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“Things are not quite so simple always as black and white.”
~ Doris Lessing
Frequently Asked Questions
When we embark on a healing diet, the hope is that we can reverse our autoimmune disease, heal our bodies at a deep level, regain abilities, and reduce or eliminate our need for medication. But that’s not something that happens overnight. Today, I’m answering the most common questions people ask about medications and the paleo diet.
Should I Go Off My Medications When I Start the Diet?
The short answer is No. Healing through diet and lifestyle takes time, and if you go off your medication before your body has a chance to heal, you will most likely have an autoimmune flare. I’ve interviewed a number of healthcare practitioners and paleo leaders, and they all agree on this point. The one exception might be people who start a healing diet immediately after diagnosis, before going on medication. Sometimes it’s possible to avoid meds at this stage, but not always. Work closely with your doctor when making this decision, because when when autoimmune disease is active, it can cause permanent damage to your body. Dr. Sarah Ballantyne sums it up in her book, The Paleo Approach:
“Changing, tapering, or discontinuing your medication – especially if you are taking prescription drugs, but also any daily over-the-counter medication that your doctor may have recommended – should, without exception, be done under the supervision of a health care professional. I must also emphasize that changing your medication is not, in most cases, something to tackle when you initially adopt the Paleo Approach. By improving your diet and addressing lifestyle factors first, you will be able to heal your body as much as you can while you are still taking these drugs, which will significantly help you adjust to discontinuing them.”
~ Dr. Sarah Ballantyne
What About NSAIDs?
You may think these are never allowed on the paleo autoimmune protocol (AIP), since they are often included on the “No” lists, and the science is clear that they do contribute to leaky gut. If you can find a supplement that works just as well, that’s ideal. However, if you are prescribed NSAIDs by your physician to specifically treat your autoimmune pain (like rheumatoid arthritis) and supplements don’t provide adequate pain relief, going off NSAIDs cold-turkey will usually lead to high levels of pain, which isn’t a healing state either. Follow Sarah Ballantyne’s advice above. Implement diet and lifestyle recommendations first, and as your symptoms improve and your pain lessens, work with your doctor to reduce/eliminate your dose.
How Long Does It Take to Reduce Medications?
This varies, depending on the medication, and the individual. Your symptoms need to go away before your medication does.
According to Dr. Terry Wahls, some of the first prescriptions people are often able to reduce are blood pressure and blood sugar medications. Many people also find their need for acid reflux medication disappears when they start a healing diet. But when it comes to autoimmune medication, that usually takes longer. Wait until you see significant improvement in your autoimmune symptoms and then work with your doctor on prioritizing which medications to reduce first.
Steroids are meant to be taken short-term to control autoimmune flares, and they’re a good first choice to try eliminating once your flares have stopped. However, you’ll want to slowly taper your dose under a doctor’s supervision, to minimize any rebound effect.
DMARDs (immunosuppressants) are designed to be taken long-term and many are often prescribed simultaneously. Some people have been able to get off DMARDs altogether, while others have been able to reduce their numbers and dosage over time.
If you have Hashimoto’s or Addison’s disease, your need for medication will depend on how much damage has been done to your glands. We need the hormones from our thyroid and adrenal glands to function, and when those glands are damaged, they stop producing enough. Some people are diagnosed before much damage occurs, and they are able to remain (or become) medication-free. Others are diagnosed after many years of damage, and therefore medication is needed long-term. If that is you, the key is finding the right brand and dose that works best for you.
Lastly, sex hormones can affect autoimmune expression. For that reason, if you are taking birth control or hormone replacement therapy, and you hit a healing plateau, you might want to look into non-hormonal alternatives. And if your hormones are out of balance, work with a practitioner to help you restore balance and remove this roadblock to healing.
If your doctor is resistant to the idea of dietary healing and won’t discuss the possibility of reducing your medications, here is a list of directories of paleo practitioners.
If I Can’t Get Off My Meds, What Am I Doing Wrong?
Autoimmune disease is serious business. It often requires medical intervention to prevent disability, treat excruciating pain, and even save lives. While the side effects can be scary (which is why it’s natural to want to get off medication), living with the symptoms of an untreated autoimmune disease is even scarier. There is no shame in taking medication. People who go off their medication aren’t superior to those who don’t. They’re often just luckier. The truth is – some people’s illness is more aggressive than others. I personally started immunosuppressant medication in 2016.
Does that mean you should give up? No.
To maximize the healing impact of the paleo diet, read this article: Top 5 Mistakes People Make on the AIP. Many people are unknowingly skipping a key element to this healing protocol. However, if you’ve read that article and aren’t making those mistakes, you might have other factors interfering with your ability to heal. At that point, it’s time to seek the help of a skilled functional medicine practitioner to do some troubleshooting.
If you’ve done all of that and you still have symptoms, know this: You are NOT a failure. Medication and diet don’t have to be mutually exclusive. In fact, they can work very well together. A nutrient-dense paleo diet reduces inflammation at a root level, allowing your medication to work better. Diet also often addresses symptoms your medication can’t. Many people achieve remission through this combination, when diet alone (or medication alone) wasn’t enough. Lastly, the paleo diet removes much of the toxic burden put on your body, making it easier to tolerate medication. Many people find their side effects minimize or disappear altogether after switching to a real-food diet.
No matter what, you are awesome! If you are part of this community, you’re willing to take your health into your own hands and mindfully choose what you eat and how you live, in an effort to get better.
Some people ask, “If I can’t get off all of my medications, what’s the point?” The point is that you are addressing your autoimmune disease at its root, helping to prevent further damage, reclaiming abilities you thought you had lost, and reducing what medication you can. That’s a lot! Perfection isn’t the only definition of success.
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Photo credit: Pixabay (public domain image).
A version of this post originally appeared as a guest post for Autoimmune-Paleo.