More Info on The Autoimmune Protocol (AIP)

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Coconut milk and coconut oil are great. Whole coconut products like coconut flakes and coconut flour should be used sparingly until you know how you handle them (high inulin fiber, which is a FODMAP).

Hello, TPM. How about meat from fresh young coconut? How frequent can one with AI condition (safely) consume it? Also, coconut water as drink. Is that alright to drink, say, everyday?
Rhodora :-)

Up to about 1/3 cup per day of fresh coconut. Coconut water should be fine, but it is fairly high sugar, so just make sure you are keeping your blood sugar well regulated.

We are supposed to avoid elevated blood sugar. But some sweet foods (mostly fruit but a little honey here and there) is okay as long as you are very careful to consume it in moderation and not cause increased blood sugar levels. How much someone can handle before that happens will be very individual and depend on what else they are eating at the same time.

Hello! I’ve been on the AIP diet for a week now and I’m feeling better. :) I’m craving carbs and chocolate – I know carbs are completely out of the question, but how about unsweetened cocoa powder? I was thinking of adding it to sweet potatoes :)

What do you mean carbs are out of the question? Carbs are allowed on AIP. You just mentioned eating sweet potatoes. Do you know what carbs are?

Hello! I just pre-ordered The Paleo Approach, and am looking forward to receiving it. I saw the list of what should be eaten (meat, veggies, coconut oil, etc) for the AIP diet. What did you eat at each meal to get you through. I am struggling to eat correctly, but am failing miserably. I have been so used to the Southern cuisine of Mexican food with salsa, corn chips, eggs, nuts, and the night shade veggies, thinking I was eating well balanced meals. I have never been a dieter and was able to eat anything with no problems until four years ago. I was diagnosed with Hashimoto’s Thyroiditis and I think I have a mixture of Scalp Psoriasis and Seborrheic Dermatitis at the age of 50. I have always been pretty healthy, no weight issues until this. I am hoping you can give me some advise to help me on my way. It is amazing how a couple of years of searching for solutions has put me on this information. Thank you ahead of time for any help you can give me.

I eat as much variety of meats, fish and vegetables as I can get my hands on. Typically, my meals look like some meat (often roasts) or fish (typically baked) and a few different veggies and/or salad. I also make soups and stews. It might just be a question of trying out some new veggies you aren’t used to cooking in the store, or trying some different stores or Farmer’s Markets for more variety. There’s tons and tons and tons of foods you can still eat.

Sarah, thank you so much for your website. I too recently discovered you and feel relief as Dr.’s have no idea how to deal with my Oral lichen planus which I’ve had for 6 months now. Slowly I am trying to incorporate the paeo diet. After realising I cannot eat tomatoes, eggs & nightshades & discovered your Autoimmune Protocol (so sad because I love eggs)
:( I am so scared to eat. I ate organic peanut butter with organic quinoa toast last week & believe one (or both) of those cause new gum sores. My question, is there a flour that can be made into bread that would not cause a reaction? I thought buckwheat was ok but its on the AP. Also, do you think these allergies/intolerances we have would subside if we ate purely organic, example moving to farm country, like our ancestors? Sounds crazy but often wonder…..thank you for all your hard work! Niki

I think that the purely organic farm life is more preventative. Once autoimmune/immune issues develop, it typically takes more changes than that to address them. The flours that I use are arrowroot and plantain. Vegetable powders are also a good option.

Thank you for your quick response. I’ve never heard of these flours but will definately look into them! Much appreciated.

Hi, im really struggling to find more info on coconuts. are fresh coconuts ok to eat? i eat a lot of fresh coconut (its an awesome snack through the day, but im just not sure how it is reacting with me.

Hi, I have a problem. I am following Autoimmune Protocol because I have hashimotos disease. Just by cutting gluten dairy and egg consumption last summer my antibodies went down from 915 to 180 but i wanted to get them back to 0. So i cut out all nuts, seed and gluten free grains (i had regular bowel movement then). Now I eat a lot of vegetables ( squash, winter squash, tubers, cauliflower, carrots, celery etc), i eat vegetable soups and chicken broth, i try to eat fish 2-3 times a week, i eat usually 1/2-1 avocado per day, plus i use coconut oil often, i eat meats like roaster beef or grilled chicken, like 1/2-1/3 of my meal is meat and half are vegetables. I do not have bowel movement at all now. I started this diet 2 weeks ago, and after first week (i feel no need to go to the bathroom but i eat a lot!), I had water from pickles (i eat sauerkraut also and polish dish called bigos- made of sauerkraut and cabbage), and after drinking the water from the “fermented cucumbers” i had a diahrrea, and now since then again nothing (the poop is more loose not hard) I take probiotic supplement also. WHAT I DO WRONG?? :(( ( i eat 3 times a day, and sometimes i eat grapefruit no other fruit though). I feel like my body needs insoluble fiber to pass it through :((

I eat romaine lettuce, kale, i eat spinach. I eat big portion of salad once a day. I did not try other leafy veggies like collards or swiss chard though.

There are a few things that could be going on, most likely, it’s that you’ve removed something from your diet that was stimulating peristalsis (which is good to remove those things, but it can take a while for your body to adjust). So, for the short term, I think taking a magnesium supplement (like Natural Calm) to help act as a stool softener and help get things moving again would be good. Are you drinking enough water? The other thing to try is to ad digestive enzyme supplements. Are you getting enough sleep? Also, high tryptophan foods (peristalsis is controled by serotonin and melatonin in your gut which are both synthesized from tryptophan). Organ meats are one of your best sources. You might also try eating a banana (by itself, not part of a meal).

After eating paleo for 2 years, I decided to try the AIP Paleo as of January 1, 2014. Even with taking an enzyme with every meal and taking 650 mg powdered magnesium citrate at bedtime, I still was not regular. Two weeks ago I bought a juicer and began juicing my veggies (mostly greens such as kale and chard, cucumber, radish, carrots). Only then, for the first time in my life, did I start to have regularity. In and out of the bathroom in 1 minute! Awesome! I surmise that until I heal my leaky gut, I may need the boost of juiced veggies in the mornings. Relief at last for me!!!

Thank you so much! I will do that and see what happens. I was so frustrated that I thought about introducing gluten free gains again… I take magnesium once in a while in the evening because I go to the gym and if I dont take it then i have weird feeling in my muscles. I drink a lot of water like at least 2-3liter per day.. (teas and water)

One of the ways the body deals with foods that you are sensitive to is to speed up digestion to try and push the food out. If you are cutting out those foods, your body ends up slowing digestion too much while it adjusts. It’s actually fairly common when people first go paleo to have one extreme or the other. Let me know if you’re still having issues in about 2 weeks and we can have a closer look at what you’re eating and try and troubleshoot from there.

Okay, i hope that in two week this problem will be gone :( I noticed that in the past 2 weeks being on Autoimmune protocol my thyroid is not swollen anymore thats why i didnt want to give up :)

You are amazing! xoxo

All I eat are carrots and spinach for vegetables. I just started this a week an a half ago. I’m doing aip so no tomatoes potatoes etc. what’s a list of vegetables to go off of? I read no green beans cuz they’re greens and can’t have broccoli because of my ibs. Helpppp lol. There is such little info on the aip version online

Hello, I wonder if you can help me… I have a pretty bad auto immune disease and I have tried a type of diet for it before but that one didnt include any meat whatsoever and all the grains you like… i did feel much better but i was so tired all the time. So I am starting the AIP version and so far so good (its been 2 days ;p )
I see some recipes that include baked things like Almond Flour Bread…. however i was under the impression that you werent allowed anything out of its natural state? so nothing baked? i am a little confused… ?

My blog is not purely autoimmune protocol, but rather general paleo. I have a lot of autoimmune information on here because its something that I battle with personally and also something I’m interested in, but its by no means my sole focus (although it is the sole focus of my book). Recipes that use nuts or eggs are things I make for my family, but generally don’t eat myself. If you want to just see recipes that are autoimmune protocol friendly (or that can be easily adapted to the autoimmune protocol), there is a sub menu under recipes for them.

Hi, I recently preordered your book and am very much looking forward to its release date. I, too, suffer from Hashimotos and am now being evaluated for Sjogren’s. I am not a big meat eater and wonder if there are any acceptable organic protein powders I can use. I also like using Garden of Life Raw Fiber every day. Is this acceptable? Thanks so much. I’m looking forward to your book and feeling better.

The only protein powders that are AIP-friendly are collagen/gelatin and beef plasma protein (and even this is a bit of a gray area because it contains sunflower lecithin).

Hi Sarah, I’ve been following your blog now for a while and so appreciate all your hard work. I can’t wait until your book comes out! I’ve been on the AI protocol for 2 months now as I have Hoshimoto’s and a plethora of environmental allergies and I am trying to get my health back. I’ve been very strict on the protocol and have only lost one pound and gained a chin full of acne! I’m trying to incorporate more bone broth and organ meats than I am already consuming. I don’t want to give up/I WON’T give up but I am discouraged. Is there anything I could do to help with the weight loss and the acne that has developed? I realize that healing takes time but I was hoping i would see more changes by now in my fatigue levels and general health. I was grain and dairy free for 1 year before starting the protocol. I’ve eliminated sugar except what I get from fruits and veggies. I make may own lotions, detergents, shampoo and oil cleanse my face in an effort to cut out chemicals. Any advice would be greatly appreciated.

It sounds like a stress/hormone connection to me. So, my first question is are you taking thyroid hormone? Second question, are you getting enough carbs? (you need insulin to convert T4 into T3). Are you eating seafood (for the selenium and iodine content)? And, are you getting enough sleep and having fun?

I went off synthetic hormones 8mo ago and just 2.5 weeks ago started back up on desiccated thyroid. I will be working on adjusting the dose with my Dr. this week. I started 2 weeks ago eating salmon and shrimp 3-4 times a week before that I was eating salmon 2x a week. I stopped drinking coffee and drink black decaf tea with coconut oil. The carb issue is a hard one for me. I’m not sure how much is enough. I typically eat 2 pieces of fruit a day. I occasionally eat yams either raw or cooked (3-4 times a week). I sleep a lot! 10-12 hours a day and not because I want to either:) but because I can’t cope otherwise. Exercise is an illusive goal because I get so fatigued when I work out that I need a nap afterwards. I am trying to enjoy my kids and have fun with them now that summer is upon us.

10-12 hours is actually about right. Most people need 7-10 hours per night every night and chronic illness automatically puts you on the higher end of that spectrum. Even once your body has healed, 8-10 hours will probably be normal for you.

So, I would suggest some more starchy vegetables. Parsnips, taro roots, plantains, lotus root, beets, rutabagas, turnips, jicama, carrots… You’re right that it can be tricky. You want to keep your blood sugars well regulated, so it’s a question of finding that range between enough carbs and too many carbs. My suggestion would be somewhere between 1/2 cup and 1 cup serving with every meal (smaller if you’re eating fruit with that meal and larger if you aren’t). You’ll still want to include some other veggies with those meals too.

I think getting the dose of dessicated thyroid dialed in will make a big difference (because thyroid hormone affect metabolism and sex hormones). But, do talk your doctor into fairly frequent testing because the dose may be a moving target as your body heals.

As for exercise, if you can do a little walking and/or active play with your kids most days, then that’s great. I wouldn’t worry about doing more than that. If it’s wiping you out the way you describe, then that’s too intense for your body right now. The goal with activity should be very very slowly building up duration and intensity, but you don’t need to be going for runs or lifting heavy weights (ever, unless that’s something you really enjoy). Something that moves your body weight around, like walking or gardening or yoga is perfect. Really, the goal is much more to avoid being sedentary than it is about anything else.

Keep me posted on how you feel once your dessicated thyroid dose is adjusted.

Hi, I have autoimmune hepatitis and have been taking 6-mercaptopurine and prednisolone for a few years now. I have recently been reading about low carb diets and their anti-inflammatory effect and have gone low carb for the last six weeks. Because I am underweight to start with it means I have had to be very careful to include a lot of fat in my diet, which has meant increasing dairy, eggs, nuts and meat (I was basically vegetarian before). Then I found your website and started reading more about ‘leaky gut’ and I’m thinking I should completely change what I’ve been doing. At the same time my liver enzymes and IgG are rising again, and I’m becoming anaemic and have a low white cell count.

I have a few questions;
1) How can I follow the Autoimmune protocol and not lose more weight?
2) Does excluding dairy mean excluding yoghurt and sour cream, and why? (sorry, you might have explained this somewhere but I haven’t seen it yet)
3) Do you know if prednisolone could actually contribute to change in gut flora and increase gut permeability?

And any advice would be much appreciated!


Yes, you can stabilize or gain weight on the autoimmune protocol, which I do recommend (along with increasing your carb intake; low carb is very stressful on the liver and kidneys). There are many issues with dairy, but mostly it comes down to it being both a common food sensitivity and potential gluten cross-reactor. I recommend leaving it out (all of it, even butter and ghee) initially and then when you start to see improvement in your symptoms, try adding it back in and see how you feel. Yes, prednisone increases gut permeability.

I have just found your podcasts and blog in the past few days. Thank you! I have several autoimmune and related diseases and will start the AIP next week. I am on Warfarin (Coumadin) so I can’t eat liver. I have not been able to find the Vitamin K content of beef heart and tongue in my many references, and the Coumadin Clinic is also having a hard time finding this info. Do you have any references? Thank you!

If it’s not in the USDA database, then I don’t know (but, that’s where I’d check). With some autoimmune diseases, very high doses of omega-3 fatty acids (DHA and EPA) can be used in place of blood thinners, so that’s something to talk to your doctor about (you would have to be very closely monitored while you scaled up your omega-3 and scaled down the coumadin).

Sarah, I’m wondering why rice is not allowed. You mentioned above that you don’t recommend it, but why is that? And do you mean all rice, or would organic wild rice be different? Thanks for your input.

It has proteins that are known to be problematic for those with gluten intolerance (which is tightly linked to autoimmune disease and may actually be everybody with autoimmune disease). This has been shown in research evaluating whether or not proteins in rice cross-react with gluten (they do) and in research showing that rice is problematic for most celiacs.

Hi! First off, I really appreciate all the information you have provided. I have not been diagnosed with anything but I do know I have a leaky gut as well as massive bloating (I look like I’m 4 months pregnant) with constipation. I have a few questions when trying to follow an AIP and/or FODMAPs. If you have time, I’d really appreciate your intake :) and sorry if any of this has already been answered, I read so many comments on different weeks that I don’t remember which have been answered >.<

1) If I try to follow a low FODMAP, will fermented FODMAP foods be okay? (Ex: sauerkraut, asparagus, peppers). What about the brine? I usually pour sauerkraut brine in my mayonnaise to create nice dressing, ofc I won't be eating mayonnaise on the protocol due to eggs but I'd like to use the brine in recipies. Or should I not have any source of probiotic foods/drink the first couple of months?
2) In your diet recommendation, you stated no nuts or seeds. Should I also avoid adding seeds for flavoring fermented foods? (Ex: Adding whole mustard or coriander seeds to carrots or pickles to ferment with the vegetable)
3) I'm 23 and I cook all the meals for my parents. So yes, they are eating paleo without a fuss. If I avoid high FODMAP foods or nightshades, spices, etc. per the diet recommendation but cook them for my parents using the same cooking utensils (cutting board, knife, pan…) this won't stall the healing since I'm not eating it directly, will it?
4) I can't wait for your book because I enjoy learning about the gut. Will you have a kindle or ebook version on the same day your official book it comes out or even have an ebook version? I only buy ebooks to prevent me from having a library in real life.

I didn't actually develop bloating until a few months into paleo but I think that's because I introduced too many new things to my body too fast. Never ate nightshades, nuts, non-spice seeds, majority of the vegetables, kombucha, and fermented foods pre-paleo because I grew up a very picky eater but now I developed tastes for them after paleo.

1)brine should be okay, fermented foods will have less FODMAPS, but how much remaining will depend on how long they were fermented for. It’s worth trying to see if you have a reaction.

2)generally, I recommend absolutely no nuts or seeds for the first month.

3)should be okay for FODMAPS, although for allergies or intolerances, you’d want to wash well in between.

4)yes, there will be a kindle version

Hi Sarah, just wondering if organic cow milk kefir is okay at the start of the diet? Thanks in advance, you are changing the lives of many people :)

Hi, I’m loving your blog!! But I’m a bit confused…. I see that you have some great recipes that use eggs for instance, I thought eggs were a no-no… Thanks in advance….

Hi Sarah, I have pre-ordered your book and can’t wait for it!! I also ordered Micky’s AIP Cookbook and am “gearing up” to take the BIG plunge to eliminate all these things in my diet (Hashimoto’s Thyroiditis, wheat/gluten allergy) I took my son to a holistic pediatrician today and he suggested I get tested for the MTHFR gene…have you heard of this? I thought it was quite interesting when I visited the website….
Just curious what your thoughts are on this! Thank you so much for all your wonderful info!! You’ve been such a big help to me and my friends that I share your website with:)

It can be a useful test to have done, not that I’m a big fan of the huge lists of supplements they’ll likely recommend if you have either the A1298C or the C677T variant of the gene, but it does tell you that there is some need for a focus on B-vitamins (esp. 6, 9, and 12) and magnesium to support methylation (I prefer food sources, but magnesium is a little hard to get from the modern food supply, so a magnesium supplement is still a good idea).

Thank you for your reply! I will check out food sources of B’s and have already been taking magnesium. I guess I will take the test just to know!

Hi there,
I started aip 3 months ago very strictly for my psoriasis. I saw great results. I started reintroducing things like nuts and eggs and had flare ups the week after. I am under weight and struggling to fulfill my hunger. I am feeling discouraged and not sure how to continue. I don’t have an issue with meals, but snacks and textures like baked goods or bread. I will never reintroduce dairy or gluten but I just am at a loss for how to maintain my weight and stay full. I have meat, veggie and fruit every meal. I feel tired of certain foods I’ve been eating all the time; like coconut, dates, the same old stuff. I have two young children and I feel it’s hard to keep up with them and all the cooking required. I think I have an issue with coconut flour as I was having rashes occur on my elbows and now that i have eliminated it, the rashes are gone. I wouldn’t know what to do without you and Mickey but I’m in the valley and need some help!

I have huge problems with coconut flour too. So for gaining weight, I think it’s important to add a starchy carb like plantain or parsnips to your meals and add more fat (tallow, lard, fatty fish, avocado, olives…). It sounds like you are craving more variety, which probably means it’s time to go to a different store than you usually shop in (maybe a new Farmer’s Market or Asian Food Market) and start buying things you’ve never eaten before. There really is an absolute ton of variety allowed on the AIP, but just like people can get stuck in their comfort zones with a standard Paleo diet, it gets easy to cook the same familiar things all the time. I know well how hard it is to do this with kids (mine are 6 and 3), and the only thing I can recommend is asking for help (maybe someone to come over and help watch them once a week so you can do a big batch cooking session for the freezer). Hang in there!

Also, how much coconut is allowed? Are you concerned with any health issues due to the high saturated fat content?

No worries on saturated fat at all (there’s lots of great resources out there explaining why saturated fat is good for you). I would as 1cup of coconut milk OR 1/2 cup of coconut flakes OR 1/4 cup of coconut butter OR 2 Tbsp coconut flour per day at the very maximum. No limits on coconut oil.

Thank you! I am going to preorder your book as well and hope to find some new inspiration. Do you have any thoughts on supplements or multi vitamins? I just take magnesium now. I used to take the alive vitamins.
Thank you.

I think magnesium is good. The only other supplements I think are worthwhile for most people with autoimmune disease is digestive support supplements. Other than that, I think it’s far better to get what you need by choosing really nutrient-dense foods.

Hello and thanks for sharing your expertise; I’m looking forward to your book.

I have been paleo for over a year and AIP for 3 months (plus) to help manage my ME/CFS.

I wanted to ask your thoughts on pork. I have been advised to exclude it in addition to following AIP as it’s pro inflammatory (high Arachiadonic Acid and its similarity to human protein, causes cross protein contamination)…..

Also my thyroid results are at the very low end of ‘normal’, is there anything on the diet front I can do to up these? Or is Thyroxine or the like my best option. My rationale being; anything I can do to up my energy levels will help combat my fatigue.

Where might I resource the GI load of fruit? I’m a big fruit fan and want to make sure I’m not having too much. I generally have; berries and apples. Grapes are my heroin, but I’m managing to wean myself off them.

Many thanks.

How much will The Paleo Approach discuss the affects of medications on healing from autoimmune diseases? I’m dealing with two (and possibly three) autoimmune diseases. I also have secondary adrenal insufficiency (caused by long-term steroid use). I’m currently on hydrocortisone (replacement dose – not therapeutic level), levothyroxine, and estrogen.

From what little I understand, each of these meds can affect my immune system and/or leaky gut – for better or for worse. And they all interact with each other, so changing the dose of one can sometimes require changing the dose of the others.

I want to start tapering off of the estrogen as soon as I get stabilized on the thyroid med, and then I want to try tapering off the steroid again, under close medical supervision. But each of those can also affect my thyroid dosing. And it may take up to a year to finally get off both the estrogen and steroids.

Meanwhile, I’ve started the AIP. How much can being on these medications affect the healing process? And, if I try tapering off the steroids again, it will mean I will be in a low-cortisol state for months in an effort to encourage my pituitary and adrenal glands to start functioning again. Could that state slow or prevent the healing?

My doctors don’t have a clue about these issues. And I’m not sure if being on the very low-dose steroids is better or worse than trying to taper off during this time I’m trying to heal. I wish I could afford a functional medical doctor, but I’m on disability and simply don’t have any money to spare. Any thoughts or references? Thanks so much for all of your hard work!

just going to start AIP diet soon…i have ibs and borderline leaky gut..adrenal fatigue and a bit of hypothyroidism…is coconut a nut? is it ok on the AIP? should i avoid it cuz i have ibs? if i cant have it..when hsould i reintroduce? i seem to get ibs spasms from it..and maybe diarrea there a certain amt tha tis generally safe for a person? will i never be able to eat coconut flour because i have ibs? thanks!

Typically low FODMAP approaches are very useful for IBS symptoms, which means coconut oil is okay and maybe coconut milk depending on your sensitivity but all other coconut products would be a problem.

On the AIP, I recommend coconut in moderation (limit to 1/4 flakes OR 2 Tbsp butter OR 1 Tbsp flour OR 1 cup milk per day) due to phytic acid and inulin content.

Hi Sheila. That’s quite an autoimmune history! I’m not familiar with all of your medications, but the one that is a big red flag for me is simvastatin. The research doesn’t show any benefit of statins to women, and the most current research is showing that slightly higher cholesterol in postmenopausal women reduces the risk of cancer. That’s the one I would definitely talk to your doctor about discontinuing. Plus, paleo diet is great for cardiovascular disease risk. I usually recommend no black pepper in the beginning because so many people are sensitive to it. It would also be great to get off NSAIDs, but you can tackle that in a few weeks once you have the diet down. Research in RA shows high omega-6 can greatly reduce pain. Also taking a collagen supplement and making lots of broth will be very helpful for your joints. You also might want to ask your doctor about low-dose naltrexone, which has the double benefit of helping regulate the immune system and reducing pain. I also think working to increase your sleep to 9 hours would be very helpful. I hope this helps!

Hi Sarah,
I have had a headache for over a week. Do you think the Paleo AI diet has anything to do with it? I do have a history of migraines. Could you delete my post from Oct 1st or at least summarize it so it is not so long & personal?

Oh, sorry! I’ve been so busy lately and sometimes when I don’t get a chance to reply to a comment or email right away, I forget to come back to it. I deleted your comment from the 1st. For the advil, I recommend getting diet and everything in check (black pepper is a common sensitivity, so I suggest avoiding it at first) and then slowly decrease your dose and/or increase how long between taking it. Things that will greatly improve pain and migraines: dramatically increasing omega-3 fatty acids, preferably from seafood (rather than fish oil supplement), regulating blood sugar (not too low, not too high… so don’t go too low carb and the easiest way to make sure you aren’t going too high is to get a glucometer), managing stress, getting tons of sleep, getting some activity (like walking or yoga), and eating a nutrient-dense diet (lots of organ meat, seafood, vegetables and fruit in moderation).

You might have headaches if you aren’t drinking enough (sometimes thirst goes down on the AI diet and people don’t drink enough while they’re bodies are adjusting), eating something that you’re sensitive to (any new foods that you’re eating a lot of that you didn’t eat that much of before?), going too low carb (remember that the AIP is not a low-carb diet, just not a high-carb one), not getting enough sleep. I do have a history of migraines too and I only get them now when I really overdo sugar or eat something stupid (chocolate, for me).

Again, sorry I missed this before. I hope this helps.

whats your take on Pressure cooking? if one is to avoid alcohol and sugar on the AIP..can i still do water kefir?and if which way to minimize alcohol and sugar? is there a way to use cultures: kefir, yogurt , buttermilk etc (that come with dairy and sugar) to culture ND milks and have no dairy leftin the end product? can palm shortening/oil cause inflammation? is hemp a grain? should one avoid casein/dairy forever? ( it really just not something us as humans should be eating? is yeast paleo or ok on AIP? is carcinia cambrogia ok for someone with adrenal fatigue? any excercise recommendaions for someone with adrenal fatiuge? is cocoa a seed? should one buy blanched almond flour? i know it decreases phytic acid but wouldnt raw almond flour be beneficial? should one sprout their own..dehydrate and grind? thansk so much! btw..i had submitted a nother reply earlier with this same info in it but its gone and i dont see it anymore..any idea what might have happened?

That’s a LOT of questions! Pressure cooking is fine. Water kefir is fine (the longer you let it go, the less sugar but the more alcohol, but it still won’t be high alcohol and most people will tolerate it well). Yes, you can culture kefir and yogurt in non-dairy milks (rinse kefir grains before putting in coconut milk, and use a non-dairy yogurt starter). Palm shortening/oil is a pretty good fat (oil is better since it has more vitamins). Hemp is a seed, but not a grain. Some people can reintroduce dairy and some can’t. Yeast is okay if you tolerate it. I have no idea about carcinia cambrogia. With adrenal fatigue, walking, yoga, tai chi, maybe swimming… gentle exercise. Cocoa is a seed. Blanched almond flour has less phytic acid than unblanched, but still not recommended for those with autoimmune disease. Sprouted homemade would be better, but still start with no nuts whatsoever. No, I don’t know what happened to your reply… I never saw it, so maybe computer glitch?

thanks! i sorry..i just cant seem to find ht eanswers!what if one has leaky gut also (in regards to the alcohol/sugar water kefir) so pressure cooking doesnt destroy nutrientsin teh food? can u recommend an organic (or equivalent) source of ND starters? (yogurt…buttermilk etc)? where cani find more info on why u dont support stevia and allow sugar etc instead? so would blanched flour be ok for ppl with adrenal fatigue and leaky gut? (i know we will not be using it initially…but when we try adding it back in along iwth nuts..) im just wondering about the messages cuz i said alot of nice things and compliments about u! :) but im sure i messed up something on my end :) thank u!

Kefir is a great probiotic, should be helpful. You can use a dairy-free probiotic as a yogurt starter. The stevia post is under Teaser Excerpts for The Paleo Apporach. Blanched almond flour might be okay… you’ll need to try it and see how you do.

so pressure cooking doesnt destroy nurients in the food? thanks..what are the basics to the probiotic as a starter? does it need to be a certain CFU or # of caps/x amt of milk kefir etc? any way to make coconut milk buttermilk? thanks!

Somewhere between 10 and 20 billion CFU for 2 cups of coconut milk will work well. I usually add about a tsp of honey too, to help the bacteria since coconut milk has less sugar than dairy.

My understanding is that pressure cooking doesn’t destroy nutrients any more than other methods of cooking. And cooking makes food more digestible and can increase some nutrients.

so maybe only ppl with very healthy robust guts benefit from raw /a third to half raw diets? how long should i let the probiotic/coco milk yogurt sit?

Oh my goodness and I just made bread last night for my husband and he’s the one that has the autoimmune issue!! Bread is the one thing he misses the most! And he’s been snacking on almonds! I’ve been cooking gluten free and going by the Paleo diet….guess I’ve messed up using almond meal to make bread!

sorry for all the questions! its just that we are supposed to start the AIP tomorrow and i still have a few unasnwered questions and im not sure what to do! is vegetable glycerine an ok sweetener? is it paleo? is bee pollen/honey ok if one has IBS or leaky gut? I made a coconut milk yogurt with a dairy kefir u think the “now coconut milk” starter has dairy left?
if we are avoiding fruits for a bit..can we still have coconut milk and butter? what about coconut? i do react to coocnut flour (IBS flares)..I made a stock with random veggies in the freezer..this includes corn..spicy veggies/nightshades,etc..can we still have this strained broth on AIP? or should I donate it?
betaine and pepsin=before OR after a protein meal? and if we are taking dig. enzy’s they need to b spaced from the dig enzymes or nething?
is 7 day fermented kombucha ok (even if we are avoiding alcohol due to leaky gut)..should one do eulethero and maca 2mos on and 1 mos off? THANK U SO MUCH!

Glycerin can be gut irritant. Bee pollen in honey should be fine, but I wouldn’t go out of my way to eat straight pollen (that might stimulate the immune system). I don’t really understand about the kefir… are you using a spoon of kefir from a previous batch or using grains that were in milk? If you’re using a spoon of it, it would take a few batches to really be dairy free. If you’re using grains, rinsing them before putting them in coconut milk should be sufficient. Coconut milk and butter and whole coconut in moderation. Actually, if you react to coconut flour, I’d stay away from coconut butter and whole coconut and just stick with coconut milk and oil. No, don’t drink that broth. You typically take betaine within the first minute or two of a meal. You don’t need to space out digestive enzymes. 7 day kombucha may have a lot of sugar left… try it and see how you feel. What are eultethero and maca?

I have been following the AIP so faithfully for several days. I do fine all day. But every night after I eat, same bloating and abdominal distension begins. What am I doing wrong? I know my RA has already shown improvement but I have sooooo much going on in my gut. It seems like nothing helps. If I were to eat the same thing for lunch I would be fine. But after dinner, I stomach disagrees. I am just so frustrated.

There are a few things that cycle during the day that could be causing this. One could be a cortisol link. Do you also get a second wind in the evening after feeling tired in the afternoon? If your cortisol is rising in the evening (which it shouldn’t be but is very common with RA), then that would hinder digestion. The other possibility is that you are eating after your dim-light melatonin starts, which also slows digestion. In either case, moving your meal a little earlier (and going to bed earlier) should help. You could also take a digestive support supplement (probably pancreatic enzymes) with dinner. And you can do both. If the problem is more cortisol, working to increase sleep and reduce/manage stress will be helpful. If the problem is melatonin, spending time outside, and shifting your schedule so that you aren’t eating when your body is preparing to sleep should help.

thank yoU! when should i try to introduce veggie glycerin or should it not be something i do add in ever cuz of the leaky gut/adrenal fatigue/ and IBS? how can i make “extracts” of powdered vitains w/o alcohol or veggie glycerin? what if i already made some? it will prolly be a highly concentrated extract but still…so..pollen plus that even ok for someone with leaky gut? ive kind of heard that maybe that could make leaky gut worse..if so…should honey be avoided 100%? of so..when should it be added back in? not until leaky gut is healed? so what about creamed coconut lets do organic or native forest…? is that considered coconut butter or is it ok? or can one use the creamed coconut/coconut butter to make coconut milk and then drink that? if my kombucha is very vinegary after 7 days..would that be ok then? eulethero is an herb and maca im not taking both for adrenal fatingue..about the cultures… I made a coconut milk yogurt with a dairy kefir starter (body ecology)..then i saved some finished product for a new batch later..and was wondering if u thought that the new batch woudl still have dairy .i also hav esome dairy starters form cultures for health and wilderness family naturals (yogurt..buttermilk,etc) and they can be used ot make DF coconut milk products but how long will it take to get the dairy out? thank you!

Why do you want to eat veggie glycerine? as a supplement capsule, I think it’s okay, but is there another reason you want to consume it? a little alcohol in a supplement is usually well tolerated. raw honey is fine. creamed coconut is the same thing as coconut butter. yes, sounds like your 7 day kombucha would be fine. You’ll have to ask a healthcare professional about your adrenal fatigue supplements. I think I’ve already answered your kefir question.

oh yes..also..when one adds back in fruits after the should one do it? by type? by consistency? by sugar content?
with adrenal fatigue.. I really want to lose this 15 lbs! am i ok to continue counting calories? if so…what should my daily intake be? 5’6” 140lbs..should I avoid eating 3 hrs before bed? (would it be taxing on the system)? (i have leaky gut too) and i wonder..if i have probs with coconut flour (=ibs spasms) u think i would tolerate cocnut palm sugar? how is coco palm sugar better than cane sugar? thanks!

You shouldn’t be eliminating fruits altogether but continuing to eat a couple of servings a day. Look at how much fructose those fruits contain and keep your total fructose for the day under 20g. Other than that, eat what you want.

I don’t recommend trying to lose weight when you start the AIP. You might lose, you might gain, but the goal is to get healthy not to get thin.

Coconut palm sugar is not better than sugar.

veggie glycerin:I’ve Read it can b a healthy sweetener but want u don’t recomed then right? i was told to avoid all alcohol (even extracts) cuz of the leaky gut so i was looking for an alternate way to make extracts by using veggie glycerine..any ideas? so..can i make coconut milk with coconut butter? or is that to b avoided cuz coconut is to b for now? how much if any alcohol would b present in the kombucha do u think? this is a diff question..this isn’t about the’s about the starters :)

I do not recommend vegetable glycerin as a sweetener, but if it’s a supplement ingredient I think the small amount is probably okay. But I also think the small amount of alcohol in extracts is okay, unless you are taking a ton of supplements (in which case, I would ask you why you are taking so many). Can any of your supplements be taken as capsules? or water-based tinctures?

If you make coconut milk with coconut butter, it will still have lots of fiber. Since you already know this doesn’t work for you, I don’t recommend it.

Kombucha is typically about 0.5% alcohol.

If you are using a dairy-based starter culture, you will need to go a few rounds in coconut milk before there’s no dairy in your product.

as for the fruit..i was told to leave it out for a month cuz of glycemic dysregulation and poss fructose Will add fruit back in in a month and was wondering the best way to do it….btw..I’m not trying to get thin..just trying to get back to my ol “preadrenal fatigue”self :) what about the eating before bed thing? thanks so much!

I think it’s important to work on getting healthy before you think about your weight. Getting healthy might be all it takes for your body to get to a healthy weight on its own without you trying.

Eating before bed is often recommended for people with adrenal fatigue, but it can disrupt sleep, so I think it’s something you need to experiment with.

.so..maybe 3 batches of cultured veggies..yogurt. etc and then the culture should b relatively df? and as far as adding Back in the fruit? thanks!

Hi Sarah! Did I miss your reply from my post on October 4th? I have been looking & can’t seem to find it. Thanks for all your support helpingso many of us. I preordered your firstbook & still need to order the second. When will the first book be released?

Hi Sarah,
I have been following the Paleo AI diet for just over a month & because of some of the meds I take I am required monthly blood work & UA. Mon I received a call from my Rheumatologist that my creatinine level had increased from .8 in Aug to 1.55 Fri. He took me off all protein & dairy (which of course I was already not using). I have been drinking as much water as possible & eating almost exclusively vegetable soup since Mon. On this Fri I am scheduled to have my labs checked again. What do you suggest since I am unable to eat any protein? I have been trying to continue to refrain from the spices which are not AI friendly.

Hi Sarah,
Still trying to figure out what is going on with my body. I have been on a roller coaster of deteriorating health for a couple years now. At present my digestive issues seem to be under control. I follow a paleo diet and among other things I am taking HCL, which seems to be helping. However, now my whole body aches, especially my legs and I have a lot of stiffness and tightening in my joints especially in my neck. I pretty much feel sick all over and very fatigued. Things just seem off. My doctor suggested going on a low salicylate diet although I’m not really sure why. She’s very hard to follow and I will be finding a new doctor but for now I’m trying to make sense of her recommendations. I also have a MTHFR mutation. Could this be the reason for a low salicylate diet? She wants me to combine the low salicylate diet with SCD. It just seems like I would have nothing to eat. Would you suggest the autoimmune protocol first before trying the low salicylate diet? That one just seems really restrictive and I don’t want to do it unless I know for sure it is going to help. I have also been told for the last 8 months by three different people that I have a high level of candida. I am currently on a no sugar diet and taking candisol. She wants me to switch to a different medicine for the yeast which costs another $65!! I’m really tired of spending money and not feeling better. I just don’t feel good and don’t understand why since I am eating so good.

I think the autoimmune protocol will allow you to eat more foods than low salicylate plus SCD (and as someone who has been researching it for two years, I think it’s a better route to go anyway). What test have you done for the candida? (this being the number one quack diagnosis out there–it certainly happens, but far less often than people are diagnosed with it). With MTHFR mutation, there’s some B-vitamin supplements that you should be taking (along with a focus on organ meat and shellfish). I can not think of any reason why low salicylates would help. Salicylate sensitivity needs to be diagnosed with food journals… have you done that?

Hi Sarah,
I’ve read that people with psoriasis should cut out red meat, but you say grass fed is ok. So it is ok to have red meat then? Dr Pagano and many other sites say to cut our red meat, but lamb is ok. They also say not to eat pork. But on the aip you can have them? I’m having a hard time with the aip and finding things to eat. I downloaded the book by Mickey Trescott but I’m afraid there isn’t much I find myself dying to make. I work 2 hours away from my house so my commute is 4 hours a day and when I get home I really don’t want to cook. I do make things ahead of time but this diet is really hard. I’m not interested in food at this point because I find it to be very boring and I’m not a big meat eater. For breakfast i’m finding this the hardest as I cut out eggs. I used to be a fruit and toast girl before going paleo for my scalp psoriasis. I started cutting that out and then gradually cut out rice, dairy, and alcohol and last week I cut out nuts which are what kept me going. I love almond butter and flour. I’m going to do this for 30 days because i’s desperate for relief from this awful disease. I know there are worse things but emotionally/mentally this really takes a toll on one’s mindset. I see a naturopath and she has me on enzymes and probiotics and we’re going to add in vitamins once I get my food sensitivity results back. I also had my blood tested for vitamins. I’m of course low in d, b-12, iron, and I have high cholesterol which is weird because I don’t eat that poorly even before paleo I wasn’t eating terrible, just liked my bread but I had already cut out nightshades last year. And I was eating egg whites until I ready your article about eggs. Anyways any advice you can give is helpful. I was going to preorder your book and I actually did in fact but after ready Mickey’s book I was afraid it would be very similar recipe wise and I was afraid to spend the money again. I think Mickey did a great job, just a lot of the recipes aren’t for me. I did look into GAPs but I find that way too restrictive. And my dr told me to try fermented veggies but then I ready your post about mold and I do have mold allergies so I cut that out.


There is no science to support cutting out red meat (or pork) as long as you are eating vegetables. And in fact, red meat is high in iron and B-12, and if you get grass-fed, it’s also high in vitamin D. High cholesterol could come from too much sugars, especially fructose, but can also be high because of uncontrolled inflammation. As for making this work within your life, that’s hard for me to help with. It sounds like both finding time to cook and finding recipes that inspire you are a problem. I often batch cook on weekends, making a bunch of stuff for the week ahead. Also, there’s a lot more AIP-friendly recipes on the internet these days (I have a pinterest board dedicated to them, but also check out Mickey’ site, and and Paleo Parents also have a lot of AIP recipes and Stacy has an AIP pinterest board too).

The Paleo Approach is not a cookbook at all, but a science/guidebook. It explains all of the science behind the diet and lifestyle recommendations (like why it’s healthy to eat red meat). The companion cookbook The Paleo Approach cookbook has 150 recipes and will be released at the end of March. Only about 3-4 recipes are similar to recipes in Mickey’s books, and my approach to cooking is fairly different.

Hi I am considering going on the aip diet and have been doing a lot of research but I am concerned about the meat intake. I am not a fish eater at all!. I do not like fish or shell fish from any source of water, is it sustainable on chicken, turkey and beef alone?

It would be tricky to balance omega-3 to omega-6 intake if you’re eating a lot of poultry (even pasture-raised chicken and turkey are still pretty high omega-6), but much easier if you’re eating a variety of red meat (lamb? bison? pork?). Even though I’m not a fan of fish oil supplements in general, you might want to consider sourcing a high quality one.

Hi there!

I’ve sort of lost track of when your book is ‘officially’ being released. What is the official date now?

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