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One question nearly everyone asks when transitioning their diet is “Should I be taking any supplements while on the Autoimmune Protocol?”. Supplements are some of the most commonly-recommended additions to dietary and lifestyle modifications, with everyone from functional medicine physicians to internet-forum users recommending their patients and friends take them. It is important to note that while supplements can be very helpful to the healing process, often times they can be a hinderance, stall progress, and even cause flares. A lot of people think of supplements as harmless, natural compounds, unlikely to cause problems, while in reality they can be profoundly effective at affecting change, for either good or bad. Because of this, I think it is important to educate yourself about what is in your supplements and the reason why you are taking them.
In this article, I aim to give you an overview of what supplements are, the pros and cons of taking them, how to evaluate a supplement, and some basic recommendations.
What are supplements?
Supplements are usually (but not always) extracted vitamins, minerals, and other compounds that have nutritional qualities contained in a small, but concentrated dose. Often these compounds are isolated to their most basic structure, and are combined with fillers in a standardized dose to supplemented with the diet. Sometimes these compounds are combined (as in a multi-vitamin), sometimes they appear alone with just fillers, and other times they are composed of pure, whole-food derived ingredients (such as encapsulated freeze-dried herbs). The idea behind supplements is to provide the body with a source of nutrients or other compounds that are not available in the diet, or to provide the nutrient or compound at a dose that would be impossible to get through diet.
Do you need supplements on the Autoimmune Protocol?
One of the strongest arguments for the Autoimmune Protocol is that it is an incredibly nutrient-dense diet (the most nutrient dense diet I’ve ever come across, in fact, especially when a person is eating organ meats, fish, shellfish, and a variety of vegetables). Eating this way (or a real-foods, ancestral style diet also incorporating these foods) provides all the nutrients a person needs to thrive. Beyond that, the nutrient-density is so high that the body has extra raw materials in order to regenerate and restore, which is necessary when healing from the inflammation caused by autoimmunity and chronic illness.
That being said, a good diet is only as good as it is digested. It does not matter precisely what we are eating, if we are not digesting our food properly, those components will not be properly broken down and transported to the cells that need them. For instance, eating a ton of liver may not help a person deficient in iron unless they correct the condition of low stomach acid that inhibits the digestion of iron. Many people find that supporting their digestive process with supplements in the beginning of their healing journey is more helpful than blanket supplementation of nutrients. If you suspect digestive dysfunction is at the root of your nutrient deficiencies, it is important to work with a practitioner who can help you support this process, there is no one-size-fits-all approach.
Past digestion, there are a few other reasons why people would chose to take supplements while on the Autoimmune Protocol. Some people suffer from autoimmune diseases where nutritional requirements are well known (for instance, selenium and zinc for thyroid). This does not always mean that they need supplements–it may just mean that they should make a better effort to get those nutrients from food (in the above case I would recommend eating 3-5 servings a week of fish and shellfish).
Some people take supplements, especially glandulars and herbs, to try and manage inflammation, influence the immune system, and combat stress. While this can be incredibly effective for some people, it is like playing with fire for others (read my article on Th1 and Th2 dominance for more info). If you are going to go this route, I recommend working with a knowledgable practitioner instead of putting yourself on a protocol. For managing stress, I believe those of us with autoimmunity have a better (and safer!) response to lifestyle changes than taking supplements–if you are looking for tips, Susan Vennerholm has a great article on the topic here.
How do you evaluate a supplement before deciding to take one?
I’ve come up with a list of questions you can ask yourself or your provider before deciding to incorporate a supplement into your routine:
- Who recommended this supplement to you? Was it your doctor or someone you met in an online forum? Be weary that there are people online who make their living off of recommending supplements to those who are sick.
- What is the purpose for this supplement? Is it to correct a nutrient deficiency or is it to encourage the body to change in some way? If your adviser cannot tell you why it is necessary, this should be a red flag.
- How long will you need to be on this supplement? Is it a short-term thing, or is it something you will always be dependent on?
- Does this supplement contain immune stimulants? Reference this article for a list of herbs and compounds that everyone with autoimmunity should be cautious of. If it has a known effect of stimulating the immune system, be warned that it could impact you negatively.
- Does this supplement have known side effects, drug interactions, or warnings?
- Does this supplement contain ingredients that are non-AIP, or is it produced in a facility that is not allergen free? Check out this article for more information on this topic.
- Does this supplement contain any fillers that are unsuitable or that you have a sensitivity to? Again, this article can be helpful here.
- Is this a supplement you could avoid taking by eating more of a particular food or correcting a known digestive issue?
How do I introduce a supplement into my routine?
It is very important, when deciding to incorporate new supplements, to introduce them slowly, one at a time (much like a food reintroduction). Nothing is worse than coming home from an appointment with a new natural practitioner with a bag of supplements, to start them all the next day and feel terrible. If you introduce too many things at once and have a negative reaction, it is impossible to pinpoint which supplement is causing the problem.
What are some supplements everyone can benefit from?
As you can see from the above, I am hesitant to recommend supplements in addition to diet because of the many issues concerning them. That being said, there are a few supplements that tend to be low-risk, well tolerated, and where the benefits outweigh the negatives. Here is my short list of recommendations, in addition to focusing on nutrient density wherever you can!
- Magnesium–Because modern farming practices have left our soils depleted, it is actually pretty difficult to get enough magnesium, even on a real-food or Autoimmune Protocol style diet. It isn’t because we aren’t eating enough magnesium-rich food, but because the nutrient isn’t there for the plants to access in the first place. My favorite type of magnesium is magnesium malate.
- Fermented Cod Liver Oil–I consider this more of a real food supplement than a traditional supplement, because it is not refined or treated in any way. While the Omega-3 fats like EPA and DHA are important for managing inflammation, most fish oils on the market are heat treated and refined, rancidifying the fats (not good!). Those who do not wish to eat organ meats or seafood like to take this brand of FCLO to make up for those lost nutrients.
- Probiotics–A lot of people find that adding in a high-quality probiotic goes a long way to accelerating their healing. After all–we are all trying to heal our guts! One thing to know, is that the same probiotic that works for one person can cause symptoms in another, so it is important to start slow and not get discouraged if one does not work for you. I like to rotate between this product which is a more traditional probiotic as well as this one which contains soil-based organisms.
I hope that this article has answered your questions about supplementation and the Autoimmune Protocol, and if anything, has convinced you that a nutrient dense diet and less, not more supplementation is the safer approach.
Have you found supplements to be helpful or harmful on your healing journey?