Autoimmune Paleo Diet and Hashimoto's - Dr. Izabella Wentz (2024)

There are numerous dietary protocols that can help a person with Hashimoto’s feel better. In some cases, a dietary approach can produce a complete remission of the condition!

For me, as a clinician, the goal of the approach is to help your body reset, nourish itself, and reduce inflammation caused by reactive foods — as well as to help you reconnect to an intuitive way of eating, where (eventually) you will naturally select foods that make you feel better, and avoid those that make you feel worse.

While I don’t believe in a “one size fits all” diet, I have seen versions of the Paleo style diet work wonders for many people with Hashimoto’s, as it eliminates many of the foods that are most problematic — including gluten and dairy. However, some people with autoimmune conditions will need to take their diet a step further. In such cases, the Autoimmune Paleo (AIP) diet has been shown to be highly effective for many.

Recently, some exciting new research was released on the benefits of the AIP diet, so I’d like to take some time to explore:

  • The origins of the Paleo and AIP diets
  • What the AIP diet consists of
  • Benefits of the AIP diet for Hashimoto’s
  • A sample meal plan
  • More resources to help you heal

The Origins of the Paleo Diet

First, let’s talk about the Paleo diet, which is the diet from which the Autoimmune Paleo (AIP) diet originates. Many people, even those not diagnosed with Hashimoto’s, are aware of the benefits of the Paleo diet. It has helped countless people feel better from a wide range of symptoms: fatigue, brain fog, joint pain, gas, and bloating, to name a few. In a survey of my readers and clients, a resounding 81 percent reported that they felt better on a Paleo or grain free diet. In the case of Hashimoto’s, the traditional Paleo diet has even helped many people lower — or completely eradicate — their thyroid antibodies.

For those of you who have tried going Paleo but have not seen significant improvement, I want you to know there are additional steps you can take that will give you the power to take back your health!

The traditional Paleo diet is a classic elimination diet that focuses on omitting foods people are commonly sensitive to in an effort to lower inflammation.

As you may know, the Paleo diet eliminates all grains, legumes, soy, and processed foods. The focus is on replacing the foods you take out of your diet with other nutrient-dense foods, such as organic or grass-fed meats, wild-caught fish, organic vegetables and fruits, nuts, seeds, eggs from pasture-raised hens, and (depending on who you ask) dairy.

The Paleo diet is certainly a great start, but it is not always enough to address every case of Hashimoto’s. Often, we need to peel back more layers of that onion! The good news is, with each new diet, supplement, or treatment that you try, you are finding out how your body responds to different external factors. Each case of Hashimoto’s is unique, and many of us have additional food sensitivities that are deregulating our immune system. People with Hashimoto’s often have sensitivities to a wide range of foods — particularly to gluten, dairy and soy— which are all omitted on the traditional Paleo diet.

Anecdotally, the Paleo diet is said to have been introduced in the 1970’s with the book The Stone Age Diet by Walter Voegtlin, but it has significantly gained in popularity over the past ten years. Since then, countless resources such as cookbooks, websites, and articles have been created that include recipes ready for you to use. I’m sure many of you have seen these resources at your local bookstore, your go-to health food store, and even at Costco. It’s a very exciting time to be on a Paleo diet!

If the Traditional Paleo Diet Does Not Improve All My Symptoms, What’s Next?

Now that you understand Paleo, let’s talk about the AIP diet, which helped many of my own symptoms of Hashimoto’s.

The creation of the AIP diet has been attributed to Loren Cordain, a scientist who discovered that certain foods can sometimes trigger inflammation in people with autoimmune disease. It was further popularized by Paleo authors such as Robb Wolf in The Paleo Solution, and Sarah Ballantyne (also known as The Paleo Mom) in her book, The Paleo Approach.

The goal of the AIP diet is to heal leaky gut by removing commonly problematic foods, thereby reducing inflammation in the body and healing autoimmune disease.

I have seen many of my clients find almost complete relief from their symptoms by implementing the AIP diet into their lifestyle changes. The symptoms that many find relief of include joint pain, muscle aches, fatigue, bloating, diarrhea, brain fog, tinnitus, skin rashes, as well as decreased food sensitivities. Even those who do not recover completely will often experience significant improvement. You have nothing to lose (except for symptoms!), and everything to gain by considering the AIP diet.

Will I Feel Better Right Away on AIP?

Please note that there is often a short transition/withdrawal period before you start feeling better on the AIP diet, especially if you are new to coming off gluten, dairy, and processed foods.

Research suggests that casomorphins (from the dairy protein casein) and gliadorphins (from gluten, a protein found in wheat) can bind our “feel good” endorphin receptors, much like the morphine found in addictive drugs can.

This has led some people to say that these foods are as addictive as heroin and other drugs (which also bind our endorphin receptors). While I think this is an exaggeration, I have seen people experience withdrawal-like symptoms, including brain fog, irritability, cravings, fatigue, and headaches, after quitting gluten, dairy, and sugar while they were adhering to the Autoimmune Paleo diet.

The good thing is, once these inflammatory foods have been eliminated, you will start to feel better. You can expect to see results within 30-90 days of implementing the AIP diet, although it may take longer. If you do not see results in 30 days, eliminate mammalian meat and use fish as your main protein source. Then, you can start to systematically reintroduce certain foods one by one. This allows you to create a diet for the long term that is tailor-made for you.

This process will allow you to be more in touch with what does — and doesn’t — work for you. I felt incredibly empowered when my grocery shopping and prep work resulted in a lasting improvement in health — and this can be your story, too!

AIP and Hashimoto’s

I was excited to discover new research by my colleagues Angie Alt (who co-wrote The Autoimmune Wellness Handbook with Mickey Trescott), Rob Abbot, and Adam Sadowsk, that shows the impact an AIP diet can have on those with Hashimoto’s.

In this study, 17 women between the ages of 20 and 45 with a prior diagnosis of Hashimoto’s participated in a 10-week online health coaching program, focused on the implementation of an AIP diet. They each filled out a questionnaire that was used to measure the participant’s health-related quality of life (HRQL) and clinical symptom burden, in addition to undergoing thyroid function tests and white blood cell counts, before and after the 10-week program.

The study revealed some exciting results, including a statistically significant improvement in HRQL, particularly in the areas of physical role functioning, emotional role functioning, vitality, and general health. Clinical symptoms, as reported by each participant at the beginning of the study, decreased from an average of 92 symptoms, to an average of 29 at the end of the program. Symptoms that saw significant improvement included joint pain, muscle aches, headaches, sleep quality, energy, body weight, mood, and cognitive function, among many others. Inflammation, as measured by hs-CRP (c-reactive protein), was noted to significantly decrease by 29 percent, from an average of 1.63 mg/L pre-intervention, to 1.15 mg/L post-intervention. Additionally, weight and body mass index (BMI) saw statistically significant decreases, with an average of six pounds lost, and a one point drop on the BMI scale.

Surprisingly, there were no statistically significant changes noted in any measure of thyroid function, including TSH, free and total T4, free and total T3, or thyroid antibodies. However, the study suggested that the AIP diet may decrease systemic inflammation and modulate the immune system, as evidenced by changes in white blood cell counts.

Additionally, six out of the 13 women beginning the study on thyroid replacement medication decreased their dose of hormone replacement medication after the 10-week intervention, while all three of the women who began the study without the use of hormone replacement medication continued without the use of medication (as of the final post-intervention study visit). The authors of the study speculate that we would observe an eventual decrease in thyroid antibodies and a decreased need for thyroid medication, as well as further changes in immune and inflammatory markers, in participants adhering to the AIP dietary principles for longer periods of six to 12 months.

Given the improvements seen in the participants’ HRQL, symptom burden, and markers of immune activity and inflammation, this is exciting news, indicating that an AIP diet can have a profound impact on healing from Hashimoto’s!

While the Paleo diet has helped some people with Hashimoto’s feel much better, I have found that the AIP diet can be even more helpful, based on 75 percent of my readers and clients reporting significant symptom reduction — and almost 40 percent seeing a reduction in thyroid antibodies!

On a personal level, this was one of the key protocols on my own healing journey, and it helped me get my condition into remission.

However, while the Autoimmune Paleo diet has helped many people with Hashimoto’s and autoimmune conditions get better, it can be quite difficult to implement. As a pharmacist, I see this daily: many people know what they need to do to get better, but just don’t know how to get started.

If you’ve been eating the standard Western diet for most of your life, starting a dietary protocol like the AIP can be extremely intimidating. Though you may eventually end up “going AIP,” it’s okay to take baby steps and begin with going gluten free, then move on to going dairy and soy free.

I encourage you to remove one food group at a time, if that makes you feel more at ease with the transition. Committing to a 100 percent gluten-free diet is an important first step, and 88 percent of my readers with Hashimoto’s have indicated that they felt better after going gluten free.

I know that some of you, however, love taking action and will dive right in and immediately begin your healing journey with the AIP! However, many of you will find the AIP diet difficult to adhere to at first. We all have different needs, motivations, and challenges, and I encourage you to honor your individuality and listen to your body.

The Autoimmune Paleo Diet Guidelines

At this point you’re probably wondering where to begin with the AIP diet. Let’s start by going over the lists of foods to avoid and those to focus on with the diet.

Autoimmune Paleo Diet and Hashimoto's - Dr. Izabella Wentz (1)

Foods to Be Avoided on the AIP Diet

When you do decide to start the AIP diet, you’ll notice that, in addition to following the Paleo diet guidelines of removing gluten/soy/dairy/grains/nightshades/legumes/processed foods, it also removes additional foods that are known to cause inflammation in many people. Here’s the full list of foods to be avoided on the AIP:

  • Gluten
  • Grains (including corn, quinoa, buckwheat, and rice)
  • Dairy
  • Eggs
  • Soy
  • Alcohol
  • Caffeine
  • Beans and legumes
  • Nightshades – tomatoes, potatoes (except for sweet potatoes), eggplant, peppers, goji berries, ashwagandha (herb that helps balance adrenals), paprika and other nightshade spices
  • Seaweed and other sea vegetables*
  • Sweeteners (including honey, maple syrup, and agave) in high quantities (small amounts are allowed)
  • Canned foods, processed foods, coffee
  • High glycemic index foods
  • All nuts and seeds (except coconut)

*While seaweed and sea veggies aren’t traditionally removed on the AIP diet, I recommend avoiding them because of their high iodine content, which may exacerbate autoimmune thyroid disease.

Foods to Be Included on the AIP Diet

  • Organic vegetables (except nightshades and legumes)
  • Fermented foods (sauerkraut, nightshade free kimchi, coconut kefir, kombucha, fermented vegetables, and jams)
  • Organic and grass-fed meats
  • Organic and grass-fed organ meats
  • Wild-caught fish
  • Fatsand oils
  • Low-glycemic organic fruits
  • Coconut (including coconut milk and coconut oil)
  • Herbs and spices
  • Hydrolyzed beef protein
  • Sweet potatoes

Recommended Best Practices

While the AIP diet can seem a bit intimidating, if you follow a few rules and stick to the list of allowed foods, you will find that you quickly adjust to the diet, and it’ll become second nature:

  • Limit fruits to 1-2 servings per day and make sure they are low on the glycemic index (a ranking of how fast carbohydrates are digested)
  • Include 6-8 servings of vegetables per day
  • Aim for 80 percent vegetables, and 20 percent meat or fish in each meal
  • Focus on sauces, dips, and broths
  • Incorporate plenty of fats and oils (coconut oil, duck fat, beef tallow, avocado oil, olive oil), cooked at the appropriate temperature
  • Don’t eat on the run, and make sure to chew your food thoroughly
  • Learn to ferment your own vegetables
  • Drink plenty of filtered water
  • Don’t forget to check supplement labels to make sure they are free of non-compliant ingredients. For your thyroid medication, read Is Your Medication Gluten Free?

An Example Day’s Worth of Meals

On a personal note, eliminating eggs was a tough step for me, and although I knew I was sensitive to them, I put off excluding them from my diet. This delayed my progress for many months, and I don’t want that to happen to you!

I’m sure many of you are thinking… what am I going to eat for breakfast? I know I asked this question! I used to eat eggs for breakfast almost daily, in omelets or scrambled eggs on weekdays… and every weekend, my husband would cook a nice breakfast for us that included runny yolk eggs.

However, the transition to life without eggs did not feel limiting after all. I found it made me more creative in the kitchen! Here are some meal ideas — my husband’s included:

Breakfast, Courtesy of My Hubby

  • Bacon
  • Steamed spinach with olive oil
  • Avocado
  • Fermented cabbage (from farmer)
  • Fermented cucumbers (my recipe)

Lunch

  • Butternut squash chili — last night’s leftovers! (Remember, batch cooking is your friend 🙂
  • Fresh Swiss chard with lemon, sea salt, and olive oil

Dinner

  • Coconut crusted trout

Thirsty?

  • Mineral water with lemon and lime or, for the occasional treat, add a few berries
  • Herbal teas are a great choice on an AIP diet

Need a Snack?

  • Sip on some homemade bone broth, enjoy a root cause green smoothie, a slice of avocado with a squeeze of lime and sea salt (yum!), or make some savory sweet potato chips

If you are interested in these recipes, you can find those and more in my cookbook, Hashimoto’s Food Pharmacology. In the meantime, you can check out a sneak peek here. (Please note that not all recipes are AIP-friendly, but they can be modified by omitting non-AIP compliant ingredients.)

For more AIP recipes, you can download my Root Cause Recipes eBook and select the Autimmune Paleo option. You’ll receive a bundle of some of my favorite recipes, along with a 10-day meal plan to make your AIP diet easy to follow!

Autoimmune Paleo Diet and Hashimoto's - Dr. Izabella Wentz (2)

What If AIP Is Not Enough?

The Autoimmune Paleo diet is meant to be short term. As I mentioned earlier, the goal is to reduce body inflammation and allow the gut a chance to heal. These variations in diet give you the power to improve how you feel and isolate your root causes.

If, however, AIP doesn’t resolve many of your symptoms after 90 days of following it, you may have to go a step further and incorporate a rotation diet (as described in Hashimoto’s Protocol), a low-histamine diet, or low-oxalate diet.

After you are finished with the 90-day elimination period on the AIP diet, you may want to re-test your thyroid antibodies to monitor improvement. You should see a trend in your antibody levels reducing (or going away). If, after 90 days, you are still having gut issues, it may be a good time to test for parasites and other gut infections, as well as SIBO.

Other Resources for Your Autoimmune Paleo Diet Journey

Ready to start? To help kickstart your AIP journey, I’ve compiled a list of helpful resource to make this transition a little bit easier for you.

Books & Recipes

Food & Pantry Items to Help You Stock an AIP-friendly Kitchen

  • US Wellness Meats
  • Desert Farms Camel Milk
  • Paleo On The Go
  • The Flavor Chef (The Brothery) – Be sure to look for the products marked as AIP and use “thyroid10” for your special discount!
  • Thrive Market

Other Related Articles

  • Food Pharmacology for Hashimoto’s
  • The Best Diet for Hashimoto’s
  • A Paleo Diet: Will It Resolve Your Hashimoto’s?
  • Uncover Your Hashimoto’s Root Cause with an Elimination Diet

Some Helpful Cooking Tools to Make AIP Life Easier

The Takeaway

While there is no one-size-fits-all diet, the Autoimmune Paleo diet has helped many people with Hashimoto’s. If you find you are stuck in a rut with your thyroid symptoms, trying this diet for a period of time may be the solution you need to find relief.

Starting an AIP diet may seem intimidating at first, but for many people with Hashimoto’s, the benefits far outweigh the inconveniences. Remember, 75 percent of my clients saw a reduction in symptoms on the AIP diet, so it is definitely worth a try! I know that you can do it… and enjoy it too. ? Once you get going and see the progress you make, you will not want to turn back!

I’d love to hear from you… what type of benefits have you seen from the AIP diet?

P.S. To help you on your journey, you can download a free Thyroid Diet Guide, 10 thyroid-friendly recipes, and the Nutrient Depletions and Digestion chapter of my Hashimoto’s Root Cause book for free by signing up for my weekly newsletter. You will also receive occasional updates about new research, resources, giveaways, and helpful information.

References

  1. Abbott RD, Sadowski A, Alt A3. Efficacy of the Autoimmune Protocol Diet as Part of a Multi-disciplinary, Supported Lifestyle Intervention for Hashimoto’s Thyroiditis. Cureus. 2019 Apr 27;11(4):e4556. doi: 10.7759/cureus.4556.

Note: Originally published in July 2017, this article has been revised and updated for accuracy and thoroughness.

Autoimmune Paleo Diet and Hashimoto's - Dr. Izabella Wentz (2024)

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