Discover the Ultimate AIP Diet Supplements List for Optimal Health & Healing!

The Autoimmune Protocol (AIP) diet is a specialized elimination diet designed to reduce inflammation, pain, and other symptoms caused by autoimmune diseases. It aims to identify and eliminate foods that may trigger immune responses, focusing on gut health and the gut microbiome's importance in immune regulation and overall well-being. This article offers a comprehensive overview of the AIP diet, including its principles, phases, potential benefits, and a detailed list of supplements that may be considered while following the protocol.

Understanding the AIP Diet

The AIP diet is similar to the paleo diet but is typically more strict. It involves eliminating certain foods that may cause inflammation and reintroducing them gradually once symptoms improve. Many people who have followed the AIP diet report improvements in how they feel, as well as reductions in common symptoms of autoimmune disorders, such as fatigue and gut or joint pain. The AIP diet aims to reduce inflammation, pain, and other symptoms caused by autoimmune diseases, such as lupus, inflammatory bowel disease (IBD), celiac disease, and rheumatoid arthritis.

How the AIP Diet Works

A healthy immune system produces antibodies that attack foreign or harmful cells in the body. However, in people with autoimmune disorders, the immune system produces antibodies that attack healthy cells and tissues. This can result in a range of symptoms, including joint pain, fatigue, abdominal pain, diarrhea, brain fog, and tissue and nerve damage. Autoimmune diseases are thought to be caused by a variety of factors, including genetic propensity, infection, stress, inflammation, and medication use.

Some research suggests that, in susceptible individuals, damage to the gut barrier can lead to increased intestinal permeability, also known as “leaky gut,” which may trigger the development of certain autoimmune diseases. Certain foods are believed to possibly increase the gut’s permeability, thereby increasing your likelihood of leaky gut. The AIP diet focuses on eliminating these foods and replacing them with health-promoting, nutrient-dense foods that are thought to help heal the gut, and ultimately, reduce inflammation and symptoms of autoimmune diseases. It also removes certain ingredients like gluten, which may cause abnormal immune responses in susceptible individuals.

Phases of the AIP Diet

The AIP diet consists of two main phases: the elimination phase and the reintroduction phase.

The Elimination Phase

The first phase is an elimination phase that involves the removal of foods and medications believed to cause gut inflammation, imbalances between levels of good and bad bacteria in the gut, or an immune response. During this phase, foods like grains, legumes, nuts, seeds, nightshade vegetables, eggs, and dairy are completely avoided. Tobacco, alcohol, coffee, oils, food additives, refined and processed sugars, and certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) should also be avoided. Examples of NSAIDs include ibuprofen, naproxen, diclofenac, and high dose aspirin.

On the other hand, this phase encourages the consumption of fresh, nutrient-dense foods, minimally processed meat, fermented foods, and bone broth. It also emphasizes the improvement of lifestyle factors, such as stress, sleep, and physical activity. The length of the elimination phase of the diet varies, as it’s typically maintained until a person feels a noticeable reduction in symptoms. On average, most people maintain this phase for 30-90 days, but some may notice improvements as early as within the first 3 weeks.

The Reintroduction Phase

Once a measurable improvement in symptoms and overall well-being occurs, the reintroduction phase can begin. During this phase, the avoided foods are gradually reintroduced into the diet, one at a time, based on the person’s tolerance. The goal of this phase is to identify which foods contribute to a person’s symptoms and reintroduce all foods that don’t cause any symptoms while continuing to avoid those that do. This allows for the widest dietary variety a person can tolerate.

During this phase, foods should be reintroduced one at a time, allowing for a period of 5-7 days before reintroducing a different food. This allows a person enough time to notice if any of their symptoms reappear before continuing the reintroduction process. Foods that are well tolerated can be added back into the diet, while those that trigger symptoms should continue to be avoided. Keep in mind that your food tolerance may change over time. As such, you may want to repeat the reintroduction test for foods that initially failed the test every once in a while.

Step-by-Step Reintroduction Protocol

Here’s a step-by-step approach to reintroducing foods that were avoided during the elimination phase of the AIP diet.

Step 1. Choose one food to reintroduce. Plan to consume this food a few times per day on the testing day, then avoid it completely for 5-6 days.
Step 2. Eat a small amount, such as 1 teaspoon of the food, and wait 15 minutes to see if you have a reaction.
Step 3. If you experience any symptoms, end the test and avoid this food. If you have no symptoms, eat a slightly larger portion, such as 1 1/2 tablespoons, of the same food and monitor how you feel for 2-3 hours.
Step 4. If you experience any symptoms over this period, end the test and avoid this food. If no symptoms occur, eat a normal portion of the same food and avoid it for 5-6 days without reintroducing any other foods.
Step 5. If you experience no symptoms for 5-6 days, you may reincorporate the tested food into your diet, and repeat this 5-step reintroduction process with a new food.

It’s best to avoid reintroducing foods under circumstances that tend to increase inflammation and make it difficult to interpret results. These include during an infection, following a poor night’s sleep, when feeling unusually stressed, or following a strenuous workout. Additionally, it’s sometimes recommended to reintroduce foods in a particular order. For example, when reintroducing dairy, choose dairy products with the lowest lactose concentration to reintroduce first, such as ghee or fermented dairy products.

Foods to Include and Avoid on the AIP Diet

The AIP diet has strict recommendations regarding which foods to eat or avoid during its elimination phase.

Foods to Avoid

Grains: rice, wheat, oats, barley, rye, etc., as well as foods derived from them, such as pasta, bread, and breakfast cereals
Legumes: lentils, beans, peas, peanuts, etc., as well as foods derived from them, such as tofu, tempeh, mock meats, or peanut butter
Nightshade vegetables: eggplants, peppers, potatoes, tomatoes, tomatillos, etc., as well as spices derived from nightshade vegetables, such as paprika
Eggs: whole eggs, egg whites, or foods containing these ingredients
Dairy: cow’s, goat’s, or sheep’s milk, as well as foods derived from these milks, such as cream, cheese, butter, or ghee; dairy-based protein powders or other supplements should also be avoided
Nuts and seeds: all nuts and seeds and foods derived from them, such as flours, butter, or oils; also includes cocoa and seed-based spices, such as coriander, cumin, anise, fennel, fenugreek, mustard, and nutmeg
Certain beverages: alcohol and coffee
Processed vegetable oils: canola, rapeseed, corn, cottonseed, palm kernel, safflower, soybean, or sunflower oils
Refined or processed sugars: cane or beet sugar, corn syrup, brown rice syrup, and barley malt syrup; also includes sweets, soda, candy, frozen desserts, and chocolate, which may contain these ingredients
Food additives and artificial sweeteners: trans fats, food colorings, emulsifiers, and thickeners, as well as artificial sweeteners, such as stevia, mannitol, and xylitol

Some AIP protocols further recommend avoiding all fruit - both fresh or dried - during the elimination phase. Others allow the inclusion of 10-40 grams of fructose per day, which amounts to around 1-2 portions of fruit per day. Although not specified in all AIP protocols, some also suggest avoiding algae, such as spirulina or chlorella, during the elimination phase, as this type of sea vegetable may also stimulate an immune response.

Foods to Eat

Vegetables: a variety of vegetables except for nightshade vegetables and algae, which should be avoided
Fresh fruit: a variety of fresh fruit, in moderation
Tubers: sweet potatoes, taro, yams, as well as Jerusalem or Chinese artichokes
Minimally processed meat: wild game, fish, seafood, organ meat, and poultry; meats should be wild, grass-fed or pasture-raised, whenever possible
Fermented, probiotic-rich foods: nondairy-based fermented food, such as kombucha, sauerkraut, pickles, and coconut kefir; probiotic supplements may also be consumed
Minimally processed vegetable oils: olive oil, avocado oil, or coconut oil
Herbs and spices: as long as they’re not derived from a seed or a chilli pepper
Vinegars: balsamic, apple cider, and red wine vinegar, as long as they’re free of added sugars
Natural sweeteners: maple syrup and honey, in moderation
Certain teas: green and black tea at average intakes of up to 3-4 cups per day
Bone broth

Despite being allowed, some protocols further recommend that you moderate your intake of salt, saturated and omega-6 fats, natural sugars, such as honey or maple syrup, as well as coconut-based foods. Depending on the AIP protocol at hand, small amounts of fruit may also be allowed. This usually amounts to a maximum intake of 10-40 grams of fructose per day, or the equivalent of about 1-2 portions of fresh fruit. Some protocols further suggest moderating your intake of high glycemic fruits and vegetables, including dried fruit, sweet potatoes, and plantain. The glycemic index (GI) is a system used to rank foods on a scale of 0 to 100, based on how much they will increase blood sugar levels, compared with white bread. High glycemic fruits and vegetables are those ranked 70 or above on the GI scale.

AIP Diet Supplements List

One question nearly everyone asks when transitioning their diet is “Should I be taking any supplements while on the Autoimmune Protocol?”. Supplements are some of the most commonly-recommended additions to dietary and lifestyle modifications. It is important to note that while supplements can be very helpful to the healing process, often times they can be a hinderance, stall progress, and even cause flares. A lot of people think of supplements as harmless, natural compounds, unlikely to cause problems, while in reality they can be profoundly effective at affecting change, for either good or bad. Because of this, it is important to educate yourself about what is in your supplements and the reason why you are taking them.

Read also: Potential Risks of Keto

Supplements are usually (but not always) extracted vitamins, minerals, and other compounds that have nutritional qualities contained in a small, but concentrated dose. Often these compounds are isolated to their most basic structure, and are combined with fillers in a standardized dose to supplemented with the diet. Sometimes these compounds are combined (as in a multi-vitamin), sometimes they appear alone with just fillers, and other times they are composed of pure, whole-food derived ingredients (such as encapsulated freeze-dried herbs). The idea behind supplements is to provide the body with a source of nutrients or other compounds that are not available in the diet, or to provide the nutrient or compound at a dose that would be impossible to get through diet.

Do You Need Supplements on the AIP Diet?

One of the strongest arguments for the Autoimmune Protocol is that it is an incredibly nutrient-dense diet, especially when a person is eating organ meats, fish, shellfish, and a variety of vegetables. Eating this way provides all the nutrients a person needs to thrive. Beyond that, the nutrient-density is so high that the body has extra raw materials in order to regenerate and restore, which is necessary when healing from the inflammation caused by autoimmunity and chronic illness.

That being said, a good diet is only as good as it is digested. It does not matter precisely what we are eating, if we are not digesting our food properly, those components will not be properly broken down and transported to the cells that need them. For instance, eating a ton of liver may not help a person deficient in iron unless they correct the condition of low stomach acid that inhibits the digestion of iron. Many people find that supporting their digestive process with supplements in the beginning of their healing journey is more helpful than blanket supplementation of nutrients. If you suspect digestive dysfunction is at the root of your nutrient deficiencies, it is important to work with a practitioner who can help you support this process, there is no one-size-fits-all approach.

Past digestion, there are a few other reasons why people would chose to take supplements while on the Autoimmune Protocol. Some people suffer from autoimmune diseases where nutritional requirements are well known (for instance, selenium and zinc for thyroid). This does not always mean that they need supplements-it may just mean that they should make a better effort to get those nutrients from food (in the above case I would recommend eating 3-5 servings a week of fish and shellfish).

Some people take supplements, especially glandulars and herbs, to try and manage inflammation, influence the immune system, and combat stress. While this can be incredibly effective for some people, it is like playing with fire for others. If you are going to go this route, it is recommended working with a knowledgable practitioner instead of putting yourself on a protocol. For managing stress, lifestyle changes may be better than taking supplements.

How to Evaluate a Supplement Before Taking It

Before deciding to incorporate a supplement into your routine, consider these questions:

Who recommended this supplement to you? Was it your doctor or someone you met in an online forum? Be weary that there are people online who make their living off of recommending supplements to those who are sick.
What is the purpose for this supplement? Is it to correct a nutrient deficiency or is it to encourage the body to change in some way? If your adviser cannot tell you why it is necessary, this should be a red flag.
How long will you need to be on this supplement? Is it a short-term thing, or is it something you will always be dependent on?
Does this supplement contain immune stimulants? Be warned that it could impact you negatively.
Does this supplement have known side effects, drug interactions, or warnings?
Does this supplement contain ingredients that are non-AIP, or is it produced in a facility that is not allergen free?
Does this supplement contain any fillers that are unsuitable or that you have a sensitivity to?
Is this a supplement you could avoid taking by eating more of a particular food or correcting a known digestive issue?

How to Introduce a Supplement into Your Routine

It is very important, when deciding to incorporate new supplements, to introduce them slowly, one at a time (much like a food reintroduction). If you introduce too many things at once and have a negative reaction, it is impossible to pinpoint which supplement is causing the problem.

Supplements That May Be Beneficial on the AIP Diet

Given the considerations above, here are a few supplements that tend to be low-risk, well tolerated, and where the benefits outweigh the negatives.

Magnesium: Because modern farming practices have left our soils depleted, it is actually pretty difficult to get enough magnesium, even on a real-food or Autoimmune Protocol style diet. It isn’t because we aren’t eating enough magnesium-rich food, but because the nutrient isn’t there for the plants to access in the first place. My favorite type of magnesium is magnesium malate.
Fermented Cod Liver Oil (FCLO): Consider this more of a real food supplement than a traditional supplement, because it is not refined or treated in any way. While the Omega-3 fats like EPA and DHA are important for managing inflammation, most fish oils on the market are heat treated and refined, rancidifying the fats (not good!). Those who do not wish to eat organ meats or seafood like to take this brand of FCLO to make up for those lost nutrients.
Probiotics: A lot of people find that adding in a high-quality probiotic goes a long way to accelerating their healing. After all-we are all trying to heal our guts! One thing to know, is that the same probiotic that works for one person can cause symptoms in another, so it is important to start slow and not get discouraged if one does not work for you.
Vitamin D: Vitamin D stimulates your T cells and teaches your immune system not to attack your body’s own cells. Studies show that 25-100 micrograms or 1000-4000 IU is required per day.
Zinc: One of the best AIP diet, autoimmune-friendly sources of zinc is grass-fed beef.
Selenium: selenium is a vital mineral for supporting your thyroid.

Benefits of the AIP Diet

Though research on the AIP diet is limited, some evidence suggests that it may reduce inflammation and symptoms of certain autoimmune diseases.

May Help Heal a Leaky Gut

People with autoimmune diseases often have a leaky gut, and experts believe there may be a link between the inflammation they experience and the permeability of their gut. A healthy gut typically has a low permeability. This allows it to act as a good barrier and prevent food and waste remains from leaking into the bloodstream. However, a highly permeable or leaky gut allows foreign particles to crossover into the bloodstream, in turn, possibly causing inflammation.

In parallel, there’s growing evidence that the foods you eat can influence your gut’s immunity and function, and in some cases, possibly even reduce the degree of inflammation you experience. One hypothesis entertained by researchers is that by helping heal leaky gut, the AIP diet may help reduce the degree of inflammation a person experiences.

May Reduce Inflammation and Symptoms of Some Autoimmune Disorders

To date, the AIP diet has been tested in a small group of people and yielded seemingly positive results. For instance, in a recent 11-week study in 15 people with IBD on an AIP diet, participants reported experiencing significantly fewer IBD-related symptoms by the end of the study. However, no significant changes in markers of inflammation were observed. Similarly, a small study had people with IBD follow the AIP diet for 11 weeks. Participants reported significant improvements in bowel frequency, stress, and the ability to perform leisure or sport activities as early as 3 weeks into the study.

In another study, 16 women with Hashimoto’s thyroiditis, an autoimmune disorder affecting the thyroid gland, followed the AIP diet for 10 weeks. By the end of the study, inflammation and disease-related symptoms decreased by 29% and 68%, respectively. Participants also reported significant improvements in their quality of life, despite there being no significant differences in their measures of thyroid function.

Clinical Evidence for AIP Diet in Autoimmune Diseases

Elimination diets have long been used to manage diseases, including celiac disease, allergies, and inflammatory bowel disease (IBD). Regarding autoimmune diseases, the AIP diet has been implemented in organ-specific and systemic autoimmune diseases such as Hashimoto thyroiditis (HT), IBD and rheumatoid arthritis (RA), improving QoL and disease-related symptoms.

Hashimoto's Thyroiditis (HT): Two uncontrolled clinical trials concluded that patients undergoing the AIP improved and showed that the physical and emotional statuses had less malaise and enhanced general health subscales.
Inflammatory Bowel Disease (IBD): One uncontrolled trial implemented the AIP in patients with active disease for 11 weeks. Clinical remission and endoscopic improvement were documented in most patients as opposed to inflammatory markers (C-reactive protein, fecal calprotectin), which remained unaltered.
Rheumatoid Arthritis (RA): In systemic autoimmune diseases, a non-randomized, crossover trial was conducted in patients with RA, comparing QoL measures following the AIP against the usual diet.

Common Challenges and Solutions

The AIP diet is considered an elimination diet, which makes it very restrictive and potentially hard to follow for some, especially in its elimination phase. The elimination phase of this diet can also make it difficult for people to eat in social situations, such as at a restaurant or friend’s house, increasing the risk of social isolation. It’s also important to note that there’s no guarantee that this diet will reduce inflammation or disease-related symptoms in all people with autoimmune disorders.

However, those who experience a reduction in symptoms following this diet may be reticent to progress to the reintroduction phase, for fear it may bring the symptoms back. This could become problematic, as remaining in the elimination phase can make it difficult to meet your daily nutrient requirements. Therefore, remaining in this phase for too long may increase your risk of developing nutrient deficiencies, as well as poor health over time. This is why the reintroduction phase is crucial and should not be skipped. If you’re experiencing difficulties getting started with the reintroduction phase, consider reaching out to a registered dietitian or other medical professional knowledgeable about the AIP diet for personalized guidance.

Social Situations and Dining Out

Before dining out, take a look at online restaurant menus for AIP-friendly options. You can also call ahead to ask if the restaurant can accommodate special dietary requests. Look for dishes prepared with simple cooking methods such as grilling and steaming. Opt for simple dishes like grilled meats, steamed or roasted vegetables, and salads. Talk to your restaurant server and explain your dietary needs, emphasizing that you need to avoid specific ingredients. If it’s not clear on the menu, ask the server to verify with the chef which ingredients are used in dishes that you are considering.

Staying Motivated

Keep a journal to regularly track any changes in symptoms as you follow the elimination phase as well as when reintroducing foods. Document any improvements or flare-ups, including details like pain levels, digestive issues, skin changes, and energy levels. Plan regular check-ins with your healthcare provider or dietitian to help you assess progress and make any necessary adjustments. Since following the AIP diet requires quite a bit of change in your day to day routine, joining a support group can help. There are AIP support groups online that discuss meal planning tips, share recipes, and offer support for navigating challenging situations.

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