil in order to fall asleep. Due to the nature of my issues, I really do need an anti-inflammatory to cut the inflammation – right? I am trying really hard to follow the autoimmune paleo diet and I do see some improvements. I hate to sabotage it by taking the Advil (if I am going to cheat, it should be more fun 🙂 ). Sometimes Deep Blue (a doTerra blend) will get it but not always. What is friendlier to the gut? A muscle relaxer seems to slow things down; but, is it a better choice than NSAID? I am very hesitant to take narcotics or other prescription pain killers. I am also allergic to codeine and Lortab. I appreciate any advice. I cannot say thank you enough for your website! It has been so helpful! I appreciate your science behind your solutions. Thank you for all of the care, time and research that you put into it!!

You are saying ” If you have Grave’s Disease or Hashimotos Thyroiditis, you must also avoid goitrogenic foods”. I heard in the last Hashimoto summit that this is a myth that is very popular on internet sites but actually when you go and dig where’s the paper that supports this – then you can’t find one. I was wondering if you can back this statement with a relevant paper.

[…] so a sleep study, too. Also, I’ve written before about having a paleoish diet. There’s an autoimmune protocol (AIP) version of the paleo diet I may check out over the summer and see if that helps, […]

I suffer from autoimmune disease (MS) and I’ve spent a year researching how immune system works, and was ultimately able to put my disease under control. I feel great 99% of the time. This article is steaming pile of shit. I eat both grain and legumes and all of your “forbidden” foods all the time in large quantities. “Leaky gut” syndrome doesn’t exist. Food never affected my condition. Stress did. Ask any real immunologist to explain you why this story sucks, I don’t have time to waste on you people.

I have Hashimoto’s, leaky gut, food sensitivities big time, major fatigue (adrenal fatigue). I am on the AIP diet though I have had some sprouted walnuts recently. My inflammation is improved and my gut overall is improved but still having issues. I am extremely sensitive to so many things. For two weeks I didn’t take any supplements because I was preparing for the adrenal saliva test and I think I felt a little better. As soon as I began the supplements again, my low back pain started again and my fatigue is worse than ever. I am getting sick of meat, my HCL levels are extremely low as I got up to about 10 HCL without any burning but then they started getting stuck in my throat so I quit and started using ACV which helps. I just don’t know what to do at this point. I have an acupuncturist who is pretty knowledgeable but I really do need some guidance to repair the leaky gut. I am waiting for my genetic test to return and am sure I have the MTHFR gene. Help!

I realize that even cooked sulfur veggies…Brussels broccoli etc causes migraines for me and bloat. I think some of us with MTHFR and detox issues may be challenged to eat high sulfur veggies. Its hard as heck bc starch triggers no sweet pot winter squash any form of grain etc.., and now no sulfur veggies or ferments…. I’m at a loss. I’m eating some lettuce and cukes but know that’s not good long term.

Undoubtedly you are very knowledgeable and kind for providing all this wonderful info for free to help people but I find your use of a lot of medical terms makes it very hard to understand the basic info. I often have to research words then come back to your page and try to apply those definitions to barely grasp what you’re conveying. For eg, I was completely lost in your explanation about why egg whites should be omitted from the diet but I’m going to stop eating egg whites anyway. I’m very confused and overwhelmed

I’m a small man and with all the diet restrictions, I’m wasting away. to begin with, I can’t eat most cruciferous veggies and the veggies you said to omit are what I was surviving on. i eat fish, and some chicken but can’t bring myself to eat meat or organ meat and with potatoes, brown rice and oats out the picture, I have no idea what to eat. is there a way for you to simplify all this? Thank you

This is SO depressing. I’m a vegetarian, and no that is not changing.
SO, basically I can live on greens with a little coconut oil.

I get confused on the grains and legumes. So after my elimination period, I can’t reintroduce brown rice? Or gluten free flour blends? I miss brown rice.
And the only thing I’m really craving on this AIP diet, is chickpeas, but now that seems to be out the pictures. No more chickpeas? Is that accurate? As a vegan, that’s one of my main staples.

Oh my THANK YOU SOOOOO MUCH Dr Sarah for all your efforts, research and sharing. What a blessing you are!!!

After learning how these various foods affect our bodies (Paleo Approach), why would anyone want to start eating them again? After all the hard work we go through to repair our bodies, I sure don’t want to start destroying it again.

60 years of damage to repair now. 35 years since my first bout with MS. Nutritional route only, not medical or rx, trying to eat ‘real food’ not processed has kept me going this long. But I knew nothing about autoimmune disease or how foods heal or destroy us, till now.

My body is healing nicely (also my mind and emotions), my symptoms and health have improved greatly after a short time on AIP Paleo Approach. I am truly thankful Dr Sarah for your research and advice, for your caring and kindness.

When I reintroduce something, it’s going to have to have more benefits/nutrients than potential harm. But that’s a future story. Hugs!!! Oh my goodness, Hugs!!!

I have MS and started the Wahls Protocol a couple of weeks after the diagnosis. Three days after starting the Protocol/Paleo, I have had SEVERE insomnia. I cannot sleep. When I lay down my heart pounds or my muscles twitch. I have lost too much weight and all of my symptoms and stress are getting worse. I have tried magnesium supplements (helped with the twitching), increasing “good” carbs to daily (just to increase my weight), I eat an avocado a day, coconut oil and full fat coconut milk. I am about to lose my mind. About to give up. My 30 days is tomorrow. Please help!

Sarah, I’m sorry you’re dealing with this! Sometimes when we transition to a new way of eating it can take a little while for our bodies to adjust. But your symptoms sound incredibly difficult to manage, especially since sleep is so critical for healing. I recommend that you work with a practitioner on this. Do you have a good doctor that you’ve been seeing for your MS? -Kiersten

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