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Today we’re going to talk about a practice that can both bolster and streamline the process of discovering which changes you’ve made are helping (or hindering!) your healing process, and how that process is progressing over time.
Disclaimer: The practice of tracking can bring up issues for some folks and isn’t always appropriate. See the section at the end of this article about some warning signs to help recognize when tracking may not be supportive or helpful for you.
What is tracking and why would you do it?
Tracking is the process of recording symptoms, health metrics, and/or interventions over time. It gives you both immediate and long-term feedback you can use to evaluate if what you’ve put into practice is helping you achieve your wellness goals. Tracking can include what most of us consider keeping a symptom log or journal, as well as be expanded to include lifestyle factors like diet, exercise, medications, and supplements.
When tracked data is looked at on a micro-level, it can help you “zoom in” and give immediate feedback useful for correlating habits or choices to outcomes (such as getting a headache every time nightshade foods are eaten, or bloating after taking a certain brand of probiotic).
When tracked data is looked at on a macro-level, it can help you “zoom out” and see how your habits or choices are impacting your healing process over a longer period of time (such as improving energy levels from a 5 out of 10 to a 7 out of 10 after one month of adhering to the elimination phase of the Autoimmune Protocol).
Without tracked information you need to rely on your memory to make connections and gauge your progress. And while that may be easy to do when the changes are obvious (like having a chronic rash disappear when you avoid gluten, or noticing you have a bowel movement every day when you include a magnesium supplement), it is really difficult to both make connections and gauge subtle changes when using memory alone. Not to mention when a symptom of your autoimmune disease is brain fog…
Why is tracking useful to those on AIP?
Tracking is specifically helpful when you are embarking on and working through an elimination and reintroduction process like the Autoimmune Protocol. Here are a few ways you might use tracking while on your AIP journey:
- Establishing a baseline. It can be helpful to have a baseline “snapshot” of symptoms and diet/lifestyle habits before undergoing any changes. This might look like a few days to a couple of weeks of symptom and diet journaling, or even just writing down your most common complaints with the date so you have a record to look back on. In terms of the Autoimmune Protocol, this type of tracking is most helpful both before starting the elimination phase, and before starting the reintroduction phase. This type of tracking might look like more detail over a shorter period of time.
- Tracking long-term progress. In contrast to a snapshot, this looks more like the kind of information you could chart or graph (only if you wanted to, of course!). Tracking long-term can take many different forms, but I recommend honing in on the things that give you meaningful information about your health journey over time. This can be especially revealing and helpful if healing is slow or if your autoimmune disease comes with nebulous or hard-to-pin-down symptoms.
- Gauging reintroductions. Tracking is absolutely essential during the reintroduction phase of the Autoimmune Protocol (to learn more about that, read this article). While your baseline or long-term tracking may be much more sparse and casual, detailed tracking is absolutely essential for a successful and actionable reintroduction process.
What can you track?
The first category we are going to talk about is health metrics. I like to use this term instead of symptoms, as that word usually has a negative connotation for those of us with autoimmune disease. Tracking your health metrics gives you a picture of how your body is changing over time. Each day, week, month, or other period of time you are tracking, you’ll check in with your body and take down data points in any of these areas.
- Bowel movements
- Notable symptoms
- Body measurements
- Lab work results
The second category we are going to talk about is interventions. In contrast to health metrics, think of the interventions as inputs. For instance, in contrast to tracking how many hours you slept the night before, as part of your intervention tracking you might track the time you went to bed. Essentially, you are keeping a record of the actions you took to support your health that day, week, or month.
- Stress management techniques
- Sleep hygiene
- Food/beverage intake
While one category isn’t more important than the other, it is valuable to have data from both of them so that you can make correlations and conclusions that can best support your actions going forward.
What tools do you need for tracking?
While there are lots of tools out there to help you gather and track data, you don’t need to purchase anything to start. The most accessible way to get started is to simply print out some journal pages or use a notebook.
Once you have an idea of what kind of information you’d like to track, or how you’d like to do it, you can research some of the following options to make things easier for you:
- Health metric trackers – These are apps or journals designed to help you track your health metrics over time. Some apps are designed to send notifications and reminders to input information, and are quick and easy to use, which can decrease overwhelm and increase compliance. (I say “can” because apps are not a great solution for everybody – personally I have never enjoyed tracking with apps that require me to input information and prefer to use pen and paper). A few tracking apps that have been mentioned positively in the AIP community are Flaredown and MySymptoms.
- Nutrition trackers – These are apps or journals designed to help you track your food intake and nutrition over time either in app or desktop form. This intake is then used to give a report on daily and long-term micro and macronutrient intake. My favorite is Cronometer.com due to the detail of nutrient data and high-quality ingredient options in their database.
- Wearable trackers – These are devices worn on your body that automatically gather data and send it to an app on your smartphone or computer. The simplest ones track things like steps and movement, and the most complex can read your heart rate, body temperature, and sleep cycles. The upside to wearables is that they are able to collect data without you needing to “do” anything, besides charge them. The downside is that accuracy and significance of this data is sometimes questionable, and often the data can lead to a feeling of overwhelm. I’ve been using the Oura Ring to track my movement and sleep for the past two years and find it a good way to gauge my self-care inputs that takes very little attention from me. Others like products like the Fitbit Ionic which tracks both movement and sleep.
Best practices for tracking
- Don’t start by tracking everything. Instead of tracking all of the metrics and overwhelming yourself, track the ones that will give you the information you need to determine what is and isn’t working for you. Once you build a solid habit of tracking, expand only as you identify areas that you want to get curious about (and stop tracking information that isn’t helping you!).
- Use a number scale instead of adjectives when tracking nebulous symptoms. This will make your data more usable and easier to compare down the line. It might look like “energy – 7” instead of “I had a good amount of energy today.”
- Don’t worry about perfection. If life gets in the way and you aren’t able to track, this doesn’t render your data useless. Maintaining the record long-term will be helpful even if there are some gaps.
- Only use tools that truly make tracking simpler for you. This is a tough one, as we can get easily sold on gadgets and apps for gathering data. The truth is a lot of work can be done freely and easily with a pen and paper. Only invest in tools if they will truly make your tracking easier and more actionable.
My experience with tracking
Deciding how and what to track is incredibly personal, and I thought I would share a little bit about my experience with tracking so you can see how it has supported my healing journey.
In the very earliest days of my transition to the Autoimmune Protocol, I did not track anything. I was too exhausted, overwhelmed, and depressed by the depths of my illness. Most of what I remember now about how I felt back then was through random journal entries where I mentioned my symptoms, medical records from appointments, or things that I told family members I was experiencing that they have brought up over time.
The first thing I began tracking was my body temperature when I began to suspect that I had a thyroid issue. This was pre-diagnosis with Hashimoto’s thyroiditis, and after logging chronically low morning temperatures for a few weeks, I was able to better advocate for myself at my next doctor’s appointment (and eventually ended up getting antibody testing that revealed my condition).
When I initially transitioned to AIP, I was still too deep in the depths of my illness to track anything. About three months in, I thought I started noticing some positive changes, and discovered my morning body temperature was improving when I started taking it for a week or so. I found that information so motivating that I set out to track some basics like bowel movements, energy levels, mood, and a general log of food and supplements consumed. I wasn’t totally compliant with my tracking, as I was quite sick during this period of time, but I do remember being surprised at reviewing my data, thinking that I had not been making much progress, but seeing in my logs that there was a clear trend in the positive direction.
By the time I made it to the reintroduction process, I had been doing the elimination phase for nine months. At this point Dr. Sarah Ballantyne had provided clear guidance about the reintroduction phase and the importance of tracking reactions, so I was incredibly detailed about my tracking at this point. I kept both a complete symptom journal (energy, sleep quality, mood, and any other notables), as well as a log of my lifestyle inputs like sleep, exercise, supplements, and most importantly, detailed tracking of the ingredients in my meals. I tracked heavily for this 3-month period as I learned which foods were supporting and which foods were hindering my healing process. This is when I remember tracking was most productive for me, and to this day, rely on the information I learned then about what makes me feel truly great.
How do I track now, 7 years into my recovery? I track very minimally, unless I have an issue I am trying to get curious about or resolve. Twice a year I track a week or two of meals with Cronometer to identify any problematic dietary habits and to motivate me to eat more of my favorite nutrient-dense meals. Once I’m done tracking I average my intake over that period of time and make some goals to shift my diet (such as eating more cold-water, fatty fish or organ meats if I’m lacking in nutrients).
I also track my bi-annual lab work to keep tabs on my thyroid function and medication levels. Generally this has been consistent over time, but I like to reference how my levels have changed over time to get a heads up on any issues brewing. And lastly, I use the Oura Ring to track my sleep, activity, and recovery. Over the years I have learned that when my sleep suffers, all of the other pieces of wellness are likely to be impacted later, so I check in with this data once a week or so to help motivate me to continue the practices that enable me to sleep well. Eating a nutrient-dense diet comes naturally to me at this point, but I still have trouble cultivating a good sleep routine, so checking-in regularly here helps me focus on this piece.
When can tracking become problematic?
A discussion about tracking isn’t complete without mentioning that tracking can be or become problematic for some people or in some situations. If you have a history or show signs of an eating disorder, you should bring in the help of a qualified mental health counselor before you start tracking, especially when tracking your weight, body measurements, or food intake (you can read more about eating disorders and AIP here).
There is an important difference in tracking ingredients and using a nutrition or calorie counter. When using a food journal to track your meals, you’ll be writing or inputting the basic ingredients contained in your meals (such as “lunch – magic chili” or “lunch – ground beef, root vegetables, herbs, and bone broth). When using a nutrition or calorie counter, you’ll be inputting weighed, measured, or approximated amounts of each ingredient in order to receive a full breakdown of the nutrition content of that meal. The latter is incredibly tedious and can easily cause overwhelm and shift the focus to tracking perfectly or worrying about calorie intake.
If you are curious to explore if your usual diet is nutrient-dense and meeting your nutritional needs, I suggest detailed tracking into a nutrition tracker for only 3-7 days. When averaged, this will give you a great picture of the nutrient density of your average diet. If there are any areas that need improvement, you can adjust accordingly and go back to basic food journaling (if that is appropriate or necessary for you).
If you feel at any time that tracking makes you feel overwhelmed or hyper-focused on something, pause and re-evaluate why you are aiming to track and how that information is going to help you. Sometimes tracking can cause people to obsess or get hyper-focused on negative symptoms, bring out perfectionistic tendencies (more on that here), or heighten the desire to be able to “control everything.” If you notice any of these things, it is a good indication that tracking (either in general or specifically how you are applying it) may be more harmful than helpful for you.
The goal of working through the Autoimmune Protocol is to discover which foods and lifestyle practices help you live well with autoimmune disease, not to develop a burdened heart and mind.
In closing, I’d love to know how you’ve used tracking in your health journey – what has been the most impactful metric to track, and what is your favorite tool to use? Let me know in the comments!