More Info on The Autoimmune Protocol (AIP)

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Hi Sarah, Thanks for all of this helpful information. I have never been diagnosed with an autoimmune condition but have been struggling with moderate to severe digestive issues (ranging between constipation and diarrhea, always with severe bloating and gas) and occasional joint pain and stiffness for a long time. I have been following a paleo diet on and off for two years, and on much more strictly for about six months, with limited success. I seem to react differently to the same foods, there is no pattern – I can never pin point what is bothering me, which led me to think that my underlying issue is a leaky gut.

I am considering trying the AIP to see if that does the trick. Is the protocol worthwhile for people without autoimmune diseases? I have already given up grains, dairy, all sugar and processed food, soy, and legumes.

It is the most nutrient-dense version of the Paleo diet, with all of the “gray” area foods removed, so yes, worthwhile if you aren’t seeing improvements on standard Paleo. Something to try first though might be digestive support supplements (Betaine HCl is contraindicated in some circumstances so check with a doctor, pancreatic enzymes, plant enzymes and ox bile, also many all-in-one formulas available) and a focus on increased sleep and stress management.

This seems like it is a silly question, but I’m at my wits end and would love your input. I’ve been trying to figure out my 2 year old’s skin issues (not sure if it’s eczema, psoriasis, dermatitis? Lots of bumps all over her body, but especially bad breakouts on her face with lots of redness and almost acne like…). So, finally realized that it might be because of what I’m feeding her so we have had her eating paleo- that wasn’t enough so realized I just need to bite the bullet and put her on AIP to figure this out. Here’s the silly question: Are sweet potatoes classified under ‘potatoes’ for foods to avoid? I thought they’d be fine since they’re paleo-friendly, but gave her a sausage/kale/sweet potato mix for breakfast and her skin, which had been clearing up completely broke out again. REALLY appreciate what you do for all of us. Thanks.

They are considered paleo and AIP, although it’s possible that your daughter has a sensitivity to them. The first culprit I would look at though is the seasonings in the sausage (red pepper, cayenne, paprika?).

My son has had this issue since he was very little. We found out that his body doesn’t process yeast/sugar very well. Going paleo removed most of it. However we have to keep natural sugars low as well. Doing so has help greatly and the rash only flairs when his sugars go up. Hope that helps.

Hi! I have been coming to your site quite often in the last few weeks gathering info from you, as well as, and I must say that your recipes have been super yummy! I suffer from hidradenitis suppurativa and based on the info from, I have decided to go paleo AIP. Surprisingly, my husband and 2 year-old are embracing the change in our meals, but I am still getting resistance from my 9 year-old. What meals do your kids love best?
Thank you!

Sarah has a section of “kid staple” recipes here: (although not all of them are AIP). You can view all AIP recipes here: You can read her posts about feeding kids here: (scroll down for sections for older kids). You may also want to join our new The Paleo Approach Community group on Facebook and seek support there. The group has over 4,000 members, you can request to join here: — Tamar (Sarah’s assistant)

Hi, I have been battling with weightloss after I had my thyroid removed a few years ago. I also have a minor case of cirhossis. For a couple of years, I have exercised my butt off and ate clean in regards to processed foods, sugars and etc. I have found that I need to keep myself in a very narrow range in regards to eating and exercising which really borders on OCD. Recently, due to an injury, I have not been able to exercise and put on about 30lbs. Recently learned of the Paleo diet but someone suggested the AIP protocol. My wife has realized that she is gluten intollerant (maybe we all are!!) so there is a lot that we have a base understanding. My biggest problem is that at some point, when I lose weight again, I will hit a level and won’t be able to lose more. Is this something that the AIP/Paleo can help?

Any information regarding Paleo and Thyroidectomies would be appreciated too

That’s a hard question to answer. Certainly, the AIP is a great diet for weight regulation (so if you’re overweight you will probably lose weight and if you’re underweight you will probably gain weight) due to micronutrient suffiency, hormone regulation, and blood sugar regulation. But, it can’t help if the weight that you want to be is not actually a healthy weight for you (and this is pretty common for people to want to be 10-20 pounds lighter than what is actually a good weight for them). And, your ability to lose weight will be very influenced by whether or not the dose of your thyroid hormone is accurate.

If you have hypothyroidism, and you’ve been tested to see if your glucose intolerant, would the AIP diet be of any use?

starches are not “paleo friendly” and are best avoided right? and this includes tapioca rihght?
and legumes/beans are paleo right?but only..if properly soaked etc? would they be paleo if they were srpouted? and that they were an advanced i ahve leaky gut and adrenal fatigue..then i shouldnt add them in until leaky/adrenal are healed? so even rooibos..peanuts..mequite..etc should be avoided? (cuz they are all legumes/beans right?
rice is a grain right?
is potato a starch or anightshade?
is soy paleo? what about fermented soy? would fermented soy otherwise be ok for thosse w/o thyroid probs or leaky gut?
is xylitol ok/paleo? what about xanthan guM?
thanks you guys!

Starches are not eliminated on Paleo, only those that come from grains or legumes. Legumes (including peanuts) are not considered Paleo, although green pods (like peas and green beans) are a gray-area food you may choose to include or reintroduce if they do not cause symptoms for you. Rice is a grain, white potatoes are nightshades, and soy of all kinds is a legume. Sarah does not recommend additives like xylitol or xanthan gum because they are gut irritants. – Christina, Sarah’s assistant

Just found my answer further down the thread. It is a gray area. Thank you! Do you maybe know of a good brand of Coconut Milk to put in fridge so that fat will harden? I use it for “whipped cream” to have on my cinnamon baked apples. Thanks! :)

thanks! what would some examples of starches be that are paleo safe and that dont come from grains/legumes? potato st? tapioca st? can i get a full list? ok so even if legumes are soaked/sprouted they still are not paleo, right? (aka there not even considered an “advanced” paleo food?) and rooibos..peanuts..mequite are legumes right?ok so xylitol and xanthan gum would not be considered paleo right? thanks so mcuh! ok so soy (even fermented is not paleo) would it otherwise be ok for those that dont have leaky gut/adrenal fatigue?

Hi Amanda, If you search Sarah’s website here, with any of your questions, I’m pretty sure she has written about it! The search bar is on the right under the FB links. Hover your cursor over the links in the menus: About, Inquiries, Eating Paleo, Living Paleo, Ingredients, etc. -Diana

ok so teh safe starches are all only veggie starches then? and potato and tapioca and arrowroot starches would be considered paleo then? am i missing any that come in handy as far as cooking goes? i didnt see anythiong on the site about my ? in regards to srpo9uted/soaked legumes..can u help or give me a link or something? didnt see anything about xylitol or xanthan gum…so are they paleo ro not? im thinking xanthan gum isnt right?

ok so even soaked and sprouted legumes would not be considered paleo then right? and would stil cotnain harmful lectins?

Legumes are not considered Paleo, especially if you are on the Auto-Immune Protocol (AIP). People with healthy guts might tolerated them occasionally, but I haven’t seen anyone recommending legumes as part of a regular paleo lifestyle. If you have gut or auto-immune issues, just stick with real food. Focus on eating vegetables and protein and fats. If you are trying to lose weight don’t eat too many starchy vegetables. However, if you are dealing with low thyroid, you might find adding in the starchy vegetables helps with energy levels. Use the menus on this website to find answers to most of your questions. They are really helpful! :)

so all dairy, goat products etc arent actually considered paleo tehn?
but..if one doesnt have a prob with them..then one can include them just fine?

ok so guar gum is indeed paleo then? is it another one that is ok only as long as one has a healthy gut? or is it typically ok for all just as long as its only occassionallY?

No, sugar alcohols are generally not considered paleo. For a complete foods list, you can subscribe to Sarah’s newsletter in the sidebar to the right and receive a free Paleo Quick-Start Guide. – Christina, Sarah’s assistant

do you think one without a healhty gut wouold tolerate coco palm sugar being used as the main sugar for kombucha or water kefir fermentation?

Right..but sometimes i switch off and experiment with other things :) so i was wondering if It wud affect a person without a healthy gut just as bad as It wud if it wasn’t fermented?

Hi, I am trying to figure out if coconut palm sugar, honey, or stevia are acceptable on the AIP diet. I know it would be moderation with all of them, but are they allowed at all?
Thank you for your help

are tapioca starch..potatoes..and vinegar paleo? even if its grain vinegar but no grain proteins are presetn in the end product?

Grain vinegars are not paleo, but other vinegars, tapioca, and potatoes are fine. You can get a complete list of foods by subscribing to Sarah’s newsletter (in the sidebar to the right) and receiving her free Paleo Quick-Start Guide. – Christina, Sarah’s assistant

whats sarah’s take on whether or not there is actually any “grain” or gluten etc present in the end vinegar product?

recently did an alcat test and it shows that i have no reaction to coconut…but ive heard coconut palm sugar and coconut shreds and nectar etc arent good for ppl with leaky would it hinder any progress or not?

ok so even if the alcat test shows “coconut ” is ok..the coconut palm sugar is still best avoided unitl leaky gut is healed?

That’s interesting that coconut nectar/sugar is a gut irritant (it’s so tasty!), are there any links about this? Also is using it occasionally detrimental to gut health? I’m pretty sensitive :/.

On a different topic, is aip the best course of action for those with lupus? Have you heard of FODMaps, etc., helping? I’m helping my friend get healthy.

Sarah says that occasional use is fine except for those with very leaky guts. Yes, the autoimmune protocol is appropriate for all autoimmune patients. Sarah only recommends going low-FODMAP if SIBO or a FODMAP malabsorption issue have been diagnosed. – Christina, Sarah’s assistant

i checked that page otu before..but there wasnt an all purpose flour sub that was coconut free was there? maybe i missed it

Hi, a lot of the recipes seem to use coconut a different forms. What about people with a coconut allergy. What can be substituted for coconut amino acids, oil, milk?

Coconut oil can be replaced with any other cooking fat in most recipes. Coconut milk can usually be replaced with milk, cream, or nut milk. Personally, I use apple cider or balsamic vinegar instead of coconut aminos (though they do not provide the same flavor). – Christina, Sarah’s assistant

oh ok so there is a coconut free substitute then? ic ant find it? can u point me in the exact paragraph or copy/paste teh sub?

would soaking sweet potatoes (like white potatoes) be beneficial to reduce acrylamide etc? should one then also soak sweet potato flour if they soak potato starch?

Carob powder is ground up bod, not bean, so generally considered okay. Isolated gums can be gut irritants though, so I wouldn’t advise eating those unless you are healthy and know you don’t have problems with them.

ok so carob bean gum and locus bean gum wouldnt be considered paleo? or they would…but should just be avoid if one doesnt have a healthy gut?

I’ve been on the Paleo diet and numerous others since 2010 without much success. My biggest problem is that due to my Addison’s Disease, I’m on hydrocortisone three times a day and will stay on it for the rest of my life. Several of my doctors have told me that it’s going to be very difficult to lose weight while on this drug. Plus, I’m on Lyrica which also contributes to weight gain. Does anyone else have this problem?

All of the bacon I have found contains a lot of additives. What bacon do you recommend for aip? also, what are your recommended staring points for macronutrient breakdown? I have been low energy and very sluggish for the past several weeks. Eating lots of protein,because I crave it, but it’s not grass fed. I can only afford conventional meat at this point. Does that make a huge difference in your experience? Thanks for your help.

Hi I was diagnosed with SIBO (methan producing bacteria specifically) 3 months ago and have been on a highly restrictive version of the FODMAP diet ever since. I went on 3 rounds of herbs to try and get rid of it and may or may not have solved the SIBO issue. Either way, my bloating, gas, constipation, and discompfort have improved but not gone away and it seems likely that I would have a leaky gut.
I am considering the AIP diet since it can help with leaky gut, but am at a bit of a loss as to how to sufficiently feed myself because my SIBO/FODMAP needs require that I cut out even more foods. Most significantly, I cannot have any cruciferous vegetables or starchy vegetables, which leaves me with carrot, cucumber, and small servings of spinach, squach, and green beans.
Is there anywhere in the AIP diet where I can add back in foods?
From what I understand about the issues with eggs and nuts/seeds:
can nuts or seeds be acceptable if sprouted?
egg yolks alone?

What about white rice since it does not ferment and is digested higher up in the digestive system? this was the only grain i was allowed to add back in my fodmap protocol.

thank you!

Siena–I’ve been on an AIP and low fodmaps (for methane SIBO. Tested at 115) for almost 4 months now. I eat tons of different greens, berries, bananas (1 a day), mac nuts (I tolerate these really well and have been AIP for 2 years and so I’ve tested them), loads of zucchini, all types of squash: pumpkin, delicate, spaghetti, etc.. I have been rotating botanical antibiotics and pharma antibiotics the whole time. I haven’t retested, but I will in a couple of weeks. The protocol I’m on (sibo clinic in Portland) has me doing antibiotics until I feel better and then mass amounts of anti-inflammatories. I guess this can take a year. If my numbers aren’t significantly lowered, I’m considering a fecal transplant. Yep. GOOD LUCK TO YOU. I guess we have the really tenacious version of SIBO.

I am also in school and a professional dancer who exercises for 3 hours everyday. My days are long and having enough calories to function is crucial for me. This is why the limitations of AIP and FODMAP combined worry me so greatly

Hi Sarah,

I have been doing the AIP for about 2 months now. I am still reacting to foods and often feel unwell for about 2 hours after eating. Would you recommend food intolerance testing? Also, by chance do you know of any specialists that could help me in Melbourne, Australia..

Thanks so much


Hi Sarah, thank you for all the information on your website. I am going to order your book. I do have celiac and severe psoriasis and I just started to follow your AIP. Am I allowed to have coconut milk (for my green smoothie)? Thank you, Martina

What brand of bacon is AIP safe? a lot of the AIP recipes have bacon in them but I have not found a brand that does not contain celery salt (which I react to) or nitrates.

Thanks in advance for your help

Hi Sarah,
I have an autoimmune disease called Sjogren’s. I have been doing the AIP diet for going on 3 weeks now and have noticed some improvement in my symptoms, especially an increase in energy. One of the main problems that I face with Sjogren’s is sore salivary glands. This has gotten about 50% better, but I am still experiencing some discomfort. In your opinion, is this typical at this point in the game? At what point do I begin re-introducing foods back into my diet and can popcorn ever be re-introduced?
Thank you,

I actually think this is really awesome improvement for only 3 weeks! If you can hang tough for a few more weeks, I think that would be best, but with this much improvement, you could try some careful reintroductions now. And yes, popcorn is a possibility. In fact, I have popcorn about once a month as a treat and seem fine with it (and oddly enough, don’t do well with rice or any other gluten-free grain I’ve tried). I get organic heirloom popcorn from a local farmer and pop it myself. :)

While studying the list of food to avoid and the list of food that are ok, I didn’t find okra listed. Do you know if this food is alright to eat or should I avoid it. I do enjoy it when I make a good vegetable soup. Could someone e mail and let me know if I have to eliminate it before I start buying seed for my small garden.

I would like to make my own coconut yoghurt but all the recipes say to use Maple Syrup or Rapadura. Are these ok on AIP? Thank you

Hi Sarah,

Alot of AIP receipt call for coconut milk or coconut concentrate. However, I am intolerant to coconut.
What can I use as replacement for coconut milk and coconut concentrate?

Thank you

Today, my dentist cleaned one quadrant of my teeth. He told me that he found “exudate” (pus) on one of my teeth and I should get checked for autoimmune disease, specifically diabetes.

I started cutting back on cards and following a ketogenic diet about 2 months ago. I only get carbs from cruciferous vegetables. I added meat, including pork, to my diet at the suggestion of a keto coach and I try to consume large amounts of fat throughout the day.

Is there a correlation between what my dentist suspects and my state of ketosis?

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