Where Medication Fits on a Healing Diet


Medications and the Paleo Autoimmune Protocol (AIP)

With the paleo autoimmune protocol, the hope is that we can reverse our autoimmune disease, heal our bodies at a deep level, regain abilities, and reduce/eliminate our need for medication. But that’s not something that happens overnight. Today, I’m answering the most common questions people ask about medications and the AIP.

Should I Go Off My Medications When I Start the AIP?

The short answer is no. Healing through diet and lifestyle takes time, and if you go off your medication before your body has a chance to heal, you will most likely have an autoimmune flare. The one exception might be people who start the AIP immediately after diagnosis, before going on medication. Sometimes it’s possible to avoid meds at this stage, but not always. Work closely with your doctor when making this decision. Here’s a quote from The Paleo Approach, the ultimate guidebook to the autoimmune protocol:

“Changing, tapering, or discontinuing your medication – especially if you are taking prescription drugs, but also any daily over-the-counter medication that your doctor may have recommended – should, without exception, be done under the supervision of a health care professional. I must also emphasize that changing your medication is not, in most cases, something to tackle when you initially adopt the Paleo Approach. By improving your diet and addressing lifestyle factors first, you will be able to heal your body as much as you can while you are still taking these drugs, which will significantly help you adjust to discontinuing them.” ~ Dr. Sarah Ballantyne

What About NSAIDs?

You may think these are never allowed on the AIP, since they are often included on the “No” lists, and the science is clear that they do contribute to leaky gut. If you can find a supplement that works just as well, that’s ideal. However, if you are prescribed NSAIDs by your physician to specifically treat your autoimmune pain (like rheumatoid arthritis) and supplements don’t provide adequate pain relief, going off NSAIDs cold-turkey will usually lead to high levels of pain, which isn’t a healing state either. Follow Sarah Ballantyne’s advice above. Implement diet and lifestyle recommendations first, and as your symptoms improve and your pain lessens, work with your doctor to reduce/eliminate your dose.

How Long Does It Take to Reduce Medications?

This varies, depending on the medication, and the individual. Your symptoms need to go away before your medication does.

According to Dr. Terry Wahls, some of the first prescriptions people are often able to reduce are blood pressure and blood sugar medications. Many people also find their need for acid reflux medication disappears when they start a healing diet. But when it comes to autoimmune medication, that usually takes longer. Wait until you see significant improvement in your autoimmune symptoms and then work with your doctor on prioritizing which medications to reduce first.

Steroids are meant to be taken short-term to control autoimmune flares, and they’re a good first choice to try eliminating once your flares have stopped. However, you’ll want to slowly taper your dose under a doctor’s supervision, to minimize any rebound effect. DMARDs (immunosuppressants) are designed to be taken long-term and many are often prescribed simultaneously. Some people have been able to get off DMARDs altogether, while others have been able to reduce their numbers and dosage over time.

If you have Hashimoto’s or Addison’s disease, you might need to stay on your medication. We need the hormones from our thyroid and adrenal glands to function, and when those glands are damaged, they stop producing enough. Some people are diagnosed before much damage is done, and they are able to remain (or become) medication-free. Others are diagnosed after many years of damage, and therefore medication is needed long-term. If that is you, the key is finding the right brand and dose that works best for you.

Lastly, sex hormones can affect autoimmune expression. For that reason, if you are taking birth control or hormone replacement therapy, and you hit a healing plateau on the AIP, you might want to look into non-hormonal alternatives.

If your doctor is resistant to the idea of dietary healing and won’t discuss the possibility of reducing your medication, here is a list of directories of paleo practitioners.

If I Can’t Get Off My Meds, What Am I Doing Wrong?

Autoimmune disease is serious business. It often requires medical intervention to prevent disability, treat excruciating pain, and even save lives. While the side effects can be scary (which is why we have the goal to get off medication), living with the symptoms of an untreated autoimmune disease is even scarier. There is no shame in taking medication. People who go off their medication aren’t superior to those who don’t. They’re often just luckier. The truth is — some people’s illness is more aggressive than others.

Does that mean you should give up? No.

First, read this article: Top 5 Mistakes People Make on the AIP. Many people are unknowingly skipping a key element to this healing protocol. However, if you’ve read that article and aren’t making those mistakes, you might have other factors interfering with your ability to heal. The Paleo Mom Consulting is a team of practitioners well-versed in the AIP and autoimmune healing. Contact them for 1:1 guidance.

No matter what, know this: You are awesome! If you are part of this community, you’re willing to take your health into your own hands and mindfully choose what you eat and how you live, in an effort to get better. If you’re trying your hardest and still have symptoms, you are NOT a failure. In that circumstance, taking medication alongside your healing diet is a wise choice.

Some people ask, “If I can’t get off all of my medications, what’s the point?” The point is that through the AIP, you are addressing your autoimmune disease at its root, helping to prevent further damage, reclaiming abilities you thought you had lost, and reducing what medication you can. Perfection isn’t the only definition of success.  #aipbalance

About Eileen Laird

Eileen Laird of Phoenix Helix has been living the paleo lifestyle since June 2012, reducing her rheumatoid arthritis symptoms by 95% without any steroid or immunosuppressant medication. Merging straight talk with inspiration and information, Eileen strives to help us all live the autoimmune life well! She believes in the power of symbolism: the phoenix represents our ability to transform; the helix represents the power we have over the expression of our genes. In addition to her blog, she hosts the only paleo podcast dedicated to autoimmune healing. She also hosts a weekly AIP Recipe Roundtable, is the author of the e-book Reintroducing Foods on the AIP, and you can find her on Facebook and Pinterest.


  • Carla says

    Has anyone gotten better with vasculitis from this

    • Mickey Trescott says

      Hi Carla,
      Have you checked out some of the online support groups, like The Paleo Approach community on FB? There might be people who can answer your question. You can find the group here: https://www.facebook.com/groups/TPACommunity/

    • Bailey says

      Hi Carla, did you ever get any response to your query. I have vasculitis (EPGA) and have had very limited success with AIP.

  • […] “Autoimmune disease is serious business. It often requires medical intervention to prevent disability, treat excruciating pain, and even save lives. While the side effects can be scary (which is why we have the goal to get off medication), living with the symptoms of an untreated autoimmune disease is even scarier. There is no shame in taking medication. People who go off their medication aren’t superior to those who don’t. They’re often just luckier. The truth is — some people’s illness is more aggressive than others.” Where Medication Fits on a Healing Diet – Autoimmune Paleo […]

  • […] all want to minimize pharmaceuticals, but sometimes drugs are appropriate. Eileen Laird considers where medication fits on a healing diet in a guest post on Autoimmune […]

  • […] Sometimes we see the world in black and white, believing that the only paleo success story is someone who has achieved a medication-free remission. The reality is that there’s a whole spectrum of autoimmune healing. It’s not about perfection; it’s about getting better, and that will look different for each of us. I get emails from people who are taking the strongest medication available and still experiencing loss of abilities and autoimmune flares. That’s what motivates them to try the paleo diet. While most people are able to reduce their medication after 6-12 months of living the paleo lifestyle, not everyone can eliminate it completely. And that’s OK. Some people have more aggressive autoimmune diseases than others, and the combination of medication plus diet is what improves their quality of life. Whatever keeps you flare-free and living a better life than you had before, is cause for celebration. Medication is not failure. […]

  • Alex Campion says

    Hi Mickey! I love your book, and I have just had my dad buy it for my mother. She has advanced MS and has not been able to leave her bed in nearly 3 years. All she can do is talk, listen to audio books and watch television. She used to be a vital and industrious woman. She suffers from terrible muscle spasms. They live in England and have almost no money for healthcare. What little they do they use for carers who come and clean her every day (she cannot go to the bathroom anymore so she goes where she lies). It’s pretty bleak, but my dad is the living embodiment of “in sickness or in health”. He is trying to get her a colostomy so none of that would have to happen anymore. The hospital is dragging its feet. I think they’re hoping the problem will just go away. She has started her on the autoimmune protocol and is completely committed to it. She’s also going to be on natural antimicrobials (pau d’arco, grape seed oil), as well as lactoferrin and prescript assist. Is there any way the diet could resurrect her from the awfulness her live has become? I dream of her being able to get up and move around again.

    • Mickey Trescott says

      I am so sorry to hear about your mother. Her situation sounds truly heartbreaking! I honestly can’t tell you if a dietary intervention can turn things around for her in this late stage of illness. Generally it is harder the longer and more advanced the disease process is. I’m not a believer in delivering false hope, but I also know that focusing on good nutrition isn’t going to make the situation any worse–giving her body the nutrients it needs to be healthy is foundational for anyone in any disease state. Your family will be in my thoughts!

  • Anna Bassett says

    I was diagnosed with AS a couple months ago. In the past year and a half I have spend 10 of those months in an awful and painful active AS state. About a month ago, my doctor put me on Naproxan. Since then, I have spent 14 straight days with a severe Migraine (prescribed a tiered prednisone on top of the Naproxen). Since the prednisone has left my system I have been ill. Sinus infection going on 3 weeks. I was put on antibiotics and I have only gotten worse. Also, my AS symptoms have increase. I feel that the Naprozan and antibiotics are making my body weaker and sicker. I have not been sick in two years and have never been this sick ever! If medication is link to increase illnesses and AS symptons, then could any meds I take be causing an increase in flares and daily symptoms? I have been on ADD meds for about 15 years. Could there be a connection? Or are my ADD meds safe for my stomach? Could the long term us of ADD meds have activated my AS? Totally frustrated!

    • Mickey Trescott says

      Hi Anna! I am so sorry to hear of your struggles. Unfortunately, since I’m not a medical practitioner I can’t specifically address your issues with medications (this is best addressed to your doctor) but I do wish you wellness and hope that you find some interventions to help you out of this situation!

  • Audra Thomas says

    I am just in the beginning stages of being diagnosed with MS and possible rheumatoid. I have researched the AIP like crazy, listened to interviews and didn’t know endometriosis is also on that list, I’ve had that for years. I am doing everything in my power to get myself healthy. I love my cookbooks and this website and all the information that is out there. I stumbled across this article and it’s exactly where I’m stuck. From my understanding to slow or possibly stop the progression of MS requires medication. I know if will follow the AIP to remain healthy and help my body all I can, but can I really even ever consider not taking a disease modifying drug for MS? It feels risky, any thoughts on that? Anyone with MS in this boat too?

    • Mickey Trescott says

      Hi Audra!
      Have you checked out Dr. Terry Wahl’s work? She personally has healed her secondary-progressive MS to the point where she takes no disease modifying medication. There are many in the AIP community who have done the same. That being said, you need to make the decision on medication with your doctor but depending on how well you can manage with dietary and lifestyle interventions you might have an option to go without. Wishing you luck!

  • Fiona Andrew says

    Thanks for this article. I have Hashimoto’s and I had been doing really well on the paleo diet for about a year. I was feeling great, and my blood work reflected that. I started AIP for about two months last winter and felt great! After getting blood work done, my Dr was concerned that I was now over medicated because there had been such an improvement in my tsh/t4 and dropped my synthroid dose from 125 to 100 mcg. Since I was feeling so great, and had been doing really well with paleo, I foolishly jumped back to regular paleo without doing the reintros properly. I had to get blood work done 4 weeks later and within that month started to feel terrible. My tsh had jumped from 0.03 up to 8. I had hair loss, muscle aches, tingly limbs, extreme fatigue, brain fog etc. I don’t know what was more to blame – the medication change or the botched reintros but I’m sure they both played a role! I’m now back to strict AIP and my dose was upped to 112 mcg. One month later, I’m slowly starting to feel a bit better and have follow up blood work tomorrow. Although I will always require medication, it’s great to know that AIP can help so much!

    • Mickey Trescott says

      Hi Fiona! So sorry to hear your reintro situation, there are definitely some foods eliminated on AIP that could be affecting you. I hope you are able to find out what they are this time!

  • Diana says

    Hi, thank you for all Thai insightful information. I just started the AIP diet about a week ago due to my psoriasis condition. I had to stop my treatment about 3 months ago because of health insurance coverage. I wanted to know if you know of stories or cases where people with psoriasis have gotten better after following the diet for a long term period? Thank you for all the info.

    • Diana says

      I meant to write *that and not Thai lol

    • Mickey Trescott says

      Hi Diana! I don’t have any specific links, but I have heard from some psoriasis sufferers in the community that the elimination diet has helped them pinpoint some of their food triggers. Hope it helps you!

  • Sheila says

    Do you know of people with Primary (Addison’s) or Secondary Adrenal Insufficiency who has made a significant improvement with Paleo or AIP? It’s hard to find info. — Thanks!

    • Mickey Trescott says

      Hi Sheila!
      We don’t keep tabs of everyone who has written in with success–sometimes you never know how things are going to shake out until you take the leap! Wishing you the best.

  • Carrie says

    Can you tell me if wheat grass shots can help someone with hashimotos or make things worse?

    • Mickey Trescott says

      Hi Carrie, even though wheat grass is unlikely to contain gluten, I would avoid while on the elimination diet. You can reintroduce it later if you’d like to, but I don’t see any particular nutritional benefit you can’t get from eating other vegetables.

  • katrina chavarria says

    Hello! I started the aip diet to help with my hashimotos and adrenal fatigue flare. But the process has been debilitating…and isolating. I feel depressed, even with exercise, relaxation techniques and a vitamins. How do antidepressants fit into the AIP?

    • Mickey Trescott says

      Hey Katrina! If you need antidepressants to get you through, there is no shame in taking them. I would additionally see if you can connect to the community, either in a local meet-up group or in some of the support groups online!

  • Lauren says

    Hi! I have a skin condition called Hs as well as hypothyroid. Is it better to stay on medication while doing reintroductions? Or should I work with my doctor to reduce my medicine before doing reintroductions?

    Thank you for all the information. I hope AIP help reduce my symptoms.

    • Mickey Trescott says

      Hey Lauren! Since we aren’t medical practitioners here we can’t give advice about conditions or medications. You should absolutely work with your doctor if you are changing or reducing medication. A lot of people do AIP until their symptoms are in remission for 6 months before asking for a reduction in medication w/ their medical team. Sometimes it is possible, sometimes it isn’t. Wishing you the best!

  • Tim says

    Hi, if my medication has effectively eliminated my symptoms, how will I be able to tell if the AIP diet is having the desired effects? I’m not sure I’ll be able to tell there’s any improvement…

    • Mickey Trescott says

      Hi Tim! We can’t give specific advice about medication because we aren’t doctors here, but what a lot of folks do is implement the elimination diet with their medication in place, and then work with their doctor to wean if medically possible. Dr. Terry Wahls talks about how this avoids rebound flares that some people get when they try to wean medication before starting diet or lifestyle therapies. Wishing you luck!

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