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Simplifying Autoimmune Protocol Reintroduction - Part 2

CC image courtesy of Nomadic Lass

CC image courtesy of Nomadic Lass

So a couple weeks back, I wrote Part 1 in this series. Go check it out if you have not read it, as it contains tips on apps you can use to help you simplify. 

This post is about my specific planning and how Im using those apps to help me identify which foods will become part of my normal regimen and which foods will stay out for an undetermined amount of time. Let's start with my plan, shall we? I wanted it to be simple and I wanted to just start with a few foods to add back. So I set up a 5 week plan, introducing two foods each week, giving myself 3 days of introduction and then 4 full days of rest. I also planned out what forms of that food I would try in my reintroduction meals. This is exactly how I help clients with their plans, and now its time for me to put my work to test on me!

So for week one, over the course of 3 days (which equals 9 meals and maybe a few snacks), I experimented with almonds, almond flour and chocolate. Really, what happened, was it was Halloween and my husband really wanted some Capello's GF Cookies and I caved to have some with him - hence my choice of almonds and chocolate. But it was not all Capello's those three days, I also tested by eating almonds and a few bites of 100% cacao. 

Then it was about monitoring. In testing two foods at once using the Food Detective app, I can identify a culprit food and simplify introduction. Without it I can only test one food at a time and it would take me twice as long to do this rather lengthy n=1 experiment. Im keeping track of any symptoms using another app and with those two, I can easily see if I have an adverse reaction. Plus, I have an additional 4 days in the week to track symptoms - sometimes it takes 72 hours after eating a food for symptoms to show up. See the sample calendar below.

Week 1 results are in!

The green checkmark (above) denotes no symptoms and nothing on the Food Detective app. The red X's indicate symptoms and that Food Detective suspected a food. So what happened? Well, I got pretty bad brain fog, nasal congestion, my thyroid started acting all janky and I started gaining weight (water weight = inflammation). This started about 30 hours after the first introduced cookies and continued through Wednesday.

So what does this mean? Well it means either Im sensitive to Almonds, or Cacao, or Sugar! Sugar got tested since there was also sugar in the cookies and any chocolate that was not 100%. And, truth be told, I ate french fries at a restaurant on Saturday *SHOCK & HORROR*. Which means I also tested Potatoes and seed oil! So now I have 5 culprit foods and no clear way to sort out which one it was. What can I say? Life happens and I am human and sometimes you just have to get a little crazy.

Now that I have done a complete AIP reintroduction bender in week one - I can say that I have some suspects. But I have to be my own food detective and sort out which one of the 4 caused the reaction. And it could be several, not just one.

So now what?

Im giving myself an extra week back on full AIP to let the inflammation reside and get back to my normal full-AIP-feeling-great self. Then I will proceed with Week 2 as planned. For me, its just easiest to put my week 1 test items (almonds, cacao) at the end of my plan. So I will re-test those and this time test without sugar... and potato fries.... and seed oils :)

The important thing here is to take the information in stride. It could be really easy for me to say, "forget it, Im not reintroducing anything else" but then I would never know if any of the other foods (which all are fantastic sources of nutrients by the way) will work. Its also important to realize that I, while trying to keep things simple, gave myself a complex multi-variant analysis problem. And since I never liked those problems in Calculus, I'll just re-do the test and keep it simple this time.

This stuff is not easy, but boy is it easy to make it hard! So Im carrying on and sticking to my plan. Its going to take some time, but I think its worth it in the end. Frankly, I have felt better in the last several months than I have in years and I know its because I have finally removed something that is causing inflammation and autoimmune flares. So let the sleuthing continue!



Simplifying Autoimmune Protocol Reintroduction - Part 1

CC image courtesy of Barbara Krawcowicz

CC image courtesy of Barbara Krawcowicz

As you may know, I'm currently in the full elimination phase of the autoimmune diet protocol (AIP). I decided back in June that I would try AIP again to see if it could help some of my lingering symptoms. After a phased in approach to the eliminations (of which I wrote about over on Mickey Trescott's blog, Autoimmune-Paleo), I decided to stick with 100% elimination for a number of months while I work at getting rid of my Giardia friends. So its been quite a while that I have been without grains, legumes, dairy, sugar, alcohol, nightshade veg, nuts, seeds or eggs!

Conducting an n=1 experiment with the Autoimmune Protocol definitely requires patience and dedication! The protocol takes a while, and often times people are (er, I mean, I am) impatient to add all the foods back in during the reintroduction phase because they miss them. Totally understandable. This is exactly what I did the first time I tried AIP, and I lost all the opportunity to really learn if any of the foods listed above could be triggers for autoimmune flare or symptoms.

So lets not waste all this effort of some fairly radical food elimination by rushing the reintroduction! I decided to plan out my approach this time, and in doing so am going to share with you. This will be a two part series that will out line the steps I am taking while I start my reintroduction phase.

What is a reintroduction phase?

The basic concept is that you start reintroducing foods one by one slowly back into your diet. By doing this, you control the variables you need to analyze so that you can identify if any specific food is a trigger. It's a lot easier in concept than it is in application. For example, I eliminated nuts & eggs (full list above) as an entire food group in one step. But during reintroduction, I'll need to reintroduce walnuts separately from almonds, separately from cashews, etc. The same with eggs: egg yolks separately from whites (more people are intolerant to whites than yolks). Couple that with the notion that it takes sometimes up to 3 days to create a response from an irritating food, you can start to see why reintroduction takes some patience! You'll want to vary the meals and keep track of any symptoms that may arise as a result of a reintroduction.

Preparation for Reintroduction

This is a super important step! If you are not prepared, then its easy to rush because you have not set any established guidelines for yourself. But what does that really mean? Most people are on full AIP elimination for 30-60 days. Well, I for one have been on it now for 5 months and plan to go to 6 months. All that time away from those wonderful foods - well the imagination gets to you after a while. I have conjured up mental images of just eating eggs and chocolate for breakfast, and lunch, and dinner... and snacks for a week but I know that won't be wise. With a little preparation, its much easier to be successful at the end!

  1. Decide what you will introduce first, second, and so on. This can be done based on your particular AI condition, or you may want to base it on seasonal availability of certain foods. Or, you may decide that you simply miss certain foods more than others. Either way, know which foods you will never reintroduce - for me, I won't introduce gluten; I already know its a bad idea for me - and which foods you want to try again. Remember, there is no guarantee after being on full AIP elimination, that you *will* be able to tolerate a food. You won't know, however until you try.
  2. Figure out a system for documenting symptoms and health markers. What we don't measure, won't improve! I always like to keep copious notes on all sorts of health markers when I reintroduce a food. You'll want to keep track of as many markers as possible: items such as sleep quality/quantity, skin health (rashes, itching, breakouts), digestive health (gas, bloating, belching, etc), energy/fatigue, mood, headaches, stool quality/quantity (use the Bristol stool scale), blood sugar/ketone levels, weight, joint pain/stiffness, etc. For some, this is going to be a journal and pen, for others its going to be a spreadsheet, and for me, I like to use a symptom tracker app, like this one that was recently introduced to me by a client.
  3. Food Detective - this is another app, but its really a great way to determine if a food is causing inflammation for you. It tracks the components of what you eat during meals and also monitors for elevated heart rate. Its based on the Coca Pulse Test that says if, after eating, your pules increases more than 16 beats per minutes above your morning pulse, then you may have eaten something you body is having difficulty breaking down or digesting. What is nice about this app, is that you can introduce two foods at a time and in combination with pulse tracking and symptom tracking (Step 2) you can narrow in on a food sensitivity and compress the time it takes for reintroduction.
  4. Set a schedule or plan. This last step is really important. You'll want to not only prioritize, in Step 1, but also set out a plan. The rule of thumb is that you want to introduce a single food across 3 days and at varying meals, and then give yourself another 3 days of rest without the food before having it be a "permanent" addition. The rest days are important because often times the symptoms are subtle and we won't notice them until they disappear. With the addition of Food Detective, you can have an additional food item introduced across the 6 days. This allows us to test 2 foods every 6 days. Depending on the number of specific foods, you can see how this might add up to a long period of time!! Start to plan out the foods and meals you plan to use in those weeks that you reintroduce.

In the next installment of the series, I'll lay out my plan for reintroduction and which meals I will introduce those items to share that with all of you. 

Are any of you planning or doing a reintroduction phase now? Would love to hear about your experience! If you have questions, leave a comment below!