The Epidemic of Autoimmunity
Autoimmunity is a 21st century epidemic, especially in the Western developed nations. Most likely, you have a close friend or family member with an autoimmune disease – or maybe you have one yourself. The American Autoimmune Related Diseases estimates that 50 million Americans suffer from an autoimmune disease.
Why is autoimmunity so prevalent? As Hippocrates accurately said, All disease begins in the gut. Our modern diet and lifestyles cause permeable digestive tracts so that we are prone to develop autoimmunity or have a child with a predisposition for autoimmunity. Understanding the root cause of autoimmunity is key to healing it, so we’ll go into more details in a moment.
The good news? When it comes to addressing autoimmune diseases, diet works. And I’m living proof.
Healing my own autoimmune disease
As you may know, I struggled with a severe form of ulcerative colitis, an autoimmune disease. I quickly gained remission and was able to stop my medications after starting the GAPS Diet, a popular protocol for autoimmune disorders.
While the GAPS Diet absolutely turned my life around, it took a year of experimenting before I found foods that were impeding my healing process. I found my problematic foods included egg whites, nuts, seeds, and nightshades. Recently, I learned that I had modified my diet to closely resemble the Autoimmune Paleo Protocol (AIP), a dietary regimen for treating all variations of autoimmunity.
The Autoimmune Paleo Protocol
I began learning about the AIP first through Sarah Ballentyne’s site, The Paleo Mom. Sarah is a scientist delves into details about exactly why the AIP works. Quickly afterward, I found Mickey Trescott (that’s her on the left!), author of The Autoimmune Paleo Cookbook and the blog Autoimmune-Paleo.com.
I asked Mickey some questions about the AIP to give you an overview of the protocol. You can find even more information about the protocol on her site and The Autoimmune Paleo Cookbook, which I review below.
What foods are included in Autoimmune Paleo Protocol?
Mickey:
Strictly avoid:
- Grains (including pseudo-grains like quinoa)
- Beans and legumes
- Dairy
- Eggs (of any kind)
- Nuts (including chocolate, unfortunately)
- Seeds (including coffee and seed-based spices like coriander and cumin, and seed oils)
- Nightshade vegetables (tomatoes, bell peppers, hot peppers, eggplant, potatoes, and spices derived from them like paprika, cayenne, and curry)
- Food chemicals and non-nutritive sweeteners, including stevia
- Alcohol
- NSAIDs
Include:
- Pastured meats like beef, chicken, turkey, lamb, duck, and bison
- Bone broth and organ meats from pastured animals
- Wild-caught fish and shellfish
- Animal fats like tallow, lard, and duck fat from pastured animals
- Tropical oils like coconut and red palm (sustainably harvested)
- Olive oil and avocado oil (for cold applications)
- Any fruit (except ground cherries and tomatoes, which are nightshades)
- Any vegetable (except nightshades, denoted above), especially leafy green veggies, roots and tubers
- Herbs and spices that are not seeds or nightshades, like thyme, rosemary, turmeric, garlic, ginger, etc.
- Coconut flakes and coconut butter
- Vinegars, like apple cider, ume plum, or coconut
- Fermented foods like saurkraut, kombucha and water kefir
Here are handy reference lists with print-out guides to stick on your fridge.
How does the Autoimmune Paleo Protocol support healing?

From the book
Mickey: It has been shown recently in studies that all autoimmune diseases have one thing in common – intestinal permeability, otherwise known as leaky gut. When the gut lining becomes permeable, undigested particles of food, toxins, and pathogens are let into the bloodstream, thereby triggering the immune system. All of the foods avoided on the autoimmune protocol are those that have been shown to exacerbate leaky gut, and strict avoidance gives it a chance to heal.
In addition to this, the autoimmune protocol is an extremely nourishing, nutrient-dense diet and contains all of the nutrients needed to heal the gut lining, as well as the other parts of the body that have been broken down and inflamed by autoimmune disease. Once a person experiences a measurable improvement, they can then reintroduce foods to see which ones are contributing to their symptoms, ending with a unique diet that promotes the maximum amount of healing for their bodies.
Who is a good candidate for the Protocol?
Mickey: Anyone who has an autoimmune disease should try the autoimmune protocol, regardless of what organ or tissue the autoimmune disease affects – thyroid, skin, joints, connective tissue, and so on. In addition, anyone who suspects that they may have an autoimmune disease or has undiagnosed symptoms should try the autoimmune protocol.
The protocol is not a quick-fix – learning how to promote healing by trial and error is a long process and not for the faint of heart, although it is incredibly rewarding.
How much room for flexibility in the Foods to Avoid is there in the AIP?
Mickey: Unfortunately, there is no flexibility in the elimination diet. While some people choose to ease their way into the protocol, once all of the foods are eliminated a person must be 100% strict in order to have the best chance of making progress. This means checking the ingredients of everything – including teas, supplements, and condiments, as well as being extremely careful while eating out or at someone else’s house.
Once the elimination diet is over, a person can then reintroduce foods systematically to find out what their tolerance is to the various un-allowed foods, but until they get to that point, they need to be 100% strict.
How long should one follow the Autoimmune Paleo Protocol?
Mickey: I generally recommend people start with a month for the diet, but it is best not to reintroduce foods until you feel a measurable improvement in your symptoms. This could take anywhere from a month to over a year (rare, but I have heard of it happening!) Otherwise, it is very hard to tell which foods are affecting you when you go to reintroduce them.
Some people start to feel better, and they continue on the elimination diet because they want to keep healing. This is the approach I took – I reintroduced a few foods (nuts and seeds) a couple of months in, but waited a fairly long time (1 year) to reintroduce eggs. I still haven’t been able to reintroduce grains, dairy, or nightshades, and it has been 2 years.
What should one eat if one decides to transition off Autoimmune Paleo Protocol?
Mickey: I recommend people transition to a standard Paleo diet after being on the autoimmune protocol, and I think it is important to continue to include fermented foods as well as organ meats and fish. It is very important for those with autoimmune disease to stay grain-free, at the absolute minimum.
I think adding certain foods to my diet, like homemade bone broth and organ meats, has been as helpful as removing certain foods. How to these foods fit into the AIP?
Mickey: The Autoimmune Protocol is as much about the additional healing foods as the foods that are avoided. Bone broth, organ meats, fatty fish, and ferments are all an important part of the protocol, and those that do not include them do not progress the way that those who do. All of these foods are incredibly nutrient-dense and contain the raw materials to heal the gut and promote healthy flora balance, which is what the Autoimmune Protocol aims to do.
What is the AIP approach to sugar consumption?

From the book
Mickey: The Autoimmune Protocol is not a sugar-free diet, although refined sugar and excessive fruit consumption is not allowed. A piece or two of fruit a day is perfectly fine, provided it is well tolerated. I don’t advocate making treats or using sweeteners like maple syrup or honey on a regular basis, but they are fine for occasional use (maybe once a month).
I use fruit in some of my recipes for flavor and to add a touch of sweetness, but they always appear in the context of adequate fat and protein (like some citrus in a pot-roast, or cranberry short-ribs). Blood sugar issues are well known to cause autoimmune flares, so I stress that people take it easy on the fruit and treats without completely depriving themselves. It is about balance!
Finally, how has the Autoimmune Paleo Protocol affected your own health?
Mickey: I came to the Autoimmune Protocol after I had been diagnosed with both Hashimoto’s and Celiac disease. I had been vegan for 10 years, and I had a massive crash that left me bedridden and unable to work for months. Out of desperation I decided to try the Autoimmune Protocol, and finding out about my food sensitivities turned out to be the thing that enabled me to find health again. It was a long road, and I am still working on healing my gut two years later – but it has absolutely changed my life!
The Autoimmune Paleo Cookbook
Are you ready to heal your autoimmune disease through diet, but overwhelmed with the idea of this protocol? I totally get it. It takes a lot of courage to make these drastic changes – both Mickey and I understand this! If you are ready to make the commitment to heal, then I strongly encourage you to look at Mickey’s book, The Autoimmune Paleo Cookbook, an essential guide for the protocol.
Here’s some of the highlights in this guide:
- A detailed explanation of the Autoimmune protocol
- Multiple AIP friendly meal plans with shopping lists
- Step-by-step guides for preparing staples like bone broth, probiotic drinks and coconut products
- Over 110 creative, straightforward, and delicious recipes for the protocol
- Gorgeous photography by food photographer Kyle Johnson
- Extremely tasteful layout and design (a point oddly dear to my heart… am I the only one who judges a book based on the graphic design?)
Don’t forget to check out the other wonderful resources and free recipes on Mickey’s site!
You wrote in the article that leafy greens are fine, but spinach and Swiss chard , or silver beet , are very high in oxalates. There could also be others.
I read that tumeric is also very high in oxalates .
Spinach and Swiss chard or silver beet , also tumeric , are very high in oxalates.
I’ve read that bone broth is extremely healing for the gut, but I get terrible headaches when I consume it. I’m guessing because of an MSG sensitivity. What else is as powerful as bone broth for gut healing? Are collagen supplements helpful?
Do you girls realize how many conflicting statements & how much conflicting info you have here? Your lists of Oxalate content in foods, Lauren, is very different, even completely opposite of other lists available online. I realize all lists online of Oxalate content in foods have differences from one another but where their lists agree your info has low oxalate foods listed as high Oxalate foods. And some of the foods you suggest to eat to heal the gut on this protocol are high Oxalate foods, “especially leafy greens” which would include spinach, swiss chard & kale….
Then Mickey recommended staying on the AIP diet for 1 month minimum and up to however long it takes to heal your gut & reintroduce problem foods. Yet after 2 years she still could not reintroduce “grains, dairy or night shades”. One could ask, Is it working? And then lastly it was suggested if you go off the AIP diet to “at least remain grain free” & follow a paleo diet. A paleo diet has you practically living on nuts & nut flours which are all very high Oxalate foods.
Have you heard of the plant base whole foods diet/lifestyle/way of eating to regain health? They have the science to back up why low carb & no grain ways of eating don’t work & are bad for you.
While I believe your intentions to help others is good, your approach seems more like a one size fits all. We are all unique chemical factories & genetic combinations & environmental factors that makes everyone’s journey to find the best health they can achieve a unique one. I’m sorry I didn’t find anything useful here but rather a good example of, consider the source. Sometimes personal experience & personal opinion can be helpful to point someone in a useful direction but your multiple contradictions reduced your credibility to 0. I’m sorry if my view sounds harsh but for me your contradicting info was not useful. 🙁
Hi, my name is Joseph, I’m a 28-year old male who was diagnosed with Interstitial Cystitis. Previously I had been diagnosed with Dysuria which was treated successfully with antibiotics. I have also been struggling with a toenail fungus for years as a result of candida. Unfortunately, I have mercury fillings and cannot afford a holistic dentist and was wondering if I could still do the GAPS diet to get rid of my suspected candida overgrowth? Will it still be as effective in removing yeast in the wrong places in my body? I’ve also had recurring infections that my doctor thinks are balanitis. Please help me? I need to get rid of this candida overgrowth. Thank you for your time.
Hey Joseph, I’m 31 and I have urinary troubles related to previous amalgams. I know what you’re going through, sort of. It really sucks. I had my amalgams drilled and replaced by a conventional dentist in 2015 and though the physical symptoms didnt show up immediately, they ruined my life. I didn’t even know they had contained mercury until the research I did in 2017. The bladder troubles are just the tip of the iceberg for me! I think you have made the right move by holding tight until you can afford a holistic dentist. It’s a shame they are so expensive and I think it’s unfair, lest I sound like I’m tooting the horn for them. But, if I could turn back time that’s what I would have done. I also got IBS from a round of antibiotics that was supposed to help my “UTI” that I actually never had. By that point my microbiome was probably already impaired which could explain why one hit was so damaging. I stay away from antibiotics because bathroom trips are bad enough.
Joseph, IC is tough to treat however I picked up a tip from a gal while a managed a health food store. Drinking black cherry juice saved her when all else (doctors) failed her for years. Also there is a relationship to serotonin and IC (too much causes it). There are holistic books on how to heal it.
I developed a lot of difficult symptoms due to the treatment of Lyme disease (doxycycline is a killer) It destroyed by intestinal flora and I developed the toenail fungus. After years of trying alternatives I bit the bullet an took Lamisil. They (doctors) will monitor your liver enzymes to make sure you don’t get liver damage from it. Just take milk thistle every day and methionine and your liver will be protected (another health food store tip that works.) Both cherry juice and milk thistle are high in oxalates but it’s worth it. The candida is definitely systemic and sometimes you need the drugs to kill it. It worked for me and I avoid drugs at all costs. Candida overgrowth is also a classic sign of leaky gut.
Between a low histamine diet, a low oxalate diet, Candida diet, and paleo protocol ( which includes problem foods you should avoid when on the other diets), how do you determine which diet is best for you? I have arthritis and a lot of high inflammatory markers, but I don’t know why. Is there a way to tell if you have a leaky gut before cutting out oxalate? Or a histamine problem before cutting out yeast, yogurt and fermented foods? Or a Candida problem before cutting foods from that list? Or if cutting dairy or eggs is required the way some diets recommend?