Dr. Michael Ruscio, DC is a clinician, Naturopathic Practitioner, clinical researcher, author, and adjunct professor at the University of Bridgeport. His work has been published in peer-reviewed medical journals and he speaks at conferences around the globe.
How the Autoimmune Protocol Diet Can Work for Hashimoto’s, IBD, and More
Being diagnosed with an autoimmune disease like Hashimoto’s thyroiditis or inflammatory bowel disease, or experiencing autoimmune symptoms such as joint pain, brain fog, fatigue, and gut pain can be distressing. But it’s good to know that an elimination diet such as the autoimmune protocol (AIP) diet may reduce your symptoms and improve your quality of life.
It’s important to understand that, in spite of the name, an autoimmune protocol diet is not necessary for everyone who has an autoimmune disease. However, if less-restrictive diets haven’t been effective or this diet has been specifically recommended for you, it’s definitely worth a try.
The AIP diet can be a little daunting, but over time you’ll generally find a version of it that works for you. Once you know the basics of an AIP diet for beginners (which we’ll go through in this article), the rest is generally personalizing the diet to achieve the best results for your specific symptoms. Before getting into the details, here’s a quick overview.
The AIP Diet for Beginners: Quick Guide
The autoimmune protocol diet — also called the autoimmune Paleo diet — is a stricter version of Paleo eating that eliminates a wider variety of foods linked with triggering inflammation for those with autoimmunity.
In addition to being a gluten-free diet, AIP eliminates dairy, legumes, and grains, and also removes nightshade vegetables (e.g. tomatoes, peppers, and potatoes), nuts, seeds, eggs, and seed-derived spices.
Some small studies have shown the AIP diet can improve the symptoms of Hashimoto’s thyroiditis and inflammatory bowel conditions.
After the initial elimination phase of the AIP diet, you’ll reintroduce foods one by one, watching out for symptoms.
Over time you can use what you’ve learned about your food sensitivities to create a maintenance diet that works for you.
The restrictive nature of the AIP diet for beginners means it shouldn’t be your first choice in dealing with autoimmune symptoms.
You might try a standard Paleo or reduced-carb (low FODMAP) regimen first, only moving onto AIP if these don’t produce good enough symptom improvement.
How Diet Can Help Autoimmune Conditions
Excessive inflammation underlies many autoimmune conditions , which is where changes to your diet can help. By removing potentially inflammatory foods that may aggravate your symptoms, you can achieve some symptom relief. Identifying your worst trigger foods and then continuing to avoid them can help to maintain your autoimmune symptoms at a lower level .
Here are some general principles for an elimination and reintroduction approach:
Start with the least-restrictive diet framework possible.
Follow your new diet for two to three weeks and observe symptoms.
If symptoms improve, gradually reintroduce healthy foods while monitoring how you feel.
If symptoms don’t resolve, try a more specialized diet.
In functional medicine, it’s usually best to start with a lighter intervention first. For many people with autoimmune illnesses, a Paleo diet, which focuses on unprocessed whole foods close to the pattern humans were eating in Paleolithic times, is sufficiently anti-inflammatory to ease symptoms. For others, the low FODMAP diet, which removes the carbohydrates that trigger gut bacteria to produce a lot of gas, is helpful.
However, if neither of these diets works well, or if you experience just limited success with a standard Paleo diet, the more advanced AIP may be the best diet for you, at least in the short term.
Getting Started With AIP
There are three parts to any elimination diet: the elimination phase, the reintroduction phase, and the maintenance phase. Here’s how to work the AIP diet into your daily life for the best results.
To begin your AIP diet, eliminate eggs, grains, legumes, nuts and seeds, added sweeteners, alcohol, nightshade veggies, and processed foods (check the box below for a list of foods to eat or avoid). If you’re already following Paleo principles, you’ll likely already be gluten-free and dairy-free.
AIP Diet for Beginners: A Food List
Fine to Eat
Avoid at First
Nose-to-tail grass-fed or wild-caught animal proteins, including meat, fish, fowl, organ meats, and bone broth
All grains, eggs, and legumes, such as green beans, black beans, white beans, kidney beans, and garbanzo beans
Healthy fats and oils such as coconut oil, olive oil, avocados and avocado oil, and coconut milk
All nuts and seeds, such as almonds, walnuts, and chia seeds, including their derivatives like seed oils and vegetable oils; for example, canola oil, walnut oil, and almond flour
A wide variety of fresh fruits and veggies, including sweet potatoes, greens, lettuce, cucumbers, zucchini, berries, apples, and melon
Nightshade vegetables, including tomatoes, potatoes, peppers, eggplant, tomatillos, and spices derived from nightshades, like paprika and cayenne pepper
Non-dairy fermented foods, including sauerkraut, kombucha, and kimchi
All dairy products, including ghee, kefir, milk, cheese, and cream
Herbs and spices not derived from seeds, such as cinnamon, turmeric, thyme, oregano, basil, and rosemary
Spices derived from seeds, including fennel, cumin, dill, anise, mustard, coriander, and nutmeg
Stevia and maple syrup
Most added or artificial sweeteners and food additives, plus alcohol and coffee
If you don’t see any symptom improvement after two to three weeks, it’s likely that your symptoms aren’t related to the foods you eliminated on the AIP diet.
If you do notice improvement, continue the elimination phase until your symptoms plateau.
Once your symptoms have plateaued, it’s time to begin reintroductions. Reintroduce one food at a time, and watch for symptoms for 1-2 days before reintroducing additional foods. It’s most practical to start your reintroductions with the foods you miss most. Use a food diary to help you.
If you have a symptom flare after reintroducing a food, that food may need to stay out of your diet for a while longer. Keep in mind that some symptoms like stomach pain or headache will often be observed quite quickly, while others like joint pain or constipation may take more than 24 hours to show up. If you don’t notice any symptoms after 1-2 days, you can safely include it in your diet again.
Once you’ve reintroduced all the foods you want to test, use what you learned to create a custom diet plan that minimizes your symptoms while you focus on improving your gut health and other treatments.
Tips for Success
Making any diet change can feel overwhelming and challenging at first, so to make the AIP diet for beginners easier, try these few tips:
Find a few basic recipes that sound good and use them to develop a simple meal plan. Once you’re comfortable with your dietary changes and know which foods trigger your symptoms, research new recipes to expand your menu options.
Stock your pantry with ingredients you need for your basic meal plan, and remove all off-AIP plan foods. Make a few big batches of your simple starter recipes and load up your freezer.
Be as strict as possible about the diet during the first two to three weeks. This will help you feel better faster and give you better results during your food reintroductions.
Research on AIP and Autoimmunity
There’s not a wealth of data on the AIP diet, but the research we have is supportive and suggests the AIP diet can improve the quality of life and symptoms for people with autoimmune conditions. Consider these study results:
An 11-week AIP diet for patients with active inflammatory bowel disease (IBD) improved their quality of life .
Women with Hashimoto’s thyroiditis improved their quality of life and symptoms by using the AIP diet for 10 weeks . After following the AIP diet for Hashimoto’s, their tests showed no significant changes to any measures of thyroid gland function or thyroid antibodies, but inflammation decreased by an impressive 29%.
Inflammatory bowel disease patients who used the autoimmune protocol diet saw significantly improved IBD scores. Follow-up endoscopies after 11 weeks on the diet showed signs of mucosal healing in some patients .
The team that published the above findings regarding mucosal healing later performed follow-up research to see whether there were measurable changes in inflammation in the large intestine after following the AIP diet. They found significant improvements in the patients’ endoscopy scores, indicating the diet had reduced disease activity . However, the study had a very small sample size, so larger trials will need to be completed to confirm these results.
A few additional studies of nutrient-rich diet interventions similar to the AIP diet have also found a reduction in symptoms, inflammation, or specific blood markers, minerals, and plant foods.
For example, a 2020 systematic review found that a low-calorie, low-protein diet high in fiber; omega-3 and omega-6 polyunsaturated fatty acids; and vitamins A, B, C, D, and E; as well as calcium, zinc, selenium, iron, copper, and polyphenols, improved symptoms and quality of life for lupus patients . The AIP diet has a similar but not identical nutritional profile, and this result implies that it may have an impact on autoimmune symptoms.
A second systematic review found that lupus patients treated with omega-3 fatty acids, vitamin D, turmeric, and a diet low in high-glycemic foods reduced inflammation and improved blood pressure and fatigue .
Finally, a 2019 systematic review found that various dietary patterns impact high-sensitivity C-reactive protein, an inflammatory marker . Three months of the Paleolithic diet reduced CRP from baseline marginally.
To date, no studies have shown that the AIP diet reduces autoantibodies (the hallmark of many autoimmune ailments), but symptom improvement is certainly its own reward. There’s enough inferential evidence to warrant trying the AIP diet to see how your autoimmune condition responds, especially if you haven’t seen any symptom relief from a less-restrictive diet like the Paleo diet.
Understanding Autoimmune Disease
Autoimmune disease happens because your immune system mistakenly attacks your own tissues. Depending on which part of your body is being attacked, you may experience a wide range of symptoms, from fatigue to skin rashes, bloating and other gut problems, thyroid health issues, and chronic pain.
Autoimmune disorders affect approximately 16% of Americans and appear to be increasing in prevalence . Women account for 78% of autoimmune disease patients . Quality of life can be low for autoimmune patients whose disease isn’t under control.
Some of the most common autoimmune diseases are:
Inflammatory bowel diseases, like Crohn’s disease and celiac disease
The thyroid disorders Hashimoto’s thyroiditis and Graves’ disease
Lupus (systemic lupus erythematosus or SLE)
Multiple sclerosis (MS)
Type 1 diabetes
Swollen glands or lymph nodes
The Gut-Autoimmune Link
Your genes and stress level are two factors that can affect your chances of developing an autoimmune condition [11, 12]. However, disruptions in gut microbiota are also now thought to play a major role [11, 13, 14].
Out-of-balance gut bacteria can increase intestinal permeability [15, 16, 17], which causes a cascade of inflammation and an overzealous immune response. Increased intestinal permeability (a leaky gut) is thought to be particularly closely related to the development of autoimmune disease [18, 19, 20, 21, 22].
When you remove inflammatory foods, as happens in the AIP and other elimination diets, inflammation decreases, which may help to heal your gut lining and calm your overactive immune response.
In addition to dietary changes, you can give yourself a helping hand by taking a well-formulated probiotic supplement. Probiotics have been shown to:
If you have an autoimmune disease and haven’t seen any symptom relief from a basic elimination diet like the Paleo diet, the autoimmune protocol diet is a worthwhile option. It’s been shown to reduce symptoms and improve quality of life for inflammatory bowel disease and autoimmune thyroid disease patients.
Try the AIP diet for beginners with confidence by keeping things simple, creating a simplified meal plan, and preparing your pantry. Only stick with the diet after the first several weeks if you’re seeing symptom improvement. If you’re doing the AIP diet for Hashimoto’s, you can find more specific help here.
For more individualized help with autoimmune conditions, you can book an online consultation at the Ruscio Institute for Functional Health.
The Ruscio Institute has developed a range of high-quality formulations to help our patients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you.
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