My Experience with the Paleo Autoimmune Protocol“I wish for you a lifetime of eggs.”~ Colleen Michaels Where I Started. I shared part one of my story back in January when I started this blog. I talked about the onset of rheumatoid arthritis, my choice of the GAPS diet for dietary healing, and the results of that diet, which were profound. All products and services featured are selected by our editors. Health.com may receive compensation for some links to products and services on this website. Q&A: DIET, ARTHRITIS, & AUTOIMMUNE DISEASES. Klaper: “Could what I eat be making my arthritis worse? Is there any kind of diet or supplement that might. Is ther an anti inflammatory diet? Learn about how food can play role in your arthritis. Without inflammation, wounds and infections would never heal. Similarly, progressive destruction of the tissue would compromise the survival of the organism. What is a low carb diet, really? When can a low carb diet be beneficial? Should everyone follow a low carb diet? Or, can a low carb diet ruin your health? But after 5 months on GAPS, I plateaued in my progress, so I decided to try the Paleo Autoimmune Protocol (AIP). It’s now 9 months later, and here are the results: RHEUMATOIDONSETGAPSRESULTSAIPRESULTSExcruciating daily joint pain flares. Moderate flares a few times per month. No flares. Extremely stiff mornings & evenings. Semi- stiff mornings. Barely stiff mornings. Intense daily pain. Mild daily pain. No daily pain. Weather affects joints. Weather affects joints. Weather no longer affects joints. Pain interrupts sleep. Sleep OK but get sore after 6 hours. Sleep deeply and long most nights. Exhausted. Normal energy. High energy. Disabled in many ways. Functional but weak. Getting stronger every month. Couldn’t exercise at all. Long daily walks, weekend hikes, gentle strength training. Road trips are painful. Road trips cause stiffness. Road trips are comfortable. High doses of painkillers daily. Aleve tablet morning and night. Aleve tablet morning and night. Food Reintroduction Results. The AIP is an elimination diet, where you avoid certain foods for a minimum of 3. Here’s what my body had to say: Eggs: I reintroduced egg yolks first, and then whole eggs. I had no reaction to either one and happily included them back into my diet. Chocolate: I reintroduced cocoa next because I missed it, and I believe we all need indulgences, even on restricted diets. Luckily, my body responded well. Note: I made homemade chocolates to be sure there were no hidden ingredients or cross- contamination issues. Nightshades: In this category, I decided to reintroduce nightshade spices before the vegetables. I made some taco burgers and ended up having a huge reaction. My whole body became tender. I felt like I was 9. The pain made sleep difficult, and it took a couple of weeks before my body returned to baseline. A good autoimmune disease diet can help fight autoimmune disease. I didn’t risk trying nightshade vegetables, since I reacted so strongly to the smallest amount of spice. They’re out of my diet long- term. Motivated patients say it makes them feel better. The Autoimmune Disease Diet is a 4 step program for overcoming autoimmune conditions with diet and lifestyle changes. Sample meal plan and recommendations. As a followup to our look at the root causes of autoimmune illness, this post reviews several natural ways to protect yourself against autoimmune illness. An RA healthy diet is basically a well-balanced diet that is low in saturated fats, high in Omega-3 fats, and full of brightly colored fruits and vegetables. Dairy: First a confession: I never removed ghee from my diet. I felt like I was giving up so much already. However, I removed all other dairy, and chose to reintroduce grassfed butter first, fully expecting to eat it without a problem. I got a huge stye on my eye, flared in two joints, got constipated and had PMS during my next menstrual cycle (something I hadn’t experienced since starting a healing diet.) A wise woman would have stopped there, but I had been told that: (1) goat’s milk is different from cow’s milk, (2) raw milk is better than pasteurized, and (3) fermentation makes it easier to digest. So, once I felt normal again, I made some raw goat’s milk kefir and had a smoothie. I flared in two joints again, felt stiffness bodywide, got 2 more styes (smaller ones), and my PMS that month was out of control. So, for my body, dairy is dairy, and it doesn’t like it! If any of you are surprised that dairy affected my hormones, I was, too. I knew that conventional dairy had hormones added, but I didn’t realize that raw milk naturally contains 2. I was reminded that dairy is meant to be consumed by baby animals who need those hormones to grow. Their affect on me as an adult human was quite different. Dairy is out of my diet long- term. Update: Since writing this post, I have met a number of people who react negatively to ghee, so in 2. I removed it from my diet to see if it was the key to my remaining inflammation. I flared upon reintroduction. Unfortunately, its removal didn’t eliminate my need for Aleve, but I’m glad to have removed a source of hidden inflammation in my body. I now recommend anyone new to the AIP go ahead and eliminate it for at least 3. Interestingly, my polls in the autoimmune community show that most people who tolerate ghee tolerate butter as well, and those of us who react to butter also react to ghee. So even though it’s advertised to be allergen- free, there is something in it that can affect autoimmune expression. Read my complete research into ghee in my post: To Ghee or Not to Ghee. Nuts: My reaction to nuts was more subtle. If you read my article on reintroducing foods on the AIP, I talk about 2 phases: (1) Eat the food at least 3 times within a 2. Then stop eating it, and monitor your body for the next 3 days. If you have no reaction, that food is potentially safe for you to eat. Food intolerance seems to come in two forms: either a strong reaction (like with the nightshade and dairy paragraphs above) or a cumulative inflammatory response (where you slowly feel worse the longer you eat the food). This was my experience with nuts. I took a couple of months to test them thoroughly, trying nut flours vs. I really like nuts, and was hoping I’d find a type that my body loved! What I discovered was that, to my body, a nut is a nut. If I just eat a small amount for one day, the reaction is so minor I wouldn’t notice. However, if I eat them daily, I develop insomnia within the first couple of days, digestive discomfort midweek, and increased joint pain by week’s end. So what does this mean for me? Whereas I’m acutely intolerant to dairy and nightshades and will avoid them altogether, I’m only moderately intolerant to nuts. As I continue to heal and my digestion improves, I expect to be able to eat nuts more comfortably. For now, though, I’m avoiding them. Seeds: My reaction to seeds was very similar to my reaction to nuts, but milder. I had no digestive distress at all. With seed butters and soaked/dehydrated seeds, it took 4 days of daily consumption before I noticed my joints becoming more sore. With raw or toasted seeds, I noticed increased tenderness on day one. So, there’s more nuance here. I would say I am only mildly intolerant to seeds. For that reason, I include soaked/dehydrated seeds in my meals occasionally for some extra crunch and flavor, but I don’t make them a part of my daily diet. However, this will probably be the first group I’ll be able to eat again without trouble. Extras: I voluntarily added a few extra restrictions to my autoimmune protocol. I removed citrus because I heard that some people with RA react negatively to it. I removed pork because many people claim it’s an inflammatory meat. It turns out, for me anyway, they were wrong. During the elimination phase, I felt deprived, and a little pissed off that I had to do it. However, I really wanted to feel better, and within a few weeks, I started to notice improvements. So, obviously at least one of these foods was problematic for me. My hope was that it would only be one food, so I was looking forward to the reintroductions with optimism. My original intention was to do the elimination protocol for 2 months before reintroducing foods, but at the 6 week mark, I found myself getting angrier at my food limits, bored with my food choices, and resentful that the joy seemed to have been sucked out of my kitchen. I even started craving standard American junk food, something I hadn’t craved since starting a healing diet. I was afraid that I might binge and set myself back. I was also afraid that my emotions themselves would cause my joints to flare. I had experienced that in the past, and I didn’t want to create a situation where it would happen again. Elimination diets are usually done for 3. I had set my own 2- month goal randomly. So, I started reintroductions after 6 weeks. The reintroduction phase ended up being an emotional rollercoaster. With each reintroduced food, I had high hope that I would be able to eat it without trouble. Every time my body reacted negatively, I grieved the loss of that food, and I also had to deal with the symptoms of the reaction itself. Meditation was an important part of my daily routine. I discovered that you need a lot of patience for the reintroduction process; it usually takes many months to complete the reintroductions, and if you rush things, you blow the whole experiment by introducing too many variables at once. The other aspect of the rollercoaster were the positive emotions I experienced: a deep gratitude to have such clear communication with my body, and the joy of feeling better and better the longer I was on the autoimmune protocol. By the last reintroduction (which for me happened to be dairy), I wasn’t grieving at all any more. I just wanted to be done and know which foods I could eat and which I needed to avoid. During the elimination phase, I gave up all these foods based on a theory. By the end of the reintroductions, it was no longer theoretical. It was very practical. I had reintroduced some foods successfully and happily, and the ones I could no longer eat gave me very clear reasons for avoiding them. I read an interview with Michael J. Fox, where he talked about his Parkinson’s disease. This quote reflects how I felt at the end of my AIP experience: “There’s an idea I came across a few years ago that I love. My happiness grows in direct proportion to my acceptance and in inverse proportion to my expectations. That’s the key for me. If I can accept the truth of . In the summer of 2. I didn’t know how I could make it through each day. When I re- read part one of my story, my eyes filled with tears. It was such a painful and terrifying time in my life, and I’m so glad it’s in my past. In contrast, I feel good now on a daily basis, and every month I regain an ability I had lost. But I’m not yet symptom- free: When I walk and hike, there is occasional tenderness in the balls of my feet. It’s not to the level of pain, but it’s no longer that glorious “taking my feet for granted” that I felt before developing RA. While my hands no longer hurt, and I’ve regained grip strength, I have two fingers that have restricted range of motion. Diet, Arthritis, & Autoimmune Diseases. Yet, it has long been known that many factors can affect arthritis – physical activity, emotions, even the weather. However, prevailing medical thought still holds that food has little or no effect upon joint pain. The diet- arthritis connection is often disdainfully dismissed as “unscientific” or as “magical thinking.” Fortunately for the millions who suffer from arthritic pain, recent medical studies indicate that relief can be as close as their dinner plate. Numerous articles published in prominent medical journals confirm what I have witnessed for years in my medical practice: many people with rheumatoid arthritis and other forms of inflammatory joint disease really ARE reacting to substances in their food (1). The studies also demonstrate that identification and elimination of the offending foods – a therapy completely free of cost and risk – often provides dramatic improvement, or even complete remission of joint pain and disability. Why are physicians so reluctant to consider the possible connections between painful joints and what the owner of the joints has been eating for breakfast, lunch and dinner? A major reason is that in medical school, most physicians- to- be learn that fragments of food proteins are simply too large to be absorbed from the intestine into the bloodstream, and thus cannot be involved in inflammatory reactions in distant organs, like the joints. Consequently, the patient’s diet as a causative factor is usually discounted and instead, powerful (and expensive) anti- inflammatory medications are prescribed as the foundation of therapy. Both physician and patient can then settle for mere suppression of inflammatory symptoms while overlooking a possibly treatable cause that may be as close as the patient’s dinner plate. This “relief” can often inflict severe side effects, such as intestinal bleeding, inflammation of the liver, depression of bone marrow function (where new blood is made) and, of great concern, injury to the wall of the intestine. Why is this important? IS YOUR GUT LEAKY? Ignoring the effect of the diet of the patient with inflammatory arthritis is scientifically short- sighted; it is now clear that in most people with these conditions, fragments of protein from foods and from organisms living in the gut certainly DO leak into the bloodstream after most every meal. In reaction to these foreign substances, antibodies in the blood are commonly produced against components of egg protein, chicken protein, milk protein, and wheat protein within hours after eating these foods. This phenomenon of the “leaky gut” is present in everyone to some degree, but is far more pronounced in those whose intestinal walls are inflamed for any reason, such as in people with chronic parasite infestation, diarrhea of bacterial or viral origin, inflammation of the large intestine (colitis) or small intestine (enteritis or Crohn’s disease,) as well as in many allergic/atopic conditions, like asthma and eczema. Non- steroidal anti- inflammatory drugs (NSAIDS), including ibuprofen (Advil) and naproxen (Aleve) can injure the intestinal wall directly (more about those later) and, ironically, contribute to the gut inflammation they are taken to treat! Our food choices can injure our gut lining directly by their physical or chemical properties (fatty, acidic, nutrient poor, etc.) but also indirectly by unbalancing the micro- biome – the trillions of microbes that live in the mucus layer lining our intestine and form part of the functional barrier of our gut. Fatty foods, especially saturated fats, reduce bacterial populations while high- meat diets spawn bacteria that can tolerate lots of bile in the intestine – and promote DNA damage and cancer growth (2). People drink chlorinated drinking water, sodas with phosphoric acid, coffee, black and herbal teas and, of course, alcohol in wine, beer and other drinks – all of which kill beneficial bacteria! Foods are sprayed with pesticides that alter the bacterial balance and most commercial flesh foods contain residues of antibiotics fed to the animals, which then concentrate in their tissues. And of course, people often go to their doctor with a viral cold and ask for a prescription for antibiotics, “just in case” which inevitably unbalances the micro- biome – NOT a good idea! All these agents and actions can reduce the numbers of beneficial organisms in the gut lining. This allows more unfriendly, harmful microbes to “set up housekeeping” in the mucus layer – which then proceed to injure the integrity of the intestinal wall. This makes the gut more permeable (“leaky”) to molecules that should never enter the bloodstream – and this is just what happens. Once in the bloodstream, these small fragments of foreign proteins can lodge in sensitive tissues – like the delicate synovial membranes that line the joints. There, they can incite significant reactions, ranging from subtle but uncomfortable inflammation of connective fibers to hot, painful swelling and distention of the joints, as in acute rheumatoid arthritis. Chronic inflammation of the joints – or any tissue – over the years can result in tissue scarring, contracture, loss of function and ultimately, destruction of the joint. Many other organs in the body – heart, lung, eye, kidney, muscle – can also suffer damage from repeated inflammation: failing “rheumatoid heart,” fibrous “rheumatoid lung,” bleeding kidneys in lupus nephritis, etc. Chronic inflammation is energetically expensive and ultimately harmful for the body to sustain – yet, our Standard American Diet(“SAD”) diet filled with daily deluges of meats, dairy products, processed foods, concentrated sugars, preservatives, colorings, flavorings and other chemicals may foster that very process. So, the various kinds of joint inflammations, including some forms of rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis and others, may, indeed, have nutritional components and may greatly improve when offending foods are eliminated from the diet and other measures taken. Not surprisingly, other inflammatory conditions including asthma, psoriasis, eczema, and related disorders also can involve the so- called “leaky gut syndrome,” and so, too, frequently respond to the same therapies outlined below. THE MOST LIKELY CULPRITSAlmost any protein or other food substance can set off adverse reactions in the joints; however, in my clinical experience, the foods most likely to trigger joint inflammation are (in order): 1. Milk proteins (especially casein and lactalbumin) in dairy products – including whey, buttermilk solids, skim milk solids, “calcium caseinate,” “sodium caseinate,” all milk- derived cheeses, yogurt, ice cream, chocolate, etc. Chicken protein – including the “light meat” and “dark meat,” as well as egg whites. Wheat protein – including breads, pastas, wheat cereals, etc. Beef and other red meats. Soy protein – including tofu, tempeh, etc. Corn protein. 7. These four plants all contain anmolecule called solanum that, in a small number of people, may cause inflammation in the tissues – hence the shady reputation of these otherwise nutritious foods. In my experience, less than 1. I find that after 4 – 6 months, when most or all of the inflammatory symptoms have subsided, the above four can be introduced back into the diet, one at a time, in the manner suggested below, assuming the person desires to eat them. The following food plan will fully nourish your body while helping to you identify problem foods.“THE BASELINE SAFETY DIET”Note: The following has been modified to incorporate the very useful analysis and guidelines of Clint Paddison who has been successful in helping thousands of patients with inflammatory arthritis overcome their painful symptoms. For 2 days, consume only fresh vegetable juice made of celery and cumber only. From day 2 – 1. 2, reintroduce foods according to the following “Paddison Program” protocol (link opens in a new tab or window): During this time of diagnosis through dietary simplicity, it is best to minimize confounding factors by keeping seasonings to a minimum, as some spices like cayenne can incite inflammatory reactions in susceptible people. A “pinch” (1/8 teaspoon) of iodized salt on the surface of vegetables may be permitted – and will go a long way to make these baseline foods more palatable – but be aware that high- salt diets can turn on genes that promote autoimmune processes in the body (3), so, when it comes to added salt, “less is more.”Also, as the vital element iodine is washing out from our soils, and thus from our foods. If you are going to be using table salt at all, it is wise to use a pinch of iodized salt on your food. Iodized sea salts are available.) After the inflammation has been improved to the maximal extent on this food program, “new” seasonings can be re- introduced, one at a time, as described below. One of the benefits gained through this is increased appreciation for the natural taste of fresh fruits, vegetables and other whole foods. After following this regimen, many, if not most, people will find their joints much improved or completely free of pain and stiffness, perhaps for the first time in years. Beneficial fats have a role here: “Omega- 3” fatty acids can exert an anti- inflammatory effect in rheumatoid arthritis and autoimmune diseases. Ample (1 – 2 cup) helpings of dark leafy greens should be consumed daily, as should a small handful of walnuts, either as whole nuts or blended into dressings and sauces. One to two tablespoons of fresh ground flax, chia, and hemp seeds should be eaten daily sprinkled on cereals salads or soups (4). DHA/EPA supplements derived from algae (as opposed to fish oil (5) can be purchased online and in natural food stores; 3. DHA with approximately 1. EPA is appropriate. GLA (gamma- linolenic acid) is an “omega 6. GLA to help reduce inflammation.
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