How to Navigate AIP Food Reintroductions
After being on the AIP diet for some time, the idea of getting into the food reintroductions phase can be exciting and terrifying all at once! This post will provide some insight about the AIP reintroduction process so that you know what to expect, when to expect it and how to get the most out of the process. Hopefully I can take some of the anxiety out of it for you!
I do advise, however, that your best bet for going through the AIP protocol successfully and carefully determining your food triggers, is to work with a team of health care practitioners who specialize in autoimmunity and the AIP diet.
When can I start the reintroduction process?
The decision as to when you are ready to start the reintroduction process is a very individual one.
Generally, you should start to see some improvements after about 30 days, but you may not be where you want to be until about 3-6 months of full AIP. If, after 6 months, you are still not seeing progress, you want to touch base with a functional medicine practitioner to make sure there aren’t any underlying causes you might have missed such as SIBO, parasites, candida, or methylation dysfunction (1). These will need to be addressed before you can fully heal.
Ideally, you don’t want to start the reintroduction process until you have achieved total remission from your autoimmune disease. However, not everyone will achieve 100% remission. Those who have had autoimmune disease for many years commonly have tissue damage that is not able to resolve in even the 3-6 month timeframe and requires a longer healing approach. However, even in those cases, most people will see improvements in peripheral symptoms such as skin, mood, digestion, sleep and energy. If those changes are clear, then you may be able to use those as guideposts for reintroductions.
My rule of thumb is that you want to be in a place where you feel like you could live happily for the rest of your life. The idea is to have a solid baseline of health so that when we reintroduce foods you will know if they are a problem or not based on the reappearance of symptoms.
Why should I reintroduce foods?
If you’ve done a ton of healing and you’re feeling great, the idea of adding things back that might have been your triggers is scary.
When working with my autoimmune clients, I am often asked if it is even worth doing reintroductions at all.
“Why can’t I just say on the AIP diet forever?”
It is important to go through the reintroduction process for your long term quality of life. As much as we get into the swing of things, it can be incredibly hard to maintain the AIP protocol forever. You shouldn’t have to avoid a food if it is not a problem for you.
Being able to order a dish that is made with butter at a restaurant, or having a meal at a friends house that uses cayenne pepper should be things that you have the freedom to do if you can tolerate it.
In many cases it also offers a wider reach of nutrition. Some of the foods we eliminate such as eggs, nuts, seeds & nightshades have plenty of health benefits if they are not a trigger food for you. We want to be able to incorporate them occasionally into a healthy diet if we can.
What if I can’t tell if a food is causing symptoms or not?
In some autoimmune diseases, like Hahsimoto’s Thyroiditis, the symptoms being tracked are much more subtle and hard to pinpoint, such as energy levels and mood fluctuations. It is important to keep a careful food & symptom tracking journal through the reintroduction process.
I recommend tracking not only symptoms associated with your disease but also considering symptoms you may not think are connected, including sleep, digestion, mood, cravings, skin, energy, aches & pains, as well as allergy-like symptoms such as runny nose, coughing, itchy eyes, mouth or ears, sneezing or dizziness.
The best way to track these things is by noting them and giving them a number on a scale from 1-10. This is more informative than descriptors like “good” or “bad” and gives you and your practitioner a better sense of your overall progression.
Again, it may be most helpful to utilize the expertise of a health care practitioner to help identify when you have had a reaction.
What if I have a bad reaction to a food?
This is probably the question that causes the most anxiety. Often clients don’t want to face the possibility that it might be the chocolate after all! But we must remember that an adverse food reaction is a loving signal from our body telling us what it needs.
First, it is important that we take reintroductions slow. Please make sure you are clear on the full reintroduction procedure with your health care practitioner. If we go from never having tomato to eating a full tomato soup and that is a trigger, you are likely to suffer much more than if you started with a spoonful. As much as it can be tedious, this is an important step to ensuring that a reintroduction doesn’t knock you on your butt.
If you have a reaction, stop eating this food and do not include it in your diet at this time.
If the reaction is severe, go back to the elimination phase until you get back to the baseline of health that you had before starting reintroductions. Do not reintroduce another food until you have reached that baseline, otherwise it will be unclear whether you are reacting or not.
It may take a few days to a few weeks to get back to your baseline after a bad food reaction. This is where it may also be helpful to work with your health care practitioners to decide when you are ready to attempt more reintroductions.
Make sure that you are tracking your reactions closely with that 1-10 scale. This will help us to determine which trigger foods are more or less problematic for you. If your reactions to some foods are lighter, there may be a chance that you can tolerate that food from time to time. Over time, you will be able to determine your maximum tolerance for foods like these.
Having an adverse reaction to a food doesn’t necessarily mean you can never eat it again. Sometimes, it just means continuing with a diet that omits your trigger food and coming back to reintroductions after a time of incorporating more gut-healing strategies (2).
Why can’t I do food allergy testing instead?
Unfortunately, food allergy testing cannot replace the reintroduction process. A true allergy is always to a protein and can be identified through IgE antibody testing. However, the testing for food sensitivities (IgA, IgD, IgG and IgM) is unreliable and points to the presence of a leaky gut rather than a true allergy (3,4,5). The symptoms of these sensitivities, however, are very similar to allergic reactions, which is why we can pinpoint them through an elimination and reintroduction process.
Intolerances and sensitivities are usually created as a result of a damaged gut or digestive process. The good news is, this means they may be healed with time, focused nutrition and a healthy lifestyle that supports gut-healing, immune support and hormone balancing.
If you have gone through the work of healing through AIP, I encourage you to commit in the same way to the reintroduction process. It is the part where you get to decide what the “your name here diet” is, so that you can live the rest of your life to the fullest, free from autoimmune disease symptoms.
Be kind to yourself. It is not your fault if you have an adverse reaction. Thank your body for showing you what it needs. Give it that love and respect and move forward with empathy.
I hope this article has help to ease some of your concerns about diving into the process. If you ever need that extra hand to help you along the way, I am a holistic nutritionist and certified AIP coach and would be happy to help. Just head to the contact page and shoot me an email!
You can also follow me on instagram @realistic.holistic to follow my journey with autoimmune disease (hashimoto’s & celiac disease), pick up recipes and grab some knowledge bombs about how to use nutrition & self-love to heal your guts and HAVE IT ALL!
Kisses & Kombucha,
1) IL-17 and Infections: https://www.ncbi.nlm.nih.gov/pubmed/25398490
2) Gut Microorganisms & Food Sensitivities: https://www.ncbi.nlm.nih.gov/pubmed/30214038
3) Testing for Food Reactions: https://www.ncbi.nlm.nih.gov/pubmed/20413700
4) Allergy Tests Do Not Predict Food Triggers: https://www.ncbi.nlm.nih.gov/pubmed/27247257
5) Evaluating the Clinical Relevance of Food Sensitivity Tests: https://www.ncbi.nlm.nih.gov/pubmed/15253678