The last time we talked about nutrition, I first introduced the AIP protocol, and then discussed its elimination phase. But after eliminating all those foods, how and when should you reintroduce them? In this article, we will look at the reintroduction phase of the AIP protocol. This is my personal experience, not medical advice. I am not a doctor, and Hidradenitis Suppurativa (HS) has no definitive cure.
The Reintroduction Phase of the AIP Protocol
This phase is one of the most important for anyone exploring a change in eating habits while managing Hidradenitis Suppurativa or an autoimmune condition.
The AIP protocol is not simply a diet to follow for 30 days and then abandon in the expectation that it will produce remission.
The aim is to identify whether certain foods may need to remain outside your regular diet, except perhaps on rare occasions. This is highly individual and should ideally be explored with a qualified healthcare or nutrition professional.
This is a highly empirical and delicate phase. Just as people can respond differently to the same medication, partly because of genetic and other individual factors, responses to food can also vary.
Likewise, some of us may not tolerate certain foods well, while others may tolerate them reasonably well or notice no effects at all.
Symptoms to Track During the AIP Reintroduction Phase
Below are some symptoms you may want to track when reintroducing foods during this phase. These symptoms do not necessarily prove that a food is responsible, so seek professional guidance if you are unsure or if a reaction is severe:
- Sore joints or muscles, joint pain or stiffness, or old injuries that suddenly "reappear"
- Itchy skin, including dry skin, rashes, hives, eczema, or dandruff.
- Pimples, ingrown hairs, bumps, or spots. This can be especially relevant for those of us living with Hidradenitis Suppurativa
- Headaches, migraines, or dizziness
- Congestion, a runny nose, or allergy symptoms
- Depression, anxiety, mood changes, or increased stress
- Anything that seems to leave you feeling "switched off," such as fatigue, insomnia, or waking up with very little energy
- Digestive issues, including an upset stomach, gas, acid reflux, bloating, constipation, diarrhea, or changes in bowel habits
How Much Should I Eat to Test My Tolerance?
There are several methods and approaches you can use to work toward a careful reintroduction of foods that were initially eliminated.
Personally, I follow a cautious approach that is closer to the first method. Since I am still at the beginning of this process, however, I cannot tell you which method is best. Consider discussing food reintroduction with a qualified healthcare or nutrition professional, especially if you have a history of allergic reactions.
First Approach to Reintroduction on the AIP Protocol
The first approach involves eating the food several times during one day and then avoiding it over the following days. Here is how:
- Choose the food you want to test and plan to eat it 2-3 times during the same day
- The first time, taste a very small amount, about half a teaspoon, and wait 15 minutes
- If you notice any of the symptoms listed above, stop the test. If you do not notice any significant symptoms, continue with a small amount, about one teaspoon or a small bite. Wait 15 minutes.
- If you notice any of the symptoms listed above, stop the test. Otherwise, eat one and a half teaspoons of the food, or a slightly larger bite.
- That is all for now. Wait two to three hours and monitor your symptoms.
- If you still have not noticed any symptoms, eat a regular serving of the food, either on its own or as part of a meal.
- Do not eat that food again for 5-7 days, and do not reintroduce any other foods during that period.
- Continue monitoring your symptoms. If you have no symptoms on the day you eat the food or at any point over the next 5-7 days, you may decide, ideally with professional guidance, to add it back into your diet.
Second Approach to Reintroduction on the AIP Protocol
- Day one: eat a small amount of the food.
- Day two: eat a small amount of the same food.
- Day three: eat a moderate amount.
- Day four: make it a central part of your meal.
- Day five: take a day off, with no potential trigger foods.
- Day six: take another day off, with no potential trigger foods.
- Day seven: if you have noticed no symptoms, you may consider adding the food back into your diet. If symptoms appeared, stop and discuss them with a qualified professional.
How to Monitor the Reintroduction Phase
To keep track of the foods you reintroduce and any effects you notice, you can use a table like the one shown here, especially if you decide to follow the second method described above.
You can customize it to suit your preferences. The important thing is to know exactly which foods you ate each day.
Do not underestimate the value of keeping a record like this. It can help you and a qualified professional make more informed decisions about your diet going forward.
P.S. In the "following day" row, note any symptoms worth mentioning
Which Foods Should You Reintroduce First?
Foods should be reintroduced one at a time.
My personal preference is also to wait at least two weeks to one month before moving on to the next food. I find this especially important if a reintroduced food appears to cause problems, as the break gives my body time to settle. This timing is based on my experience, not a universal medical rule.
Below are the foods commonly grouped into reintroduction stages. The order reflects how likely they may be to cause problems within the AIP framework, but individual tolerance can vary considerably.
Stage 1: Foods Considered Less Likely to Cause Problems
- Egg yolks
- Fruit, berry, and seed-based spices
- Seed and nut oils, plus clarified butter (ghee)
- Coffee, occasionally
- Cocoa or chocolate
- Grass-fed butter
- Peas and legumes with edible pods, such as green beans and snow peas
- Legume sprouts
Stage 2: Foods Considered Somewhat More Likely to Cause Problems
- Various seeds
- Nuts
- Chia seeds
- Coffee on a daily basis
- Egg whites
Stage 3: Foods Considered Moderately to Highly Likely to Cause Problems
- Eggplants
- Sweet peppers
- Paprika
- Well-peeled potatoes
- Grass-fed dairy products
- Lentils and chickpeas
Stage 4: Foods Considered More Likely to Cause Problems
- Chili peppers
- Spices derived from nightshades
- Tomatoes
- Unpeeled potatoes
- Large amounts of alcohol
- Gluten-free grains and pseudograins
- Traditionally prepared or fermented legumes
- White rice
Do I Have to Follow This Order?
The order above is only a guide. It reflects the suggested likelihood that certain foods may cause problems within the AIP framework, not a guarantee that they will affect everyone in the same way.
You do not have to follow this exact order. Reintroduction can be adapted to your preferences and needs, ideally with qualified guidance.
Also, if you do not tolerate a food from Stage 1, that does NOT mean you will necessarily have problems reintroducing foods from Stages 2, 3, or even 4.
The key is to proceed carefully, keep good records, and seek professional support when needed. Your responses are individual, and no single dietary protocol works for everyone.
Reader comments (0)