One of the biggest concerns with going on the autoimmune protocol is how long to stay on the diet and how to reintroduce foods systematically. The Paleo Mom has the most in-depth article out there on this topic, and my personal experience and research has lined up perfectly with what she recommends in her article. Here, I hope to answer some key questions as well as offer my personal experience on food reintroduction for anyone using the autoimmune protocol as an elimination diet.
How long should I stay on the Paleo Autoimmune Protocol?
I recommend at least 30 days of 100% adherence to the protocol before contemplating reintroduction. 2-3 months would be better, but it is tough to go that long. This should be enough time to see if it is making an improvement. Ideally, you would be able to stay on the diet until you notice a significant improvement or even elimination of symptoms – then you have a baseline to compare how you feel when you are reintroducing foods.
I am ready to reintroduce foods – now what?
Before you go crazy and cook up your first non-AIP meal, it is important that you approach the reintroduction process with a plan. All of the work of adhering to the protocol is easily gone to waste if you don’t do this part carefully. The way I approach a reintroduction is to eat a little bit of one of the foods and wait for a reaction. If you don’t get one in 2-3 days, have a meal with a lot of that same food. Then wait 3 days for a reaction. It is important that if you have a bad, long lasting reaction, wait until you are back to feeling how you were on the protocol before moving on. Continue this way with all of the foods that you are re-introducing. The slower and more systematically you do this process the more you will be aware of your tolerance and sensitivity to certain foods.
Which foods should I re-introduce first?
It is important to start with foods that are the least likely to be a problem. According to the Paleo Mom, this group would be egg yolks (pastured, soy and wheat-free), grass-fed ghee, seed spices, or starches or FODMAPs (if you have been avoiding them). The next category would be nuts, seeds, alcohol and grass-fed butter. If nuts don’t go well, another step could be soaking and peeling them (if they are peel-able). On the moderate list are nightshades (excluding tomatoes), coffee, chocolate, sesame seeds, tapioca/cassava/yucca, yeast, grass-fed raw cream, and fermented grass-fed dairy. According to the Paleo Mom, the most likely foods to be problematic are egg whites, chili peppers, alcohol in large quantities, tomatoes, and NSAIDs, with the last two possibly never being able to be included in the diet.
I experimented with the autoimmune protocol strictly for six weeks, where I saw a great improvement in my symptoms, most notably my energy, sleep, and acne. Before strictly adhering to the protocol I had never found anything that would relieve my acne, yet after a few weeks I could not believe how soft and clear my skin was. I knew this was good news, as skin health is often said to be a reflection of what is happening in the gut. I had been about 80% compliant for the few months previously, but I did not get anywhere near the benefits that I got from going completely strict, I believe because I was not doing a good enough job avoiding nightshades (which I have found to be particularly problematic for my body). My first re-introduction was egg yolk, which went fine, and then seed spices in moderation. I have been attempting almonds for the last month or so, and have found that soaking and peeling them makes it possible for me to eat them in small quantities. Too many and I find my autoimmune symptoms worsening. I have also found that I can tolerate a small amount of alcohol. I have not been successful with any other re-introductions, and so I believe that my gut needs more time to heal. Feeling good is motivation to continue, however, and I am excited for the day that I can expand what is on my menu even if it happens little by little.
I am curious to know how long some of you have been on the protocol, and what foods you have been able to reintroduce. Do they line up at all with the least to most problematic list from the Paleo Mom?