To start, let me explain what autoimmune means. If you take the word immune from the whole word, it means, according to the Merriam-Webster dictionary:

1. “Not susceptible or responsive”
2. “having or producing antibodies or lymphocytes capable of reacting with a specific antigen”
3. “marked by protection”1

This relates to our bodies immune system, which is responsible for fighting off things, like bacteria and viruses, that mean to do us harm. Now, autoimmune, according to the Merriam-Webster dictionary, means:

1. “relating to, or caused by autoantibodies or T cells that attack molecules, cells, or tissues of the organism producing them”2

When a person is diagnosed with an autoimmune disease or disorder, this generally means the person has a condition in which the body’s immune system mistakenly attacks the body’s own healthy tissues, blood, organs, cells, etc. Some of the most commonly diagnosed autoimmune diseases are Type 1 diabetes, Rheumatoid arthritis, Lupus, Inflammatory bowel disease (including Crohn’s and ulcerative colitis), MS, Psoriasis, Celiac disease, Addison disease, Graves diseases, and Hashimoto’s thyroiditis, and “leaky gut” (also known as intestinal permeability). This is by no means a comprehensive list. 

Some of the most common autoimmune disease symptoms are:

• Fatigue
• Joint pain and swelling
• Skin problems (excessive dryness)
• Abdominal pain or digestive issues
• Recurring fever
• Swollen glands

Again, having just one of these symptoms is not a sure tell sign that you have an autoimmune disease, and there’s no one test that can be done to make a diagnosis. Usually, these symptoms are combined with certain or specific blood markers or even in congruence with a tissue biopsy2. The exact cause of autoimmune disorders or diseases is unknown, but there is one theory that suggests that some bacteria or viruses or drugs may be responsible for triggering changes in the immune system4. In most cases, treatments depend on the diagnosis, though most treatments include supplements to replace substances the body is deficient in, including:

• Thyroid hormone
• Vitamin B12
• Insulin
• Vitamin D
• Blood transfusions4

There are times when providers will prescribe medications called immunosuppressants, which are responsible for decreasing inflammation in the body4. The prognosis for autoimmune disorders is varying, as some are chronic and can be controlled with treatment, while others have symptoms that come and go, and when the symptoms get worse, they have a “flare up”4. 

The AIP, or Autoimmune Protocol diet, isn’t specifically a diet, as much as it is a lifestyle change approach to eating. The AIP diet is an elimination diet (think Whole 30 or Paleo on steroids). There are two main phases in the AIP diet. First is the elimination phase, followed by the reintroduction phase. You basically cut out all major allergen categories, as well as any type of food that might be inflammatory, such as gluten5. You then go on to eat very nutrient and protein dense meals for 30-90 days to help your body “reset”, or until your symptoms have improved. After this elimination period, you gradually reintroduce foods, one at a time, while monitoring the body’s response. If you feel good after the reintroduction period, you are good to keep the food in your eating plan! If you don’t tolerate the food well, you put it back on the elimination list, and possibly try it again later after you have reintroduced more foods. It sounds complicated, and at times, it can be. However, it is a great way to determine the foods that make you feel “yucky”, or that don’t bother you. 

The whole point of the AIP is to reduce inflammation, pain and other symptoms commonly caused by autoimmune diseases. The diet focuses on replacing “trigger foods” with health promoting, nutrient-dense foods that encourage gut healing, and reduce overall inflammation and symptoms related to autoimmune disorders5. 

Elimination Phase

During the elimination phase, all foods and medications that may contribute to gut inflammation, imbalances between levels of good and bad bacteria in the gut or that may promote an immune response are removed from the diet. This includes:

• Grains
• Legumes
• Nuts
• Seeds
• Nightshades
• Eggs
• Dairy
• Tobacco
• Alcohol
• Coffee
• Oils
• Food additives
• Refined or processed sugars
• NSAIDS (non-steroidal anti-inflammatory drugs)

This phase then encourages the consumption of fresh, nutrient-dense foods, minimally processed meats, fermented foods, and bone broth5. It also focuses on a whole body aspect of improvement, such as limiting stress, improving sleep and increasing physical activity5.

The elimination phase typically lasts about 30-90 days, though most individuals begin to see improvements within the first 3 weeks.

Reintroduction Phase

After symptoms have improved overall, the foods on the elimination list can gradually start to be reintroduced, one at a time, to the individual’s tolerance. Yes, it’s nice to be able to eat a larger variety of food, but the overall goal of this phase is to determine which foods cause an inflammatory reaction. 

When a food is reintroduced, it is done in a very specific way. 

• Step 1: Choose a food to reintroduce. You will eat this food a few times on the day you are testing, and then you will avoid the food for about 5-7 days.
• Step 2: Eat about 1 teaspoon of the food, then wait 15 minutes to see if you have a reaction. If you have a reaction, end the test and avoid this food.
• Step 3: If you have no symptoms, eat 1 ½ teaspoons of the same food, and monitor how you feel over the next 2-3 hours without consuming any more of this food, even as long as 24 hours.
• Step 4: If you do not notice any unusual symptoms during this period, try eating a “medium” portion of this food. Do not eat any more of this food for about 5-7 days.
• Step 5: If you do not notice any unusual symptoms during this time, as some symptoms may have a delayed reaction, you may now begin eating this food as part of your daily diet6!

I have to say, after going through this process for years now, this is definitely one of the best ways to reintroduce food. I can’t tell you how many times, as careful as I am about going out to eat, that I inadvertently ate something that I was intolerant to and ended up feeling terribly sick for hours after. And the worst part, I didn’t even know what I ate that bothered me so much! So let me just say that this reintroduction phase is so important!

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References

1. https://www.merriam-webster.com/dictionary/immune
2. https://www.merriam-webster.com/dictionary/autoimmune
3. https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-are-common-symptoms-of-autoimmune-disease
4. https://www.mountsinai.org/health-library/diseases-conditions/autoimmune-disorders 
5. https://www.healthline.com/nutrition/aip-diet-autoimmune-protocol-diet#what-it-is 
6. https://autoimmunewellness.com/how-to-reintroduce-food-on-aip-the-definitive-guide