Update: 60 Days on Autoimmune Paleo Protocol for Crohn’s Disease

It has now been 60 days since I started the autoimmune paleo protocol (AIP) and I am happy to report that over the last 30 days I have begun reintroducing foods, mostly with success. I’m feeling great, I’ve gained another 2 pounds (finally back to the baseline I started at when I first cut out grains in January!), and my digestion is ranging from  good to excellent. As long as I go easy on my consumption of foods that are high in FODMAPs, I have virtually no symptoms of Crohn’s disease or irritable bowel syndrome (IBS). I see my gastroenterologist this week for a periodic followup and am looking forward to telling him the good news!

So what am I not eating?

First of all, I continue to follow a basic paleo eating plan that strictly avoids all grains, legumes, and refined sugar. Of these, the most important for me is to avoid anything containing gluten because of its role in creating intestinal permeability (also known as “leaky gut”), and I have always found that legumes, especially peanuts, cause varying degrees of digestive distress. For now, I am also continuing to avoid nuts, most seeds, coffee, and alcohol because they are gut irritants and may cause an immune response.

What have I reintroduced?

Typically, a paleo autoimmune protocol diet excludes eggs, nightshades (potatoes, tomatoes, peppers, and eggplants), seeds, and nuts, in addition to the grains, legumes, and dairy that a standard paleo diet avoids. Once significant improvement in the autoimmune disease have occurred (ideally, complete remission), one can begin reintroducing foods one at a time. Experts recommend reintroducing the foods that are least likely to cause a reaction first.

Sarah Ballantyne of The Paleo Mom, says that the foods least likely to be problematic are egg yolks, ghee from grass-fed dairy, and seed-based spices, and the foods most likely to be problematic are egg whites, chili peppers, potatoes, and tomatoes. She has a great post explaining this and detailing how to conduct reintroductions that I highly recommend reading. As a summary, I created the following chart:

I started out following this chart exactly. The first food I tried was egg yolks and the second was one of the seed-based spices I’d most been missing (cumin). Both of those went very well.

Then I got impatient and decided to try whole eggs. Even though I knew that egg whites are highly likely to be problematic according to expert research, I’ve always felt like eggs were a safe food for me that I could always handle well even if my disease was highly active. I was prepared to back down and remove them from my diet immediately, but I was very thankful to discover that I could eat them without problem.

I also jumped to the red zone of my chart and started eating potatoes early on. I have discovered that my body really does best when I eat high amounts of starch (read this post I wrote about that topic) and as I mentioned in my last update, I cheated once with potatoes while I was still in my initial 30 day elimination period. I started with small amounts of peeled potatoes, then gradually increased the quantity and even tried a few bites of “new” red potatoes with their peel. Happily, I experienced no problems.

The final food I successfully reintroduced this month was chocolate. I keep the quantity limited to just a couple bites of dark chocolate (dairy and soy free) every other day or so and that seems fine.

UPDATE: Since I published this post, my friend Eileen Laird of the blog Phoenix Helix has published a fantastic guide to reintroducing foods on the AIP. I encourage you click here and check it out!

What about dairy?

I am still on the fence about the potential role of dairy in my diet. I had a business dinner this week with my new teammates and decided to cautiously test it by ordering a dish that included some butter. The next day my digestion was markedly poorer, but I cannot say for certain whether that was caused by the butter or perhaps by another factor such as another ingredient in the restaurant meal or just general stress caused by starting a brand new job! For now, I’m holding off on dairy and will retest in a more controlled situation sometime in the next few weeks and start with grass-fed ghee and then move up to butter if that goes well.

What’s next for days 61-90?

Even though I am very tempted by the last few fresh tomatoes that are coming off our plants right now, I’m going to hold off on trying those. In order to give my meals a little more punch, I want to test the remaining seed-based spices and paprika. If that goes well, I’ll give sunflower seed butter a shot and then maybe begin to try some nuts.

 

See my earlier AIP updates here: Starting the protocol, week 1, week 2, week 3, and 30 days.

 

Shared on Peeling Back the Onion Layers Healing with Food Friday.