You May Have an Autoimmune Disease But Don’t Know It!

May 12, 2012 in Categories: by

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Do you have an autoimmune disease that you are unaware of?  I’m not talking about the severe autoimmune diseases like lupus, multiple sclerosis, non-Hodgkin’s lymphoma, and Grave’s Disease.  If you are unfortunate enough to suffer from one of these types of conditions, you are probably already aware that they are autoimmune in nature.  I’m talking about the conditions which are generally not life-threatening (although some of them can become so), for which the treatment may be as simple as a small dose of steroids or daily NSAIDS, and for which doctor’s typically shrug their shoulders like it’s no big deal.  Yes, a surprising number of those types of conditions, eczema and arthritis for example, are actually autoimmune in nature.

As I perused a list of confirmed and suspected autoimmune diseases, I was shocked by how many common skin conditions and gut health disorders are autoimmune in nature (to the point where I wonder if all digestive disorders and skin conditions will eventually be considered autoimmune diseases).  I was also surprised by how many autoimmune diseases are characterized by nebulous symptoms that could easily be ignored and attributed to not getting enough sleep (at least until they get bad enough).  Wikipedia has a comprehensive list of autoimmune diseases (here’s the link), but here are some that stood out to me as ones that many people suffer from without ever being told that they are actually autoimmune diseases (some of these are suspected autoimmune diseases rather than confirmed and some of them are certainly life-threatening serious diseases but maybe not commonly understood to be autoimmune in nature).

  • Alpopecia (spot baldness)
  • Arthritis (all forms)
  • Atopic Allergy (tendency to be hyperallergic)
  • Dermatitis (all forms)
  • Cancer
  • Type I Diabetes
  • Eczema
  • Endometriosis
  • Gastritis
  • Lichen Planus
  • Lichen Sclerosis
  • Morphea (localized scleroderma)
  • Myositis
  • Chronic Fatigue Syndrome
  • Narcolepsy
  • Polymyalgia rhematica
  • Psoriasis
  • Restless Leg Syndrome
  • Schizophrenia
  • Scleroderma
  • Vasculitis

It is worthy to note here that there is a whole other group of diseases, such as anxiety and depression, asthma, allergies, Type II Diabetes and even acne, that are not considered autoimmune disease but for which the immune system still plays a part.  If you suffer from any of these conditions, it is worth while giving strong consideration to following the paleo diet Autoimmunie Protocol, especially if out-of-the-box paleo doesn’t address your health issues. 

The more I read about health and nutrition, the more I am coming to believe that autoimmunity acquired as a result of a leaky gut caused by the Standard American Diet is far more rampant than epidemiological reports would have us believe.  I suspect that autoimmunity is a spectrum with symptoms so mild in the early phases that we are generally unaware.  I suspect that autoimmunity is very common is people with metabolic syndrome (or even people who simply struggle with weight loss).  And I think that in many people those ethereal early phases of autoimmunity can last years or even decades.  The symptoms of autoimmune conditions can be nebulous.  They can come and go and not seem to be anything more than the result of the stresses of normal life and what we consider to be a normal part of aging.  But if you find yourself claiming that “I’m just not getting enough sleep these days” or “yeah, my knees have been bugging me” or “well, my mom had arthritis at my age”, take a hard look at these symptoms and consider the possibility that you are perhaps dealing with the very beginnings of autoimmunity. 

Symptoms which may be caused by autoimmunity:

  • Extreme Fatigue
  • Muscle and Joint Pain
  • Muscle Weakness
  • Swollen Glands
  • Susceptibility to Infections
  • Sleep Disturbances
  • Unexplained Weight Changes
  • Resistance to Weight Loss
  • Yeast Infections
  • Digestive Problems
  • Anxiety and Depression
  • Migraines
  • Recurrent Headaches
  • Memory Problems
  • Allergies
  • Rashes
  • Blood Pressure Changes (usually low)
  • Low Blood Sugar
  • Thyroid Problems
  • PMS

When dealing with these early symptoms of autoimmunity, you are unlikely to get a clear diagnosis from your doctor.  But, you are more likely to see rapid resolution of your symptoms by following The Autoimmune Protocol (you may even see resolution of your symptoms with out-of-the-box paleo).  And on the very bright side, if you “catch it early”, you may be able to eventually reintroduce nuts, seeds, eggs, nightshades and alcohol.  So, are you a person who needs to follow The Autoimmune Protocol?  Maybe.  I would make this suggestion:  if you don’t feel amazing after a couple of months on out-of-the-box paleo, try The Autoimmune Protocol.  It just might be right for you.


Great article! Have you read Dr. Alessio Fasano’s research? He runs the Center for Celiac Research at U of Md Medical School. His work is on the cutting edge, and looks at the issue of gluten as a spectrum from gluten sensitivity to full blown Celiac. He is also currently researching the effect of gluten on all other AI. Here is a recent article:

Hey Sarah, ive never considered myself having an autoimmune condition but after reading this im wondering if I should make a lifetime commitment to follow AIP to keep
my hodgkins lymphoma in remission. Do u have any thoughts on this?

I’m so glad to see you list cancer. I have realized for a long time that it is autoimmune in nature and suggested the paleo diet to my brother who just found out he has colon cancer. My dad’s family has a long history of cancer and my mom has lupus (her mom had schizophrenia). Thought this article might interest you

I would like to add aphthous stomatitis (recurrent canker sores). Many people don’t realize they are connected to diet.

You have transitioned so fast to a paleo diet -kudos. We have been GF (and variations of dairy and sulfite free)for almost 6 years. Right now, we still eat some grains. I have been playing with GF sourdough, but it’s too much for my oldest daughter who has impaired glucose tolerance so I am introducing more and more paleo foods. Your blog is encouraging me to get moving forward in our journey.

I have suffered from mouth sores my whole life and finally found relief with paleo! I know realize I have a wheat and gluten allergy and that’s what causes the sores.

This is SO timely.
I have suffered from cysts on my ovaries for years and years. Last year I finally had to have a hysterectomy because they were becoming so large. My mother had such terrible ovarian cysts that when one ruptured it ruptured her ovary and she was in the hospital for a while.
No answers, no help for either of us. As you can imagine there were numberous thyroid symtpoms (but bloodwork is fine etc.) So many hormone problems, sleep problems…oh yeah, reuhmatoid arthritis runs in my moms family along with diabites.
Fast forward to this past month at an edocrenologist with my poor teen age daughter (15). She has been having terrible monthly cycles etc. Find out she has PCOS Polycyctic Ovarian Syndrom. This causes cysts on BOTH the thyroid and ovaries (shocker huh?)and it’s cause by-take a guess-insulin problems! o.O I believe 100% that both me and my mother have suffered from this most of our reproductive lives.
Monday, I got to leave the doctor office with a blood testing kit and a prescription for metformane because by blood sugar is getting way too high and a referal to a reuhmatiologist because I now have symptoms of reuhmatoid arthritis. 🙁
I have suffered with the list of symptoms you mention above since after the birth of my last child and gotton ZERO help for doctors.
Thank you for putting this information out there.

During pregnancy, your immune system shifts and autoimmune conditions have a tendency to be suppressed. The drawback is that they get way worse after the baby is born. I had the same thing happen with my lichen planus lesions, which got even worse after weaning. I hope that you and your daughter find some answers in the autoimmunity protocol!

After I had my daughter I notice things happening. My lymph nodes on my neck were swelling to the size of a softball. I had to have one removed. That was when I was 30 yrs old, @ age 41 diagnosed with Sjorgens & connective tissue disease. I’m being closely watched for lympthnoma.

Do you know if the same thing happens when your body thinks it’s pregnant? I was on the pill for 7 years which covered up my acne and pms, but since switching to an IUD it’s been an onslaught of symptoms: the acne is back, depression, joint pain, fatigue, among others… I’m going to see a holistic MD in a couple days, but I wondered if you had any insight. Thanks for all you do!

This week I am starting the elimination diet through Chris Kresser’s Personal Paleo site. I generally feel healthy. I have no digestion or energy complaints but I have a rash on my hands and some hint pain. I’m not sure I can stick to it for 30 days, but I’m going to do my best.

My daughter, who is 9, recently tested for possibly having an autoimmune disorder. Her ANA levels are high and her symptoms seem to be pointing towards Crohn’s disease. I have her on a grain free diet now, crossing fingers it works, because I am a natural mom and don’t trust doctors or drugs.

Wow, that was a brilliant article. Thankyou for that, it’s really opened my eyes!I think following the protocol seems a good idea for me!

I first learned about this when I was living in England and we spent a night in the hospital with my 2 year old son. The pediatric nurse did a home visit and observed my son and his eating habits. I learned then that by changing his diet to (what I have recently learned is very “paleo”) that it would help with his hyper-activity and his constant need for a “fix”. Apparently, children with ezcema and severe allergies to foods and “environmental” issues are also prone to sensitivity in additives, food colorations, sucralose, etc. They call them specific “E” numbers. I was given a list of things and went on my way. When we came back to America it was harder to maintain, especially with his pre-school. We just recently converted the whole family to this for our health as well as his. I appreciate this blog very much. Thank you.

That’s so cool that the diet they recommended was similar to paleo! Figuring out not to give my oldest food coloring was probably my first introduction to food affecting health (other than weight).

I am starting the Paleo Diet in a different position. I am starting the Paleo Diet as the ONLY treatment recommendation from my doctor after I was diagnosed with Hashimoto’s. I am also breastfeeding my 3rd Milk/Soy Protein Intolerant baby (coincidence? I doubt it.) They found the Hashimoto’s when after several thyroid tests throughout my life due to the typical symptoms (weight problems even as a child, hair loss, tired, dry skin, mood swings, diagnosed and medicated ADHD as an adult, extreme PMS, foggy brain, extreme water retention requiring medication) they tested for the antibodies and I was finally diagnosed at 33 years old. I need to lose over 100 lbs and I am exhausted. So here I am ready to start Paleo, but now I see there is the AIP. I know you have recommended to start with the regular Paleo, then move into AIP if you suspect an autoimmune disorder. I already know I have one. I am also quite used to elimination diets as I have been milk/soy free for 2.5 years. I want to cry reading one list, then another, than another…LOL. Coffee? Eggs? Chocolate? Sucky, but I think I can do it. Now, I found this list of vegetables and fruits that may also be a problem! Brussel Sprouts? Cherries? Tomatoes? Mangoes? I am a bit overwhelmed, but I don’t want to waste time when I know I have Hashimoto’s already. Do I need to get like, a nutrition consultant? I am overwhelmed! LOL! Help me, Paleo Mom! I have these three kids (one of which is already showing similar symptoms at age 5) that have to eat with me, my husband is about to be deployed! I need to get myself healthy but I am just feeling overwhelmed! Your site is the only thing that gives me hope that I can weed through all of it, but with my ADHD, I was wondering if you had a shorter list of things that AIP can eat, or that you ate.

Also, what happens if I did Paleo and still had coffee? Would that negate all my efforts? What about cacao powder, is that the chocolate that I have to give up? I was looking forward to mango, cherry, almond milk smoothies for snacks, but all of those are on the highly reactive list you have on that one page…LOL.

Thank you so much for helping all of us navigate these waters.


It’s completely worth trying standard paleo first and then moving to the autoimmune protocol after paleo seems easier and if it doesn’t do the trick by itself (it might!).

Sara, I felt your pain reading your comment as I share most of your story and the frustration that goes with it! Mine has been mostly within the last 5-7 year period, and just now putting two and two together as I read up on ThePaleoMom’s amazing posts!!! Thank you Sarah Ballantyne!!! 😉 I too am very overwhelmed!!!!
Cutting out sugars and simple carbs is not new to me, yet I’m having Such a Hard Time this time around! Now I understand why my ADD symptoms are worse than ever! And with all the other AutoImmune/ Leaky Gut symptoms, such as fogginess and major fatigue, I go in circles and everything to me is now so much more complicated than it normally is!
I finally convinced my fiancé to a Paleo-like lifestyle change for ridding of our pain and inflammation and for our much-needed weight loss, and because cooking separately for him and for me was proving to be impossible for me to handle. Although a cheat-sheet would be so very helpful in our case, I will say that Pinterest has made it so much more tangible! You can follow ThePaleoMom and her wonderful recipes and posts, and also search for “AIP” or “Auto Immune Protocol recipes” and get more ideas that way! It’s helped me tremendously starting Paleo-like and now needing to adjust to AIP. Hope that helped you some, Sara! Good luck to you on your new path to health and wellbeing!!!

I came across your podcast with Stacey on Jimmy Moores casts. So it brought me to your great site. I am intrigued about what you have to say about autoimmune disorders and the protocol. Navigating it might be a bit of a challenge for me. Female of 46 years, type 1 diabetic for 36 years eating a high carb diet for most of those, 4years of being on dialysis. I have gone from being a vegetarian to eating fish every day, using a paleo/primal diet, and Dr. Bernstein’s low carb diet for diabetes. Being on dialysis we had to find a protein source I could tolerate because of the phosphates are so high in them. So we found research that egg whites do not put your phosphates up as much and can give the protein I need. I can’t indulge in a lot of leafy greens again because of the potassium or phosphate levels. Nuts I have once a day because of my sweet tooth–1 oz. or a tablespoon of butter. I only eat 30 grams a day. I get some berries with a little cream. I don’t have chocolate any more, don’t drink, or take any NSAID’s, only meds I take are–insulin eltroxin, epotein. It is very hard to balance everything without going crazy and of course I am a little bit of a perfectionist and this hurts me–But I feel you have some good advice and will look into this more. Thanks for being out there.

Would love to interview you one day.

I am very impressed with you and your site–hope one day to build mine up like yours–very inspiring.

Nicole Manley

I’ve got some sort of autoimmune thing brewing (very high ANA, off-the-charts anti-thyroid antibodies, weakly positive for various other antibodies associated with various autoimmune diseases.) However, I am for the most part asymptomatic (well, except for five miscarriages diagnosed as “bad luck” and being tired chalked up to having two active young boys and migraines and arthritis.) My rheumatologist’s approach is “we’ll monitor it and in a few years when you start exhibiting symptoms then I’ll be able to tell you what autoimmune disease you’ve got.” I wanted to STOP whatever is brewing and keep my body from destroying itself instead of waiting for an exact diagnosis, so I did some of my own research and decided to go off gluten 11 months ago. She humored me, but seemed surprised at my last visit 6 months ago that my antibody levels were down by a statistically significant amount. Not only that, but my migraines are also greatly reduced and my arthritis is gone. We’ll see if the trend continues when I go back next week for more bloodwork. However, after reading some of the articles on your blog, it looks like I really should try the autoimmune protocol. It seems like a huge step, especially cutting dairy and eggs and nightshades. I guess gluten seemed like a huge step at first and I managed that.

Anyway, thanks for the info. It’s common to see all sorts of crazy diet info out there, but it’s very uncommon and very appreciated to see diet info that is actually based on actual scientific studies published in peer-reviewed journals.

I’m amazed to find your site. I have been on my very own created low lectin diet for about 6 months now from my own research and reading this, our diets almost overlap 100%!!!!

I have auto immune diseases running in my family. I also have a genetic issue with my joints and another condition that seems to be attacking my joints that the doctors have yet to diagnose.

Out of desperation and pain, with a steady decline in my condition I began cutting things out of my diet. And then with reading, I cut more and more things out. As my diet variety decreased, I realised certain foods really made me quite ill. Nuts made me sick. Stopped eating them. Coffee made me sick, cut that out. Curry put me in bed for a week. No more spices and so on. Now I am rather limited to what I can eat I am really feeling much better. I can really pin point each food item I consume. Now I can tell you that the seeds in cucumbers are affecting me. No more cucumber seeds.

I have added in extra oils and fats to help with caloric intake. Coconut oil, avocados and oilve oil are my main stays. Sweet potatoes are my super food starch. The rest is meat, non seed fruit and vegetables. And that is it. What a difference it has made. I can move again! I can get out of bed. My hands and feet are no longer in agony.

One slip up though, even a small one and I am back curled in bed, miserable for a week. Yes, food has this affect. Thanks for your research and helping us understand the whys behind all my ah-hah moments! I’m so glad we came to basically the same conclusion.

hey aedmar, it seems we both have rheumatoid arthritis. im reading this book called a doctors home cure to arthritis and it mentions a similar elimination approach. our of curioity what have you been eating

Thank you for linking to the list of AI diseases. I glanced through it and found that Henoch-Schonlein purpura is considered to be AI. I had no idea. I have lupus and my daughter (now 23) had HSP when she was six. I had worried that my genes would cause her problems later on. Now I think I’ll try harder to convince her to eat better. Poor thing.

GF is a good way to start, I think. That alone made a huge difference with me. She already knows that avoiding gluten makes her face clear up, but she doesn’t consider it bad enough for the sacrifice.

I posted I a comment on your podcast site then realized I’m not set up yet. 😉 My question was about poop!! Floating or sinking what do they both mean?

Sinking is normal, but floating doesn’t necessarily mean abnormal. Floating can be caused by excess gas production (like eating more fiber or fermentable sugars than normal) or improperly digesting fibers and carbohydrates (also causes excess gas production, but the root cause is slugging digestion), also poor fat digestion can cause poop to float (because there’s so much fat passing through). If it also smells very bad, that’s usually due to poor fat digestion, so you could try adding an ox bile supplement. If it’s the fiber, you can try adding a plant enzyme supplement. If you aren’t sure, both of those supplements are very safe, but if it happens more often than not, it’s worth mentioning to a doctor.

Thanks so much for this post. For the past 7 (or more) years, I have had some random symptoms that no one has ever linked together: geographic tongue, some joint pain, and recently a rash that “may be” psoriasis. This includes a positive ANA, which I have been told doesn’t have to mean anything. In my gut, I feel that everything is inflammation related and also related to the food I eat. Fairly recently I had stopped gluten for a month or so. When I ate gluten for the 1st time again, I woke up with joint pain. Your post has made me realize I need to look at my diet even more closely. I have an MD apt tomorrow morning…it will be interesting. Thank you again. Looks like I need to educate myself a little more about the paleo diet.

Actually, any kind of chronic disease will be impossible to clear if you have food sensitivities and continue to eat food that causes your immune system to ramp up. When your immune system has learned to respond to a food, it will devote a big percentage of its resources to creating B cells, T cells, and antibodies to the food, instead of working on clearing the real disease.

People with Lyme’s disease, for example, need to be on an autoimmune protocol in order to clear their illness and co-infections. For example, see Healed From Lyme Disease by Stephen Leslie ( He says that every time he ate wheat, he had a flare-up of his Lyme disease that lasted about a week — a classic “food sensitivity”. He healed his Lyme infection with a combination of diet (not eating foods that caused an immune response), herbs, and mind-body healing (prayer, meditation, qigong, etc).

I suspect that all people with Lyme’s have food sensitivities to wheat and dairy, and likely other foods, and that when they continue to eat them they need antibiotics to deal with the infections…

Hi, I have had a bunch of these symptoms and recently jumped into autoimmune paleo. It’s been eight days now and in general I feel good and energetic, but my eczema has actually gotten worse this week. Any idea what might be up with that or if there’s something I should try tweaking already?

Hi. The last few months I have tried to research food and endometriosis. I was diagnosed last year after a big cyste ruptured and I almost died (it took a couple of days before the doctors really believed it was something more than menstrual cramps, and the old blood was contaminating my body). But I never read anything about it being a autoimmune condition. I have found one article about how a key ingredient in sun screen may be linked to the illness. Do you know of any scientific studies about it worth reading?

I have most of the symptoms on your list.. My aunt was recently diagnosed with lupus. Maybe I should give this a try. but eggs, cream (lactose free), nuts/seeds, aubergines, peppers and tomatoes are some of my staple foods. You wrote somewhere that coconuts were okei in moderation, why is that? Are coconuts nuts?

I recently discovered your blog and I really like it.

Thanks for all the great information.
-Vivian- (from Norway – why my english can be a bit strange 😉 )

It is strongly suspected to be an autoimmune disease, and a large percentage of women with it have autoantibodies against endometrial cells. I would definitely recommend reading about the autoimmune protocol (my book will have even more information). I would also recommend checking out The Hormone Cure by Dr. Sara Gottfried.

Thank you 🙂 I will try to read about it and then maybe make a gradual change. Will your book be available in a kindle edition?

Is testing positive for ANA considered an autoimmune disorder or disease? After testing positive for a 1:320 titer ANA, I was referred to a rheumatologist who tested me for the standard AI diseases, but nothing came back positive. I’ve had 3 miscarriages and was told that if I get pregnant again, I will need to be on Prednizone. In the meantime, I started eating Paleo with occasional slip-ups and within 4 months, I noticed my TSH levels went down one point on their own. My RE also prescribed 81mg baby aspirin/day because of the positive ANA. I am currently on a regimen with my nature to heal my gut with some prebiotics, probiotics and glutaloemine. I may look into the AI protocol, because I really want to be at optimal health so I can conceive! Thanks for this great blog!

As a general rule, autoimmune diseases are hard to diagnose (at least until the diseases have advanced enough for symptoms to be very obvious and fit into a pattern consistent with a specific disease). A positive ANA could mean that you have an autoimmune disease, or are in the early stages. I definitely think that the AIP is a good choice for you (and I do recommend talking to your doctor about getting off the aspirin, which is going to hinder healing your gut).

Carolyn, antiphospholipid antibody syndrome can cause clotting, resulting in early pregnancy loss, and it is an autoimmune disorder. Might be worth checking.

Carolyn, I just saw the other reply to your question. I wanted to share that I had four miscarriages (after having two kids with no conception or pregnancy issues) and after months of doctor’s visits, and blood tests we decided to try Lovenox injections (blood thinners). (Very) long story short, it worked and I was able to carry a pregnancy to term (she’s four now!). I encourage you to talk to your doctor about that. I also agree that the AIP could improve your immune system and general health.

This is wonderful, and gives me a glimmer of hope to fix my chronic hives (23 years now, and I’m so over it…).

Just in reading your above list of ‘symptoms that can be caused by autoimmunity’ I notice one of them is ‘swollen glans’. Is this right? Or is it meant to be ‘glands’?

I did an elimination diet 2&1/2 years ago and realized the gluten and dairy were out for me. And two years ago discovered the Paleo lifestyle and that was so much easier than trying to replace my SAD diet with gluten free foods. But I have noticed that I struggle with energy and my sleep isn’t as great as it once was. White potatoes have been the one food that I know I am most intolerant to since the elimination diet. As a matter of fact when I have accidentally ingested potato starch I have a worse reaction than if I accidentally have wheat. I wake up in the middle of the night with my back on fire and can’t go back to sleep for an hour or three( I call that my angry intestines). Then the next day I feel hung over, lots of headaches and will almost pass out asleep in the afternoon like a narcoleptic. After following you this summer, you have brought the night shade/autoimmune to my radar. Since potatoes are a night shade and I have such a reaction to them, my odds for being auto immune and reactive to all night shades is probably high. I want to try AIP, but I have already eliminated eggs once, and reintroduced with no problem, could I try AIP with eggs? Giving up Paprika is already going to be hard enough!
PS OCT. 22 will not get here soon enough! I have sooo many question i think your book will answer!

You could absolutely try AIP with eggs! Different people will have different sensitivities to different things, and if you know that eggs work for you, then go for it. Also, all my concerns about eggs are really about the egg whites, so you can also do AIP+egg yolks if you aren’t 100% sure. And I hear you on paprika!

At this point, it looks like the book will be delayed (edits and graphic design are taking longer than typical because of how long and technical the book is). Not sure exactly how long, but as soon as I know, I’ll make a big announcement about it.

Love reading all of your posts and articles! I was just recently diagnosed with pityriasis lichenoides / PLEVA and have suffered from it for over 1 year now. Although my symptoms could become much worse than they have been I do not want them to evolve into something more serious. I started cutting out all grains just 3 days ago, but I am still having 1/2 & 1/2 in coffee and coconut milk and also eggs.

I should probably follow the AIP 100%, but I would hate to cut out the other things I love if its just the grains causing my main issue.

If you have any advice for me I would greatly appreciate it! I have not found anyone with this same condition I have who has tried the Paleo diet to help them, nor very many at all!

I think it’s fine to warm into the AIP slowly and see how far each step gets you. But, I would recommend grain-free, dairy-free, soy-free, and night-shade free as a first goal.

Wow, I now realize my autoimmune issues actually started a lot earlier then I thought! I started getting headaches (our of character for me) almost 10 years ago, every couple years a new “symptom” would appear and the headaches got progressively worse. I have been eating mostly Paleo for the past 6 months, but I realized a week ago that I need to do the AIP. I started transitioning a week ago, and yesterday was my first “pure” day. Anyway, I’m struggling. I’m HUNGRY. I’m exclusively nursing my 4 month old, and I’m already at an ideal weight for me. I’m really trying to get in lots of fat, but I still feel hungry… Any ideas for me? Even when I was eating “mostly Paleo,” I was still eating Paleo baking, potatoes, and some dairy (which I suspect is likely my biggest immune trigger). I’m trying to eat only 3-4 times a day, but if I’m still hungry should I eat more often (I know that’s not ideal)? The good news, the dermatitis (on my hand), which has been really bad for the past month is almost entirely gone already. Now I just need to fully heal my gut and my couple remaining symptoms (that didn’t go away with the “regular” paleo) will hopefully be a thing of the past.

Yes, you should eat more if you’re hungry. Try as best you can to increase the size of your meals, but since you’re nursing, you metabolism is different. Also, make sure you aren’t going too low carb. Starchy vegetables will help keep your milk supply from dropping (and will actually suppress ghrelin better after meals which might help with the sensation of hunger).

Thank you so much for this and for the information on the autoimmune protocol you provide on this blog. I have a lot of those symptoms and after doing extensive research this past week (starting with just dietary changes for mastocytosis), I’ve come to the realization that at the very least, I’m at very high risk for developing an autoimmune disease, if I’m not already in the early stages of it. That’s a very scary realization and I was feeling pretty depressed and defeated, but after reading your blog, I’m very hopeful that I can at least keep things from getting worse and give my body the best chance of healing itself, maybe even to the point of full remission (well, not from mastocytosis, but from anything else inflammatory or autoimmune that might be going on). I really can’t thank you enough for that! I’m actually pretty excited about getting started!

I was diagnosed with schizophrenia 9 years ago and now I’m on the minimum schizophrenia maintenance dose of Seroquel XR, which has 400 mg quetiapine and probably trace amounts of A1 milk proteins from the 15 mg lactose(anhydrous) a day which also might have caused some abnormality in some of my blood cell counts I’ll mention. Whenever I ate some gluten after avoiding for some time I had serious pain in my digestive system so I removed gluten from my diet long ago, but I do not know if I have celiacor not. I removed A1 milk before gluten and in the last year I removed corn, later soy and lastly all other grains and legumes except small amounts of Bacillus Subtilis fermented legumes I use about a teaspoon a day and all dairy. Some of my blood cell counts used to be abnormal(I’ve read neutropenia in an autoimmune list) but a test I had in february revealed all normal numbers which I think probably is due to the changes in my diet. I have allergic conjunctivitis and allergies to a few things including mites for which I’m being vaccinated currently once a month and on a paper about it I’m marked to have allergic rhinitis(read it in an autoimmune list). My hands are colder than normal often though it may be due to caloric restriction and low carb, adequate protein, high fat diet I have. I used to shake my legs more than a regular person and when the vaccines first started it flared(I’ve read restless legs syndrome in an autoimmune list) but now they’re normal. Currently I do not have any problem about schizophrenia I can tell.
Nightshades dose dependently cause me joint pains unless it is a summer day with a good weather or alike as far as I’ve observed with moderate amounts, so I do not eat nightshades these days. I do not have any problems from eating eggs, nuts, seeds, potato(other than I described for nightshades), hemp, cocoa, cocoa butter, baker’s yeast, coffee as far as I can tell without ever consciously trying an elimination diet with these. I do not currently consume any milk products but I can’t tell if A2 milk products have any bad effect on me except once after not consuming them for a while I suspected they increased my restless legs syndrome I had then. I used to consume sesame and tahini and small amounts of sourcherry or red wine but since some time I do not and I can’t tell if they have any bad effect on me. When I used a NSAID after not using NSAIDs for some time I had pain in my digestive system and since then I do not use them.
I will continue not consuming any alcohol, sesame, most seeds and nuts(I use some that I believe are beneficial regularly, 12-15 almonds, a dessert spoon cocoa, a teaspoon cocoa butter, a tablespoon coconut flakes, a teaspoon of flaxseeds for lignan and fiber, one cup of coffee prepared with a dessert spoon of Turkish coffee a day and I may also consume hazelnuts, macademias, brazil nuts, chestnuts without exceeding a big handful nut a day at most if it includes chestnuts and less if not), NSAIDs, alcohol, and I may totally remove nightshades from my diet and though I was thinking consuming some A2 milk product such as raw/fermented/butter/ghee might be better than none I may change my mind about it easily but I think I will need more information/advice about others that the autoimmune protocol advises removing from the diet.
What signs should I be looking for when doing an elimination trial of the foods autoimmune protocol advises removing from the diet ? Should all of them removed from the diet together in this trial and for how long ? Do you think I can seriously benefit from those eliminations ? What benefits may I have from eliminating the foods suggested to be eliminated in the autoimmune protocol ? I’m particularly curious about raw/fermented/butter/ghee A2 milk products because when it’s raw it has many advantages over pasteurized and when fermented provides a huge number of probiotics and when it’s full fat or butter or ghee it has butyrate and butyric acid, I suspect at least some sort of it may be more beneficial to me than harmful.

Any input is welcome

Paleo Mom, thank you very much for sharing your knowledge and spending time doing these

It sounds like you are doing a very good job of detecting food sensitivities. All of the symptoms you are describing would be signs that you are sensitive to those foods: any symptoms of any of your conditions, any gastrointestinal symptoms, headaches, mood changes, skin conditions (like rashes, acne, dry skin), trouble sleeping.

As for whether to eliminate all and then reintroduce versus one at a time, it’s really up to you. I like eliminating everything and then adding back in one at a time because I think it’s a bit easier to tell what’s a problem, especially if there’s more than one food that you are sensitive to.

Because schizophrenia is a suspected autoimmune disease, along with your other conditions that have autoimmune links, I think this would be a good thing to try.

The only think I would add is to make sure you are eating seafood for the long chain omega-3s, which can be extremely helpful both for allergies and for the schizophrenia. I’m not sure what to suggest about trace dairy in your medication other than talking to your doctor and seeing if a) there in another option, or b) if the drug can be specially compounded without lactose for you.

I hope this helps.

Thank you very much. About the drug, my doctor doesn’t want me to change it though a long time ago I told her that A1 dairy made my auditory hallucinations lauder, actually with eliminating A1 dairy I eliminated my auditory hallucinations. I also checked other quetiapine drugs and many other antipsychotics but they all had lactose(more lactose except another quetiapine drug my doctor doesn’t suggest to be used because it’s not extended released) except an aripiprazole drug. I was impressed with what was written about aripiprazole also so though my doctor didn’t want me to try aripiprazole I persuaded her to help me try it but it had very bad side effects on me so I turned back to Seroqul XR 400 mg once a day. Even if the drug can be specially compounded for me without lactose that would be out of my health insurance and I guess would cost much more than the drug itself and I think my budget is not loose enough to seek the advantage of it… I’m living in a country with much smaller wages than there…

One last question, if one or more of those foods are contributing to one’s autoimmunity, does it mean that he/she can not heal a leaky gut without avoiding those foods ? Or can it be enough for them to do all that you wrote in the link below with the exception of eating a heaping teaspoon of Bacillus Subtilis fermented legumes other than soy and peanut, and one egg white a day to heal the leaky gut ?
I’m curious because I’ve read in Chris Kresser’s site that healing a leaky gut can reverse autoimmune diseases…
Thank you very much in advance !

He referred to Fasano about that. I think maybe healing the leaky gut and keeping the diet that healed it can do as much as the autoimmune protocol at a slower pace… How would you compare the leaky gut diet with the autoimmune protocol for people with autoimmune diseases ?

The autoimmune protocol is not only focused on healing the gut, but also on regulating the immune system through addressing micronutrient deficiencies and removing foods that stimulate the immune system. Granted, I’ve spent over a year intensely researching every single aspect of this for my book, but I don’t think you can do better.

I was still thinking about the change and today I tried a raw egg white alone, maybe for the first time in my life, and not long after I started having some pain, probably from my gut… I guess I’m not an exception that can get away with eating whole eggs and maybe there are no exceptions about it who have an autoimmune disease. I guess your references might tell me the same if I had the time and read each…

Would you consider bursitis to be an autoimmune condition? Nearly two years ago I had a bad flare up in each hip at the same time. Now I have it on the bottom of my foot. I know it is a result of inflammation. I know I do have osteoarthritis in my knee so I would benefit from the Autoimmune Protocol but wanted to get your opinion on bursitis. Thanks and can not wait for your book and cook book. I really enjoy your blog you are such an inspiration!

Hi Sarah;
Your positive results are really inspiring to me. Following your blog and FB posts, trying your recipes. Looking forward to your books. I was wondering if you thought Lichen Sclerosus could be helped by the AIP food approach. Just sitting here in Nova Scotia wondering how to fix this AI disease. Thanks for any info you can throw my way.

Should I be following the autoimmune protocol? I have lupus, so I assume yes. But I don’t have any joint pain or any other symptoms that I am aware of since I started plaquenil back in 2011. i have some fatigue but not sure if it’s AI related. I’m just so confused about going full AIP when I’ve been doing paleo since July 2013 without any noticeable symptoms.

Great list of deseases!

There is also some evidence that GERD can be autoimmune also (though the trigger factor is refluxing process)

And recently i saw an interesting article written by Dr, Robillard about connection between IBS and autoimmunity

It seems like the majority of deseases (or at least the most hard and dangerous of them) are linked to autoimmunity.

Personnaly i struggle with a lot of conditions: severe GERD and biliary reflux, low function gall bladder, gastritis… All these turned my life to a very hard point. Just three years ago i was healthy and now i am almost disabled with constant pain and fear…GERD is my primal problem.
I use low FP diet (it is close to FODMAP) of Dr . Robillard with The Paleo Approach. The latter i started recently because low FP seemed not enough for my case). It is 11 days of my strict diet and i see no improvements yet. But i hope.

I recently bought The Paleo Approach. I have suspected I might have some sort of autoimmune problem for some time. Over the course of the last 2-3 years, I have had more and more pain. It started in my knee, then my left shoulder (frozen), then right knee, then left shoulder. This morning my elbow hurt. I know I need get it checked out but I’m not sure where to start. Which doctor would I go to first? It’s all very excruciating. I’ve been low carbing for 4 years to keep my blood sugar in check(I’m Type 2) but I don’t feel good on it. I don’t have any energy. I tried your protocol for 3 weeks but found it raised my blood sugar and I didn’t feel any different. Maybe I didn’t stick to it long enough. Could you possibly help me decide where to start 1st? I’m practically house bound.

If you are having trouble regulating your blood sugar on the AIP, you may need to reduce the amount of fruit/carbs you eat and/or increase the amount of fat and protein you eat with them. Traditionally, you would see a rheumatologist for pain and they would check for connective tissue disease like RA. You might also consider a functional MD or DO for a full-body approach. Sarah recommends both and as excellent directories for finding a practitioner. – Christina, Sarah’s assistant

I have multiple autoimmune syndrome, and have been incorporating some AIP principles for a while. My partner has non-Hodgkin’s lymphoma as a complication of a lifetime of undiagnosed celiac disease. I was actually searching for NHL stuff and your page popped up (Goggle probably knows I visit it often!), and was surprised to see NHL listed as an autoimmune disease. I think it would be worth clarifying in your post that NHL is a cancer and not an autoimmune disease, but that having an autoimmune disease can be a risk factor for NHL. Thanks for all your work Sarah!

Thank you for the informative article, I always learn so much from you. I’m confused about Chronic Fatigue Syndrome and autoimmunity. I have had reactivated Epstein Barr virus much of my life since I had Mono when I was 18. This caused chronic fatigue and a bunch of other symptoms over the years. It is now inactive due to a course of anti-viral herbs and other aspects of my health are slowly improving. I have been following AIP for a year. Would this qualify as an autoimmune condition or disease? I know I will have to keep it in check for the rest of my life. Thank you for any insight you can provide.

Hi Heather, how do you test for reactivated EB virus? I have all sorts of random symptoms and fatigue and low white blood cell counts – I had mono at 12 and wonder if this is my issue too. Hope you see this!

hi there
id like to know if the paleo diet could be adapted for a vegan or vegetarian

also, i read that restless leg syndrome is caused by lack of iron, is that completely wrong?

No, you cannot get adequate nutrition from Paleo if you do not consume animal products. Seafood and eggs would be sufficient, though. Mineral deficiencies do commonly cause twitchy limbs and can be diagnosed by your healthcare professional. – Christina, Sarah’s assistant

Hi, do you know if being itchy is an auto-immune response/symptom? (It started a couple of months ago- I just get insanely itchy somewhere on my body and if I can stop scratching for a minute it goes away)

My doctor says it’s a histamine response and to take antihistamines, but that’s not a good enough answer for me! I’d rather fix the problem than hide it!

Itching is most commonly thought of as a histamine response and may improve with antihistamines and a low-histamine diet. It could also be a symptom of food intolerance or some other environmental allergen, and some AIDs can result in dry, itchy skin. – Christina, Sarah’s assistant

I’m really starting to feel great on the AIP. Been on it for two months now. I personally think everyone after 30 should go on it to eliminate any potential problems and just for a detox.

I had no idea that Endometriosis was autoimmune. I have suffered with it for many years and no drugs or surgery ever helped. I was diagnosed with Lupus and RA two years ago and the AIP diet has really helped (been doing it for almost 30 days). Hopefully my endo will improve as well

My niece of 4 is just diagnosed with TRAPS. I know it has to do with genetics, but do you think the AIP would be helpful? Thank you in advance for answering.

I’m on day 12 of the AIP. Have done GAPS a few years back, and also have been grain free (mostly Paleo) for over 6 months. I’m wondering if you have ever heard of heart rhythm issues being autoimmune or allergy issues? I get racing episodes and 2 years ago was diagnosed with atrial flutter which would not resolve without a cardioversion. Not fun! So curious if you have ever run across heart rhythm issues/ racing particularly being connected to auto-immunity.

I was diagnosed with POTS (postural orthostatic tachycardia) which is associated with intense bouts of tachycardia and heart rhythm abnormalities that don’t necessarily have a heart structure cause . It has been linked to a variety of auto-immune disorders. I am starting the AIP in hopes that I will help heal the underlying cause of my POTS 🙂

My integrative medicine professional told me that the AIP is basically like the elimination diet…NOT something to do long term. What’s up with that?

my doc said my autoantibodies are slightly higher then normal but that it’s probably not a cause for concern… Could I have the beginnings of an autoimmune disease? Or is my problem something else? I have all of the symptoms….

2 1/2 months on autoimmune diet and haven’t sen changes in my psoriasis. Feeling discouraged. Maybe I haven’t given it time. Pressing on. Any advice would be greatly appreciated

Are you also following her article “Modifying Paleo to treat Psoriasis” from Paleo Mom?
I tried linking it, but it won’t let me. 🙁

Give it more time. You are battling years of negative inputs into your body. It may take up to a year to see significant improvement. But you also could have other triggers like stress, toxins or heavy metals that need to be addressed. Seek out a practitioner of Functional Medicine.

Have you heard/do you know anything about Sweet’s Syndrome? My 70 y/o father has developed it and I can’t find any studies about dietary changes helping it. But he’s just miserable with flare-ups

If cancer is an autoimmune disease and you’ve had chemotherapy to get rid of the cancer does this mean that your autoimmune disease is cured?

I have suspected an autoimmune disease for over a year now and my symptoms have just come to a head about 2 months ago, causing me to start on the AIP diet on my own and consult a doctor. He has tested me for everything he can think of as far as AI diseases are concerned and can’t find anything. I don’t want to be on this diet forever if I don’t have to, but shouldn’t it follow that if I’m finding some (frustratingly inconsistent) relief from AIP, that I must have some sort of AI disease? I really want a diagnosis to guide me in my healing path. What are your thoughts on maintaining this diet without an AI diagnosis?

Hello 🙂 I was wondering if you consider Raynaud’s Disease an autoimmune condition, (no known contributing factors). Some doctors say it is, and some say it’s not. What are your thoughts on this?
Thank you very much!

Hi Sarah!

I follow your website and your diet a little bit over a year. I’m glad that I found it and the diet helps to give me relief.
I have a question about a disease that my friends son has.
A year ago he was diagnosed with Henoch-Schönlein-Purpura and he already has kidney problems because of a delayed diagnosis and mistreatment.
The doctors told my friend that her boy only has 2-3 more years to live . He is only 10. So, they gave up on him.
Do you think that the autoimmune diet could help him? Could you recommend a specialist in Germany since we live there?
It would be so great if anyone could help with an answer. Thanks so much for reading!


I am so glad i found you and all this great information. Over the holidays I had what I thought was the flu – but no fever. Really achy joints and muscles. I felt like I had been run over by a truck. Then a couple of days ago I woke up with a swollen knee, and I have not had an injury.

For many months now my morning headaches, stuffed up nose, post nasal drip and vertigo are more and more prevalent. I can’t remember the last time I woke up without a headache! I believe I have some autoimmune issues going on. I am going to follow AIP for a few months and see what happens. Because how I feel now – it sucks!

I was diagnosed with Seronegative Inflammatory Arthritis about 12 months ago. I have been on medication during that time i.e anti-inflammatories and two different types of drugs to help with the Arthritis itself but they don’t seem to be working. I am not a fan of the next drug or any for that matter that they want to put me on and the only thing that gives me any relief is the anti-inflammaries. I have been gluten free for 4 years and follow some of the paleo eating however I have decided I would like to give the AIP a go. It scares me and I am afraid as I am quite tiny already that I will fade away to nothing but was also wondering if I can still take the drugs whilst I am doing the AIP or is it pointless?

About A-fib, read Dr. Carolyn Dean’s book on A-fib (Kindle) and her book Magnesium Miracle. Go to her blog and you can download some free pdf’s on magenesium info. She sells on her website a magnesium supplement that does not cause digestive problems. I have A-fib, and using her products have eliminated almost all my symptoms. Her products are pricey. I buy my magnesium from Amazon (Good State brand) at a more practical price. But occasionally buy them from her site because she saved my life and I want to support her for all the work she has done. Paleo has also made a huge difference. Look into this and do your research.

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