White Willow Bark as an Alternative to NSAIDs on the Paleo Autoimmune Protocol

The past few months I have been experimenting with using white willow bark (salix alba) instead of NSAIDs for my menstrual cramps. I believe it is a bit controversial given that a lot of people are worried about salicylates these days, but I have had a good experience and wanted to pass along what I have learned.

Why are NSAIDs not allowed on the paleo autoimmune protocol?
NSAIDs are a well-known gut irritant and have been shown in studies to contribute to intestinal permeability. Since the autoimmune protocol seeks to remove everything that contributes to this, it is suggested that people avoid them during the elimination phase of the diet (if not forever – they are one of the items that is strongly implicated in leaky gut.)

What is white willow bark?
White Willow Bark is a tree native to Europe and Asia that has been used as a traditional remedy for relieving pain and inflammation. When it was discovered that salicin, the active component in white willow bark, was responsible for its anti-inflammatory and analgesic effects, a synthetic version was created. This synthetic salycilic acid was very harsh on the stomach, leading to the development of acetylsalicylic acid by Bayer, which was then mass produced as the aspirin we know today.

How does white willow bark work?
When white willow bark is ingested, the salicin is converted into saligenin by the intestinal flora, where it is then absorbed into the blood stream. The liver then metabolizes it into salicylic acid. Because of the time required for the body to metabolize the salicin into salicylic acid, the effects start longer after it its ingested and last longer than with synthetic salicylates. It is thought that white willow bark does not affect the gut lining the way NSAIDs do because it is converted into the acid form after it is absorbed from the stomach. Salicylates relieve pain and inflammation by inhibiting the formation of prostaglandins – the body’s natural pro and anti inflammatory messengers.

I thought salicylates were bad?
According to this article on The Paleo Mom, many of us with autoimmune disease and other chronic illness can be sensitive to salicylates. Synthetic derivatives can be found in a multitude of household products, beauty products, and medications. Natural salicylates are also found in many foods. I think there is a good argument for the removal of synthetic salicylates, but there may be a place for natural ones such as white willow bark for occasional pain relief.

Are their any contraindications for taking white willow bark?
People who are allergic to aspirin or salicylates should not take white willow bark. Those with tinnitus, peptic ulcers, or bleeding disorders also should not use it. Because of the risk of developing Reye’s syndrome, children with fever should not be given salicylates.

My experience using white willow bark
I have suffered incredibly painful cramps every month since I started getting my period. I have never been able to go a month without NSAIDs – when I start getting cramps, I would take some aspirin and my pain would begin to subside in 15 minutes. When I started the autoimmune protocol, I was worried because I knew I would not be able to make it without painkillers. The first month I tried doing without, and instead staying extra hydrated, taking extra omega-3 from fish oil, heating pads, baths, moxa – and none of it worked. I was in so much pain and swore I would never do that again.

I was incredibly discouraged and considered asking my doctor for a prescription for an alternate painkiller. I did not want to ruin all of my progress on the autoimmune protocol by taking NSAIDs! My sister told me about white willow bark, something she had been using successfully for her headaches. I first wrote it off as something that would not be allowed because of the salicylate content, but then I read about it being different from synthetic salicylates because of how it is absorbed in the gut and then formed into the acid in the liver. I decided to try it, and after a little trial and error with timing (it takes about 2-3 hours to take effect) I have been successful in using it to treat my menstrual pain for a few months now.

The last few months that I have been off NSAIDs have been great in terms of autoimmune symptoms. I am on a roll with the autoimmune protocol, and I continue to see nothing but benefits the more time that passes. I haven’t noticed anything negative from using white willow bark, and feel incredibly happy to be liberated from my monthly NSAID usage.

I wouldn’t advise anyone to begin using white willow bark daily for pain, but I do believe it has a place for those of us who need an alternate painkiller or anti-inflammatory.

Have you been able to give up NSAIDs while on the autoimmune protocol? I’d be curious to know of any other strategies out there! 

About Mickey Trescott

Mickey Trescott is a co-founder here at Autoimmune Wellness and a co-teacher of AIP Certified Coach. After recovering from her own struggle with both Celiac and Hashimoto’s disease, adrenal fatigue, and multiple vitamin deficiencies, Mickey started to write about her experience to share with others and help them realize they are not alone in their struggles. She has a Master's degree in Human Nutrition and Functional Nutrition, and is the author of three best-selling books--The Autoimmune Paleo Cookbook, The Autoimmune Wellness Handbook, and The Nutrient-Dense Kitchen. You can watch her AIP cooking demos by following her on Instagram.


  • Katy says

    This was a great post! I will be sure to try this. I also suffer from horrible menstrual cramps and NSAIDs were the only thing that helped. Since my IBD diagnosis, I have avoided them because of the connection with leaky gut syndrome. Even though my doctor tries to convince me that it’s okay to take NSAIDs, I believe otherwise. So, I’ve pretty much been suffering without the NSAIDs for several months now. I do take Tylenol, but it doesn’t provide much relief for me. Heat helps…a little. I will try this and report back. Thank you for sharing.

    • I am glad you found the article useful! I am so happy to be off the chemicals and dyes. White willow bark does take a while to work (2-3 hours for me) so keep that in mind – my experience is that if I don’t take it proactively, I get in trouble. I will be curious to see how it goes for you!


  • Thank you! Thank you! Thank you!

    I’ve been trying to keep off the NSAIDS, so every few weeks I’ll suffer all day through a headache (having tried acupressure, caffeine), then finally give in because I’m sick of feeling crappy and know I won’t sleep well enough to do two days worth of work the following day. Hopefully with this I’ll only miss a few hours of productivity…

    • Good luck! Let me know how it goes. My sister has had an epic battle with hers and she finds that the white willow bark and good hydration keep her headaches at bay. 🙂

  • Martin says

    Very useful information. Being on autoimmune paleo myself I was struggling with how to handle occasional headache. So far I was using kid doses of paracetamol but I will definitely give white willow bark a try.

  • Richard says

    Hi there. Because I chronically suffer from many old sports injuries, I have taken way too many NSAIDS and pain killers. Because of this and my auto-immune issues, I really appreciate the natural alternatives. Do you have any thoughts on pure cherry juice? I had read and heard about this as having anti-inflammatory properties. My wife read that even a trainer for a pro football team has it in the locker room as a substitute to ibuprofen. thanks.

    • autoimmunepaleo says

      Richard, I have heard of this – my dad actually has used it in the past, but I have no experience using it myself. If you have a good result, please come back and let me know!

      • Barb says

        Hi- I wondered why you don’t advise taking white willow every day? I wanted to try it for skin, veins and metabolism as well as for inflammation. I take a baby aspirin daily for possible blood cots and would like to try white willow bark capsule once a day instead. Any reason you would discourage this? I have slight symptoms of autoimmune problems (some tiny white spots on skin and tiny bit of psoriasis once.) Any info or advice is appreciated. Thx! -Barb

        • Mickey Trescott says

          Hi Barb! I’m not an herbalist or a doctor so I can’t advise on if this would be helpful for you. I’m usually weary of taking anything anything every day unless there is a lot of research about the effects. Hope it helps!

  • Mary says

    Thanks for this post! Can you advise what type of store you purchase white willow bark and also how it is administered?

    • autoimmunepaleo says

      Hi Mary,
      I bought capsules at a health food store. I don’t really want to advise on maximum quantity, but I started with 2 capsules a few times a day and went up from there. I would consult a qualified herbalist for a safe upper limit on using it :).

  • Kelly says

    Thanks for this great post! I am finding your blog and recipes so helpful and loving the results of the AIP. However, I am curious how much white willow bark you take? I have been trying this the past day, but I feel like it takes awhile to work AND wears off fast and I am fast approaching my limit for the day. I feel like perhaps my timing with it is all off. Thanks a lot!

    • Mickey says

      Hey Kelly! I can’t really tell you how much, because I don’t want to be liable for anyone overdosing as a result of my advice. I would contact a qualified herbalist to see what the safe upper limit is.

      Another option, that I have heard of people having success is taking it in tincture form.

      Good luck!


  • Allison says

    I am a big proponent of Mayan Abdominal Massage for painful periods. Sometimes, structural issues and a uterus that is out of alignment will cause bad cramping, even if the diet has decreased inflammation. I have had really painful periods but after receiving 3 treatments, I didn’t have to take any NSAIDs this past cycle. It felt like such a feat! I use my health insurance to see a chiropractor but massage therapists, midwives, physical therapist also do this work. https://arvigotherapy.com/

    • Mickey says

      I haven’t heard of this, but that is awesome you found something that gives you relief!


  • […] This article has moved to a location on my new website (autoimmune-paleo.com), click here to read it! […]

  • kate says

    This is great! I lean on NSAIDS for occasional joint pain, especially around my period. I have hashi’s and AI Arthritis. In the past I used A LOT of NSAIDS, and still had pain, but now, after Paleo and using certain supplements, I am mostly pain free. I use doTERRA essential oils to manage my pain and inflammation internally as well as topically on site of pain. There are great ways to solve headaches and joint pain with essential oils, like peppermint and wintergreen – it works so fast and is so easy! I’d love to share info on this.

  • Teresa says

    I had a long term history of taking mega doses of nsaids until they completely tore my stomach up. Currently I take a variety of prescription pain meds/muscle relaxers for migraines, TMJ, back issues, etc. As far as I can tell none of them (cephadyn, flexeril, lortab) contain nsaids, but some do contain acetaminophen. Also, if I have a migraine that requires an ER visit, they give me toradol which is an nsaid. How can I find out if any of my current medicines will conflict with the AIP? I found an OB/GYN on PrimalDocs and I have an appointment with him in two weeks, but don’t know if I can go two weeks without needing meds but I also don’t want to take them if they are going to mess up the AIP.

    • Mickey says

      Unfortunately I am not a medical doctor so I am unqualified to answer any questions about medications. I think you are on the right track working with someone who is familiar with ancestral nutrition, and can help you find medications that won’t stall your progress. Good luck!


    • Jinji Donato says

      Try formula 303 for your tmj issues. It is a wonderful herbal muscle relaxer. I have suffered with bruxism and tmj for years and I am finally experiencing relief and restful sleep. For something even stronger look into apitherapy. Bees are amazing!

  • Hope says

    My son suffers from frequent, sometimes daily, growing pains. I’ve been looking for an effective alternative pain relief besides NSAIDS. Would white willow bark be beneficial for growing pains as well?

    • Mickey says

      I would find an experienced herbalist to direct that question to, as I am not sure!


  • Shannon says

    Hi Mickey!

    I usually never take NSAIDS but have been taking them recently (for about 5 days now) for a sports injury but since I’ve started I’ve noticed some serious gastrointestinal problems (constipation, gas, bubbly stomach, etc.) so I’m thinking of switching over to WIllow Bark Extract like you suggest! Do you have any suggestions for good brands of tablets and/or teas you’ve used??

    • Mickey says

      I can’t recommend a brand here for legal reasons, but look for a 100% pure version of the herb in capsule form. Good luck!


  • Grace Bottitta-Williamson says

    Any suggestions for folks with tinnuitis?

    • Mickey says

      Unfortunately I cannot advise on medical conditions, since I am not a doctor. I recommend finding an open-minded practitioner, possibly a naturopath or doc who specializes in functional medicine to help you troubleshoot.


  • Ellen says

    Hi Mickey,

    I have been following your facebook entries a lot and have bought your book as well.
    Thank you for all the helpful information you provide.

    I am a bit wary of fully coming off my Naproxen fully, though, since I have been diagnosed with Hypermobility Syndrome which is infamous for causing inflammation in tendons. My GP suggested a while back to try and live on Paracetamol with codeïne to prevent my stomach from developing ulcers, but it was no go, unfortunately. There was just too much inflammation to keep under control with just Paracetamol/codeïne.

    Do you have any suggestions for me on this front?


    • Mickey says

      Unfortunately I can’t advise, since this question is very much in medical territory. I know others who are on AIP with improvements, but continue to take NSAIDs because they need it to get through the day. This is a personal choice, and I hope you find a solution.


  • Tori says

    Hi Mickey – does White Willow Bark still have similar anti-coagulant (mild blood thinning) properties as aspirin? I take a baby aspirin daily as a preventive measure and am curious if a while willow substitution could serve that function or not (unrelated to pain management). Thanks!

    • Mickey says

      Hi Tori,
      I am not a medical professional or herbalist and cannot answer this type of question–so sorry! This is one to ask your doctor or naturopath about.

      Good luck!


  • […] 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 […]

  • Leslie says

    Thanks for the informative post, Mickey! I’ve been trying alternatives to NSAIDS that I have been relying on for the past 8 yrs. for hormonal migraines and cramps. I have tried chiropractic adjustments and acupuncture every week for two years to no avail. Frustrating. My naprapath suggested white willow bark, but I have not had much success unfortunately. As far as my menstrual cramps though, she suggested a supplement called Cramplex from Medi Herb (Standard Process brand) and I have seen amazing results. It has Corydalis tuber, Raspberry leaf, Wild Yam, Cramp Bark, and Ginger. Would recommend it in a heart beat! I just started Camu Camu powder to help regulate my hormones, but haven’t been taking it that long to see results yet-crossing fingers something works for this head of mine! Thanks for all you do-an inspiration for all of us with Hashimoto’s!

  • Denny Serra says

    I can’t believe I am writing this to you, but I no longer have any menstrual cramps and I tracked the reason down to drinking 1 bottle of kombucha per day starting the week before my period starts. I have no idea why it works… But it totally does for me.

    • Mickey Trescott says

      Wow, I wish that worked for me! Thanks for sharing 🙂

  • Lindsey says

    I didn’t start getting cramps until my leaky gut problems started, so I think they are definitely related, and I try to avoid NSAIDs now as well. But one of the things that seems to prevent cramps most effectively for me is keeping a low fat diet before my period (I would say for at least a week prior); I’ve noticed that every time I’ve been eating high fat foods before my period, I will get a much heavier flow and worse cramps. You mentioned staying hydrated as a tactic, but I’m afraid that might actually make things worse in this case, because diuretics are also one of the most helpful remedies for me. You could even try some natural diuretic herbs. Also, exercise seems to help quite a bit. I’d be curious to know if these tactics work for you!

  • […] If you’d like to learn more about white willow bark, I’ve written an article about it here. […]

  • Kat says

    Thanks for the article. I have some white willow but i have loath to try it as one of my AI conditions is immune thrombocytopenia and I am not sure if I should be using anything that could thin my blood.

    • Mickey Trescott says

      If you have a medical condition that affects blood thinning, best to chat with your doctor who is familiar with herbal treatments so they can advise you on that! Good luck!

  • Noucky says

    Is White Willow Bark better than curcuma?
    I use the T4 pills from redd remedies now.

    • Mickey Trescott says

      Hi Noucky,
      Best to consult a doctor or a practitioner to see which one is best suited to you!

  • Jeanette says

    I am allergic to aspirin & cannot take NSAIDS. Would that also be the case for white willow bark since they contain salicylates?

    • Mickey Trescott says

      Hey Jeanette! Yes, I would hold off on the white willow bark and consult a doctor. You can’t be too careful.

  • Dana says

    Thanks Mickey for the article. Have you also tried OTC Progesterone cream? It worked wonders for me with painful periods.

  • Stacie says

    Love your blog! 🙂 I first came across your post on Kombucha and ended up here from another Google search.

    Quick question, how many days prior to the onset of your period did you start with the willow bark, and how frequently would you take it until then? I know you don’t want to give exact dosages, but what do you do as your personal protocol (not necessarily what you would tell someone else to do)?

    I look forward to your reply and thanks for all your helpful tips 🙂

    • Mickey Trescott says

      Hey Stacie! I don’t use white willow bark anymore, but I only used it for the first 24 hours of my period when cramps were bad. Hope it helps!

  • MJ says

    Why don’t you use the white willow bark anymore? Did you find something more effective?

    • Mickey Trescott says

      I went through a phase where my pain went away, and then it surfaced again – lately I have been experimenting with CBD oil.

  • Sam j says

    I see a lot of no-NSAIDS on AIP articles that mention NSAIDS are bad for your gut. But what about using an OTC Pain relieving patch? I have one whose active ingredient is methyl salicylate. Because it is a patch, it does not pass through my gut, instead is absorbed through the skin into my bloodstream. Does this avoid the gut issue enough to make it okay on the AIP diet? (Brand name i use is Salonpas)

    • Mickey Trescott says

      Hey Sam! I’m not a doctor so I can’t give medical advice – I think you have a really interesting idea about getting the medicine through the skin, I just don’t have any medical knowledge to know if it still affects the gut or if it would be problematic for you. Best chance would be to ask Dr. Ballantyne, who has compiled the research on AIP and made the original recommendation, or an MD. Good luck!

  • Joy Colclough says

    Awesome article

    Im still trying to heal my gut after years of NSAIDs for arthritis
    Needless to say a host of other problems csne about from the consumption of those drugs
    You answered my question
    ..i can use white willow for my arthritis pain
    Thank you so much

    • Mickey Trescott says

      Hi Joy! Glad you found it helpful – always best to check with your medical provider to make sure it is right for you. Good luck!

  • Hope says

    I’m in a program for RA, I recently started the AIP
    diet. I’ve realized it’s not working as fast as I thought . Then I stumbled onto this site . I think it’s the nsaids that are causing me not to get rid of pain . I’m taking 1200 mgs of Tumeric curcumin a day I have white willow bark . But don’t think I should mix the two . Any ideas

    • Mickey Trescott says

      Hi Hope! Unfortunately we are not medical providers here and can’t advise you on whether or not to take NSAIDs, and if it would be safe to mix them with turmeric or any other supplement. You need to run this by your doctor or another medical professional for advice. Wishing you luck!

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