Originally posted 26 January 2018. Last updated 31 August 2021.
It seems as though more folks are suffering from autoimmune-related diseases or conditions these days. For some of these conditions, it’s not always clear whether the actual numbers of those suffering has actually increased, or whether the improvements in medical technology have allowed doctors more accurately diagnose these conditions.
When we think about how far we’ve come with simple things like blood tests, there’s so much more we can interpret now thanks to newer technologies. Regardless of this, the diet can play a critical role when it comes to managing autoimmune conditions.
I have to mention my disclaimer here. Whatever I am about to suggest will not work for everyone. Please discuss any changes you plan on making with your doctor BEFORE attempting any of this.
The Paleo Diet for Autoimmune Conditions
The Paleo Diet is a lower carbohydrate, high protein, medium-to-high fat diet. Someone modified the Paleo Diet and made it even more restrictive to hopefully help those with autoimmune conditions. But here’s the problem.
There are many versions of this Paleo Diet –each claiming to help with autoimmune diseases. Some versions of this protocol will say you need to remove grains, beans, soy, peanuts, dairy and vegetable oils from your diet. Others will say you also need to remove fruits. Other versions will tell you to avoid eggs… but again, not all. It’s difficult to know which one you’re supposed to follow.
Paleo is a type of elimination diet, because like I said, it requires you eliminate certain foods from your diet. Since Paleo is an elimination diet, maybe it’s not following Paleo that is proving to be helpful, but merely the fact that it forces you to remove those 1 or 2 foods that are causing your condition to flare up.
Let me give you an example: let’s say eggs cause your condition to flare up, but you don’t know that just yet. You’re still not sure which food or foods is causing you to feel worse. To help you figure it out, you happen to start a version of the Paleo Diet that requires you to remove all eggs and egg products completely. At the same time you start increasing your intake of red meats, decreasing your intake of grains (including whole grains), and beans because that’s what the protocol requires. So you start to feel better… the food that was triggering your symptoms (eggs) has been removed.
However, you have been increasing your intake of other foods that may not be so great to eat over the long term, like red meat, and decreasing your consumption of foods that may help you in the long term (like whole grains and beans)! So it’s not the Paleo Diet itself that’s helping you, it was you not eating eggs.
Meanwhile, by increasing your consumption of red meat and decreasing your consumption of whole grains and beans, you might be raising your risk for developing other chronic conditions like heart disease or cancer!
In reality, it was a coincidence that the Paleo Diet helped you feel better–it wasn’t because of Paleo–it was because you removed the one food that caused you to feel worse.
Gluten and Dairy
A listener recently sent in the following question.
QUESTION: “Hi Dr. Neal, I’ve been diagnosed with an autoimmune disease. Over the years, I’ve had doctors tell me to avoid gluten and dairy, while others have said it won’t do any good. Do you have any advice and what are your thoughts on whether gluten and dairy will activate or worsen autoimmune disease?”
Gluten and dairy are often listed as common offenders for triggering an immune response. So I appreciate the question. Let’s quickly get to the heart of this by looking at what the science says.
What do Gluten and Dairy have to do with the Immune System?
Let’s start with gluten. Gluten is actually made up of 2 proteins, gliadin and glutenin. In foods, gluten acts like the “glue” that holds breads and pastas together.
The link between gluten and the immune system goes something like this: in certain individuals, their defense system (e.g., their immune system) gets hyperactive when the body is exposed to the 2 proteins found in gluten. When it comes to dairy, the same type of process happens – in certain individuals their bodies’ immune systems overreact to some of the proteins found in dairy.
In some people, this leads to an actual allergic reaction. This allergic reaction could be something like hives, eczema, asthma, or even something as serious as anaphylactic shock. Anaphylactic shock is when a person’s body basically shuts down in response to exposure to an allergen.
What about those with Autoimmune Disease?
Gluten and dairy may not be problems for those with autoimmune disease. It really just depends on the individual and what their immune system overreacts to. There are many with autoimmune diseases that can regularly enjoy foods that contain gluten or dairy and feel perfectly fine. The trick is to discover what triggers each person’s immune system to overreact.
Luckily, there is a systematic way to go about this. The trick is to carefully remove foods from the diet and very deliberately add them back. Throughout this process, careful records need to be taken in order to keep track of which foods are triggering a potential immune response. I share more tips on keeping a food diary at the end of this post.
A healthcare professional that specializes in treating the specific autoimmune condition is a great resource when it comes to this process. An allergist or a Registered Dietitian Nutritionist that specializes in helping those with allergies can also guide individuals through this process.
What's the Best Diet for Hashimoto's?
Hashimoto’s is short for Hashimoto’s thyroiditis. For those of you that don’t know, with Hashimoto's, immune cells start attacking the thyroid gland. The thyroid gland is found in your neck, right in front of your windpipe. If the body starts attacking this gland, it can lead to problems with metabolism, or basically how many calories you burn each day. For someone with Hashimoto’s, they may find their metabolism slows down, they begin to feel tired, and they may start to gain weight.
Here’s what’s really interesting about diet and Hashimoto’s: when we look at the research, both Paleo AND a vegan diet have been shown to help! Those are like two complete opposites and yet, both, can be helpful! Doesn’t that just prove my point?
It’s not following Paleo, or Atkins, or South Beach, or anything else that might be helpful. It’s the fact that, by coincidence, those diets might just force you to remove the 1 or 2 foods that trigger your symptoms. However, the other restrictions might actually negatively affect your health in other ways over the long term!
Side note: What we do know about Hashimoto’s is that it’s good to avoid these foods specifically: cauliflower, broccoli, bok choy, and cabbage. That’s because these foods can aggravate the thyroid.
So what should you do?
Keep a Detailed Food Diary
The first thing I would recommend is to keep a food diary along with a record of your symptoms. Anytime you eat or drink something, write down the date, the time, and what you ate or drank. If you can also include a guesstimate of how much you consumed, that would be helpful, too. Keep this with you at all times.
Whenever you begin experiencing a flare up of your symptoms, write that down in the diary. Describe the symptoms in as much detail as you can. Were you feeling any pain? Cramping? Did you have a skin reaction? What did that look like? If you can, use your phone to take a quick photo. You get the idea.
This will allow you to find any patterns between those foods you ate and the appearance of symptoms.
Autoimmune Disease and Other Lifestyle Factors
Don’t forget about other lifestyle factors that contribute to a flare up of autoimmune conditions. Stress, for example, is one of the most common reasons people tend to flare up. Getting adequate sleep is also important. This allows your body’s healthy cells to rejuvenate and keep that autoimmune condition in check.