F.A.Q.s

First of all, who are you guys?

We are all well-researched autoimmune patients who are happy and eager to share our knowledge and experiences with others, whether newly diagnosed or seeking new ways to treat their autoimmune disease(s). We are constantly learning new things from all of our members, and are grateful to be part of such a supportive and spirited community. We are not medical professionals and neither are most of the groups’ members, so we encourage everyone to temper the advice they find here with their own needs, experience, and the advice of a knowledgeable medical practitioner.

Can I contact one of the moderators?

If you have a concern about the site, forum, members, moderators, or spam, please contact the administration via the contact form on this site. If your query is health- or diet-related, consider that the forum may be better able to address it in a timely manner. Note that our moderators are happy to help in any way they can, but cannot always answer every personal message due to the large number of them.

Can anyone who is not a member of the forum or Facebook groups see what I post there?

No. Our forum requires registration to view, so only registered members can see what you post. Our Facebook groups are both closed and will not be visible to non-members. Anything you share there is safe from friends, family, employers, and anyone else you may not want to have access to that information. You need a valid e-mail address to register for our forum, but you do not have to use your real name as your public username.

Do you allow practitioners or retailers?

We welcome practitioners who frequently treat autoimmune patients or have autoimmune disease themselves. However, to maintain the integrity of the “for patients, by patients” atmosphere, we do not tolerate any soliciting from or of our members. Practitioners are welcome to share scholarly information, but any links to sites advertising paid services will be removed with a warning. Frequent plugs (i.e., “I’m a doctor”) will also result in a warning. Multiple offenses will lead to a permanent ban. It is one thing for a patient to recommend their doctor or a treatment they have tried, and another thing for that doctor or company to recommend their own practice or product. Our zero-tolerance policy assures that our members are always protected from anyone with profit-driven motives, and we expect that practitioners who truly want to share with and learn from our members will understand and comply.

What’s your membership policy for the forum and Facebook groups?

In addition to our spam policy (see the previous question), we also expect our members to adhere to the golden rule, “do unto others”. We are a support group with the sole purpose of helping patients through their chronic health problems. In that vein, “unhelpful” and “un-supportive” comments have no place in our discussions. We ask that our members respect each other, regardless of any personal differences or disagreements. We ask that our members give each other the benefit of the doubt, assume no ill-will was intended in ambiguous situations, accept apologies when given, and refrain from escalating any negative situations by responding in kind. Bullying, bickering, condescension, personal attacks, and any other kind of negativity toward other members will not be tolerated. The moderators reserve the right to delete all threads containing these comments and to remove or ban any members that engage in or escalate these kinds of situations. If you notice an escalating situation between members, whether you are personally involved or not, please report it to the moderators. That said, our moderators and members alike have more productive and positive things to do than mediate or listen to disputes. If you can settle your differences on your own or avoid the situation to begin with, please do so.

AUTOIMMUNE DISEASE AND HASHIMOTO’S

Help! I just got diagnosed with an autoimmune condition. What can I do?

You’ll want to learn everything you can about your diagnosis. Unfortunately, most of us find that mainstream medicine offers more frustration than actual relief, and we wind up looking elsewhere for help, understanding, and true healing. Begin with your diet. All autoimmune diseases link back to the gut and food sensitivities, so doing an elimination and provocation diet is essential for any autoimmune patient that wants to feel better. Getting off gluten is especially important, as it has been linked to over 200 conditions including all autoimmune disease. Try to find a good integrative doctor that will look at the whole body and how all of your symptoms relate. Test for sex hormone imbalances, adrenal stress, vitamin and mineral deficiencies, infections or infestations in the gut, and metabolic function like insulin, glucose, and the liver, kidneys, and gallbladder. Depending on your specific diagnosis, you’ll want to get imaging done every 6-12 months to check on the physical state of your affected organ.

Help! I was diagnosed with an autoimmune condition years ago, but I still feel like crap. What can I do?

See the above question.

I have a family. Should my kids be tested for autoimmune diseases? What should I do about their diets?

Yes, keep an eye on your kids’ symptoms and have them checked for antibodies and other red flags like abnormal hormones and vitamin deficiencies periodically as they age, especially around puberty and during other times of high-stress. You should put them on an autoimmune-friendly diet immediately, in the hopes of keeping them from ever getting sick or from getting any worse. Even behavioral problems can be improved on the right anti-inflammatory diet, as autism and ADD have both been linked to food sensitivities as well.

What kind of tests do I need to have run? What else should I look out for?

Test for sex hormone imbalances, thyroid and neurotransmitter issues, adrenal stress, vitamin and mineral deficiencies, infections or infestations in the gut, and metabolic function like insulin, glucose, and the liver, kidneys, and gallbladder. Depending on your specific diagnosis, you’ll want to get imaging done every 6-12 months to check on the physical state of your affected organs and should check on certain antibodies depending on your symptoms.

My doctor doesn’t believe there’s a connection to diet or that my symptoms are related to my autoimmune disease. What do I do?

You can try bringing in some scientific articles to show your doctor about the specific problem (diet, adrenals, etc.) you would like him or her to address. You can also recommend some good books on the subject, and see how open they are to your suggestions. If you’re looking for a new doctor, send him or her an e-mail stating your diagnoses and expectations and see if they’re open to the approaches you have in mind. Not all doctors are willing to work with “difficult patients” that go against the grain. Some may call you paranoid or crazy, and some may lecture you about learning too much on your own. If a doctor isn’t willing to listen to your concerns or doesn’t treat you and your symptoms with care and respect, thank them for their time, and then fire them. Don’t be afraid to stick to your guns, because you are the one that has to live with this illness every day.

What is TH dominance, why is it important, and how do I determine mine?

The immune system has several “branches” that help keep us healthy in different ways. Often, one branch becomes “dominant”, or overactive, and bringing the branches back into balance can help alleviate symptoms not only of autoimmune disease, but also of infections and allergies. This is done by boosting the non-dominant TH with the appropriate diet and supplements or by taking adaptogens that help bring them into balance. Cytokine blood tests, the TH challenge pack from Apex, or a basic dietary provocation can help establish which of your branches is dominant.

What are the specific home tests for TH dominance?

Take X-Viromin (2 capsules 3x/day) or drink echinacea tea (1 cup 3x/day) for 3 days, noting symptoms. Wait 3 days, avoiding all TH stimulants. Then add X-FLM (2 capsules 3x/day) or drink green tea (1 cup 3x/day) for 3 days and note symptoms. Wait 3 more days for any latent reactions to appear. If you feel worse on X-Viromin/echinacea and better on X-FLM/green tea, you are TH1 dominant and should remove TH1 triggers (ashwaganda, astragalus, beta glucans, beta sitosterol, chlorella, echinachea, garlic, glycyrrhiza, goldenseal, grape seed, licorice root, melissa officinalis, mushrooms, and panax ginseng) from your diet and supplement with TH2 triggers. If you feel worse on X-FLM and better on X-Viromin, you are TH2 dominant and should remove TH2 triggers (caffeine, curcumin, genistein, green tea, lycopene, pine bark, pycogenol, quercetin, reservatrol, turmeric, and willow bark) from your diet and supplement with TH1 triggers. If both make you feel worse, remove both TH1 and TH2 triggers from your diet and supplement for TH17 dominance with nitric balance. If neither make you feel worse, it could be a sign that there is still some lingering gut infection or inflammation, and a longer period on an elimination and anti-bacterial diet would be in order before retesting.

What about prescription drugs?

Many of the factors that doctors want us on prescriptions for (like blood pressure, heart palpitations, cholesterol, or infections) are actually symptoms of our overall autoimmune condition and can eventually be managed by diet and supporting our various affected systems (like the thyroid, adrenals, liver, etc.) instead. It’s important to establish that your prescriptions are actually doing more good than harm, and only you and a good doctor can determine that. Try to get prescriptions that don’t contain any fillers or ingredients that you may react to. All-natural is always your best approach. One particular prescription that many autoimmune patients swear by is low dose naltrexone, which is believed to work by modulating the immune system.

Can I get some more information on low dose naltrexone (LDN)?

The latest research has concluded that LDN works by targeting the opioid growth factor pathway, the suppression of which inhibits the growth of cancer cells. LDN interacts with your body’s endorphins, which help relieve pain, improve mood, improve immunity, and regulate the growth of cells. Taking LDN at bed time blocks opioid pathways for a few hours at night, increasing your body’s endorphin levels. Many patients on an optimized dose of LDN report not only an improvement in symptoms but a safe reduction in other medications, but your experience may vary. For more information, there’s a great Facebook LDN group.

What’s the deal with Hashimoto’s and iodine?

There is some evidence that iodine can aggravate the autoimmune response in Hashimoto’s patients by stimulating the part of the thyroid that the immune system is trying to suppress. Many people believe that the addition of iodine to table salt is one of the contributing factors to the growing incidence of thyroid disease, and many Hashimoto’s patients experience flares when they consume iodine. However, there is evidence that patients with adequate selenium levels do just fine with iodine. Also, an iodine deficiency can cause serious symptoms just like any other deficiency, as iodine is an essential nutrient. If you are iodine deficient, Dr. Brownstein’s iodine protocol may be the safest way to supplement with iodine. Most patients with balanced selenium levels do not find iodine-rich foods such as seaweed to be a problem.

What about thyroid disease and goitrogens?

Everyone reacts differently. If you suspect you are sensitive, remove them from your diet during your elimination phase and test them one by one during provocation. Many people find that they are sensitive to some but not others, whether eaten cooked or raw. There is evidence that goitrogen sensitivity is due to low thyroid hormone cofactors such as selenium, zinc, and/or iodine, so patients who are sensitive to goitrogens should consider having these minerals tested or supplementing with them. Goitrogens are otherwise very healthy foods that should not be avoided unnecessarily.

What kind of prescriptions should I take?

Everyone responds to certain medications differently. It’s best to work with a knowledgeable practitioner when trying to determine which drug is right for you and what dosage you should start on. It generally takes some trial and error to find your fit. It takes at least six weeks for a new medication or dosage increase to stabilize in the body, so a new drug or dosage should be given at least that long to do its work. Many autoimmune patients are sensitive to common fillers like cellulose and may need to have a hypoallergenic drug compounded. The types of thyroid medications are:

  • Dessicated Thyroid, also known as NDT or NT, which contains both T4 and T3. Brands: Armour, Nature-Throid, Wes-Throid, Thyroid by Erfa, NP by Acella. Compounded NDT can be used to fine tune the amounts of T4 vs. T3 that a specific patient needs.
  • Synthetic T4. Brands: Synthroid, Tirosint (hypoallergenic gel cap), Levothroid, Levoxyl, Levothyroxine, Levothyrox, Eltroxin.
  • Synthetic T3. Brands: Cytomel, Liothyronine, slow-release T3. Compounded synthetic T4 and T3 can be used to fine tune the amounts of T4 vs. T3 that a specific patient needs.

Most patients prefer some form of NDT, which is more easily absorbed. Most Hashimoto’s patients need both T4 and T3 because our bodies do not produce enough T3 on their own.

What’s the Circadian T3 Method?

The CT3M uses a personalized dosage of T3 in the early morning within four hours before waking, when the adrenals most need T3 hormone. It is used to treat adrenal fatigue when low morning cortisol is a problem. There is more information on the recovering with T3 site, though it is best to work with a practitioner if you are interested in using this method to treat your adrenal fatigue. If you do not have low morning cortisol, this method may cause adrenal stress. If you have chronic low cortisol and/or taking thyroid medication causes heart palpitations or other “hyperthyroid” symptoms, the CT3M may help.

Any special tests to consider as a Hashimoto’s patient?

Get a yearly thyroid ultrasound to check for and monitor nodules. Do an elimination and provocation diet to root out your own food sensitivities, but give up gluten, soy, added sugars, and GMOs forever. Get a 24-hour saliva-based test for adrenal cortisol and DHEA, which are often out of whack in thyroid patients. Check the levels of your nuerotransmitters, sex hormones (if you’re a woman who is still menstruating, test these 19-21 days after your last period started), and other hormones, as they are often out of balance along with thyroid hormones. Check all vitamin and mineral levels and supplement as needed to get them near the top of the ranges; common problems are with D3, B12, and iron, ferritin, TIBC, and iron % saturation. Gallbladder and liver function can get sluggish when thyroid hormone is low, so check on them every now and then. Also check for metabolic issues like glucose, insulin, and anemia with a complete metabolic panel, lipid panel, and CBC. For your thyroid, test your Free T4, Free T3, and reverse T3, and get them near the top of the ranges. Your TSH should be low or suppressed. Every cell in the human body requires T3 to function and autoimmune thyroid patients often do not produce their own, so pay attention to your FT3, reverse T3, and reverse T3 ratio and adjust your dose of T3 as needed. Check your thyroid peroxidase antibodies and thyroglobulin antibodies, which can confirm autoimmune disease. Antigen and stool tests can help pinpoint parasites, bacteria, yeast, mold, viruses, fungus, chemicals, heavy metals, and food sensitivities. Always get copies of your labs to keep for yourself and pass on to any future doctors. The CD4 to CD8 ratio test can establish why your immune system is out of whack and which TH dominance you are.

That’s a lot of tests! Do I really need all of them?

Well, if you feel fine, don’t worry about the ones you haven’t had too much. If you don’t, what you want to have tested first depends on what your symptoms are. Insomnia, weight gain, fatigue, and heart palpitations are common symptoms of adrenal stress. Pain, brain fog, and depression are often symptoms of neurotransmitter deficiency. Hormone imbalances in both men and women can cause depression, fatigue, brain fog mood swings, hot flashes, sweating, weight gain, and decreased stamina. Acid reflux, GERD, and indigestion can mean low HCL in the stomach. Food sensitivity and leaky gut symptoms include pretty much everything, including vitamin and mineral deficiencies due to poor absorption, so a clean diet is incredibly important no matter what other problems you have.

What are the best ranges for my lab results?

Labs can only reveal so much, and how you feel is far more important than what any piece of paper tells you. That said, most of us feel best with a TSH around or below 1 (though it should be suppressed if you’ve had your thyroid removed). FT3 and FT4 should be mid-range or above, and many feel best when they’re near the top of the range. Some people feel fine with a high reverse T3 if their FT3 and FT4 are optimized, so RT3 is a very personalized issue. Iron, ferritin, D3, B12, and other vitamins and minerals should all be near the top 75% of the range.

Can I get rid of my Hashimoto’s by removing my thyroid?

Hashimoto’s is first and foremost an autoimmune disease. Your thyroid isn’t the problem, but the victim of a brutal assault by your immune system. Cancer is the most common reason to remove the thyroid; otherwise, most patients prefer to keep it. Those without a thyroid have to supplement with thyroid hormone for the rest of their lives and pay very close attention to their hormone levels, which are more unstable than for those with a thyroid. Removal can endanger your calcium levels if the parathyroid is damaged. Even without a thyroid, if you don’t tame the immune system, the autoimmune disease will continue to target whatever tissue is left and may move elsewhere, since having one autoimmune disease greatly increases your risk for developing another. Since the appropriate diet and lifestyle changes work to reign in the immune system and need to be adopted anyway, there is little sense in removing the thyroid simply because you have Hashimoto’s.

What about my antibody levels? Why do they keep going up despite treatment, or why don’t I feel better even though they’ve gone down?

It seems to make sense that fewer antibodies means that the thyroid is not under attack and should therefore be doing better than it was when antibody levels were higher. However, there has been no clinical evidence to suggest that lower antibody levels correlate with fewer symptoms. Plenty of patients feel great with high antibodies and plenty others feel poor with lower antibody levels. Some people notice a decrease in antibodies when they begin medication or change their diet, and others don’t. Think of it as your body waging war on your thyroid: Just because the war is over doesn’t mean there isn’t a lot of cleaning up to do (or that the war won’t start up again for no apparent reason). Problems with thyroid, sex, adrenal, vitamin, and mineral levels and underlying food sensitivities must be addressed. Once you have been diagnosed with autoimmune thyroid disease, there is little purpose in continuing to check the antibody levels.

What kind of exercise is best?

Because thyroid disease often comes with adrenal stress, it’s important not to over-stress your body by exercising too intensely, for too long, or too frequently. For someone with adrenal fatigue, cardio exercise such as running would not be recommended. Any gentle-to-moderate exercise, including walking, yoga, swimming, and strength training, is encouraged. Any exercise at all boosts hormones that can benefit mood, sleep, appetite, weight, bone health, insulin sensitivity, metabolism, and stress levels. Try to get some kind of movement in every day. You should feel challenged but not strained.

DIET

What’s your diet philosophy, and why?

The immune system and the GI tract are closely related. Almost all autoimmune patients present with a leaky gut, and it is widely accepted that gut permeability is one of the major factors leading to the development of an autoimmune condition. For autoimmune patients and anyone seeking to boost their digestive and immune health (whether to fight cancer, allergies, colds, irregularity, or any general malaise), a number of dietary changes should be considered. In many cases of chronic illness, these changes can lead to full remission. However, the diet must generally be adhered to for the rest of the patient’s life in order to maintain wellness. The exact regimen varies depending on who you ask, and every patient responds to every food a little differently. The Paleolithic autoimmune protocol is probably the most widely-followed diet among autoimmune patients and the one our group has had the most success with. According to the protocol, the most common foods contributing to and exacerbating autoimmune disease include:

  • Dairy, including lactose and casein, which increase allergies, inflammation, and mucous
  • Sugars, including those found in honey, which increase inflammation and metabolic disorders
  • Eggs, especially egg whites, which increase inflammation
  • Grains, especially gluten and corn, which contain indigestible enzymes
  • Legumes, including soy and peanuts, which contain indigestible enzymes
  • Nuts and seeds, including coffee and cocoa, which contain indigestible enzymes
  • Nightshades, including potatoes, tomatoes, eggplants, peppers, and spices, which increase inflammation
  • Alcohol, tobacco, and NSAIDS, which increase inflammation and inhibit immune function
  • Hormonal birth control, which causes estrogen dominance

Eliminating these foods puts the focus on organic veggies and high-quality meats with hefty supplemental helpings of coconut oil, apple cider vinegar, probiotics, stress management, and adequate sleep, all of which will help the gut heal from infection, inflammation, and years of dietary abuse, leading to a reduction in symptoms and, sometimes, full remission. Even within the confines of the autoimmune protocol, we believe there can be found an endless array of perfectly satisfying dishes, especially considering that these foods promote wellness like no others.

What’s an elimination and provocation diet? How long until I feel better?

First, you eliminate all of the most common allergens (grains, legumes, sugars, starches, nuts and seeds, eggs, nightshades, alcohol, and processed foods) and any additional foods you may suspect are problems based on your own personal experience (such as FODMAPs for bacterial infections). When you feel better, you can start testing your body’s tolerance of the foods you omitted. If you notice a reaction to one (symptoms of a reaction can include literally anything, and everyone reacts differently), cut that food out for the long term. This article lays out the provocation process in-depth. Gluten is one food that everyone should consider giving up permanently.

What are the SCD, GAPS, Paleo, and AIP diets? What’s the difference between them, and which one do you recommend?

Each of these diets is naturally gluten-free and is supposed to fight inflammation throughout the body, but only the AIP further seeks to reduce all food sensitivities. Anyone with any kind of chronic health complaint (from recurring infections to heartburn and indigestion to a diagnosed illness) can benefit from one of these diets. They all eliminate grains, added sugars, starches, and processed foods. The Specific Carbohydrate Diet allows lactose-free dairy. GAPS allows lactose- and casein-free dairy, like ghee. Paleo cuts out all dairy, legumes, and alcohol, and is a very common lifestyle for those with chronic health problems. The Paleo autoimmune protocol (AIP) goes even further and eliminates all nuts, seeds, nightshades, eggs, caffeine, and chocolate in addition to dairy, legumes, and alcohol, and should be the starting point for any autoimmune patient. Each has merit when compared to the processed, carb-heavy standard American diet, and it’s becoming easier and easier to find great recipes for each diet on the internet. If you aren’t comfortable jumping into the AIP, you can start with one of the other models and see how you feel. The goal, however, should be to stay on the AIP for at least 30-90 days and, ideally, until you are feeling well. The faster you get there, the faster you can start feeling better.

Why shouldn’t I have [gluten, grains, legumes, dairy, nightshades, eggs, NSAIDs]?

The Paleo Mom has a great series of articles covering “the whys of the AIP“ to explain why each food group should be eliminated. Essentially, they have all been shown to contribute in some way to inflammation and immune dysfunction. Gluten especially has been established as a major contributing factor to over 200 illnesses, including autoimmune disease, alzheimer’s, and autism. There are many in the health community that believe that no one, no one should be eating gluten.

What if my blood/skin/stool tests for food sensitivities to the “not allowed” foods, like gluten, are negative?

The lab tests for food sensitivities are not as accurate as an elimination and provocation diet. While a positive result on an allergy test means you should avoid that food from now on, false negatives are extremely common. A negative result does not mean that food is safe. An elimination/provocation diet is still the gold standard for finding out for sure what your own unique sensitivities are.

What if I don’t feel better when I quit eating the “not allowed” foods, like gluten?

It’s common when removing foods to not notice a difference right away, usually because the gut and body are so inflamed. Sometimes, people even feel worse due to detox and withdrawal, and this can last for a few weeks. Usually, a month or so on the full elimination diet will reduce your inflammation and let the gut heal enough that when you add foods back in, you will be able to tell which ones upset you.

How long until I do feel better? When can I start reintroducing foods?

The longer you’ve been sick and the more damaged your body is, the more time you will need to spend eating only safe, anti-inflammatory foods. It’s recommended you stay on the elimination phase for at least 30 days, but many of us wind up staying for months or even years either because we have complicated problems like SIBO or candida that take a long time to get rid of or because we feel so darn good that we don’t want to change our diets! Only you can tell when it’s time to reintroduce. Don’t rush into it because you miss the foods you used to eat or because you just want the whole process to be over with. Do it because you can honestly say that you feel as well as you want to feel and that you’re ready to confront whatever sensitivities you might discover. Realize that “adding foods back in” does not mean “reverting to my old diet”. You may discover a lot of sensitivities you’d never suspected and some people even wind up staying on the AIP due to reactions to everything else. Move forward patiently, expecting some disappointments. This article lays out the provocation process in-depth.

What about processed foods? Are gluten-free breads and cookies okay?

Well, they’re better than breads and cookies that contain gluten. But that doesn’t make them ‘okay’ and it certainly doesn’t make them ‘healthy’. Processed foods are low-nutrient while being high in sugar, carbs, bad fats, preservatives, and who knows what else. Even “whole food supplements” like Vega are not as nutritious as their actual whole food counterparts and often contain ingredients many people are sensitive to. A home-cooked meal will do you more good than anything out of a box or can any day, even if its as simple as throwing together a salad or quick stir-fry. When grocery shopping, stick to the perimeter of the store, focusing on non-nightshade produce and meats.

What kind of protein powder can I use?

There is no such thing as an autoimmune-friendly protein powder. Most of us prefer to get our protein in natural, whole foods like grass-fed beef or pastured poultry. That said, some protein powders are safer than others if you’re going to use one anyway. Your most risky options would be whey/dairy, soy, and rice protein. Hemp and pea protein powders are a little safer. If you’re on a Paleo diet, either one is fine. If you’re on the AIP, pea protein would be your safest bet. Peas are technically a legume, but because they’re green, many people prefer to consider them a starchy vegetable and actually do tolerate them much better than typical beans. You can naturally up the protein content (and lower the sugar content) in your smoothies by making them with leafy greens instead of fruit, or by adding unflavored gelatin.

What DO I eat on the autoimmune protocol, then? What can I do for breakfast?

Forget everything you thought you knew about breakfast. Who says you can’t have a soup or a salad or a stir-fry for breakfast? No one! Many of us have last night’s leftovers for our first meal of the day. We’re into salads, soups, stir-fries, and roasts, all of which can be easy-to-prepare, flavorful, and satisfying. For autoimmune protocol recipes, see our Resources page. Here’s a brief list of some allowed foods:

  • Vegetables: Anise, artichoke, asparagus, beets, bok choy, broccoli, cabbage, carrots, cauliflower, celery, chives, cucumbers, garlic, kale, kohlrabi, leeks, lettuce, mustard greens, onions, parsley, radishes, rhubarb, shallots, spinach, squash, sweet potatoes, water chestnuts, watercress, yams, zucchini.
  • Meats: Grass-fed beef, pastured chicken, wild-caught low-mercury fish, pastured turkey, wild game.
  • Low-Glycemic Fruits: Apples, apricots, avocados, berries, cherries, grapefruit, lemons, oranges, peaches, pears, plums.
  • Other: Apple cider vinegar, extra virgin olive oil, coconut oil and flesh, herbs, pink or grey sea salt.

What kind of supplements should I take?

That depends entirely on your unique circumstances. Test all your vitamins and minerals and supplement the ones that are low with whole-food-based supplements that don’t contain any additives or substances you’re sensitive to. I believe that most people could benefit from high-quality probiotics, a B complex, and emulsified D3. Many autoimmune patients do well with neurotransmitter support like 5-HTP or a glutathione recycler. Anyone with SIBO or recurring infections could look into oil of oregano or GI Synergy. A good integrative doctor should be able to point you in the right direction for your own needs.

Will I be able to stop taking my thyroid hormone, or start taking less of it?

Many people find that changing their diet to heal their gut and improve their health leaves them with hyperthyroid symptoms when they take the same dosage of thyroid hormone they took before the diet change. If you begin to experience hyper symptoms, consider lowering your dosage. Some patients are able to give up medication as long as they continue to feel well and maintain a healthy diet; others remain on medication to continue to support their thyroids, but at a lowered dose.

What if I’m vegan, vegetarian, or otherwise not eating meat or fish?

Vegetarianism is one of the oldest diets on the planet, and therefore there is an abundance of research into its effects on overall health. However, autoimmune disease was discovered only recently, and its relation to the diet is only now beginning to be understood. As discussed above, vegetarian staples such as grains, beans, soy, nuts, and seeds have been shown to exacerbate leaky gut and contribute to the development of inflammatory diseases. There is concern that a long-term diet dependent on these foods (vegetarian or otherwise) correlates with a higher risk of vitamin and mineral deficiencies due to poor absorption; of chronic inflammation, food sensitivities, and gut permeability; and ultimately, therefore, of autoimmune disease. Meats and fish have a very different nutritional profile from vegetarian substitutes, and are generally considered to be more anti-inflammatory and nutrient-rich than plant-based protein sources for autoimmune patients. Many of this group’s moderators and members are former vegans who made the difficult decision to adopt the AIP only after accepting that their continued ill-health meant that it was time to try something new. In agreement with the evidence supporting the protocol (both scientific and anecdotal), it was their experience that a long-term vegetarian diet resulted in declining health, and that they were able to recover once they removed grains, legumes, nuts, seeds, and other problematic foods from their diet. Ultimately, that meant consuming animal products in order to obtain adequate protein, B vitamins, zinc, iron and essential fatty acids. As a result, many of our members are uniquely placed to help other current- or former-vegetarians determine their own dietary needs. This group does not recommend that vegetarians attempt a meat-free version of the autoimmune protocol. Without the dense source of protein, vitamins, minerals, and essential fatty acids found in meat and fish, it is unlikely that optimal nutrition can be obtained from vegetables and fruits alone. We encourage everyone to consult with a qualified medical practitioner well-versed in autoimmune disease and leaky gut before making any dramatic dietary changes.