I hear this quite a bit on Autoimmune Paleo social media: "I am not feeling as good as I want on the AIP diet". Maybe you feel marginally better? Or maybe you feel quite a bit better but not as good as you want? There can be a number of reasons for this. Using an experienced practitioner is key when this situation arises.
I complied a list of what may be happening when folks go on AIP and don't feel as good as they should:
1. There is a food in the AIP diet they are sensitive to
2. Their liver detoxification pathways are not robust enough
3. Digestive function has not been restored
4. Inflammation has not been properly addressed
5. An infection that has not been diagnosed (like SIBO, virus or dental infection)
6. The Brain-Gut axis is impaired and has not been repaired
7. The Hypothalums-Pituitary axis is impaired and has not been repaired
8. Endocrine disruption in form of hormone imbalance or adrenal dysfuntion
9. Emotional/Heart component of the Autoimmunity has not been examined
10. Micro or Macro Nutrient deficiencies
11. Blood Sugar Issues are present and are related to entire endocrine system and brain function (even while Paleo!)
12. You have an undiagnosed anemia
So which way to go? Well, if someone is not or does not know how to look at lab work, and food is the only piece being examined, it is only including part of the picture. If for example you see a moderately elevated MCV (mean corpuscular volume) on lab work, how would your practitioner proceed? When might they consider sending you to a doctor to rule out pernicious anemia? What if you have undiagnosed hemachromatosis and a well meaning health coach strongly suggests adding organ meat to your diet. Would that be contraindicated? How would they tell the difference between moderate and mildly elevated liver enzyme markers? How do the role of bio-identical hormones play a negative role in autoimmune disease? Are probiotics improving function or hindering it? How long should you be on digestive support? Why look at sodium markers on routine lab work? How can memory impairment be related to Autoimmune Disease and how can it be supported? What if you go on the AIP diet (like I did for a year) and you still have Insulin Resistant Hypoglycemia? Then what?
You can eat as much liver pate and bone broth as you want but if you are not improving function or absorption, then is it useful? Liver pate may very well eliminate micronutrient lows, but does it matter if one is not addressing the impaired integrity of the intestinal mucosa? Does a low inflammatory diet alone heal the intestinal mucosa? Does bone broth with natural levels of l-glutamine repair the intestinal mucosa? What is the role of adrenal glandulars and adrenal adaptogens? Do they go together? Should they be taken apart? What about the cytokine pathways? Are they relevant? What about the role of Nitric Oxide in your autoimmune disease. Should that be addressed? If you have a high homocysteine level, should you test for the MTHFR gene? Or just take methylated folate and B-12? What if you have an autoimmune disease AND an active viral infection. What do you do then?
Above is just a sliver of the normal everyday issues I observe clinically with AIP clients. These are the extremely relevant issues that can go along with the Heart-Mind-Body issues that can be at the very root of Autoimmune Disease. These are critical questions to ask and critical questions that need to be addressed in my opinion. You can't heal the thyroid without looking at the brain. You can't heal the brain without looking at inflammation. Autoimmunity is a truly multidisciplinary approach.
There are a multitude of factors that go along with health, healing and the Autoimmune Paleo diet. Having a visionary approach not only helps you sort through the complexities of what you are facing, but helps to streamline the path to healing. Who is your team? What is their approach? How far are they willing to go to get you to where you need to go? There is a great divide in the healing world around autoimmunity. A number of practitioners are emerging that know about the Autoimmune Paleo diet and how to support your efforts and physiology while on it. But how comprehensive is their approach? I am lucky that I have had amazing training and count myself in this group of knowledgeable contributors. If you have been doing the AIP diet and you are not feeling better, or as good as you hoped, there are still stones unturned. And if diet is the only component you are exploring, perhaps there is more that could be thoughtfully examined. There are still many, many options out there for you. Don't give up. The answers are still waiting to be discovered!