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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Hi! Thanks for the information! This helps a lot as i amtrying to
reintroduce food again:) I have a question thoguh, about liquorice. I
thought it was a seedbased spice and reintroduced it as such, but
recently i heard that liquorice is actually a legume. If so, does it
classify as a legume with edible pods which can be reintroduced early on
or should i wait until reintroducing lentils and bean way long in the
future? I have tried googling this but came up with nothing.. Kind
regards, Ebba
Hi Ebba. I think the reason you don’t see licorice mentioned is that it’s pretty rare to use it as a spice and much more common to use it as a supplement. If you are just adding a small amount to a meal, I would put it in the spice reintro category. If you are considering taking a supplement, be aware that it can have an effect on the immune system. Some people find it very beneficial. Others have an inflammatory response. With all reintroductions, the goal is to listen to your body.
Thanks for your response! I see, then I think I will try it as a spice in smaller quantities for my low blood pressure as it usually raises it. Thank you again!
Hello! There is a chance I may be allergic to bananas, avocados, or/and coconuts. I notice that my ears get a little itchy when I eat certain foods. So sad. How should I approach this? I’ve been so reliant on all three foods since I started AIP 2 months ago! :(((
Hi Euni. If you think you might have a true allergy, you can go to a doctor to get allergy testing. If you think you might be simply sensitive to those foods, you could remove them for a month and then reintroduce them one at a time to test for a reaction. Those three foods are very different from each other, so it’s unlikely you are sensitive to all three.
Hi Eileen, thank you for responding! That’s a great idea. I haven’t had any of these foods for 4 days and my dermatitis has already cleared up by 50%. I’m relieved to hear that I probably will not be sensitive to all three! 🙂
A friend of mine has mast cell activation disorder and is on a low-histamine diet-she says avocados are high histamine-producers. Also the longer a fruit sits after picking before being eaten, it produces more too. Freckled bananas would have more histamines, and she said leftover meat especially would. Hope that helps!
Bananas and avocados are very high latex containing foods. Coconut is considered moderate, so there actually is a strong connection between these 3 foods, and the most common latex reaction is itching. My healing didn’t really start until I took these guys out of my diet
Bethany, thanks so much for sharing your experience! That is good to know. I did a little research, and you are absolutely right that banana and avocados can cause cross-reactivity in someone with latex allergies, but coconut is on the “low risk” list. So, Euni don’t assume you’ll find all three to be a problem upon reintroduction. Just listen to your body. Also, if you think a latex allergy might be at play, I recommend seeing a physician and getting allergy testing.
I’m starting the re-into phase… and I’ve read and understand the order in which to re-intro food groups. My question centers around the way in which I try, say, spices. I’ve read that I should eat a small amount, wait, eat some more, wait, etc. So, I’m here thinking that I would have to have a teaspoon of cumin, then another, and another etc., but that does not sound like a good time taste wise. I’d rather add cumin to a dish and try it that way. Which is the intent of the re-intro phase: to have teaspoons of spices to test, or can I add to an otherwise AIP friendly dish and assess??
Hi Erin. You instincts are accurate. For spices, you simply cook a recipe that incorporates them, and then proceed with the steps from there. You definitely don’t need to eat a straight-up teaspoon of a spice. The goal is to reintroduce things in the way they are normally eaten. Best wishes with your reintros!
I’m helping a family member on reintroductions and we’ve done great with eggs and grassfed butter. We currently don’t have a food dehydrator. I’m looking into buying a dehydrator since using the oven is a bit impractical in my situation. Besides using the oven to dehydrate seeds, what other processes do you recommend to make seeds/nuts easier to digest? For example, could I attempt a bread recipe with flax or chia seed, or do you recommend the soaking/dehydrating process?
Hi Heather. Soaking is the only method that I know works. However, if it’s not feasible for you, it’s fine to just attempt reintroductions directly with whole nuts and seeds. If they’re not tolerated well, you could always try again later once you have a dehydrator. Just be sure to test one at a time and follow the process above.
Hi Eileen,
Any suggestions on re-introduction of grain-like seeds such as quinoa and buckwheat? thank you!
Hi Marianna. Grain-like seeds would be treated just like grains. Soak or sprout for optimal digestion to give yourself the best chance for reintroduction success. This would be a late-stage reintroduction. (Wait until you’ve had successes in other categories).
Thanks so much!
I’m currently following the process in your book and I’m curious, if we aren’t able to get raw dairy, would pasteurized be okay? Also, I had eliminated FODMAPs because I am sensitive to some of them. Since dairy isn’t aip, I couldn’t test lactose. How should I go about reintroducing it?
Work with what you have available, but I do recommend organic dairy, so no synthetic hormones or other chemicals have been added. Also follow the guide’s instructions on least allergenic options within each category. With dairy, you’ll start with ghee and then butter, before moving onto anything else. If you tolerate those, you can test milk and cheese separately. Milk is higher in lactose and cheese is higher in casein. If you are only intolerant to one and not the other, that will help you figure that out. It is possible to be intolerant to both, though.
Thank you for your response! So if I fail milk, should I still try cheese to test casein?
I’ve also tried black pepper and star anise and both failed, does that mean I shouldn’t test the rest of the fruit spices as well as the seeds/seed spices and nuts? It also seems like most people are fine with the fruit based ones, does that mean I wasn’t as prepared as I thought when I tested them?
I forgot to mention for context, I’m 24 and have Hashimotos, grave’s, ulcerative collitis, and potentially celiac (I couldn’t test because I was already gluten free for years- not sure it’s worth triggering all of the above just to be truly tested). I find my doctors are very wary of aip. I recently told my endocrinologist and he basically dismissed it as “opinion without solid data,” then told me to go try eating white rice and potatoes. It was very upsetting because doctors said the same thing when I discussed the gluten connection to autoimmune thyroid disease years ago and it turned out to be true. AIP is really working for me and I wish they’d take it more seriously. Do you have any suggestions on how to deal with such doctors? Even with other people? Sorry this message is so long, but it’s nice to talk to someone who understands aip. Most people don’t understand why I’m doing what I’m doing even when I explain and just label me as picky or difficult (I often get the “well MY wife is celiac and SHE can eat there!” Sort of comments). There must be a better way?
You have a lot of questions, so you might benefit from some more detailed guidance than I can provide. There’s an online class starting on February 1st called AIP Reintros. It’s run by 2 health coaches who have autoimmune disease themselves and understand the process inside and out. I highly recommend it.
I’m so sorry you’re having to deal with that! I wish your doctors would educate themselves. Maybe if you gave them Dr. Ballantyne’s book or Dr. Amy Myers’ book-since I know Dr. Myers herself had an autoimmune disease and wrote what she did to recover in it. I’m surprised that I haven’t had more pushback in semi-rural MS-I’m blessed to have people supporting me and not questioning and doubting me-i understand how much energy it takes to defend what you’re doing and then have negative people pick it apart. I believe God put me in a place where I can heal even though it’s not going to be easy-but people are generally supportive and I hear a lot of “Bless your heart.” I pray you and all others fighting through this have strength and the wisdom to know when to pick your battles❤️
my son 20 months AIP .(MY SON STRICT AIP BECAUSE OF ANTITPO)
daughter 9 months aip (but takes very little amount of rice)
and i am planning to start with egg yolk. can i go ahead .
i was reading some article mention if celiac then egg yolk will also react.
how to know excat whether celiac or not.
Hi Suryabhan. The only thing celiacs absolutely need to avoid is wheat. Everything else can be tested through the reintroduction process, and based on your daughter’s reaction you will learn to personalize the diet for her. If you don’t already have my ebook, I recommend it. It will guide you through the reintro. process. Egg yolks are an excellent first choice, because they are so nutrient-dense. As long as your daughter tolerates them well, they’re a very healthy food.
Hi Eileen
As a coeliac I would just like to clarify that we must avoid all foods which contain gluten which includes wheat, barley and rye. Here in Australia we are also advised to avoid oats.
Regards
Lynn
Lynn, you are absolutely right. I should have used the word gluten instead of wheat. Thanks for taking the time to clarify.
My husband has had elevated ANA for 11 years with no progression or diagnosis other than his chronic inflammatory muscle pain and frequent leg and back muscle spasms. He is on plaquenil and celebrex prescribed by his rheumatoid doctor which keep his normal pain to a “3” on a 1-10 scale. He independently began the AIP diet 2 months with a significant improvement with his pain to a “1” on a daily basis. He has reacted 3 times with new foods – jicama, parsnips (I thought they were safe to try as something different during the initial elimination phase) and almonds during reintroduction of stage 2 foods. We are in stage 3 of reintroducing foods avoiding all night shades. What is the relationship of these 3 foods? I cannot find anything to help me understand his reactions to these foods. Additionally I am very frustrated that none of his 4 rheumatoid MD’s ever recommended trying the AIP diet even though we consistently asked if there was anything we could do to help him feel better. This diet has improved his quality of daily life.
Hi Diane. That’s wonderful that your husband has reduced his pain to a 1. How empowering! Food intolerances often fall into different categories, and they are unique to each person. You won’t always find a “common thread”. That said, people who have trouble with root vegetables like jicama and parsnips which are allowed on the AIP, often have gut dysbiosis. Foods high in starch and fiber can preferentially feed pathogenic bacteria in some people and that can increase inflammation in the body. Once you are done with the reintroduction process, if you want to troubleshoot further, you might consider working with a functional medicine practitioner and having a stool test done. This article explains more and includes test recommendations: How to Find a Good Functional Medicine Practitioner.
Hi there. I’m desperate to find help with this. I have Hashimotos, take Synthroid. TSH around 4.8 usually which I know is too high. I feel fine though, no symptoms such as brain fog, irritability, depression etc. I however have a few health issues which I am now linking back to my Thyroid: gum recession, scalloped tongue, snoring, low libido, etc. So I started the AIP diet. My problem is that when I want to try to reintroduce foods a few months from now, I don’t know what symptoms to look for as I have nothing concrete to compare it with from before like depression, anxiety, bowel issues (which I’ve never had), etc. All of my “problems” are not going to show whether or not a food that I reintroduce is reacting. I’ve read the symptoms to look out for however I never had any of those symptoms to begin with. So I fear that I’ll never know which foods are the culprits. Can you advise me in any way of how best to go about this? Thank you so much.
Hi Andrea. You started the AIP to address health issues – those are what you’ll be watching: gum recession, scalloped tongue, snoring, low libido, high TSH, etc. The first thing for you to watch is whether or not the AIP helps you with those symptoms. If it does and you find those symptoms improving or disappearing, you have a baseline for reintroductions. Then, if those symptoms return or worsen after a food reintroduction, that will be your sign of a reaction. Also, sometimes new symptoms pop up during reintroductions. For example, I don’t experience insomnia or depression normally, but I did during food reintroductions. Your body will let you know if a food is a problem for you, as long as you follow the elimination/reintroduction protocol.
I have found your article on re-introducing starch very helpful. I am on the GAPS diet and found that I can just about tolerate seeds, nuts, lentils (soaked in salt and vinegar for over 12 Hours) and haricot beans (soaked etc..). If I have potatoes, rice or sweet potatoes my immune system gets weakened. When I soak (etc..) quinoa, I get mildly constipated.
The reintroduction process teaches us so much about our bodies, doesn’t it? Wishing you continued healing on GAPS and tolerance for more and more foods in your future! For people who haven’t read that article, here’s a link: The Great Starch Experiment.
Hi Eileen, where does mustard fit it? As stage 2 (1)?
Hi Erik. Mustard is a seedbased spice, so it’s good to try reintroducing that before trying whole seeds. In The Paleo Approach, Mustard is considered a Stage 1 reintroduction. If you’re looking for a recipe, I love this one: Honey Mustard Broccoli Salad. Good luck!
I am new to AIP – 2 weeks in and on reading overload. Well, I actually started 4 weeks ago but I consider my first 2 weeks a
“trial” period because I had a planned vacation which I knew would be my “last supper” – but I still made what I considered smart choices, not all wild. I’m already reading about reintroduction though I am NO where NEAR that point. Just dreaming. I’ve had psoriatic arth. for 6 years and hope my joints aren’t screwed up for life so I won’t use that as a marker. But I also have psoriasis and lichen schlorosis and will use those AI signs as my markers.
I’m finding it very hard to continue socializing with my friends. Examples: we met for bfast Sat morn and THE ONLY item i could REMOTELY have on the menu was bacon or sausage and that’s a stretch. NOTHING else (eggs, pancakes, toast, white potato hash browns, corn grits…..). I’m going to my brother’s wedding this week and not dreading it because I know there will be a veggie tray (oh joy). I’m going to an annual crawfish boil I always look forward to in a week and stressing out. Its business related and not going is really not an option. There will be NOTHING there I can eat because everything will have been boiled in redpepper or fried with flour and corn or dessert with flour. So yeah, I’m reading about reintroducing so I’m not “the weird one”, “the pain in the butt”. I just want to be happy with my friends and family- not the one that sits there and watches them eat while I sip on a bottle of water. When I go to the boil, having been AIP for almost a month, can I just go for the cayenne boiled crawfish and figure that to be my red pepper reintroduction? Go big or go home style?
And if I read correctly, if the reintroduction (like eggs, butter) don’t go well, if may not be for life? When you’re in remission, you can retry? Thanks. I enjoy your blog and podcast!!
Oh, I can so relate to this feeling! You are flipping out, and I get it. I felt similarly when I first started the AIP. First, take a deep breath. It’s normal to have some temper tantrums and pity parties in the beginning – I did, too. But once you’ve let that out, it’s time to shift your perspective. Focus on the end goal – you want to reverse the course of your autoimmune diseases. That’s a BIG goal – and it’s one that will transform your life positively in every way. While eating may have been easier before, life wasn’t. It’s not easy having autoimmune disease. It’s not easy living with pain and watching your joints degenerate. It’s not easy watching rashes take over your body. And while the AIP isn’t easy either, it’s worth it! Next, be proud of what you’re doing. It’s not weird or obnoxious. It’s strong and self-loving and wise and something to be admired. Cultivate those feelings in yourself. Next, you need to get a support system. Are you in the AIP support groups online? Are you part of a local meetup group (these are great because everyone eats AIP in these groups)? Do you some 1:1 help? If so, there’s an online AIP coaching class called SAD to AIP in SIX that really helps if you’re struggling sticking with it. The next class starts in May. As for reintroducing foods, you are right that it’s too soon. Unfortunately, if you’ve been ordering bacon and sausage in restaurants, you likely already had ingredients you shouldn’t have since they almost always include spices not allowed on the AIP. If you eat at the crawfish boil, that’s not really a reintroduction since you haven’t yet been AIP long enough to have a baseline of improvements, where you can see if a food is your trigger. If you eat there, I recommend starting over with Strict AIP the very next day, and consider that Day 1. However, you don’t want every social occasion to derail you. Instead, you need to develop a system of taking care of yourself AND having fun at social events. That will usually involve bringing your own food and being confident enough to not feel weird about it. The more comfortable you are, the more comfortable your friends and family will be about your choices. Here’s a great article from Autoimmune Paleo about this: How to Really Eat AIP. To answer your final question, yes if you fail a reintroduction once that isn’t necessarily forever. You can try again. However, I think you might be hoping that you will eventually be able to go back to your old way of eating – I had that fantasy too in the beginning – and that doesn’t happen. While you will be able to expand your diet again, it will still be paleo-ish in nature, which means you’ll always be making careful choices in restaurants – although each reintroduction does expand those choices. So, there is a point where you need to decide what you are willing to do for your health. It does get easier with time. I’ve been living my paleo life for 4 years now. I’m no longer overwhelmed. I’m very comfortable bringing my own food to events. When I eat in restaurants, I order very simple unseasoned meals, and enjoy the company of my friends. I invite people to my house for dinner parties, where the food is MUCH better. 🙂 I also make non-food plans with friends – walks, tea dates, going to museums, music, plays, festivals, or just hanging outside somewhere beautiful on a nice day. The world is so much larger than the food you used to eat. You can do this!
Oh my. Tears. I live in New Orleans, the food capital of the US. So hard. N.O. Jazz Fest coming up: no outside food or drinks allowed, no re-entry. I can buy water. Not sure what else I can do. I don’t want to NOT go because of my food choices. I looked for a support group and haven’t found it yet. Maybe I’ll have to make one, which I’m not opposed to doing. I do feel empowered but at times I can’t help but feel denied. I’ve been listening to your podcast and they are inspiring but at times I question if I can do that – the “travel” podcast where the girl brings her own oven, cooking utensils, etc. to someone’s house to avoid cross-contamination. Really? Can I do that? Not sure. (though I’ve been known to travel with my own frozen meals before because my destination didn’t have food I’m used to here in N.O.)
I’ve been SO good! But even thinking I’m doing awesome and so proud, yea – I had bacon. So yea – it’s discouraging feeling like “what the heck – even when I THINK I’m doing good…”. I hosted an AIP Easter dinner with rave reviews (stressed over it)…but I did have a seasoned pork roast for “them” and a slab of salmon for me. My PT-paleo sister had brought salad which I had to pick out the sliced egg and peppers. When I didn’t eat it, she asks “aren’t you taking this a little too far?” So my support group does NOT start in my home.
I APPRECIATE you taking the time to respond. I will look into all the wonderful (!) suggestions you listed. As for the answer to my question, I will NOT eat the crawfish because I’m not well enough. And for my second question regarding some No-Go foods, I’m glad to hear that I may ONE DAY be able to have ghee (maybe even butter), eggs (that will be huge), dark choc covered almonds, and at least black pepper if not red. And please God, please, one day let me be able to eat a tomato-basil salad (I can forgo the mozzerlla if necessary).
My goal is to one day have the flexibility in my wrists to resume doing yoga… I’ll keep a picture on my fridge so I can focus on why I’m making these choices.
Thanks. Peace.
Thanks for sharing, TBNOLA. That’s wonderful that you hosted an Easter Dinner. Good for you! It’s not the same as eating out, I know, but there IS an AIP Cajun Cookbook available to satisfy some of those cravings.
TBNOLA – I just wanted to respond with support. I just moved from Nola about a year ago, miss it desperately! My extreme symptoms didn’t start until I left New Orleans, I can’t imagine doing the AIP while living there, I know how difficult it is. I was supposed to start AIP the first of March, but had to wait until after my visit there for St. Patties day/Parasols. I’ve had all those feelings you expressed, but in the end I knew that I couldn’t live the way I was and heal my body. I just made 7 weeks! It was a rough start, but gets easier and you re-learn how to eat. I avoid going out to breakfast, not much on the menu to eat. I will meet friends occasionally for lunch or dinner and have found most restaurants accommodating. Overall though I have avoided eating out, I find it too difficult to control what I’m eating and to really know whats in my food. I just keep reminding myself that this isn’t forever and I was in such a desperate place and I would have done about anything to heal my body. I wish you the best of luck!!
Penny, thanks for sharing your story!
I know this is an old post but I too have thought about attending events and this girl needs to eat so I requested a note from my doctor. A note from a doctor telling the workers at the entrance that you have a medical condition should allow you to bring snacks and even water. I prefer my own water without chlorine or fluoride. I can’t stand Dasani and many places don’t have always have spring water. Hope this helps (someone)!
Kacie, that’s a great tip. For other tips, listen to a podcast I recorded, which was largely inspired by this very question: Social Lives on the AIP.
Hi TBNOLA- I’m from New Orleans and live here too. I’m mostly AIP and also follow Wahls Protocol/ketosis. It is hard in this city – I understand. I’ve yet to make contact here with anyone else who lives as I do, but would love too. I’m responding to your post a bit late, but respond back if you want to get in touch and form our own support group. Take care and stay healthy!
Hi Eileen! Question about reintroducing eggs: I react negatively to conventional eggs but seem to do ok with soy free eggs. Does this also mean I should take the same precautions when eating chicken and pork meat? Unless buying from a local butcher, I find it’s next to impossible to find chicken or pork that is fed a soy free diet. What are your thoughts? Thanks! – Molly
Hi Molly. Sensitivity to eggs from soy-fed chickens is common, but it’s not as common to have that same sensitivity to soy-fed meat. The best way to know for sure would be to test it, and see if your body can tell the difference.
When you get to the reintroduction phase, are you supposed to introduce things on an empty stomach? Will it change the results if you eat a lot of AIP-safe foods right before eating something new?
Hi Rachel. There’s no need for you to reintroduce on an empty stomach. You can incorporate the new food you are reintroducing into any meal. Just be sure you only reintroduce one new food at a time. Best wishes with your reintros!
Thank you!
You really should have a disclaimer in regards to dairy reintroduction… When you stop eating dairy your body stops producing lactase enzymes and you can’t break down lactose. The first time you drink a glass of milk, you’ll be running to the toilet 15 minutes later. This doesn’t mean you react negatively to dairy and are lactose intolerant. It just means your body adapted to being without dairy. The you’re body will immediately start producing lactase enzymes and you’ll be good to go in a day or so.
Hi David. Actually this a myth. If you get diarrhea immediately after consuming dairy, that is indeed a sign of intolerance. I know hundreds of people who have gone off dairy for up to a year, and then reintroduced with no negative symptoms whatsoever. And then for those of us who do react negatively, it’s not always diarrhea. For example, I never had diarrhea after eliminating and then reintroducing different forms of dairy. My body responded with rheumatoid arthritis flares, which is how my body shows intolerance.
Hi, thanks for writing this! I have RA and have been completely on the AIP for 4 months (working up to it before then – the last thing I gave up was black pepper in August). I was reading on Sarah Ballantine’s recommendations for reintroductions that you had to wait until you were in full remission and did not need any DMARDs. Is this always true, or can you just wait until you are in kind of a stable place, even if not drug-free and in remission? My inflammation markers have been normal for the first time in the blood tests the past two months and the pain is quite manageable and barely bothers me now. But I still do have pain and swelling, and I am on methotrexate and prednisone and a DMARD. Am I really not to reintroduce anything until this changes? Also, I don’t know if the improvement I’ve seen in the past few months has been due to AIP or the DMARD (started Orencia in October, but my rheumatologist said it was kind of soon to be seeing the effects of that) or the large amounts of Bikram Yoga I’ve been doing since October after never consistently exercising in my life before. So it’s hard to tell how the diet specifically is going.
Another question I have is – do people really not often react to meat? I’ve been divided about this because I’ve read in several places that a low-fat vegan diet can improve RA symptoms in some people. I have even read a peer-reviewed study that suggests a vegetarian diet can be helpful for RA symptoms. Really I would like to eliminate meat as well for a bit just to see if this has any effect, but I don’t really know how I would get enough protein this was while on the AIP because I already am not eating legumes or grains. Also I had a mini flare-up the other day after eating a lot of (AIP-friendly) bacon the day before, though I suppose this could have been due to something else. Thoughts?
Hi Laura. I never agreed with that recommendation, and I believe Sarah has softened her stance on that over time as well. This diet isn’t meant to be strict for life, and the truth is, not everyone achieves a drug-free remission. That said, you are on a lot of medication and have numerous potential factors affecting how you feel. I do recommend waiting until you no longer need the prednisone. Steroids are meant to be taken short-term and come with a lot of side effects if used long-term. Definitely work with your doctor before slowly tapering your dose, however, since it can be addictive and have a rebound effect if you go off it too fast. When you’re ready, I have a reintroduction e-book to guide you through the process. To answer your other questions, you will find lots of conflicting dietary advice on the internet. I don’t recommend combining dietary protocols for the reason you already stated – you won’t be able to get the nutrition you need. You can try doing a seafood-based AIP diet, if you want to see the effect of meat specifically on your system. Seafood is high in omega 3 anti-inflammatory fats, so is recommended on the AIP anyway. I hope you continue to feel better and better in 2016!
Hi! Thank you for all your information! I have lupus and I have been AIP for 4 weeks now and my symptoms seem to be in remission so I am going to start reintroduction this week, I was wondering, in terms of nuts and seeds, if I have to do spices, oils, seed butter, then the actual seed first, or if I can just skip to the whole seed first and then see if there is a reaction or not, if not, then I’m good, but if I do, then I can eliminate and do a slow reintroduction? I was trying to find a reason for why the reintroduction requires, spice, oil, seed butter then actual seed, but I couldn’t find a good reason, especially when you don’t think you have a specific allergy to it.
Thank you!!!
I don’t recommend skipping ahead, Sonja. It’s actually impossible to tell what you will and won’t react to until you go through the process. Everyone is surprised during reintroductions. It’s much wiser to reintroduce things most likely to be tolerated first, rather than increasing your inflammation unnecessarily by trying to rush the process.
Thank you for your reply! This is helpful. I know certain foods are not triggering symptoms for me, and other foods are triggering symptoms. Ive been feeling more emotional about the diet recently, and criticism did not help, so I appreciate your helpful information! Krysta
I have a question on reintroductions. I’ve had a few people criticize me recently for being on the autoimmune protocol (started 5 months ago). The main criticism has me wondering as well. If I go without a type of food for a few months (as I need to on the protocol), when I re-introduce it, wouldn’t it be expected that I have some sort of reaction since my body is not used to the food? I’ve continued to follow the protocol, but this question has been lingering with me. Thanks for your help! Krysta
Hi Krysta. If that was true, none of us would be able to reintroduce foods successfully. As you can see from my experience, and the experience of others, we only react to foods to which we are intolerant. It is the removal of foods for at least 30 days that allows this communication to take place. In fact, over time, many people are able to reintroduce more and more foods due to the healing that takes place on the autoimmune protocol. Sarah Ballantyne writes about this in her book, The Paleo Approach. When you eat a food regularly to which you are intolerant, your body stays in a chronically inflamed state where it’s difficult to identify the food (or foods) that are the problem. Removing them and reintroducing them one at a time allows this identification to take place. During the elimination period, the chronic inflammation dissipates, your immune system calms down, and just a few memory cells float around your body which remember which foods caused the problem. They’re the ones that will trigger a reaction when you eat that food again. They don’t react to every food. They are food-specific.
I eliminated all dairy foods from my diet for a year. I was ready to try butter or ghee. I bought grassfed organic ghee by Pure Indian Foods. I made cauliflower rice and prawns in the ghee. I had some red wine with the dinner. Immediately while eating I started getting really fatigued. I thought it was the wine knocking me out, and couldn’t figure it out. I had to go take a nap after dinner, then my nose started running. Then in the middle of the night my stomach got upset. Nope not the wine, not the prawns or the cauliflower. Never reacted to those 3 foods that way before or since. I reacted to the ghee. I can’t figure out what would be left in the ghee to react to. It’s been 6 months, I’m wondering if I should try again. Or just accept that any dairy just might not ever work for me.
Ghee is tricky. While most people tolerate it, not everyone does. Trace dairy proteins remain, so if you’re highly sensitive to dairy, that might be enough to cause a reaction. All dairy (including ghee) also contains natural hormones and all autoimmune disease can react to hormonal influence. So, it could be that also. Or it could be something we haven’t yet identified. I actually did finally eliminate the ghee myself, as some of the commenters above suggested. It made zero difference in my remaining inflammation, yet when I reintroduced it, I did seem to get a mini-flare. Like you, I find it hard to believe/accept. I will reintroduce again when I’m ready, just to confirm one way or another. I didn’t mind giving up the nightshades and the other dairy, because it made such a dramatic difference in how I felt. I must admit I kind of resent losing the ghee, since I can’t feel any improvement from removing it from my diet. I like its taste better than butter.
Thx for the reply. Well, my husband gets to work on the jar all by himself. He can’t do any dairy, but the ghee seems fine with him. I think I’ve had a gluten & dairy sensitivity for quite some time and didn’t know it. I complained about how milk tasted when I was in high school. I kept thinking it was bad–like expired. But it wasn’t. And then for years when I drank coffee I had to keep clearing my throat in the morning, had groggy voice. I know now it was from the dairy put in the coffee. I haven’t done any gluten tests, keep wondering if I should. But I won’t put it back in my diet again.
Hi Eileen!
Thanks for the information, I read your eBook also! You suggested to introduce white rice (and every foods in stage 4) only after full remission. I didn’t reach it till now, but would like to reintroduce white rice. What do you think about that? Many thanks!
Erika
That’s Sarah Ballantyne’s recommendation, not my own. In my e-book I offer two paths for reintroduction: One is the foods you miss the most, and the other is following Sarah’s stages 1-4, and white rice is in her final category. It sounds like you’ve chosen to follow the stages, and you’ve met her suggestion of remission, so there’s nothing holding you back.
Hi Eileen,
I just read your e-book. Thank you for the helpful information! I began introductions last week and need some additional help in identifying whether certain things are reactions, such as: 1) slight stomach cramping and 2) feeling emotional. Also, if I have a stomach ache 2 nights after eating something, is that a reaction to the test food? I’m feeling quite confused. Thank you!
Maureen, whenever you’re unsure, do the second stage reintroduction recommended in the ebook (eat a little bit every day for a week). If you are having a reaction, it will become very clear by the end of the week.
Thanks, Eileen! You’re a godsend during this challenging time.
Hi Eileen,
I have a question. I have been strictly on the AIP protocol now for over 30 days. I tried to reintroduce egg yolks last week and experienced an immediate red rash on my abdomen, as well as mild nausea. As I continued through the week of trying egg yolks each day, some days I seemed to have mild digestive symptoms and some days I didn’t seem to have any symptoms. I decided to keep egg yolks out for a few more months because the trial was not clear to me. I would like to reintroduce some other foods, but I don’t know if it is too soon or not and when I have symptoms during reintroductions, I truthfully do not know if the symptoms are from the food or simply from my condition. Even while on the AIP protocol, some days I am fatigued and achey (probably related to work stress). The symptoms that can be experienced with reintroductions are so varied that I don’t know how to tell if it’s a food related reaction or simply my autoimmune condition. Do you have any suggestions? Thank you for your time!
Hi Krysta. You might want to wait until your symptoms stabilize a little bit more, making reactions more clear. Are rashes part of your normal symptoms? If not, then that was a clear reaction to the yolks. If rashes come and go even when you’re strict AIP, then it’s not so clear.
I’m going to be staring reintroductions soon, and I was wondering if you recommend testing each legume with edible pod, one by one, or if it’s fine to presume that if green beans are okay, peas are okay. I have the same question regarding spices, seed and nut oils, etc. Thank you!
This is a reintroduction choice each person gets to make themselves, but here’s what I recommend:
The foods you mention are considered Stage 1 Reintroductions by The Paleo Mom, and most people reintroduce them successfully, so I’m less cautious about separating these. I would never recommend reintroducing all dairy at once, for example, but I do recommend trying some of these together, just to shorten the reintroduction time.
I consider edible pod vegetables the same: green beans or snow peas. However, I treat frozen peas as a separate introduction, because they’re out of the pod, and you eat more of the inner pea with them.
For seed spices, I recommend introducing a blend like my curry, and if it goes well, you’re good with the whole category. If it doesn’t go well, then you can break it down and introduce one spice at a time to see which one(s) the problem
For seed and nut oils, I would reintroduce those one at a time, since they aren’t sold as a blend anyway, and aren’t shelf-stable for long. Start with whichever one you miss the most.
Does that makes sense?
This makes good sense. Thank you, Eileen!
If I had a bad reaction to peas (specifically in split-pea soup), should I try reintroducing green beans and snap peas separately, or assume that the whole category is a problem?
Hi Amy. Split peas are actually dried legumes, so that might be the problem. Go ahead and try any of the fresh legumes next (snap peas or green beans) and see how that goes. They are usually much better tolerated.
Thanks Eileen, I just made the carob chocolate and it was good. I’ll take all of your advice and tips on board and put them into practice now, thank you
Help – I wrote to you a little while ago explaining that I felt like I was never going to be able to reintroduce foods because I wasn’t feeling better enough due to a winter holiday and a bad cold taking a big hit on my immune system. I had a few set backs since then, did AIP for 69 days but I ate out 4/5 times ordering things I thought were aip compliant but they turned out not to be 🙁 so decided nopt to eat out and make sure I was 100% so I’m 19 days in. I feel like I’m at breaking point. RA in my hands – seems a bit stiff in the mornings and sometimes during the day but it’s not bothering me or causing pain. It’s also gradually better than it had been. I feel like I’m about to break and go eat loads of chocolate 🙁 I also feel like the thoughts of reintroductions taking so long will drive me to giving up even sooner. I was hoping to have finished introductions by June as I have two big events and I was hoping not to have to worry about being so strict. So I’m asking your advice. Should I go ahead and reintroduce now benchmarking against how I’ve felt the last few days, wait until I hit 30days and then reintroduce and also could I reintroduce a few things up to my event in June, “eat non AIP foods” for a day and then do another 30days of eliminating and reintroduce the rest of the foods? I’m going out of my mind and all I can think about it chocolate, help.
Also I forgot to mention, there are something’s I am happy not to reintroduce for now if it meant I could get through the more important things I miss sooner, so I am wondering if I could just pass them by and as I said have a non AIP day and then do another 30days of eliminating and reintroduce those things then?
Hi Christina. 30 days is the minimum, so I don’t recommend reintroducing foods now. I’m sorry you’re having such a tough time. If it makes you feel better, the elimination phase was hard for me too! Reintroductions helped me in a way that might surprise you. When I reintroduced a food that I tolerated, of course I rejoiced. But when I reintroduced a food that caused me to flare, it was a powerful lesson that removed cravings for that food altogether. I understood very clearly why it was eliminated as part of the AIP. I think we all fantasize about being able to reintroduce everything, so we rush through reintroductions just trying to give up all the restrictions. That’s not how it works, though. The AIP + Reintroductions is about learning what your body needs. It’s a science experiment, and it takes time. I know that’s not what you want to hear, but that knowledge really is worth the effort it takes. Here are my recommendations: (1) Start incorporating some form of relaxation into your life every day, because you are stressing out, and that increase autoimmune symptoms. I understand – I’ve been there! (2) Come up with a list of things that comfort you and bring you pleasure and post that on the fridge. When you’re craving a non-AIP food, choose something from that list instead. (3) Make yourself some AIP-Friendly treats and stick them in the freezer. Eat one of those as an indulgence, rather than bingeing on something you know might harm you. I have a Pinterest Board of AIP Desserts (and there are carob recipes there that can help with your chocolate cravings. (4) Keep focused on the big picture. You want to heal. That’s more important than any passing food craving. Hugs to you, my friend!
Hi Eileen
I bought your ebook to help with reintroductions. I was really scared to start, but your book gave me courage. I tried egg yolk and after just the first day (doing it just like you suggest) I woke up the next morning feeling like I’d been hit by a truck. I am waiting for the full two weeks and want to try spices next.
I’m writing because I can’t quite figure out if I am supposed to try each of the fruit based spices one at a time or if I can do several at once. Same question with seed-based spices. Your book only has a recipe for the seed-based spices and it is a mixture (I think) of more than one. If I am ok after trying black pepper, does that mean all seed-based spices are now ok?
Thanks for your help,
Kelly
Hi Kelly. I’m so sorry the egg yolks were a no-go. You have a choice with spices. You can introduce a blend of spices within each category, or one spice at a time. I did the categories (fruitbased first and then seedbased), and that went well for me. If I had reacted to the blend, I would have separated it and tried a few spices individually to see if just one was the problem. It all depends on how long you want the spice reintros. to take. The good news is that most people are successful reintroducing the fruit and seedbased spices. Nightshade spices are a different story. Postpone those until late in your reintroductions.
How do you scale down the quantities for spice reintroductions? Obviously eating a teaspoon of pepper is not very appealing! How much should you have in the initial attempt and is it necessary to eat unaccompanied? Thanks!
Just add the spice to the food, and then eat a teaspoon of the food (and follow the rest of the reintro. steps from there.) The idea is to reintroduce food in the quantity and manner it is usually eaten. May your reintroduction be successful! Black pepper is nice to get back.
Thanks so much for the quick response Eileen. I’ve had two small doses and now I’m trying a full size. It tastes great after months of nothing spicy!
I have your ebook, it’s very helpful 🙂
Reintroducing black pepper was a failure! So disappointing
I’m so sorry! I know the grief of failed reintroductions.
I’m curious what your reactant to black pepper was? I “think” i react with my tongue breaking out/geographic tongue/tingling tongue….just curious what your reaction was? Thanks!
Hi Eileen,
I reintroduced seed spices on Saturday. Didn’t feel that great but didn’t feel significantly worse so I considered it may just be an ordinary “feeling not so great day.” There wasn’t any very significant change. I wanted to wait the 72 hours until today to retry it but then yesterday, I felt HORRIBLE! Considered it may be the seed spices but then I decided to investigate the fillers from a pill I took on Sunday for something unrelated. Comes out that the pill contains lactose and corn flour! Argh. It’s such a small amount as it’s just in a capsule. Could that have brought back my symptoms in full force? I’m scared to try the seed spices again but I have a feeling they weren’t causing any harm. How crazy that I could have milk without any “supposed” symptoms for years. Maybe I wasn’t seeing what it was doing to my body.
Supplements can definitely be road blocks if they contain allergenic ingredients. I’m so glad you checked. It sounds you might like some 1:1 guidance through this process. Angie at the Paleo Mom Consulting is a great health coach, if you would like someone to help sort through these decisions. She works with people around the world, via Skype: http://www.thepaleomomconsulting.com/
Hi! I’ve been on AIP for 3 months now which I started because of severe eczema. Healing started after about 2-3 weeks & is still continuing. However, about 6 weeks ago I started losing my voice which has gotten worse. Some days I can only whisper & I also feel short of breath. Have you ever heard of this as a side effect of a food allergy?
I haven’t, but anything’s possible. The important thing is to have that checked by a doctor; it sounds serious, Ric, especially if you’re getting short of breath. I recommend making an appointment this week.
Hi! I’m 15 years old and have just finished the 30-day detox period of an AIP diet. Do you have any recommendations for adding back grains?
Hi Savannah. I actually don’t recommend adding back grains at all. Here’s an article that explains why. However, I realize you may have a different philosophy. If you want to reintroduce grains, I recommend doing them one at a time, starting with some of the milder ones like quinoa, buckwheat and white rice and seeing how your body responds. You might also consider soaking or sprouting them first, to make them easier to digest.
Alrighty! Thanks so much.
I stocked up on Vitamin C today in case it is just an illness but my gut tells me its not… Its just frustrating that 5 days after eating the eggs, I am still not well. Its funny because I was paleo for a few months last year and never felt that great and I think now it might be because I was eating eggs literally everyday for breakfast! So curious to test again in a few weeks. Thanks again for all the info and feedback about the AI protocol!
I have been on the protocol for 7 weeks and decided to introduce eggs this weekend. I didnt take your advice by starting with just the yolk, I had the whole egg and I think that was a big mistake! I ate 3 for breakfast on Saturday and 3 on Sunday morning. I broke out in acne on face, got a sore throat & headache, and was very tired all weekend. Its now Thursday and I still feel almost like I am getting over the flu. Are these typical reaction symptoms or am I just actually getting sick? I guess I just thought the symptoms would have subsided by now if it was caused by the eggs.
During my reintroductions, when I reacted negatively to a food, it took 1-2 weeks for that reaction to pass. I would start to feel somewhat better after a few days, but it would take longer to return to baseline. Since this happened immediately after eating the eggs, it is very likely a reaction to the eggs. However, there’s always the chance the timing coincided with illness. If you want to double-check, wait until you feel better and reintroduce eggs again – maybe just 1 egg at each meal for the second attempt. This is the un-fun part of reintroductions – when your body says no to a food. On the other hand, having clear communication with our bodies is empowering. You know just what to do to avoid feeling this way again. In the mean time, I’m sending hugs to you!
I have an atypical reacction to offending foods–I sneeze. Sometimes I get congested too, or just congested with no sneezing. My nose is my first round of defense that tells me to go get Benadryl. My second round of defense is a rash on hands & feet, sometimes accompanied by tingling. Third round is swollen, achy joints, and lastly, anaphylaxis. If I don’t listen to my nose, I know it’s *fun times* ahead, so we keep Benadryl everywhere (even in the car).
Wow, your body communicates in the gentlest way possible. How cool is that?
I have been doing well for a while and decided to re-introduce eggs after 60 days. I just added yolks. Today my back is in a constant painful spasm and my husband had to come home from work to take care of the kids! OW! No more eggs. Message received. Thanks for sharing on Natural Living Monday 🙂
Oh Amanda, I’m so sorry! Maybe in a few more months, you will have healed enough to try again. I know how hard it is to live without eggs.
I just posted a roundup of some great egg-free recipes and desserts, to help you and anyone else who needs to live without eggs. http://www.phoenixhelix.com/2013/06/09/link-love-20-egg-free-breakfasts-and-desserts/
This is perfect timing, as I’m reintroducing foods! This is my second time around doing an elimination diet, and I’m taking reintroduction really really slowly this time around.
I definitely learned that taking it slowly was necessary to get accurate results. It takes a lot of patience, but it’s worth it!