Paleo Autoimmune Protocol FAQ

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Ladders going up a rocky mountainside

“I’m not telling you it’s going to be easy. I’m telling you it’s going to be worth it.”
~ Art Williams

What Is the Paleo Autoimmune Protocol (AIP)?

If you’re brand new to the protocol, read this article first: What is the AIP? It provides an overview that covers all the basics. If you have further questions, I’ve included some frequently asked questions below. I also have a book that makes it much easier to understand and succeed at the AIP.

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Why are certain foods excluded during the elimination phase? 

Are you curious about the science behind the foods removed on the AIP? Here are some links: Eggs ~ Dairy ~ Nuts & Seeds ~ Nightshades ~ Alcohol ~ Guar Gum ~ Refined Oils ~ Refined Sugar ~ Grains ~ Legumes ~ Soy ~ Stevia.

What can I eat?

  • You can enjoy fresh meats, seafood, fats, fruits, and all fresh vegetables except the nightshades. Here’s an AIP grocery list.
  • You can find many AIP recipes here on my blog, my pinterest page, and at the weekly AIP Recipe Roundtables.
  • Check out my article: Meal Planning – A Paleo AIP Survival Tool, to see what I eat, and what resources are available to help you get started.
  • There are also many fabulous cookbooks available for the AIP. I’m summarized them for you in this cookbook roundup.
  • You can find AIP-friendly convenience foods and cooking ingredients in my blog’s Healing Store.
  • Avocados make a great snack, as do coconut chips. Also, you can enjoy AIP approved treats on special occasions.
  • Most deli meats, cured meats, hot dogs, beef jerky and pre-cooked meat contain nightshade spices, as well as other additives and must be avoided. The exceptions are Whole Foods Naked Deli Meats, and ShopAIP sells a variety of AIP-friendly meat bars.
  • Is sugar-cured bacon allowed on the AIP? Yes, provided that it was cured naturally, contains no artificial ingredients and no spices beyond salt. Sugar’s role in the bacon curing process is to feed beneficial bacteria. There’s usually no sugar left by the time it hits your plate. That’s why if you look at the nutrition panel on a brand of natural bacon, it should say 0 grams of sugar, even though sugar is listed in the ingredient list. One more tip: uncured bacon is actually cured, but it’s cured naturally instead of with chemicals. This is why the Epic Bison Bar is AIP-approved. Your best source for natural (AIP) bacon is a health food store. In this blog post, I share some of my favorite brands.
  • There are also specific healing foods recommended for people with autoimmune disease, so start adding these to your diet as well: organ meats, bone broths, fermented foods and a wide variety of vegetables.

Why can’t I just do an allergy test?

The autoimmune protocol addresses food intolerances, which are different from allergies. Food allergies can be threatening, sending people to the hospital in anaphylactic shock. Intolerances, on the other hand, ramp up inflammation in the body over time, exacerbating the symptoms of autoimmune disease. Unfortunately, there is no scientifically proven lab test for food intolerances. (Although there are tests sold under the names IgG, Alcat, Enterolab, EAV and Muscle Testing, these tests often give both false positives and false negatives.) For that reason, the elimination diet is the gold standard for discovering food intolerances. It takes effort, but it’s your only guarantee of accurate results.

Why is the reaction to a food stronger after the elimination diet?

When you eat a food regularly, to which you are intolerant, your body goes into a chronic state of inflammation in response. Symptoms vary from person to person. It might be digestive distress or joint pain or mood swings. For people with autoimmune disease, it exaggerates the symptoms of your disease. When you eliminate this food for 30 days or more, two things happen: (1) You start to feel better, and (2) your body has a chance to calm down its defenses. Then, when you reintroduce the food, the response can be acute. Although it feels bad, this is actually a good thing, because you have a clear communication that this food harms your body. As long as you stop eating the food, the acute response goes away, and you return to feeling better than ever before.

I have autoimmune disease and am just now learning about the paleo diet. Should I start right away with the AIP, or begin with the full paleo diet (without the added AIP restrictions)?

Begin with full paleo for 3-6 months. This will be a big change already, and some people are lucky enough to go into remission with no further restrictions needed. If, after 3-6 months, you haven’t seen the results you want, then transition to the autoimmune protocol.

I developed constipation after starting the AI Protocol. Why would this happen?

When you make a big change to your diet, constipation is a common temporary side effect. As your body adjusts to the new diet, this should clear on its own. During the transition, some things that can help are: (1) be sure you’re eating enough fruits and vegetables, (2) be sure you’re drinking enough water, (3) be sure you’re eating enough healthy fats, (4) have a cup of warm water upon waking – drink slowly, (5) prune juice, (6) magnesium citrate, (7) probiotics and fermented foods, (8) digestive tonics, (9) abdominal massage, (10) squatty potty, (11) enemas.

I’m already thin and can’t afford to lose any more weight. How can I make sure I’ll maintain my weight on the AIP?

  • Some autoimmune diseases result in unwanted weight loss due to digestive difficulties. The AIP is a nutrient-dense diet that helps heal the digestive system, so it’s actually a good choice in this situation. That said, some people accidentally eat low-calorie on the AIP. Here are some ways to make sure you eat enough:
  • Track your daily diet in Cronometer. It not only tracks calories, but also nutrients.
  • Eat plenty of protein, fat and starchy AIP vegetables.
  • If you can afford it, eat an avocado a day. They are nutrient-dense and full of beneficial fats.
  • Here’s a great recipe for a weight gain shake from SCD Lifestyle, providing 1200 calories in one drink: 1 avocado, 1 cup of coconut milk, 2 medium bananas, and 1 cup cooked sweet potato.
  • You can also use this meal plan to get a sense of how much is enough: 14-Day Calorie Challenge.

What can I do to help myself succeed on the AIP?

  • Plan ahead. Look at your daily eating habits and think of what foods won’t be allowed on the autoimmune protocol. Plan your substitutes in advance. What will you eat for breakfast, lunch, dinner and snacks?
  • Keep a journal of your autoimmune symptoms for 2-4 weeks before beginning the autoimmune protocol. This will be your baseline. Continue the journal during the AIP. You’ll be looking for positive changes once foods are eliminated and testing for reactions when foods are reintroduced.
  • Enlist the support of your family and friends.
  • Get support from the global community: Like my Facebook page for daily inspiration. Join this AIP Recipe Group for more great meal ideas. Join this AIP Support Group for support on any question or concern your have during your AIP journey.
  • If at all possible, remove tempting food from the house, and fill your cabinets, fridge and freezer with AIP approved foods instead.
  • Avoid restaurants during this time, if you can. Restaurant food always contains hidden ingredients over which you have no control. If you find you have to eat out, follow the tips listed in this article or look at the AIP notes on paleo restaurants.
  • If possible, postpone changes to your medications/supplements/treatments until your AIP experiment is complete. Changes to your medical protocol can skew the results of your food tests. If you need to make a change, postpone food reintroduction until your response to your new treatment stabilizes.
  • Be patient. The elimination period is a minimum of 30 days, and the reintroduction period takes at least a few months. Be prepared for that.
  • Open yourself up to new meal habits. For example, in our culture, we think breakfast has to be either grain or egg-based, but much of the world starts their day with soup, salad or leftovers. I love soup for breakfast. Here are 50 other great AIP breakfast ideas!
  • Don’t binge. Sometimes, when people are allowed only a limited number of foods, they’ll binge on what they can eat (a whole box of clementines, a whole batch of homemade crackers), but binging is always hard on the digestion, no matter what the food, and the result will be a flare in your autoimmune symptoms. Instead, eat balanced meals and moderate snacks. Eat plenty; eat variety; just don’t binge.
  • Take care of yourself mentally and emotionally during this time as well. This type of restricted diet can be a stressful experience. Carve out “time for you” each day, even if it’s only 15 minutes to relax. Meditate, take a bath, take a walk, listen to some favorite music, have a good cry, have a good laugh, whatever you need. Resource: 101 Ways to Treat Yourself That Have Nothing To Do With Food.
  • Believe in yourself, and know that the AIP can be a powerful tool in your healing process.

If I fall of the AIP wagon, do I have to start over on day 1?

Unfortunately, yes. The science of an elimination diet is that you need to avoid the foods for a minimum of 30 consecutive days. This is the only way your body can communicate tolerance/intolerance clearly during reintroductions. This doesn’t mean you have to be perfect. Many people take a few tries before getting solidly on the protocol. Do the best you can, and eventually you’ll get there.

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106 comments on “Paleo Autoimmune Protocol FAQ”

  1. Hey there, I’m a few days into AIP and I was wondering about a sore throat. I know that you can start getting symptoms of dry mouth, and adding starchy vegetables in are advisable. I also know that detox symptoms occur when starting the diet. Would a sore throat be included there, out of curiosity? Any information would be helpful. Thank you!

  2. I am about to start the AIP diet, I have Celiac and autoimmune issues run in my family. I am very good about keeping my diet gluten free but I’ve been having weird symptoms and think I may have something else going on. Getting a doctor to look more into it has been hard. I do have a couple of questions. My husband has barely controlled gout will this help him or is a different diet better for him? I have tried cutting back on non gluten grains and replacing them with coconut flours, oils,milks and butters. Oh my, my stomach was so upset. I feel like I may be sensitive to coconut, what are some better substitutes other than coconut? I would love to start out doing this the right way. Thank you for your help.

    1. Hi Nicholle. The AIP is an anti-inflammatory diet, so it has the potential to help a wide range of conditions, including gout. The only way for your husband to know is to try it. Regarding coconut, for many people it’s not about being intolerant to coconut, but rather watching the quantity. The recommendation is to limit coconut milk to 1 cup daily, coconut flakes/coconut butter to 1/4 cup daily, and coconut flour to 1/8 cup daily. There is no need to limit coconut oil. If you still have digestive symptoms at that level, you can do the AIP without coconut products altogether. Here’s a good article with tips, if you choose to go that route: . Welcome to the AIP community! Wishing you and your husband wellness in every way.

  3. Kimberlee Christensen Schwierm

    I stopped having cravings at day two and for three full weeks I have been doing fine avoiding chocolate, peanut butter, and sweets. I’m now craving chocolate, peanut butter, and cookies. Maybe it’s because Halloween is two days away and candy and treats are all over, even in my house via my children. But they’ve not bothered me until the last two days. Is there a scientific reason for this? Is this a common occurrence? Are there certain gut flora that die off at this time, giving my body signals for sugar? Or, is it just behavioral/environmental?

    1. Hi Kimberlee. There are so many possibilities and you named some of them. Another is simply a hormone shift. Women tend to crave sugar surrounding their menstrual cycle. I don’t know if that applies to you? But holidays can also trigger those kinds of cravings. You might want to make yourself an AIP-friendly treat to carry you through. Here’s a low-sugar AIP dessert recipe roundup. And here’s a list of 101 non-food treats, too. It’s normal to be tempted sometimes; I don’t know if that ever goes away 100%. It’s good that it’s not present all of the time! This is an opportunity to develop self-care practices to keep yourself on the healing path. Thanks for writing. Happy Holidays!

  4. I’m on day 28 of strict AIP and am always gassy and a bit constipated, whereas I used to have very good/normal bowels. Any thoughts on what this is and how to fix it? Thank you!

    1. Hi Karly. Grains are high in fiber and also tend to irritate the digestive tract (not a good thing for leaky gut, but one side benefit is stimulation of peristalsis). I gave advice to address constipation in the article above. Just go back and read that section. There are 11 tips.

  5. Susan did you manage to get the dry mouth under control? I have Sjogren’s which is why I am interested. Thanks.

    1. Lizzy, this FAQ is about the Paleo Autoimmune Protocol, not SCD. Where you got confused is that the website with the recipe is called SCD Lifestyle. They have 5 recipes in that blog post, and the first two are SCD (but not AIP because they include eggs). I listed the ingredients in the one’s that’s AIP. (Sweet potatoes are allowed on the Paleo Autoimmune Protocol).

  6. Hi! I have Hashimoto’s. I’m on day 4 of the AIP and after I started the diet my usual headaches and muscle/joint pain are so much worse! Is this normal when starting up with the aip diet? Surely it should pass within a few days? Any experience? I have mostly eaten plantain, cassava flour, some fruit, avocados, chicken, beef, pork and allowed vegetables

    1. Hi Kirsty. Sometimes your body can go through a detox period, especially if you went straight from a Standard American Diet previously. The body is reacting to the loss of sugar and reduction in carbohydrates. Here’s a good article with advice for this transition. Some of the recommendations you need to adapt for AIP, but it gives you some great overall guidance: I also recommend doing a nightly Epsom Bath. It adds detox and can alleviate headaches, and it also helps you sleep. Lastly, remove the cassava flour from your diet for now. Some people react negatively to that. Replace that with whole foods starches like sweet potatoes, parsnips and butternut squash. Hang tough! It should pass soon.

  7. Eileen, you linked to an interview with Carrie on putting her Hashi’s into remission, but the link doesn’t work. Can you provide a new link to it? Thanks!

  8. Hi; I’m on day 10 of the Paleo AIP reset and last night I accidentally had ground beef that on the ingredient list said “natural flavors.” This morning I can feel my knees have inflammation in them. Does that mean I have to start completely over?

    Also I bought ground turkey (but I haven’t eaten it) that says it has “natural rosemary flavor” Thoughts on that?

    1. Hi Annie. Natural flavors are used to mask ingredients that the food manufacturer doesn’t want to share. I recommend avoiding them. It’s crazy that you actually have to look at the ingredient labels on ground meat, but I’ve run into this problem myself at stores like Wal-Mart. My health food store sells meat that is 100% meat, for which I’m grateful! If the turkey had fresh rosemary added, that wouldn’t be a problem. But rosemary flavor could contain other things as well (such as soy oil as a carrier). I’m sorry, but I do recommend starting your reset over. Sending wishes your way that your inflammation pass quickly.

  9. Hi. Thanks for this comprehensive list! So helpful. I am just starting AIP after a year or so of intense and confusing symptoms and a more FODMAPS type diet. I am now very thin and am losing weight after a week of AIP, but that seems understandable given the metabolic changes taking place. I appreciate your question about that! So much is geared toward weight loss out there that sometimes I’m not sure what is appropriate for me. I am wondering about how the AIP perspective understands eating meat fat, when that has so long been considered inflammatory for the gut? Thanks for any insight into this!

  10. I’m confused about black pepper and white pepper–some AIP lists allow them, others don’t. Are they unadvisable to use?

  11. Update 2. I guess I was premature in my first update. The extra sugar began to stop my skin’s healing. Now I am eating half a plantain or half a sweet potato every other day. My mouth is not dry so far. But I am not seeing any real clearing of my psoriasis. But for now I don’t know if that is from the starch or from the ibuprofen that I have been taking for the pain in my feet. Hopefully I will find a more friendly way to manage the pain.

  12. Thank you, Susan. I’m sorry that you are going through this dry mouth problem. It sounds so innocent doesn’t it? But I know how awful it can be. I truly hope you find an answer and please keep us updated.

  13. It may be a bit early for an update, but here goes. I thought I was eating a starch everyday, but evidently I was not. Since my last post I make sure to have one of the foods you mentioned every day. I am doing great, no problem at all now with dry mouth. I guess since I ate a fair amount of sweet potatoes that it seemed as if I had them every day. I want to thank you again, Eileen, for sharing your knowledge. You have spared me such a lot of trouble and I appreciate it so much.

    1. Vickie, that’s wonderful! Thanks for letting us know. It’s so nice when a problem has a simple solution.

    2. How wonderful for you, Vicki! Thanks for the update; I am so glad this worked for you. Unfortunately, I already get plenty of starch so I don’t think that is the solution for me 🙁 I hesitate to reintroduce white rice because I seem to be emerging from a 3 month flare that started about a month after AIP. I am finally doing better but am still on more meds than I was when I started. I’m curious about the rice/glucose thing. I thought everything turned to glucose eventually (except when in ketosis) since that is the preferred food for our cells? Am I wrong about that, Eileen? Thanks much for the insights.

      1. Susan, since your dry mouth actually stems from your autoimmune conditions: RA & Sjogrens, it’s definitely more complicated to address. That’s why I recommended to you that you work with a functional medicine practitioner to troubleshoot. However, if you want to know more about glucose, Paul Jaminet is the expert: . Wishing you wellness.

        1. Thanks, Eileen. I am working with a functional medicine practitioner. We are currently approaching it using TCM. Though I am not actually diagnosed with Sjogren’s, I suspect that I have had a mild case for a few years (my rheumy says it’s all the same thing!). The thing that confounds me is why it got so bad a few weeks into AIP and is unrelenting. I’m not sure that this diet is right for me. But I will keep at it under guidance for a while longer. Thanks again.

          1. Hi Susan. I’m glad you’re working with a practitioner. It is frustrating when there’s a dietary piece we just can’t figure out. I hope you start to see benefit on the AIP, and if not, find the dietary protocol that’s right for you.

  14. Two years ago I used the AIP to help clear my psoriasis. I had good results,although not 100% healing. But a few months in I developed extreme dry mouth and burning tongue. I eventually went back to my unhealthy diet and the dry mouth went away. Now I have been back on the AIP for 3 weeks and I am developing dry mouth again. The burning tongue has never gone away but it is becoming worse now. I cannot figure out why a healthy diet would cause this. This time I have been taking vitamins so I don’t believe it is a deficiency. Do you know of any reason this would happen? Thank you for any help.

    1. Hi Vickie. That can happen if you aren’t eating enough starch. The Standard American Diet is super high in starch, so that could be why your dry mouth went away when you went back to your unhealthy diet. Try increasing the winter squashes, sweet potatoes and plantains. If that doesn’t resolve it, try reintroducing white rice – that is well tolerated by a lot of people and often alleviates dry mouth issues.

      1. Thank you so much! I eat a sweet potato most days, but that must not be enough. I will try the rice and plantains. You are amazing!! Thanks again.

        1. Vicki, can you let us know what you do and the results? I’ve had the same experience with dry mouth (and dry eyes, but thankfully not the burning tongue). Interestingly, I saw someone else post about the same thing but can’t find that post now (I think it was on the Autoimmune Paleo site, but not sure). It happened for me about 3 weeks in too. Weird. I think I eat plenty of starch, though. I usually have a sweet potato every day and usually plantain chips or a banana. Eileen, is that enough starch? Any ideas if it’s not the starch?

          1. Susan, it might be the type of starch. White rice is unique in that it breaks down into 100% glucose in the body, and according to Paul Jaminet, dryness can be a sign of a glucose deficiency. That’s why he includes white rice on The Perfect Health Diet. So, if you’re ready for reintroductions, you might want to try it. That might be your missing link. My reintroduction guide has a recipe for Bone Broth Rice, and if you eat it as part of a meal, you can get the benefit of the rice while minimizing the risk of blood sugar swings. Everyone’s body is unique; I’m not saying that everyone needs or benefits from the addition of white rice, but some people do. I big part of autoimmune healing is personalizing our diets for our own unique needs.

          2. Yes, I will let you know my results. I would prefer not to add rice for a while, BUT if the dry mouth is as extreme as the last time I may have to try it sooner. I can’t express how bad it was. There were times I could barely speak. Another thing I will try is making an energy drink that I read about (because I see that electrolytes are mentioned in reference to this, also). A couple of cups of filtered water with a pinch each of sea salt and calcium carbonate and a squirt of lemon or lime juice. I was going to try this for energy after my walk /run workout. Maybe it will help the dryness?

  15. Eileen, I’ve had a pretty severe case of RA for over 16 years. I’m on 4 medications, including 6 mg of prednisone and 4 tabs of Aleve, because I can’t function without them. I’ve been on strict AIP for over 70 days and began a horrible flare about 3.5 weeks ago after a day of gardening. I had dropped 3 of the Aleve and 1 mg of pred about 3 weeks before that with no negative effects but I’ve added them all back and then some just so I can walk again. In addition, I’ve had mild Sjogren’s for several years, mostly just an occasional dry mouth at night. After 3 weeks on AIP, it became quite severe and also developed dry eyes at night. I am continually awakened at night because of a bone dry mouth. So my question is, should I really be getting worse on AIP? I understand that given the severity of my disease, it will take time to heal, but I didn’t expect to get so much worse and for so long. Thanks for your insights. I love your blog, it is hard to find folks with RA who have been successful on AIP. I haven’t found any yet that were on significant meds.

    1. Hi Susan. If I understand you correctly, you reduced your anti-inflammatory medication before the flare and the increased sjogrens symptoms? I think that’s a more likely the cause behind your feeling worse than the diet itself. A lot of people make this mistake. It’s really important to wait until you feel substantially better for at least a few months before reducing medication. And then you should do it under your doctor’s supervision. Also, extreme thirst is a common side effect of an increase in steroids (which you said you did after your flare) – steroids flood the body with glucose which throws off blood sugar balance and causes symptoms similar to pre-diabetes. I don’t say that to scare you – just to make you aware. Any time you increase your steroid medication, you’ll want to pay close attention to blood sugar management. Reduce or elimination your desserts. Eat fresh fruit and plenty of vegetables, but always have them with protein and fat. When blood sugar is unstable, it can be helpful to have 4 or 5 mini meals daily instead of 3 large meals. Lastly, if you go too low-carb, that can cause thirst and dry eyes symptoms as well. Are you eating plenty of starchy vegetables, like sweet potatoes, plantains, butternut squash, etc? You might want to add more of those to your diet. Everyone’s so unique that it’s hard to troubleshoot, but these are the first things that came to mind. To answer your other question – I know many people with RA who have benefited from the AIP. I’m not alone, and some have had RA for years. Some have gotten off all medication, some have reduced their medication, and others find medication + diet to work best for them, with diet relieving the symptoms that medication doesn’t address. Success is individual, and there is no “one way to heal.” I understand your impatience, but 70 days isn’t very long after 16 years of illness. If you need further guidance, I recommend The Paleo Mom Consulting. They would be able to assess you more accurately than my brainstorming possibilities. Wishing you healing in every way, Susan. I know the pain of an RA flare, and it’s demoralizing. Gentle hugs coming your way. May your flare pass quickly!

      1. Thank you, Eileen, for your quick and kind response. The Sjogren’s symptoms worsened before I dropped any meds. I was phasing in AIP and almost 100% when it happened, literally overnight. I dropped the meds because I was feeling so much better. In the past, if I dropped too low, I felt it instantly, so I am flummoxed that it would hit me so much later. At my doctor’s behest, I’ve been trying to get off at least the pred for many years, we are both worried I am headed for osteoporosis, so I have a lot of experience with reducing meds. But you are probably right that I should slow down. I am definitely going to work with a Paleo Mom consultant. Can you share any links to success stories for RA folks, especially those who have taken significant meds? Mostly what I find are people with things like Crohn’s, IBS, etc. and Hashimoto’s. Thanks again for your very kind response and your wonderful blog!

  16. Hi Eileen, you’re site is a gift! I was diagnosed with Crohn’s Disease about a year ago after a life long struggle with no answers. My chiropractor originally steered me towards the AIP diet, but the list he gave me was somewhere between too cut and dry and at the same time, pretty vague. I was really able to understand the approach after finding phoenix helix online. I successfully carried out a strict elimination diet for a month in September, and I felt amazing. I was overjoyed to have control over my body for the first time!! I began the reintroduction process and it was going well..until it wasn’t. I was using the first method – kind of willy nilly, just trying things I wanted to eat. I had really good luck with dairy, nightshades where an absolute no, I tolerated some alcohol very well (wine and 100% agave tequila) then I jumped the gun and had coffee, chocolate (not the good kind – it was a starbucks mocha ugh) and eggs all within a short period of time. I had almost a complete relapse and felt terrible again. In February, I started over and I’ve been waiting and waiting for that amazing feeling again, but this time I’m just not quite getting there. I don’t know what I’m doing wrong. I found so much comfort in my belief that I could always go back on the AIP diet and feel ok again. It scares me that I’m finding this not to be the case. do you have any suggestions? I can’t get rid of the bloating, and I’m dealing with more constipation than usual. in the past, I’ve had a constant back and forth (even within one day) between feeling like I can’t go at all, and then all hell breaks loose. Now i feel like I’m always backed up. I need some advice!

    1. Hi Leah. I recommend consulting with a functional medicine professional to do some troubleshooting. I have a list in this article: Paleo Practitioner Directories. I’ve also interviewed a number of people through my podcast, so if one of them in particular resonates with you, you might choose from there as well: Podcast Archives. Wishing you wellness in every way!

  17. Eileen, Thanks for this website. It’s been very helpful. I’m on day 2 of the AIP. I have two questions for you that I haven’t seen addressed before. First, can I still have my kombucha even though it is made with sugar. I know that the fermentation process rids it of most of the sugar, but is the rest of the sugar ok?

    My second question is, can I still take Estrovan for my menopausal symptoms or should I stop for the month. I have terrible hot flashes and this product helps.

    Thanks for your time and diligence to helping others!

    1. Hi Robin. The fermentation process actually doesn’t rid kombucha of most of the sugar. It changes the structure of the sugar, but the quantity remains almost the same. However, it’s believed that the benefits of the ferment outweigh the negatives of the sugar, so it’s allowed on the AIP as long as you drink it in moderation (maximum 4-8 ounces daily). I have a series of articles on kombucha, if you’d like to learn more. As for Estrovan, because it contains soy, it’s not an AIP supplement. You might want to start looking for an alternative hormone balancing supplement that’s AIP in its ingredients. Wishing you health in every way, Robin!

  18. That’s a good question. I haven’t had coconut flour before but the sinus issue started the day before so I don’t think that’s it. Maybe just detox.
    Thank you for responding. 🙂

  19. I have been on the AIP diet for three days and have had severe sinus issues for two days now. Is it related? I also have a rash on my arm that has redeveloped that I haven’t had for about a year.
    Thank you for being such a great resource for all autoimmune disease sufferers.

    1. It’s so hard to say, Lisa. It could be a coincidence. It could be detox. It could be a reaction to a new food. Is there anything on the AIP that you just started eating, that you’ve never eaten before?

  20. I have been diagnosed with Hashimotos and have been on the
    AIP diet for over a year, and improving all the time.

    I also am taking a supplement I bought online called “digestacure”.
    It claims to cure autoimmunity. I have noticed great results taking this product & wondered if you have heard of it and what your opinion of it is.
    It is expensive, but I feel so much better taking this & also doing the AIP diet.

    Thanks for all you information & help.

    1. While I’m glad you like the supplement. I don’t trust companies who promise a cure. They care more about sales than authenticity. While it’s possible to reverse autoimmune disease and improve our symptoms, a cure isn’t possible, and promising it simply sets people up for failure.

  21. Hi, Eileen 🙂
    As a cake-loving person, soon to be on the AIP-diet after being diagnosed with Hashimotos, I was wondering if it’s possible to make a delicios AIP-wedding cake ? No party without a cake, if you ask me – It’s hard for me to imagine my future wedding without a wedding cake – or going to parties and attend weddings without being able to eat cakes or dessert! 🙁 I know there are a lot of recipes for AIP-friendly cakes, muffins etc., but no one has ever posted anything about beautiful cakes for ceremonies 🙂

    Kind regards

    1. Hi Elli. While I haven’t yet seen a recipe for an AIP wedding cake, I’m sure it’s possible. There are some creative bakers in the community. Here’s one cake that looks beautiful and delicious. I’m sure the recipe could be multiplied into tiers for a cake: . You also might enjoy reading this article by Grazed and Enthused about her own AIP wedding:!A-Pretty-Paleo-Wedding/cu6k/1DAE8778-36DF-4E39-B99F-0F3425189F59.

      1. Thank you for your answers, I find the links very useful! 🙂
        Have a nice day! 🙂 Btw I love your site!
        Thank you!

  22. Maria McCarthy

    Hi, Am doing the Paleo approach diet 2 1/2 months and much has improved. But I need to know, is Bentonite or castor oil ok for constipation? I know that aloe vera is not recommended since it stimulates the immune system.

      1. Thanks Eileen,
        I had thought the Bentonite would remove all ¨feces¨ lining the walls of the intestines, in all the grooves and that my blood pressure would normalize more easily like it did 25 yrs ago when I was on the yeast-free diet for toxic levels of candida. Anyway, I started using it about 1 week ago along with a bit of psyllium and lots of water in the am. Do I need to prolong the AIP or is it just not a good idea to take Bentonite for another reason?
        And by the way, I love your e-book ¨reintroducing foods on the paleo¨ and also the 85 recipes e-book. They’re both great. Thank you for all that you do.

        1. Hi Maria. You’re the only one who can make those kinds of medical decisions for yourself, but cleanses like that aren’t recommended on the AIP. Bentonite clay not only removes toxins from the body but nutrients as well, and psyllium husk can irritate the digestive tract, exacerbating leaky gut. The AIP is a healing lifestyle that helps build and restore a healthy digestive tract long-term. “Quick-fixes” like Bentonite/Psyllium cleanses aren’t part of the protocol. In the end, we all decide what we do and don’t want to do for our health, but this is the AIP view. Thank you for the compliments on my e-books. Wishing you health in every way.

  23. I was just wondering what I was doing wrong on my AIP diet. I’ve been really strict, and I’m no stranger to the Paleo diet in general, but I decided to go on the diet because I’ve got a lot of food allergies and 2 different autoimmune diseases that have been making me severely sick. My question is, why am I still so sick after 2 weeks of strict AIP? I get bloaty and nauseous after every meal (other then my morning smoothie). I eat nutrient dense veggies and fruits and healthy meats with lots of grass fed gelatin and the recommended supplements for inflammation and healing leaky gut. Any thoughts you have would be very helpful! Thanks

  24. Hi ! I have Hoshi’s and cut gluten a few years ago , with great results. I’ve since cut dairy , though I indulge occasionally (& pay for it when I do) – the past few months I’ve been feeling awful – stressed, anxious, bloated etc . I started paleo AIP last week and I’m terribly constipated. I also seem to be gaining weight ( though I’m not weighing myself) – is that possible????? Think I’m over doing it on the protein? Help!!

    1. Hi Sammi. It’s common to go through a transitional period of constipation when you make a major change to your diet. If you read the article above, there’s a paragraph of constipation solutions, where I provide 11 ideas. Give some of those a try. And hang in there. When it comes to Hashi’s and weight loss, you need to heal your body before your weight will stabilize. I know it’s difficult to be patient, but put that scale away!

  25. I have been living LCHF for 18 months to get my T2DM into full DRUG FREE remission. Fruit juice and vegetable juice spikes my blood glucose so is a NO NO for me. Even though my diabetes is in full remission my autoimmune disease is still rampant…. How can I combine both eating plans for disease remissions of both>

    1. Congratulations on getting your diabetes into remission. That is awesome! Many people do a low-carb version of the AIP, so you can, too. Another option is to do the Wahls Paleo Plus protocol (which is ketogenic). You definitely have options. If you want more guidance, to be sure you’re getting optimal nutrition with the extra restrictions, I recommend consulting with either Anne or Amy at The Paleo Mom Consulting. Anne’s a functional medicine practitioner who does low-carb AIP herself. Amy’s a top-notch nutritionist.

      **For anyone else reading this comment thread who is curious, LCHF is Low Carb High Fat and T2DM is Type 2 Diabetes.

  26. I suffer from psoriasis and started the AIP last week after being gluten and dairy free for a year. I’m curious, since I assume there is healing starting, should I expect the itching to subside gradually because there is still permeability and therefore still food particles entering my blood stream? I still find myself itching quite a bit, so another assumption is that even the nutrient dense food will contribute to symptoms until I heal. I know there are alot of AI diseases out there and that everyone is different, but I’m wondering if I should further exclude more foods such as the FODMAPs or just give it more time. Thanks for any input

    1. Give it more time. The skin actually takes the longest to heal, because the body heals from the inside out. Wait at least 3 months before troubleshooting further. Good for you for starting!

  27. Hello! I have almost completed three months of AIP and previously completed a two year stint on GAPS. I am attempting to heal from 27 years of alopecia (varies between areata, universalis, totalis etc). My problem is when to reintroduce anything as I don’t appear to have symptoms I can easily monitor for reactions, seeing as phase for normal hair growth is about three months. Any suggestions, other than only introducing one new food every 3-4 months? Many thanks for your invaluable information and help.

    1. I recommend paying attention to other signs in your body when you reintroduce a food. Although I have rheumatoid arthritis and joint pain is my main symptom, when I first reintroduce a food, I have pre-symptoms before pain appears: moodiness, insomnia, and digestive distress. You might find that you also have some pre-symptoms that signify intolerance before alopecia would appear. Another suggestion is something I haven’t done personally, but Dr. Terry Wahls recommends. It’s called the pulse test. Here’s a link:

      1. Thank you Eileen, I will give it a try (I tend to have a bit of white-coat syndrome, so suspect my pulse will be very reactive whether it needs to be or not!). I did not experience any noticeable changes on my two years on GAPS, and have not yet on AIP, what would you think would be a reasonable length of time to stick strictly to AIP, without and reintroductions, if I continue to experience no change? Loaded question, I know!

        1. How long you wait before reintroductions is really a personal choice. If you’re comfortable on the AIP and don’t find the restrictions stressful, then continuing until you see improvements is ideal. Be sure you’re eating a nutrient-dense version of the AIP – plenty of calories, organ meats, bone broths, seafood, fermented foods, and diverse vegetables. A good part of healing isn’t the food we take out, but the food we add in. If you start to find the AIP food restrictions stressful, that stress can interfere with healing, so reintroductions are wise at that point. Trust your instincts.

  28. help! I just found out that I am pregnant! great but i have been on the AIP for 50 days and have just started reintroducing foods. But now i don’t know if i should stop. It feels so restrictive since i am also avoiding fodmaps. What should i do? eat the same till i deliver? how bad would it be if i added some foods? I am eating AIP for my ME and leaky gut. so happy but lost about the food!

    1. Congratulations! First let me say that I’m not a doctor, so this is advice from a friend. Many people with autoimmune disease go into remission when pregnant and are able to eat a much wider variety of foods without flaring. That was true for Angie of Alt-Ternative Autoimmune and Whitney of Nutrisclerosis. So, go ahead and expand your diet and make sure you’re eating enough for you and your little one! After delivery is when it’s more common to flare, so that would be a good time to plan on doing the AIP again, preventatively.

  29. Thanks–I hated to cut back even more from what she was eating! She has been drinking quite a bit of kombucha and I gave her a bottle of Prescript assist probiotics to supplement but I’m not sure if she’s been taking them–I’ll ask her. She also takes apple cider vinegar for premenstrual symptoms but I see it’s on the tonic list so may get her to try that more regularly.

  30. So this is day 15 of my 15 year old daughter’s paleo AIP diet. Today she had a beef, broccoli, carrot and onion stir fry (in olive oil) for lunch. She said she felt very bloated after lunch. She had the exact same stir fry yesterday for lunch and didn’t have any problem but after thinking about it, said she thinks she remembers feeling that way after dinner the other night when we also had beef. We have had beef 3- 4 times in the past week for the first time since she started the diet because she was getting tired of chicken and pork. Any thoughts? Should we stop the beef for a week and try again to see if that happens again? Oh, also she made a chicken stir fry last week and put thyme in it and got a stomachache, which she blames on the thyme as she’s not had any up to this point. We still have 15 days to go before starting to add back any foods but didn’t think these two would be an issue! Thanks!

    1. It’s tempting to try to connect a food to a symptom, but reactions can take up to 72 hours, so there’s no way of knowing if the beef or thyme were the problem, or something else she ate in the prior 3 days. It could also simply be a digestive issue unrelated to a specific food. Healing takes time, and your daughter can expect intermittent symptoms as she heals. I don’t recommend removing any more foods at this point. Instead, focus on supporting digestion. Is she taking any digestive tonics or enzymes? Most people with gut issues need those. For supplements, it’s best to work with a practitioner. If you want to try homemade digestive boosts, here’s a good list (just don’t do the cayenne, since it’s a nightshade).

  31. Hi

    My family has been eating “clean” for several years, mostly following a Wesron Price diet although we are not that strict about occasionally eating out or having junk once in a while. However, my 15 year old has just started a paleo AIP diet (day 5 yay!) in hopes of addressing some skin and other autoimmune issues before they get worse. My question is does it matter what order we introduce foods back? She’s hoping to get back to(raw) milk, cheeses and eggs first, (assuming no reactions to them) but I didn’t know if there is a reason to start with other foods. Thanks!

    1. The important thing with reintroductions is to reintroduce one food at a time, and give yourself plenty of time to feel a reaction before reintroducing another. The order of foods within each category is more important than the order of categories. For example, she’ll want to reintroduce egg yolks by themselves, before reintroducing whole eggs. In the dairy category, she’ll want to reintroduce ghee first, then butter, then fermented raw dairy, before regular dairy. Have her read my article on Reintroductions to safely guide her through the process. Kudos to her, by the way, for doing that AIP at age 15! She’s very wise for her age.

  32. How about peas, the Green kind , not snap peas, but regular peas? Can i have them in the first phase? Thank you for sharing and giving us hope. I have ME and have noticed great imrovement when i change my diet but i have never embarked on a full AIP. … Although it is Boring to have this food over christmas i don’t want to postpone the healing.

  33. Your blog and posts are so helpful. I became sick after a trip to Europe in July. It started with numbness in my right big toe, Panic attacks and dizziness that I link to gluten, difficulty swallowing and then acid reflux. The doctors kept telling me I had anxiety and gave me pills. I searched around for a doctor who I felt was a good match and in out first appointment she immediately suspected an auto-immune disease. My ANA panels came back positive and last night I received my test results online. I meet with my doctor Friday to go over the results but I was able to deduct the diagnosis through online searches.
    When my symptoms severely evolved about 6 weeks ago I read about GaPS but was intimidated by the meat. I went vegan and cut out all processed foods for 2 weeks. I got so sick and weak. I decided 2 weeks ago that I would implement some GaPS philosophies into my diet and I have regained some of my strength back. On Saturday I got the results of positive ANA and spent a lot of time on the AIP website which led me to further cutback my food selections (I had suspected a night shade sensitivity and fodmap sensitivity). I have now cut out nuts, seeds and eggs in addition to dairy, grains and wheat.
    I am already noticing improvements in my symptoms but I am concerned that I have made too many dietary changes in such a short time. The way my body has reacted to certain foods I know to avoid them.
    Does the AIP cookbook fully explain the elimination/introduction process?
    When I got sick I started a homeopathic protocol, is the alcohol used in homeopathic tinctures enough to cause a flair, if that alcohol is grain-based?

    Thank you for your guidance on this blog. The positive outlook and success stories are motivating. I hope to be one of those success stories.

    1. Hi Celia. First of all, congratulations on taking such quick control of your health! Don’t worry about the alcohol in your homeopathy; only alcohol abuse is linked to leaky gut, not small doses. The cookbook is great because it gives you menu plans and over 100 recipes that are safe to eat, and when you’re new to AIP, that can be hard to figure out. When you’re ready for reintroductions, I recommend following the protocol I outline here on my blog. You mentioned worries about making so many dietary changes so quickly. If you’re feeling malnourished, the best thing to do is to increase the healing foods in your diet that are recommended on AIP: bone broth, organ meats, seafood, and plenty of veggies. It sounds like you’re doing great, and I fully believe you WILL be a success story.

  34. Thanks so much for this post. I have just discovered this site through stumbling on the auto immune paleo protocol a few months ago .What a joy to discover people who eat like I do , who have noticed the same responses from food as I do and who are often seen as picky eaters . I was diagnosed with Crohn’s disease 9 years ago and did not like the effects the medication prescribed had on my body and mind .Over the years through trial and error I realised diet had a huge effect on my health but also realised it wasn’t just diet sometimes. I started with eliminating the usual suspects wheat dairy and eventually gluten but noticed sometimes this would not stop a flare up . I went to loads of food allergy testing and they worked on improving my health a little . Maintaining and improving my health through homeopathy acupuncture and chi Kung I finally found Paleo . It dramatically improved my energy levels . I felt like there was just one tiny thing that I needed to do so when I found the auto immune paleo diet I finally felt like I’d arrived ! It’s so good to find information on how to put on weight or at least preventing more weight loss as I struggle with this constantly . Thanks so much for all your information I no longer feel like I’m searching aimlessly alone in the quest for better health.

  35. Eileen:
    Thank you so much for this amazing information. I have Hashimoto’s, Lichen Sclerosis, and major allergies (everything outdoors but a pine tree and animals). I have been diagnosed with cross allergies based on my extreme outdoor allergies making me intolerant to many fruits and veggies. We actually did scratch tests with fresh foods that I typically eat and was able to see what intolerance’s I have. Most of them are on the nightshades list. I am treating these disorders with different specialists, but not getting the relief with traditional medicine that I would like to see. I think a diet change thanks to all of my autoimmune issues might be the next necessary step. How would you recommend starting? I am currently eating the average American diet. Is it best to start regular Palio or start the Autoimmune from day 1. I have even had suggestions from friends to start with going Gluten-Free and Dairy Free to begin with. (My 18 month old has to go Dairy Free thanks to GI issues he is already developed.) To be honest, I have a Cherry Coke addiction and that is my one true love in life. I plan to start as soon as my last Cherry Coke is gone. 🙁 I don’t want to give that up, but don’t really have much of a choice. Where would you suggest I start??? Please help!!!

    1. It depends on your personality. Some people find change easiest in stages. Others need to dive in 100%. I also had to switch from a Standard American Diet (and I had a diet coke addiction, so I empathize). I tried gluten-free/processed food-free first, but saw no improvement. So, very quickly, I went to full Paleo and started improving. I stuck with that until I plateaued in my progress (about 6 months later). That’s when I did the AIP. For me, going straight from SAD to AIP would have been too hard a transition. But follow your intuition on this one. If you decide to do the AIP now or in the future, the Autoimmune-Paleo Cookbook is really helpful, because it provides menu plans along with the recipes.

  36. Hi Eileen. I have been suffering from Hashimotos for the past 4 years and Rhematoid arthritis for a year now. Unfortunately I am on methotrexate…at the time of diagnosis I literally could not get out of , and had tried all the dietary healing that I knew of at that time. I have been gearing up to do GAPS intro, and just came across this AiP. Would you suggest starting with GAPS, as you did, for that initial gut healing? (I know I have leaky guy and candida). Or would you start with AIP? Does AIP heal the leaky gut as well? I’ve been gluten free for 3 years, grain free and yeast free for 2. I tested positive for allergies to about 25 different foods, yeasts, and ferments, and eggs among them. (so no fermented foods for now?) I already consume bone broths, and do mostly pastured/grass fed and/or organic meats. Mostly all organic fruit and veggies,and I drink fresh veggie ginger lemon juice every other day. I do have a weakness for seed butters and raw cream in my coffee, so I know those will have to go. Thanks in advance for any advice!!

    1. Hi Lisa. The GAPS Introduction diet can be very healing. The problem is that it introduces foods that are common food intolerances (like eggs, nuts and dairy) rather quickly. If people are intolerant of those foods, they get stuck on Stage 2 (which gets really boring after a while.) A leaky gut can’t heal if it’s getting irritated by food intolerances. This is where the AIP is very helpful. It’s a self-experiment, where you learn which foods your body does & doesn’t like. After completing the AIP, you could do a modified version of the GAPS Introduction Diet, based on your own body’s needs as a finishing touch. that would be my recommendation anyway. If you want to see my results as an example, read this post of my AIP experience.

  37. Which is the quantity of carbohydrates, and the good ones, that we need to mantain the thyroide healthy and avoid high insuline. I have hashimoto and insuline resistance. Sorry for my english

    1. Hi Lucia. Everyone’s needs are different, so I can’t give you a number on this. The best thing to do is try different levels and see how you personally feel. The best carb sources are vegetables, especially the safe starches: sweet potatoes, turnips, beets, carrots, winter squash, etc.

  38. Colleen Stewart

    Thank you so much Eileen! How nice to wake up to your quick reply/answer! I will be checking out the info you recommended!

  39. Colleen Stewart

    I have Fibromyalgia. I quit gluten 2 years ago and do fell better as far as my digestive system and my acne is gone. I also try to stay grain free. In your opinion do you think doing the AIP would or could be beneficial? I’m planning on starting the Whole30 in September to see if that helps. So I’m just curious if any one with fibromyalgia can be helped? Thanks!

    1. I think it would be worth trying. It’s basically a method of communicating with your body, to learn what foods it does and doesn’t like. If you don’t want to jump into the full autoimmune protocol yet, I recommend giving up nightshades for 30 days. If you look at the symptoms of nightshade intolerance, you’ll see a lot of fibromyalgia symptoms on the list. Here’s a link to my Nightshade-Free Survival Guide.

  40. thank you so much for posting all of this amazing info. I have Hashimoto’s (just recently diagnosed after 3+ years of agony and no answers from doctors). I am excited to start the immune protocol as I will do whatever it takes to feel better! However, I read on another blog (PaleoMom) that for some the protocol can take up to 3 years!? Is it true that some would need to stay on it for that long? It seems like 30 days vs 3 years is a huge difference.

    1. It’s common to need to stay on your personalized version of the protocol for up to three years, but you don’t need to stay on the full autoimmune protocol that long. Do 30-60 days elimination period. Then test out the reintroductions (this can take many months to complete). After that time, you’ll know what foods your body can’t tolerate, and which ones are fine for you. This varies from person to person. For example, one person might do fine with eggs, while another might do fine with nuts. The protocol is a means to discovering what your body needs. Then, when you know that, make that your diet longterm. Every 6 months, you can try to reintroduce foods again. As you heal, you’ll be able to eat more of them. But overall, healing takes time. Some people get into remission quickly. For others, it can take years. But don’t be discouraged, because within that time frame, improvements happen, and I can say from experience that you’ll celebrate each way you begin to feel better. Does that make sense?

      1. Yes that makes sense. So does this also mean that once we are more healed down the line and our antibodies are lower that we may be able to eat more of the foods on the elimination list? (eggs, nuts, dairy,etc) that we were not able to tolerate in the early faces of the elimination? And that gluten, soy, etc we must always avoid?

        I ask this because I did Paleo for about a year and felt a little better but not 100%. (this was before my diagnosis, I did this on my own) My family thought my diet was too strict so I began eating grains, gluten and dairy again. I felt fine at first, my autoimmune symptoms did not kick in until the 4th month or so, and then it got really bad. I know clearly that I have to avoid these but its interesting it took so long for my symptoms to get bad. I regret even stopping Paleo because of how I feel now and it made me gain 35lbs in 5 months! Hoping the weight will come off naturally as my body readjusts and heals!

        1. That’s the goal! For example the Paleo Mom originally had such a high intolerance to egg whites that she actually rinsed her egg yolks before using them. Now, after having been on the protocol for a year, she can have whole eggs occasionally. Mickey from Auto-immune Paleo stayed on the full protocol longer – I’m thinking like 6 months. Now she can have nuts and eggs in moderation. Stacy from Paleo Parents reacted very strongly to dairy originally, but now she can have butter. As for the rest of Paleo, it’s considered a lifestyle, so most people have no intention of reintroducing grains/legumes/soy again.

          Do you know about the Hashimotos 411 Facebook group? There are 6,000 members, and they’re experts on dietary healing of Hashimotos. There’s more to it than just the foods you don’t eat. You need to add in healing foods like bone broths and organ meats. You need to work on reducing stress, improving sleep, etc. Many Hashis people continue to take thyroid medication and that combined with the paleo autoimmune protocol allows them to feel their best. It depends on how much damage happened to the thyroid before intervention. Either way, diet and lifestyle can make a huge difference in our health.

  41. Nowhere is it written in stone that we have to have cereal or eggs for breakfast–nobody’s going to arrest us for eating “dinner” foods for breakfast! I regularly eat lamb chops, or occasional salmon salad out of a bowl. Whatever’s in the fridge, I eat, and if there’s no cereal or eggs, or other inappropriate food (which there never is these days), I don’t eat it.

    1. It’s funny – our expectations built on habits often feel like the way things should always be. That’s why change is hard, but then once you make the change, the world becomes a bigger place. I can’t imagine going back to my old breakfasts. They were so unsatisfying!

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