The autoimmune protocol (AIP) is a nutrition and lifestyle protocol designed to help those with autoimmune disease lower inflammation, find relief from autoimmune symptoms, improve gut health, balance hormones, maximize immune health, and more.
The nutrition protocol of the AIP is essentially an elimination diet followed by a reintroduction phase where foods are reintroduced systematically to determine which, if any, foods are triggers and may need to be eliminated permanently.
The AIP is not going to look the same for everyone, and the goal of the reintroduction phase is to find a personalized way of eating that helps those with autoimmune disease live their best life!
AIP reintroduction schedule: When is the right time to reintroduce foods?
There is no set AIP reintroduction schedule. Rather, the AIP is a template to use when adopting an individualized approach to living well with autoimmune disease.
While there are no set timelines for when to reintroduce foods on AIP, there are general guidelines that can help you to determine when the time is right for you to start the reintroduction process.
In a perfect world, you’d ideally want to wait until you feel substantial or total relief from your autoimmune symptoms before you reintroduce any foods. With that said, if you are already seeing some improvements in your health and feel ready to reintroduce some foods, you can start to try some reintroductions after 30 days of the elimination phase. Just a word of caution to try not to let cravings determine your reintroduction choices.
If you are not seeing improvements on the AIP elimination phase after 90 days or 3 months, it is usually time to work on troubleshooting or digging deeper. Working with a functional medical doctor or a nutritional therapy practitioner with AIP experience to help you personalize the AIP as well as troubleshoot can be incredibly helpful.
Remember to keep in mind the importance of bio-individuality, meaning what works best for one person will look different than what works best for another person. One person may start their reintroduction phase after just 30 days on the AIP elimination phase, while another person may need to wait longer.
How to reintroduce foods on AIP
After the elimination phase, it can be tempting to reintroduce foods all at once. However, it is important to reintroduce foods one at a time, systematically, in order to identify potential trigger foods.
Here are some guidelines to follow when reintroducing foods on the AIP:
- Pick which food you plan to reintroduce. You will eat the chosen food up to three times, then avoid it for five days.
- The first time you eat the food, only eat half a teaspoon. Wait for fifteen minutes to see if you experience any symptoms.
- If you notice any symptoms, do not eat the food again. If you do not notice any symptoms, eat one more teaspoon and wait another 15 minutes.
- If you notice any symptoms within the 15 minutes, do not eat the food again for now. If you do not notice any symptoms, eat a bigger bite of the food (about one and a half teaspoons), then wait two to three hours and watch for symptoms.
- If you notice any symptoms within two to three hours, do not eat the food again for now. If you do not notice any symptoms, eat a normal-sized portion of the food. Do not eat that food again for five days.
- Be on the lookout for any symptoms during the five days.
- Do not reintroduce any other foods during the five days.
- If you have no symptoms at all during the five days, the reintroduction is successful! You can go ahead and reincorporate this food into your diet!
- Note: just because a food fails the reintroduction process at this point does not mean you will not be able to reintroduce the food in the future (exceptions include foods that you are allergic to). You can continue to work on your healing journey, other reintroductions, and return to any previously failed reintroductions in the future.
AIP reintroduction stages
While you can decide which order to reintroduce foods, there are four recommended stages of reintroduction.
The foods in the first stage are foods that are least likely to cause a reaction, while the foods in the fourth stage are foods that are most likely to cause a reaction.
Stage 1 Reintroductions
- egg yolks
- fruit-, berry- and seed-based spices
- seed and nut oils
- ghee (from grass-fed dairy)
- occasional coffee
- cocoa or chocolate
- peas and legumes with edible pods (green beans, scarlet runner beans, sugar snap peas, snow peas, etc)
- legume sprouts
Stage 2 Reintroductions
- seeds
- nuts
- chia seeds
- coffee on a daily basis
- egg whites
- grass-fed butter
- alcohol in small quantities
Stage 3 Reintroductions
- eggplant
- sweet peppers
- paprika
- peeled potatoes
- grass-fed dairy
- lentils, split peas, and garbanzo beans (aka chickpeas)
Stage 4 Reintroductions
- chili peppers and nightshade spices
- tomatoes
- unpeeled potatoes
- alcohol in larger quantities
- gluten-free grains and pseudograins
- traditionally prepared or fermented legumes
- white rice
Symptoms to watch for in the AIP reintroduction phase
Symptoms of a reaction aren’t always obvious, so keep an eye out for any the following:
Changes in energy levels
- Reduced energy
- Fatigue
- Afternoon energy dips
- Extra energy in the evening that interferes with sleep
Cravings
- Sugar
- Fat
- Salt
- Caffeine
- Minerals from nonfood items (clay, chalk, dirt, sand)
Disrupted sleep
- Struggling to fall asleep
- Waking during the night
- Feeling unrested in the morning
Gastrointestinal symptoms
- Stomachache
- Heartburn
- Nausea
- Gas
- Bloating
- Undigested food particles in stool
- Constipation
- Diarrhea
- Change in frequency of bowel movements
Headaches
- Mild
- Migraine
Increase in mucus production
- Phlegm
- Runny nose
- Postnasal drip
Mood issues
- Mood swings
- Feeling low or depressed
- Anxiety or feeling anxious
- Low tolerance for stress
Pain
- Muscle
- Joint
- Ligament
- Tendon
Skin changes
- Acne
- Rashes
- Dry skin
- Dry hair
- Dry nails
- Little pink bumps or spots
Other
- Cough or feeling an increase in the need to clear your throat
- Itchy eye or mouth
- Lightheadedness or dizziness
- Return or worsening of any symptoms
- Sneezing
Tracking AIP reintroductions
Organizing and tracking AIP reintroductions, as well as keeping a food and symptom journal, can be incredibly beneficial when navigating the AIP reintroduction phase.
Quick tips for tracking reintroductions:
- Schedule your AIP reintroductions. Choose which foods you’d like to reintroduce this month, and calendar them in your schedule. Remember to allow at least 5 days between reintroductions. You may want to avoid scheduling new reintroductions during particularly stressful times, the days before and/or during your cycle, and during travel.
- Keep a food and symptom journal. You can use an app on your phone like Cronometer to track your food and take note of any corresponding symptoms, or you can use a handwritten journal. Record all of your food (or at the very least your reintroductions), your hydration / anything you drink, your sleep and stress levels, your movement, as well as any symptoms that you experience. Then, if and when symptoms pop up, you can look at your journal to determine if you think the symptoms were caused by the reintroduced food, an increase in stress, poor sleep, overexertion, or a combination of all of the above.
AIP reintroduction stage FAQ
I've been feeling amazing on the AIP elimination phase. Do I have to reintroduce foods?
This is your journey, and you get to decide the next steps you will be taking. The AIP is not designed to look exactly the same for each of us, and you get to design your AIP reintroduction journey.
While it can be tempting to stay on the elimination phase, there are a number of important reasons to start the reintroduction process:
- Nutrient density - A nutrient-dense diet is incredibly important for optimal health and wellness. While there are many, many nutrient-dense foods in the AIP elimination phase, there are also many that you can reintroduce in order to provide your body with additional needed nutrients. Examples include nuts, seeds, eggs, grass-fed dairy, and more.
- Variety - The reintroduction phase allows you to increase the variety of nutrient-dense foods you eat, which is not only great for cellular health, but it also helps you avoid getting bored!
- Traveling and eating out - The reintroduction phase allows you to have more options when eating out and traveling.
- Feedback - Going through the reintroduction process will give you valuable feedback about your body and your wellness journey.
I've come so far on my wellness journey that I am very afraid to reintroduce foods. I do not want to ever go back to feeling unwell. Does anyone else feel this way?
Yes, you are not alone. It is understandable and fairly common to feel fear when it comes to reintroducing foods. Many find relief from autoimmune symptoms for the first time in years during the elimination phase of the autoimmune protocol. After finally finding relief, some may not want to reintroduce foods for fear of triggering autoimmune symptoms again.
The important thing is you are mindful of your fear. With the awareness of your fear, take steps to work through it. Practice extra self-care, and be aware of stress or tension. Keep in mind that stress is a common trigger of symptoms and the increase in stress may be the culprit triggering your symptoms, rather than the reintroduced food.
Remember there is no time limit on your reintroduction phase. You can take your reintroduction phase as slowly as you need to, while you work through your fears and stress. Talk to a trusted friend or loved one. Seek professional help if needed.
Are there times when I may want to avoid reintroducing foods?
Yes! There are some instances when you may want to avoid not reintroducing new foods since it may be hard to identify the cause of a reaction. Examples include: illness, chronic lack of sleep, very stressful periods of time, or after an unusually strenuous workout.
Further, consider your motivation. Are your cravings dictating your decision to move into the reintroduction phase? If so, depending on the person, it may be a better idea to hold off on the reintroduction phase and instead, work through your cravings and emotional eating tendencies. Taking the time you need now to overcome cravings and allow your taste buds to change can set you up for longer-term success and freedom from cravings.
Do I have to reintroduce all foods in stage one before moving on to stage two reintroductions?
Not necessarily. This is your journey, and you can choose to reintroduce as many or as little foods from stage one as you’d like to before moving on to stage two, and so on. Remember, the stages are set up so you reintroduce the foods least likely to cause a reaction first. However, it is your choice how you move through the stages.
What if I know I react to a certain food(s)? Do I have to try to reintroduce those?
Nope. Again, this is your journey, and you get to decide which foods you’d like to reintroduce and in what order. Each of us is different, and you are the expert of your body. If there are foods that you have a history of a severe reaction to, you do not need to reintroduce them.
I've reacted to some reintroduced foods in stage one. Does this mean I will react to stage two foods too?
Not necessarily, but it is a possibility. If you find yourself constantly reacting to reintroduced foods in stage one, you may want to refocus on the elimination phase while continuing to improve gut health, deeper healing, and troubleshooting.
I experienced a reaction to a reintroduced food. How long should I wait before trying a different reintroduction?
It depends on your body and the severity of the reaction. Be sure to allow your body to heal and get back to your baseline before trying any new reintroductions.
In closing
Keep in mind the goal of the AIP elimination phase is to help lower inflammation, reduce symptoms, improve gut health, balance hormones, and more.
The goal of the AIP reintroduction phase is to build on the elimination phase and help you find your personalized way of eating that helps you live your best life!
It can take time and patience, but it’s worth it!
