The Process
The Paleo Autoimmune Protocol includes 2 phases: elimination and reintroduction. We aren’t meant to stay in the elimination phase forever. The reintroduction process is how we learn to communicate with our bodies and personalize our diets. It’s a process that requires patience, and it can be a little confusing and intimidating. Here’s a quick overview. I’ve also written an ebook that walks you through the process step-by-step.
- After eliminating the AIP foods for a minimum of 30 days and seeing clear improvement in your autoimmune symptoms, you can start reintroducing them into your diet, one at a time. This is the testing period, where you discover if you are sensitive to any of these foods.
- Choose one food to reintroduce. The first reintroduction step is a series of tiny bites which minimize the risk of intense reactions. Start with 1/2 teaspoon and wait 15 minutes. If you have no reaction, eat a full teaspoon, and wait another 15 minutes. If no reaction, eat 1-1/2 teaspoons. Then wait a few hours. If still no reaction, go ahead and eat a normal size portion of that food. Now, stop eating the food altogether, and watch your body for symptoms over the next 3 days. Reactions can happen anywhere from immediately, to a full 72 hours later. A reaction is an increase in your autoimmune disease symptoms. This might be pain, fatigue, difficulty sleeping, a skin rash, digestive distress, brain fog, moodiness, etc.
- If you do have a negative reaction, you know you are intolerant and should avoid that food. Wait for the symptoms to pass before reintroducing another food, so you have a clear baseline for each reintroduction.
- If you have no reaction, that food is potentially safe for you to eat. To confirm this, eat a little bit of this food every day for a week, and monitor your body again. Food intolerance seems to come in two forms. (1) A strong reaction, where there’s no doubt that your body reacts negatively to the food. (2) A cumulative inflammatory response that starts off so mild you can miss at first, but becomes noticeable after daily consumption. If after eating the food for a week, your body still feels good, then you know that food is not a problem, and you can introduce the next one.
- Tip: as human beings, our bodies fluctuate from day to day; some days we feel a little better than others, and some days we feel a little worse. When you’re monitoring for a reaction, you’re looking for a clear response outside of the range of your normal fluctuations.
- Emotions can also affect the reintroduction process in two ways: (1) Denial: you reintroduce a food, have a negative reaction, and think to yourself, “There’s no way this is a food reaction; it’s gotta be something else.” That’s one of the reasons there’s a second phase, where you eat a little bit of the new food every day for a week. If the food causes a reaction, there will be no question by the end of the week. (2) Fear: you’re so afraid of what might happen when you reintroduce a food that the emotion itself causes you to flare. Emotions are powerful; don’t ignore them. Meditate, practice heartmath, do some deep breathing, write in your journal. Do whatever helps you relax, before reintroducing the new food. If you can’t let the fear go, postpone reintroductions until you feel emotionally ready. There’s no rush.
Order of Reintroduction
When you start reintroducing foods, you want to begin with the lease allergenic food in each category.
- Introduce egg yolks by themselves, before introducing whole eggs. Most people tolerate the yolks well; if there’s an intolerance, it’s usually to the egg white. Note: Soy is a common chicken feed, and research shows the soy protein is transferred to the eggs. If you find you’re intolerant to eggs, you might actually be reacting to the soy. Some people have found that they can eat pastured soy-free eggs, but not conventional ones, for this reason. If you can’t find soy-free eggs locally, you can buy them online through Healthy Traditions.
- Introduce seeds before nuts. (1) Start with fruitbased and seedbased spices. (2) Next, test seedbased oils (like sesame). (3) If that went well, proceed to soaked and dehydrated seeds, (4) Then try seed butters and flours, raw seeds and toasted seeds. (5) Finally, test cocoa and coffee separately. Although they’re seeds, the body responds to them uniquely. The best way to reintroduce cocoa is through homemade chocolates, so you isolate other variables. (Storebought chocolate often contains soy and refined sugars.) The same goes for coffee. Don’t go to Starbucks; make it at home. (6) If you digest most seeds well, you’re ready to try nuts. Start with nut oils (like walnut and macadamia). (7) Then soaked and dehydrated nuts, (8) Then nut butters and flours, raw nuts and toasted nuts. Why? Seeds are easier to digest than nuts, and soaking seeds and nuts increases their digestibility another level. Individual vs. group: Since many people find they tolerate one type of nut or seed and not another, it’s best to reintroduce one variety at a time. Start with your favorite. Tip: When you’re ready to try toasted seeds or nuts, it’s better to buy them raw and toast them at home, rather than buy toasted ones from the store. Store-bought varieties are often toasted in refined oils not allowed on the paleo diet (such as canola oil).
- For dairy, reintroduce in this order: (1) grassfed ghee, (2) grassfed butter, (3) raw goat yogurt or kefir, (4) raw goat milk, (5) raw goat cheese, (6) raw cow cream (7) raw cow yogurt or kefir, (8) raw cow milk, (9) raw cow cheese. Why? Dairy is made of three components: butterfat, lactose and casein. Many people don’t have a problem with butterfat, which is why ghee and butter come first. If there is a food intolerance, it will be either to the lactose or the casein (milk is highest in lactose and cheese is highest in casein.) Raw dairy is recommended as long as you can find a trusted source. It contains living enzymes that make it easier to digest, as well as a higher nutritional profile. Lastly, goat dairy is introduced before cow dairy, because goat dairy is easier to digest.
- Nightshades are recommended as the last reintroduction, because they are the most common food intolerance for people with autoimmune disease, and the effects of the inflammation after reintroduction can take longer to tone down. When you reintroduce them, do so one vegetable at a time. While some people find they are intolerant to all nightshades, others find they tolerate some and not others.
- What about grains and legumes? Fresh legumes like green beans and peas don’t have the digestive challenges of dried legumes. For that reason, many people enjoy them on a paleo diet, and many people with autoimmune disease reintroduce them successfully. However, dried legumes and grains are excluded on a strict paleo diet, because they can cause a variety of health challenges. Some people never attempt reintroducing them. Others reintroduce them back into their diets in small amounts. If you decide you want to try dried legumes, try soaking and/or sprouting them first, which can sometimes make them easier to digest. When it comes to grains, the recommendation is to try white rice or gluten-free oats first, as they tend to be better tolerated. If you decide to reintroduce other gluten-free grains, try soaking them as well. Remember that these are nutrient-poor foods compared to vegetables, meat, and seafood. For that reason, even if you reintroduce them successfully, they aren’t recommended to eat every day. Focus on nutrient-density in your daily diet, for optimal autoimmune health. Gluten-containing grains can trigger autoimmunity more than almost any other food; for that reason, reintroduction isn’t recommended.
- 4 Stages of Reintroduction: In The Paleo Approach, Sarah Ballantyne wrote about an order of reintroduction based on her best guess on which foods are easiest vs. hardest for the body to tolerate. Things like fresh legumes, black pepper and seed-based spices are included in Stage 1 (first foods to reintroduce), whereas tomatoes and gluten-free grains are included in Stage 4 (last foods to reintroduce). I’ve included this information in my ebook as well.
Testing Again in the Future
Just because you have a food intolerance now doesn’t mean this will always be so. As your body heals, you can often reintroduce foods again and find that your intolerance is gone. Wait 6 months, focus on healing, and then try the reintroduction process again.
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