Can a Paleo diet successfully support people with chronic autoimmune conditions?

What are autoimmune diseases?

Autoimmune diseases are a collective group of conditions (most of which are chronic), where it is thought that the body’s immune system mistakenly attacks healthy cells. The exact number of autoimmune conditions is unknown. However, some sources report 80 known conditions and others as many as 140. UK briefing puts the number at 80 while the American Autoimmune Related Disease Association states that ‘there are more than 100 Autoimmune Diseases’. In her document, The Spectrum of Autoimmune Diseases, Dr. Sarah Ballantyne, (aka The Paleo Mom), who has formalised the AIP protocol, lists 140 ‘diseases that are either confirmed autoimmune diseases or for which there is very strong scientific evidence for autoimmune origins’.

Even in the absence of exact figures, we can all agree that the number of diseases is alarmingly high. And research also shows that more and more people are affected. According to the British Society for Immunology, ‘for different autoimmune conditions, incidence is increasing at ranges between 3% and 9% year on year’. And, approximately 75% of all people affected are women.

What are the most-common autoimmune diseases?

Some of the most common and better-researched conditions are:

• Rheumatoid Arthritis.

• Multiple Sclerosis (MS).

• Hashimoto’s hypothyroidism.

• Lupus.

• Crohn’s.

• Ulcerative Colitis.

• Type 1 diabetes.

• and Psoriasis.

Symptoms and diagnosis

Before getting a diagnosis, people suffering from chronic autoimmune conditions will often be labeled as ‘hypochondriacs’. In many cases, the diagnosis comes after someone has experienced symptoms for years. It’s no surprise that when describing the impact of autoimmune diseases, health authorities talk about a ‘silent epidemic’. This is because symptoms and conditions can progress slowly and may be totally invisible for long periods of time. Some of the most common symptoms are generic and include fatigue, recurring infections, chronic  pain, pins and needles, brain fog, etc. Of course, these are ‘common’ symptoms that can be attributed to various other conditions or lifestyle choices. So it’s not uncommon that people reporting some of these symptoms struggle to seek and receive a diagnosis.

Once the disease has progressed enough, it becomes specific to an organ or a system. And this is usually when doctors are able to diagnose a specific disease. At this point, it is likely to be a relief to sufferers, to finally ‘understand what’s wrong with them’. This was definitely my case, as I’m pretty sure I was battling with autoimmunity for more than 4 years before my diagnosis.

The uncomfortable truth about autoimmune diseases

While autoimmune diseases are thought to be a result of someone’s body attacking its healthy cells, I like to think that the immune system is having a normal reaction to abnormal conditions. The immune system is often weakened by years of ‘abuse’. And much like a wounded animal, it becomes aggressive as a defense mechanism. In other words, the symptoms are a result of the fact that the body is ‘confused and dysregulated’ by many different factors. And identifying and addressing these root causes is precisely what protocols such as AIP aim to do.

There is currently no cure for autoimmune diseases. Unfortunately, once the autoimmunity is ‘switched on’, it remains on. However, proponents of lifestyle interventions, such as:

• the Autoimmune Paleo protocol,

• Dr. Wahls (The Wahls Protocol),

• Dr. Amy Myers (The Autoimmune Solution)

• and many other functional medicine practitioners,

believe that autoimmunity can be put into clinical remission with specific solutions. Considering I am in remission from Rheumatoid Arthritis and have experienced this first hand, I believe this to be true.

AIP and other healing protocols

Despite their differences, AIP and the other protocols listed above have some common aims:

• Healing the gut.

• Reducing inflammation.

• Promoting optimal nutrient intake.

• And regulating hormones.

In order to achieve these aims, all protocols have two main pillars: nutrition and lifestyle or self-care. I personally started making changes to my food choices, as this seemed like the logical starting point for me. But I also observed that my own recovery accelerated when I added the lifestyle and self-care elements. Today, whilst I am in remission, I do suffer proportionally more from stress or lack of sleep, for example, compared to people who do not suffer from autoimmunity. And yet, I still struggle to go to bed early enough to guarantee my ideal sleep duration. We are all human after all!

Do we have proof that these protocols work?

This is a really tricky one.  At the moment, these types of “therapies” or protocols are not recognised by conventional medicine as successful therapies to support people with autoimmune conditions.

But, there have been a few studies, small scale, but very robust in methodology, who have showed some really promising results.

For example, in this study, more than 70% of IBD sufferers (Crohn’s and Ulcerative Colitis) achieved clinical remission within 6 weeks.  And not only that, all participants remained in remission during the maintenance phase.

In a follow-up study, the efficacy of the protocol was also demonstrated in the support of patients’ with Hashimoto’s hypothyroidism.

And there are also hundreds, if not thousands, of stories online, my own included.  What I will always say to my clients, is you have nothing to lose.  4 to 6 weeks of your life will be enough to determine whether this protocol can help (for me, it didn’t take this long, it took 3 days to feel major improvements!).

Nutrition in AIP and other healing protocols

When it comes to nutrition, AIP and other healing protocols focus on a combination of two key elements:

• an elimination diet,

• and a focus on adding a lot of micronutrients.

Elimination diet

The purpose of the elimination diet is three-fold.

1. Firstly, the immune system is fired up by food one may be sensitive to.  And the immune system is responding with chronic inflammation (a normal and – normally – beneficial process).  In other words, it’s trying to defend the body against these foods (which of course, it shouldn’t do!).

2. The second purpose to eliminate foods that are detrimental to our gut microbiome (the so-called ‘friendly bacteria’). The gut microbiome is key to a healthy immune system, making sure it can properly respond to a threat or not respond to something normal (such as food).

3. Healing the gut.  You may have heard of the term ‘leaky gut’ – or intestinal permeability.  Many factors can lead to leaky gut, including consuming gluten and an unbalanced microbiome.

Specialists of autoimmunity now believe that non-celiac gluten sensitivity and leaky gut are a pre-requisite for people to develop an autoimmune disease.  Dr Alessio Fasano has published this research in 2013 and here is a more accessible article

If you want to find out more, this is a great article about AIP and elimination diet.

Focus on micronutrients

The focus on micronutrients, on the other hand, guarantees that we consume more of the nutrients that our immune system needs in order to work properly. These include (but are not limited to) vitamin A, zinc, magnesium, B12, etc. Our standard western diets are notoriously low in these nutrients – we’re used to calorie-rich and nutrient-poor diets. From a nutritional point of view, we’re effectively malnourished.

As an interesting aside, check out this post if you want to find out more about how the AIP protocol can affect weight loss. It’s a question I get asked often.

Lifestyle and self-care in AIP and other healing protocols

The most impactful areas in terms of helping people with autoimmune diseases go into remission are:

• Sleep.

• Stress reduction or stress management.

• Exercise and movement.

• Social connections and nature.

There is nothing new, and most of the recent books on health and wellbeing will cover these.  This is not unique to autoimmunity – all chronic conditions will improve with the right self-care measures.  Most importantly, it will also prevent serious conditions from developing in the first place (and prevention is always better!).

Sleep

Getting enough sleep is essential for immune system regulation. But sleep also has a considerable impact on detoxification, energy conservation, and physical and mental wellbeing. Sleep also contributes to reducing the sensation of pain, which, for someone with an autoimmune disease, is a considerable benefit.

And yet, in our society, sleep is underrated. We applaud and envy people who can function on less than 6 hours of sleep a night! But the truth is that a healthy adult needs at least 7-9 hours of sleep each night.

If you feel you’re consistently not sleeping enough, you probably are! And you should consider making sleep a priority. There’s a lot that you can do to improve how long and how well you sleep. For example:

• Having a consistent bedtime.

• Creating a bedtime routine that focuses on winding down before bed.

• Making your bedroom sleep-friendly (no TV or devices, keeping the room cool, etc.)

• Keeping a sleep diary to spot any patterns. You may find that you don’t sleep as well if you eat too late, for example.

• Using essential oils have also had a really positive impact on the quality of my sleep.

Stress

The fight-and-flight state of the body is a normal response to ad-hoc and potentially dangerous situations. For our ancestors, it was all about survival, like running away from a tiger in the jungle. Today, it’s more about crossing the road without being run over! Unsurprisingly, during a stress response, the body shuts down all non-essential systems (including the immune, reproductive, and digestive systems). It’s literally all hands on deck so your body and mind can focus on handling or surviving the situation you’re in.

And this is great if you’re avoiding traffic. Or even participating in a sports competition or going through an important work presentation. But it’s only beneficial when this response is triggered for a short period of time. The problem is that in our modern lifestyle we rarely get out of fight or flight and into rest and digest state.

From the moment the alarm goes off in the morning, we are rushing. Our bodies don’t know the difference between running away from a tiger and being late for work. Physiologically, the body reacts in exactly the same way.

The effect of chronic stress

The result? We remain stressed for long periods of time with some of our key systems in shut down mode – not doing what they’re meant to be doing. Stress becomes chronic and starts to affect our gut health too. And that’s how we enter a dangerous vicious cycle. Because our gut health is compromised, we cannot digest and absorb nutrients the way we should. So our nutrient needs remain unmet.

This, in turn, makes it harder for our bodies to come out of fight or flight state, so it’s important that we learn how to manage stress. Reducing stressors (i.e. anything that triggers our stress response) and improving our resistance to stress should become priorities in our lives. If you’d like to learn more about stress and ways to manage it, this podcast episode with Dr. Chatterjee is quite interesting and informative, especially for women.  Dr Chatterjee’s Stress Solution is a fantastic book to support you to better manage your stress.

Exercise and movement

I like to talk about movement (alongside exercise) as people often see exercise as ‘having a gym membership, going to a class or going for a run’. But actually, movement (intended as avoiding being still for too long) is as important. And more is not always best.  Too much exercise can be as detrimental as too little can be.

There is now a significant amount of research that demonstrates not only the benefits but actually the importance of exercise in the management of chronic autoimmune conditions. This abstract from Science Direct refers specifically to physical activity and autoimmune diseases.

What’s key is that you find what works for you. This makes it much easier for you to enjoy the activity and integrate it into your life by turning it into a regular practice. Walking, yoga, Pilates, and swimming are all ideal. But any other low impact activity that doesn’t put a lot of pressure on your joints is fantastic. As I now do regular work at our allotment, I can definitely guarantee that gardening is also a great form of exercise. I am certainly discovering muscles I didn’t know I had!

Connections and nature

Having regular social and interactions with friends, family, local communities, or co-workers are also key for improving the symptoms of someone with an autoimmune disease. Feeling connected, helpful, valued and appreciated can have a great impact on your overall health and wellbeing.

Being in nature and green spaces has amazing benefits. For one, being outdoors can increase your oxygen and vitamin D levels, especially in summer for higher latitudes. But it can also help reduce stress and, once again, increase a sense of belonging and wellbeing. Heard of ‘tree bathing’? Yes there is such a thing!  So enjoy an afternoon in the garden or head over to the park!

What if medications are working really for me?  What is the benefit of following a protocol such as AIP?

Autoimmune diseases are a disease of the immune system and not of the affected or organ. And controlling symptoms of one disease through medication doesn’t necessarily mean that the immune system is getting better. Sadly, it means that people with one autoimmune disease are 6 times more likely to develop a second immune system in their lifestyle (and sometimes even more).

This is one of the primary reasons why I follow AIP.  And why I highly recommend anyone with an autoimmune diagnosis (or family history of autoimmunity) to test AIP as a way to improve their disease management and outcome.

Would you like some help with your remission journey?

If you’ve been diagnosed with an autoimmune disease or think you may be suffering from an undiagnosed autoimmune disease and would like to find out more about how AIP works, I’m an AIP certified Health Coach. I’m in remission from Rheumatoid Arthritis, and you can learn more about my own story here. If you’d like to discuss how AIP may be able to help you, you can book a FREE 20-minute discovery call with me, and I’ll be happy to help.