In celebration of the release of my Autoimmune Protocol Reintroduction Cookbook I asked some of my favourite AIP bloggers to talk about their experiences with reintroductions.
The Autoimmune Protocol is a three-pronged healing diet based on the Paleo template, which is aimed at people living with autoimmune disease. It removes inflammatory foods and incorporates healthy lifestyle factors such as optimized sleep, gentle-moderate exercise, stress management and self care. The protocol is designed to heal the gut, calm the immune system and rebalance hormones.
- Elimination Phase. This is where the foods that are inflammatory for people with autoimmune disease are removed. There is also a strong focus on foods that are particularly high in nutrients.
- Reintroduction Phase. Previously eliminated foods are brought back into the diet in a slow and methodical process, while watching for reactions.
- Maintenance Phase. The holy grail where you have found the diet and lifestyle that not only works for you, but enables you to thrive.
Note: The Elimination Phase is intended to be followed for the shortest time possible.
As mentioned above, the elimination phase was never created to be a stand alone diet, in fact it should be seen as a temporary diet only. The point is to remove foods that are known to be inflammatory to those living with autoimmune conditions by exacerbating intestinal permeability (leaky gut) and driving the immune system. At the same time, nutrient dense foods are used to heal the gut and regulate the body's immune system and hormone balance.
The minimum time you should spend in the elimination phase is 30 days, however the maximum will differ from person to person. One thing is clear though; if, after 3-4 months you are not progressing or even becoming more symptomatic, it is crucial that you look for a practitioner who can help you dig deeper for the root cause. Don't sit and dwell in the elimination phase and see your diet shrinking due to underlying factors.
Note: The Reintroduction Phase is a non-negotiable part of the Autoimmune Protocol.
It's fair to say that the reintroduction stage can cause mixed emotions and many people are overwhelmed, intimidated, or even fearful of starting. But it really shouldn't be an anxious time. My aim in this post (as well as my book) is to get you excited about the potentials of having your favourite foods back in your diet, but provide some balance and perspective at the same time.
My own experience with reintroductions started as a reluctance to move out of my comfort zone. I came to AIP from the GAPS diet, so had been gluten free for some time already but, even so, think I stayed on the elimination phase for around a year. Looking back on it I realize it was overkill because as soon as I started reintroducing I became happier and healthier. My life of restrictions was tying the family down so it was actually them who pressed me to move forward. One of the reasons why I wrote my book is because I fully understand how hard it can be to take the plunge.
My first reintroduction attempt was egg yolk. On the GAPS diet we were eating a tremendous amount of eggs so giving them up at first was a relief to be honest. However in the end I was starting to miss them - the taste and the convenience, so I was relieved to have them back again. Other early reintroductions were seed spices such as cumin and coriander, as well as ghee because I wanted more fat soluble vitamins in my diet. I can eat most things now, but remaining cautious of nightshades, especially hot peppers which are alright in small doses on a rare occasion otherwise I'll pay for it digestively and in my joints. Whole eggs make me feel good, but not on a daily basis or I may have a mild digestive reaction. And I don't feel great after eating chia seeds or quinoa so, while I don't go out of my way to avoid them, I don't tend to bother.
I asked some of my favourite AIP bloggers about their first reintroduction experience and, as you'll read, they each have a unique story to tell:
Angie Alt, Autoimmune-Wellness - "It's been 9 yrs, so a little hard for me to remember, but I think I stayed on the elimination phase pretty long. I think it was about a year, because I had some underlying health issues that needed treatment, like SIBO. I think I started w/ butter, then chocolate & alcohol. After that I probably tried green beans & peas next. Most of my first attempts were a success, but once I got into eggs & white potatoes, I started to have trouble. Both of those took me several attempts, with more healing in between each try. I have not been able to successfully reintroduce tomatoes or any of the nightshades outside of white potatoes."
Mickey Trescott, Autoimmune Wellness - was on the elimination phase for 9 months. "My first reintroduction was black pepper, which was successful. Foods that I have not been able to reintroduce are bell peppers, tomatoes, all dairy (including ghee) and soy."
Alison Marras, Food by Mars - did the elimination phase for 6 weeks. "The first food I tried was egg yolk which went well! No symptoms immediately or over a few days. I was able to reintroduce most paleo-ish foods, but eggs and nuts in moderation (not several times every day, for example). I do some goat's/sheep cheese in moderation and don't eat most beans really because those don't work well for me. Overall, I was able to reintroduce a lot!"
Jaime Hartman, Gutsy by Nature - spent just 30 days on the elimination phase but started after having been eating a grain-free healing diet for about 9 months prior to that. "My first reintroduction attempt was egg yolks. Ultimately I was successful, but I wasn’t sure about it at first. I followed the procedure carefully, and during the second 15 minute waiting period I noticed mild heartburn. I was surprised, because that is an extremely unusual thing for me. I stopped (and fed the rest of that egg yolk to my dog!). A couple weeks later I tried again and completed the whole procedure without problem. I’ve never tried reintroducing gluten, but have had a few accidental exposures and they made it really clear that I need to stay gluten-free forever. I have tried adding back in dairy multiple times and sometimes I convince myself that as long as it is a low-lactose form it is fine, but truthfully I feel better when I am avoiding dairy entirely. The same is true in regards to alcohol - I can have an occasional glass of wine or gluten-free beer and it doesn’t completely wreck me, but I don’t like how I feel the next day so for the most part I abstain."
Nicole Charles, Heal Me Delicious - spent 3 months on the elimination phase. "As an island girl I was eager to add some heat back into my cooking so naturally I tried black pepper first. I am also a massive tahini fan so went for sesame seeds shortly thereafter. I was really careful to be observant and to follow the suggested reintroduction timing while reintroducing these foods and fortunately was able to successfully reintroduce both black pepper and sesame seeds without any issues. Nuts and many nightshades remain problematic for me. Thankfully scotch bonnet peppers are okay :)"
Joanna Frankham, Joanna Frankham Coaching - spent 9 months on the elimination phase. "It changed my life and I was a bit scared to start reintroductions, to be honest. HS is a crazy-awful affliction. The first food I introduced was COFFEE!!! which was good. Thank goodness! I missed it SO MUCH! I will be gluten free forever. Sadly, even gluten free oats trigger an HS flare. Nightshades remain a ’sometimes’ food, too."
Eileen Laird, Phoenix Helix - did the elimination phase for 6 weeks before starting reintros, although she followed a paleo diet for six months before that and had been focused on gut healing. "My first food attempt was egg yolks which was very successful. When the yolks went well, I tried whole eggs next, and that was a success as well. I can eat eggs daily with no inflammation or autoimmune symptoms. I realize that isn't true for everyone, and I'm very grateful. I've never tried to reintroduce gluten. Also, my food tolerance varies based on whether I'm in remission vs. experiencing a flare. Before going on medication for rheumatoid arthritis, my body was more sensitive to foods, and dairy and nightshades were my biggest flare triggers so I avoided them completely. Now that I have an integrative approach to my health (diet, lifestyle, and medication) I enjoy a side benefit of greater food freedom. My immune system is calmer and less reactive. I still don't make dairy and nightshades part of my daily diet, but I can enjoy them occasionally."
Whitney Shook, Rooted in Healing - spent 2 months on the elimination phase and her first reintroduction attempt was egg yolk. "I think I got in my head a lot about whether or not something was working and that got in the way of me understanding my results at first. Once I calmed the F down I was able to see things more clearly and it turns out I tolerate all non-aip paleo foods. I was not great with gluten-free grains and legumes when I tried to bring them back the first time. I didn't eat them for a few years (just didn't miss them very much) and recently have started having them in small quantities. Beans still make me bloated, and some grains, but I have them every now and then!"
Cristina Curp, The Castaway Kitchen - did the elimination phase for 4 months before moving on to reintroductions. "My first reintro attempt was coffee which was successful. But the foods I haven't been able to reintroduce are nightshades, gluten and milk."
Indira Pulliadath, Cook2Nourish - was on the strict elimination phase for 30 days after which she started reintroducing foods.. "Being of Indian origin, I missed my spices greatly! So the first foods I tried were all seed based spices one after the other - cumin, coriander and black pepper. Black pepper was the one I tried first. I did well with black pepper. I did not have any reactions to it and my healing continued to happen on AIP. I have not been able to reintroduce eggs, almonds or nightshades. However, I am able to tolerate Kashmiri chilli pepper (which is a mild pepper) in small quantities. I am also able to tolerate rice in small quantities as long as I eat them only occasionally."
Beth Chen, Bon Aippetit - has had more challenges than the other bloggers interviewed here and her health is certainly complicated. Her diet has been restricted beyond the AIP for most of the last 5 years due to persistent severe fungal and bacterial infections. "There have been months of my life where I could only tolerate a handful of foods so for me, reintroductions were simple foods that are actually AIP friendly."
"A few weeks ago I was finally able to reintroduce a few foods beyond the autoimmune protocol like chia seeds and white rice. I've had many attempts at reintroducing foods over the years. Some have gone well but they were never permanent and my health deteriorated and I had to remove those foods again. Healing is usually two steps forward and then one step back for me. However, this recent attempt has gone rather smoothly and I've been able to reintroduce foods that I haven't been able to eat in 10 years. I'm still having issues with any types of sugar whether it's from fruit, coconut sugar, or honey and I'm nervous about trying any nuts or seeds. I've never ever been able to tolerate those and am cautious about how my body will react to those foods."
As you'll see, everyone's experience is different.
What you do get a sense of by hearing these experiences, is the fact that each person knows the foods that do and don't serve them well. There's a lot of value there because it's necessary to avoid foods that fire up your immune system and have the potential to create more autoantibodies that may cause more sensitivities. Another important point to note is that when the AIP hasn't gone to plan, as in Beth's case, it's crucial to seek help. As she says, "I have an entire team that I've been working with for the last few years. The autoimmune protocol is just one tool in my toolbox and I don’t think my overall health would be as good if I didn’t follow the AIP template. I’m doing better now than I have in years so I choose to focus on that."
Ready to start the reintroduction phase?
As mentioned above, it's important to be faithful to the elimination phase for at least 30 days. Then, once your symptoms are under control, you’ve done a significant amount of healing and you are sure you would be able to recognize a reaction should you have one, you're ready to move on. Have a read of the information provided in the post What Is The Autoimmune Protocol?
Want more help with your own reintroductions? My new book, The Autoimmune Protocol Reintroduction Cookbook, has been written with the aim of you getting through the reintro process with the least amount of stress, and maximum amount of success. It also gives you 100 recipes (25 for each stage) to enjoy along the way. Check it out here.
If you'd like an AIP Reintroduction Journal Template, download a copy here.
And if you're not sure whether you are able to recognize a reaction, download my FREE audio body scan, which is designed to get you in tune with your body so you can listen to what it is telling you.
Tell me about YOUR reintroduction experience now. Have you started? Are you still on the elimination phase? Are you nervous to get going? If so, what's holding you back? Let me know in the comments below.
Beverly Movius says
I am currently in the AIP elimination phase. When you say “reaction” to foods once reintroducing them, what am I looking for? I was hoping those in Themis blog would share what their reactions/symptoms were specifically, and how soon after eating? I fed so much better but wondering I’m to look for? Thanks!
Reactions can be anything that's out of the ordinary for you, so what constitutes a reaction for one, may not be the same for another. Common reactions include digestive changes, skin irritations, cravings, mood changes, energy fluctuations, sleep difficulties, aches and pains, and other symptoms such as headaches, dizziness and much more. Digestive changes usually happen fairly soon after, whereas skin issues can happen up to several days later. I outline this and so much more in my AIP Reintroduction Cookbook if you want to take a look.
This post was really helpful, thank you! I do not have an autoimmune disease however have had other health issues. It is rare for non-autoimmune folks to try the elimination. I have reintroduced plenty of things but still learning more as I go. It's amazing having reactions to foods that I never thought were problematic before.
I'm so pleased the post was helpful. Wishing you much luck with your healing 🙂
Hi I did AIP for 4 months. I started introducing coffee almond milk and rice which all seemed fine. I got a bit cocky and introduced lots of different nuts and potato’s. Started to get a flare of finger joint pain ( the original reason why I started AIP. Do I have to go back to the beginning or relatively safe to go back to coffee almond milk and rice ? Thank you
If it was me I'd go back to the coffee almond milk and rice. See what happens with your joint pain and try some stage 1 reintros when you feel the time is good. Best of luck!
Although I’m late to this party Thanks for this great post. I’ve been doing AIP strictly for at least 3 months due to nerve pain in hands, feet and ears, a flare of my Hashimoto’s. My functional medicine practitioner says it’s inflammation after thorough lab work and as of 2 weeks ago has me on thyroid meds and HRT. I have quite a bit of relief of symptoms from my own research and recognizing my food sensitivities. I can’t tolerate coconut, in any form! No red meat, starchy veggies, cabbage or collards. This has made my AIP more challenging to say the least.
Thanks to Isabella Wentz by increasing my Benfotiamine Ive been able to reduce the pain that’s mostly in my feet now. And I reintroduced eggs, glorious eggs! I eat lots of avocado, chicken, Turkey and fatty fish too. And bone broth of course.
Have you ever heard of anyone with sensitivities/inflammation like mine? Any suggestions for other foods I might try?
Hi Chante, it's common to have multiple sensitivities when you have a lot of inflammation to deal with and it's great news that you've been able to identify yours. It's also good that you're working with a practitioner, who hopefully has you on a gut healing protocol beyond the AIP. Be sure not to lose sight of the fact that AIP is as much about what you add IN to your diet, as it is about what to remove. Organ meat such as chicken liver should help fuel your nutrient stores, as well as shellfish if tolerated. And congrats on the eggs reintroduction, I agree it's a godsend to be able to eat those!