The paleo autoimmune protocol (aka AIP) was initiated by Dr. Loren Cordain, who read about the concept of paleolithic nutrition in 1987 from the New England Journal of Medicine. He discovered that certain foods can trigger an inflammatory response in genetically predisposed people. Almost 30 years have passed and paleo diet skyrocketed in popularity, however not much information was available on how paleo diet could benefit people with autoimmunity. Luckily Dr. Datis Kharrazian has done further research in this area and in his book “Why do I still have thyroid symptoms?” Dr. Kharrazian outlined the importance of going paleo if any form of autoimmunity is present. Furthermore, Dr. Sarah Ballantyne in her book “The Paleo Approach” provides a detailed information on how to implement the autoimmune protocol and gives an exhaustive list of foods to eat and avoid during the AIP. She also breaks down reintroduction of foods into four successive stages with a list of foods to reintroduce during each stage.
Shortly speaking, the autoimmune protocol is a specific diet (aka autoimmune paleo diet) that helps to heal “leaky gut”, a condition that leads to autoimmunity. As soon as the leaky gut is addressed, by removing foods that may cause sensitivities thus participating in formation of low-grade inflammation and by introducing certain supplements that assist in reparation of gut mucosa, immune system calms down and remission can occur. The autoimmune protocol is not a cure because once immune cells learn to attack your body they will store this information in their cellular memory (I wish we, humans, had such a terrific memory, which doesn’t slow down with age!). However, this protocol will stop your immune cells from permanently attacking your body, which will make your body and mind much stronger. Your reparatory capacities will drastically improve and your protective mechanisms (for example against seasonal viruses) will be more efficient. Remember, before your immune system was busy attacking various organs in your body and once you give it a rest your immune system will place a greater focus on the outer aggression.
Standard recommendation is to continue elimination diet of the AIP for 30 days minimum, but the time you will stay on the strict autoimmune diet may vary, depending on your condition. If you feel better after 30 days with many of your symptoms lessening and hopefully disappearing, you may start reintroducing foods slowly, one by one, while watching out for any unusual reactions (return of symptoms, insomnia, tingling and so on). If, however, most of your symptoms are still there, I would suggest to stay longer on the elimination diet, as your body probably needs more time to heal. You may also find using certain supplements helpful, just because several groups of foods are no longer present in your diet. I personally prefer to supplement with extra calcium because there are many controversial studies in regards with the amount of calcium human body needs and being a woman complicates the issue even further. I included calcium in its powdered form after 30 days on the AIP. Another very helpful supplement is L-Glutamine, it helps to restore gut barrier function and should be taken during elimination stage of the AIP. Depending on your individual needs you may consider including some other supplements.
FOODS TO EAT
The autoimmune protocol may seem intimidating and very restrictive from a layman’s point of view: no grains, no nuts, no dairy, no nightshades, no nothing…? In fact, the opposite holds true! When you give up restricted foods your taste buds will be thankful to discover many new flavors and you may be surprised to find out that some of the foods you neglected for so long can be that delicious! You won’t miss pizzas, cakes, potatoes or chips, as there are many healthy and tasty substitutes among fruits and vegetables what you can safely eat. Here is the list of foods that you can enjoy during the autoimmune protocol and beyond. However, make sure to exclude foods to which you have individual sensitivity or genuine allergy.
- Fruits (note of caution here not to overindulge into very sweet fruits, especially if you have candida or SIBO). Here I would like to mention that my personal struggle with candida has come to an end after I stopped gluten (makes me suspect a strong gluten-candida connection via leaky gut)
- Vegetables (eat a variety of vegetables and try to choose from a rainbow of colors to make sure that you benefit from vitamins, minerals and protective components that they provide)
- Quality fats and oils (lard, duck and goose fat, tallow, coconut oil, palm oil, olive oil, avocado oil)
- Animal proteins, such as fish, shellfish, poultry, red meat, frog legs… Choose organic meat as often as you possibly can, the best is free range, grass fed. Eat organ meats several times a week as they are densely packed with a number of very important nutrients including vitamins (such as iron, zinc, B vitamins etc) aminoacids and many other micronutrients that are usually lacking in people with autoimmune conditions
- Include prebiotics and probiotics (water kefir, kombucha and supplements, such as prescript assist)
- Sulfur-rich foods (onions, garlic, cruciferous vegetables)
- Certain spices (cinnamon, ginger, wasabi, horseradish, turmeric, mace)
- Aromatic herbs (basil, parsley, dill, mint, rosemary, sage, savory, lemongrass, lavender, chives, thyme, oregano, cilantro, tarragon and more)
FOODS TO AVOID
Foods avoided on the Autoimmune Protocol are those foods that have been shown to exacerbate intestinal permeability and lead to a leaky gut condition, therefore if you remove those foods your gut will have a chance to heal.
Shortly speaking, if you have an autoimmune condition (leaky gut is always present in any autoimmune condition) and you wish to take control over it and possibly to put it into remission, you can choose to adhere to a paleo diet, which means that you will give up grains, dairy, legumes, refined vegetable oils and refined sugars. Besides, during the initial stage of the Autoimmune Protocol you will avoid completely a number of foods listed below:
- Nuts and seeds
- Nightshades (potatoes, eggplants, peppers, tomatoes, tomatillos, goji berries)
- Spices (except the ones authorized)
- Alcoholic beverages
- Emulsifiers and thickeners (for example guar gum, carageenan often found in coconut milk)
- Non-nutritive sweeteners
- Any food additives
- Please also note that NSAIDS should be completely avoided, if possible, as they are known to cause intestinal permeability in the first place.
After the initial 30 days on the autoimmune protocol you can start reintroducing certain foods, provided that you have measurable improvements in your symptoms. It is important not to reintroduce foods before your symptoms improve, because you won’t be able to differentiate which foods are affecting you.
According to Dr. Ballantyne, foods should be reintroduced gradually, in four stages. Foods from stage 1 are much better tolerated and should be reintroduced first, before proceeding to the next stage. Here are the four stages of reintroductions:
- Egg yolks, green beans, snow peas, berry and seed-based spices, nut and seed oils, grass-fed ghee
- Egg whites, nuts (except pistachios and cashews) and seeds, grass-fed butter, cocoa
- Pistachios and cashews, grass-fed yogurt and kefir, coffee, eggplant, sweet peppers
- Gluten-free grains, rice, tomatoes, potatoes, chili peppers, grass-fed milk and cheese
Food challenges are done with one food at a time once every three to seven days, because IgG reactions can take anytime from several minutes to several days to manifest. When you reintroduce a new food take a small bite of it and wait for 15 to 30 minutes. If nothing happens you can take a bigger bite and wait for 30 more minutes. Again, if no symptoms manifest, take a bigger bite and wait for a couple of hours. This time take a normal size portion of the challenged food and monitor your symptoms for up to a week. Don’t eat this food while you monitor your symptoms and do not reintroduce any new foods during this time.
What symptoms should you watch out for if you react to a certain food? Food reactions can vary and include any of the following:
- gastrointestinal symptoms (gas, bloating, nausea, constipation etc)
- aches and pains
- mood swings or increased anxiety
- fatigue or reduced energy
- increased sensitivity to heat or cold
- trouble sleeping (insomnia or difficulty staying asleep)
- coughing or sneezing (due to mucus build up)
This is not an exhaustive list of symptoms that you may experience but any unusual reaction should be a signal to you that you react to that particular food.