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The WHYs behind the Autoimmune Protocol: Nuts and Seeds

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When it comes to understanding the whys behind the extra restrictions of the autoimmune protocol, it is usually easy to see the link between certain foods and increased intestinal permeability and/or interaction with the immune system.  In the case of nuts and seeds, however, it is actually much harder to make a very strong case for their removal from the diet for those with autoimmune conditions.

There are plenty of books and websites that list all nuts and seeds as foods to avoid on the paleo Autoimmune Protocol (for example, The Paleo Solution, It Starts With Food, and Practical Paleo).  The rationale ranges from none to a simple statement that nuts contain lectins and phytic acid.  However, as I have delved deeper into this subject, the science behind this argument is lacking.

It’s not about lectins.  As I have mentioned before, lectins are a class of sugar-binding proteins with a variety of functions in both plants and animals.  Almost every food contains lectins and this fact by itself is not sufficient to avoid eating something (otherwise we wouldn’t eat anything!).  The lectins that we avoid eating on a paleo diet are lectins such as gluten (and related lectins in other grains and legumes) that are known to survive cooking, be poorly digested, interact with the cells that line the gut, increase intestinal permeability and/or cross the intestinal barrier largely intact where they can stimulate the immune system.  To date, there is no scientific evidence that the lectins in nuts and seeds cross an intact gut barrier or prime the immune system.

It’s not about phytic acid (well, not much, anyway).  Nuts are relatively high in phytate, which is the salt of phytic acid, i.e., it is phytic acid bound to a mineral.  These minerals are not available for absorption, which is why consuming large amount of foods high in phytic acid and/or phytate is not a good idea (it leads to mineral deficiency).  And it certainly means that the minerals found in nuts are not really a good rationale for eating nuts, if we can’t absorb them very well (although I should mention that your gut microflora help release the minerals for you to absorb).  Consumption of excessive phytic acid/phytate may irritate the lining of the gut and contribute to a leaky gut by reducing the activity of a variety of digestive enzymes, including trypsin 1, pepsin 2, amylase and glucosidase 3.  However, phytate may also be an important antioxidant and help reduce cardiovascular risk factors and risk of developing cancer when consumed in moderate quantities 4.  Dose is important here.  But, this is an argument to limit nut consumption, not cut nuts out of our diets completely.

It isn’t about the omega-6 content of nuts.  Nuts tend to have much more omega-6 polyunsaturated fats than omega-3 polyunsaturated fats.  So, when one of the main goals of a paleo diet is to normalize the ratio of omega-3 to omega-6 fatty acid intake, eating large quantities of nuts is not helpful.  With the importance of resolving inflammation for those with autoimmune condition, increasing the amount of omega-3 fatty acids (and simultaneously decreasing omega-6 fatty acids) in the diet is critical.  Even walnuts, which have the highest omega-3 content of all nuts have a 1:3 ratio of omega-3 to omega-6, and these omega-3 fats are the short chain ALA fats which are not as readily used by the body as the longer chain DHA and EPA that are found in seafood and grass-fed meat.  Macadamias are the exception with the vast majority of their fat being monounsaturated.  However, in a diet rich in fish and grass-fed meat, small quantities of nuts that are conscientiously consumed should not be a problem.

So, why are nuts so uniformly restricted on the paleo autoimmune protocol?  Actually, they aren’t.  Two prominent examples are the opinions of Prof. Loren Cordain, author of The Paleo Diet and The Paleo Answer, and Dr. Terry Wahl’s, author of Food As Medicine and Minding My Mitochondria and well-known for her TedX-Iowa Talk.  Prof. Loren Cordain hesitantly recommends their removal for those with autoimmune disease with the following caveat:  “In addition to peanuts, which are not a nut at all, but a legume, tree nuts (almonds, walnuts, pecans, brazil nuts etc) are one of the most common allergenic foods.  To date, tree nuts have been poorly studied for antinutrient content, and it is unclear if they increase intestinal permeability of adversely affect the immune system.  This would be one of the last foods I suggest restricting [for those with autoimmune disease].” 5.  Dr. Terry Wahl’s lumps nuts in with grass-fed dairy and thoroughly-cooked sprouted legumes as foods she consumes “very little” of but doesn’t restrict altogether 6.

It boils down to two simple facts.  Tree nuts are one of the top allergens and most common food sensitivities.  People with autoimmune disease are very likely to have a leaky gut, which increases their susceptibility to developing food allergies and food sensitivities (the difference is in the type of antibody formed).  This means that people with autoimmune disease are more likely to have a sensitivity or allergy to nuts (and seeds) than other people.  And cutting nuts out of the diet using an elimination diet approach such as the autoimmune protocol is a good way to isolate whether or not nuts are a problem for you.  If you continue to eat something that you have an allergy or sensitivity to, it is very difficult for your gut to heal and for your immune system to deactivate. 

 Additionally, the fiber in nuts and seeds can be difficult to digest, particularly almonds, pistachios and hazelnuts (read my FODMAP post), which is an additional way that some people can be sensitive to them.

I personally have found that avoiding almonds has been very important for me although I seem to be able to handle small amounts (like 1-2 ounces) of other nuts (typically macadamias, walnuts and pecans).  Larger amounts of nuts do seem to be a problem for me and I attribute this to the omega-6 contribution that they make to my diet.  I still think it’s important to remove nuts and seeds from your diet, at least for a month, when you first start the autoimmune protocol.  However, unlike tomatoes or egg whites, which have a much higher ability to be problematic, reintroduction of individual nuts and seeds should only worsen your symptoms if you have a sensitivity.

 

 

1 Singh M and Krikorian AD “Inhibition of trypsin activity in vitro by phytate” J. Agric. Food Chem., 1982, 30 (4), pp 799–800

2 Vaintraub IA and Bulmaga VP.“Effect of phytate on the in vitro activity of digestive proteinases” J. Agric. Food Chem., 1991, 39 (5), pp 859–861

3 Kunyanga CN et al “Antioxidant and type 2 diabetes related functional properties of phytic acid extract from Kenyan local food ingredients: effects of traditional processing methods.” Ecol Food Nutr. 2011 Sep-Oct;50(5):452-71.

4 Food Phytates; N.R. Reddy and S.K. Sathe, editors. 2002

5 http://thepaleodiet.com/hidradenitis-suppurativa/
6 http://www.thepreparationstation.com/2011/terry-wahls-md-cured-her-ms-with-a-paleodieta-paleodiet/

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Reader Interactions

Comments

  1. Sarah, I will be starting the auto immune protocol in a few days and I’m both hesitant and excited. My family and I have been on the Paleo diet since the end of March and we’ve been doing really well. I was diagnosed with vitilgo 5 years ago. It’s only in the last year that I’ve finally made the connection between my diet and my health. This will be my next big step and I’m looking forward to some positive results. All the information you share is every encouraging. Thank you!

    Reply

  2. Hi Sarah! What about cashews… where do they fall on the list?? I have been on the AIP for 2 months with no nuts at all (and seeing this post makes me think it’s time to try to add something back!) 🙂 thanks!

    Reply

    • Cashews can have issues based on being a nut/drupe and also because they come from the same family as poison ivy. Some people will be sensitive to them and not other nuts, and vice versa. I would try them, up to you what order (remember to just try one type of nut at a time, giving 3-4 days in between).

      Reply

  3. It was really timely for me to read this. I have been following the Paleo AI protocol for only a week…but I haven’t dropped nuts and seeds yet as it all seemed a bit overwhelming. I have Grave’s Disease and Celiacs. I have been egg and dairy intolerant for about 18 months. My doctor is certain I have leaky gut. I have found taking out all grains and nightshade vegetables has made a HUGE difference in just a week. I actually don’t have brain fog anymore and I am sleeping again. I will now take out the nuts/seeds as well..

    Reply

  4. This is encouraging. I got rather depressed after your nightshade post as it made me realize I may never get my beloved peppers back. But after reading this, I am at least hopeful that I can try adding the seed spices back in at some point – hello cumin and coriander. I also have Graves and am struggling a bit to get fully on board with the protocol. I come here pretty much daily for some inspiration and motivation as understanding the WHYs really helps me stay on track.

    Reply

  6. Thank you. What does this mean? “However, unlike tomatoes or egg whites, which have a much higher ability to be problematic, reintroduction of individual nuts and seeds should only worsen your symptoms if you have a sensitivity.”

    Reply

    • It means that tomatoes and eggs can cause problems through mechanisms different than the immune reactions that happen in the case of food sensitivities. Specifically, the lysozyme in egg white can act as a transporter for foreign proteins across the gut and the saponin alpha-tomatine in tomatoes can ramp up an immune reaction through its adjuvant activity.

      Reply

    • Some people tolerate it better than nuts because soaking removes the some of the anti nutrients and removing the pulp gets rid of most of the fiber. But, if you are sensitive, you will still be sensitive to nut milk. I definitely recommend leaving it out in the beginning.

      Reply

    • Seeds in fruit are meant to be eaten (and then planted in very fertile soil on the other end of the digestive tracts) compared to seeds that are designed to be spread by wind, etc. I consider foods with edible seeds (pomegranate, berries, zucchini, cucumber, etc.) to be a gray area. Some people tolerate them and some don’t (similar to berry spices).

      Reply

  9. This article is so informative ! Thanks so much. I had to start an anti-TNF called Remicade one month ago. This treatment is the only one which relieves me, after having tried to heal naturally then with different drugs.
    The bad news is I can not do any food allergy testing while on this drug. Before I started Remicade, I became allergic to almost everything ( Crohns, severe pain in stomach)in a 2 month time . It was impossible to identify the culprits. I have a deep feeling that sprouted bread – even small amounts, but repeated over one month – has been the initial trigger for my flare, then eggs.
    I had no grains and no eggs for the last 3 months and might l avoid them for good. I have re-introduced almond butter and macadamias on a daily basis, without any pain. Do you think it is possible that my body is not allergic anymore to nuts as my gut is healing ? Or is it just hidden by the fact I am having a medication which hides a possible allergy ?

    Reply

    • I think it’s more likely being masked by the medications. I typically recommend that people follow the strict autoimmune protocol until their symptoms are on remission and their need for medications ceases. That being said, it is still completely possible that you may be able to reintroduce them successfully.

      Reply

      • Hello, I wonder if you can tell me what’s wrong with whole coconut. Is it the fiber or something else? And would there be any reason for getting bad reaction to coconut oil? I feel it’s not quite safe for me, but I know sometimes I’m a bit paranoid about my bodily reactions…. Any thoughts on this would be very much appreciated!

        Reply

        • Coconut allergy/sensitivity is entirely possible, especially if the oil seems to trouble you. Many people have trouble with the inulin fiber in the meat, but do okay with the oil and milk. – Christina, Sarah’s assistant

          Reply

  11. How does food allergy/sensitivity testing play into this? I have an Hashimotos and recently got my food allergy/sensitivity test done. Many of the ones I already suspected showed up (gluten/wheat/barley, dairy, tomatoes, coffee), and I have already cut those out anyway. The only nuts that showed sensitivity were peanuts and walnuts. I did not show any significant sensitivities to almonds or cashews. I am starting a strict elimination period based on all the foods that showed sensitivities, but should I also cut out all nuts and seeds during this period as well? I guess what I am asking is, can I use food sensitivity testing as a basis for which nuts and seeds I can eat, or is it still a good idea to go through the elimination and reintroduction process to make sure?

    Reply

  12. If the leaky gut is the reason for nuts causing food allergies than reintroducing them after leaky gut is healed should be fine.
    On the omega 6 content the “small amounts” needs to be emphasized though. To balance omega 6 from 100 grams of walnuts one needs to eat 1 kg of salmon.

    Reply

  13. What about chia seeds? I have Hashimoto’s. Have gone gluten-free and am educating myself about/ working toward a transition to Paleo. Introduced chia seeds a few months ago, and the only change I’ve noticed is that I’m not losing nearly as much hair in the shower every day.

    Reply

  14. I love almonds and ate a ton of them without issue before trying the AIP. Other nuts (pecans, walnuts, macadamia) I had to limit because they were migraine triggers. (Just as background, I have been gluten free for about 3 years–celiac testing was negative but I had been gf for a year before they tested me, dairy free for 20 because of sensitivity, and have a severe shellfish allergy, My husband went paleo over a year ago so I’ve been mostly paleo since then (still would do gf flours occasionally) However, after almonds for 45 days of autoimmune I decided to try a reintroduction and everytime I have almonds or almond flour I get stomach pain and bloating. Wth? I ate almond butter on everything without noticing a reaction, why would avoiding it and then reintroducing it allow the reaction to show? I’ve successfully reintroduced eggs (but I limit them) and nightshade spices without reactivity. I would appreciate hearing your thoughts. Thanks!

    Reply

    • The whole point of an elimination diet is that it allows you to see those reactions more clearly. There’s two reasons: your body has natural defense mechanisms to protect itself from foods that harm it (like increasing the thickness of the mucus layer in the gut). When you cut out a food that you are sensitive to, you stop protecting yourself against it, so when you have it again, the reaction is bigger. The other reason is that when you eat something frequently, you don’t necessarily really notice that you feel a little crumby when you eat it. Stopping for a while, you gradually feel better and better, then when you eat that food and feel crummy like you used to, it feels more dramatic because it’s been a while since you felt that way and you feel so good now.

      Reply

      • I knew you would be able to explain it. I so appreciate you! Your blog is the one thats made paleo and AIP do-able for me because you explain it in a way that makes sense. Thanks!

        Reply

  15. What a wonderful post, OMG I have just learnt so much more about the AIP. I thought I knew everything about paleo….Thank you so much! ?:-)
    Quick questions – how about chestnuts and squashes/pumpkins? Winter types. I prefer to use them instead of fruit for denser carbs, are they ok?
    Chestnuts seem to be ok with me – Crohns disease – but regular nuts and seeds are not as you suggested. I can get whole or grated chestnuts here in Hungary and they are a good carb source I assumed. Should I ditch them for now? Thank you! 🙂

    Reply

  16. I was leading a candida diet for alopecia and I guess it all leads back to the same thing with autoimmune diseases; heal our guts and eat non-inflammatory foods. I am going to do the even stricter AIP now. Wondering if hemp seeds are a no?

    Reply

  17. Wow, thanks PaleoMom for all of your guidance and science based explanations. I am impressed (and relieved) to see so many recipes that provide such a great variety. It’s hard for me to think about life without milk, cereal and cookies!!! I have denied that I have an issue because “I’ve been OK for 40+ years”. Unfortunately this came to a screeching halt when I was diagnosed with MS 3 years ago. I have continued to exercise, keep my weight in check but I continued to have extreme fatigue as well as other MS symptoms. I surely thought it had NOTHING to do with my diet but low and behold I have had 4 months of new onset extreme, generalized pruritis with my continued fatigue. Despite multiple medication attempts, and a medication vacation from my MS meds, I still have these symptoms. When 3 different people (2 of them my MD friends) asked me if I considered a paleo diet, I thought there would be some hope for me. I have eliminated gluten from my diet and am working toward the paleo diet and ultimately will try the AIP. I really hope this can help with my pruritis and my MS symtoms as well. My question to you is HOW the heck do you manage 3 meals per day without using the convenient foods we Americans have grown dependent using? Any tricks?

    Reply

    • I make a batch of homemade sausage, cook it (baked in the oven) and freeze for very fast breakfasts. I usually make 6 lbs at a time, which lasts me almost three weeks (I’m the only one who eats it because the rest of the family has eggs for breakfast). I typically grab some lettuce or other greens, some homeade sauerkraut and some fruit for the side. Lunches for me usually are either leftovers or canned fish with some raw veggies (or sometimes leftover cooked veggies). These are also super easy. My kids typically have grass-fed deli meats and veggies and fruit (although my youngest also loves canned fish and will often join me). When I cook supper, I plan for leftovers. It’s pretty typical for me to cook once every 2-4 days with maybe making a few extra vegetables in between. So, basically, I commit larger chunks of time less frequently.

      Reply

      • I’ve found that “batch cooking” is a great aid to having appropriate food available at all times (though I only cook for one–imagine it is really helpful when you’re cooking for a family!).
        I also do batch shopping for protein, and then portion the food for the freezer. Yesterday the local Whole Foods had a 1/2 price sale on wild coho. You *know* I snapped up 3 pounds, and with a big smile on my face!

        Reply

  18. Hi Sarah, thanks for all that you do, I find your information so helpful, and your writing style so enjoyable to read.
    My question is about nut sensitivity. I am noticing lately that when I eat some nuts (or even homemade nut milk) I get a kind of tingly rawness on my tongue, almost like a very mild version of when you stick your tongue on a 9-volt battery (I’m not the only one who did that right?), that lasts for several hours, as well as a little catch in my throat, like I need to clear it, that doesn’t last very long. Are these signals of intolerance? I haven’t been able to find any references about this anywhere. Macadamias seem fine, almonds not so much.
    Any thoughts?
    Thanks again,
    Kellie

    Reply

    • I get the exact same sensation when I eat raspberries. I have always associated it with an allergy. Certainly, itchy mouth or throat is definitely a allergy symptom (this would be a true allergy, rather than a sensitivity or intolerance), and allergies can cause swelling in the tongue and throat, which could also account for the sensations. The few occasional that I have has raspberries in the last few months, I haven’t noticed anything (although I still didn’t particularly like them), which might just say something about the level of inflammation I my body now. Anyway, I would say that whatever is going on, your body is telling you that nuts aren’t a good idea (at least for now). Although if you’re okay with some nuts, I think it’s probably okay to keep eating those (macadamias are pretty different from other nuts too, in a good way in terms of allergies).

      Reply

          • Thank you both for this little thread.

            I found your blog and this post after searching for “homemade nut milk tongue sensitivity.” I too get that 9-volt-battery feeling in my tongue with my homemade nut milks. I was trying to avoid the carrageenan I’ve been hearing so many bad things about — so I started making my own. Homemade almond milk always gave me sensitivity issues so I switched to hazelnut, but now (after a few months of making hazelnut milk with no problems), it just gave me that sensitive 9-volt-battery feeling.

            I’m quite sad to have to cut out nut milks as I’m not a huge dairy fan either… but I’m sure I’ll find something suitable to put on my granola. Of course, after I explore your site a bit more, I’m sure I’ll discover much better things to eat! 🙂

            Thank you! -Christine

          • Oh my… the whole reason I commented here (before I got side-tracked with my back-story) was to THANK YOU for sharing your allergy issues here so that I know I’m not the only one in the world with this problem. :]

  19. Thank you so much for all of this wonderful information. I am preparing myself to start this diet. I will miss my eggs for sure :(. Are flax seeds ok? Thank you.

    Reply

  20. thanks for the great info,
    my husband has auto immune, eczema,a peanut allergy and what we think is ? auto immune inner ear disease/disorder. AIED. causing vertigo, fullness in the head/ear amongst other things. he was diagnosed as having Meniere’s Disease, this was without us and the specialist realising about the AID so we are investigating further.
    we have just started the AIP today! fingers crossed for some relief.

    Thanks Zoe

    Reply

    • Zoe-Your post is almost a year old. I am wondering how your husband has been doing. I, too, have autoimmune inner ear disease profound deafness in my left ear. This has been going on for about 13 years with a severe flare-up 3 years ago. I feel like I am still recovering from the intense steroid treatment. I did an elimination diet 2 years ago but didn’t add things back slowly – just went right back to standard american diet and drinking! So now I’m starting again. My hearing is stable and I haven’t had severe vertigo since the flare up but now my joints and muscles are aching so much I can hardly walk. I would love to hear how the AIP has worked for your husband. Thanks!

      Reply

  21. Thanks for a straight answer on this! I have frequently wondered about coconut and it’s so good to hear that despite losing my coffee, cheese, eggs, and red wine, at least I can still have my coconut milk (and the occasional whole product treat)! You autoimmune protocol info is priceless – thank you for doing what you do!

    Reply

  22. Thank you so much for this post …… I know for a fact I have dairy intolerances but can manage a small amount but I’m suffering huge outbreaks the last few days after making a paleo pizza with ground almonds and have been trying to figure out the culprit ….. My poor back has been on FIRE, and really itchy and I’ve also been headachy, could all these symptoms be coming just from the almonds?

    Reply

  23. The last few days I have tried to look at the “recipes” under the recipes tab but no matter which one I click on it takes me to egg free muffin recipe or the spaghetti and meatballs recipe. These are the only 2 recipes I see. I would really like to see the others, is there something I am doing wrong? Thank you so much!

    Reply

  24. Thank you for your wonderful posts. I have not read anything about pumpkin seeds. You say yes to pumpkins and squashes, so wonder if their seeds are part of that when dried. I love the pumpkin seed butter. Thank you so much for all your amazing expertise and love that you share here.

    Reply

  25. Thank you. I just started the AIP, finding the first week doable and not feeling deprived or missing any of the foods I have eliminated. I have Menieres Disease and Hashimoto. I thought I was eating healthy before, but I learned there are a few saboteurs pretending to be healthy – causing me grieve and discomfort.

    Reply

  26. Sarah, your maternal guidance, knowledge and confidence have been a Godsend to me since my recent MS diagnosis. My neurologist had me give up gluten, and I cut out the rest and went AIP after reading about Terry Wahls. Thankfully my MS is mild and I hope to keep it that way. Over the past few days I indulged in some raw, although Whole Foods purchased, cocoa covered kale chips and also a 1/4 cup of walnuts. these were the only two introductions I have made in my diet in over 6 weeks. I finally realized last night that either the caffeine in the cocoa or the walnuts were the reason for the return of my myoclonic jerk in my arm. Do you have a guess as to which it most likely was, although both are out of my house for good now.

    Reply

    • It could be either. I’m personally extremely sensitive to chocolate (not that I don’t sometimes make a bad decision and eat some anyway). Chocolate is extremely high in phytic acid too. Next time you reintroduce, just try one thing at a time. 🙂

      Reply

  28. In another post you recommended almond milk to someone. Is it safe to drink homemade almond milk instead of the dairy you have to cut out on the protocol? Also if you want to avoid supplements where would your calcium come from?Thank you again.

    Reply

  29. Im having pricking sensations randomly all over the body mainly knees and hands, fingers, face from eating flax seeds. does this mean Im a bit allergic? Thanks

    Reply

    • There are so many different allergic reactions, certainly this sounds like it may be a reaction to the flax. You should always check with your doctor to be sure. — Tamar, Sarah’s assistant

      Reply

    • Hi Angie, I had similar problems with flax and it made my fingers and hands go all puffy and tingly. I recently discovered that it’s listed as being goitrogenic so if you have thyroid issues, best to avoid it.

      Reply

  30. Why not nuts and seeds? Or coffee, for that matter? I’ve been reading that the tannins in these foods may be the problem. I’m interested in your expert opinion on this!

    Reply

  31. I have a question I am hoping someone can answer. I’m seeing a lot of contradictions on cross allergies with nuts & coconuts. Given, a coconut is a drupe not a tree nut. But, so are almonds, cashews, macadamias, walnuts etc. Indeed most ‘tree nuts’ we eat are actually drupes (hazelnut is the one exception I can think of). So why is it the other drupes are to be avoided & then tested as allergens on the AIP elimination protocol, but not coconuts?, if one finds they have an allergy to drupes, should one not be concerned that they also have an allergy to coconut? I am just surprised they allowed up front.
    Thank you!

    Reply

    • There isn’t much cross-reactivity because coconut palms are not actually trees (botanically, they are more closely related to grasses than trees). That’s why coconut are typically fine for people with tree nut allergies.

      Reply

      • So they are a grain? (yes I’m being silly! 🙂 )

        Funny you say that, as while I was researching further, I found an article that said botanists aren’t sure how to classify coconuts and aren’t even sure how/where they evolved from – they seem to be their own ‘animal’ so to speak (http://www.loc.gov/rr/scitech/mysteries/coconut.html). So it appears they have no anti-consumption defense mechanisms either (other than that super hard to open shell!)?

        And thank you for your response – and for all your information and books! 🙂 As a fellow scientist I like to know where my information is coming from; it can be hard trying to separate the wheat from the chaff (sorry non-paleo analogy!). Few people back up their ‘facts’ with anything more than anecdotal evidence (not that anecdotal evidence doesn’t have merit, but a study of n=1 & cherry picking from those scenarios is not convincing me that you are not selling snake oil). I really appreciate all the work you have put into your literature!

        Reply

  33. Hello! I have just developed eczema (out of nowhere..so strange) and it is spreading pretty quickly. So I have been reading up on these “elimination diets” .
    3 questions:
    1) Some people say hemp seeds are good for you in this diet. Is this true?
    3) What about Quinoa? I read that this was okay too??
    2) and Where can I find some recipe ideas for this elimination diet…has someone come up with this…at least a couple weeks of some ideas to make this easier?

    Thank you a million! Not fun! 😉

    Reply

  34. And… 2 more questions:
    The other website said garbanzo beans and navy beans are okay. Is this true?

    Thank you thank you! I’m ready to eat what ever:)

    Reply

  35. Could you please explain why chia seeds are included in the new book with Mickey trescott but you state here chia is not AIP. I am upset by the confusion

    Reply

  36. I just got The Paleo Approach (yay!), and I have a question about cocoa butter. I know chocolate is not approved, but what about pure cocoa butter? It doesn’t have caffeine, but I haven’t yet been able to find any information on whether or not it contains lectins (I’m not even sure that pure fat can contain lectins), and I’m unsure if the omega 6 content is very high. That said I know all the oils and flours from nuts and seeds are not approved, so I’m thinking this means cocoa butter is in the same boat.

    If that’s the case, what about using cocoa butter on the skin or lips? I make my own lotion bars that contain cocoa butter and sometimes use it as a lip balm. Would that amount be enough to prevent healing?

    Reply

    • Sarah still recommends eliminating cocoa butter along with chocolate, but it should be safe for most people except those with severe chcocolate sensitivity. – Christina, Sarah’s assistant

      Reply

  37. Dang it, I got so excited reading the first part of this article like “OMG I have finally found an answer!”. But nope, no answers. My body hates all nuts and seeds (that I’ve tried) in virtually any quantity. After reading this and thinking about the timing – how long after I eat them – I am thinking it’s either the fiber fermenting in the large intestine or the O-6, or a combo.

    Reply

    • It could also be a histamine reaction. I must admit I *love* macadamia nuts and ate loads of them on a keto diet…but they were making me ill. I would get puffy hands and didn’t feel good at all after eating them. They’re difficult to digest and digestion is involved with histamine, so they’re a real stress on the body and I’m guessing cause extra inflammation.

      Reply

  38. I have been treating my daughter’s ( now 4yrs old ) eczema with a nutrient dense food diet for over a year. We first started gluten free for the first year and of course we did not see the results we wanted. We then did the gaps diet and saw great results for the first few months, then it all went back to square one after some time on full gaps. Im sure that I moved to fast on certain foods, its the only thing that make sense to me.
    I now have the paleo approach for aip, I really like the science behind all of the food. We are pretty much back to an elimination diet. My question is why are macadamias okay and are berries with seeds safe?

    Reply

  40. What about seed oils – hemp seed oil, poppy seed oil, pumpkin seed oil etc? Are they a no, too? I have been paleo for two months now, am feeling and sleeping better, have lost weight, but my eczema and allergies are getting worse. I thought this was a sign of improvement (things getting worse before they get better) but right now, as I’m reading through your blog, I guess it’s rather a reaction to the tons of nuts, seeds and eggs I started eating. I definitely want to try AIP now but still am curious: do I have to sacrifice seed oils as well or are they different from the very seeds?

    Reply

  41. I am 41 years old and I have Alopecia Universalis which started as Alopecia Areata in early 2011 and progressed to Alopecia Universalis midway through last year. It seems like it happened right after a bad tooth infection. I took antibiotics for the first time in 20+ years with that infection and the tooth was initially root canaled. I had the root canal removed as well in 2013. I did read your book which was an amazing read and resource. I have been strict AIP for 4 months now following it very closely. I wasn’t expecting a miracle but I have not seen any change at all. I was wondering if that could mean it is not food related. I would love to reintroduce foods but its hard since I have no digestive distress or pain of any sort and my only indication of things getting better would be some hair growth. I had a food allergy blood test taken in 2011 that didn’t show any allergies. I can’t recall right now which type of test that was in 2011. Do you think I should reintroduce any foods or just keep on the path for a while longer?

    Reply

    • Have you looked at the troubleshooting guide in the back of the book? It may shed some light on areas within the AIP that could use some improvement or further investigation. If you feel ready, you can always try reintroducing foods and see how it goes, then cut back to the AIP if you do notice reactions. – Christina, Sarah’s assistant

      Reply

  42. Hi sarah, thank you so much for all your information! I have a question for you, I am a former vegan gone paleo for the past four months! Every time I eat beef,lamb or chicken including broth I get hives all over my body! What should I do? Thank you so much!

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  43. If I cut nuts and eggs out of my diet and still try and stay paleo what would I have for breakfast, currently I have eggs most days or granola which has a lot of nuts in it. I wouldn’t even know where to start if I cut those out.

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  44. Can I have coconut products if I am on the AIP diet? How are they ok while other nuts should be avoided?

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  45. I see that several people have asked about hemp seeds, and that the answer is no. I understand, but I have a further question. I am sensitive to shellfish and I am not allergic/sensitive to fish but I have not ever liked any fish, even the ones people claim are “not fishy.” My former way of choking down fish was to drown it something like mac and cheese, or breaded fish sticks loaded with lemon juice and ketchup–none of which is an option anymore now that I’m gluten and dairy intolerant.

    Hence, I found hemp seeds and hemp milk as a way of getting a good ratio of omega-3s and 6s. I also am not much a fan of organ meat. I could eat it, but it’d be the old choking-it-down thing. So finally the question: since i am not likely to eat fish, shellfish, or organ meat in any significant quantity and eggs and hemp products are off the plate, am I going to cause myself problems for not getting sufficient 3s and 6s?

    Reply

    • If you are allergic to seafood, organ meats are the best source of omega-3s. Sarah has written two things on the subject: 1) Really reduce your intake of omega-6s by choosing grass-fed meats and fats and avoiding or severely limiting nuts/seeds and poultry and 2) Eat seafood and organ meats anyway. – Christina, Sarah’s assistant

      Reply

  46. Thanks. Yes, I do grass-fed meats. But sorry, seafood is not an option, as i mentioned, I am way too sensitive, it’s worse than my gluten sensitivity, which I am extremely reactive. So it sounds like the answer is yes, I will be deficient in omegas unless I try to choke down organ meat. Too bad I can’t drown it in Mac and Cheese. Very discouraging. Thanks for your time anyhow.

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  47. And what about sunflower seeds? I’m not sure if I can eat them. I’ve heard that they’re not so harmful when they’re roasted, is it true?

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  52. You said “To date, there is no scientific evidence that the lectins in nuts and seeds cross an intact gut barrier or prime the immune system”

    What then, is the specific evidence that the lectins in grains cross an intact gut barrier or prime the immune system?

    Reply

  53. i can eliminate them for at least a month. I suspect I do not have a problem with most nuts. But, I’m wondering how almond Milk and cashew milk fit in? I love them, & feel they are a good substitute for dairy in recipes. I probably consume one serving per day. Thoughts?

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  54. If I’ve done the ELISA food sensitivity test, does this mean I can stop the AIP and go back to regular paleo? None of the AIP flagged foods were positive for me.

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  55. Hi,
    I was wondering why nuts and seeds are not allowed in autoimmune paleo but you can still eat fruit that contain seeds. What is the difference between for example a watermelon seed and a sesame seed?

    Reply

  56. This topic came up on the Facebook page and I am really interested to know the answer. What about the seeds in berries? I have been doing AIP for 3 weeks and was so happy to reintroduce seeds first after 30 days. However I have been using berries in my smoothies (strawberries, blackberries, and blueberries) which all include seeds. Do I have to start over again?! I hope not. Please let me know so I know what step to take next.

    Reply

  57. Hello Paleo Mom, first can I say thank you. Thank you for the time and dedication that you have invested in this field. You are paving the way for so many of us. When I was 13 I was diagnosed with Juvenille Rheumatoid Arthritis. I’ve had ups and downs. On meds, off meds. It’s been a roller coaster. I have been trying to manage my swelling (my left knee swells up when not on meds) through diet for the past 4 months. I did a 21 day Cleanse (Alejandro Junger) and then amped it up anotch with the Myer’s Way (Amy Myers). Both Junger and Myers maintain that 100% Cacao (NOT cocoa) is okay on the the Autoimmune Protocol but I’ve read from some others that cacao is NOT okay. What are your findings/opinion on the matter? I highly regard what you have to say due to your research-based approach. Your response would be appreciated. Thank you.

    Reply

    • For arthritis forget supplements. Stop ingesting the causes, lectins. Arthritis-causing lectins are in grassy grains (wheat, barley, rye and oats), in legumes (beans, peas and peanuts), and in nightshades (potatoes, tomatoes and peppers). Aggravating the arthritic condition is fructose. Fructose is in any food which tastes sweet. The combination of fructose and any of the above foods opens intestine tight junctions and allows them into the bloodstream.

      Get your nutrients from meat and fat …..especially fat.

      Reply

  59. Almonds in the United States are irradiated which is a problem for our liver as our liver can’t handle very well irradiated nuts. Both organic and inorganic almonds are irradiated. Most all other countries don’t irradiate almonds

    Reply

  61. Hi Sarah
    I have Graves, and have been following the AIP for approx 18 months. I feel great and got my condition into remission within 5 months of following the AIP way.
    So thankful I found your page and to you for your incredible knowledge and insight to the complexities of health and autoimmune.
    I am now taking a look into my bathroom products and can’t seem to find a natural body lotion that doesn’t contain nuts or seeds.
    How potentially damaging is it to have seeds/nuts in body products for someone with an autoimmune.?
    (I do eat almond meal sometimes when baking and don’t appear to have an issue.)
    Thank you
    Bronte

    Reply

  62. foods containing phytic acid have caused my MS. the day that i stopped eating foods high in phytic acid is the day i started to improve. just because there is an absence of studies/data doesn’t mean something is not true.

    phytic acid leaks from the gut.
    phytic acid crosses the blood brain barrier in rats
    phytic acid triggers an immune response that damages my cns

    my degrees are in research methods and statistics. this post is not baloney.

    john PhD

    Reply

  63. What about SPROUTED beans and seeds? My understanding is that much of the composition of what you’re eating changes in the process from a seed to a sprout….

    Reply

    • Sprouted beans and seeds can be good options, however I would still recommend eliminating them on the autoimmune protocol for at least 30 days before reintroducing them. -Kiersten

      Reply

  64. I’m sorry, I don’t know what you mean when you say the fiber in nuts can be difficult to digest. Fiber isn’t digested. It’s roughage. That’s why it moves things through your system. Is this a typo? Thanks. 🙂

    Reply

  65. This explained nuts, but not so much seeds. Why are raw pumpkin seeds to be avoided- but the seeds in berries and bananas okay?

    Reply

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