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Rheumatoid Arthritis and the Autoimmune Protocol Diet


For individuals grappling with the challenges of rheumatoid arthritis (RA), an intriguing avenue of exploration revolves around dietary interventions. Amidst the quest for alternative approaches to managing RA, the Autoimmune Protocol Diet (AIP) has garnered significant attention. In this discourse, we delve into the Autoimmune Protocol Diet, its development, and its potential impact on autoimmune diseases, particularly rheumatoid arthritis.


Understanding the Autoimmune Protocol Diet (AIP)

Unveiling the AIP Diet

In the realm of autoimmune diseases, where the body inadvertently targets its own tissues, the Autoimmune Protocol Diet emerges as a beacon of hope. This dietary regimen primarily focuses on mitigating gut inflammation, a factor closely associated with autoimmune disorders. The AIP Diet, in essence, aims to rejuvenate both the immune system and the gut mucosa, thereby potentially alleviating inflammatory conditions such as rheumatoid arthritis.

AIP vs. Paleo: Navigating Dietary Territories

Is the AIP Diet a Variant of Paleo?

Discerning individuals often wonder if the Autoimmune Protocol Diet and the paleo diet are one and the same. Some even perceive AIP as an amped-up, more restrictive version of the paleo diet. The core principle underpinning the AIP Diet is the notion that autoimmune ailments stem from a condition known as "leaky gut," or altered intestinal permeability. In cases of leaky gut syndrome, food particles traverse the gut lining's minuscule fissures, triggering an immune response—albeit an exaggerated one. Here, we draw comparisons and distinctions between AIP and the paleo diet.

Origins of the Autoimmune Protocol Diet

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A Scientific Journey

The genesis of the Autoimmune Protocol Diet can be traced back to the pioneering work of Dr. Loren Cordain, who unearthed the connection between certain foods and inflammation in individuals with autoimmune disorders. Author Robb Wolf subsequently outlined this dietary approach in "The Paleo Solution," presenting it as an elimination diet. Dr. Sarah Ballantyne, also known as The Paleo Mom, further delved into the scientific foundations of the AIP Diet, documenting her findings in "The Paleo Approach." Dr. Ballantyne stands as a prominent authority on the Autoimmune Protocol Diet, having played a pivotal role in its development.

Nourishing Choices: AIP Diet Foods

What to Embrace and What to Avoid

The Autoimmune Protocol Diet offers a specific selection of foods that individuals are encouraged to include in their diets:

    • High-quality meats, preferably grass-fed, and fish.

    • A variety of vegetables, with nightshades notably absent.

    • Sweet potatoes.

    • Limited fruit consumption.

    • Coconut milk.

    • Avocado, olive, and coconut oils.

    • Dairy-free fermented foods like kombucha, sauerkraut, kefir made with coconut milk, or kimchi.

    • Small quantities of honey or maple syrup.

    • Fresh nonseed herbs, including basil, mint, or oregano.

    • Green tea and nonseed herbal teas.

    • Bone broth.

    • Vinegars.

    • Grass-fed gelatin and arrowroot starch.


Conversely, the AIP Diet strictly prohibits the following:

    • All grains, including oats, wheat, and rice.

    • Dairy products.

    • Eggs.

    • Nuts and seeds.

    • Legumes and beans.

    • Nightshade vegetables like tomatoes, potatoes, eggplants, and peppers.

    • Sugars in all forms, including alternative sweeteners such as stevia and xylitol.

    • Butter and ghee.

    • Oils other than coconut oil, olive oil, and avocado oil, which remain permissible.

    • Herbs derived from seeds.

    • Food additives and processed foods.

    • Chocolate.

    • Alcohol.

The Unresolved Question: Efficacy of AIP in RA

Seeking Clarity Amidst Uncertainty

The role of diet in addressing leaky gut and autoimmune diseases has been a subject of investigation since 2011. Notably, research has hinted at a potential link between leaky gut and the onset of autoimmune conditions. However, the landscape remains devoid of conclusive clinical studies elucidating the impact of diet on leaky gut and autoimmune diseases.

The Complex Tapestry of Rheumatoid Arthritis

Laboratory, scientist, holding a conical flask with blue fluid in it.The Science behind the Autoimmune Protocol Diet

Multiple Influences on RA

Rheumatoid arthritis is a complex malady, influenced by a multitude of genetic and environmental factors. Genetic factors, notably human leukocyte antigen (HLA) alleles, bear significant weight in risk assessment. Environmental triggers, such as smoking and infections, also play a role. Moreover, hormonal fluctuations and age-related changes in the immune system are linked to the pathogenesis of RA. Intriguingly, these factors intersect with the gut microbiome, serving as a nexus between various influences on RA development.

Diet's Impression on Gut Health and RA

An Ongoing Pursuit

Recent research has underscored the profound impact of diet on the composition of the gut microbiome and its secreted metabolites. Dysbiosis, a state characterized by an imbalanced gut microbiota, has emerged as a potential contributor to various chronic diseases, including RA. Nevertheless, the causal relationship between dysbiosis and RA remains a subject of exploration. The intricate interplay between gut health and RA poses more questions than answers, leaving us in a realm of uncertainty.

RA and Diet: A Trial-and-Error Approach

A Pathway Forward

In the realm of rheumatoid arthritis, there exists no definitive dietary regimen with proven efficacy. The influence of diet on RA remains speculative and demands a trial-and-error approach. The AIP Diet offers a structured method, involving the elimination of potentially inflammatory foods, followed by their gradual reintroduction, allowing individuals to discern their personal responses.

Encouraging Signs: AIP's Impact on Inflammatory Conditions

Insights from Limited Studies

Although concrete evidence remains elusive, glimpses of hope emerge from small-scale studies. One such study explored the effects of the autoimmune protocol diet on inflammatory bowel disease (IBD), encompassing patients with Crohn's disease and ulcerative colitis. While the study showcased promising results, including complete remission in some participants, its sample size was modest, lacked a control group, and did not employ randomization—a reminder of the complexity in assessing dietary interventions.

AIP as a Potential Adjunctive Therapy

Insights from Hashimoto's Thyroiditis

A pilot study centered on Hashimoto's thyroiditis, a prevalent autoimmune thyroid disease, provided insights into the AIP Diet's potential as an adjunctive therapy. Although no statistically significant alterations in thyroid function or antibodies were observed, the study suggested that AIP may mitigate systemic inflammation, as evidenced by reductions in average hs-CRP levels.

A Promising Avenue for IBD

Expanding the Scope

Another small-scale study, involving individuals with inflammatory bowel disease (IBD), hinted at the AIP Diet's capacity to enhance quality of life within a relatively brief timeframe, even during the initial elimination phase. Importantly, these benefits appeared independent of concurrent IBD medication usage. While promising, these findings warrant validation through more extensive, long-term research.

The Quest for Definitive Evidence

The Imperative of Rigorous Research

As interest in the Autoimmune Protocol Diet surges for inflammatory conditions, notably rheumatoid arthritis, the imperative for larger, randomized clinical trials looms large. The quest for conclusive evidence remains unfulfilled, and the intersection of diet and RA remains an enigmatic realm, awaiting further exploration.


In the world of rheumatoid arthritis management, the Autoimmune Protocol Diet beckons as a potential avenue worth traversing. While tantalizing hints of its efficacy surface from small studies, the intricate web of diet's impact on autoimmune diseases remains cloaked in uncertainty. As we navigate these uncharted waters, the call for rigorous research to bridge the knowledge gap grows ever more imperative. Until then, the Autoimmune Protocol Diet remains a promising, albeit unproven, element in the multifaceted landscape of RA management.
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