This post comes to us from Smitha Nair, M.D., board-certified Family Physician, Functional Medicine Practitioner and AIP Certified Coach who has lots of experience working with patients who have autoimmune disease. Her approach to supporting these autoimmune patients has evolved significantly throughout her career, and in her guest post, Dr. Nair tells us about the differences she’s noticed in her patients’ autoimmune health since she started incorporating AIP into her approach.
When I quit my job in 2016 as a conventional medicine family practitioner, I had reached a stage of burnout, although I didn’t know to call it that at the time. I was so close to quitting medicine altogether, and that is when I found the Integrative Medicine Fellowship program by Dr. Andrew Weil. I signed up and it was the best decision of my life. That is when my introduction to food as medicine truly came about.
In medical school and my family practice residency, I remember advising patients with diabetes on how they should cut back on carbs, eat more vegetables and low glycemic fruits. I told patients with high blood pressure to cut back on salt, and those with high cholesterol to cut back on fatty and fried foods. All of them were advised to eat at least 5 servings of fruits and veggies a day. They were told to return in 3 months for a checkup, but inevitably at those checkups nothing had changed. I thought I was doing everything I could to help them out. It wasn’t until I started the Integrative Medicine Fellowship that I started to understand how nutrition plays a role in prevention and management of chronic illnesses.
During my fellowship I also started my functional medicine training through The Institute of Functional Medicine, which is where I first became exposed to a variety of food plans. I learned about phytonutrients, how fat is not as bad as we claimed it to be, the difference between good carbs and bad carbs, and the science behind gluten, dairy, and sugar as proinflammatory foods. This broadened my knowledge on nutrition and how I could wisely apply food as medicine to help my patients with chronic illness.
A year after quitting family medicine, I was ready to get back into the workforce and did not want to go back to a traditional family practice setting. That’s when I decided to start my own practice. I saw a lot of women, mostly with thyroid conditions, especially hypothyroidism. I had learned in my trainings that checking TSH alone was not enough and so I started checking complete thyroid panels and to my surprise found many of my patients had autoimmune thyroiditis but had never been diagnosed. Their common presenting complaints were inability to lose weight, fatigue, poor energy, and improper bowel habits.
I started researching ways to manage patients with autoimmune thyroiditis and came across many resources by Isabella Wentz, Sarah Ballantyne, and Dr. Datis Kharrazian. I had an account with mybodysite and they had an AIP plan and I would email patients the plan to follow on their own. Only a handful of patients followed through, that too after doing a lot of research on their own. When they returned for their follow ups, the ones who had followed the diet plan noticed much improvement in their energy levels, had lost a few pounds, fatigue had resolved, and their bowels were more consistent and regular. The patients who were overwhelmed and did not follow the plan came back frustrated and ready to give up. This is when I knew I had to do something to help them out.
And that’s where my own health story comes in. At that time, I thought I was healthy. Sure, I could stand to lose a few pounds and sleep better and have more energy, but I attributed all of that to the stress of starting a new practice and running a business for the first time in my life. In any case, I decided to embark on the AIP plan myself, not for any specific health reason but to see what it was like and to find some recipes and ideas for my patients to implement.
I spent 3 hours the first day shopping for ingredients. I had not prepped and all I had was the food plan I emailed my own patients: a list of “yes” and “no” foods. I was lost. I came home with a handful of stuff and cried to my mom, telling her I understood how difficult it must have been for my patients. She decided to help me out. I am from Kerala, India and we eat a lot of rice, roti and use a lot of spices in our cooking. Cutting these out from my diet seemed like an impossible task. Looking at the AIP plan, I knew I had to cut out the grains, some spices, my favorite chilli peppers, and find a good replacement for my rotis.
My mom came to my rescue. She tried different combinations of cassava flour and coconut flour and finally she found a cassava flour tortilla recipe online that I liked. She also substituted sweet potatoes for white potatoes in the stew we normally make with coconut milk. Using turmeric, ginger, mint, cilantro, saffron, to flavor the foods it became easier to follow the diet. In a week or two I started losing weight, sleeping well, and having more energy and that is when I realized how much better I could feel.
It was an eye opener. After 17 days I fell off the wagon and found it difficult to get back on path and did not have a structure to reintroduce the foods. What my own experiment helped me do was give my patients more recipe ideas and tips.
So fast forward a few years to when I came across the AIP Certified Coach Training Program. I did not blink an eye and signed up immediately. Understanding the science in more depth was beneficial in explaining to patients why we were eliminating certain foods. The resources and support that this program offers are priceless. Now, I can help my patients so much better in implementing the AIP and guiding them through the reintroductions the right way. Using the AIP protocol, I have been able to walk them through the process of elimination and reintroduction and noticed great results in them. The handouts are very helpful. My patients are noticing more energy, improved sleep, weight loss and just overall feeling more vibrant and like their true self again. Most importantly they feel more supported in their AIP journey and not deprived.
Comparing how I used to treat patients with thyroid concerns back in my conventional medicine practice to now, it is a big difference. Using food to reduce inflammation in the body is so important and that is something we never do in the conventional medicine world. I think every doctor needs to learn about the AIP protocol and start implementing it for all their patients who suffer from an autoimmune condition and see the benefits for themselves. This should be included in the curriculum starting from medical school. As you may know autoimmune disease is an epidemic in our society and affects 50 million Americans. The cost of healthcare to treat autoimmune conditions can be significantly reduced if we use food as one of the treatment options early on. One of my goals and dreams is to have a teaching kitchen in my community to teach patients how to cook using the AIP protocol. The AIP coaching program resources are by far one of the best tools in my tool kit.