the autoimmune wellness handbook: a diy guide to living well with chronic illness
TRANSCRIPT
PRAISEFOR
TheAutoimmuneWellnessHandbook
“Packedtothegillswithapplicablesolutions,TheAutoimmuneWellnessHandbookismynewfavoriteresourcefortoday’s#1emerginghealthchallenge.Ifyouoralovedonesuffersfromautoimmunityandaren’tsurewheretobegin—STARTHERE.”
—RussCrandall,NewYorkTimes-bestsellingauthorofPaleoTakeoutandTheAncestralTable
“Itisnormaltomeetanautoimmunediagnosiswithatremendoussenseofconfusion,loss,andbetrayal,andtheinformationoverwhelmcanleavetheinitiatetumblinginitswake.ThisiswhereMickeyandAngie’sbookcomesin.TheAutoimmuneWellnessHandbookisanelegantandencouragingguidethatnotonlysuccinctlyreviewsthenutsandboltsofautoimmunediseasemanagementbutalsoleadsyouthroughanoftentumultuousinnerjourneywithlovingwisdom.Initsownunforgivingway,autoimmunediseasesforceustohonorhumandesign,notsociety’s(oftenshaming)version.Theautoimmunepatientmustlearntorest,self-advocate,loveandbeloved,self-nourish,moveappropriately,releasetoxicpeopleandsituations,andlifttheveilonburiedshadows.Likealloflife’sbestrewards,autoimmunemanagementishard-won.But,asthishandbookshowsyou,theautoimmunejourneycanalsobeanenrichingpathtoamoreauthenticyou.”
—DatisKharrazian,authorofWhyDoIStillHaveThyroidSymptoms?andWhyIsn’tMyBrainWorking?
“TheAutoimmuneWellnessHandbookoffersapowerful—yetsafeanddrug-free—approachtothemillionsofpeoplenowsufferingfromautoimmunediseases.MickeyandAngierecognizethatdietisthethecornerstoneofmanagingautoimmunedisease,buttheyalsoknowthatstressmanagement,sleep,pleasure,andlivingarichandrewardinglifecanbejustasimportant.Ican’trecommendthisbookhighlyenough.”
—ChrisKresser,MS,LAc,NewYorkTimesbestsellingauthorofYourPersonalPaleoCode
“WhenIthinkofaguidebook,Ithinkofafishingguide,atravelguide,astudyguide…abookthatshowsmethewaytodosomething.Asthetitlelists,TheAutoimmuneWellnessHandbookisado-it-yourselfguidetolivingwellwithchronicillness.Iwouldtakeexceptiontothistitle.AsIreadthisbook,Ifoundittobenotonlyamasterfullywrittenguidebutmuchmore.It’smorethanajournalandpersonalinside-scoopoftwopeoplewhohavefoundthepathbacktohealth.Thisbookisinacategoryofitsown.
“It’snotjustaguide;it’smoreofahealthmissal-abookcontainingallinstructionsandtextsnecessaryforthecelebrationoflifewhenaddressingachronicillness.
“Inmyopinion,they’vefoundtherightpathbacktohealththathasthepotentialtohelphundredsofthousands.Readthisbookandyouwillunderstandwhatittakestoputadiseaseintoremissionandkeepitthere.ThankyoutoMickeyTrescottandAngieAltforthisinspiringroadmaptolivingwellinthistoxicworldwehaveinherited.”
—TomO’Bryan,DC,CCN,DACBN
“Anautoimmunediagnosiscanknockourworldonitsside,leavingushurting,scared,andconfused.Thisbookisaguidethroughthatdarkness,backintothelightagain.MickeyandAngiehavewalkedthispaththemselvesandhelpedthousandsofothersdothesame.They’vetakenalloftheirpersonalexperienceandprofessionalknowledgeandcreatedathoroughworkbookforcreatingahealthy,vital,joyfullifeagain.Ourstorydoesn’thavetostopwithourdiagnosis.Inmanyways,it’sanewbeginning.”
—EileenLaird,authorofTheSimpleGuidetothePaleoAutoimmuneProtocol
“MickeyandAngiehavecreatedsomethingwonderful:anunapologeticallyempoweringguidetoeverythingautoimmunethatletsyouknowyou’renotalone.TheAutoimmuneWellnessHandbookisatruecompanion,friend,andadvocateforanyonewantingtolivevibrantlyinthefaceofautoimmunedisease.”
—RachaelBryant,authorofNourish:ThePaleoHealingCookbook
Contents
INTRODUCTION
THEMANIFESTO
CHAPTER1Inform
CHAPTER2Collaborate
CHAPTER3Nourish
CHAPTER4Rest
CHAPTER5Breathe
CHAPTER6Move
CHAPTER7Connect
CHAPTER8Recipes+MealPlan
CHAPTER9LifestyleGuide+Exercises
CONCLUSIONPuttingItAllTogether
GRATITUDE
RESOURCES
REFERENCES
Introduction
Mostpeople’sautoimmunestoriesstartthesameway,withatrickleofstrange,seeminglydisconnectedsymptoms—thingslikeincreasingfatigue,jointpain,ormorefrequentheadaches.Intime,thetricklebecomesasteadystreamthatexistsasbackgroundnoiseinourdailylives.Afterrepeatedanddesperateattemptstoexplainthesymptomstodismissivedoctors,mostofusresolvetosilentlysuffer.Later,thesteadystreambecomesanundeniableflood,andwithitcomesthesensationthatyouaredrowninginanunnamedillness.Atthislatestage,doctorsmayfinallyhaveadiagnosis,butfollow-up,ifitisevenoffered,consistsoflimitedtreatmentoptionswithdisablingsideeffects.Feelinghopelessanddemoralizedisstandardforthosewithautoimmunedisease,anditisprobablywhyyouhavethisbookinyourhandsrightnow.Ifyoufollowtheconventionalapproach,livingwellwithautoimmunediseaseisrarelyachievable.
Weareproposinganalternatewayofthinkingaboutautoimmunediseaseandhealthcareingeneral:patient-centered,guidedbyself-discovery,informed,andproactive.Thisisastarkcontrasttothetypicalexperiencethatleavespatientsfeelingfearful,anxious,anddemeaned.Inordertolivewellwithchronicillness,youneedtobecomeanewkindofpatient,onewhoissavvyenoughtoknowthatawhole-bodyapproachisnecessary.Youcanredefinetheprocessbyempoweringandinformingyourself,combiningthebestofmedicalcarewithdietaryandlifestylemodifications.Despitethecurrentstandardofcare,itispossibletolivevibrantlyinthefaceofautoimmunedisease!Withfiveautoimmunediseasesbetweenus,thisisexactlytheprocesswe,the
authors,haveusedinourownliveswithastoundingresults.Throughyearsofexperience,wehaverefinedthetoolsandresourcesweusedandaimtosharethatknowledgewithyou,someonewhoisreadytotakepersonalresponsibilityforyourhealthandwellness.Butwheredoyoustart?TheAutoimmuneWellnessHandbookencompassessevenkeystepsonthe
autoimmunepath:inform,collaborate,nourish,rest,breathe,move,andconnect.Theseverbselegantlydescribethesimpleactionsthatyoucantaketoachievewellness,despiteautoimmunedisease.Thisbookisaboutdemystifyingandbreakingdownwhatcanbeaverycomplex,overwhelming,andisolatingprocess,andreplacingitwithonethatisclearandliberating.Throughtheuseofpracticaltools,resources,andself-assessments,youcanbeginyourownjourneyofrecoverybysettingyourselfupforsuccess.
First,you’llinformyourselfbydeterminingwhereonthespectrumofillnessyoulie.You’llrecognizetheimportanceofdiagnosisandeducateyourselfaboutyourautoimmunedisease,includingtesting,treatmentoptions,andprognosis.You’llthenlearnhowtocollaborate,educatingyourselfonthedifferencebetweennaturalandconventionalapproaches,aswellashowtoassembleyourhealth-careteam.You’llgoontoprioritizeeachstepofyourjourney,includinghowtoapproachyourownmedicalsituation,andidentifywhenmedications,treatments,andsurgeryarenecessary.Onceyoucompletethestepsofinformingandcollaborating,youmoveontoa
centralpartoftheprocess,inwhichyounourishyourbodyinordertorecoverfromautoimmunedisease.Here,you’lldiscovertherelationshipoftheguttoautoimmunedisease,whythereisnoone-size-fits-allapproachtodiet,andwhyaneliminationandreintroductionprotocol,intheformoftheAutoimmuneProtocol,isthebestplacetostarttogettotherootoffood-drivensymptoms.We’llshowyouhowtotransitionyourdiet,howtoexplorefoodreintroductions,andwhybalancematterswhenapproachingwhat’sonyourplate.Continuingyourjourney,you’llputthepiecestogetherandgrasphowtotruly
restandbreathe.Detailswillbeuncoveredaboutwhysleepandstressmanagementmatter.Inthenextsection,you’lllearnhowtooptimallymove,withassessmentsdesignedtopinpointifyouareunder-oroverdoingactivitiesandhowtocomeupwithaplanthatsupportsyourgoals.Totieitup,you’llconnect,bothwithothersandthenaturalworld.Thissectionofthehealingjourneyisoftenoverlooked,butyouwilllearnwhyitisacrucialpartofrecovery.Asmuchaswe’dliketogiveyoualltheanswers,whatwehavefoundisthat
thereisnostandardformula.Self-discoveryandindividualityarethemissingingredientsinmostgurus’schemes.Instead,wearepresentingahandbookforuncoveringsolutionsthatwillbespecifictoyouruniquehealingjourney.AsBruceLeefamouslysaid,“Absorbwhatisuseful,discardwhatisuseless,addwhatisessentiallyyourown.”Weareadvocatingawaytotakethebestofabrokensystemandcombineitwithself-empowerment.Thepathwearesuggestingischallenging,butalsorewarding;byfollowingit,youwillfindatruesenseofbalanceandallowthejoyofdiscoverytotransformyourlife.TheAutoimmuneWellnessHandbookcombinesknowledgewithactionand
pioneersanewerainhowautoimmunediseasesareviewedandtreated.Youcanjoinusbytakingownershipofthisphaseofyourlife.Fromparticipatinginyourmedicalcaretodecidingwhatisonyourplate,empowermentcanguideyoutomakethechoicesthatsparktruehealth.Thetideisalreadyturning,theshiftisunderway—whatyoustandtogainfromthisbookisvibranthealththatwill
outlastthehype!
WHYWEWROTETHISBOOKLivingwellwithautoimmunediseasecanseemdauntingordownrightimpossible,butourhealingstoriesproveotherwise.Likeyou,we’vealsobeenatthebaseofthismountaingazingatthepinnacleandwonderingifthereisaroutetothetop.Whilewecoachpeoplethroughrecoveryusingdietandlifestyleinourprofessionallives,itisactuallyourpersonaljourneysaspatientsthatbreatheheartintothisbook.We’vebeeninyourshoeswithautoimmunedisease,andfirst,we’dliketosharehowourexperiencesinspiredthisuniqueapproach.Ourownpathstodiagnosiswerelongandcomplex.Afterexperiencing
troublingsymptoms,Mickeyworkedwithfivedifferentdoctors(allofwhomtoldhereverythingwas“normal”)beforegettingherprimarydiagnosisofHashimoto’sthyroiditis.Angiedevelopedsymptoms11yearsbeforeherprimarydiagnosisofceliacdisease.IttookdoctorsonthreecontinentsandeventuallysomeofthemostadvancedmedicalcentersintheUnitedStatestogetananswer.Sadly,theserunaroundsareoftenthenormforautoimmunepatients.Eventhoughgettingadiagnosishelpedusunderstandwhatwasgoingonin
ourbodies,itdidn’tchangetheseverityofthesymptomswewereexperiencing.Mickeywasundergoingamajorhealthcrisisandwasnolongerabletowork.Shewasdealingwithunrelentingfatigue,brainfog,dizziness,vertigo,insomnia,neuropathy,andjointpain.Angiewassoillthatherfamilyhadtorelocatefromtheirdreampositionoverseas.She,too,wasunabletoworkanddroppedoutofschoolbecauseshewasexperiencingsymptomslikenumbnessalloverherbody,slurredspeech,anxiety,panicattacks,musclewasting,andextremebonepain.Thesesymptomswerepowerfulmotivatorsforusbothtoseekdeeperanswers.Wecametotherealization,onourown,thatwehadtorelyonourselvestocomeupwithamorecomprehensiverecoveryplan.Atthetime,webothfeltisolated,defeated,andoverwhelmedlookingatthe
roadbeforeus.Throughsearchingonline,wediscoveredtheAutoimmuneProtocol,andinourdesperation,becametwoofthefirstpeopletotryit.Oncewestartedmakingdietarychanges,itwasclearalmostimmediatelythatthiswasgoingtobeapowerfulcomponenttohealing,andwebothstartedbloggingaboutthoseearly“wins.”Later,wediscoveredthatrecoverywasnotonlyaboutfoodbutalsoitneededtoinvolvecollaborationwithourhealth-careteamsandadoptingahealinglifestyle.Throughfindingtherightcombinationofconventional,natural,andDIYapproaches,implementedgraduallyoverthecourseof4years,bothofushavecompletelyregainedourhealthandhappinessandareabletolivefull,vibrantlives.We’vehadachancetolookbackonallthethingswetried:whatworked,
We’vehadachancetolookbackonallthethingswetried:whatworked,whatdidn’t,andwhatwewishedwehadknownsooner.Now,wegetoutofbedeverymorningwithonethingonourminds,“HowamIgoingtomakethiseasierforthenextperson?”Thewayweviewandtreatautoimmunediseaseinthiscountryandallaroundtheworldisundergoingarevolution,andyoucanbepartofit!Wewrotethisbooktoputtheinnovativetoolsweuseinyourhandsandtoconvinceyouthatlivingwellwithautoimmunediseaseismorethanapossibility—itcanbeyourfuture,too.
OUREXPERIENCEIfwechronicledallofthedetailsofourjourneys,itwouldbeawholeseparatebook!Instead,we’vedecidedtogiveyouglimpsesintoourexperiencesthroughtheseboxesinrelevantareasthroughoutthebook.Itisourhopethatthroughhonest,opensharing,wecanhelpyoufeellessaloneinthisprocess,providearealisticlensforviewingautoimmunewellness,andhelpyourecognizethatthisapproachwasnotalwayssimpleoreasyforus.
TheManifesto
You’reabouttogetintothedetailsandbeginapplyingtheprincipleswelayoutinthisbook.Beforewegothere,perspectiveonthelargerhealthmovementyouareabouttojoincanprovideawelcomesenseofcommunityandmotivationbeforeyouembark.
1. TRUSTYOURINTUITION.Youdon’tneedagurutonavigatethisprocesssuccessfully.
2. EMBRACETHETEMPLATE.TheAutoimmuneProtocolisnotone-size-fits-all;it’satemplatethatpromotesindividualityandself-discovery.
3. INFORMATIONISPOWER.Learnenoughtobeaninformedandproactiveadvocateforyourhealth.
4. STARTSIMPLE.Beginwiththefoundationsofdiet,sleep,stressmanagement,movement,andrelationshipsbeforedelvingdeeper.
5. TAKEITSLOW.Don’tbeafraidtomakechangesinphases—itwasthetortoiseandnottheharethatwontherace!
6. FOODISYOURFRIEND.Itprovidesnourishmenttoeverysinglecellinyourbody!
7. SETYOURSELFUPFORSUCCESS.Planningandpreparationarethekeys.
8. BEANUTRIENTSEEKER.Don’tignorethefoodsthatacceleratehealingandrestorehealth.
9. FOODOVERSUPPLEMENTS.Nutrientsareoftensynergisticandmorepotentinnature’spackaging.
10. DON’TDIET“HARDER.”Resistthetemptationtofurtherrestrictinsteadoftroubleshoot.
11. SEEKHELP.Whennecessary,thoughtfullyaddpractitionerstoyourteamwhodon’tundermineyourauthority.
12. TEST,DON’TGUESS.Alwaysusetestingtorevealrootissues,ifprogressisnotasexpected.
13. BESKEPTICAL.“Magicbullets”thatonlytheelitecanaffordarenotthesolutiontoourhealth-carecrisis.
14. STRIVEFORBALANCE.Restoringyourhealthisaworthypursuit,butitisnotareligion.
15. SUPPORTISCRUCIAL.Ifyournetworksaren’tstrongenough,explorewaystoaddtoyourhumanconnections.
16. REFRAMETHENEGATIVES.Findareaswhereyourlifehasbeenexpandedbyyourexperiencewithillness.
17. PRACTICEGRATITUDE.Givethoughtenergytowhatisgoodinyourlife.
18. KEEPYOUREYESONYOUROWNJOURNEY.Thepathtowellnessisuniqueforallofus.Resisttheurgetocompare.
19. HEALTHBEFOREIMAGE.Valuewellnessabovenumbersonascaleorreflectionsinamirror.
20. VIBRANTHEALTHISALIFELONGJOURNEY.Nobodyeverregretsinvestinginhisorherownwellness.Enjoytheprocessofrestoringyourhealth!
CHAPTER1
Inform
“Nothinginlifeistobefeared,itisonlytobeunderstood.”—MARIE
CURIE
Thefirststeptolivingwellwithautoimmunediseaseisbeinginformedaboutyourillness.Wehavechosenthisasthefirststep,becausetheburdenoftrulyunderstandinglieswithyou.Althoughthereisalotofinformationtobegainedinworkingwithaskilleddoctor,relyingonhimorhertoalsobeyourteacherdetractsfromyourpersonalresponsibilityinhealing.Youmayfindlearningthedetailsaboutyourdiseasetobeunnerving,becauseknowingmakesithardtohidefromyournewreality.Aftertheinitialfearsubsides,understandinginspiresalevelofcourageyoupreviouslydidn’thaveandempowersyoutotakecontrolofyourhealthandstartonthepathtowardhealing.Inthischapter,weaimtogiveyouanoverviewofwhatautoimmunediseaseis,howtogetandcopewithadiagnosis,thedifferenttreatmentsyoumightexpect,andhowtogatherandstoreinformation.
WHATISAUTOIMMUNEDISEASE?Simplyput,autoimmunediseaseoccurswhenyourimmunesystem,whichisdesignedtoprotectyoufromforeigninvaders(pathogenslikevirusesandbacteria),startsattackingyourowntissue.Thisisdonethroughthecreationofantibodies,whichareordinarilyusedtoidentifyanddestroypathogensandhelpyourecoverfromanillness.Inthecaseofautoimmunity,however,theseantibodiestargetyourownhealthytissue,whichleadstoinflammationanddestructionofyourcells.Thisislikeyourownteamplayingagainstyou—notfair!TheAmericanAutoimmuneRelatedDiseasesAssociation(AARDA)
estimatesthatmorethan50millionAmericans(roughly1in6)sufferfromautoimmunediseases,75percentofwhicharewomen.Medicalsciencehasidentifiedmorethan100autoimmunediseases,withanother40suspectedtohaveanautoimmunecomponent.Autoimmunediseaseisoneofthemostsignificanthealth-careissuesfacingourworldtoday.AccordingtotheAARDA,
intheUnitedStatesalone,morethan$100billionisspentannuallyontheconventionaltreatmentofthiscondition.Itsincidenceisontherise,withsomediseaseprevalencetriplinginthelastdecade.Itremainspoorlyunderstood,withnomedicalspecialtytosupportitandaseverelackofresearchfunding,aswellastreatmentoptionsthatonlymanagesymptoms,butdonotproducelastingwellness.Autoimmunediseasecaninvolveanyorganorsysteminyourbody,including
joint,skin,digestive,hormonal,connective,nerve,andmuscletissues.Ifyouhaverheumatoidarthritis,yourjointsareaffected;ifyouhaveHashimoto’sthyroiditis,it’syourthyroid;andifit’smultiplesclerosis,themyelin,theprotectivelayeraroundyournerves,isdestroyed.Whileitmayseemthattheseconditionsarevastlydifferent,thecommonthreadofanimmunesystemgonehaywirelinksthemtogether.Often,autoimmunediseaseaffectsmultipleorgansorsystems,whichcancrossmedicalspecialtiesandmakegettingpropertreatmentextremelydifficult.Someautoimmunediseasescausechronic,consistentsymptoms,whileothers
arecharacterizedbyperiodsofremission(littleornodiseaseactivity)andflare(morediseaseactivity).Autoimmunediseasescommonlypresentwithnonspecificsymptomslikepainandfatigue,whicharenoteasilyidentifiedwithaparticularconditionandmakediagnosisdifficult.Symptomscanalsovarywidelyfrompersontoperson,makingacorrectdiagnosistoughtonaildown.Thesymptomsofautoimmunediseasecanrangefromlife-threateningand
serious,renderingapatientinneedofround-the-clockcare,toamildannoyancethatbarelydisruptsaperson’slife.Mostofus,however,fallinthemiddleofthespectrum—welivewithchronicsymptomsthatimpactourproductivityandabilities,yetourhealth-careprovidersandthoseinoursupportnetworkoftendon’tunderstandandareunabletoprovidelastingrelief.Ifyouhaveanautoimmunedisease,it’slikelyyouwillfindthediagnosis
processandtreatmentoptionschallenging,atbest.Thereisnomedicalspecialtyfocusingonautoimmunediseaseingeneral.Asapatient,youaretreatedbyaspecialistfocusedontheorganorsysteminvolvedinthecondition,ratherthanyourwholebody.Ifyouarefeelingisolatedandlackingsupport,youarenotalone—manyofushavefeltthisway.Ifwehaveyouworried,it’snotalldoomandgloom!Therearewaysofusingtheconventionalsystemtoyouradvantageandtoolsatyourdisposalforlivingwelldespiteautoimmunedisease.
WHATTYPESOFAUTOIMMUNEDISEASESARETHERE?Autoimmunediseasesareusuallyclassifiedintotwocategories.Thereareorgan-
specificdiseases,likeHashimoto’sthyroiditis(whichaffectsthethyroidgland)andtype1diabetes(whichaffectsthepancreas)andnon-organ-specificdiseases,likerheumatoidarthritis(whichaffectsthejoints)andlupus(whichaffectsconnectivetissue).Themostcommonlyaffectedorgansarethoseoftheendocrinesystem,suchasthethyroid,pancreas,andadrenalglands.Themostcommonlyaffectednon-organtissuesarethoseoftheblood,likeredbloodcells,orconnectivetissue,likemusclesandjoints.Somediseasesseemtooccurbetweenthetwotypesandsomepeoplemayexperienceseveralautoimmunediseasesatthesametime.Additionally,manyautoimmunediseasescommonlycoexistwithothers,forexampleceliacdiseaseandHashimoto’sthyroiditis.Ifyouhavethreeormoreautoimmunediseases,youhavemultipleautoimmunesyndrome.Theautoimmuneprocessitselfcanalsotakedifferentforms.Specificcellsor
tissuesmightsteadilybedamaged,anorganmightgrowexcessivelylarge,orthefunctionofanorganmaybedisturbed.Somediseasesarelifethreatening,othersaredisabling,andstillothers,iftheyarerecognizedearly,canbesuccessfullytreatedormanagedrelativelyeasily.
WHATARETHERISKSFORANDCAUSESOFAUTOIMMUNEDISEASE?AutoimmunediseaseaffectsmillionsofAmericansandmanymorepeopleworldwide,butthereareparticulargroupswhoaremostatrisk.Inaddition,researchhasidentifiedthreecontributingfactorsthatinteractwitheachotherto
researchhasidentifiedthreecontributingfactorsthatinteractwitheachothertocausethedevelopmentofautoimmunedisease.
1.GENETICS—Thegenesyouinheritfromyourparentsplayapartindeterminingyourpredispositionfordevelopinganautoimmunedisease,andbecauseofthis,itisverycommonforthemtoruninfamilies.Forinstance,theincidenceofceliacdiseaseinthegeneralpopulationis1in100people,whiletheincidenceinthosewithafirst-degreefamilymemberwhohasit,likeparents,siblings,orchildren,is1in22.Unlikegeneticdiseases,however,whereoneortwogenemutationsare
responsibleforthedisease,therearecountlessgenesthataffectyourriskforautoimmunedisease.Insteadofinheritingonespecificautoimmunegene,youinheritalargercollectionthatputsyouatriskfordevelopinganautoimmunedisease.Thismayplaceyouatmoreorlessriskforcertaindiseasesanditiswhyspecificdiseasesarenotalwaysinheritedinfamilies,butmanymembersofthesamefamilysufferfromdifferentrelatedautoimmunediseases.Forinstance,yourmommayhavetype1diabetes,whileyouraunthasCrohn’s,andyoursisterhasHashimoto’sthyroiditis.Similarly,thosewhoalreadyhaveanautoimmunediseaseareatahigherriskfordevelopingadditionaldiseases,becausetheymostlikelyhaveacquiredthecollectionofgenesthatpredisposesthemtoautoimmunedisease.Disproportionately1ofthegreatestriskfactorsisgender,withfemales
makingup75percentofthediagnosedautoimmunepopulation,mostlikelybecauseofthehormonaldifferencesbetweenthesexes.Yourethnicityisalsoafactor.African-Americans,NativeAmericans,andLatinosareatagreaterriskthanCaucasians.
2.ENVIRONMENTALTRIGGERS—Althoughitcanbehandytoblameautoimmunediseaseallongenetics,itonlyaccountsforaboutone-thirdofyourriskofdevelopingone.Itisoftensaidthatwhilegenesloadthegun,environmentpullsthetrigger.Pathogens,chemicals,andsubstancesyourimmunesystemisexposedtoinyourdailylifecanhaveanimpactonwhetherornotyoudevelopanautoimmunedisease.Certainbacterialandviralinfections,bothacuteandchronic,havebeenlinked
tothedevelopmentofautoimmunity—mostlikelybecausetheycontainproteinsthatcloselyresembleyourown,confusingtheimmunesystem.Exposuretotoxinsandchemicalscansimilarlytriggerautoimmunity.Youareexposedtothesecomponentsthroughpollution,thewatersupply,pesticidesandherbicidesinfoods,cleaningproducts,personal-careproducts,chemicalexposureinyourhomeorinyourworkplace,andmore.
homeorinyourworkplace,andmore.
3.DIETANDLIFESTYLE—Apoordietcontributestothedevelopmentofautoimmunediseasebyexacerbatingintestinalpermeability,creatingnutrientdeficiencies,andoveractivatingtheimmunesystem.Similarly,sleepissues,lackofmovement,anddrugexposure,bothprescriptionandrecreational,canalsoincreaseyourriskofdevelopingautoimmunedisease.Stressalsoplaysanimportantpartintheautoimmunediseaseprocess.People
experiencingacuteandunmanagedstressorchronicstressareoftenathigherriskfordevelopingautoimmunedisease.Finally,yourgeographiclocationmayplayarole.Forexample,intheUnited
States,ithasbeenshownthatthoselivinginthePacificNorthwesthaveahigherincidenceofcertainautoimmunediseases,whichmaybeinpartduetolackofnaturalsunlightathigherlatitudes,contributingtovitaminDdeficiency.Whileyoucan’tdomuchaboutyourgeneticinheritanceandexposureto
infectiousdisease,youcandosomethingaboutmanagingyourdietaryandlifestylechoices,aswellaslimitingyourcontactwithtoxinsandchemicals,andwe’llgetintothisinmoredepthinChapters3and6.
DOESHAVINGONEAUTOIMMUNEDISEASEPUTYOUATRISKFORDEVELOPINGOTHERS?Roughly25percentofthoseofuswith1autoimmunediseasewillgoontodevelopadditionalautoimmunediseases.Having3ormorediagnosedautoimmunediseasesisclassifiedasmultipleautoimmunesyndrome(MAS).Thissyndromeusuallyincludesoneskindisorder,suchaspsoriasisorvitiligo.Awarenessoftheautoimmunediseasesrelatedtoyourcurrentdiagnosiscanbehelpfulifsignsofnewdiseasesbecomeapparent,asitcanmakethesenewdiagnoseseasierforhealth-careprovidersbypointingthemtowardlikelydisordersandallowingforearlieridentificationofmultipleautoimmunesyndrome.Forinstance,celiacdiseaseisassociatedwithtype1diabetes,Hashimoto’sthyroiditis,Graves’disease,andAddison’sdisease.Delayindiagnosisallowsmoretimeforfurtherautoimmunediseasestodevelop,whichisasecondreasonthatawarenessofMASissoimportant.
Ihavemultipleautoimmunesyndrome(MAS),whichisdefinedashavingthreeormorediagnosedautoimmunediseases.Mineareceliacdisease,endometriosis,andlichensclerosus.Lichensclerosus(LS)isanautoimmuneskincondition,andduetoitsnature
sclerosus.Lichensclerosus(LS)isanautoimmuneskincondition,andduetoitsnature(affectingthegenitalsandcausingdiscomfort,tearing,andbruisingoftheskin),mostsufferersareincrediblyprivateabouttheirdiagnosis.WhenIreceivedmine,Ihadnoideathatitwasanautoimmunedisease,thatmyrisksofdevelopingfurtherautoimmunediseaseswereheightened,orthatMASexistedandhowitoftenincludesaskincondition.LSwasmyveryfirstautoimmunediagnosis,andIlearnedaboutitmanyyearsbeforemynext.HadIunderstoodandbeenfullyinformed,perhapsIcouldhavetakenmorepreventativemeasuresinmyhealthcareorproactivelyadvocatedformyselfwithdoctorsinordertobevigilantaboutdevelopingnewdiseases.Imighthaveevendiscoveredthenewdiseasesmorequickly,ifIhadbeenabletopointoutmyexistingconditionasautoimmuneandhelpdirectmydoctor’ssuspicionsasIgrewmoreillwithautoimmunedisease.IdecidedseveralyearsagotobeginspeakingaboutLSpubliclyinthehopethatotherswouldfeellessashamedinseekingtreatmentforskinconditions,evenonesthatweredifficulttoreveal,inordertocatchdiseaseprogressionearlyandpossiblypreventgoingontodevelopadditionalautoimmunediseases.
ListofConfirmedAutoimmune,SuspectedAutoimmune,andAutoimmune-RelatedConditionsWhilesomediseaseshaveaclearautoimmunecomponent,manyaresuspectedtohaveanautoimmunecomponent,andinsomecases,thathasyettobeproven.Otherconditionsareknowntobepathogenicinorigin,buttheinitialinfectioncantriggeranautoimmuneresponse(suchasLymeorChagasdisease).We’vecompiledthislisttoincludeallconditionsontheautoimmunespectrumrangingfromspecificallyautoimmunetothosethataresuspectedtobeautoimmuneinnature.
Acutedisseminatedencephalomyelitis(ADEM)
Acutenecrotizinghemorrhagicleukoencephalitis(AHL)
Addison’sdisease
Agammaglobulinemia
Alopeciaareata(AA)
Amyloidosis
Ankylosingspondylitis
Anti-GBM/Anti-TBMnephritis
Antiphospholipidsyndrome(APS)
Autoimmuneangioedema
Autoimmuneaplasticanemia
Autoimmunedysautonomia
Autoimmunehemolyticanemia(AIHA)
Autoimmunehepatitis(AIH)
Autoimmunehyperlipidemia(AIH)
Autoimmunehyperlipidemia(AIH)
Autoimmuneimmunodeficiency
Autoimmuneinnereardisease(AIED)
Autoimmunemyocarditis
Autoimmuneoophoritis
Autoimmunepancreatitis(AIP)
Autoimmuneretinopathy(AIR)
Autoimmunethrombocytopenicpurpura(ATP)
Autoimmuneurticaria
Axonalandneuronalneuropathies
Balodisease
Behcet’sdisease
Bullouspemphigoid
Castleman’sdisease(CD)
Celiacdisease
Chagasdisease
Chronicinflammatorydemyelinatingpolyneuropathy(CIDP)
Chronicrecurrentmultifocalosteomyelitis(CRMO)
Churg-Strausssyndrome(CSS)
Cicatricialpemphigoid/benignmucosalpemphigoid(MMP)
Cogansyndrome
Coldagglutinindisease
Congenitalheartblock
Coxsackiemyocarditis
CRESTsyndrome
Crohn’sdisease
Dermatitisherpetiformis(DH)
Dermatomyositis(DM)
Devic’sdisease/neuromyelitisoptica(NMO)
Discoidlupus
Dressler’ssyndrome
Endometriosis
Eosinophilicesophagitis(EoE)
Eosinophilicfasciitis(EF)
Erythemanodosum(EN)
Essentialmixedcryoglobulinemia
Essentialmixedcryoglobulinemia
Evanssyndrome
Experimentalallergicencephalomyelitis(AEA)
Fibrosingalveolitis
Giantcellarteritis/temporalarteritis(GCA)
Giantcellmyocarditis
Glomerulonephritis
Goodpasturesyndrome
Granulomatosiswithpolyangiitis(GPA)(formerlycalledWegener’sgranulomatosis)
Graves’disease
Guillain-Barrésyndrome(GBS)
Hashimoto’sencephalopathy(HE)
Hashimoto’sthyroiditis
Henoch-Schönleinpurpura(HSP)
Herpesgestationis
Hypogammaglobulinemia
Idiopathicpulmonaryfibrosis(IPF)
Idiopathicthrombocytopenicpurpura(ITP)
IgAnephropathy
IgG4-relatedsclerosingdisease
Inclusionbodymyositis(IBM)
Interstitialcystitis(IC)
Juvenilearthritis(JA)
Juvenilediabetes(type1diabetes)
Juvenilemyositis(JM)
Kawasakisyndrome
Lambert-Eatonmyasthenicsyndrome
Leukocytoclasticvasculitis(LCV)
Lichenplanus
Lichensclerosus
Ligneousconjunctivitis(LC)
LinearIgAdisease(LAD)
Lymedisease,chronic
Mèniére’sdisease
Microscopicpolyangiitis(MPA)
Mixedconnectivetissuedisease(MCTD)
Mooren’sulcer(MU)
Mucha-Habermanndisease
Multiplesclerosis(MS)
Myastheniagravis
Myositis
Narcolepsy
Neonatallupus
Neutropenia
Ocularcicatricialpemphigoid(OCP)
Opticneuritis(ON)
Ord’sthyroiditis
Palindromicrheumatism(PR)
Paraneoplasticcerebellardegeneration(PCD)
Paroxysmalnocturnalhemoglobinuria(PNH)
Parry-Rombergsyndrome
Parsonage-Turnersyndrome(PTS)
Parsplanitis(peripheraluveitis)
PediatricAutoimmuneNeuropsychiatricDisordersAssociatedwithStreptococcus(PANDAS)
Pemphigusvulgaris
Peripheralneuropathy
Perivenousencephalomyelitis
Perniciousanemia
POEMSsyndrome
Polyarteritisnodosa(PAN)
Polymyalgiarheumatica(PMR)
Polymyositis(PM)
Postpericardiotomysyndrome(PS)
Primarybiliarycirrhosis(PBC)
Primarysclerosingcholangitis(PSC)
Psoriasis
Psoriaticarthritis
Pureredcellaplasia(PRCA)
Pyodermagangrenosum
Raynaud’sdisease
Reactivearthritis/Reiter’ssyndrome
Reflexsympatheticdystrophy(RSD)
Reflexsympatheticdystrophy(RSD)
Relapsingpolychondritis(RP)
Restlesslegssyndrome(RLS)
Retroperitonealfibrosis(RPF)
Rheumaticfever
Rheumatoidarthritis(RA)
Sarcoidosis
Schmidtsyndrome
Scleritis
Scleroderma
Sjögren’sdisease
Spermandtesticularautoimmunity
Stiffpersonsyndrome(SPS)
Subacutebacterialendocarditis(SBE)
Susac’ssyndrome
Sympatheticophthalmia(SO)
Systemiclupuserythematosus(SLE)
Takayasu’sarteritis
Temporalarteritis/Giantcellarteritis(GCA)
Thrombocytopenicpurpura(TTP)
Tolosa-Huntsyndrome(THS)
Transversemyelitis
Type1diabetes
Type1,2,and3polyglandularautoimmunesyndromes(PAS)
Ulcerativecolitis(UC)
Undifferentiatedconnectivetissuedisease(UCTD)
Uveitis
Vasculitis
Vesiculobullousdermatosis
Vitiligo
SEEKINGDIAGNOSISWhyDoYouNeedaDiagnosis?
Inordertopreventcomplicationsfromthedamagecausedbyautoimmunedisease,earlydiagnosisisessential.Acorrectdiagnosishelpsyoutoconnect
withthespecialistsandothermedicalprovidersyouneed,weightreatmentoptions,andthinkabouthowyouwanttonavigatedietaryandlifestylemodifications.Unfortunately,obtainingaproperdiagnosisisoftenthemostdifficultpartoftheprocessforthoseofussufferingfromautoimmunedisease.AccordingtotheAmericanAutoimmuneRelatedDiseasesAssociation
(AARDA),thosewithanautoimmunediseasespendanaverageof4yearsseekingdiagnosis,withvisitstomorethan4physiciansintheprocess.Somegoundiagnosedforyears,whileothersgetmisdiagnosedwithotherconditions.Theundiagnosedandmisdiagnosedrateforjust1ofthesediseases,celiacdisease,canbeashighas83percent,whichshowshowdifficultittrulycanbetoobtainanswers.Autoimmunediseasesymptomscanbenonspecific,mild,andgraduallybuildovertime,makingitdifficultforyoutodetermineifyouneedtoseeyourphysicianaboutthem.Often,whenyoudo,youaretoldeverythingisfineandfurthertestingthatcoulduncoverearlywarningsignsisn’tordered.Oneofthebiggestissueswiththetreatmentofautoimmunediseaseisthat
thereisnomedicalspecialtytoservethesediseasesasawhole.Incombinationwiththembeingpoorlyunderstoodbythemedicalprofession,ingeneral,thisleadstopatientsbeingbouncedaroundbetweenprimary-carephysiciansandspecialistsbeforeobtainingpropertestingandtreatment.AnAARDAstudyshowedthat46percentofautoimmunepatientsweretoldtheywerecomplainersortooobsessedwiththeirhealth,insteadofbeingofferedthemedicaltestingandtreatmenttheyneeded.Manyofuswhosufferfromautoimmunesymptomswonderwhyweshould
evenbotherseekingadiagnosis,especiallyifoursymptomscanimprovejustbymakingdietaryandlifestylechanges.However,asyoucanseefromthefollowinglist,therearebenefitstohavingacleardiagnosis.
Thebenefitsofhavingadiagnosis1.Ithelpsyouconnectwiththerightmedicalspecialistforyourcondition.
2.Ithelpsmedicalpractitionersdecidewhichtestingtopursueregularlytogaugeprogress.
3.Ithelpsyouandyourdoctordecidewhichtreatmentoption(medication,surgical,orother)isbestforyou.
4.Ithelpsyouconnectwithotherswhoaresufferingfromthesamecondition.
5.Ithelpscomplementarycarepractitionerstailortheirprogramsandprotocolsspecificallytoyourneeds.
6.Itenablesyoutoresearchandeducateyourselfaboutyourdisease.
7.Ithelpsyouandyourdoctorpracticegoodpreventativecare,ordertestingtogaugeprogress,andanticipatepotentialissues.
8.Ithelpsyouunderstandwhatdiseaseprogressionmightlooklikeaswellassignsandsymptomstobeawareof.
9.Itgivesyoupeaceofmindknowingwhatiscausingyoursymptoms.
WhereAreYouontheSpectrum?AutoimmuneStatusSelf-TestYoucannotgetanywhereifyoudon’tknowyourstartingpoint.We’vedesignedthistesttohelpyouevaluatewhereyouarerightnow.Thinkofitlikethebigmapinthecenterofthemallstating,“Youarehere.”Thepointisnottodwellonyourcurrentexperience,buttoinformyouaboutwhereyouwanttogonextintermsofdiagnosis,treatment,andlifestylechanges.Wewereinspiredbytheideathatautoimmunediseaseoftenoccursonaspectrum,instead
ofbeingblackorwhite(firsttalkedaboutbyAmyMyers,MD,inTheAutoimmuneSolution),aswellastheideasofDatisKharrazian,DC,regarding“silentautoimmunity.”Thistestblendstheirmaterialwithourexperienceinordertoempowerthosewhoaresufferingfromautoimmunediseaseorchronicillnessbyprovidingastartingpoint.INSTRUCTIONS:Youwillfindtwosections,thefirstwiththesamescoringforeach
question,andthesecondwithanindividualscoringsystemperquestion.Attheendofthetest,youwilladdthescoresfrombothsectionstocomeupwithyourAUTOIMMUNESTATUS.Fromthere,youwillhavesomeinformationtoguidethenextstepsinyourhealingjourney.YoucanalsocomebacktoSection1ofthistestonceyouhavemadesomechangestogaugeyourhealingprogressovertime.
DISCLAIMERAquickdisclaimer—someofthesymptomslistedherecanindicateseriousmedicalissuesthatabsolutelydorequireinterventionfromamedicaldoctor.Ifyoufindyourselfhere,pleaseseeaqualifiedprofessionalaboutthesesymptomssoon.Now,ontothetest!
SECTION1
SCORING0=neveroccurs
1=occursrarely(monthly)2=occursoccasionally(weekly)
3=occursfrequently(daily)
__ Fatigueandlackofenergy
__ Chronicpain—muscles,joints,andbones
__ Heavinessinlimbs,lossofmuscletone
__ Morningstiffness
__ Weaknessand/ortremor
__ Headaches
__ Feelingpuffyorinflamed
__ Rashes,hives,andskinissuesofunknownorigin
__ Dryeyes,mouth,orskin
__ Dermatitisoritchyskin
__ Whitepatchesonskinorinsideofthemouth
__ Mouthulcers
__ Troublemaintainingahealthyweight
__ Difficultywithexercise
__ IBS,orirritablebowelsyndrome—constipation,diarrhea,orboth
__ Abdominalpainorstomachcramps
__ Bloodormucusinstool
__ Troublefallingorstayingasleep
__ Coldhandsorfeetandtroublestayingwarm
__ Heatintoleranceand/orsunsensitivity
__ Rapidheartbeat
__ Nightsweats
__ Difficultyswallowing,hoarseness,orlumpinthethroat
__ Decreasedsenseoftasteorsmell
__ Difficultyconcentratingorfocusing(brainfog)
__ Thinninghairorhairloss
__ Lossofouterthirdofeyebrow
__ Numbnessortinglinginextremities
__ Dizzinessorlightheadedness
__ Foodallergies/sensitivities
__ Darkcirclesundereyes
__ Unexplainedlow-gradefever
__ Periodontalinfectionsorgumissues
TAKENOTEOFYOURTOTALFORSECTION1(keepthishandytoaddbelow)
SECTION2Thissectionisscoredalittledifferently—followtheinstructionsoneachquestionandtotalthematthebottom.
WOMENONLY__ Iamawoman(0=no,10=yes)__ MyperiodisheavyandIcannotmakeitthroughwithoutdisruptivepain.(0=no,1=yes)
__ Infertility(0=no,1=yes)__ Multiplemiscarriages(0=no,1=yes)
EVERYONE__ Anemiaofanytype(0=no,1=yes)
__ Osteoporosisorosteopenia(0=no,1=yes)__ Historyofchronicviralcondition(Epstein-Barr,mono,herpes,shingles,chronicfatigue
syndrome,hepatitis,orotherchronicviralcondition)(0=no,5=yes)
__ AdoctorhastoldmeIwastoosensitive.(0=no,5=yes)__ Membersofmyimmediatefamilyhaveautoimmuneconditions(0=no,5=one,10=
morethanone)
ANSWERONEOFTHEFOLLOWING,IFITAPPLIESTOYOU__ Ihaveadiagnosisofoneautoimmunedisease.(0=no,30=yes)
__ Ihaveadiagnosisoftwoautoimmunediseases.(0=no,40=yes,inadditiontothepreviousquestion)
__ Ihaveadiagnosisofthreeormoreautoimmunediseases.(0=no,50=yes,inadditiontotheprevioustwoquestions)
TAKENOTEOFYOURTOTALFORSECTION2
NowaddupthevaluesfromSection1andSection2todiscoveryourautoimmunestatus.
SECTION1TOTAL+SECTION2TOTAL=YOURAUTOIMMUNESTATUS
Compareyourautoimmunestatusscorewiththecategoriesbelow:
SCORING
1-29,STATUS1:Itappearsyourriskforhavinganautoimmunediseaseislow,howeverifsomeofthesymptomsyouareexperiencingarebothersome,youshouldmakeitaprioritytospeakwithyourdoctortofindoutiftheycouldbecausedbyotherconditions.
30-59,STATUS2:Itappearsyourriskforhavinganautoimmunediseaseisaverage.This
isthephasepractitionerssometimesrefertoas“silentautoimmunity.”Thismeansthattheremaybeantibodiespresent,butyouarenotexperiencingdisruptivesymptoms.Ifyouaresufferingfromautoimmunedisease,thisisthebesttimetoseekdiagnosisandtakeactionalthoughitcanbedifficultbecausemanysymptomsarenotyetpresentsoyourdoctormaynotagreetoorderantibodytesting.Ifyouarehavingtroubleworkingwithyourhealth-careprovidersonthis,weprovidemoreinsightinChapter2.
60-99,STATUS3:Itappearsyourriskforhavinganautoimmunediseaseishigh,anditispossiblethatsomeofyoursymptomscouldbecausedbyanautoimmunereaction.However,seekingdiagnosismaybedifficult—althoughsymptomsarepresent,theymightnotpointtoacleardiagnosis.Interventionatthisstatuscansignificantlyimproveyourqualityoflife.
100+,STATUS4:You’vebeendiagnosedwithanautoimmunediseasealready,oryourcombinationofhealthhistoryandcurrentsymptomsmakediagnosisverylikely.Diagnosisatthisstageisusuallyquick,duetomultipleandclearsymptomspointingtoaspecificdisease.Itisnecessarytoformahealth-careteam(ifyoudon’talreadyhaveone),starttreatment,andconsiderchangesimmediatelyinordertoregainqualityoflife.
WHATTODOWITHTHISINFORMATIONDon’tgetderailedbythespecificsofyoursymptomsoryourautoimmunestatusaccordingtothistest—instead,usethisinformationasastartingpointforconversationswithyourhealth-careteam.InChapter2,wewillgiveyousuggestionsonhowtoassemblethisteamandquicklymoveforwardwithplanstorestoreyourbesthealth.
WhatIfYouCan’tGetaDiagnosis?Sometimespatientssufferfromchronicsymptomsthatcouldbeautoimmuneinnaturebutcan’tobtainadiagnosisforonereasonoranother.Thismightbebecauseofpoor-qualitymedicalcareoralackofaccesstomedicalcare,lackoffinancialresourcesformedicalcare,ornotbeingabletofindacollaborativephysicianwhoiswillingtodothepropertestingtomakeadiagnosis.Ifyoufindyourselfinthissituation,don’tfret!Wegiveyoulotsofinformationabouthowtofindacollaborativehealth-careproviderwhocanassistyouinChapter2.
OverlappingDiagnoses
Itiscommonforsomeonewhohasoneautoimmunediseasealreadytogetadiagnosisofadditionalautoimmunediseasesduringhisorherlifetime.Addingtothis,symptomsofsomeautoimmuneconditionsareoftensimilartoothers,whichisknownasoverlap.Thisoccursmostintheautoimmuneconditionsthataffectconnectivetissue,suchasrheumatoidarthritis,scleroderma,Raynaud’sdisease,mixedconnectivetissuedisease,Sjögren’sdisease,andlupus.Someautoimmuneconditionsfrequentlycoexistwithothers,likeHashimoto’s
autoimmuneconditionsfrequentlycoexistwithothers,likeHashimoto’sthyroiditisandGraves’disease.Thesesymptomanddiseaseoverlapscanmakeitdifficulttoobtainan
accuratediagnosisandpropertreatment.Patientswithmultipleautoimmuneconditionsoftenseedifferentspecialiststomanageeachone.Inthecaseofmultipleautoimmunediagnoses,thediseasewiththemostseveresymptomsisusuallygiventreatmentpreference.Ifyoufindyourselfhere,makesurethatyouareconnectedtoproviderswhoarewellequippedtotrackallofyourconditions,eventheonesthatmaynotbecausingthemostseveresymptoms.
CommonMisdiagnoses
Becauseautoimmunediseasecancausenonspecificsymptomsthatoverlapwithmanyconditions,patientscanoftenbemisdiagnosedwithother,nonautoimmuneconditions,ortheymaynotbesufferingfromanautoimmuneconditioninthefirstplace.Itisimportanttobeawareofthesediseasesthatcanproducesimilarsymptoms,inadditiontothefactthatapersoncansufferfromautoimmunediseaseincombinationwithothernonautoimmuneconditions.Hereisalistofconditionsthatarecommonlyconfusedwithautoimmune
disease.
●Alzheimer’sorParkinson’sdisease
●Chronicfatiguesyndrome(CFS)
●Chronicinfection(cantriggerautoimmunity)
●Fibromyalgia
●Irritablebowelsyndrome(IBS)
●Lymedisease(canresultinautoimmunity)
●Mentaldisorderslikedepression,anxiety,andbipolardisorder
●Migraines
●Nutrientdeficiency(likeanemia)
●Sleepapnea
Howdoyouknowifyouhavebeenmisdiagnosed?Thiscanbetrickytopinpointandinvolvesalotoftrialanderror,butmostpeoplefindthatoneorallofthefollowingistrue:Theydonotimproveusingthetypicaltreatmentsfortheirdisease;theybegintoexperiencesymptomsnotexplainedbytheirdiagnosis;ortheycontinuetogettestedanduncoveranewdiagnosis.Forexample,acommonmisdiagnosisforceliacdiseaseisIBS,andpatientsmayrealizeitwasamisdiagnosiswhentheydonotrespondtothecommonIBS
realizeitwasamisdiagnosiswhentheydonotrespondtothecommonIBStreatment.
HowDoYouCopewithaDiagnosis?Althoughatfirstitcanseemrathercutanddrytoreceiveanautoimmunediseasediagnosis,itisrarelythatsimple.Mostofusexperiencearangeofcomplex
diagnosis,itisrarelythatsimple.Mostofusexperiencearangeofcomplexemotionsfollowingdiagnosis.Oftentheinitialreactionisoneofrelief;youmayfeelgratefultoknowthecauseofpreviouslyunexplainedsymptoms.Thisisespeciallytruewithanautoimmunediagnosis,sincethediseasemayhavebeenprogressingforyearswithconfusingperiodsofillnessandremissionthatareoftendismissedbyfamily,friends,andevenphysicians.Adiagnosiscanofferyoumuch-neededvalidation.Itisnotuncommonforyourrelieftoquicklyfade,though,andforyouto
enterthegrievingprocess.ManyofuswithautoimmunediseaseencounteratremendouslossofidentitypriortoandfollowingdiagnosisandmayexperiencesomeoralloftheemotionsassociatedwiththeKübler-Rossstagesofgrief,includingdenial,anger,bargaining,depression,andacceptance.Thisprocessisnotnecessarilylinear,andyoumightfindyourselfgoingbackandforththroughsomeoftheseemotionsasyoucometotermswithyourdisease.Manyautoimmunediseasesufferersreportfeelingthattheyarealoneandnot
understoodbyothers.Youmaystruggletoconstructanewsenseofself,whichmaybedifficultforyourlovedonestoaccept.Theabilityofyourfamilyandfriendstocopewellwiththediagnosisitselfmayalsobeverydifficult,leadingtoanevengreatersenseofisolation.Further,youmayexperienceprofoundanxietyaboutincreasingphysicaldisability,relianceonothers,hospitalizations,treatmentoptions,painlevels,financialstrainofhealth-carecosts,andyourabilitytomaintainajob.Understandably,thefeelingofbeingalonecoupledwithveryrealphysical,emotional,andsocialconcernscanleadtodepression.However,mostofussufferingfromautoimmunediseasecansuccessfully
navigatethegrievingprocessandovercomeanydiagnosis-relateddepression,eventuallyfindingevengreaterhappinessandpersonaldepth.Thisrequireslearningtheskillsassociatedwithresilience.Foryoutoreboundsuccessfullyafterreceivingalife-changingautoimmune
diagnosis,youneedtolearntoberesilient.Resilienceisasetofskillsthatgivesustheabilitytowithstandstressandadversity.Thefirstandmostimportantthingtounderstandaboutresilienceisthatitisnotsomethingwearebornwith,anditisnotapersonalitytrait.Again,itisasetofskills,whichcanbelearnedand,withpractice,betterused.
PracticingResilience
Resiliencecomesdowntosixbehaviors.Takingtheseactionsrepeatedly,eveniftheydonotcomenaturallytoyou,allowsresiliencetobuild.
●MAINTAININGAPOSITIVESELF-IMAGE—havingconfidenceinyourstrengthsand
abilitiesandviewingyourselfasasurvivor,ratherthanasavictim.
●MANAGINGEMOTIONSANDIMPULSES—thismeansnotfreakingout.Althoughacrisismayatfirstseemoverwhelming,takingtimetoadjustyourselfandthenreactinginacalm,composedmannerismoreeffectivethanlosingit.
●TAKINGCHARGEOFTHINGSINYOURCONTROL—activelyproblemsolving,communicatingclearlywiththosearoundyou,andseekingresourcesthatcanhelpyou.
●ESTABLISHINGHEALTHYVERSUSHARMFULCOPINGSTRATEGIES—findingwaystolaugh,gettingexercise,practicingprayerormeditation,consideringtalktherapy,ifappropriate,orspendingtimewithlovedonesversusharmfulstrategieslikeabusingalcoholordrugs.
●INVESTINGINCLOSERELATIONSHIPS—formingintimatepersonalrelationshipsifyouarelackingthemordevotingtimetotheimportantonesthatalreadyexist.Theserelationshipstogetherfunctionasacrucialsupportsystemthatallowsyoutoaskforhelpandgivehelp.The“givinghelp”partmattersasmuchasthe“gettinghelp,”becauseitincreasesmeaninginyourownlife.
●FINDINGPOSITIVEMEANINGINLIFEEVENTS—reframingnegativesituationstoseetheirvalueorthefavorableeffectsthesesituationsmayhavehadonyouasaperson.
Don’tallowyourdiagnosistodiscourageyou;instead,incorporateresilienceintoyourresponsetothenewinformationyou’vereceived.Thiscrucialinformationallowsyoutomovetowardwellness.
WhenIwasdiagnosedwithbothHashimoto’sthyroiditisandceliacdiseaseinthesameappointment,IstruggledtocopewithalltheemotionsIwasfeelingrelatedtothisnewinformation.WhileIdidfeelrelief,Iwasalsostuckinaperiodofintensegriefformanymonths.IwasmourningmypastlifeandalloftheactivitiesIhadassumedI’dneverbeabletoparticipateinagain,likeridinghorses,cycling,androckclimbing.IwasmourningtheroadtripsandspontaneousadventuresIhadgoneonbeforewithmyhusbandandfriends.Inaddition,Iwasmourningmyabilitytoeatanythingandnothavetotakecareofmybodysoattentively.Iknewatthistime,onechapterofmylifewasending,andIstruggledwithitimmensely.Duringthisphase,itwashardformetoconnectwithmyfriendsandfamilyandaskforsupport,despitethefactthattheywerereadyandwilling.Isufferedfromdiagnosis-relateddepressionformonthsuntilIlearnedhowtocopewithmyemotionsandreorientmyselfontheroadtohealth.
LEARNABOUTYOURCONDITIONTesting
Therearemanylaboratoryteststhatareusedtodiagnoseorgaugetreatmentprogressforthosewithautoimmunediseases.Dependingonyourdiagnosisorsymptoms,youmayundergocertaintestingonlyfordiagnosisandthenanothersetoftestingregularlytoassessdiseaseprogressionandtreatmentresults.Thesecanbedividedintofourcategories.1.ANTIBODYTESTS—Testingforbothantinuclearandautoantibodiesiscommonifthereisaknowntestfortheparticularautoimmunedisease.Theseteststellthedoctorwhichtissuesthebodyistargetingandatwhatrate.Mostofthetime,antibodiescanbedirectedattheself(tissueswithinthebody),butothertimestheycanbedirectedtowardenvironmentaltriggers,suchasinthecaseoftransglutaminase(aproteinfoundinwheat)inceliacdisease.Antibodytestsareusedbyspecialiststomakeadiagnosisanddeterminetreatment,aswellastogaugehowthattreatmentisworkingforyou.Thefollowingaresomecommonantibodybloodtests.
●ANTINUCLEARANTIBODIES(ANA)—Theseareantibodiesthattargetthenucleusofacell.Sometimestheyarepresentinautoimmunediseasesthataffectconnectivetissue,suchassystemiclupuserythematosus,Sjögren’sdisease,andmixedconnectivetissuedisease.ItisimportanttonotethatsometimesapositiveANAisfoundinpeoplewithoutautoimmunedisease,andfurtherevaluationisneededforadoctortomakeadiagnosis.
●RHEUMATOIDFACTOR—Thisisanantibodythatiscommonlyfoundinautoimmunediseasesthataffectthejoints,likerheumatoidarthritis.
●THYROIDANTIBODIES(TPO,TgAB,andTSI)—ThesearethreeantibodyteststhatarecommonlyusedtodiagnoseandtreatautoimmunethyroidconditionslikeHashimoto’sandGraves’disease.
●ANTITRANSGLUTAMINASEANTIBODIES—Thistestindicatesantibodiestoproteinsfoundingluten,whicharefoundinthosewithceliacdisease.
2.TESTINGTODETERMINEORGANDAMAGEAND/ORINFLAMMATION—Thesetestsarerelatedtowhicheverorganisaffectedbyyourdiagnosedorsuspectedautoimmunedisease.Theyrangefromminimallyinvasive(suchasathyroidultrasound)tomoreinvasive(suchasacolonoscopy).Sometimesthetestsareonlyneededtomakeadiagnosis,andothertimes,theyarerepeatedtogauge
yourprogressortomakeongoingdecisionsabouttreatment.Herearesomecommontestsandprocedures.
●UPPERENDOSCOPY—Thisisaprocedurewhereasmallcameraonaflexibletubeisusedtovisuallyexamineyouresophagus,stomach,andduodenum(beginningofthesmallintestine).Itmayalsobeusedtocollecttissuesamplesforabiopsy.Thisprocedureisusedinthediagnosisandtreatmentofdiseasesaffectingtheuppergastrointestinalsystem,likeceliacdisease.
●COLONOSCOPY—Thisisaprocedurewhereasmallcameraonaflexibletubeisusedtovisuallyexamineyourcolonandrectum.Itmayalsobeusedtocollecttissuesamplesforabiopsy.Thisprocedureisusedinthediagnosisandtreatmentofdiseasesaffectingthelowergastrointestinalsystem,likeCrohn’sdiseaseandulcerativecolitis.
●MAGNETICRESONANCEIMAGING(MRI)—Thisisatestwhereyouareplacedinatube-shapedmachinethatcontainsmagnetsthatmovebackandforth.Themagneticfieldcreatedbythismovement,aswellasradiowaves,createsdetailedcross-sectionimagesoftissuesthroughoutyourbody.Thistestisusedinthediagnosisandtreatmentofdiseasessuchasmultiplesclerosis.
●X-RAY—Thisisatestwhereapictureismadeoftheinternalstructuresofyourbody,wheredensematerialssuchasboneshowupwell.Thistestisusedinthediagnosisandtreatmentofdiseasesthataffectthejointsandconnectivetissue,suchasrheumatoidarthritis,systemiclupuserythematosus,andmixedconnectivetissuedisease.
●ULTRASOUND—Thisisatestthatuseshigh-frequencysoundwavestoproduceimageswithinyourbody.Itisusedinthediagnosisandtreatmentofdiseasesthataffectcertainorgans,likethethyroidinHashimoto’sdisease.
3.GENERALTESTINGRELATEDTOOVERALLHEALTH—Thistestingrangesfrombeingspecificallyrelatedtotheknownprocessofanautoimmunedisease(suchasthemalabsorptionofironandvitaminB12thatisaknownfactorinceliacdisease)tojustcheckinguponyouroverallwell-beingandmakingsurethatallorgansarefunctioningproperly.Herearesomecommongeneraltests.
●CBC(COMPLETEBLOODCOUNT)—Thisisanoverallbloodtestscreenthatwillrevealthingslikeanemia,infection,andblooddisorders.
●CMP(COMPREHENSIVEMETABOLICPANEL)—Thisisabroadscreeningto
evaluateliverandkidneyfunctionthatisparticularlyofinteresttothoseoncertainmedications.
●NUTRITIONALANEMIAPROFILE—Theseareaseriesofbloodtestsincludinghemoglobin,hematocrit,folate,ferritin,andB12thathelpsfindthesourceandtracktheprogressofanemia,whichisacommonsymptomofmanyautoimmunediseases.
●VITAMINANDMINERALTESTS—Thesearespecificbloodteststhatlookfordeficienciesincertainvitaminsandmineralsandaresometimesperformedinconjunctionwithotherpanels(suchasaCMP).CommontestsincludevitaminB12,vitaminD,andiron.
●CRP(C-REACTIVEPROTEIN)ANDESR(ERYTHROCYTESEDIMENTATIONRATE)—Thesearebloodteststhatindicatethelevelofinflammationinyourbodyandareusefulfortrackingtreatmentprogressinconditionslikerheumatoidarthritis.
●LIPIDPROFILE—Thisisacollectionofbloodteststhatlookattheamountofcholesterolandtriglyceridesinyourblood.
●THYROIDPANEL—Thisisacollectionofbloodteststhatlookattheamountofthyroidhormonesinyourblood.ItiscommontoincludeTSH(thyroidstimulatinghormone)andtotalT4;sometimes“free”T3,“free”T4,aswellasreverseT3andantibodytestsareincluded.
4.FUNCTIONALMEDICINETESTING—Whilenotcommon,thosepatientsworkingwithafunctionalmedicinepractitionermayhavetestingorderedthatgoesbeyondwhatisstandardintheconventionalmedicalsystem.Thesetestsarenotneededfordiagnosisbutcanhelpguideyourtreatmentwhenconsideringaholisticapproach.
●COMPREHENSIVESTOOLTESTING—Toperformthistest,yousendastoolsampletoalabtobeevaluatedforpathogenicovergrowthsorinfectionslikebacteria,yeast,andparasites.Somestooltestsincludetestingpathogensagainstpotentialantimicrobialagents,bothprescriptionandherbal,whichcanbeincrediblyhelpfulforguidingyourtreatment.
●HORMONETESTING—Thisisasalivarytestusedtodetermineyourhormonalbalance,bothforsexandstresshormones.Manytestscallformultiplesamples,providingacompletepictureofhowyourlevelsarefluctuatingoveraperiodoftime.
●MICRONUTRIENTTESTING—Thisisabloodtestthatcanhelpdetermineifyou
haveanymicronutrientdeficienciesthataren’tpickeduponaconventionallabtest(suchasvitaminAorselenium).
●GENETICTESTING—Thesearebothbloodandsalivateststhathelpdetermineifyouhaveageneticmutationthatmaypredisposeyoutoautoimmunedisease(suchastheHLA-DQgenemutations,aswellastheMTHFRgenemutations).
●FOODANDENVIRONMENTALALLERGENTESTING—Thesearebloodteststhathelpdetermineifyouhaveanysensitivitiestofoodorenvironmentaltriggersandcanhelpdeterminepersonalizeddietandlifestyleinterventions.
●ORGANICACIDSTESTING—Thisisaurinetestthatcanhelppinpointmetabolicissues,pathogenicovergrowths,neurotransmitterimbalance,oxidativestress,andimpairedmethylation.
●HEAVYMETALSTESTING—Thisisatestthatisperformedbydrinkingachelatingagent(asubstancethathelpsdrawoutminerals)andthentakingaurinesample.Itisusedtodetermineifyouhaveahighloadofheavymetalsinyourbody.
WhatIstheTreatmentforAutoimmuneDisease?Unfortunately,thereisnocureforautoimmunedisease—oncetheimmunesystemstartsattackingthebody’sowntissues,thereisnothingthatcanbedone
systemstartsattackingthebody’sowntissues,thereisnothingthatcanbedonetogetitto“turnoff”orstoptheattack.Currentconventionaltreatmentisfocusedonslowinginflammation,preservingorgans,andmanagingsymptoms.Atbest,thistreatmenthasyoubarelyputtingadentinyoursymptomswhilecreatingawholelotofsideeffects.Patientsgoingthroughthisexperienceoftenfindthemselvesfrustrated.Some
aretoldthereisnothingthatcanbedone,findingthemselveswithmildbutirritatingsymptomsthatdon’twarrantpowerfulmedications.Othersfindthemselvesonimmunosuppressantsandthenhavetosufferorworryaboutsideeffectslikeinfectionorcancer.Thosewithevenmoreseriousandlife-threateningflaresorconditionsmayfindthemselvesfacingsurgicalintervention,althoughthisisnottypical.Thecurrentapproachtomanagingautoimmunediseaseisn’tashopelessasit
seems!Thereisaburgeoningcommunityofpeoplereclaimingtheirhealthwithanewapproach.Youwillfindsomeusefulsolutionsintegratingthebestofconventionalmedicinewithnaturalinterventionsthroughouttherestofthisbook.Commonmedicaltreatmentsforautoimmunediseasesinclude:
●NONSTEROIDALANTI-INFLAMMATORIES(NSAIDS)—Thesearemedicationsthatreduceinflammationandrelievepain.Theyareavailableover-the-counterorbyprescriptionandareusedtotreatmuscleorjointstiffnessandpain,aches,menstrualpain,andheadaches.Manypatientswithjointpain,forexample,useNSAIDstomanageit.
●HORMONEREPLACEMENT—Indiseasesthatresultinalossofhormone(suchastype1diabetesorHashimoto’sthyroiditis),replacementhormone(likeinsulinorlevothyroxine)isusuallyprescribed.
●CORTICOSTEROIDS—Thesemedicationssuppressinflammationbymimickingthebody’sownsteroidhormones.Theyareprescribedindifferentformsandmaybetakenorally,topically,inhaled,andbyinjection.Whileeffective,steroidmedicationscancomewithunpleasantsideeffects,likemoodswingsandweightgain.
●ANTIBIOTICS—Certainautoimmuneconditions,suchasankylosingspondylitis,arelinkedtobacterialinfections(inthiscaseKlebsiellapneumoniae),forwhichantibioticsmaybeprescribed.
●DISEASE-MODIFYINGANTIRHEUMATICDRUGS(DMARDS)—Inconditionswithmoreserioussymptoms,thesemedicationsareusedtosuppresstheimmune
system,therebycalmingtheautoimmuneprocess.Theyareavailableorallyorbyinjectionandusuallytakeweekstomonthstostartworking.Theyarenotrisk-free,assuppressingtheimmunesystemcancauseagreatersusceptibilitytoinfectionaswellascertaintypesofcancer.Additionally,thesemedicationscanbehardontheliverandkidneys.
●BIOLOGICDMARDS(ALSOCALLEDTNFINHIBITORS)—ThesearenewertypesofDMARDsmadetomimictheactivityofcompoundsinyourbody(hencethenamebiologic).Theyareavailablebyinjection,tendtobequickeracting,andareoftenprescribedinadditiontotraditionalDMARDs.TheycarryasimilarsideeffectriskasotherDMARDs,withpossiblyahigherriskforinfectionbecauseofthespecificpartoftheimmunesystemtheysuppress.
●SURGERY—Althoughthisisnotascommon,someautoimmunediseasescanresultinsurgicalintervention,suchasCrohn’sdisease,ulcerativecolitis,andendometriosis.
Inadditiontothesetreatmentsspecificallytocontrolautoimmunedisease,youmayfindyourselfputonothermedicationstocontrolthesideeffects.Notuncommonaremedicationsthataffectdigestion,likeantacids,proton-pumpinhibitors,H2blockers,laxatives,andantidiarrheals;antibioticsandantifungalstotreatinfections;andhormonaltreatments.
IsThereAnythingElseYouCanDo?Inthisbook,wearenotproposingdietandlifestyleinterventionsasatreatmentinandofitselfforautoimmunedisease;rather,wearesuggestingthattherearethingsyouasanautoimmunepatientcandoforyourselfinadditiontothemedicaltreatmentyoureceivefromyourpractitionerorteam(withtheirblessing,ofcourse!).Manyautoimmunepatientshaveregainedtheirhealthusingacombinationofnaturalapproachesandconventionalmedicine.It’snotamatterofoneortheother,buthoweverythingworksinconcerttoproducelastingwellness.Thefollowingaresomenaturalapproachesthatyoumaybeableto
incorporateinanefforttolivehealthier.Wewillbetalkingmoreindepthabouteachoftheseitems,butbriefdescriptionsareoutlinedbelow.
●DIET—Researchhasestablishedalinkbetweenleakygut(otherwiseknownas“intestinalpermeability”)andallautoimmunediseases.Adietaryapproachthat:(1)providesallofthenutrientsneededforoptimalhealingandrecoveryand(2)
eliminatesallfoodallergiesandsensitivitiesisbestforlongtermhealingandmanagement(seeChapter3).
●SLEEP—Theinabilitytofallasleep,poor-qualitysleep,orinterruptedsleepareissuesthatmanywithchronicillnesssufferfrom.Becausesleepisnecessaryforproperhormonalbalanceaswellasrepairandrestorationofthebody,troubleshootingthesebarrierstopropersleepcanmakeabigdifference(seeChapter4).
●STRESSMANAGEMENT—Chronicstressiswellknowntocauseautoimmuneflaresbecauseofitsimpactonthebody’shormonalbalance.Learninghowtomanagestresseffectivelyandappropriatelycanhelpreducethisimpact(seeChapter5).
●EXERCISE—Impropermovementorlackofmovementcancontributenegativelytoautoimmunesymptoms.Itisimportanttoengageintherighttypeofexerciseatadifficultylevelthatisrightforthecircumstances(seeChapter6).
●SUPPORT—Connectingwithothersandnatureisanimportantpartofthelongtermmanagementofchronicillnessandautoimmunedisease(seeChapter7).
INFORMATIONGATHERINGOrganizingMedicalInformation
Itisimportantforyoutohaveallofyourmedicalinformationandrecordsonhandandorganizedsothattheycanbeeasilyaccessed.Thosesufferingfromchronicillnesstendtoseealotofnewpractitioners,andinformationcanveryeasilygetlostintheprocess.Havingyourownrecordsonhandalsogivesyoutheopportunitytotrackchangesovertime.Followthesesimplestepstomakesurethatyouhaveyourmedicalinformationorganizedsothatitcanbestbeusedtoguideyourcare.
1.Alwaysrequestcopiesofyourlabtestsanddocumentswhileatyourdoctor’soffice.Youhavearighttohaveacopyofthisinformationforyourrecords.Itispossibletorequestduplicatefilesofanyimaging(MRI,CTscan,x-ray)andstorethemonaharddriveforlongtermsafekeeping.
2.Keepafileofmedicalinformationinaconvenientlocationathome.Ifyourrecordsaredigital,printcopiesincasetherecordisaccidentallylostor
destroyed.Organizebydateforeasyaccess,withonelargefolderforeachyearfilledwithfilesforeachmonth.Youcanalsoconsiderusingoneofthemanyhealth-trackingappsonyourmobilephonethatcanstorephotographedrecordsandinformationandtracklabresultchangesovertime.
3.Ifyouhaveaconditionlikehypothyroidism,wherethesamelabtestsareperformedonaregularbasis,considermakingaspreadsheetonyourcomputerforeasycomparisonoflabvaluesandtotrackchangesovertime.Again,anappmaybeusefulforlongtermtracking.
4.Whenbringingyourownmedicalrecordstoanewdoctororappointment,makecopiesandleavetheoriginalsathomesothatthepractitionercankeepthemforhisorherrecords.Thiswayyoualwayskeepacompleterecordathome.
KeepingaSymptomJournalJournalingisatoolthateveryonecanusetotrackprogresswhileonahealingjourney.Thewaysofkeepingajournalareinnumerable—youcouldusepenandpaper,awordortextdocumentonyourcomputer,aspreadsheet,oranapponyoursmart-phone.Moreimportantthanthemethodyouuseisthefactthatyouactuallydoitinaconsistentwaywherethedatacanbeusedtoinformfuturedecisions.
Metricstotrack●Energy
●Pain
●Bowelmovements
●Exercise
●Mood
●Food/beverageintake(seeNote)
●Notablesymptoms
●Bodymeasurements
●Digestion
●Medications
●Supplements
●Stressmanagement
Trackingtips●Useascalefrom1to10insteadofadjectives(“energy—7”insteadof“Ihadagoodamountofenergytoday”),makingyourdatamoreusable.Thiswillalsomakeitquickerforyoutotrackresultsandmakethemeasytocompare.
●Inordertoavoidbeingoverwhelmed,onlytrackwhatisimportant.Startwithafewmetricsandbuildasyougetintothehabit.
●Don’tbeatyourselfupifyougetbusyandforgetafewdays.Maintainingtherecordlongtermisusefuleveniftherearesomegaps.
●Assessandtrackyourbowelmovementsregularlytoseeifthereareany
changesduetoyourdietorlifestyle.
Onceyouareinthehabitofregulartracking,setasideatimeonceamonthtogooveryourjournalandseeifyoucanmakeanycorrelations.Youmaybeabletoputthingstogetherinawayyoucouldn’twhileinthemoment—maybeyougetbloatedconsistentlyaftereatingacertainfood,oryounoticethatyouhadaheadacheeverydaysinceintroducinganewsupplement.Trackingbecomesincrediblyimportantanytimeyouincorporatesomethingnewintoyourroutine—likeamedication,supplement,exercise,orafoodreintroduction(whichwewilltalkmoreaboutinReintroductions).Evenifyouarejustbeginningyourhealingjourney,learninghowtotrack
soonerratherthanlaterisagreatidea.Youmayfeelasthoughtrackingnowisnotgoingtodoanygoodsinceyoudon’thaveaplan,butitisalwaysusefultohaveabaselineofhowyouwerefeelingbeforeyoustartedtomakechanges(justthinkhowusefulitwillbeforlookingbackonyourprogress!).
NOTE:Wearen’tsuggestingtoobsessivelycountfoodintakeorweighyourselfeveryday,evenifoneofyourgoalsisweightloss.Whentrackingfood,describingthefoodsyouatethatday(i.e.,saladwithcarrots,lettuce,beets,cannedsalmon,andavocadodressing)inenoughdetailtomakeconnectionsaboutdietandsymptomsismorethangoodenough.Evenifyouwouldliketoloseweight,werecommendditchingthescale(thatnumberdoesn’ttellusanythingaboutyourvalue!)andrelyingonweeklybodymeasurementsinstead.Actualcaloriecountingcanbeusefulforuptoaweekjusttoseeaballparkrangeofhowmuchfoodyouareeatingandtodetermineifallnutritionalrequirementsarebeingmet.
WHATISTHEPROGNOSISFORAUTOIMMUNEDISEASES?Eachspecificautoimmunediseasehasunpredictableoutcomes.Someareaggressiveandcanbelife-threatening,whileothersappearquickly,butspontaneouslypass.Occasionally,autoimmunediseasescanbebothacuteandchronic.Understandingwhichcategoryyourdiseasefallsintocanhelpyoucommunicatebetterwithyourhealth-careproviders.Autoimmunediseaseisgenerallynotanacutemedicalcrisis,anditmost
likelymanifestsasalongterm,chronicillness.Thecourseitwilltakeinyourbodyisuncertainandnotsomethingadoctoriscapableofpredictingforyou.However,thoseofuswithautoimmunediseasecanactivelyworktodecreasefactorsthatmayworsensymptomsandstrivetoimproveourprognosis.Withastrongplanandhealth-careteaminplace,livingwelllongtermisusually
strongplanandhealth-careteaminplace,livingwelllongtermisusuallypossible.ItisworthnotingherethattheWesternhealth-caremodelissetuptoexcelin
treatmentofacutehealthcrises,likeabrokenlegoraheartattack,butnotnecessarilyofchronicillness—thisiswhypersonaladvocacyissoimportant.
CALLTOACTIONThisfirstchapterwasmeanttodotwothings,convinceyouthatknowledgeispoweronyourautoimmunejourneyandprovideyouwithsomeofthedetailsthatyoushouldexploreinordertogetempowered.Thisbasicinformation—whatanautoimmunediseaseis,howtogetadiagnosis,andtheparticularstolearnaboutyourspecificdisease—isthefoundationfortransformation.Wellnessisnotinyourdoctor’sofficeorinanewpill;itisinyourhands,anditstartswithbeinginformed.
CHAPTER2
Collaborate
“Noonecanwhistleasymphony.Ittakesawholeorchestratoplayit.”—H.E.LUCCOCK
Wethinkthesecondmostimportantthingyoucandoonyourjourneytowellnessistobuildacollaborativehealth-careteam—agroupofexpertswhoadvocateforandassistyouwiththemedicalandnonmedicalaspectsofhealing.Inthischapter,we’llbesheddingsomelightonthedifferenttypesofpractitionersyoucancollaboratewith,aswellasgiveyousometipsonassemblingandmanagingyourteam.First,weneedtoanswerthequestionofwhatcollaborationtrulymeans,especiallyasitappliestonavigatingthehealth-caresystem.
WHATISCOLLABORATION?Collaborationisoneofthosebuzzwordswithoutawidelyagreed-upondefinition.Whatweareusinghereistheintegrationofseveraldefinitionsastheyapplytomanagingyourhealth-careteam.Hereisafurtherbreakdownformoreclarity.
●Collaborationisrequiredinsituationswhereyouarenotabletosolveaproblemonyourown.
●Collaborationmeansopenlysharingknowledgeandbeingaccountable,sinceactionstakenbyonememberofyourteamcanimpacttheothers.
●Collaborationmeansblendingwhatyouandeachmemberofyourteamcanofferandcombiningthemostusefulideasintooneeffectiveplaninordertobestresolveaproblem.
Withthatclearunderstandingoftheconcept,itbecomesobvioustothoseofuswithautoimmunediseasethatcollaborationisabsolutelynecessaryforthebestpossibletreatment.Unquestionably,itisvitalinthecaseofcomplexandchangingmedicalsituations,suchaschronicillnessandautoimmunedisease,to
takeacollaborativeapproach.Unfortunately,collaborationbetweenmedicalspecialtieswithintheconventionalsystem,letalonewithothertypesofalternativeandcomplementarycareproviders,israre.Itisuptoyoutoadvocateforacollaborativeapproachtoyourcareandto
buildateamofproviderswhowillsharethatcooperativevision.Luckily,we’veclarifiedeveryaspectofthatprocessforyouinthefollowingpages.Let’sstartbylookingatthedifferenttypesofhealth-careapproachesandthedifferenttypesofprovidersyoumaywanttoincludeonyourteam.
NATURALVERSUSCONVENTIONALMEDICALAPPROACHESWhatKindsofPractitionersAreThere?
Therearemanypractitionerswithvariousbackgroundsandtrainingthatcanguideandassistyouonyourjourneybacktohealth.Itisimportanttoeducateyourselfaboutthemanydifferenttypesoflicensesandspecialtiesyourpractitionersmayhavesothatyoumaketheabsolutebestchoiceforyourneeds.Theneedforadoctorisnotspecificenough—whatkindofdoctorwillbestsuityoursituation?Forexample,ifyouhaveHashimoto’sthyroiditis,youmaybebestservedbyanendocrinologist,anintegrativemedicaldoctor(MD),oranaturopathicdoctor(ND).Althoughallofthesepractitionersmaybeabletodiagnoseandtreatyourcondition,thetreatmenttheyprescribeisgoingtobedifferent,dependingontheireducationandwhatkindofnaturalmedicine,ifany,theyincorporateintotheirpractice.Itisimportanttonotewhichtypesofpractitionersarelicensed(whichmeans
theyhavemetstandardsthatqualifythemtopractice),whichonesaremedical(qualifiedtodiagnoseandtreat),andwhicharenonlicensedandnonmedical.Thelattertypeofpractitionerscanbevitalassetstoyourhealth-careteam,butyoucannotexpecttohaveyourmedicalneedsmetthroughworkingwiththem.Attheveryleast,youneedtohaveaprimarycareprovider,orapractitionerwhomyouseefirstforannualexamsandwhenyouareexperiencinghealthproblems.Dependingonyourinsuranceandwhereyoulive,thiscanbeamedicaldoctor(MD),doctorofosteopathy(DO),nursepractitioner(NP),physicianassistant(PA),ornaturopathicdoctor(ND).
TypesofLicensedConventionalMedicalPractitionersThesearepractitionerswhohavegonethroughrigoroustrainingtoobtaintheirlicensestoprovidemedicalsupport,eitheratthehighestlevel,suchasaphysicianwithaspecialty,oratthesupportivelevel,suchasaregisterednurse
physicianwithaspecialty,oratthesupportivelevel,suchasaregisterednurseordietician.
MEDICALDOCTOR(MD)—amedicalprofessionalwhohasobtainedalicensetodiagnoseandtreatmedicalconditionsbycompletingmedicalschool(generally4to6yearsaftercompletingabachelor’sdegree)aswellasaresidency(aninternshiplastingatleast2years).Theyhavetopassanexamtoacquirestatelicenses.Mostmedicaldoctorseitherpracticegeneralcare(internalmedicine,familymedicine,orpediatrics)orspecializeinonesystemofthebody.
DOCTOROFOSTEOPATHICMEDICINE(DO)—amedicalprofessionalwhohasreceivedtrainingthatisverysimilartothatofanMD—medicalschool,residency,andanexamtoobtainalicense.LikeanMD,heorshecanchooseanyareaofspecialtyorpracticegeneralcare.ThedifferencebetweentheDOandMDtraining,however,isthataDOgetsmoreemphasisonprimary-careeducation,awhole-bodyapproach,preventivecare,themusculoskeletalsystem,andmanipulativetreatment.CommonmedicalspecialtiesforbothMDandDOinclude:
●Cardiology—heart
●Dermatology—skin
●Endocrinology—hormoneandmetabolicsystems
●Gastroenterology—digestivetract
●Hematology—blood
●Immunology—immunesystem
●Nephrology—kidneys
●Obstetrics/gynecology—pregnancyandwomen’shealth
●Oncology—cancer
●Orthopedics—boneandconnectivetissue
●Otorhinolaryngology—ear,nose,andthroatissues
●Psychiatry—emotionalormentalillness
●Pulmonary—respiratorysystem
●Rheumatology—musculoskeletalissues
PHYSICIANASSISTANT(PA)—ahealth-careworkerwhopracticesmedicineinpartnershipwithmedicaldoctors.Trainingtakes2to3yearstocomplete,much
lessthananMD,butissimilarinscope.Thus,PAsareabletomakehealthcaremoreaccessibleandaffordablebybeingabletoseepatientsquickerandspendmoretimewiththem.APAoftenworkswithinamedicalspecialtyjustlikeanMDorDO.
REGISTEREDNURSE(RN)—ageneralhealth-careworkerwhospecializesintheeducationandtreatmentofpatientswhileassistingamedicaldoctor.RNshelpcommunicatebetweenthedoctorandpatient,maintainmedicalrecords,andprovideinstruction.RNscompleteeitherabachelor’sorassociate’sdegreeinnursinganddonothavetheauthoritytopracticeindependentlyofadoctor.
NURSEPRACTITIONER(NP)—anRNwithadvancedtraining.InadditiontotherequirementstobecomeanRN,NPsobtainagraduatedegreeorhigherandfrequentlyneedworkexperienceasanRNbeforebeingacceptedintothedegreeprogram.Inmorethan25states,NPsareabletopracticeindependentlyfromadoctorandcandiagnose,treat,andprescribemedicationinadditiontothedutiesanRNwouldperform.
REGISTEREDDIETICIAN(RD)—thosewhoaretrainedtousedietandnutritiontotreatdisease.Theycompleteabachelorofscience(BS)ormaster’s(MS)degreeindieteticsandaninternshipandpassanexamtoreceivetheircredentials.Theycanworkindependentlyorconsultwithpatientsasapartofalargermedicalpractice.
OTHERMEDICALSPECIALTIES—Ifyourconditionaffectstheteeth,gums,oreyes,youmightalsoconsiderseeingaDENTIST(DDS)oranOPTOMETRIST(OD),whoaremedicalpractitionersspecializingintheseareas.Similarly,aPHYSICALTHERAPIST(PTORDPT)maybeneededifyourequirephysicalrehabilitationortherapy.
TypesofLicensedNaturalMedicalPractitionersThesearepractitionerswhogothroughrigoroustrainingtoobtainlicensingandcertificationbutarenotapartoftheconventionalmedicinesystem.Itisimportanttonotethatinsomestatesandwithsomeinsuranceplans,NDscanbeprimarycaredoctors,aswellasprescribemanymedicationsandfunctionasthekeyplayeronyourhealth-careteam(moreaboutthatlaterinthischapter).
NATUROPATHICDOCTOR(ND)—amedicalprofessionalwhohasobtainedalicensetodiagnoseandtreatmedicalconditionsbycompletingnaturopathicmedicalschool(generally4yearsaftercompletingabachelor’sdegree)andpassingaboardexam.NDsareeducatedinthesamefoundationsasamedicaldoctor,butinsteadofmovingontospecificareasofstudy,theyalsolearnaboutnatural-healingmodalities.AnNDemploysthesenatural-healingmethodsaswellasnutritionandlifestylechangesinhisorherpractice,andinsomestatesislicensedtoprescribeconventionalprescriptionmedications.
DOCTOROFCHIROPRACTIC(DC)—ahealth-careprofessionalwhofocusesonthedisordersofthemusculoskeletalandnervoussystems.Trainingconsistsofchiropracticschool(generally4yearsaftercompletingabachelor’sdegree)andpassingalicensingexam.DCs’doctoratecertificationisnonmedical,andtheyarenotabletoprescribemedicationlikeamedicaldoctorwould.Sincethenervoussystemissointegraltowhole-bodywellness,alotofchiropractorsoffercomprehensivedietandlifestyleconsultinginadditiontoadjustmentsandphysicalmanipulation.
LICENSEDACUPUNCTURIST(LAC)—anatural-healthprofessionalwhohasbeentrainedinChineseherbologyandacupuncture,atreatmentthataimstoidentifyandredirectenergeticimbalanceswithinthebody.ThosewhohaveobtainedtheirLAccertificationhavecompletedamaster’s-levelprogramusuallyencompassing3to4yearsafterabachelor’sdegree.Insomestates,likeCalifornia,anLAccanorderlabtesting,althoughtheyareunabletoprescribeconventionalmedicationsandinsteaduseherbalpreparations.
DOCTOROFACUPUNCTUREANDORIENTALMEDICINE(DOM)—Anatural-healthprofessionalwhohasreceivedadvancedtraining(usually2yearspastmaster’slevel)inChineseherbologyandacupuncture,withspecialtiessuchasgynecology,painmanagement,andcancertreatmentavailable.
TypesofLicensedComplementaryCarePractitionersThesearepractitionerswhogothroughspecifictrainingtoprovideservicesthatarecomplementarytoconventionalmedicine.Licensesandcertificationscanvarybystateandbyprogram,somakesuretoresearchtoseewhatkindof
varybystateandbyprogram,somakesuretoresearchtoseewhatkindoftrainingyourpractitionerhasreceivedaswellasthetypesoftherapyheorsheislicensedtoprovide.
MASSAGETHERAPIST—acomplementarycarepractitionerwhospecializesinthephysicalmanipulationofmusclesinordertoreducepain,promoterelaxation,andeasetension.Massagetherapistsarerequiredtobetrainedbyanaccreditedinstitutionandperformmassageforacertainnumberofhoursbeforeobtainingcertification.Somecontinuetheireducationandtrainingandbecomeboardcertified.
COUNSELOR—apractitionerwhospecializesinhelpingtheirclientstackleemotionalproblems,usuallybyusingtalktherapy.Somecounselorsspecializeincertainareas,likeaddictions,family,marriage,andwellness.Dependingonthespecialty,counselorsobtainabachelor’sdegreeand/oramaster’sdegreeandneedtomeetpracticerequirementstoobtainlicensureand/orboardcertification.
TypesofNonmedical,NonlicensedPractitionersSomecomplementarytherapiesfaceissuessuchasunlicensedpractitioners,notfullybackedbyscientificresearchandwithoutacceptancefromthemedicalcommunity,butanecdotally,theyhaveplayedaroleinwellnessformanywithautoimmunedisease.Beforedelvingintothiscategoryoftreatmentoptions,itisimportanttohaveyourmedicalteaminplace,asyourprimaryneedistoreceiveinstructionortreatmentfromadoctor.We’veincludedalistofsomeofthemorecommonalternativetherapiesstartingbelow.
NUTRITIONORHEALTHCOACH—acomplementarycarepractitionerwhospecializesincoachingandadvisingonahealthydiet.Thereareawidevarietyofcertifications,someaccreditedandsomenot,anditispossibleforapractitionertobecomeboardcertified.NutritionandhealthcoacheswhohavenotcompletedRDtrainingarenotconsideredmedicalpractitionersandcannotdiagnoseortreathealthconditions.
LIFESTYLECOACH—Thesepractitionerscanhelpyoumeetapersonalgoalinacertainarea,likewellness.Thiscanbehelpfulforthosewhoarelookingforguidance,recommendations,andencouragementontheirjourneys.Althoughtherearetrainingprograms,theprofessioniswithoutaccreditationorlicensing.
HOMEOPATH—Thesepractitionersusetheideathataverysmallamountofasubstancethatisknowntocausesymptomscanactuallybeusedasanagenttorelievethosesymptoms—theconceptof“likecureslike.”Homeopathicpreparationsareadministeredsublinguallyorbymouthinadropper.
AYURVEDICPRACTITIONER—Thesepractitionersemployoneoftheworld’soldesthealthpractices,originatinginIndia,andusefoundationalconceptsabout
wellnesstomanagehealth.Ayurvedacallsfordietarychangesaswellasherbalproductsastreatment.
REFLEXOLOGIST—amassagetherapistwhobelievesthatmassagingcertainpointsonthefeetthatarethoughttocorrespondtoorgansinthebodycaneffectchangeinthebody.
BIOFEEDBACKTECHNICIAN—apractitionerwhousesatherapyconnectingthebodytoelectricalsensorsthatmonitorimpulses,suchasheartrateorbrainactivity.Biofeedbackcanhelpyoumonitorandmakechangestoyourbodyinrealtimelikerelaxmusclesorreachameditativestate.
MOVEMENTTHERAPIST—ateacherofamind-bodypracticethatinvolvesthetherapeuticuseofmovementordancetoproducedesirablechangesinthebody,eitherphysicallyoremotionally.
HERBALIST—apractitionerwhousesplantsformedicinalpurposes.Herbalismhasdeeprootsinalternativemedicine.Manylicensedpractitioners(likeanND,LAc,orDOM)aswellasmanyunlicensedpractitioners,useherbsintheirpractices.
REIKIMASSAGETHERAPIST—thosewhouseaJapaneseenergetichealingmodalitythatinvolvestheplacementofhandsaroundthebodyandbalancingenergyfocusingonbodyareasinasimilarwaythatanacupuncturistwould.
YOGATEACHER—ateacherwhousesaphysicalpracticethatcanhavespiritualandmentalcomponents,dependingonhowitisused,andwhichinvolvesbreathworkandstretchingthebody.Yogaispracticedinmanydifferentstylesandaspartofmanyphilosophiesaroundtheworld.
MEDITATIONTEACHER—ateacherwhousesapracticethataimstobenefitthemindbytrainingittobecomemorepresentandaware.Therearemanyformsofmeditationandwaysofachievingthisawareness,andsomeareconnectedtoaspiritualpractice,althoughmeditationdoesnotneedtoincorporatespiritualitybydefinition.
Endometriosisisoneofthediseasesonthelistthatisonlysuspectedasautoimmuneatthistime.Medicalresearchersarestilltryingtounderstandtheexactnatureofthedisease.Forme,thatmakesmanagingmyendometriosiswithanintegratedapproachofbothnaturalandconventionalmedicineanobviouschoice.Theonlywaytoconfirmendometriosisisthroughaformofsurgerycalledlaparoscopy,andcurrently,thegold-standardtreatmentisthroughatechniquecalledexcision,performedbyextremelyskilledsurgeonswhospecializeintreatingendometriosis.Ihavesoughtoutthemostskilledsurgeonstohelpmeavoidcomplications.Inaddition,Iusediet,lifestyle,andtargetedsupplementationbasedontheadviceofmynaturopathicdoctortohelpmebestmanagethehighlevelofpainthatcomeswiththedisease,aswellasthehormonalfluctuationsthatcanexacerbatethesymptoms.
NavigatingNaturalHealth-CareOptionsHaveyoufoundyourselfconfusedatthemeaningofsomeofthewordsusedtodescribenaturalhealth-careoptions—alternative,complementary,integrative,orholistic?Althoughthesewordsareusedtodescribetreatmentsinrelationshiptoconventionalmedicine,theirdefinitionshavesubtledifferences.Beforeyoustarttocompileyourteam,itisimportanttohaveaworkingunderstandingoftheirmeanings.Knowthatthesetermsareneitherregulatednordotheysignifyspecifictrainingorcertification,althoughdoctorsorotherhealth-carepractitionersmayhavereceivedadvancedtrainingintheseareas.Manyprovidersusethesetermstodescribetheirpracticesorservices.Itisimportanttoknowthatitisstilluptoyoutoinvestigatewhattheirinterpretationofacomplementaryapproachis,asitcanvarywidelyfrompractitionertopractitioner.
ALTERNATIVEMEDICINE—whenanonconventional(alternative)treatmentisusedinsteadofaconventionalone.
COMPLEMENTARYMEDICINE—whennonconventionalandconventionaltreatmentsareusedinconjunction.
INTEGRATIVEMEDICINE—similartocomplementarymedicinebutexecutedinacoordinatedway.
HOLISTICMEDICINE—whenahealingmodalityaddressesthewholeperson,physically,mentally,andspiritually,insteadofthatperson’sparts.
FUNCTIONALMEDICINE—Likeholisticmedicine,functionalmedicineaddressesthewholepersonandaimstouncovertherootcausesofchronicillness.Practitionersemploydiagnosticlabtestingandbothconventionalandnaturaltreatmentsforbothbodyandmindtoproducewellness.
HowandWhentoIntegrateaConventionalandNaturalApproach
Yourdecisiontousenaturaltherapiesinconjunctionwithorinsteadofconventionalmedicineisapersonalone.Thereisnorightorwrongway—thepaththatproducesthebesthealthwithlimitedundesirablesideeffectsisyourgoal.Somepeopleareabletoreversetheirillnessesmerelybyusingdietaryandlifestyleinterventions.Othersrecoverusingacomplementaryorintegrativeapproach,usingbothconventionalandnaturalmedicalmethods.Somehaveneedsthatareverydeeplyrootedintheconventionalmedicalsystem,makingmedicationorsurgerynecessary.Yourpathisunique,andyourdecisiontousenaturaltherapiesisdependentonyourneedsandpersonalpreferencesabouthealthcare.Integrationofaconventionalandnaturalapproachcantakemanyforms.It
mightlooklikehiringanintegrativeMDasyourkeyplayerandhavingherguideyourcareforbothgeneralhealthandautoimmunedisease.Or,youmaydecidetoseeaconventionallyrootedspecialistinconjunctionwithanaturalpractitioner,suchasagastroenterologistandanNDforthetreatmentofadigestivedisease(likeCrohn’sorceliacdisease).YoucouldchoosetoseeaconventionalMDforgeneralhealthcareandemploycomplementaryhealth-caremodalitieslikechiropractic,massage,andhealthcoachingtofillthegaps.Aseffectiveandhelpfulasnaturaltherapiescanbe,everyoneneedstohavealicensedmedicalpractitionerontheteamtoserveashisorherprimarycareprovider,toperformannualexams,andtobeapointofcontactforhealthsupport.Theintegrationofanaturalapproachhasthebestchanceofsuccessifan
illnessiscaughtintheearlystagesandhasnotprogressedsignificantly.Manytryanaturalorcomplementaryapproachfirst,beforejumpingintomoreconventionaltreatmentslikemedicationorsurgery,especiallyifthosetreatmentscomewithundesirablesideeffects.Theflipsideisalsotrue—ifyourillnessissevere,youmaynothavethechoiceoftryingacompletelynaturalapproach.Makesuretomakethisdecisionwithapractitionerwhoislicensedtoadviseyouontheissue.Forinstance,don’taskyourmassagetherapistifhecanhelpyouavoidsurgery!
HOWDOYOUBUILDACOLLABORATIVETEAM?Nowthatyouunderstandwhatcollaborationis,thedifferencebetweennaturalandconventionalmedicine,thevarioustypesofproviders,andwhentointegrateyourapproach,weneedtostarttalkingaboutexactlyhowtobuildacollaborativeteam.First,itisimportanttounderstandafewkeyconceptsoncollaboration.
●KNOWWHATISATSTAKE—Knowingwhatyouwantandhowthatrelatestowhatthoseonyourteamwantwillhelpguideyourinteractions.
●VALUEDIVERSITYANDDIFFERINGOPINIONS—Insteadofexpectingeveryhealth-carepractitionertohavethesameopinionaboutsomething,valuetheinstanceswhentheyallbringsomethingdifferenttothetable.
●LEARNHOWTOHANDLECONFLICT—Yourhealth-careteammaypresentyouwithoptionsthatyouarenotexpecting,thatyoudon’tagreewith,orthatconflictwitheachother.Beingpatientandhandlingthesesituationsobjectivelycanhelpyoupreservetheintegrityofacollaborativerelationship.
●RECOGNIZETHATCOLLABORATIONISADEVELOPMENTALPROCESS—Themoreyoupracticecollaborationwithyourhealth-careteam,theeasieritwillbetocontinuethisstyleofworkingrelationshipastrustbuildsovertime.
●BALANCEAUTONOMYANDUNITY—Realizewhenitisappropriateforyoutoquestionyourpractitioner’splan,whentocometogethertodeviseamoreunifiedone,orwhentosurrenderandtrustyourteam.Thisisadifficultconceptandtakesexperienceandpracticetodevelop.
●RECOGNIZEWHENCOLLABORATIONISNOTNEEDED—Notewhenitisappropriatenottocollaborate,suchaswhenaproblemisnotsocomplexitwarrantsawholeteamtosolveit.Sometimesindependentdecisionmakingbyyouorparticularmembersofyourteamisappropriate,especiallyifinvolvingallvoiceswillmakeasimpleissuecomplicated.
Whatdoesthislooklike?Collaborationislikelytostartwithyourcommunicatingtoyourhealth-careprovidersaboutthestepsyouaretakingwithotherprovidersormakingallpartiesawareoftheofferingsofoneproviderthatcomplementtheadviceofanother.Theonusisonyou,asthepatient,asclearcoordinationbetweenprovidersisunfortunatelynotyetstandardpracticeoutsideofanextremehealthcrisis(likeacaraccidentresultingincriticalinjuriesthat
ofanextremehealthcrisis(likeacaraccidentresultingincriticalinjuriesthatrequiremultiplemedicaldisciplinestohelpthepatientrecover).Ifyouareluckyenoughtofindprovidersopenandwillingtotakethetimetospeakwitheachother,besuretosupportcoordinationoftheirefforts.Next,withthoseconceptsinmind,followingisalistofthevariousrolesyou
needtofillonyourteam.
●MVP—The“mostvaluableplayer”onyourcollaborativehealth-careteamisyou.Ittakestimeandefforttobepartofyourteam,butanengaged,empoweredpatientcanmakeorbreakaqualityhealth-careexperience.AstheMVP,youneedtochooseproviderswisely,partnerwiththemtodeterminethebestchoicesforyou,understandandcommunicatewhatqualitycarelookslikeforyou,preparequestionstoaskandgiveprovidersalltheinformation(eventheuncomfortablestuff!)theyneedtodotheirjobs,cometoappointmentswithyourvisitgoalsprioritized,bereadytofollowthroughonrecommendations,andbewillingtolookfornewprovidersifarelationshipisnotworking.
●KEYPLAYER—Thisistheproviderwhoyouseefirstforyourneeds.ItmaybeanMDorDOwhopracticesprimarycaremedicineoritmaybeaspecialist.ThispersonmightalsobeaPA,NP,orND.Sheisyourmainpointofcontactandhelpsprovidemuchoftheinformationand/ordirectionthattherestoftheteamneeds.Detailsaboutchoosingyourkeyplayercanbefoundinthenextcolumn.
●SUPPORTPLAYERS—Theseareallthevarioussupportrolesrequiredtoroundoutyourteam.Theseplayerscouldincludeonlyoneotherpersonorseveral,dependingonyourcurrentneeds,andcovereveryonefromcrucialfamilymembersorfriendstoothermedicaldoctors,licensednaturalmedicinepractitioners,complementarycarepractitioners,ornonmedicalproviders.Detailsaboutfillinginthesupportingrolescanbefoundhere.
HOWDOYOUCHOOSEYOURKEYPLAYER?Choosingyourkeyplayerwiselyiscrucialtobuildingyourcollaborativehealth-careteam.Thisproviderisgoingtoactasyourmedical“home.”Hewillbetheprovideryouvisitformosthealth-careneeds,fromroutinescreeningsforyourautoimmunediseasetolow-levelillnesseslikeasorethroatorstomachbug,towellnessvisitswhereyoushareextremelyprivateconcernsandaskimportantquestions.Ideally,thisrelationshipwilllastyears,evendecades,andbethecornerstoneofmaintainingyourgoodhealth.Attheveryleast,allmembersofyourteam,butespeciallyyourkeyplayer,
shouldberespectful,willingcollaborators,andgreatlisteners.Youshouldalso
shouldberespectful,willingcollaborators,andgreatlisteners.Youshouldalsoexpectaminimumofclinicalcare(thismeansfollowinganestablishedprocessinmeetingyourneeds),timeliness,andfollow-through.Thismeansthatyourprovideriscommunicatingtestresultsandgettingyoureferralsonatimelybasis.Withthosebasicsoutlined,therearesomeothersignificantquestionstoask
yourselfwhilechoosingyourkeyplayer.
●WHATISMYKEYPLAYER’SBACKGROUNDANDEXPERIENCE?Thinkabouttheeducationalbackgroundthatisimportanttoyou,aswellasyourprovider’sexperience,especiallyincaringforsomeonewithyourautoimmunedisease.Thatsaid,don’tdismissyoungerproviders.Thereisvaluetoboththosewithmorerecenttrainingandolderproviderswithyearsofhands-onpractice.
●ISMYKEYPLAYER“IN-NETWORK”WITHMYINSURANCEPLAN?Insurancecompanieshavespecial,discountedrateswithcertaindoctorsandhospitals,andusingprovidersandfacilitieswithinthatrateplanismuchlessexpensiveforyou.Youcancheckwithyourinsuranceplantofindoutwhichdoctorsare“in-network.”
●DOESMYKEYPLAYERHAVETHEEXPERTISEINEEDORWANTINAPROVIDER?Consideringthelistofpractitionertypes,narrowdownyourchoicestoaproviderwhobestmatchesyourpreferences.Insomestates,NDsareallowedthesamescopeofpracticeasMDsorDOsandyoumaypreferthemasyourprimarycareprovider.Thesescopesofpracticedovarywidelythough,sointhinkingaboutthis,besurethatifyourautoimmunediseaserequiresmedication,anNDwillbeallowedtoprescribeit.
●DOESANYONEIKNOWHAVEAGOODRECOMMENDATIONFORMYKEYPLAYER?Thereisnobetterreferraltoaproviderthanthoseofferedbyfamilyorfriends.Havingfeedbackaboutanin-personinteractionwithapotentialcandidateisinvaluabletoyourdecision-makingprocess.
EVALUATINGPOTENTIALPROVIDERSCHECKLISTHerearesomequestionstoaskyourpotentialproviderswhenyouscheduletheinitialvisit.Often,theirreceptionistwillbeabletoanswermostoftheseforyou,andifyouheardoftheirpracticebyreferral,otherpatientsmaybeabletotellyoumoreabouttheirexperiences.Wehavefounditbesttoasksomeofthesequestionsbeforethefirstappointmenttobesureyouarenotwastingtimewithapractitionerwhodoesnothavetheexpertiseyouarelookingfororacollaborativespirit.
◻ Whatkindofinsurancedotheytake?
◻ Howmuchdotheirservicescost?
◻ Ifyoudon’thaveinsurance,dotheyhavea“cashprice”oradiscount?
◻ Dotheyonlyofferservicesaspartofapackageordotheychargebythesession?
◻ Aretheyfamiliarwithyourcondition(s)?
◻ Dotheyhaveexperienceorexpertisetroubleshootingtoughcasesorworkingwiththosewhosufferfromchronicconditions?
◻ Howmuchtimedotheyspendwithapatientduringanappointment?
◻ Whatistheirintakeprocess?
◻ Cantheybecontactedfortroubleshootingorfollow-up?
◻ Howbusyistheirschedule—canyougetintoseethemonshortnotice?
◻ Whatistheireducation/trainingbackground?
◻ Howdotheycollaboratewithotherpractitioners?
◻ Dotheyrequireyoutopurchasesupplementsfromtheiroffice?
EVALUATINGYOURCURRENTPROVIDERSCHECKLISTHereisalistofquestionsyoucanusetoevaluatetheteamyouhavealreadyputinplaceorthenewprovidersyouareconsidering.Keepinmindthatnotallprovidersaregoingtoscorehighinallareas,butaskingyourselfthesequestionswillhelpyoudeterminetheirweakspotsandifyouwouldbebetterservedworkingwithsomeoneelse.
◻ Howcaringistheirbedsidemanner?
◻ Howthoroughistheirannualphysical?
◻ Dotheypracticeoraretheyfamiliarwithnaturaloralternativeapproaches?
◻ Dotheytakethetimetoanswerallofyourquestions?
◻ Aretheyavailablefortroubleshootingorfollow-up?
◻ Aretheyfamiliarwitharealfooddietandaretheyhappytosupportit?
◻ Aretheyfamiliarwithyourautoimmunedisease?
◻ Aretheywillingtodiscussandorder,whennecessary,testingthatyouwantdone?
◻ Aretheywillingtodiscussandreferyou,whennecessary,tospecialistsyouwanttosee?
◻ Aretheyopen-mindedaboutusingnaturalmethodsbeforeprescribingpharmaceuticals?
◻ Aretheycautiouswhenrecommendingmedicationsandsupplementsordotheytendtobeheavy-handed?
◻ Dotheyseemconcernedwithyourlong-termwell-beingandprogress?
◻ Aretheycollaborative—aretheyincludingyouandotherteammembersindecisionmaking?
●DOIWANTMYKEYPLAYERCLOSETOMYHOMEORWORK?Maybechoosingaproviderwhoislocatedclosetoyourofficemakesalotmoresensethanoneclosetoyourhome.Perhapstravelingarelativelylongdistanceforaveryworthwhileproviderissomethingyouarewillingtodo.Considerlocationinyourdecision.
●HOWACCESSIBLEISMYKEYPLAYER?Youshouldbeabletogetintoseeyourproviderwithinreasonabletimeframes.Ifyoucan’tactuallyseetheprovider,youwon’tbeabletogetthehelpyouneed.Ifsickvisits,forinstance,cannotbescheduledwithin24hours,thatmightbeasignthatthefitisnotgood.Ontheotherhand,needingtoscheduleawellvisitseveralweekstoamonthoutisusuallyacceptable.
●DOESMYKEYPLAYERANDHERSTAFFPRACTICEGOODRECORDKEEPING?Yourproviderwillnotbeabletooffermuchhelpifsheisnotproperlynoting,tracking,andstoringyourhealthdata.Alongwiththis,considerwhetherornotsheuseselectronicrecords,whichcanmakecommunicationwithyourotherteammembersquiteabiteasierandallowyoutoaccessyourowninformationmoresmoothly.
●ISTHECUSTOMERSERVICEOFMYKEYPLAYER’SSTAFFUPTOPAR?Ifyoufindyourselfgettingnervousaboutthelikelynegativeencounteryouwillhaveeachtimeyouhavetocontacttheoffice,thatisaredflag.Youwillhaveto“passthegate”everytimeyouinteractwithyourdoctor,andyoudon’twanttobeconsistentlytreatedpoorlyorwithlackofconcern.
Onceyou’vechosenyourkeyplayer,it’stimetoscheduleafirstvisitandusethatinitialencountertoassessifsheisabletofulfillthisroleonyourteam.Inthesidebar“EvaluatingPotentialProvidersChecklist,”you’llseealistofquestionstoaskwhenyouschedulethatinitialvisit.Ifsheturnsouttoberightforyou,followingthatmeeting,youcanmoveontofillingthesupportingrolesonyourhealth-careteam.Otherwise,youshouldcontinueyoursearchforyourkeyplayerbeforegettinganyfurtheralonginbuildingyourteam.
HowDoYouFilltheSupportPlayerRoles?Makingcarefulchoicesforthesupportplayersonyourhealth-careteamisn’tquiteascriticaltoaqualityhealth-careexperienceaschoosingyourkeyplayer,buttheyarestillimportant.Greatsupportcanmakeyourjourneyatruesuccess,whilepoormatchescanmakewellnessgoalsnearlyimpossibletoachieve.Thekindsofpeoplefillingyoursupportrolesaremorevariedthanthoseinthekeyplayerpositionandyourneedforthemcanchangealotdependingonwhereyouarewithyourdisease.Forinstance,theseplayerscouldbeavitalfamilymemberorfriendactingasyouradvocateand/orcaretaker;variousmedicalspecialistsrelevanttoyourdiagnosis;complementarycarepractitionerslikeachiropractor,acupuncturist,ortherapist,whomyouonlyneedforarelativelyshortperiodoftime;ornonmedicalproviderslikeahealthcoachoryogateacherwhowillhelpyouachieveveryspecificgoals.Thesupportrolesarethelastpiecestoroundoutyourteamandmakeyour
healingaholistic(whole-body)process.Yourkeyplayercannotbeexpectedtoknoweverythingandbeeverythingatalltimesforyou.Tryasshemight,itisrareforonlyoneprovidertobecapableofmeetingallofyourneeds,yethealingasawholepersonisavaluablegoal.Forthisreason,strivingtofillsupportrolesonyourteamisworthalltheeffort.Averybasicandtypicalsupportteammightincludeadiseasespecialist(ifyourkeyplayerisnotaspecialisttobeginwith),acounselor,andafamilymemberorfriend.Again,attheveryleast,yoursupportprovidersshouldberespectful,willing
collaborators,andgreatlisteners.Youshouldalsoexpectaminimumofclinicalcare(whereappropriate—thisobviouslydoesnotapplyinthecaseoffamilyorfriends),timeliness,andfollow-through.Withthosebasicsoutlined,herearesomeotherthingstoconsiderwhile
choosingyoursupportplayers.
●WHATHELPWOULDMOSTBENEFITYOUINADDITIONTOYOURKEYPLAYER?Determinealltheadditionalsupports,perhapsalongwithyourkeyplayer’srecommendations,thatwouldbestmeetyourneeds.Onceyourideallistisinplace,beginconsideringyourtimeavailabilityandfinancialresourcesinordertotrimtheteamtowhatismostpracticalforyou.
●DOYOUNEEDAMEDICALSPECIALISTORSPECIALISTSFORYOURAUTOIMMUNEDIAGNOSIS(ES)?Ifso,arethereproviders“in-network”withyourinsuranceplan?Yourkeyplayermayrecommendoneoryoumaywantaspecialisttohelpyoudigdeeper.Forinstance,agastroenterologistifyouhaveceliacdiseaseora
dermatologistifyouhavepsoriasiscanbeinvaluable.
●DOYOUNEEDANYLICENSEDCOMPLEMENTARYCAREPROVIDERS?Ifso,willyourinsuranceplancoveralloraportionoftheirservices?Someplanscoveracupuncture,chiropracticcare,massage,physicaltherapy,orcounseling.Besuretocheckandtakeadvantageofcoverageifitisoffered.
●WILLYOUNEEDTOSEEYOURSUPPORTPLAYEROFTEN?Ifso,aconvenientlocationmaybeimportant.Supportplayersfrequentlyofferroutinecarethatneedstohappenonaregular,ongoingbasis,suchasweeklymassageortalktherapysessions.
●DOYOUHAVEONECLOSEFAMILYMEMBERORFRIENDWHOMYOUCANLEANON?Whatyouneedfromthispersoncanbeconsiderablewhenyouarestillverydebilitatedbutmuchlesswhenyouareenjoyinggreaterhealth.Besensitivetothefactthatyourneedsmaybetoolargeaburdenorthispersonmaynotbeabletosupportyouinallthewaysyourequire.Ifthatisthecase,expressyourgratitudeforwhatsheisabletogiveandthenaddasecond,third,orfourthfamilymemberorfriendtoyourteam.Forexample,maybeyourpartnerisabletodoextrachoresandgotoappointmentswithyou,butnotabletolistenwhenyouneedtoventaboutyourillness.Findingafriendtoventto,particularlysomeonewhohasasimilardiagnosis,fillsthatneedandalsorelievessomeofthepressurefromyourpartner.Themorerobustyournetwork,thebetter!
Inadditiontotheseconsiderations,youmayalsowanttoaskyourselfsomeofthesamequestionsyoudidwhilechoosingyourkeyplayer.Onceyou’vechosenyoursupportplayers,schedulefirstvisitsandtreatthosesessionsasinterviews.Inthecaseofthatvitalfamilymemberorfriend,scheduleatimetotalkwithherthatisbestforbothofyouandwithoutdistractions.Beopenandfrankaboutyourneedsandexpresshowmuchitwouldmeantoyoutohaveherloveandsupportasyouseekhealing.Graciouslyaskingforhelp,ratherthantakingitforgranted,islikelytowinyouadevotedpartnerforthepathahead.
ConflictingAdviceIfyouaredecidingtousebothconventionalandcomplementarycarehealth-careproviders,itisinevitablethatyouwillfacetheissueofconflictingadvice,opinions,ortreatmentoptions.Thiscanhappenevenifyou’rejustusingonemodeortheother.Thisisafrustratingexperiencethatcanleadyoutolosetrustinyourhealth-careteam.Herearesometipsformanagingconflictingadvice.
●DOEVERYTHINGYOUCANTOPRESERVECOLLABORATIONONYOURTEAM.Bepatient,open,andhonestwithyourpractitioners.Letthemknowwhoelseisonyourteamandbeclearaboutwhenconflictsarisesotheycanhelpbeapartofthesolution.
●ALWAYSVALUETHEADVICEOFYOURKEYPLAYEROVERALLOTHERPRACTITIONERS.Thisisoneofthemostimportantreasonswhyhavingacollaborative,experienced,andsupportivedoctorasyourkeyplayerisabsolutelynecessary.Ifyourkeyplayerisnotuptopar,youmaybefacedwithlackoftrustandconfusionabouthisrecommendationsandhowtheyrelatetoothersonyourhealth-careteam.
●BESUSPECTOFMEDICALADVICEFROMNONMEDICALPRACTITIONERS.Whileitistruethatalotofnaturaltherapiescanhelpmedicalconditions,itisnottheplaceofnonlicensedornonmedicalpractitionerstomakeclaimsorprescribethetreatmentofdisease.Ifanonmedicalpractitioneristryingtogiveyouadvicethataffectsyourmedicationortreatment,makesuretorunitbyyourdoctororlicensedmedicalpractitioner,andheedhisopinionabovethatofanycomplementarycarepractitioners.
●GETASECONDOPINION.Especiallyinthefaceofseriousmedicationsand/orsurgery,don’tforgetthatyoucanalwaysseeanotherpractitionerforhertakeonit.
●ALWAYSRESPECTYOURINSTINCTS.Intheend,itisyourchoice,notyourdoctor’soranyoneelse’sonyourhealth-careteam,whatyoudoregardingyourownbody.Ifapieceofadvicecontinuesnottositwellwithyourowninnerguidancesystem,takeitasasignthatyouneedtodomoreresearchandpossiblyconsultanotherpersonbeforemovingforwardwithit.
ShouldYouEverFireaProvider?Itcanbestressfulchanginghealth-careproviders.Peopleoftenfindtheprocessofleavingaprovider,eveniftheyknowitisnotagoodmatch,sodauntingthattheystayinbadworkingrelationships.Whileweunderstandhowharditcanbetofindsomeonenew,weencourageyoutomoveoniftherearesignsthatyourcurrentproviderisnotworkingout.Thisisparticularlytruewithyourkeyplayer.Themembersofyourhealth-careteamaretheretohelpyou,somakingsuretheselinksareasstrongaspossiblematters.Thefollowingaresomeredflagsthatit’stimetosaygoodbye.
●NEEDANDSTYLEMISMATCH—Somepatientspreferveryblunt,directproviders;otherspreferlotsofempathy.Somepatientslikeaformalprovider,whileotherslikearelaxedapproach.Ifwhatyoupreferisn’tthestyleofyourprovider,youmaynotmeshinthelongterm.
●LACKOFCONTINUITY—Ifthereisnofollow-throughonyourprovider’spartbetweenvisits,oreverytimeyoureturnforanappointment,yourproviderseemstobeencounteringyourhistoryfortheveryfirsttime,thisisabadsign.Aconnectionshouldformandconsistentcareshouldbehappeningbetweenvisits.
●NEED-TO-KNOWBASIS—Ifyourproviderkeepsyouinthedarkaboutthereasonbehindtests,treatments,orevencertainresults,itistimetogo.Itisyourrighttoknowwhyhewantstotakespecificsteps,andalackofopennessorinabilitytospeakwithyouaboutitinastraightforwardmanner(withoutcomplicatedmedicaljargon)isabadsign.Inthesamevein,ifyoudon’tfeelcomfortablegivingyourproviderallofthedetailheneedsaboutyourhealth,andyouareessentiallykeepinghiminthedark,thisisalsoabadsign.
●DISMISSIVEATTITUDE—Aprovidershouldwelcomeyourquestionsandconcerns,willinglyaddressingthem.Sheshouldalsolistencarefullytowhatyouhavelearned,aswellasyournotedsymptomsandinstinctsonwhatishappeninginyourbody.Itisasignificantproblemifyourepeatedlyseeyourprovideraboutaconcerningissueandsherepeatedlydisregardsitormakesassumptionswithoutpayingattentiontowhatyou’vesaid.
●LACKOFRESPECT—Youaretheauthorityonyourbody,handsdown.Iftheproviderisplainlyrude,condescending,ordisrespectful,youshoulddefinitelyfirehim.
●UNWILLINGCOLLABORATOR—Yourprovidershouldbereadytocoordinatewiththeothermembersofyourteam,takeintoaccountanynewinformationtheyhaveprovided,andtalkwithyouabouttheinstructionsandrecommendationstheyaregivingyou.Ifheviewshimselfasa“one-manshow,”thatcanbeasignthattheworkingrelationshipisnotgoingtobeproductive.
PartofmyjourneytolivingwellwithHashimoto’sthyroiditiswasworkingwithmydoctortofindatypeanddoseofthyroidmedicationthathelpedmefeelmybest.BeforeItriedmedication,Ihadexperiencedincrediblehealingthroughchangingmydietandlifestyle,buttherewerestillsomenaggingsymptomsthatweremanagedsuccessfullywiththeadditionofmedication.Atfirst,Ifeltlikemyeffortstohealnaturallywerenotgoodenough,andthatneedingtotake
first,Ifeltlikemyeffortstohealnaturallywerenotgoodenough,andthatneedingtotakethyroidhormonewasafailure.Today,I’vereformedmyoutlookandrealizethateverythingIdo,fromdiettosleeptostressmanagementtomedication,isanefforttolivemyhealthiestlife.IamgratefulforallofthetoolsIhaveinmytoolbox,includingthatlittlepillItakeeverymorning!
●UNAVAILABILITY—Beingabletogetintouchwithyourproviderbetweenappointmentsforanyfollow-upquestionsortoreportanyconcernswithmedicationsortreatmentsisimportant.Ifsheisunreachable,that’sasignthatyourpartnershipisunlikelytoworkout.
●ALWAYSBEINGKEPTWAITING—Sometimes,havingaproviderwhoisconsistentlyabitlateforyourappointmentisactuallyagoodsign.Hemaybeverythoroughanddedicated,takingampletimewitheachpatient,includingyou.However,ifyouareconstantlysittinginacoldexamroomastheminutes(orworseyet,hours!)tickaway,thisshowshowmuchtheproviderundervaluesyourtime.Thisalsoappliestogettinginforappointments.Ifyouhavetowaitformonthsatatimetogetin,thepracticemaybetoobusytorealisticallymeetyourindividualneeds.
Ifyoudecidetofireyourprovider,itdoesnotneedtobeadramaticconfrontation.Simplywritealetterstatingyourreasonsforleavingandrequestingyourmedicalrecords.Makingsureyouhavethebestpossibleplayersonyourhealth-careteamisabsolutelyworththeeffort.
THEBIGDECISIONSMedicationandSurgery
Youmayhavestartedyourresearchaboutalternativetherapiesafteryourmedicaldoctoradvisedmedicationand/orsurgery.Therearemanyreasonswhyyouwouldn’twanttotaketheseapproaches,consideringthepotentialsideeffects,invasiveness,andpermanencethatcomewithsometreatments.Youcouldalsoalreadybeonalaundrylistofmedications,experiencingvarioussideeffects,andwishingtodoawaywiththem.Beforetakingaction,however,makesuretoreadthissectioncarefullyasitisatrickyandpersonalsubject.AswementionedinChapter1,theconventionaltreatmentformanaging
someautoimmunediseasescaninvolvepharmaceuticalmedicationsandsurgery.Asanalternativeorcomplementtothisapproach,integrativeandfunctionalmedicinepractitionershaveadditionaltoolsintheirtoolbox,sometimesbeingabletominimizeoravoidthesedrasticmeasures.Inaddition,thechangesyoucanmakeforyourselftoyourdietandlifestylemayhaveanimpactonyour
needformedicationorsurgery.Afteremployingtheseapproaches,youmayfindthatyoucanavoidconventionaltreatmentlikesurgeryorareabletoweanoffyourmedications,incollaborationwithyourdoctor.
DoesNeedingMedicationorSurgeryMeanYou’veFailed?
Sometimesitiscleartoyouandyourmedicalteamthatmedicationand/orsurgeryistheonlychoice.Whenfacedwiththissituation,especiallyaftertryingtoimplementsomecomplementarytherapies,youmayassumethatyou’vefailedentirely—thiscouldnotbefurtherfromthetruth!Instead,yourgoalshouldbelivingtoyourhigheststandardofwellnesswithautoimmunedisease.Althoughweadvocateforacomplementaryapproachtomedicalcareaswellasdietaryandlifestylechanges,weneversuggestavoidingnecessarymedicationand/orsurgery.Herearesomecommoninstanceswheremedicationand/orsurgerymaybe
necessary.
●YOULACKANIMPORTANTHORMONEFOROPTIMALFUNCTION.Thisiscommoninautoimmunediseasesliketype1diabetesorHashimoto’sthyroiditis,wheretissuedestructionpreventsthebodyfrommakinghormonesthatarecrucialforoptimalhealth(inthiscase,insulinorthyroidhormone).
●YOURSYMPTOMSAREDEBILITATING.Someautoimmunediseasescausesymptomsthatrenderapersonunabletofunctionindailylife,whetherthatisinflammation,pain,orsomethingelse.Therearemedicationsthatcanmakethismoremanageable,suchasthosethatrelievepainforrheumatoidarthritis.
●YOUHAVESIGNIFICANTTISSUEDAMAGE.Inthecaseofinflammatoryboweldisease(Crohn’sdiseaseandulcerativecolitis),sometimestissuedamageissowidespreadthatsurgeryisnecessaryforrepairandoptimalfunction.Inthecaseofendometriosis,growthsmayneedtoberemovedinordertopreserveorganfunction.
Manyofuswhosufferfromautoimmunediseasehaveemployedpharmaceuticalorsurgicaltreatmentsatkeyorongoingpointsinourhealingjourneys,inconjunctionwithnaturaltreatments,andcreditthemforourrecoveryandongoinghealth.MickeytakesreplacementthyroidhormonetocontrolherHashimoto’sthyroiditis,andAngiehasundergonelaparoscopicsurgerytomanageherendometriosis.Thereisnoreasontofeellikeafailureifyouaredoingeverythinginyourpowertoeducateyourselfandeffectivelymanageyourcondition.
DISCLAIMERYoushouldneverstoptakingormakechangestoyourmedicationortreatmentplanwithoutthecarefuladviceandsupervisionofyourmedicalteam.Keeptheminformedofallofthestrategiesyouareemployingonyourjourneytohealth,includingthosethatinvolvedietandlifestyle.
CanYouWeanOffYourMedications?
Itisabsolutelypossibleforyoutoweanoffsome,ifnotall,medicationsusinganaturalapproach,butitisimportanttonotethatthismaynotbeanoutcomeforeveryone—itdependsonyourcurrentconditionanddiseaseprogression.Thisissomethingthatneedstobehandledunderthecareandsupervisionofyourmedicalteamandneveronyourown.Ifweaningoffmedicationsisyourgoal,thefirststepistohaveaclear
conversationwithyourmedicalpractitioner,lettingherknowaboutanycomplementaryapproachesyoumaybeemployingthatsheisnotawareof(includingdietaryandlifestylechanges)andaskingforherhelpwiththepossibilityofmorefrequentmonitoringandweaning,ifshedecidesitismedicallypossible.Especiallywiththeimplementationofdietaryandlifestylemodifications,itismorelikelythatyouwillexperiencechangesinareaslikebloodpressure,cholesterol,bloodsugar,reflux,andconstipationbeforeexperiencingchangesinyourmoreseriousautoimmunesymptoms.Thus,weaningoffmedicationscanbealong-termprocessthatgoesinphasesasyourestoreyourhealth.
HowDoYouStretchYourHealth-CareDollars?Theunbelievablepriceofhealthcare,particularlyintheUnitedStates,sometimesmakesitdifficulttojustifytheideathatyourhealthismorevaluablethananythingelse.Althoughmostofuswithautoimmunediseasesknow,instinctivelyandfromexperience,thatwithoutgoodhealth,nothingelsematters,itcanstillbeunpleasantreceivingsizablemedicalbills.Wedidnotthinkthischapterwouldbecompletewithoutsomepracticalsuggestionsondecidingwhenandwheretospendandwhentopullback.
●ADJUSTYOURLIFESTYLEFORTHEGREATESTAMOUNTOFSELF-CARE.Thisshouldgowithoutsayingandtherestofthisbookwillexplainexactlyhow,butyouneedtochangeyourlifetogiveyourselfthebestpossiblechancesforoptimalhealth.Dedicatethebulkofyourhealth-carebudgettomaximizeself-care—thingslikeeatingwellandtakingadvantageofthatgymmembership!We
willbetalkingmoreaboutthisinChapter5.
●UNDERSTANDYOURINSURANCEPLANBENEFITSANDPAYCLOSEATTENTION.Educateyourselfonthefinerpointsofwhatiscovered,whatisnotcovered,thecoverageapprovalprocess,and,asdiscussedearlier,thedoctorsandhospitalsthatare“in-network.”Thenbepreparedtofollowupclosely.Ifyoufeelyourinsurancecompanyhasdeniedpaymentincorrectlyorhasnotpaidwhattheyareobligatedtopay,dedicatetimeandefforttogettingyourfullbenefit.Youmayalsoneedtoworkthissameapproachwithprovidersandhospitals.Thiscanbeextremelystressfulandtime-consumingwork,sofindingapartnerwhocanhelpyoustayontopofreviewingbillsandseekingmaximumbenefitsisagreatidea.Youwillusuallybeabletosavesubstantialamountsofmoneyifyouarediligentwiththisprocess.
●GETTHEMOSTTHOROUGHANNUALEXAMPOSSIBLEANDMAKETHEMOSTOFTHEINFORMATIONGAINED.Preventivecareiskey.Useyourannualexamasyour
primaryinformation-gatheringappointmentoftheyear.Youwillparticularlywanttopaycloseattentiontoyourlabresults.Taketimetolearnaboutthemanddiscusstheresultswithyourprovider.Ifyouseeresultsthatarequestionable,evenifyourproviderseemstofeeltheyareacceptable,scheduleafollow-uptotalkaboutthemfurther.Thisisyourchancetoadvocateforyourselfandpotentiallyidentifyandcorrecthealthproblemsbeforetheygetoutofcontrol.Inaddition,ifthereareteststhatcanberoutinelydoneforyoutostayontopofyourautoimmunedisease,learnallyoucanaboutthosetestsandhavethemconductedatregularintervals.
●ASKABOUTPAYMENTPLANSORCASHPRICINGWITHPROVIDERSNOTCOVEREDBYINSURANCE.Foranymembersofyourhealth-careteamwhoarenotcoveredbyyourinsuranceplan,besuretoaskaboutpaymentplanoptionsoriftheyofferdiscountedpricingforclientswhopaycash.Manyoftheseprovidersarewillingtoworkwithclientsonpaymentforextensivecarethatmaybedifficulttopayout-of-pocket.
Therearealsotimeswhenitisimportanttoevaluatewhetherornotspendingmakessense.Occasionally,itmightbeagoodideatostopspendingandpumpthehealth-carebrakes.Herearesomesuggestionsonbeingmoreselective.
●ANEXPENSIVEREPEATTESTISBEINGSUGGESTEDFORANISSUEYOUARENOWVERYFAMILIARWITH.Ifyoucanrecognizesymptomsofaparticularissueyourself,letyourproviderknowandaskifyoucanavoidtestingandproceedbasedonsymptomevaluation.Anexampleofthismightbeurinarytractinfections,whichmanywomenrecognizewithouttesting.
●ANEXPENSIVETESTNOTCOVEREDBYYOURINSURANCEISBEINGSUGGESTEDANDTHEINFORMATIONITWILLPROVIDEISNOTCRUCIALTOYOURHEALTHCAREATTHISTIME.Forinstance,comprehensivestoolanalysiscanprovideextremelyusefulinformation,butmaynotbenecessarytorepeatfrequently.Askyourproviderifholdingoffinordertosavemoneyisappropriate.
●AVERYINVASIVETESTISBEINGSUGGESTEDANDTHEINFORMATIONITWILLPROVIDEISNOTCRUCIALTOYOURHEALTHCAREATTHISTIME.Perhapsyourproviderisproposingyourthirdendoscopyinthelast2yearsandyoujustdon’tfeelcapableofgoingthroughtheprocedureagainorareworriedabouttheexpense.Expressyourconcernsandworkwithhimtodecideifitistrulyworthwhileorifitcanwait.
●YOUAREHAVINGASCARYHEALTHPROBLEM,BUTYOUKNOWFROMEXPERIENCETHATTHEERISNOTNECESSARY.Withsomeautoimmunediseases,upsettingsymptomscansometimescomeup,butovertime,youmaybeabletodistinguishbetweenamajormedicalemergencyandascary,butnotlife-threatening,scenario.Ifyouareinthissituationandjustneedtocalmanyfears,considergoingtoanurgentcareclinicandgettingadviceonhowtoproceed.Itismuchlessexpensive,nottomentionlessstressful,thantheER.(Naturally,wearenotadvocatingskippingtheERifyouneedit,onlystatingthatifyouunderstandyourhealthchallengeswell,youcanbemorejudiciousinhowtotreatthem.)
●ANEXPENSIVESUPPLEMENTISBEINGSUGGESTED,BUTYOUCANPOTENTIALLYGETITFROMAFOODSOURCEORWAITTOADDITTOYOURROUTINE.Doyourresearchonanysupplementsyourproviderssuggestandseekoutexpertopinionsbeforebuying.Ifyouthinkyoumightbeabletogetthenutrientsinthesupplementfromyourdietorthatitisnotessentialatthistime,askyourprovideraboutholdingoffonitandre-evaluatingitsadditiontoyourroutinelater.
●ANEXPENSIVEFORMOFCOMPLEMENTARYCAREHASBEENSUGGESTED,BUTYOUDON’TNOTICEAMAJORBENEFITWITHIN30TO60DAYS.Anexampleofthismightbeacupunctureormassage,asforsomeitmaybeextremelybeneficial,whileforothersitdoesn’tseemtohavethedesiredimpact.Don’tfeelyouhavetocarryonwiththiskindofcareifitisnotbenefitingyou.Instead,askyourproviderifanotherformofcarewouldbeabetterfitorwhatthereasonsforlackofresultscouldbesothatyoucanassesshowbesttospendyourmoney.
Ingeneral,peopledonotregretmoneyspentonmaintaininggoodhealth.Thecostburdencanbeveryhighforthoseofusdealingwiththechronicnatureofautoimmunedisease,butyouneverhearanyonesay,“Iseriouslyregretinvestingthatmoneyinmyhealth.”Nothingelsemattersifyoudon’thaveyourhealth.Thatiseasytotakeforgrantedwhenyouarewell,butdramaticallyobviouswhenyouareunwell.Youcan’tenjoyallthethingsyoucoulddowiththemoneyspentonhealthcare,ifyoucan’tleaveyourbedanyway,right?Theenormousexpensealsoforcesustotakeactionandresponsibility,tobefullparticipantsinourowncare.Andthatcanbeanempoweringbreakthrough!
CALLTOACTIONFormingacollaborativehealth-careteamtohelpmanageyourcareisasubstantial
undertaking,butitisatthecoreoftheautoimmunewellnessjourney.Seekingoutthehelpofothers,specificallythosewithnecessaryexpertise,candramaticallychangethecourseofyourdisease.Itisourintentiontopresentacompletepictureofwhatcollaborationmeansandhowtoputitintopracticewithyourteam.Understandingthevariousapproachestohealthcare,thekindsofpractitionersavailabletoassistyou,howtochoosetheplayerswhowillcomealongsideyou,andthebigtreatmentandspendingdecisionstheywillpresentyouwith,allowsyoutotrulybeacollaboratorinyourowncare.Noneofusisanislandinthislife.Itisworkingtogether,learningtocollaborate,thatisthebestwaytoachieveanygoal.
CHAPTER3
Nourish
“Itisnotanexaggerationtosaythatguthealthiseverything.Thehealthofyourguthasaprofoundeffectonyouroverallhealth.”—SARAHBALLANTYNE,PHD,THEPALEOAPPROACH
Usingdietarymodificationstomanageautoimmunediseaseisfarfromaconventionalapproach.However,asresearchcontinuestoclarifythelinkbetweenwhattranspiresinourgutsandhowthatrelatestoourimmunesystems,itisbecomingmorewidelyacceptedinthemedicalcommunity.Wheninquiringwithyourdoctorabouttheroledietplaysinbettermanagingyourcondition,youmayhavebeentoldthatithasnoinfluence.Thiscouldnotbefurtherfromthetruth!Weareheretotellyouthatwhatyoueatdoesmatter,anditcanhaveaprofoundimpactonyourhealingjourney.Thefoodsyouchoosetoeateverydayprovideyourbodywiththerawmaterialsitneedstoperformoptimally.Whetheryourdietisasourceofnourishmentorstraindependsontheparticularfoodsyouchoosetoputonyourplate.
Afterinformingyourselfaboutyourconditionandgettingyourhealth-careteamsolidlyinplace,itistimeforyoutoassessyourdiet.Thecornerstoneoflivingwellwithautoimmunediseaseiseatingadietthatbestsupportsyourlongtermhealthandwellbeing.Thiswayofeatingisgoingtobeuniquetoyou(noone-size-fits-allapproachhere!).Avoidingfoodsthatyoumaybeallergicorsensitiveto,addingmorenutritionwhereyouneedit,andpreventingorcontrollingimbalancesingutfloracanprofoundlyaccelerateandstrengthenthehealingprocess.Inthesamevein,animproperdietcanhaveahandincausinginflammationandanexacerbationofsymptoms.Figuringoutwhattoeatcanbeoneofthemosttransformativemomentsinyourhealingjourney,andnotonetotakelightly!Let’sgooverthefourkeyreasonswhydietisapowerfulcomponentof
healing.
●INTESTINALPERMEABILITY/LEAKYGUT—Researchhasshownthatthecommonthreadlinkingallautoimmunediseasesisindeedinthegut,andisknownbythe
termsleakygutorintestinalpermeability.Simplyput,thishappenswhentheliningofyoursmallintestine(theorganresponsibleforselectivelychoosingtoletnutrientsinandkeeppathogensout)becomesmorepermeable(leaky),therebylettingsomeofthecontentspassintoyourbloodstreamorlymphaticsystem.Yourimmunesystemisthenlefttodealwiththeseundigestedproteins,viruses,bacteria,andtoxinsthatshouldn’tbethereinthefirstplace,causingmoreinflammationandpotentiallysettingoffanimmuneresponse.Whatcausesleakygutinthefirstplace?Foodallergiesandsensitivities(especiallytogluten,aproteinfoundinsomegrains),dysbiosis(theimbalanceofgutflora),medications,andevenstressandoverexercisecancausetheliningofthesmallintestinetobecomemorepermeable.Byremovingorreducingthesetriggers,youlowertheburdenonyourimmunesystem,leadingtolessinflammationandfewersymptoms.
●NUTRIENTDEFICIENCIES—Ourmoderndietisnutrientpoor,lackingmanyessentialvitamins,minerals,andothernutrientsneededforwellbeing.Rapidlydecliningnutrientlevelsinoursoils(makingfewernutrientsavailableinthefruitsandvegetablesthatweeat)aswellaswidespreaddigestivedysfunctioncompoundthisproblem.Nutrientdeficienciesarethoughttocontributetothedevelopmentofautoimmunediseases,withdeficienciesinsomenutrients(likevitaminD)scientificallylinkedtotheirdevelopment.Deficienciescanalsoexacerbatethesymptomsofautoimmunediseasesandworsentheinflammatoryprocess.Thosewhosufferfromautoimmunediseasehaveagreaterneedfornutrients,especiallythosethatareinvolvedintissuerepairandmodulatingtheimmunesystem.Inordertohavethebestchanceatmanagingyourcondition,youneedtomakesuredigestionisfunctioningoptimallyandthatyouaregettingallnutrientsneededtohealyourbodyanddecreaseinflammation.
●FOODALLERGIES,INTOLERANCES,ANDSENSITIVITIES—Eatingfoodsyouareallergic,intolerant,orsensitivetocanhinderthehealingprocess.Whiletherearedifferencesinthemechanismandseverityofhowallergies,intolerances,andsensitivitieswork,gettingtotherootofwhichdietarytriggersareaffectingyoucanhelpyougetontheroadtorecovery.
●DYSBIOSIS—Ourdigestivetractislinedwithlivingmicroorganismslikebacteriaandyeasts,withmanyplayinganessentialandsupportiverole(suchasdigestingfood,producingBvitaminsandvitaminK,modulatingtheimmunesystem,andabsorbingnutrients).Dysbiosisisatermusedtoindicateanimbalanceinthesepopulationsofmicroorganismsinthegut,whetheritisfrompathogens(suchasaparasiteorbacteriathatcausesdisease)orovergrowthsof
otherwisehelpfulinhabitantsofthegut(suchassmallintestinebacterialovergrowth,wherebeneficialbacteriausuallyfoundinthelargeintestinemigrateupintothesmallintestine).Restoringthisbalanceofgutfloracangoalongwayinhelpingpromoteoverallhealth.
Inanefforttomakethisinformationmoremanageable,wewon’tbedelvingmoredeeplyintotheabovetopics.Forfurtherresearch,werecommendthefantasticresourceThePaleoApproachbySarahBallantyne,PhD.Shepresentsathoroughscientificanalysisofeachofthesedietaryfactorsthatcontributetoautoimmunedisease.
WHYISTHERENOONE-SIZE-FITS-ALLAPPROACHTODIET?Althoughmakingdietarychangescanhaveamajorimpactonyourhealthandrecovery,thereisnostandardformulatoeatingforthosewithautoimmunedisease.Thiscanbefrustrating!Itisimportanttoknowthatwhatworksforsomeoneelse’scurrentstateofhealthmaynotworkforyourseeminglysimilarissues.Therearecrucialfoundationsthatwecanallapplytoourdietsforbestsuccess,butnoteveryoneneedstobeonanexcessivelyrestricteddietforlife.Instead,weencourageyoutodosomeexperimentingtofindtheleast-restricteddietthatismostlikelytoproducelongtermhealth.Inthefollowingsection,wewillpresentyouwitharangeofhealingdiets,
fromwhatwewouldconsidertheleastextremeofthedietaryapproaches(andforhealingpurposes,thebareminimumintervention)movingalongtothemostextreme.Youcanusethislisttomodifyyourdietfromthetopdown,graduallyworkingonfindingtheleast-restrictedapproachthatproducesresults.Alternatively,youcanjumprightintoaneliminationdietliketheAutoimmuneProtocol.
DIETARYCHOICESGluten-FreeDiet
Dr.Ballantynesaysitbest—“Althoughtheexactrolethatglutenplaysinmostautoimmunediseasesiselusive,thelinkbetweenglutensensitivityissocompellingthatmanyexpertsinthefieldbelievethatglutensensitivitymaycontributetoallautoimmunediseases.”Becauseofthis,werecommendastrictgluten-freedietastheminimumdietaryinterventionforanyonesufferingfromanautoimmuneorautoimmune-relatedcondition.Althoughthissoundsharsh,theresearchisclear.Glutenisnotsomethingyouwanttobeconsumingifyouarecommittedtolongtermhealing!
arecommittedtolongtermhealing!Agluten-freedietisonethatavoidsallfoodsthatcontaingluten,aprotein
foundingrainssuchaswheat,barley,rye,andtriticale.Accordingtoconventionalmedicine,agluten-freedietisonlynecessaryforthosewithceliacdisease;however,thereisagrowingbodyofevidenceshowingthatitispossiblefornonceliacstoexperienceasensitivitytogluten-containingfoods(callednonceliacglutensensitivity).Whileceliacdiseaseischaracterizedbyareactiontotwopartsoftheglutencompound(transglutaminaseandalpha-gliadin),manyothercomponentsofwheatandglutenhavebeenidentifiedaspotentialtriggersforthosewithnonceliacglutensensitivity.Rememberleakygut,thecommonthreadlinkingallautoimmunediseases?
Well,itturnsoutthatglutenisexceptionallyirritatingtotheliningofthesmallintestine,andithasbeenshowntoexacerbateleakygutandactivatetheimmunesystem.Thereisanecdotalevidencethatsomeautoimmuneconditionshavebeenputintoremissionsimplybyavoidinggluten(andwearenotjusttalkingaboutceliacdisease!*).Ifyouarefeelingoverwhelmedatwheretostartwithdietaryintervention,goingonagluten-freedietisagreatstart.
Dairy-FreeDietAdairy-freedietisonethatavoidsallformsofmilkproducts,includingbutnotlimitedtobutter,cheese,milk,yogurt,andallpreparedorprocessedfoods
limitedtobutter,cheese,milk,yogurt,andallpreparedorprocessedfoodscontainingormadefromtheseingredients.Althoughdairyistoleratedbysomepeople,thevastmajority,especiallythosewithleakygutandautoimmunedisease,havetroublewithitforonereasonoranother.Dependingonyourethnicity,youhavea25to97percentchanceofnotbeingabletodigestlactose,asugarfoundindairyproducts.Dairyproteins,ingeneral,arehardtodigestandacommonfoodallergy.Eveninhealthyindividuals,dairyproductscancausemucousproductionthatworsenssymptomsandirritatesthegut.Thosewithasensitivitytoglutentendtobemoresensitivetodairy,asdairyproteinshavebeenshowntocross-reactwith(mimic)thoseofgluten.Ifyouareintoleranttogluten,yourbodymaytreatdairyproteinssimilarly.Notalldairyiscreatedequal—Somepeopletoleratesomeformsandtypesof
dairybetterthanothers(forinstance,somemaytolerateghee,butter,andhardcheesebutnotmilk,whileothersdowellwithgoatbutnotcowdairy).Becausedairyislikelytobeaproblemformany,werecommendremovingitfromthedietstrictlyandthenconsideringreintroducinghigh-qualitydairyslowlyoncearecoveryismade.Somepeoplefindtheirtolerancetodairychangesastheyhealtheirguts,andtheymaybeabletoreintroducehigh-qualitydairylateronintheprocess,eveniftheyhadtroublewithitearlier.
Sugar-FreeDietExcesssugarconsumptionisaseriousissuepresentedbyourmoderndiet.Thelow-fatcrazehasledtothereformulationofprocessedfoods,withthefatbeingreplacedbyrefinedsugarandcontributingtotheepidemicsofobesityanddiabetes.Manyarebecomingmindfuloftheamountofsugartheyconsumeandseeingresultsbydrasticallyreducingorcuttingitentirelyoutoftheirdiets.Whilesugarspecificallydoesnotposeaproblemforthosewithautoimmune
disease,excesssugarconsumptionleadstoblood-sugarimbalances,whichyoumayexperienceas“highs”immediatelyfollowingconsumptionand“lows”onceyourbloodsugardrops.Overtime,thisdevelopsintoinsulinresistance,whichmeansthatinflammationhasrenderedthehormonesyourbodyusestocontrolyourblood-sugarlevelsuseless.Itisimpossibletocontrolinflammationandmanageyourautoimmuneconditionunlessyourbloodsugarisundercontrol!Furthermore,excesssugarinthedietcanberesponsibleforfeedingpathogenicovergrowthsinthegut,exacerbatingleakygutanddysbiosis.Last,sugarweakenstheimmunesystemandisasourceofemptycaloriesthatpotentiallyreplacemorenutrient-richfoods.Asugar-freedietcanhavemanyvariationsbut,atitssimplest,apersonavoids
allrefinedsugarandthefoodsthatcontainit.Whilenaturalsweetenerslike
allrefinedsugarandthefoodsthatcontainit.Whilenaturalsweetenerslikehoneyandmaplesyrupareconsideredhealthieralternativesbysome,theireffectonbloodsugaristhesame—don’tbefooledintothinkingthatthereissuchathingashealthysugar!Sugarsubstitutesareequallyproblematic,withmanyofthembeingmarketedashealthyalternativesdespitehavingadetrimentaleffectonblood-sugarcontrol,appetite,orcontainingsubstancesthatareknowntobetoxic.Whataboutfruit?Althoughsomefruitcanhavealotofsugar,ingeneral,
fresh,wholefruitisadifferentstorybecauseitcontainsfiber,vitamins,andmineralsinacompletepackage.Whiledriedfruitshouldbeavoidedonasugar-freedietbecauseofhowconcentratedandeasytoovereatitis,freshfruitisusuallyfinetoinclude(andwe’dargue,healthy,becauseofallofthegreatnutrientsitprovides!).Ingeneral,ifyouaren’talreadymindfulofyoursugarconsumption,we
recommendtryingasugar-freeapproachforaperiodoftimetobettercontrolyourbloodsugar.Onceyoucutoutsugar,youwillbecome(sometimespainfully!)awareofhowdependentyourbodyisonthissubstance.Itisimportanttotakeiteasy,notcutouttoomanyfoodsatthesametime(likefreshfruit),andmakesureyoualwayshavehealthyproteinandfat-richsnacksonhandtonavigatethosehardermoments.Overtime,yourbodywillbecomemoredependentonitsownstoresofenergyandyourbloodsugarwillbecomemorestable.Wheredotreatsfitin?Forthosewhoarenotexperiencingblood-sugarissues,
naturallysweetenedtreats(thosewithhoney,maplesyrup,etc.)shouldbefineoccasionally.Fruitshouldbeconsumedaccordingtotoleranceandpreferenceandnotavoided(exceptfordriedvarieties,especiallyinthosewithmoreofasensitivitytosugar).Whilesomeformsofsugar,aswellastheprocessedfoodsinwhichitlurks,canbeincrediblyproblematicandshouldbeavoided,youshouldbeabletoreachaplaceofbalancewithsugarconsumptionthatisenjoyableandhealthy.
PaleoandAncestralDietsThePaleodietisanapproachtoeatingthathasbecomepopularinboththewellnessaswellaschronicillnesscommunities,withmanydoctors,researchers,andhealthexpertsadvocatingforitsusefulnessincombatingillnessanddisease.Paleoisascientificapproachbasedonthepre-agriculturaldietofourancestors,bypassingallofourmodernprocessed,convenience,andnutrient-poorfoods.FollowingaPaleoapproach,youwouldavoidgrains,beans,legumes,dairy,
refinedsugar,refinedoils,andfoodchemicals.Ideally,youwouldalsobeeatingpasture-raisedandgrass-fedmeatandeggs,wild-caughtfish,aswellasmaking
pasture-raisedandgrass-fedmeatandeggs,wild-caughtfish,aswellasmakinguseofthe“oddbits”likebonesandorganmeats.Paleoalsoemphasizesfermentedfoodsinordertopromotehealthygutflora.WeadvocateforadoptingaPaleodietforlongtermhealing,whetheryouland
therebygraduallyeliminatingfoodsorbyworkingbackwardfromaneliminationdiet.AlthoughPaleocanincorporatefoodssomepeoplearestillsensitiveto(eggs,nuts,seeds,andthenightshadefamilyofplants),itisgenerallyanutrient-denseandhealthywayofeatingbecauseitavoidsprocessedfoodsandgrainsthatcanbeproblematicforthosewithautoimmunedisease.
EliminationDietAneliminationdietisashort-termapproachwherefoodsareeliminatedforasetperiodoftimeandthenreintroduced,individually,togaugeareaction.Thisapproachcanbeusefulatpinpointingyourfoodallergiesandsensitivitiesandisstillconsideredthegoldstandardfordeterminingwhichfoodsyoumaybesensitiveto,eventakingintoaccountalloftheadvancedlaboratorytestingthatisnowavailable.Eliminationdietsvarybyapproach,withsomeonlyavoidingthetopeight
mostcommonfoodallergens—milk,eggs,fish,shellfish,treenuts,peanuts,gluten,andsoy—whileotherapproachesaremorecomprehensive(suchastheAutoimmuneProtocol,discussedbelow).Someeliminationdietscallforavoidingasetoffoodsforacoupleweeksbeforereintroduction;othersgofortrialsthatareamonthorlonger.Theideaisthatonceyourimmunesystemhastimeofffromafood,youarebetterabletogaugeareactionwhenyoustarteatingitagain.Webelieveaneliminationdiettobetheultimatetooltodetermineasetof
foodsthatbestsupportpersonallongtermhealing.While,intheory,nutrient-densedietssuchasPaleoarequitehealthytoeatlongterm,youmaystillfindthatyouaresensitivetosomeoftheincludedfoodsandgettingtotherootofthosesensitivitiescantakehealingtoawholenewlevel.
THEAUTOIMMUNEPROTOCOLTheAutoimmuneProtocolisaneliminationandreintroductionprotocolthathasbeenspecificallydesignedtohelpthosewithautoimmunediseasedeterminetheirfoodallergiesandsensitivities,reversenutrientdeficiencies,balancegutflora,andhealtheirbodies.TheprotocolhasbeendevelopedandrefinedbyDr.Ballantyneandisoutlinedindetailinherbook,ThePaleoApproach.We
believethisisthebestandmostspecificeliminationandreintroductionprotocolforthosewithautoimmunedisease,andfollowingitgivesyoutheopportunitytocomeupwithyourpersonalizedhealingdiet.Inanutshell,theAutoimmuneProtocolcallsforremovingfoodsthataremost
likelytobeproblematicforpeoplewithautoimmunedisease—grains,beans,legumes,dairy,eggs,nuts,seeds,andnightshades,aswellasfoodchemicalsandadditives.Inaddition,nutrient-densefoodsareaddedtorestorenutrientstatus,suchasbonebroth,high-qualitymeat,andwild-caughtfish,aswellasorganmeats,fermentedfoods,andawidevarietyoffruitsandvegetables.Overthecourseoftheeliminationphase(whichcanlastfromamonthtoayear),youtakenoteofthechangesyouexperienceinyourhealth.Whenitcomestimetoslowlyandsystematicallyreintroducefoods,youwillbeabletotellexactlywhichfoodsareholdingyoubackandbepreparedtousethisinformationtoconstructadietthatwillbestsupportyourhealingneeds.
TheAutoimmuneProtocolinDetailInthelastsection,wegaveyoutheAutoimmuneProtocolinanutshell,butin
thissection,wewanttodiveintothedetail.ThefirstthingtounderstandisthattheAutoimmuneProtocolismeanttoserveasatemplate.Templatesarepresetformatsthatcaneasilybeduplicatedbut,alsoimportantly,canbeadaptedtoindividualuses.TheAutoimmuneProtocolisaneliminationandreintroductiondiet,but“diet”onlyinthesensethatitreferstofoodintake.Itisnotadietintheprescriptive,follow-the-rulessense.Dietsofthatnaturearerigidandforcepeopleintomoldsthatmaynotfittheirneeds.Thatone-size-fits-allapproachtofoodisdoomedtofailure,sinceitleavesnoroomfortheindividual.Ontheotherhand,atemplatepromotesself-discoverythroughtheuseofanadaptableformat.Dependingonyourgenetics,yourcurrentlevelofhealth,yourresources,andyourgoals,youcanindividualizethistemplatetoheal.ByusingtheAutoimmuneProtocolasyourguide,youbeginwithafoundationthateveryonecanapplyandfromthere,withcarefulself-experimentation,youdiscovertheleast-restricteddietthatproducesyourbestlongtermhealth.TheAutoimmuneProtocolisnotasetofcommandmentsyoudesperatelyfollow,hopingforacookie-cutterresult.Itisadeliberatejourneyofhealingwhereinyoublazeauniquetrail.
ATwo-PhasedProcessTheAutoimmuneProtocolhastwophases,aneliminationphaseandareintroductionphase.Duringtheeliminationphase,removethefollowingfromyourdiet(seethecharts).
●Grainsandpseudo-grains
●Beansandlegumes
●Dairy
●Refined/processedseedandvegetableoils
●Eggs
●Alcohol
●Foodchemicals
●Refinedandalternativesweeteners
●Nutsandseeds
●Nightshade-familyfoods
Healthcanbeboostedwiththeadditionofthefollowingnutrient-densefoods.
Healthcanbeboostedwiththeadditionofthefollowingnutrient-densefoods.
●Bonebroth
●Grass-fedorganmeats
●Grass-fedgelatinorcollagen
●Oily,cold-water,wild-caughtfishandshellfish
●Fermentedfoodsorprobioticbeverages
●Acolorfularrayoffruitsandvegetables
Thereareveryspecificreasonswhythesefoodsareintentionallyexcludedorincludedintheprotocol,butwewillnotbegoingintothatdiscussionhere.Forthosewhowouldliketodomoreresearch,werecommendreadingThePaleoApproachbyDr.Ballantyne.Aftergoodhealthisfirmlyreestablished,afour-partprocessofreintroducing
foodscanbeattempted.(ThedetailsaboutreintroductionscanbefoundinReintroductions).Everyonewillneedaminimumof30daysintheeliminationphase,manywillneedafewmonths,andsomewillneeduptoayear.Theeliminationphaseishighlyvariablebecauseindividualhealingtimelinesareuniquetoeachperson.Forexample,thedegreeofseverityofyourautoimmunediseaseatthetimeyoubegintheprotocol,howlongyourautoimmunediseasewentundiagnosed(asthismayhavecontributedtothedevelopmentofadditionalautoimmunediseasesororgandamage),hownutrientdeficientyouarewhenyoubegin,andyourpersonalcommitmentleveltotheprocessallaffectthehealingtimeline.
WhyIstheAutoimmuneProtocolanIdealStartingPoint?Youmaybewondering:WhyistheAutoimmuneProtocolsuchagoodstartingpointforincreasedwellnesswhen,infact,therearesomanyotherapproachesoutthere?
1.ITREMOVESFOODSTHATMAYTRIGGERANIMMUNERESPONSE,AREHARMFULTOTHEGUT,ANDLEADTOHORMONALDYSREGULATION.AsyouknowfromChapter1,autoimmunediseaseisallaboutanimmunesystemthathasgoneawry.Oneofthecommonresponsesofourimmunesystemstoperceivedtriggersisincreasedinflammation.Withinflammationcomesallsortsofaches,pains,anduncomfortablesymptoms.Thesesamepotentiallyimmune-provokingfoodsalsodamageourintestinalliningsandleadtohormonalimbalance.Byremoving
thesefoods,youessentiallygiveyoursystemabreak.Asitcalms,inflammationsubsides,damageheals,andhormonesbalance,andwiththosechanges,allyourdiscomfortdiminishes.TheAutoimmuneProtocolgivesusacleanslate.
2.ITRESTORESNUTRIENTSANDFLORATHATPROMOTEAHEALTHYGUTANDWELL-REGULATEDIMMUNEFUNCTION.Micronutrientdeficienciesarecommoninautoimmunedisease.Manyofusaredeficientinfat-solublevitamins(A,D,E,andK);mineralslikezinc,iron,ormagnesium;Bvitamins,vitaminC,antioxidants,non-vitaminnutrients,andcertainaminoacids.Inaddition,ahealthybalanceofgutmicroorganismsisoftenseverelydisrupted.ThefoodswefocusonintheAutoimmuneProtocolareverynutrientdense,fuelinghealingandbalancingourgutflora.Overtime,thisreplenishmentfromfoodsrichinnutrientsandprobioticsgreatlystrengthensoursystems.TheAutoimmuneProtocolrestoresus.
3.ITPROVIDESAFRAMEWORKFORBUILDINGALIFELONGDIETEXACTLYSUITEDTOYOU.We’vesaiditsomanytimesalreadyinthischapter,butitbearsrepeating:Thereisnoone-size-fits-alldiet.Fortunately,theAutoimmuneProtocolprovidesacleanslateandrestorationthatallowustomoveforwardwithanexperimentationprocessthatisclear.Withallthe“noise”ofadamagedsystemsilencedandproperfunctioningreestablished,youareabletotakeastructuredapproachtofoodthathelpsyoudiscoverwhatworksbest.TheAutoimmuneProtocolempowersus.
TakingthePlungeThelistoffoodstoavoidmaybedishearteningwhenyoubegin.Thelistoffoodstoincludecanalsobeveryintimidating,becausemanyofthesefoodsareunfamiliaranddon’toftenmakearegularappearanceinthemoderndiet.Wewantyoutoknowthatthesefeelingsarequitenormal.Ifafterevaluatingyourcurrenthealthandfuturewellnessgoals,yourealizetheAutoimmuneProtocolisrightforyou,weencourageyoutotaketheplunge.Ifyoucommittothisprocessofself-discovery,allowingforadequatehealingtimeduringtheeliminationphase,intentionallyaddingnutrient-packedfoods,andcommittingtosignificantlifestyleimprovements,theresultsusuallymaketheprocesswellworththeinitialtrepidation.TheAutoimmuneProtocolalsoemphasizeshigh-qualityfoodsources,
abundantfoodvariety,andagreatdealoffoodpreparation,butitisimportanttojustgetstartedwiththetransition(seeDietaryTransitionforguidance).Overtime,youcantweakyourapproachtomaximizeyourtimeandfinancial
resourcestobestundertaketheprocess.Don’tletperfectionparalyzeyou.TheAutoimmuneProtocolprovidesafantasticstartingpointforgreatlyincreasedwellness.Ifyouputintheeffortandworkpatientlytounderstandwhatyourbodyneeds,youwillsoonhaveatemplatethatispersonalizedandpromotesyourbesthealth.
FoodstoIncludeMeat
BeefBisonElkGoatLambPorkRabbitVenison
PoultryChickenDuckGooseTurkey
FishAnchovyArcticcharBassCarpCatfishCodHaddockHalibutHerringMackerelMahi-mahiMonkfishSalmonSardineSnapperSoleSwordfish
SwordfishTilapiaTroutTuna
ShellfishClamsCrabCrawfishLobsterMusselsOctopusOystersScallopsShrimpSnailsSquid
AnimalfatsBaconfat(iftheingredientsarecompliant)Lard(renderedporkbackorkidneyfat)Poultryfat(likeduckorgoose)Schmaltz(renderedchickenorgoosefat)Strutto(clarifiedporkfat)Tallow(renderedfatfrombeeforlamb)
Plant-basedfatsandoilsAvocadooilCoconutoilOliveoilPalmoilPalmshorteningRedpalmoil
Vegetable-likefruitsAvocadosCucumbersOkraOlivesPlantainsPumpkinSummersquash(zucchini)Wintersquash(likebutternut,delicata,andacorn)
LeafygreenvegetablesArugulaBeetgreensBokchoyBrusselssproutsCabbageCeleryCollardgreensDandeliongreensEndiveKaleLettuceMizunaMustardgreensRadicchioSpinachSwisschardTurnipgreensWatercress
RootvegetablesArrowrootBeetsCarrotsCassavaCeleriacDaikonGarlicGingerHorseradishJerusalemartichokeJicamaParsnipsRadishesRutabagasSweetpotatoesTaroTigernutTurmericTurnipsWasabiWaterchestnutsYams
OthervegetablesArtichokesAsparagus
AsparagusBroccoliCauliflowerChivesFennelLeeksOnionsRhubarbSeaweed(likearame,nori,wakame)Shallots
FruitApplesApricotsBlackberriesBlueberriesCantaloupeCherimoyaCherriesClementinesCoconutCranberriesCurrantsDatesDurianFigsGrapefruitGrapesGuavaHoneydewHuckleberriesKiwifruitLemonsLimesMangoesMulberriesNectarinesOrangesPapayaPassionfruitPeachesPersimmonsPineapplePlantainsPlumsPomegranateQuinceRaspberriesStrawberries
StrawberriesTamarindTangerinesWatermelon
ProbioticfoodsFermentedmeatorfishKombuchaKvassLacto-fermentedfruitsandvegetablesNondairykefir(madewithfruit)Sauerkraut
Ediblefungi/mushroomsChanterelleCreminiMorelOysterPorciniPortobelloShiitakeTruffle
HerbsandspicesAsafetidaBasilBayleafChamomileChervilChiveCilantro(corianderleaf)CinnamonCloveCurryleafDillweedFennelleafGarlicGingerHorseradishKaffirlimeleafLavenderLemonbalmLemongrassMaceMarjoramOreganoParsley
ParsleyPeppermintRosemarySaffronSageSavoryleafSpearmintTarragonTea(bothgreenandblack;checkherbalteasfornightshadesandseeds)ThymeTurmericVanilla(whole)
OthercookingingredientsApplecidervinegarBalsamicvinegarCapersCarobpowderCoconutaminosCoconutconcentrate(otherwiseknownasbutter,manna,orcream)CoconutmilkCoconutvinegarFishsauceOlivesRedwinevinegarSeasaltWhitewinevinegar
OccasionalsweetenersCoconutsugarCoconutsyrupHoneyMaplesugarMaplesyrupMolasses
FoodstoAvoidGrainsandpseudo-grains
AmaranthBarleyBuckwheatCornKamutMilletOatsQuinoaRiceRyeSorghumSpeltTeffTriticaleWheat
BeansandlegumesAdzukibeansBlackbeansBlack-eyedpeasCannellinibeansChickpeasFavabeansGreenbeansKidneybeansLentilsLimabeansMungbeansNavybeansPeanutsPeasPintobeansSoybeans(includingsoyproductsliketofu)
Dairy(bovine,goat,orfromotherspecies)ButterButtermilkCottagecheeseCreamGheeIcecream
IcecreamKefirMilkSourcreamWheyWhippingcreamYogurt
IndustrialseedandvegetableoilsCanolaoilCornoilCottonseedoilPalmkerneloilPeanutoilSaffloweroilSoybeanoilSunfloweroil
EggsChickeneggsDuckeggsOtherspecies
Sugaralcoholsandnon-nutritivesweetenersAcesulfamepotassiumAspartameErythritolMannitolNeotameSaccharinSorbitolSteviaSucraloseXylitol
AlcoholAllalcohol
FoodchemicalsArtificialandnaturalflavorsArtificialcoloringCarrageenanGuargumLecithinMonosodiumglutamate(MSG)
Monosodiumglutamate(MSG)Nitritesornitrates(naturallyoccurringareokay)PhosphoricacidPropyleneglycolTexturedvegetableproteinTransfatsXanthangumYeastextractAnyingredientnamesyoudon’trecognize
Nuts(includingflours,butters,oroilsderivedfromthem)AlmondsBrazilnutsCashewsChestnutsHazelnutsMacadamianutsPecansPinenutsPistachiosWalnuts
Seeds(includingflours,butters,spices,oroilsderivedfromthem)
AniseCarawayCeleryseedChiaCocoaCoffeeCorianderCuminDillseedFennelseedFenugreekFlaxHempMustardseedNutmegPoppyPumpkinSesameSunflower
Nightshade-familyfoods(includingproductsandspices
derivedfromthem)AshwagandhaBellpeppersCayennepepperEggplantGojiberriesHotpeppersPaprikaPotatoesTomatillosTomatoes
FruitandberryspicesAllspiceAniseCarawayCardamomJuniperPepper(black,green,pink,orwhite)
NUTRIENTDENSITYThebiggestmistakeyoucanmakeinadoptingtheAutoimmuneProtocolisoverlookingtheconceptofnutrientdensity.It’seasytogetlostineliminations,butofequalimportanceisreplacingtheremovedfoodswiththosethathavethenutrientsneededtoreversedeficienciesandhealthebody.CommonnutrientdeficienciesinthemoderndietincludetheBvitamins
(especiallyB12);thefat-solublevitaminsA,D,E,andK;mineralslikemagnesium,calcium,andiron;antioxidantslikevitaminC;essentialfattyacidsEPAandDHA;fiberthatfeedsourgutflora;andtheaminoacidsthatmakeupourstructureandperformfunctionsthroughoutourbodies.Luckily,theAutoimmuneProtocolfocusesonincludingnutritionalpowerhousefoods,likeorganmeats(especiallyliver—checkoutourrecipes—Bacon–BeefLiverPâtéwithRosemaryandThymeandHiddenLiverChili),bonebroth,fermentedvegetables,oily,cold-waterfishandshellfish,andawidevarietyofcolorfulfruitsandvegetables.Youmightbesurprisedtofindyourhealingacceleratedandyourenergydramaticallyincreasedaftereatingthesepowerfulfoods.Onthenextpage,wehaveprovidedacharttohelpyoutocomparethe
nutrientdensityofsomekeyfoodssoyoucanchoosewhichonestoprioritizeinyourdiet.Youwillfindthemostnutrient-packedfoodsatthetopofthelist.Makingsuretoincludethemasoftenasyouareablegivesyouthebestopportunitytoheal.
opportunitytoheal.Itmaybetemptingtoseekoutsupplementsinsteadoffocusingoneating
thesenutritionalpowerhousefoods,butourexperienceisthatgettingnutritionfromfoodisalwaysideal.Naturehaspackagedthesenutrientsintheeasiestwayforyourbodytoassimilatethem—containingthenecessarycofactorsandmacronutrientsrequiredforproperdigestionandabsorption.Ifyouareworkingwithapractitioner,youmayfindthatsomesmartsupplementationspeedstheprocessearlyon,butbesuretoreviewyourdietaswell.
IbelieveincorporatingnutrientdensitywhenIembarkedontheAutoimmuneProtocolwasoneoftheearlykeystomysuccessinhealingmybody.Priortothiswayofeating,Ihadfollowedavegandiet(noanimalproducts)formorethanadecadeandwassufferingfromseverenutritionaldeficienciesthatwerenotrespondingtosupplementation.WhenIembarkedontheeliminationdiet,Iwassuretoincludelotsofnutrient-densefoodslikebonebroth,beefliver,salmon,andfermentedvegetables,andIbelievethesefoodshelpedmetomakequickprogress.Infact,includingbeefliverpâté(seemyrecipeBacon–BeefLiverPâtéwithRosemaryandThyme!)weeklyforamonthhelpedtoreversemyanemiasoquicklythatmydoctorbelievedmypriorbloodworktobeinerror!
NutrientPowerhousesOrganmeats
VitaminAVitaminB1VitaminB2VitaminB3VitaminB6VitaminB12VitaminDVitaminKFolatePantothenicacidCholineIronSeleniumZincCopper
BrothCalciumMagnesiumPhosphorusGelatinCollagen
OilyfishVitaminDVitaminB12EPAandDHAPhosphorusSelenium
ShellfishIronZincCopperSeleniumPhosphorusIodine
FermentedfoodsProbioticsVitaminK
LeafygreenvegetablesVitaminKFolateManganeseMagnesiumInsolublefiberAntioxidantsCalciumVitaminE
ColorfulfruitsandvegetablesVitaminCAntioxidantsFiber
DIETARYTRANSITIONTransitionStyles
Makingabigchangeinanyareaofourlivesisdifficult.Everyoneknowsitishardtolearnnewwaysofdoingthingsandevenhardertodropoldhabits.Decidingonthebestmethodfortransitioningcanbejustastough,especiallywhenitcomestoashiftinsomethingasfundamentalasthewayweeat.Thereareplentyofexpertopinionsaboutthebestwaytohandledietarytransition,butthereisn’tatonofsolidresearchthattellsusforsurewhattheabsolutebestwayisforlongtermsuccess.Itcomesdowntoknowingyourselfwell.Understandingyourpersonalityandrealisticallyevaluatingyourlifestylearethemostimportantfactorsinchoosingatransitionmethod.Onceyou’vedecidedtochangeyourdiet,youhavetwooptions.
1.COLDTURKEY—Ifyouknowyouthrivewitharip-off-the-Band-Aidapproach,coldturkeymightbebestforyou.Maybeyouaregreatatenvisioningyourgoalsandsteadfastlytakingonachallenge.Coldturkeyrequiresagreatdealofself-motivation.2.SLOWANDSTEADY—Manypeopleimmediatelyrebelatthethoughtofsuchadrasticchangetotheirfamiliarpatterns.Maybeanall-or-nothingapproachfeelsscaryormakesyoucertainyou’llfail.Babystepscanbeaneffectivemethodfordietarytransition.Slowandsteadyrequiresahighlevelofendurance.
Doyoufeelliketherearetimeswhenyouarebothcoldturkeyandslowandsteady?Mostofusfeelthatway.Next,you’llfindaself-testdesignedtohelpyoupinpointyourtransitionstyle.Onceyouknowthebestmethod,youcanstartimplementingsomehealingdietarychanges.
Cold-TurkeyTransitionGuideIfyou’vedeterminedthatafasttransitionisbestsuitedtoyou,werecommenda3-dayjump-startprocess.You’llstartwithaweekendofplanningandpreparation.ThefocuswillbetodoasmuchaspossibletogetpreparedforaMondaymorningtransitiontothefull-eliminationphaseoftheAutoimmuneProtocol.
●FRIDAY—Planamenuandshoppinglistfortheweekaheadwithallthefoodstoavoideliminatedandnutrient-densefoodsincluded,usingthemealplan,ifneeded.ClearoutyourpantryusingtheexerciseinPantryGuide.
●SATURDAY—Shopforfoodsnecessaryforyourmenu(youmayfindtheshoppinglisthelpfulhere).BesuretofocusonbringinginasmanyAutoimmuneProtocol–compliantingredientsaspossible,sothatyoufeelfullycapableofmaintainingthedietonceyoubegin.
●SUNDAY—Batch-cooktopreparefortheweekahead.Thismeanscookingmultipledishestoeatasleftoversoruseascomponentsofquickmealsthroughouttheweek.Greatbatch-cookingrecipesincludebroths,soups,stews,roastedmeats,andsomevegetablesides.YoumightalsoconsiderusingSundaytoreachouttoafewkeyfamilymembersorfriendsandaskforsupportforyourupcomingtransition.
WHICHWAYWILLWORKFORYOU?
Hereareafewquestionstoaskyourselfwhenconsideringwhichtransitionapproachisbestforyou.
COLDTURKEY◻ AmIwillingtomakesubstantialchangestomyscheduleinordertoprioritizehealing?
◻ AmIchild-freeordoIhaveolderchildrenwhowon’tbestronglyimpactedbythisprocess?
◻ DoIfeelreadytocommitimmediately?
◻ DoIhavestrongplanningandpreparationskills?
◻ DoIknowmywayaroundthekitchen?
◻ AmIatapointwithmydiseasewhereIneedreliefasquicklyaspossible?
◻ DoIhaveapartnerorafamilymemberwhowillsupportmethrougharapidtransition?
◻ DoIhaveahistoryofsuccessfullydivingintobigchanges?
◻ AmIwillingandabletoprioritizemybudgettofocusonfoodimmediately?
SLOWANDSTEADY◻ DoIhaveanextremelybusyschedulewithlittleflexibility?
◻ DoIhaveyoungchildrenorotherfamilymemberswhomaynotbeadoptingthisdiet?
◻ IsfullcommitmentsomethingInormallyneedtotaketimetoconsider?
◻ DoIprefertotakeonplanningandpreparationtasksinphases?
◻ WillIneedtimetolearnmywayaroundthekitchen?
◻ Doesthestressofarapidtransitionseemmoreuncomfortablethanmydiseasesymptoms?
◻ Willtheprocessbedifficultformypartnerandrequiremoretimeforhim/herasImake
adjustments?
◻ DoIfindmyselfrepeatedlytryingtomakeall-or-nothingchangesandfailing?
◻ DoIhaveaverytightbudgetwithoutmuchroomtoreallocatefundstogroceriesquickly?
Slow-and-SteadyTransitionGuideIfyou’vedeterminedthataslow-and-steadytransitionisbestsuitedtoyou,werecommenda6-weekprocess.You’llstartwithaweeklongplanningandpreparationphase,whichincludesseekingsupport,andthenusethenext5weekstotackle2foodgroupeliminationsperweek,whilealsoadding1newnutritionalpowerhouse.Theeliminationswiththegreatestimpactonyourhealthareupfirst,andtheeliminationswiththeleastimpactarelast;thisgivesyousomebangforyourbuckearlyintheprocessandhopefullyaddstoyourmotivation.Theendresultwillbecompliancewiththefull-eliminationphaseoftheAutoimmuneProtocol.
Week1●Askafewfamilymembersorfriendstoofferyouencouragementasyoutransitionyourdiet.
●PlanamenuandshoppinglistfornextweekeliminatingallGRAINSandALCOHOLandincludingHEALTHYFATS,likeoliveoil,coconutoil,andsolidcookingfat(seeRenderedAnimalFat).
●Shopforthefoodsnecessaryaccordingtoyourmenu.
●Attheendoftheweek,removeallGRAINSandALCOHOLfromyourhouseinpreparationfornextweek.
●Doonebatch-cookingsessiontoprepareyourmealsfornextweek.
Week2●Thisweek,startavoidingGRAINSandALCOHOLinyourdiet,andstartaddingHEALTHYFATS,followingthemenuyoupreparedlastweek.
●PlanamenuandshoppinglistfornextweekeliminatingallLEGUMESandNIGHTSHADESandincludingBONEBROTH.
●Shopforthefoodsnecessaryaccordingtoyourmenu.
●Attheendoftheweek,removeallLEGUMESandNIGHTSHADESfromyourhouseinpreparationfornextweek.
●Doonebatch-cookingsessiontoprepareyourmealsfornextweek.
Week3●Thisweek,startavoidingLEGUMESandNIGHTSHADESinyourdiet,andstartaddingBONEBROTH,followingthemenuyoupreparedlastweek.
●PlanamenuandshoppinglistfornextweekeliminatingallDAIRYandCOFFEEandincludingPROBIOTICDRINKS(seeResources).
●Shopforthefoodsnecessaryaccordingtoyourmenu.
●Attheendoftheweek,removeallDAIRYandCOFFEEfromyourhouseinpreparationfornextweek.
●Doonebatch-cookingsessiontoprepareyourmealsfornextweek.
Week4●Thisweek,startavoidingDAIRYandCOFFEEinyourdiet,andstartaddingPROBIOTICDRINKS,followingthemenuyoupreparedlastweek.
●PlanamenuandshoppinglistfornextweekeliminatingallFOODADDITIVES,REFINED/PROCESSEDSUGARS,EGGS,andREFINED/PROCESSEDOILSandincludingFERMENTEDFOODS.
●Shopforthefoodsnecessaryaccordingtoyourmenu.
●Attheendoftheweek,removeallFOODADDITIVES,REFINED/PROCESSEDSUGARS,EGGS,andREFINED/PROCESSEDOILSfromyourhouseinpreparationfornextweek.
●Doonebatch-cookingsessiontoprepareyourmealsfornextweek.
Week5●Thisweek,startavoidingEGGS,REFINED/PROCESSEDSUGARS,REFINED/PROCESSEDOILS,andFOODADDITIVESinyourdiet,andstartaddingFERMENTEDFOODS,followingthemenuyoupreparedlastweek.
●PlanamenuandshoppinglistfornextweekeliminatingallNUTS,SEEDS,andFRUIT-ANDBERRY-BASEDSPICESandincludingORGANMEATS(seeBacon–BeefLiverPâtéwithRosemaryandThymerecipe).
●Shopforthefoodsnecessaryaccordingtoyourmenu.
●Attheendoftheweek,removeallNUTS,SEEDS,andFRUIT-ANDBERRY-BASED
SPICESfromyourhouseinpreparationfornextweek.
●Doonebatch-cookingsessiontoprepareyourmealsfornextweek.
Week6●Thisweek,startavoidingNUTS,SEEDS,andFRUIT-ANDBERRY-BASEDSPICESinyourdiet,andstartaddingORGANMEATSfollowingthemenuyoupreparedlastweek.
●Asofthisweek,youarecompliantwiththefull-eliminationphaseoftheAutoimmuneProtocol!
●Continuetousemealplanningandbatch-cookingasyoumaintainyoureliminationphase.
REINTRODUCTIONSReintroducingFoods
TheeliminationphaseoftheAutoimmuneProtocolisnotmeanttobefollowedlongterm—thenext,andequallyimportant,phaseiscalledreintroduction.Throughaslowandsystematicprocessofputtingfoodsontrialthatyouavoidedontheeliminationdiet,youwillfindoutifanyfoodallergiesorsensitivitiesarepotentiallycontributingtoyoursymptoms.Thisisadelicatebutinformativeprocessthatrequiresyoutolearnhowtoaccessyourowninnerwisdomaboutthecauseandeffectofwhatyouputintoyourbody.Theendproductistheleast-restricteddietthatismostsupportiveofyourlongtermhealing,onethatgivesyouthebestchanceofsuccesswithoutdrivingyoucrazy.
HowLongDoYouStayontheEliminationDiet?Beforeyoudecidetoreintroducefoods,youneedtoassesswhetheryouhavedonetheeliminationphaselongenough,with100percentcompliance.Initially,youmaywanttogiveyourselfagoalof30days,andthenmakeareassessmentifyou’dliketocontinueonlongeratthatpoint—itishardtogaugeatthebeginningoftheprocesshowitwillgoforyouruniquesituation.Sometimes,peoplefeelinitialimprovements(suchasbetterdigestion,energy,andclearerskin)in30daysbutwishtoproceedfor60to90daystoseeiftheycontinuetoprogressupward.Othersmayseeadramaticreversalofsymptomsinthat30-day
period,makingthemgreatcandidatesforreintroductionsoonerratherthanlater.Yourexperienceontheeliminationdietisgoingtodependonalotoffactors—yourstateofhealthgoingin,autoimmuneconditions,degreeoftissuedamage,andstartingnutritionalstatus.Howlongtostayontheeliminationdietvariesfrompersontoperson,andadvicefromyourkeyplayermightalsobeusefulhere.
WhenAreYouReadytoReintroduceFoods?Youarereadytoreintroducefoodswhenyouhaveseenmeasurableimprovementsduringtheeliminationphase.Thiscanbegeneralhealthimprovements,likebettersleep,lesspain,ormentalclarity,orspecificimprovements,likealesseningofyourautoimmunesymptoms.Whichimprovementsyouseearen’tasimportantasthefactthattheyarethere,andthattheyareclear—ifyoudon’thaveanimprovedbaselinetocomparewithwhenyoustarttoreintroducefoods,youwon’tlearnmuch.Ifyouarenotexperiencinganychangesafter30to90daysontheAutoimmuneProtocol,youwillwanttocheckoutourtroubleshootingsectionorenlistthehelpofyourkeyplayertolookforunderlyingrootcausesthatareactingasroadblockstoyoursuccess.
WhyIsItImportanttoReintroduceFoods?Itiscommontoseealotofimprovementsandsometimesafullreversalofsymptomswhileontheeliminationdiet.Whenthisisthecaseforyou,itmaybetemptingtothink“well,maybeIwillcontinuetoeatthiswayforever!”Whilesomepeoplefindthattheyarenotabletosuccessfullyreintroducemanyfoods,itismorecommontobeabletotoleratesomeofthefoodsinthefirststagesofreintroduction(whichwewillcoverinthefollowingsection).Especiallywhenyouareexperiencingsuccess,reintroductionisanessentialpartoftheAutoimmuneProtocol.Successfulreintroductionsexpandthelistoffoodsyoucaneat,makingyourdietlessrestrictiveandeasiertointegrateintoyourlifeoverthelongterm.Whileitisnotadvisedtoreintroducefoodswhenyouhaven’texperiencedsuccess(seethetroubleshootingguide),youcanandshouldstartreintroducingfoodswhenyoustarttofeelbetter!
ReintroductionProtocolWeknowit’stemptingtostarteatingallofthefoodsyouhaveeliminatedrightawayafterexperiencingsuccess,butembarkingonthereintroductionprocesscarefullyensuresthatyoudon’thavetostartover!Thisisaverydelicateprocess
andnottoberushed.Themoresystematicyouareaboutreintroductions,theeasieritisgoingtobetomakeanassessmentaboutwhetherornotafoodisinorout.Familiarizeyourselfwiththereintroductionprotocolaswellasthestagesofreintroductionbeforeyougetthere,sothatyouknowwhattoexpect.Theprotocolforreintroductions,asoutlinedbyDr.SarahBallantyneinThe
PaleoApproach,isthefollowing:
1. Pickafoodtochallengeandgetreadytoeatitacoupleoftimesin1day.
2. Eatthefoodforthefirsttime,onlyhavinganibble.Wait15minutes,andifyoudon’thaveanysymptoms,takeasmallbite,alittlelargerthanthelast.
3. Waitanother15minutes,andifyoustilldon’thaveanysymptoms,takeanotherbite,againslightlylarger.
4. Wait2to3hours,watchingtoseeifsymptomsappear.
5. Next,eatanaveragequantityofthefood,eitherbyitselforaspartofameal.
6. Watchyoursymptomsfor3to7daysafterward,beingsuretoavoidthefoodyoureintroducedaswellasnotreintroducinganyotherfoods.
7. Youmayincorporatethatfoodintoyourdietifyouhavenosymptomsduringthiswholeprocess.
Thisprotocolmayseemoverlycautious,butitisthesafestwaytoreintroducefoodsafteralongperiodofelimination.Duringthetimeyouhaveavoidedpotentialtriggers,yourbodybecomeslessinflamedandyourimmunesystemgetsabreakfromtheconstantattack.Sometimes,evenwhenyoureintroduceafoodyouusedtoeatallthetime,youmaybesurprisedtofeelanobviousreaction.Manyofushavebeenherebefore!Toavoidunnecessarysetbacks,itisimportanttotakethisreintroductionprocessslowlyandmethodically,evenifyoususpectthatafoodisnotaproblemgoingintotheprocess.Journalingisaninvaluabletoolwhengoingthroughthereintroductions.It
helpsyourecognizesymptomsandpatternsthatmightindicatethesourceofafoodreactionthatwouldbeotherwisehardtogauge.
Reintroductionscanbesuchaconfusingprocess!WhenIfirstbeganattemptingthem,Iwasn’treallysurewhatsignsorsymptomsIshouldbelookingforthatmightindicateIwassensitivetoafood,ormorehappily,thatIcouldbeginincludingitinmydietagain.Dr.SarahBallantyne’sguidanceonthetopicwasn’tyetpublished,buttomysurprise,asIundertooktheprocess,I
guidanceonthetopicwasn’tyetpublished,buttomysurprise,asIundertooktheprocess,Iwasabletodiscernmybody’scommunication.Itwaslikeallthe“noise”I’dpreviouslybeenhearingwassilencedandsignsofsensitivityweresomucheasiertospot.OneexamplewaswhenIfirstattemptedtoreintroducewhitepotatoes,anightshadevegetable.Thenextmorning,Iwokewithsearingpaininmyhipjoints.ThishadbeensomethingIlivedwithallthetimepriortotheeliminationdietanditmadeitcleartomethatIwasstillsensitive.Thegoodnewsisthatwithseveralmoremonthsofhealing,Inolongergotthejointpain.IcaneathomemadeFrenchfrieswithoutfearthesedays!
InWhatOrderDoYouReintroduceFoods?Whendecidingwhichfoodstoreintroduceandwhen,itmaybetemptingtotrythefoodsyouarecravingthemostfirst—perhapsgrains,tomatoes,wine,orcheese.However,itisimportanttochoosetheorderofreintroductioncarefullytoavoidaflareorsetback.NotallfoodsavoidedduringtheeliminationphaseoftheAutoimmuneProtocolcarryanequalpotentialtobeproblematic,soitisbesttostartwithfoodsthatareleastlikelytocauseaproblembeforeworkingintothecategoryofmostlikelytocauseaproblem.Dr.Ballantynehascategorizedthefoodsinreintroductionstages,startingwith
thosethatareleastlikelytocauseaproblem.WerecommendstartingwiththefoodsinstageIandonlymovingontothenextstageafteryouhaveafewsuccessfulreintroductionsunderyourbelt.Whileyoumayfindsomefoodsyouaresensitivetointheearlystages,theyarelesslikelytoproducestrongreactionsthatcancauseamajorsetback.Thefoodsinthelaterstages,IIIandIV,aremostdifficulttoreintroduce.
ReintroductionStages
STAGEI
eggyolks,legumeswithediblepods,fruit-andberry-basedspices,seed-basedspices,seedandnutoils,gheefromgrass-feddairy
STAGEII
seeds,nuts(exceptcashewsandpistachios),cocoaorchocolate,eggwhites,grass-fedbutter,alcohol(insmallquantities)
STAGEIII
cashewsandpistachios,eggplant,sweetpeppers,paprika,coffee,grass-fedrawcream,fermentedgrass-fedrawdairy(yogurtandkefir)
STAGEIV
otherdairyproducts(grass-fedwholemilkandcheese),chilepeppers,tomatoes,potatoes,othernightshadesandnightshadespices,alcohol(inlargerquantities),whiterice,traditionallypreparedlegumes(soakedandfermented),traditionallypreparedgluten-freegrains(soakedandfermented)
preparedgluten-freegrains(soakedandfermented)
WhatKindsofReactionsAreYouLookingFor?Whenreintroducingfoods,youwanttobeawareofallofthepotentialreactionsyoucouldhaveandreadytotakenoteoftheminyourjournal.Reactionscanrangefromsevereandobvioustosubtleandunclear.Aftergoingthroughtheprocessofelimination,itispossibletoreacttofoodsyoumayhavebeeneatingonaregularbasisbeforeyoustartedyourelimination.Becauseofthis,youneedtobeawareofthepotentialreactionsyoucouldhave—someofthemmaysurpriseyou!
●RETURNORWORSENINGOFAUTOIMMUNESYMPTOMS—Ifyouexperiencedrelieffromyourautoimmunesymptomswhileintheeliminationphase,lookforsignsthattheycouldbecomingback(forinstance,jointpainforrheumatoidarthritis,orarashforpsoriasis).
●DIGESTIVECHANGES—Subtleorobviouschanges,dependingonhowyourdigestionfunctionedbeforetheeliminationphase,canbeabadsign.Youwanttobeonthelookoutforthingslikeheartburn,constipation,diarrhea,stomachpain,gas,bloating,orburpingwhenreintroducingfoods.
●HEADACHES,RACINGPULSE,ORDIZZINESS—Thesecanbecommonwarningsignsoffoodsensitivities.
●FATIGUE—Checkinwithyourenergylevelswhengoingthroughthereintroductionprocess.Althoughthiscanbeatrickyonetopinpoint,somepeoplefeelareturnofexhaustionwhenreintroducingcertainfoods.
●SLEEPDISTURBANCES—Troublefallingasleep,stayingasleep,orwakingupthroughoutthenightcanbeasignthatafoodisproblematic.
●JOINTORMUSCLEPAIN—Increasedjointormusclepain,especiallywithcertainfoodslikethoseinthenightshadefamily,canbecommonwithfoodsensitivities.
●SKINCHANGES—Anythingfromflushingtorashes,hives,itchiness,oracneindicatesanissue.Payattentiontoyourskinandifthereareanychangestoitasyoureintroducefoods.
●MOODCHANGES—Althoughmanyaresurprisedwhentheyencounterthisreaction,somecanfeelanxiety,depression,orothermoodchanges(likeanger,tearfulness,orrage)whentheyaresensitivetoafood.
WhatIfYouCan’tTellIfYouAreReactingtoaFood?Ifyouhavedonetheeliminationdietwith100percentcompliance,seenmeasurableimprovement,andarehavingahardtimetellingifyourfoodreintroductionsaresuccessfulornot,itissometimeshelpfultotakeaslowerapproachtoreintroduction.Insteadoftaking3to7daysbetweenreintroductions,giveyourself1to2weekstoseeifanythingcropsupoverthelongterm.Havingaddedfewervariablesintothemix,itwillbeeasiertonotereactions.
WhatIfYouHaveaReallyBadReactiontoaFood?Hopefully,ifyoureintroducefoodsintheorderweadvise(seethestagesinReintroductionStages)andstartwiththefoodsyouareleastlikelytoreactto,youwon’thaveasevereresponse.However,thiscanhappen,andifyoufindyourselfinthissituation,youneedtogobacktothefull-eliminationphasetorecover.Onceyouhavereturnedtothelevelofhealthyouwereatwhenyoustartedreintroducingfoods,youcantryagainwithadifferentfood.Ifyouencounterareactionthatisparticularlysevere,thismaybeagoodindicatorthatthisfoodwillnotworkforyourbodylongterm.
IfYouReacttoaFood,DoesThatMeanYouCanNeverEatItAgain?Youmayfindthatyoureacttomanyfoodsearlyonintheprocess,butasyourguthealth,nutrientstatus,andgeneralwellbeingimprove,youmaytoleratemorefoodsovertime.Thisiswhyitisimportanttocontinuetoreintroducefoodsoverthelongtermandnotoperateontheassumptionthatnothingwillchange.Reactingtoalotofearly-stagefoodsmaymeanthatyouneedsomemoretimeintheeliminationphase,lettingyourbodydosomehealingbeforetryingthemagain.Thatbeingsaid,theremaybesomereintroductionsthatmaynotbepossible
foryou,atleastifyouwanttocontinuetoseethebenefitsofbeingontheAutoimmuneProtocol.Later-stagefoodslikedairy,nightshades,andgrainscanbealifelongproblemforsome,butitisuptotheindividualtoseewhereheorsheliesonthespectrumoftoleranceandifthosefoodsaresupportinghealing.
ReintroductionJournalSamplePagesItisimportanttokeepajournalwhenreintroducingfoodssothatyoudon’thavetorelyonmemoryalonetoevaluateyourtrialsandsuccesses.Themore
torelyonmemoryalonetoevaluateyourtrialsandsuccesses.Themoreinformationyouareabletotrackhere,thebetter.
BALANCEFindingBalance
Itisnosurprisethatmanyofushavehadlong,difficult,potentiallyeventraumaticexperienceswithourautoimmunediseases.Wemayhavetriednumerousapproachestohealingorsymptommanagement,frommedicationstofaddiets.Thejourneycanbefraughtwithmentalandemotionalstrugglesandbalance,especiallyintermsofdiet,oftenseemsunattainable.Whenwespeakaboutbalancehere,wemeanfindingthesweetspotwhere
youarenomorefoodrestrictedthanisabsolutelynecessaryforyourpersonalbesthealthandyouareenjoyingahealthyrelationshipwithfood.Youmayfindyourselfvulnerabletolosingperspectiveandspiralingintouncompromising,evenharmful,foodrelationshipswhenadoptingfood-eliminationprotocols.Inthebeginning,thisprocessmaygounnoticed.Inyourattempttoheal,youmayfindthatcertainfoodeliminationshelpalleviatesymptomsandperhapseven
haveaddedbenefitslikeamoreslenderphysiqueorclearerskin.Yourthoughtsmoveinthedirectionof“moreisbetter,”andbeforethepatternisevenrecognized,unnecessarylevelsofrestrictionmayhaveledtointenseanxietyaroundfoodanddisorderedeating.Weabsolutelybelieveinthehealingpoweroffood.Weknowthe
AutoimmuneProtocolcanhaveanenormousimpactonthefoundationsofgoodhealthandisnot“disorderedeating,”butthelinebetweenfoodasmedicineversusfoodasfearcanbedifficulttodiscernforsome.Ourhopeisthatwithmindfulnessandself-awareness,wecanallapproachhealingwithdietandlifestylewithaspiritofenjoymentandtransformation.Thisjourneyisaboutrestoringourbestselves,notdevelopingburdenedheartsandminds.Inthefollowingpages,you’llfindmoredetailedexplorationsonmaintainingbalance.
FoodFearsandDisorderedEatingYoumightconfrontfood-relatedfearsonyourpathwiththeAutoimmuneProtocol.Foodfearcanbeatemporaryissueyoulearntoquicklyovercomeorasevereclinicaldisorderthatsignificantlyimpactsoreventhreatensyourlife.Fearsmighthavealegitimatebasisinalife-threateningallergyononeendofthespectrumbutrangetoharmfulimpairedthinkingontheother.Ifyouthinkyourpatternsarevergingonsevereandnotaseasilyaddressedasless-complexfears,therearewaystogethelp.Clinicallyrecognizedeatingdisordershaveavarietyofsignsandsymptoms.
Therearealsoeatingdisturbancesthatarenotclassified,buthavemuchincommonwiththerecognizeddisorders.Ifyounoticeyourselfedgingtowardanunhealthyplaceorifyouhavestruggledwithdisorderedeatinginthepastandrecognizeyourselfbeingtriggeredintoold,harmfulpatterns,pleaseseekhelp.Therearemanytrainedprofessionalswhocanassistyouinaddressingtheseseriousissues.YoucanstartbycontactingtheNationalEatingDisordersAssociation,TheAllianceforEatingDisordersAwareness,orusingEatingDisorderHope’sdirectorytofindmanyotherorganizationsthatarereadytohelp.
HowLongDoYouNeedtoEatThisWay?We’vesaiditseveraltimesalreadyinthischapter,butafewmorerepetitionswon’thurt—youarenotmeanttoeataccordingtotheeliminationphaseoftheAutoimmuneProtocollongterm.Astricteliminationphaseallowsyoursystemtocalmanda“wellnessbaseline”tobeestablished.Dependingonmanyfactors,
youreliminationphasemaybelongerorshorterthanothers’beforeyouattemptreintroductions.Thekeywordsherearephaseandreintroductions.Thegoalistheleast-restricteddietthatsupportswellnessandallowsyoutoliveafulllife(withoutcrazy-makingfoodrulestofollowforever!).Nowforsomegeneralizations,becausehavingsomebasicguidancehelps.
●Everyonedoesaminimumof30daysintheeliminationphase.
●Manyreachbestresultswithabitlongertimeframe,usually60to90days.
●Forsome,improvementsarenotquiteenoughafter90days.Forthisset,sometroubleshootingandhelpfromtheirkeyplayercanuncoverunderlyingissuesthatrequiretreatmentbeyonddietaryandlifestylechanges(seenextcolumn).Remainingineliminationphasewhileworkingontheserootissuescanbehelpful,sinceitremovesvariables.
●Thevastmajoritydonotneedtoremainineliminationphasebeyondayear,eveniftheyarecontinuingtoexplorerootissues.
Theimportanttakeawayhereisthatonceyou’veexperiencedsuccessfulhealing,youcanandshouldstartexpandingyourdiet.Weallagreethatchocolateisworthit!
AchievingWellness,NotanImageYourhealthisapreciousgift.Thatissuchaclichéstatement,butthoseofuswhohaveexperiencedthedepthsofautoimmunediseasehavehadthis
whohaveexperiencedthedepthsofautoimmunediseasehavehadthisdramaticallydemonstratedinourownlives.Enjoyingrobusthealthinafullyfunctioningbodyisunfortunatelysomethingveryeasilytakenforgranted,untilyounolongerhaveit.Havingperfecthair,flawlessskin,andamodel’sshapepalesincomparisontoanintestinethatcanabsorbnutrients,aheartthatcanmaintainrhythm,orlungsthatcanexpandwithlife-givingoxygen.Everyonewantstobeseenasattractive,butifyoumakeachievingwellness
theprimarymotivatorofthisprocess,notacertainnumberonthescaleorreflectioninthemirror,youwillbenefitgreatlyfromthebalancethatcomeswiththatfocus.Intime,theworkyouhavedonetorestorehealthandthedeepappreciationyouhaveforitwillshineinunexpectedways.Thatkindofvitalityissomethingeveryonenotices!
TROUBLESHOOTINGSometimes,despiteyourbestefforts,theremaybesomethingholdingyoubackfromexperiencingthebenefitsoftheeliminationphase.Inthissection,wehaveoutlinedsomeareasyoumaywanttoexploreshouldyoufindyourselfnotimproving30to90daysposttransition.Supportfromyourkeyplayercanbeusefulhere,astesting,treatment,andexpertguidancecanhelpyounavigatethesecomplexsituations.
SmallIntestineBacterialOvergrowthWhenthebeneficialbacteriathatshouldresideinthelargeintestine(colon)migrateupintopartsofthesmallintestine,aconditioncalledSMALLINTESTINEBACTERIALOVERGROWTH(SIBO)occurs.Thesebacteriawreakhavoconthedigestiveprocessbyconsumingfoodthatshouldbeabsorbedintoyourbodyandproducehydrogenandmethanegasasanendproduct.Youendupwithburping,gas,bloating,diarrhea,andconstipation.ThebacteriathatareinvolvedinSIBOconsumefoodsrichinshort-chain
fermentablecarbohydrates,oligosaccharides,disaccharides,monosaccharides,andpolyols(otherwiseknownasFODMAPs).ManycommonlyeatenfoodscontaintheseFODMAPs—onions,garlic,apples,andavocadostonameafew.Whilehealthyindividualsarelikelytofeelnodifferenceeatingsomeofthesefoods,thosesufferingfromSIBOmayfeelanexacerbationoftheirsymptomslikebloating,abdominalpain,orstoolchanges.SIBOisacommonconditionforthosesufferingfromcomplexhealthissues
likeautoimmunedisease,andsuccessfultreatmentcanprovidebenefitinmanyareas.WhileavoidingFODMAPscanbehelpfulinmanagingsomeofthesymptomscausedbySIBO,youwillneedtreatment(prescriptionorherbal
symptomscausedbySIBO,youwillneedtreatment(prescriptionorherbalantimicrobials)toeradicateitforgood.Wedon’trecommendattemptingtoself-manageortreatsuspectedSIBOwithoutapractitioner.Thatbeingsaid,tryinganeliminationofFODMAPsforacoupleofweekscanhelpyouassessifyourcontinuingdigestivesymptomsmaybecausedbythisissue.Ifso,youcantakethisinformationtoyourkeyplayerandrequesttobetestedforSIBO.Formoreinformationabouttesting,treatment,andrecoveryfromSIBO,we
recommendthebookDigestiveHealthwithRealFoodbyAglaéeJacob.
Low-FODMAP/AutoimmuneProtocol
TheHigh-FODMAPFoodsListincludeshigh-andmoderate-riskfoodsthatalsooverlapwithfoodsincludedduringtheeliminationphaseoftheAutoimmuneProtocol.IfyouhavebeendiagnosedwithorsuspectSIBO,youmaywanttoexperimentwitheliminatingthesefoodsandreintroducingaccordingtoascheduledefinedbyyourpractitioner’ssuggestions,asitcanvarywithtreatment.Youwillfindthefoodsonthislisttobeintwocategories,denotinghowpotentiallyproblematictheyareforsomeonewithSIBO.Thewordinparenthesesnexttothefoodisthefermentablesugarcontainedwithin.Acoupleimportantnotes:NoteveryonewithSIBOreactstoallfoodsinevery
category,sowhileyoumaytolerateavocados,anotherpersonwithSIBOmaynot.Anotherthingtokeepinmindisquantity:Sometimesyoucangetawaywitheatingasmallquantityofacertainfoodbeforeexperiencingsymptoms.Thisisanotherplacewherediligentjournalingcanbeahelpfulpractice.
HistamineIntoleranceHISTAMINEisachemicalproducedbythebodyorcontainedinfoodthatisaneurotransmitter(hormonalmessenger),aswellasapartofthebody’sinflammatoryresponse.Undernormalconditions,itisbrokendownanddetoxifiedinthegut.SomepeoplehaveHISTAMINEINTOLERANCE,aconditionwheretheirbodiescannothandletheexcesshistamine.Thiscancausesymptomssuchasheadachesandmigraines,flushing,rashes,hives,congestion,racingheart,anxiety,nausea,andvomiting.Histamineintolerancecanbecausedbygeneticpredisposition(likeamutationintheenzymesthatdegradehistamineormethylation),ormorecommonly,anovergrowthofbacteriainthegut(likeSIBO).Sometimes,histamineintolerancecanbeimprovedbytreatingtheunderlyingrootcause.Talktoyourkeyplayerabouttestingandtreatment.Histaminecontentinfoodisadirectproductofhowithasbeenhandledand
processed.Meat,fish,andshellfishnaturallyproducehistamineassoonastheyarebutcheredorharvested,andthishistaminelevelincreasesastimegoeson.
arebutcheredorharvested,andthishistaminelevelincreasesastimegoeson.Curedoragedmeats,aswellasfoodsthathavebeenimproperlyhandledorstored,willhaveahigherhistaminecontentthanfresh.Duringthefermentationprocess,histamineiscreatedbythemultiplyingbacteria.Ifyoufindthatyouarereactingtofoodshighinhistamine,followingalow-
histaminedietcanhelpmanagesymptoms.Histamineintoleranceisnotlikeanallergy,whereaverysmallamountofasubstancecancauseaproblem,butmorelikeathresholdthatispassedbeforesymptomsappear.Youmayfindthatyoureacttosomehigh-histaminefoodsbutnotothers,oryoumaygetcomfortablewithservingsizesandcombinationsthatallowyoutostaybelowyourpersonalthreshold.Inaddition,itisimportanttoworkwithyourkeyplayeronpinpointingtherootcauseofyourhistamineintolerance,asitcansometimesberesolved.
High-FODMAPFoodsListAVOID
VegetablesArtichokes(fructose)Asparagus(fructose)Cabbage(fructan)Garlic(fructan)Jerusalemartichokes(fructan)Leeks(fructan)Okra(fructan)Onions(fructan)Raddichio(fructan)Shallots(fructan)
FruitApples(fructoseandpolyol)Apricots(polyol)Blackberries(polyol)Cherries(fructoseandpolyol)Driedfruit(fructose)Fruitjuice(fructose)Grapes(fructose)Mangos(fructose)Nectarines(polyol)Peaches(polyol)
Peaches(polyol)Pears(polyol)Persimmons(polyol)Plums(polyol)Watermelon(polyol)
SweetenersHoney
BECAUTIOUS
VegetablesAvocados(polyol)Beets(fructan)Broccoli(fructan)Brusselssprouts(fructan)Butternutsquash(fructan)Cauliflower(polyol)Celery(polyol)Fennelbulb(fructan)Mushrooms(polyol)Sauerkraut(fructan)Sweetpotatoes(polyol)Yams(polyol)
FruitBananas,unripeLongan(polyol)Lychee(polyol)Rambutan(polyol)
SweetenersCoconutflourCoconutmilkCoconutsugarDriedcoconutMaplesyrup
High-HistamineFoodsList
FoodsontheAutoimmuneProtocolandcommonreintroductionsthatarealsohighinhistamineinclude:Alcohol(evenwhen
cookedoff)CannedfishCannedmeatCheeseCoconutaminosCuredmeat(bacon,sausage,lunchmeat)DriedfruitFermentedvegetables(includingsauerkraut)FishFishsauceFruit(bananas,grapes,citrus,pineapple,strawberries)Kefir(includingcoconut)MushroomsPorkShellfishSmokedfishSmokedmeatSpinachVinegarYogurt(includingcoconutmilkvarieties)
DysbiosisItiscommonforthosewithautoimmunediseasetosufferfromanimbalanceofgutmicroflora,otherwiseknownasdysbiosis.Thiscanpresentitselfinamultitudeofways—maybeyousimplyhavetoofewofthebeneficialbacteriathatarenecessaryforregulatingtheimmunesystem,makingessentialvitamins,andkeepingyourcolonhealthy.Othersmayhavebacterialinfections,overgrowths,orissueswithyeastandparasites.Manyimbalancesingutfloraleadtootherimbalances,andyoucanbeleftwithacomplexwebofgutproblemsthatisdifficulttounravel.Abigredflagthatyoumaybesufferingfromdysbiosisisanintoleranceto
carbohydrates,evenwhencontainedina“realfood”packagelikefruitortuberssuchassweetpotatoes.Often,thesefoodscontainthe“food”thattheseorganismsthriveon,causingsymptomstoworsen.Althoughavoidanceofcarbohydratescanbehelpfulformanagingsymptoms,itisnotagreatlongtermapproachbecauseyouendupalsostarvingyourbeneficialflora,whichcanhavenegativeconsequences.Ifyounoticeyoudon’ttoleratecertaincarbohydratesorcontinuetohavedigestivesymptomsafter30to90daysintheeliminationphase,itwouldbewisetoaskyourkeyplayerforacomprehensivestooltest,onethatcanhelpdiagnoseyourissue.Treatmentofdysbiosiscanbemultiphaseandgenerallytakestime.First,it
Treatmentofdysbiosiscanbemultiphaseandgenerallytakestime.First,itmaybenecessarytokillofftheworstoffenderswithconventionalornaturalantimicrobialagents.Next,beneficialstrainsoffloramustbeslowlyreintroduced,anddietarymodificationsmaybenecessarytostarveoutcertainspeciesorfeedothers.Thetreatmentforsometypesofdysbiosismaybeexactlywhatexacerbatesanothertype,soitisimportanttoworkwithapractitionerwhoisusingtestingtodeterminethetypeoftreatmentrequired.
DYSBIOSISCHECKLISTThisisachecklistthatwillhelpyoudetermineifyoushouldtalktoyourkeyplayeraboutbeingevaluatedfordysbiosis.
◻ Ihaveahistoryofexcessiveantibioticuse.
◻ Ihaveahistoryofeatingahigh-carbdiet.
◻ Isufferfromconstipationordiarrhea.
◻ Isufferfrombrainfog.
◻ Isufferfromabdominalpain,bloating,orgas.
◻ Ihavefoul-smellingstoolsand/orgas.
◻ InoticemysymptomsworsenwhenIeatsweetfoods.
◻ InoticemysymptomsworsenwhenIeatstarchyfoods.
◻ Icravesweetorstarchyfoods.
◻ Icontinuetohaveskinproblemslikeacneorrashes.
◻ Ifeelworseindampormustyenvironments.
◻ Isufferfromfrequentheadaches.
DIGESTIVEISSUESOptimaldigestionisnecessarytoseethebenefitsofagreatdiet.Unfortunately,digestiveissuescanbeacommonroadblocktosuccessduringtheeliminationphase,asjustchangingwhichfoodsyoueatmaynotbeenoughtorestoreoptimalguthealth.Whilemanyoftheseissuescanberemediedbysupplementsandrarelywarrantmedicalintervention,itmaybehelpfultohaveapractitionerguideyoutoensurethatyouareonlysupplementinginareaswherethereisaclearneed.
CommonDigestiveIssues●LOWSTOMACHACID(HYPOCHLORHYDRIA)—Weneedadequatestomachacidto
fullybreakdownanddigestproteinsandprepareourbodiesforfurtherdigestion.Ifyouareexperiencingacidreflux,indigestion,ornoticinglargepiecesoffoodinyourstool,askyourkeyplayertodetermineifyouhaveenoughstomachacid.
●BILEINSUFFICIENCY—Bileisnecessarytoemulsifyanddigestthehealthyfatsthatweeat.Nothavingenoughbilecanleadtosymptomslikenausea,pain,diarrhea,andgreasyorfattystools.Thoseexperiencingtheseissues,aswellasthosewithoutgallbladders,shouldasktheirkeyplayerforsupportinthisarea.
●ENZYMEDEFICIENCY—Yourpancreasmakesenzymesthatareessentialforthecompletebreakdownofproteins,fats,andcarbohydratesinyourdiet.Lackingenzymescanleadtoincompletedigestionandgastrointestinaldistress.
●LACKOFBENEFICIALGUTFLORA—Beneficialflora,otherwiseknownasprobiotics,areanessentialandnecessarycomponentofhealthygutfunction.Ifyouhaveahistoryofantibioticuse(whichcanwipeoutthebadandthegood)orareexperiencingdigestiveissues,youmaynothaveenoughbeneficialbacteriainyourgut.ThreecommontypesofprobioticsareLactobacillusspecies,Bifidobacteriumspecies,andsoil-basedprobiotics(variousspeciesfoundinthesoil).
OTHERISSUESAdditionalFoodAllergies
AlthoughtheAutoimmuneProtocolremovesmostfoodslikelytobeproblematicforyoufromanautoimmunestandpoint,itcanbecommonforyoutohaveadditionalfoodallergiesand/orsensitivitiestofoodsonthe“include”list.Ifyounoticethatyouaregettingneworworseningsymptomsafterintroducingafoodyoutypicallydidnoteatbefore,ornowareeatingmuchmorefrequently,itisimportanttoremovethatfoodasapotentialallergen.Thisoftenhappenswithfoodslikecoconut,whichisprettyuncommoninthemoderndietbutcanbeheavilyrelieduponasadairyreplacementintheeliminationphase.Itisimportanttoalsoexcludeanyfoodyouhaveaknownallergy,sensitivity,orintolerancetowhileontheAutoimmuneProtocol.
NotEnoughCarbohydratesIfyoufindyourselfunusuallytiredwhileontheeliminationphase,youmayhaveinadvertentlystartedeatingalow-carbohydratediet.WhiletheAutoimmuneProtocolisnotbydefinitionlow-carb,youcanenduphere
especiallyifyoudon’tgooutofyourwaytoeatcompliantstarchycarbs.Ifyouarehavingissues,thefixissimple—trytoincludesomestarchycarbsinyourdietonadailybasis.Everyonehasauniqueindividualtolerancetotheamountofcarbohydrateinhisorherdietsowedon’thaveaspecificrecommendation,butitisworthtryingtoupyourintakeifyoufindyourselffeelingrundownandfatigued.
Elimination-Diet-FriendlyStarchyCarbohydrates
●Arrowroot
●Cassava
●Parsnips
●Plantains
●Sweetpotatoes
●Tapioca
●Taro
●Turnips
●Wintersquash(likepumpkinorbutternutsquash)
●Yams
CALLTOACTIONThischapterisextensiveanddensewithinformation.It’swithgoodreasonthough;nourishingyourselfisthebasisoflivingwellwithautoimmunedisease.Thefoundationforsuccessislaidbyhowyouchoosetofuelyourbody.Pouringthewrongkindoffuelintothegastankofacardestroysit,ruiningeachpartofitscarefullyassembledmachinery.Thisisaveryaptmetaphorforyourbody;exactlythesameprinciplesapply.We’veworkedtoshowyouthattakingthetimetolearnaboutsoundnutritionalchoices
andthenputtingthemintopracticewithplanning,preparation,andbalancewillpayhugedividends.Afteryou’vedecidedontherightdietarytransitionforyourself,diveinandgiveyourbodytimetoreceivethebenefitsofincreasednourishment.Ifyoufindyourselfwithlingeringissuesevenaftermakingmajordietarychange,don’tbediscouraged.Simplytroubleshoot,withthehelpofyourhealth-careteam,togettotherootcausesofyoursymptoms.Thispointonthejourneyislikelytobeoneofthe,ifnotthemost,transformative
experiences.Learningtonourishyouruniquesystemisadelicateanddemandingprocess,butthewisdomgainedislikelytochangeyourlife.
*Ifyouoranyoneonyourhealth-care teamsuspects thatyoumayhaveceliacdisease,youwillwant to
requestantibodytestingbeforeyoubeginagluten-freediet,asyourresultsmaybeinaccurateafteradoptingthiswayofeating.
CHAPTER4
Rest
“Improvingthequality,duration,andtimingofyoursleepisoneofthesinglemostpowerfulinterventionsyoucanmaketoimproveyourhealth.”—CHRISKRESSER,YOURPERSONALPALEOCODE
Theevaluationandimprovementofyoursleepisameaningfulandnecessarystepinmanagingyourchronicillness.ChrisKressersaysitperfectly—sleepisnotoptional.Ifyouhavetroublefallingasleep,stayingasleep,aretireduponwaking,orfeelsleepyorfatiguedthroughoutyourday,itisclearyouareindeepneedofimplementingsomebettersleephygieneand/ortroubleshootingyourbarrierstosleep.Sleepproblemsareprevalentinourculture,andwhatmostpeopleconsidernormalsleepisanythingbut.Itissafetoassumethateveryonehasstepstotakeinimprovinghisorhersleep.Excessinflammation,lesscellularregenerationandrepair,loweredimmunity,andimbalancedhormonescanbetheoutcomeoftoolittlerest.Evenifyouhaveaddresseddietaryissuesandmadeotherlifestylechanges,theywon’tbeeffectiveifyouaren’tsleepingproperly.Inthischapter,we’llbecoveringthebasicsofsleepaswellasgivingyousomepracticaltipstointegrateintoyourhealingroutine.
WHATISSLEEP?Despitethefactthateveryonesleepstosomedegreeoranothereverynight,theexactreasonswhyyousleep,aswellaswhatexactlyhappenswhileyousleep,largelyremainamystery.Whilesleepwasoriginallythoughtofasadormant,inactivestate,itisbecomingincreasinglyunderstoodthatyourbodyisactiveduringsleep,withmanyimportantfunctionsoccurringonlywhenyouaresleeping.Researchisgettingclosertounravelingthismystery,butfornow,mostofwhatweknowisthatgoodphysicalandmentalhealtharedeeplydependentontheprocessesthattakeplacewhileyouareinthisrestfulstate.Sleepistriggeredbyamixofneurotransmitters(hormonalmessengersinthe
brain)andhormones,aswellasincreasedsleeppressure,whichbuildsasyouareawakeandculminatesasyoureadyyourselftofallasleep.Fallingasleeptakesyougraduallyfromaconscioustoanunconsciousstate.Onceyouare
asleep,yourbodyprogressesinandoutoffivestages,inacyclicalfashion.Ifyourbodyachievestheadequatedurationandtimingofallofthestages,withoutinterruption,givingitachancetoperformallofthosefunctionsnecessaryforoptimalhealth,youwakeupfeelingenergizedandrefreshed.Unfortunately,thisisoftenhardertoachievethanitshouldbe.Sleepdeprivationcausesnegativeconsequencesinourhealthonaregularbasis.
AGROWINGPROBLEMThelackofsleepourcultureisexperiencinghasreachedepidemicstatus.Whileweneed7to8hourspernight,35percentofadultsreportgettinglessthan6hoursofsleep.Fiftyyearsago,thatfigurewas2percent.Whyisthisso?Acoupleoffactors—astimegoeson,ourculturecontinuestoglorifyproductivityandworkaholismmorethanrestorationandrelaxation.Timespentsleepinghassteadilydecreasedastimespentworkinghasincreased.Inaddition,exposuretolight(especially“bluelight”emittedbyTVscreens,computers,andsmartphones)afterthesunhasgonedowndeeplyimpactsourbody’sownnaturalrhythms.Thistechnologyhasenabledustoworkround-the-clockandoverridethenaturalprocessthatcausesustosleep.Astroublingasitis,sleeplessnesshasbecomethenormandaculturallyacceptedpartofmodernlife,withmostofusunawareofitsconsequences.Whilethemajorityofpeoplesimplydon’tgetenoughquantityorqualityof
sleep,sleepdisordersandotherissuesarewidespreadandgrowing.Nearly1in4Americanssufferfromsleepdisordersthatareinturnlinkedtohealthissueslikedepression,obesity,type2diabetes,cardiovasculardisease,andoverallriskofdeath.Thesedisordersinclude:
●Insomnia—theinabilitytosleep
●Sleepapnea—interruptedbreathingduringsleep
●Narcolepsy—theinabilitytocontrolthesleep-wakecycle
Whiletherearetreatmentsfortheseconditions,theyonlyhelpmanagesymptomsanddonotattempttofixtheunderlyingimbalance.Onethingisclear—therisingprevalenceofsleepissuescombinedwiththe
ongoingculturalshiftthatdevaluestheneedforsleepisnotgoodforourhealth.Despiteagrowingepidemicofenormousproportion,mostpeopleliveunawareoftheconsequencesofsleepdeprivation,suchas:
●Decreasedimmunity(suchascatchingacoldorflumoreeasily)
●Decreasedstresstolerance
●Propensityforweightgain,obesity,anddiabetes
●Reducedlearningcapacity
●Greaterriskforchronicdisease
●Increasedfatigueandloweredproductivity
●Mentalhealthissues
●Systemicinflammation
●Increasedriskofdeath
Clearly,theeffectsonourhealtharedetrimentalandweneedtoreprioritizethisforgottenareaofourlives.Takingcareofoursleepwouldputahugedentinthevastmoderndiseaseburdenwehavetoday,aswellasactuallymakinguslevel-headedandefficient!
HOWDOESSLEEPWORK?Inordertodescribesomeofthethingsthatcangowrongwithsleep,wemustfirstaddresswhatweknowaboutthefactorsthatcontroloursleepandwakecycles.Whatweknowaboutthesecyclestodaywasdevelopedasthetwo-processmodelofsleepregulationproposedbySwisssleepresearcherAlexanderBorbély,MD.Anothersleepresearcher,DanPardi,MS,developedterminologytodescribethismodel,withtwoopposingfactorsaffectingthesecycles.Thefirstissleeppressure,whichistheincreasingneedtosleepthatstartswhenyouwakeupandaccumulatesthelongeryougowithoutsleep.Assleeppressurebuilds,youbecomemoretireduntilyouareabletofallasleep.Thesecondiswakedrive,whichproducesalertnessandwakefulnessincontrasttosleeppressure.Duringtheday,yourwakedriveincreasesandkeepsyoualertandyourenergylevelsstable.Unlikesleeppressure,whichisregulatedbythetimethathaspassedsincesleepinglast,wakedriveisdrivenbyyourcircadianrhythm,whichisa24-hourcycle,andnaturallydissipateswhenitistimetosleep.Thisisadelicatesystemthatcanbedisruptedinmanyways.Forinstance,by
notgettingenoughsleeponenight,youareleftwithsleepdebt,whichwillthenbetackedontothenexttimeyousleep.Evenifthatnextsleepcycleisoptimal,youmaystillwakeupfeelingunrestedbecauseyoudidnotsleepenoughtocancelouttheadditionalsleepdebt.Acommonpracticeistogetlesssleepduringtheworkweekandthenmakeupforitontheweekend,butitisrarelypossibletoachievewithoutleavingsomeoutstandingdebtweekafterweek.This
possibletoachievewithoutleavingsomeoutstandingdebtweekafterweek.Thisleadstoachronic“negativebalance”andlong-termimpacts.Anyonewhohasbeenthroughanexamweekincollegeknowsfirsthandhowsleepdebtcancatchupwithyou!Yourcircadianrhythmisa24-hourcycleofbiologicalprocessesthathasan
intricaterelationshipwithyoursleep-wakecycle.Yourbrainisincontroloftheseprocesses,whicharecarriedoutthroughthereleaseofhormonesthatriseandfall,dependingonthetimeofday.Somehormones,likecortisol,increaseinthemorningasyouwakeupandprovidetheenergyyouneedtogetthroughtheday.Incontrast,melatoninincreasesacouplehoursbeforebedandpromotesdrowsinesstoinducesleep.Therearemanyfactorsthatimpactyourcircadianrhythm,butoneofthemostpowerfulisthelight-darkcycle.Exposuretobrightlight(especiallydaylight)duringthedaytimeandcompletedarknessatnighthelpsourbodyregulatethiscycle.Therearemanyfactorsthatcandisruptyourcircadianrhythm,whichcancausesleepinessduringthedayandwakefulnessatnight.We’llbediscussingtheselateroninthechapter.
SLEEPANDHEALINGHowdoessleepfitinwiththehealingprocess?Gettingtheappropriatequalityanddurationofsleepisabsolutelynecessaryforhealingandrecovery.“Dialing
anddurationofsleepisabsolutelynecessaryforhealingandrecovery.“Dialingin”yoursleepcanlowerinflammation,regulateandstrengthentheimmunesystem,andpositivelyimpacthungerhormonesandmetabolism.Yourbodyengagesintherestorativeprocessoftissuerepairandregenerationonlywhenyouaresleeping—whichmeansifanautoimmunediseaseistakingitstoll,itshouldbeimportanttoyou!Inaddition,adequatesleepenhancesmemoryandmentalclarity,improvesenergylevels,helpsmanagestress,andkeepsyouhappy.Whileitmaynotbethemostobviousstepinyourhealingjourney,itisanabsolutelyessentialone!
HOWMUCHSLEEPDOYOUNEED?Sleepneedsarehighlyindividual,butresearchshowsthatmostadultsneed7to8hoursofuninterruptedsleep.Youmayfeelthatyoufunctionjustfineonthenationalaverageof6hours;ifyounoticeapatternoffeelingexcessivelytiredinthemorning,possiblyneedingstimulantssuchascaffeine,and/orhavingmoreenergyatnight,itisasignthatyoursleepneedsarenotbeingmet.Ontheotherhand,youmayfeelthatyouneedanexcessiveamountofsleep,
perhaps10to12hourspernight,tofeelrested.Thisisnotuncommonforthosesufferingfromchronicillnessandisoftenasymptomofautoimmunedisease(likeHashimoto’sthyroiditis).Ifitisatallpossible,allowyourselftomeetyourbody’sneeds.Sometimes,asunderlyingcausesareresolved(suchasthelackofthyroidhormonewithHashimoto’s)orsleepqualityimprovesduetolifestylechanges(seethelifestyleguide),youmayfindyourselffeelingrefreshedandneedinglesssleep.Asitappliestohealing,itisimportanttoerronthesideoftoomuchsleep
ratherthantoolittle.Aswehaveoutlinedinthischapter,sleepisabsolutelyessentialtothedeephealingandtissuerepairnecessaryforlivingwellwithautoimmunedisease.Doyourselfafavorandmakesuretogetinbedwithplentyoftimetospare,andgiveyourselfthatextrahourortwotosleepininthemorning.Yourbodywillthankyou!Forthosewhoregularlywakeupwithanalarmandmaybeunawareoftheir
body’snaturalsleepneeds,wehavedesignedasleepexplorationexercisetohelpyoudetermineyourrequirements.
WHATINFLUENCESAGOODNIGHT’SSLEEP?Therearemanyissuesthatcanfactorintosleepdisturbances:diet,stress,circadianrhythmdisruption,environmentalinfluences,andourhealthconditionsthemselvesarejustafewthatwe’llbefocusingonhere.Understandinghow
eachoftheseimpactsbothsleepquantityandqualitycanbeusefulintryingtocombatthenegativeeffects.
DietAlthoughitmaynotbereadilyapparent,ourdietscanhaveanimmenseimpactonoursleep.Understandingthebasicreasonswhycanhelpyoumaketheconnectionsandhopefullyallowyoutoinstituteafewsimplechanges.Caffeineconsumption(whethercoffee,tea,orchocolate)canbeadietary
factorinsleepdisturbances.Thisisbecausecaffeinestimulatestheproductionofcortisol(there’sthat“wakeup”hormoneagain!).Theselevelscanstayelevatedfor6hoursormoreafterthecaffeineisconsumed.Somepeoplefindthateven1cupofcoffeeorteainthemorning(orevenchocolate,fortheverysensitive)impactstheirsleepthefollowingnight.Youmayfeellike,overtime,youaremoreandmoretoleranttocaffeine,withitaffectingyoulessandless.Thisispartlytrue,butcompletetoleranceneveroccurs,sothinkingthatitdoesn’taffectyouissimplywrong.Alcoholconsumptioncanbeanotherdietaryfactorinsleepdisturbances,fora
fewreasons.Alcoholisadiuretic,whichmeansitforcesthebodytoexcretewaterandcanleadtodehydration.Ifyou’veeverdrunktoomuchandthenfoundyourselfawakeinthemiddleofthenightneedingabigglassofwater,youunderstandthiseffect.Alcoholconsumptioncanalsotriggerthereleaseofinsulin,whilesimultaneouslyimpairingtherectifyingreleaseofglucosefromthelivertopreventatoo-lowbloodsugar.Althoughmanypeoplethinkanightcaphelpsthemsleepwell,bothalcohol-relateddehydrationandbloodsugarcrashesdisruptsleep.Bothlow-fatandlow-carbdietsgetitwrongwhenitcomestosleepingwell.
Thesedietaryapproachescanleadtopoorsleep,eveninsomnia.Weallknowthefeelingofbeingjustabittoohungrywhenwehitthepillow—tryingtomaintainafastof7to9hourswithahungrytummyissimplyunrealisticandinsteadresultsintossingandturning.Inaddition,researchshowsthatdensecarbohydratesources,likestarchyvegetables,alsohelpussleepbetter.Carbshelptheaminoacidtryptophanenterthepinealgland,deepinthecenterofthebrain,whereitcontributestotheproductionofmelatonin(thatsleephormone).Carbsalsohelppreventyourbloodsugarfromdroppingovernight.Whenbloodsugargetstoolow,thehormonecortisolisreleased(thatalertnesshormone).Ifyouconsistentlywakeupsuddenly,feelingabitanxiousbetween2a.m.and4a.m.,it’sprobablyabloodsugarcrashfromeatingtoolittlecarbohydrateatyoureveningmeal.
Finally,thereistheissueoffoodsensitivities.Reactionscausedbyafoodyouaresensitivetocanvarywildly,andoneofthepossibleresponsescouldbetroublesleeping.Youmayfindthattroublefallingasleep,stayingasleep,orjustplainfeelingunrestedistheresultofconsumingaparticularfood.Beawareofthispossiblereactioneitherimprovingasyoueliminatefoodsorcomingbackasyouexperimentwithfoodreintroductions.
ChronicStressMostofusunderstand,intuitively,thatchronicstresscontributestosleepdisturbances.Thatawful,pressure-cookerjobishardtostopthinkingabout,evenwhenit’stimetohitthepillow,ormaybetheargumentsyou’vebeenhavingwithyourpartnerleaveyoufeelingangryandampedforhourseachnight.Whatexactlyiscausingthatsleeplessnessinresponsetostress?Youguessedit—it’scortisolagain!Chronicstressstimulatesconstant
productionofcortisol,whichcausesimbalancesinyourhormonalcycleanddisruptsyourcircadianrhythms.Cortisolneedstosteadilydecreaseduringthedayandallowmelatonintopickupintheevening.Whenitstayselevated,yourbodydoesn’treceivethesignaltoturnoffandrest.Youmayfallasleep,butifyourhormonalbalanceisoff,thenaturalsleepcyclecanbedisrupted,leadingtopoor-qualitysleep.Tomakemattersworse,lackofsleepisitselfaformofchronicstress,makingthecycleaworseningloop.Activelymanagingstress,especiallythatlong-termkind,isextremelyimportanttohealthysleep.
CircadianRhythmDisruptionCircadianrhythmreferstoyour“bodyclock.”Humans(andanimals,plants,andevenmicrobes)gothroughspecificbiologicalprocessesatkeypointsinaroughly24-hourcycle.Thisrhythmismostinfluencedbyalternatingperiodsofsunlightanddarkness,knownasthelight-darkcycle.Therearestagesinlifewheretherhythmgoesthroughsomechanges,despite
theselight-darksignals.Asinfants,ourclocksarenotmatureanddonotrespondasreadilytolight-darksignals.Then,asteens,wetypicallyexperiencesleepphasedelay,wherewefeelalertlaterintothenightandwanttostayasleeplaterintotheday.Finally,inouroldage,wemayexperienceanothershiftreferredtoasadvancedsleepphasesyndrome,wherewefeeltiredearlierinthedayandbecomealertintheveryearlymorninghours.Anyonewhohasevercaredforaninfantwhoiswakingeveryfewhoursduringthenightorparentedateenwhoisuplisteningtomusicandlaughingwithfriendsatmidnightcanattesttothefactthatregardlessoftheserecognizedrhythmshiftsoverourlifespans,doing
thatregardlessoftheserecognizedrhythmshiftsoverourlifespans,doingeverythingpossibletopromotetheregularityofourbodyclocksishugelyimportant.You’vealreadyheardaboutcortisolandmelatonin,thetwokeyhormones
affectingsleep.Thesehormoneshelpkeepthetimingofthecircadianrhythmsteady.Cortisolincreasesinthefewhoursbeforewewakeupandisatitshighestearlyintheday.Melatoninincreasesinthefewhoursbeforewegotobedandisatitshighestintheweehoursofthemorning.Productionofthishormonerampsupwithdarknessanddiminisheswithlightexposure.Iftheproductionofeithercortisolormelatoninisdisturbed,wesoonfindoursleepisamess.Soonerorlater,thisalsomeanswearemoresusceptibletoillnessanddisease,sincebothhormonesaremajorplayersinimmuneregulation.Protectingourcircadianrhythmshelpsreinforcethebalancenecessarytolivewellwithautoimmunedisease.
WhereAreYouontheSleep-QualitySpectrum?Thistestwillhelpyoudetermineifyoursleepqualityisoptimalorneedswork.Giveyourselfapointforeveryitemonthelistthatappliestoyou,andthentotalyourscoreandseewhetherimprovingyoursleepshouldbeapriority.
__ Myenergyisnotstablethroughouttheday.
__ Iamdependentonwakingupwithanalarm.
__ Ifeelrushedtogettobedatnight.
__ Ihavetroublefallingasleep.
__ Iwakemorethanonceduringthenight.
__ Ioftenwakeupbeforemyalarmandamunabletofallbackasleep.
__ Ihavetroubleconcentrating.
__ IhavebeentoldthatIsnore.
__ IhavebeentoldItossandturnatnight.
__ Igrindmyteethatnight.
__ IfindmyselfunabletofallasleepbecauseIamworryingaboutthings.
__ Ilieawakeforalongtimebeforefallingasleep.
__ Ihavetroublewakingup.
__ Ineedcaffeineinthemorningtogetmegoing.
__ Iwakeupoutofbreathand/orIhavebeentoldIholdmybreathwhileIsleep.
__ Iwakeupsweating.
__ Iwakeupsuddenlywithastrongsenseofanxiety.
__ Iwakeupsuddenlyandfeelhunger.
__ Chronicpainpreventsmefromfalling/stayingasleep.
__ Iamsleepyduringtheday.
__ Ifindmyselfirritableorunabletotoleratestress.
__ Ioftenhaveahardtimerememberingthings.
__ Ican’tgetthroughthedaywithoutanap.
__ Ifindmyselfdozingoffduringtheday,whileworkingand/ordriving.
__ IfeellikeIaminadazeorbrainfog.
1—9LOWPRIORITY—Goodjob!Yoursleepqualityismostlikelygoodenoughforoptimalhealthandhealing.Wesuggestlookingoversomeoftherecommendationsinthefollowingchapters,asyoumayhaveotherareas(suchasdiet,stressmanagement,movement,orconnection)thattakeahigherpriorityinyourhealingjourney.
10—14MODERATEPRIORITY—Lookslikeyoursleepcouldusesomework!Timetodigintotherecommendationsthatfollowinthischaptertoseeifyoucanmakesomeimprovements.Yoursleepisnotaspoorasitcouldbe,butnowisthetimetoactbeforethingsgetworse.
15—HIGHPRIORITY—Uh-oh!Itappearsthatyoursleepqualityisextremelylow.Thisisastrongindicatorthatyouneedtoprioritizeandfocusontherecommendationslaidoutinthischapter.Inaddition,youmaywanttotalktoyourkeyplayertohelpyouunravelsomeoftheunderlyingfactorsthatareimpactingyoursleep.
EnvironmentalFactorsSometimessleepdisturbanceisaboutenvironmentalfactors,likeartificiallight,electronicsusage,temperature,andnoise.Wehavetoobeythelawsofnature
electronicsusage,temperature,andnoise.Wehavetoobeythelawsofnaturewhenitcomestosleep.Sleepisbestmatchedtoaparticularenvironmentwelivedinharmonywithformostourexistenceasaspecies:dark,freeofelectronics,cool,andquiet.Weneedtominimizeexposuretoartificiallightinthehoursbeforebedand
thenaimforcompletedarknessduringsleep,otherwiseourmelatoninproductionisdisrupted.Whatyoumaynotrealizeisthatthisisnotjustaboutyoureyes,itisalsoaboutlightexposuretoyourskin!Yourskinisalsophotosensitive,sopayingattentiontothisenvironmentalfactorcanhaveabigimpactonyoursleep.Theuseofelectronics,ingeneral,aswellaselectronicsinourbedrooms,
disruptssleep.Theblue-spectrumlightbeingemittedfromyourTV,laptop,tablet,orcellphoneisparticularlydisruptivetomelatoninproduction.Removingthemfromyourbedroomeliminatesthisenvironmentalfactor.Disruptionisn’tonlyaboutthelightexposure;scrollingthroughupsettingheadlinesorhavingatextchatwithfriendsisnotcreatingthebestatmosphereforsleep.Havinganemotionalbufferbetweenyourregulardaytimeroutineandbedtimeisimportant.Haveyoueverwokenupsweating,onlytorealizetheair-conditioningwent
outduringthenight,andthetemperatureslowlyroseinthebedroomuntilyouweresouncomfortableitdisruptedyoursleep?Weneedacomfortablebutcoolovernighttemperatureinourbedroomsforthebestrest.Throughouttheday,yourbodytemperaturerisesandfallsinapatternthatistiedtothesleep-wakecycle.Yourtemperaturegoesdownasbedtimeapproachesandgetstoitslowestpointintheveryearlymorninghours.Afterthat,itstartstogoupagain.Abedroomthatistoohotcanaffectyourbody’snaturaltemperaturecontrolsandresultinpoorsleep.Sleepresearchershavefoundthatatemperaturearound65°Fisaboutright.Noiseisthefinalenvironmentalfactorweareexploringhereandprobablythe
mostobvious.Anythingfromchildren,pets,electronicnotifications,neighbors,tostreetnoisecandisruptyoursleep.Itgoeswithoutsaying,butaquietroomisbest.
HealthConditionsForsome,sleepdisturbancesmaybetheresultofautoimmuneorrelateddiseases.Forexample,painfromyourrheumatoidarthritisorthevarioussymptomsofyourotherdiseasescanruinagoodnight’ssleep.Immunecellsthatplayaroleinyourdiseasemightalsobetoblame,astheysecretearangeofhormonesthatdisruptthecircadianrhythm.Inthiscase,muchlikewithchronic
stress,anegativecyclecandevelopwheretheautoimmunediseaseiscausinglackofsleepandlackofsleepisworseningthedisease.
TROUBLESHOOTINGSLEEPYouknowyouneedtoworkonyoursleep—butwheredoyoustart?Therearemanyareaswheresmalladjustmentscanyieldbigresults.Here,wecoverthoseareasthatcanberefinedforbetterqualityanddurationofsleep.Takenoteofanythingthatringstrueforyou,andusethe“TroubleshootingChecklist”toincorporatetheserecommendationsintoyourroutine.
Diet
Thereareafewdietaryinterventionsthatmayhaveapositiveimpactonsleep.Thefirstistoeliminateorreducecaffeinefromyourdiet.Youwillwanttomakeaplandependingonwhereyouareonthespectrumofcaffeineintake(quittingcold-turkeyisnotadvised!).Ifyouaresomeonewhoreliesonafewcupsofcoffeeadaytokeepyougoing,andespeciallyifyougetheadachesorfeelgroggywithoutyourmorningcup,workonweaningyourselfgraduallyoffthecaffeine.Youcaneitherblendinsomedecaffeinatedcoffee(SwissWaterProcesscoffeehasfewerchemicals)startingwith25percentandincreasingthepercentage,orstartdrinkinglesstotalvolumeonaweek-to-weekbasis.Somecoffeedrinkershaveaneasiertimetransitioningtoblacktea,andthengreentea,whichbothprogressivelyhavelesscaffeine.Ifyouareateadrinker,youmaybesurprisedtofindouthowmuchcaffeineisinyourblackandgreentea!Chocolatecanalsobeaproblemforthosewhoareverysensitive.Ifyouarehavingtroublesleeping,itisgoodtoweanoffallcaffeine(evenchocolate!)foramonthtoseeifthatisthesourceofyourproblem.Whenyougotoadditback,youmayfindthatyouhaveathresholdoftoleranceoracutofffortimeofdaywhereitaffectsyoursleep.Acommonexamplemightbethatyoutolerate1cupofcoffeeinthemorning,butifyouhaveanymorethanthat,oranyintheafternoon,itimpactsyoursleep.Ontheotherhandaredepressants,whichcanhaveanequallynegativeimpact.
Alcoholcanbeamajorfactorforsomepeople,andwhileitcanfeellikeithelpsyoufallasleep,itislikelytopreventyoufromstayingasleepbecauseofitseffectsonhydrationandbloodsugar,asmentionedabove.Similartocaffeine,itishelpfultoavoidallalcoholforamonthormoretodeterminehowitaffectsyoursleep.Thenextdietaryinterventionthatmayhelpyoursleepisadjustingyourcarb
intakeatdinnertimeorbeforebed.Starchycarbohydrates(likesweetpotatoes,
yams,plantains,andwintersquash,ifyouareintheeliminationphase),especiallywhencombinedwithahigh-qualityfat(oliveoil,coconutoil,orpasturedlardortallow)helpkeepyousatiatedthroughoutthenight.Mostpeoplesleepbestwhentheirstomachisneithertoofullnortooempty,andhavingafew-hours’windowbetweendinnerandbedtimeisoptimal.Thischangesifyouarespecificallysufferingfromissueswithblood-sugarregulationandfindthatyouwakeupafewhoursaftergoingtosleep—hereyoucantryhavingasmallbalancedsnackwithsomestarchycarbohydrate,fat,andproteinjustbeforebed.Everyoneshouldavoidsweetorsugaryfoodsintheeveningorbeforebed,astheyarelikelytospikebloodsugarandcauseamidnightcrash,wakingyouup!Itmaytakesomeexperimentingtofigureoutwhatworksbestforyou,butadjustmentsherecanhaveanimpactonqualityofsleep.Last,foodallergiesandsensitivitiescanabsolutelyimpactsleep.Ifyou
haven’tdoneaneliminationandreintroductionprotocol,reviewthedetailsinChapter3forguidanceonpinpointingthosetroublefoods.Youmayfindthatyoursleepimprovesaftereliminatingparticularfoodsfromyourdiet.
StressManagement
Ifyouareconcernedaboutyoursleep,stressmanagementneedstobeapartofyourroutine.Startamindfulnesspracticeandmakesureyoufollowthroughwithit.Thiscouldbeassimpleastaking1ormore5-minutebreaksduringthedaytositstill,bequiet,andlistentoyourbreath.Youmayhaveotheractivitiesthathelpyoumanageyourstresseffectively—meditation,hiking,yoga,walking,takingabath,gettingamassage,orjustbeinginnature.Whateveryoufindrelaxingandrestorative,makeanefforttoincludethatinyourdailyroutinetoseehowitimpactsyoursleep.Ifyouneedmorehelpinthisarea,we’llbeaddressingitindepthinChapter5.
WhenIwasmysickest,sleepwasamajorissueforme.Despitecrushingfatigue,Ihadaveryhardtimefallingandstayingasleep.Thestayingasleeppartwasparticularlyawful!Iwokeupalmosteverynightbetween2and4a.m.inaterrifyingpanic.Iwasoftensweatingprofusely,myheartwasbeatingrapidly,andIwouldlietheresureIwasexperiencingmyfinalmoments.Dietwasplayingahugeroleinthisproblem—mybloodsugarwascrashingeachnight,causingmyadrenalglandstokickintohighgear.Thatsurgeofcortisolwaswhathadmewakingupconstantlyinterror.Tomakemattersworse,Iwascompoundingtheproblembyattemptingtousealcoholtohelpmesleep.Ithoughtthatanightlyglassofwinemighthelpmerest,but,infact,itwasexacerbatingtheblood-sugarcrashandseverelydehydratingme.WhenIbegantoincludemorecarbohydrateandfatintomyeveningmeal,andquitalcoholaltogetherforalongperiod,mysleepimprovedimmensely.IfIfocusondietaimedatwell-
altogetherforalongperiod,mysleepimprovedimmensely.IfIfocusondietaimedatwell-balancedbloodsugarandkeepalcoholconsumptiontospecialoccasions,I’malmostguaranteedarestfulnight.
SUPPORTINGYOURNATURALRHYTHMSAsyoufoundoutearlierinthischapter,itisveryeasyforyournaturalcircadianrhythmtogetofftrackfromexposuretolightatthewrongtimesduringtheday.Thisfixgoesalittleagainstculturalnorms,butcanbeincrediblyeffectiveatpromotingqualitysleep.First,youwillwanttomakesuretotimeyoursleep-wakecycleascloseaspossibletosunsetandsunrise.Formostofus,thismeansgoingtobedearlierandwakingupearlier.Beinginbedby10andupby7isagreatgoal.Itmaytakesomeprioritizingandrearrangingtomakesureyouarereadytowinddownattheappropriatetime,butyouwillmakeupforitwith
increasedenergyandproductivityafterimprovingyoursleep.Next,youwanttomakesuretominimizeyourexposuretoblue-spectrum
lightafterthesungoesdown.Thiscanmeandimmingthelights,installingblue-light-blockingsoftwareonyourcomputeranddevices,orwearingblue-light-blockingglassesintheevenings(seeResources).Youalsowanttomakesurethatyourbedroomiscompletelydarkandfreefromlightpollution(youmaywanttoinvestinsomeblackoutshades).Don’tunderestimatethisrecommendation!Minimizingyourexposuretobluelightbeforebedandalllightatnighthelpsyourbodymakethehormonesnecessaryforinitiatingandstayingasleep.Similarly,youwanttoexposeyourselftobluelightduringtheearlierpartof
theday,preferablyinthemorningrightafterwakingup.Thishelpsyourbodymakethehormonesthatwakeyouupandgetyougoingfortheday.Ifyoucangetoutsideforatleast20minuteswithoutsunglassesandletnatureworkitsmagiconresettingyourinternalclock,thatisthebestwaytogo!Forthosewhocan’tmakeitoutside,ablue-lighttherapylampcanbeagoodcompromise(seeResources).Anoteaboutshiftwork—weknowthatforsomepeople,theirjobmakesit
nearlyimpossibletosleepandrisewiththesun.Ifyouneedtoworkduringthenight,youneedtobeevenmorediligentaboutprotectingyourcircadianrhythmsandstayingonaregularcycle.Youcansimulatea24-hourlight-and-darkcyclewiththeuseofblue-light-blockingglasses,averydarksleepingarea,aswellasablue-light-emittinglamp.
PracticeGoodSleepHygieneItisimportanttohavearegularbedtimeroutinethatisconducivetohelpingyoufallasleep.Goingstraightfromwork,exercise,anintenseTVshow,oraheateddiscussionwithalovedonetoimmediatelytryingtofallasleepdoesnotsetyouuptoachievethatgoal.Trytoplanarelaxingactivityorritualtorepeateverynightbeforeyougotobed.Thismightbesomethingassimpleaswashingyourfaceanddoingashortmeditation,readingabook(carefulwithnovelsthataretoointenseorstimulating!),takingabathwithepsomsalts,orjournaling.AvoidwatchingTV,working,havingtensediscussions,doingstrenuousexercise,payingbills,scrollingsocialmedia,oranythingelsethatisgoingtopreventyoufromrelaxingandfallingasleep.Equallyimportantismakingsureyoursleepenvironmentiscomfortableand
conducivetosleep.Yourbedshouldbecleanandcozyandyourroomcoolanddark.Ifthereistoomuchlightcominginthroughyourwindows,consider
investinginblackoutshades,andmakesuretocoverupanyblinkingorsolidlightsfromelectronicdeviceswithdarktape(orbetteryet—getthemoutofthebedroom!).Ifyoucan’tcontrolthelightsituation,youmaywanttopurchaseaneyemask.Ifnoiseisanissue,youmaywantadevicetomakewhitenoise(anairpurifierorfanhelpshere)ortouseearplugs.Ifyoucan,getalltechnologyoutofthebedroomanddon’tusethatspacefor
workingorwatchingtelevision.Chargedevicesoutsidethebedroom,andmakesuretheyaresetnottoding,buzz,orbeepduringsleepinghours(forthoseofyouwhoareworriedaboutemergencies,youcansetmanydevicestoringonsecondcallorhaveaselectfewnumberswhocanalwaysreachyou).Someoftheserecommendationsareamongthemostdifficulttoimplement,becausepoorsleephygieneisingrainedinourculture.Asyoustarttomakesleepmoreofapriority,thesestepswillcomemorenaturally(seethelifestyleguide)!
MovementGettingmoreexerciseduringthedaycanhelpyoufallasleepeasieraswellasimprovethequalityofyoursleep.Ifyouarehavingtroublewithyoursleepanddon’tgetmuchexercise,trystartingagentleexerciselikewalkingoryoga.Ifyoudowellwithmoreintenseexercise,youcantryrunning,cycling,liftingweights,oranythingelsethatyoufindpleasurablethatisalsonottooenergy-depleting—justdon’tdotheseactivitiesinthefewhoursbeforebed!We’llbetalkingmoreaboutoptimalexerciseinChapter6.
SupplementationYou’llneedguidancefromyourhealth-careteamhere,buttherearesomesupplementsthatcanbehelpfulfortroubleshootingissueswithsleep,likemagnesium,variousherbalpreparations,andothernutrients.Mostpeoplefindthattakingmagnesiumbeforebedhelpsthemrelaxandfallasleepmoreeasily.Wedon’trecommendmelatoninunlessprescribedbyadoctorbecauseitcancausethebodytomakelessofthisessentialhormone.Thereareotherherbsandnutrientsthatcanbehelpfulforbalancingsleep.Ifyou’veworkedthroughsomeofthepreviousrecommendationsandarestillhavingtrouble,itmightbetimetoaskyourkeyplayerorsupportplayertoassistyouwithputtingtogetheraprotocol.
NapsIfyouareunabletogetquality,uninterruptedsleepduringthenight,nappingmightbenecessaryforyou.Foralotofpeople,nappingcanbeaproblem
mightbenecessaryforyou.Foralotofpeople,nappingcanbeaproblembecauseitlessenssleeppressureandmakesitmoredifficulttofallasleepatnight.Ifyoufeellikeyoudon’tgetsleepyenoughbeforebedandhaveahardtimefallingasleep,napsarelikelytoexacerbatethisproblem.Thatbeingsaid,ifyoursleepisbeinginterruptedforotherreasons,suchaschronicpain,anewbaby,orotherwise,napsmaybenecessaryforyoutomeetyourbody’srequirementforsleep.Forthosewhoarelackinganhourortwoofqualitysleeppernight,napping
isn’tareplacementforthatsleep—besuretofollowalloftherecommendationsabovebeforeresortingtoregularnapstomakeupthedifference.Ingeneral,a20-to30-minutenapisrestorativeandlesslikelytointerruptregularsleep.Anhourorlongernapfeelsbetterforsomepeople,butitismorelikelytomakeitdifficulttofallasleeplater.Youwillneedtoexperimentandseewhatworkswellforyou.Uninterruptedsleepatnightispreferableovernappingbecauseyourbodyismoreeasilyabletoreachthedeeperandmorerestorativestagesofsleep.Nappingcanhelpmakeupadeficit—justdon’tuseitasareplacementforgettingtobedontime!Ifyouaresomeonewithchronicsleepdisturbances,anysleepshouldbe
encouraged,includingnapping.Sometimes,likewhenthereisanewbabyinthefamily,itisnotpossibletogetuninterruptedsleep.Inthiscase,makeanefforttogetsleepwhenevertimewillallow.
TROUBLESHOOTINGCHECKLISTUsethischecklisttodetermineifyouhavetickedalloftheboxesasyoutroubleshootsomeof
Usethischecklisttodetermineifyouhavetickedalloftheboxesasyoutroubleshootsomeoftheunderlyingcausesofsleepissues.Ifyouarestillstrugglingandfindsomeoftheseunchecked,it’stimetodiginandexploretheseareas!
◻ I’veeliminatedorreducedcaffeinefrommydietforatleast30days.
◻ Iavoiddrinkingalcoholbeforebed.
◻ Iincludestarchycarbohydratesandhealthyfatsinmydietatdinnertime.
◻ Iavoidsugarorsweetfoodsintheevening,especiallybeforebed.
◻ I’vedoneaneliminationdiettoexplorethepossibilityoffoodallergiesand/orsensitivities.
◻ Iincorporatestress-managementactivities(mindfulnesspractices,meditation,walking,yoga,massage,orbreathwork)intomydailyroutine.
◻ Igotobedearly(10p.m.orearlier)andwakeupearly,closetothesettingandrisingofthesun.
◻ Iminimizemyexposuretobluelightafterthesungoesdown(throughtheuseofblue-light-blockingglassesandsoftwareordimmingthelights).
◻ Imaximizemyexposuretobluelightinthemorning(eitherbygoingoutsideorusingalight-therapylamp).
◻ Iuseblackoutshades,aneyemask,orothermethodstoensurethatmybedroomiscompletelydarkwhenIgotobed.
◻ Ihavesetupmybedroomtobeconducivetosleep—comfortable,cool,quiet,anddark.IfIcannotcontrolthetemperatureornoise,Iuseafanorearplugs.
◻ Ikeepalltechnologyoutofthebedroom.
◻ Ihavesetmydevicesnottogooffduringsleephours.
◻ Iavoidstressfulsituationsand/orworkbeforebed.
◻ Imoveanappropriateamountthroughouttheday.
◻ Iavoidintenseexercisebeforebed.
◻ I’vetalkedtosomeoneonmyhealth-careteamaboutusingmagnesiumorothersupplementsbeforebedtohelpmerelaxandfallasleep.
◻ I’veruledoutunderlyingsleepconditionslikeinsomnia,sleepapnea,restlesslegsyndrome,andnarcolepsywithmyhealth-careteam.
RulingOutUnderlyingConditionsIfyou’vemadeagoodefforttotryallofthesetroubleshootingpointsandarestillnotexperiencingsuccess,youwillwanttotalktoyourkeyplayeraboutinvestigatingunderlyingconditionsortoseeifyoursleepissuesareduetoyouralready-diagnosedconditions.Conductingasleepstudycanbehelpfulindeterminingwhyyoumaynotbegettingthequalityordurationofsleepyouneedandcangiveyourpractitionervaluableinformationtohelpgaugewhatkindoftreatmentisnecessaryforresolution.
SleepExplorationExerciseThisexerciseistohelpthosewhoregularlywakeupwithanalarmdetermineiftheyaregettingenoughsleep.Whilethisexercisewon’tbeasusefulforthosewhohaveinsomniaortroublestayingasleep,ifyoualwayswakeupwithanalarmandstruggletogettobedontime,youmaybesurprisedtofindouthowmuchsleepyourbodyactuallycraves.Trythisexerciseoveralongweekendoranother3-daystretchwhereitwillbeokayforyoutopotentiallyoversleep.Thisinformationcanhelpyoudetermineanappropriatebedtimethatgivesyouenoughsleeptomeetyourneeds.
●Reviewthechecklisttomakesurethatyouhaveallofthebasicrequirementsinplace(cool,quiet,darkbedroomfreefrominterruptions).
●Foraperiodof3days,makesureyougotobedatthesametime,andmakesurenottosetanalarmforthefollowingmorning.
●Allowyourselftonaturallywakeup,calculatehowmanyhoursyousleptforeachnight,andthenaveragethat.
●Thisistheamountofsleepyoushouldbeaimingforeverynight.
I’vealwayshadtroublefallingasleep,andbeforeprioritizingactioninthisarea,Iwouldlieawakeinbedforhours,sometimes3to4beforedriftingoffintoafitful,restlesssleep.Creatingandfollowingabedtimeritualhashelpedmemakeprogressinthisarea,andifIfollowit,Iwillfallasleepquickly,stayasleepallnight,andwakeupfeelingrefreshedandreadyfortheday.Twohoursbeforebedtime,IputonamberglassesifIamusingascreenanddimthelightsinmyhouse,andIprioritizeactivitiesthatarecalmingandrelaxing(likereadingabook,knitting,cuddlingwithmyhusbandorcat,orgentlestretching).Onehourbeforebedtime,Igetthingsreadyforthefollowingday,washmyfaceandbrushmyteeth,diffusesomeessentialoilsinthebedroom,andmakeacupoftea.RightbeforeIturnoutthelights,Ienjoyteawhilereadingorcuddlewithmyhusband.IfIamfeelingparticularlywounduporstressedout,IwilldoashortmeditationorbodyscanasIfallasleep.
BedtimeRitualsHerearesomeritualideasyoucangetintothehabitofincludinginyourbedtimeroutinetohelpyourelaxandgetreadyforsleep.Theseactivitiescanactastriggerstogetyourbodyandmindintoarestfulstate.Usethemalone,orincombinationsthatworkforyou.
●Takeahotbathwithepsomsaltsandcalmingessentialoilslikelavender.
●Takeafewminutestowriteinagratitudejournal.
●Engageinaspiritualpracticelikeprayerormeditation.
●Createa“worrylist”tohelpgettheseitemsoutofyourheadasyoureadyforsleep.
●Dosomegentlestretchingand/orbreathwork.
●Dimthelights—youmightenjoycandlelightorsaltlamps.
●Usearomatherapyoressentialoilsthatarecalmingorrelaxing
●Readarelaxingfictionalbook(takingcarethatitisn’ttoogrippingorstimulating).
●Taketimetopracticeyourbedtimeself-careroutine(washingyourface,brushingyourteeth,moisturizingyourskin).
●Listentocalmingmusic.
●Engageina“bodyscan”—lyinginbed,startatyourtoesandendatyourscalp,tensingeachpartofyourbodyandreleasingit.
●Quietlycuddleorengageinpersonalcontactwithyourpartnerorfamilymembers.
●Practiceamindfulnessroutine—focusonyourbreath,theenvironment,andbodysensationsinthemomentsbeforesleep.
●Takesometimetounplugyourdevicesandplacetheminanotherroom.
●Prepareyourclothesandbelongingsforthenextday.
CALLTOACTIONAlthoughitisoneofourmostinstinctualbiologicalprocesses,itcanbeunusuallydifficultto“getitright”whenitcomestosleep.Thisisonlygettingmoredifficultinourmodernworld,asresearchrevealshumansaresleepinglessandless.Asolidunderstandingofsleepanditsimportancetohealingmakesitclearthatalltheeffortiswise—sleepisabsolutelynecessarytohealth.Inthischapter,wetouchedonallthecommonreasonsforsleepdisturbancesandhelped
youfindwaystoaddressthem,aswellaswaystoassessyouruniquesleepneeds.Everyjourneyrequiresafewpitstops,momentsofrefuelingandrepair,andtheautoimmunewellnessjourneyisnoexception.Givingprioritytorestwillbringwithitmanybenefits.AswriterThomasDekkersaid,“Sleepisthatgoldenchainthatbindshealthandourbodiestogether.”
CHAPTER5
Breathe
“It’snotstressthatkillsus,it’sourreactiontoit.”—DR.HANSSELYE
Stressisubiquitousinourmodernlives,andwedonotvalueorprioritizetheself-careandrecoveryneededtoeffectivelymanageourculture’sgrowingproblem.Workandproductivityareconsistentlyvaluedmorehighlythanrecoveryandvitality,asmostofusareexpectedtoworklongerhoursandwithlesstimeoffthaneverbefore.Doyoufrequentlyfeellikeyoucanbarelyhandlethepressuresofworkandlife?Youarenotalone—a2014AmericanPsychologicalAssociationreportfoundthat42percentofAmericanssaythattheyarenotdoingenoughtomanagetheirstresslevels.Inthesamereport,themostcommonlyexperiencedsymptomsrelatedtostresswerefeelingirritableorangry,nervousoranxious,havingalackofinterestormotivation,feelingfatigue,feelingoverwhelmed,andbeingdepressed.Evenconsideringthesheervolumeofpeopleexperiencingthesesymptoms,motivationtomakechangesisincrediblylow,withmostcontinuingonuntiltheyphysicallyormentallycannotcopeanylonger.
Whatarewedoingtomanagethisstress?Unfortunately,manypeopleturntodestructivehabitslikeovereatingorbingeingonunhealthyfoods,skippingmeals,drinkingalcohol,smokingcigarettes,watchingTV,surfingtheInternet,orplayingvideogames.Ifyou’veeverfallenface-firstintoapintoficecreamafterexperiencinganunexpectedlydifficultlifeevent,youunderstandhowstressdrivesustothesepoorlifestylechoices!Whilestressitselfcanhavelong-termnegativehealthconsequences,itappearsthatitalsodrivesustoengageinunhealthycopinghabits,compoundingtheproblem.Whetherornotyouareawareofthenegativeconsequencesofstressonyour
body,managingitisabsolutelyessentialtoimprovingyourhealth,especiallyforthosesufferingfromchronicillness.Youmaybeunawareofthefactthatunderlyinghealthconditionslikeautoimmunediseaseareasilentsourceofstressforyourbody,makingitevenmoreimportantthatyoulearntoengageinhealthystress-managementhabitsinsteadoffallingintothatpintoficecream.Inthischapter,you’lllearnaboutthestressresponse,commontriggers,andhowto
betterpracticestressmanagementinyourownlife.
WHATISSTRESS?Whilethewordstressusuallyconjuresupanegativeresponse,itissimplyaprocessthathelpsourbodiesadapttoourenvironments.Thiscanbebeneficial,asexperiencingandadaptingtostresscancauseustobecomestrongerandmoreabletoconfrontthechallengesinourlives.Inaddition,whenweexperienceanemergencyorotherappropriatelystressfulsituation,thebodyisabletorisetotheoccasionandperformatahigherlevelinordertoavertdangerandstayalive.Thisprocessdevelopedtohelpusdealwithoccasionalcircumstanceswhereweneededtohavebetterthanaverageabilitytoperformphysicallyandmentally,suchasevadingawildanimalattack.Intoday’sworld,bearsandtigersareuncommonthreatstooursafety,butsituationslikeafightwithyourspouse,anunexpectedtaxpayment,oratrafficticketonthewaytothegrocerystorecanproducethesamephysiologicalresponse.Ourbodiesrespondtostresswithasimilarcascadeofhormones,regardlessofthetypeorsource,keepingusinastateofhighalertanddepletingourenergyreserves.
EustressandDistressStresscancomeinmanydifferentforms,fromphysical,emotional,psychological,orenvironmentalsources,oracombinationofthese.Inaddition,stresscanbeperceivedaspositive,whichisknownaseustress,ornegative,whichisknownasdistress.Eustressisgenerallyperceivedtobewithinourcopingabilities,shorter-term,havingbeneficialresultslikebetterenergyorfocus,andimprovingperformance.Distress,ontheotherhand,isstressthatisoutsideourabilitiestocope.Whileitcanbeshort-orlong-term,distressisdraininganddepletingofourenergy.Inthelongrun,itcontributestodiseaseandadecreaseinperformance.Itisimportanttonotethatwhatonepersonmayexperienceaseustressmaybedistressforanother.Forinstance,moderateexercisefeelsbeneficialtothosewhoaregenerallyhealthy.Toanotherpersonwhohasanautoimmuneconditionaffectingenergyandmobility,exercisecanbeacauseofdistress.Inthesamevein,ifahealthypersonweretotrytorunamarathonwithouttraining,hisbodywouldbeunderdistress.Whetherastressorhasapositiveornegativeimpacthastodowiththewaythatweperceivethestress,aswellasourphysicalabilitytohandleit.
StagesoftheStressResponse
GENERALADAPTATIONSYNDROMEisamodelthatwasoriginallypostulatedbystressresearcherDr.HansSelyetodescribetheprocessbywhichstressaffectsthebody.Oncethebodyexperiencesastressor,thereisaninitialreaction,followedbymovementintofurtherstagesdependingonthedurationofstress,aswellasthebody’sabilitytocope.Oneofthebreakthroughfacetsofthismodelisthatithasawayofshowingthatthereisalimitonthebody’sabilitytohandlestress.Thethreestagesofthestressresponseareasfollows:
●ALARMSTAGE—Youhavebeenexposedtoastressorandyourbodyinitiallyreactstothisexposureandactivatesthe“fight-or-flight”responsesystem.Thehormonesadrenalineandcortisolarereleasedtoproducethephysicalchangesthathelpyourbodydealwiththesituation.Heartrate,respiration,andbloodpressureincrease,andmorebloodflowstothebrainandmusclesinordertopreparethemforaction.Naturalanti-inflammatorycompoundsarereleasedintoyourbody,andyourvision,sight,hearing,andawarenessallsharpen.Yourbodyispreparedtomeetthisthreat!
●RESISTANCESTAGE—Youhaveovercomethestressor,andthethreatiseithergoneorreduced.Yourbodyentersaperiodofweaknessasitusesitsremainingenergytorecoverfromthestressresponseandpossibleinjuryoractivity.Inthisstage,yourbodyisstillonguardtofightcontinuingstressors,althoughwithoutasmuchstrengthasitdidintheinitialreaction.
●EXHAUSTIONSTAGE—Youhavebeenfightingstressorsforalongperiodoftimeandnowyourbodyisunabletohandlethem.Atthispoint,yourbodywon’tbeabletomeetthechallengeofanysubsequentstressors.
Aslongasthestressresponsesyouexperienceareconfinedtothealarmandresistancestages,yourbodyisabletostrengthenandadapttoitscircumstances.Forinstance,startinganewlightexerciseprogramisasmallstressortothebody.Youareunlikelytoget“firedup”inthealarmstagethesamewayasifyouwererunningfromabear,butyourbodywillincreaseadrenalineandcortisoltomeetthedemandsoftheincreasedmovement.Aslongasyougiveyourselfadequatetimeintheresistancestagetorecovercompletely,therepeatedexerciseislikelytostrengthenandhaveapositiveimpactonyourbody.Incontrast,ifyouareinpoorphysicalshapeandyoustartanintenseexerciseprogram,youralarmstageisgoingtoresultingreaterstresshormonesbeingproduced,aswellasmoredamageandinjurytoyourbody.Thenexttimeyouworkout,youareunlikelytobeoutoftheresistancestage,puttingyourbodyintheexhaustionstage—unabletohandlefurtherstressors,whichthenleadstoadditionalnegativehealthconsequences.Manyofussufferingfromchronic
additionalnegativehealthconsequences.Manyofussufferingfromchronicillnesshaveexperiencedthisveryexamplewhenstartinganexerciseroutine,whichisallthemorereasonforustotakeiteasy!
HormonesandStressTherelationshipbetweenthreeorgansinyourbody,thehypothalamusandpituitaryinyourbrain,andtheadrenalglandsthatsitontopofyourkidneys,iscalledtheHPA(HYPOTHALAMUS-PITUITARY-ADRENAL)AXIS.Thiscomplexsystemoffeedbackloopsassessesthelevelsandneedsofstresshormonesinthebodyandsetsoffachainreactionthatendsintheproductionofthesehormones(likecortisolandadrenaline).Allittakestosetoffthisprocessisthemerethoughtofastressor,likethepresentationdeadlineatworkoracallfromyourchild’sschoolsayingsheisrunningafever.Evenifthisthreatisnotphysical,yourbodywillcontinuemakingstresshormonesuntilitperceivesthatthereareenoughtomeetthethreatandinhibitstheirproductionbyanegativefeedbackloop.Thehormonalresponsefordifferenttypesofstressisthesame;it’sallabouthowyouperceivethethreat!UnderstandingthecomplexmechanicsoftheHPAaxisisnotasimportantas
understandinghowpowerfulourthoughtsareatdrivingtheresponse.Somepeopleexperiencealargeamountofphysicalstress,possiblyfromastrenuousjob,takingcareofchildren,andmaintainingahousehold.Othershavelittlephysicalstressbutareunderalotofemotionalstresscausedbothbythewaythattheyperceiveeventsandthoughtstheyhavethroughouttheirdays.
HowDoesChronicStressImpactHealth?Anyonewhohasexperiencedaperiodofextremechronicstressisfamiliarwiththeexceptionallynegativetollitcantakeonthebody.Whenwecan’trecovereffectivelyfromthestressresponse,webreakdownandbecomeevenmoreintoleranttoit.Theheightenedphysicalandmentalcapabilitythatisproducedduringthealarmstagecomesatacost—whenthatcortisolandadrenalinehitthesystem,yourbodyprioritizesthefunctionofthebrainandmusclesoverdigestion,reproduction,andimmunity.Thiscanbeveryhelpfulwhenrunningfromabear,butifitcontinuestooccurchronically,thenyouendupwithimbalancesthataffectothersystemsofyourbody.Someoftheresearchedhealthconsequencesofchronicstressareasfollows:
●Anxiety
●Cognitiveimpairment
●Depression
●Digestiveupset
●Heartproblems
●Sleepproblems
●Weightfluctuations
Withstress,wehavetopayattentiontothetricklebeforeitbecomesaflood.Itstartswiththingslikebills,overscheduling,andnotenoughtimeoff,and,ifleftignored,canresultinseeminglyunrelatedchronichealthissues.Theseconsequencesarefamiliarandservetoremindusthatunmanagedstressissignificant.
WhatAreSomeCausesofStress?Thecausesofstressrangefromsomeobviousexamples(likeanunexpectedlifeevent,illness,orchangeinmaritalstatus)tothosethataremoresubtle,likediet,chronicillness,lackofself-care,andfears.We’veincludedalistbelowtohelpyoupinpointsomeofthecausesofstressinyourlife,andhelpyourecognizeeventsthatmaybecontributingtoyouroverallstressburdenwithoutyourevenknowingit(suchashavingachildgoofftocollege,embarkingonanewdiet,orremodelingyourhouse).
●UNEXPECTEDMAJORLIFEEVENT—Thiscouldbeadeathinthefamily,anaccident,oranacuteinjuryorillnessthatneedstobehandledwithoutwarning.
●DIET—Therearemanywaysinwhichdietcanbeanunderlyingstressorforyourbody:
●Excesssugar
●Toxins
●Caffeine
●Alcohol
●Foodallergy/sensitivity
●Nutrientdeficiency
●CHRONICHEALTHPROBLEMS—thosethatarenoteasilyresolvedwithmedicationorsurgeryandpersistonanongoingbasis:
●Chronicdisease
●Chronicinfection
●EXPOSURETOENVIRONMENTALTOXINS—Thiscanbefromwork,home,watercontamination,orpersonal-careproducts.
●EXERCISE—Bothtoomuchortoolittleexercisecanbeanunderlyingsourceofstress.
●ALLERGIES—Environmentalallergieschronicallyimpacttheimmunesystemaswellasinterferewithdailylife.
●LACKOFSTRESSMANAGEMENT—nothavingthemeansorprioritizingstepstomanagestress:
●Lackofsleep
●Lackoftimeoff
●Lackofself-care
●FAMILYSTRESS—anytypeofstressrelatedtoyourimmediateandextendedfamilyandclosefriendships:
●Maritalorrelationalstress
●Marriageordivorce
●Additiontothefamily
●Familychanges
●In-lawtroubles
●FINANCIALISSUES—anytypeofstressrelatedtoyourfinances:
●Debt
●Defaultingonaloanorbankruptcy
●Lackofresources
●LEGALPROBLEMS—anythingfromreceivingatraffictickettobeinginvolvedinalawsuittobeingincarcerated.
●EMOTIONALDIFFICULTIES—Howyoureacttosituationsinyourdailylifecanbeanunderlyingcauseofstress.
●MAJORHABITCHANGES—anymajorchangestoyourhabits,likequittingsmokingortryinganewdiet.
●PRESCRIPTIONOROTCMEDICATIONS—Sideeffectscancauseyousignificantstress.
●EMPLOYMENT—changestoemploymentstatus:
●Newemployment
●Endingemployment
●Promotionordemotion
●Boss/coworkertroubles
●Changeinworkinghours
●EDUCATION—changestoschoolingoreducationyoumaybereceiving:
●Startingformaleducation
●Endingformaleducation
●Changinginstitutions
●CHANGESINLIVINGSITUATION—changestoyourhousingorenvironment:
●Moving
●Remodeling
●Lackofstablelivingsituation
●FEAR—Anyapprehensionorworrythatinterfereswithdailylifeisachronicstressor.
●ATTITUDESANDBELIEFS—Thewayyouviewtheworldcanbeasourceofstressforyourbody.
Itisimportanttonoteagainthatitisn’tjusttheeventorprocessthatisstressful,butitisthewaywereacttoit.Whileweareincontrolofsomeofthesestressors(likethewaywetakecareofourselves,ourattitudesandbeliefs,orthedietwechoosetoeat),thereareothersthatwehavenocontrolover.Thepointhereisnottoeliminateeverystressorwehaveinourlivesbuttocontrolyourreactiontothestressorsthatyoudon’thavecontrolover.Stresswillalwaysbeapartofoureverydaylives.Welearntolivehealthierandwithmoreresiliencebymakingadjustmentswherewecan.
WarningSignsofBurnoutandExcessiveStressYourbodyhasmanywaysofwarningyouthatthelevelofstressitisunderisnotsustainable.Beingunderaconstantbarrageofstressfulsituationswithoutallowingtimeforrestorationandrecoverymakesitpossibletoreachastateofchronicburnoutandfurtherhealthdisturbances.Ifyouareexperiencinganyofthesymptomsonthislistonaregularbasis,youshouldinvestigatewhetheryourcurrentstress-managementroutineisadequateforyourneeds,orifthereareanystressorsyoucouldpotentiallyeliminatefromyourlife.
●DIFFICULTYWAKINGUPINTHEMORNING—Cortisol,thathormonesecretedbytheadrenalglandsthatisnecessaryforstimulatingyourenergylevelsinthemorning,canbelackingduetoexcessivelong-termstressandburnout.
●FATIGUEDESPITEADEQUATESLEEP—Whenyourneedforrestandrecoveryisgreaterthanwhatyourbodyisgetting,youendupfeelingtiredandunrefreshed.
●SALTYFOODCRAVINGS—Chronicstresscanleadtoelectrolyteimbalances,whichcausesomepeopletocravesalt.
●DECREASEDABILITYTOHANDLESTRESSFULSITUATIONS—Ifyouhavebeenexperiencingprolongedstress,yourtoleranceforandresilienceinsubsequentstressfulsituationsdecreaseconsiderably.
●IRREGULARMENSTRUALCYCLESANDINCREASEDPMS—Sincethebodyprioritizesstresshormonesoversexhormones(andoftentheyaremadefromthesamerawmaterials),chronicstressleadstoimbalancesinhormonesthatcanresultinirregularcycles,PMS,andevencontributetoinfertility.
●FREQUENTCOLDSANDFLUSWITHANINCREASEDRECOVERYTIME—Similartohormonalbalance,thebodyprioritizesstresshormonesoverimmunefunction,makingitextrahardtofightcommoncoldsandotherillnesses.
●LIGHT-HEADEDNESSWHENSTANDINGUP—Theelectrolyteimbalancesthatarecommonwithchronicstressoftencauseyoutofeellight-headedordizzywhenstandingupsuddenly.
●BRAINFOG—Excessivestresscancauseyoutofeellikeyourthinkingisconsistentlyfoggyandmemorycanfalter.
●RELIANCEONCAFFEINEORSUGARTOGETTHROUGHTHEDAY—Caffeineandsugarbothgiveyouaboostwhenenergylevelsdipandnotbeingabletogo
withoutthemcanbeasignthatyournaturalenergyreservesandresiliencetohandlestressarelacking.
●BLOOD-SUGARSWINGS—Chronicstresscanwreakhavoconyourblood-sugarbalance,causingyoutohaveenergyhighsandlowsthroughouttheday.
WhereAreYouontheStress-ManagementSpectrum?Thistestwillhelpyoudeterminehowhighaprioritystressmanagementistoyourhealingjourney.Giveyourselfonepointforeveryitemthatappliestoyouonthelist,andthentotalyourscoreandseeyourresultsatthebottom.
__ Ihavebeenexperiencingaperiodoflong-termstress.
__ Iregularlydrivemyselftoexhaustion.
__ Idonotprioritizerestandrelaxation.
__ Iameasilyfatigued.
__ Ihaveahardtimewakingupinthemorning.
__ Iexperienceenergylowsintheafternoon.
__ Itendtogainweightaroundmymiddle(hipsandthighs).
__ Ihaveoneormorechronicillnessesordiseases.
__ Ifeelthatmytolerancetostressisnotwhatitusedtobe.
__ Isufferfrombrainfog.
__ Myproductivityhasdecreased.
__ Igetlight-headedwhenstandingupsuddenly.
__ IamtiredeventhoughIgetanadequateamountofsleep.
__ Ibecomelight-headed,shaky,orgetaheadacheifIgotoolongwithouteating.
__ Ihavefatiguethatisrelievedbyeating.
__ Irelyoncaffeineand/orsweetstogetthroughmyday.
__ Ihaveadiminishedtoleranceforpeoplewhoirritateorbotherme.
__ Isufferfromintensefearsoranxieties.
__ Ihavefeelingsofhopelessness.
__ Isufferfromfrequentcoldsorflus.
__ Ittakesmelongerthanmypeers/familymemberstorecoverfromacoldorflu.
__ Isufferfrompanicattacksornervousbreakdowns.
__ Ihaveirregularperiodsand/orPMS.
__ Icravesweetand/orsaltyfoods.
__ Ihaveajobthatcausesmealotofstress.
__ Myjobrequiresmetoworklonghourswithlittletimeoff.
__ Ioftenworryaboutworkduringnonworkhours.
__ Ihavetroubleinmyprimaryrelationships.
__ Idonotexerciseregularly.
__ Idon’tgetenoughsleepeverynight.
__ Idon’thaveanyhobbiesoractivitiesthatIdoinmyfreetime.
__ Idon’tallowmyselfunstructuredtime.
__ Idon’thaveastrongsocialnetwork.
__ Idon’tpracticestress-managementorrelaxationtechniquesonaregularbasis.
__ Idon’thaveenoughincometomeetmyneeds.
1-10LOWPRIORITY—Goodjob!Itlookslikeyouarealreadyprioritizingyourstressmanagementand/orhavemadeapointtoremoveunneededstressorsinyourlife.
11-19MODERATEPRIORITY—Lookslikethiscouldusesomework!Timetodiginandusetheresourcesthatfollowinthischaptertostartgettingyourstressundercontrolbeforeitgetsworse.
20-35HIGHPRIORITY—Uh-oh!Itappearsthatyourstresslevelisexcessive.Learninghowtoeffectivelymanageyourstressislikelytohaveaprofoundimpactonyourhealingjourney.
WhatCanYouDotoManageYourStress?Nowthatyouknowallaboutwhatstressisandwhereyouarerightnowintermsofcopingwithit,weneedtostarttalkingaboutwhatyoucandotomanageit.
ofcopingwithit,weneedtostarttalkingaboutwhatyoucandotomanageit.Allthatpreviousinformationwon’tbeusefulifitdoesn’tleadtoaction.Thefollowinglistgivesyouspecificideastomanagestresseffectively,withdetailedtipsandexercises(foundonsubsequentpages)toaccompanysomeoftheideas.
●IDENTIFY.Manyofussimplygofrom1daytothenextknowingwearestressedout,butnotreallyevertakingtimetospecificallyidentifywhatthesourcesofstressareforuspersonally.YoumayhaverecognizedsomeofyourstressorsintheexampleslistedintheprecedingsectionWhatAreSomeCausesofStress?Taketimetositdownandwritethemostcompletelistyoucanofeverythingthatyouperceiveasstressinyourlife.Yourlistshouldincludeobviousthingslikeajoblossandlessclearthingsthatareasourceofstrain,likethatstackofpaperworkonthekitchentable.
●EXAMINE.Honestlyexamineyourdailyroutine.Askyourselfifyouaredoingallyoucanintermsoflifestylehabitsthatgreatlyinfluenceyourstressload.Eatingwell,gettingenoughsleep,andexercisingregularlyhaveanenormousimpactonyourabilitytocopewithstress,andhavingexceptionallypoorhabitsinanyoftheseareascanbeastressorinitself.Besuretocheckinwithyourselftoseeifmeasurestoimprovethesebasicareascouldmakeadifference.
●ELIMINATE.Evaluatesourcesofstressthatcansimplyberemovedfromyourlife.Wearenotabletocontroleverythingwemayface,buttherearesomethingsthatarewithinourcontrol.Whereitispossibleforyou,eliminatesourcesofstresswithoutguiltorshame.Thismightmean,forinstance,sayingnotointeractionswith“energyrobbers.”“Energyrobbers”isthenamecoinedbyJamesL.Wilson,ND,DC,PhD,authorofAdrenalFatigue,todescribepeople,conditions,andevenfoodsthatdrainus.Anotherexamplemightbethatyoustopconnectingonaparticularsocialmediaplatform.Anhonestlookatwhatcanbecompletelytakenoffyourplateisahugestrideforwardinmanagingyourstress.(SeetheTipsforMaintainingaHealthyRelationshipwithTechnologysection).
●PRIORITIZE.Animmensestressorformanyofusisbeingoverwhelmed.Withsomanyitemsonthedailyto-dolist,itisinevitablethatwefindourselvesparalyzedonwheretodirectourattention.Itcanbehelpfultoassesswheretheseitemsfallintermsofimportanceandproactivelyprioritizeinordertoaccomplishthem.Themantrahereis,“Manageyourto-dolist,don’tletitmanageyou.”
●PRACTICE.Itisgreattofindwaysofeliminatingstress,butwemustalsoadd
healthystress-reducingactivitiesintoourlives.Carvingouttimetopursuefunandrelaxingactivitiesthathelpcounterbalancethestressthatcannotbeeliminatedisvital.Onthefollowingpageisalistofpossiblehabitsforyoutopracticeusingonadaily,weekly/monthly,orseasonally/yearlybasis.Youwillfindthatsomeofthemareeasyandstraightforward,whileotherswilltakeconsciouseffortonyourparttoscheduleordevelop,forinstancepracticingmindfulness.(See“HabitstoCultivate”andtheMindfulnessTipssection.)
●REFRAME.Somestressors,despitehowlargetheymaybe,canbegreatlydiminishedwhenwereframeourinternalthoughtsaroundthem.Analyzinghowwethink,feel,andtalktoourselvesaboutasourceofstresscanbeapowerfultool,especiallyifwetakeitastepfurtherandchallengethosethoughtswithanewdialogue.Forexample,theauthorMalcolmGladwell,inhisbookDavidandGoliath,encouragesreaderstorecognizesomeobstaclesinlifeas“desirabledifficulties,”atermusedtodescribeunfavorablesituationsthatresultinadvantagesforthepersonfacingthem.Learningtoseethingsinadifferentlightcanbeaprofoundstress-managementtool.Seeresilienceacademy.comforpracticalguidanceonhowtoreframe.
●ACCEPT.Thereareoccasionswhenthemostpositivestepyoucantakeinaddressingasourceofstressislearningtoacceptit.Thiscanbeaveryuncomfortableprocess,butsometimesplainlyacknowledgingtherealityofastressorthatyoucannotchange,likeatroublesomefamilysituationorillness,andlettinggoistheonlywayforward.Inthesecases,itcanbemeaningfultoregularlycheckinwithyourselfaboutwhatvaluablelessonsyoumaybegainingbylearningtolivewiththestressor.
●ALTER.Themostradicalideaissavedforlast.Youmayfindthatsomestresscannotbemanagedwithanyoftheotherideaspresentedhereandthatcontinuingtotolerateitisalsonotanoption.Ifthatisthecase,itistimetoalteryoursituation,evenifthechangeitselfwillpresentstress.Perhapsyourjobhasbecomeabsolutelyunbearableoryouareveryunhappywhereyoulive.Maybearelationshiphasgrowntoxic.Withthesekindsofstressors,consideringamajorlifestylechangeisinorder.Starttocarefullyplanhowtomakenecessaryadjustmentsintheleast-disruptiveandmosttimelywaypossible,whileleaningonyoursupportnetworkthroughthechange.
Activelymanagingmystressisanongoingprocessforme.JustwhenIthinkIhaveitall
Activelymanagingmystressisanongoingprocessforme.JustwhenIthinkIhaveitallmastered,somethingnewcomesup,andfindingthebestwaytotackleitsothatstressdoesn’tderailmyhealthbecomesmypriorityonceagain.Ofalltheideasonhowtomanagestress,howto“reframe”wasthebreakthroughforme.AnalyzinghowIthought,felt,andspoketomyselfaboutcertainsourcesofstresswashugeinreducingmyreactions.WhenItookitfurtherandbeganusingnewwordstodescribechallengesinmylife,ittransformedme.RealizingIhadthepowertostructuremythoughtprocessesforincreasedpositivitywasamazing!
THEIMPORTANCEOFSELF-CARESelf-careisthechoicetoprioritizeactivitiesthatareessentialtoprotectingyourwellbeing.Whilewewouldallagreethatself-preservationisanaturalandappropriateinstinct,thetruthisthatthemoreproactiveversionofpreservation,self-care,iskindofasensitivetopic,especiallyintheUnitedStates.Wetendtohaveanearlyoverpoweringworkethic,attheexpenseofequaltimegiventocaringforourselves.Eventhoughthereareagreatmanyresourcesandmuchtalkabouthowimportantitistopracticegoodself-care,theunderlyingmessageinoursocietyisoften“self-careisselfish.”ThetruthisbeststatedbyauthorandeducatorParkerJ.Palmer,PhD,“Self-
careisneveraselfishact—itissimplygoodstewardshipoftheonlygiftIhave,thegiftIwasputonEarthtoofferothers.Anytimewecanlistentotrueselfandgivethecareitrequires,wedoitnotonlyforourselves,butforthemanyotherswhoseliveswetouch.”Wesometimesdescribethistopicasthe“planecrashscenario.”Ifyourplaneisgoingdownandoxygenmasksarerequired,youmustfirstputonyourownmaskbeforeyoucanhelpthepersonsittingnexttoyou.Somepeoplemightsay,“Butwhatifthatpersonsittingnexttomeismypartnerorchild?”Itdoesn’tmatterhowmuchmoreimportantthepersonnexttoyouseemstobe,withoutyourownoxygenflowing,youwillquicklyloseconsciousnessandbecompletelyunabletohelpyourselforanyoneelse.Itmaybethecaseinlifethatthe“personsittingnexttoyou”issomeonetotallydependentonyou,likeachildorelderlyparent,whichmakes“puttingonyouroxygen”evenmorecrucial.Youwillnotbeabletoupholdyourresponsibilitytocareforanyoneelseifyouhavenotfirstupheldyourresponsibilitytocareforyourself.Don’tundervalueself-careorallowguilttocreepinwhenyouprioritizeit.
Eatingwell,sleepingdeeply,managingstress,andotherpracticesthatprovideawell-roundedholisticself-careroutinearesmartinvestmentsinnotonlyyoubutallthosewhodependonyou.Thisisespeciallytrueifyouhaveanautoimmunedisease,sinceanythingyoucandotosupportgoodhealthminimizestheimpactofthechronicnatureofyourillness.It’sjustplainsmarttodedicatetimeand
resourcestothe“maintenance”ofyou!
HABITSTOCULTIVATE
DailyHabits●Mindfulnessorspiritualpractice●Prayer
●Breathwork
●Meditation
●Creativeactivities●Art
●Playingmusic
●Creativewriting
●Lightexercise●Walking
●Yoga
●Unstructuredtime
●Self-care●Bathing
●Diffusingessentialoils
●Reading
●Listeningtomusic●Playingagame
●Delegatingtasks●Journaling
Weekly/Monthlyhabits●Twowork-freedaysaweek
●Acupuncture●Massage
●Talktherapy●Gatheringwithyourcommunity
●Caretaking
Seasonally/yearlyorasneeded
●Vacation
●Timeofffromwork●Sabbatical
TipsforMaintainingaHealthyRelationshipwithTechnologyThemoderntechnologythatwehaveaccesstoisnothingshortofrevolutionary,
Themoderntechnologythatwehaveaccesstoisnothingshortofrevolutionary,andcanbebothanincredibletoolaswellasachronicstressorforourbodies.Itisn’ttheparticulartechnologyitselfthatis“good”or“bad,”butthehabitsthatwedeveloparoundhowweuseit.Ifyouaresomeonewhosleepswithyourphoneinterruptingyouwithaseriesofnotificationsthroughoutthenight,checksemailfirstthingwhenyouwakeuporbeforebed,andcannotgotoasocialeventwithoutpullingoutyourphoneevery5minutes,youmayhavesomeworktodoincultivatingahealthierrelationshipwithtechnology.AswedescribedinChapter4,screensfoundontelevisions,computers,and
devicessuchastabletsandsmartphonesallemitblue-spectrumlightthatisdisruptivetoyourcircadianrhythm.Exposuretothisspectrumoflightafterdarkcanbeastressorforyourbody,asitdisruptsyournaturalhormonalbalanceandinterfereswithsleep.Thisisn’ttheonlywaytechnologyisastressor—beingconnectedtoyourworkandsociallife24/7canbeincrediblydepleting.Ourbrainsneedtimeofffromtheconstantbarrageofto-dolists,emails,messages,updates,andnotifications.Sometimes,itfeelslikedrinkingfromafirehose!Ifyouarelookingforsome
tipstohelpcultivateamoreusefulandlessstressfulrelationshipwithtechnology,followtheseguidelines.
●Limityoursocialmediausetocommunicatingandsharing;don’tuseitasa“time-filler”orasareplacementforactivitywhenbored.
●Avoidscreensanhourortwobeforebed.
●Chargeyourdevicesoutsideyourbedroom.
●Minimizetheuseofnotificationsondeviceapplications(email,socialmedia,etc.).
●Checkemailsonlyafewtimesadayanddon’tleaveemailapplicationsopenwhileworking.
●Avoidcheckingemailrightbeforebedorrightuponwaking.
●Avoidreplacingone-on-onetimeorphonecallswithsocialmediacontact.
●AvoidwatchingTVorusingadevicewhileeatingmealsorhavingaconversation.
●Takea“technologydetox”ora“socialmediavacation”periodically.
●Avoidspendingsomuchtimewithtechnologythatyoudon’thaveanytimeforreal-lifeactivity.
●Leaveyourdevicesathomeorturnedoffinyourpockettohavearicher,moremindfulexperiencewithoutthedistraction.
MindfulnessTipsMindfulnessisallaboutrecognizingthelittlethings,somethingthatisalltoooftenabsentfromourbusy,overscheduledmodernlives.Itisimportanttofindwaystoactivelycheckinwithyourselfandaskquestionsaboutthemomentyouareexperiencing.Thiscanhelpyouconnectmoreoftenandmoredeeplytoyourlife,aswellashelpyoushapeanddirectyourthoughts,ratherthanallowthemtooverwhelmyouandcontributetostress.Usethelistofquestionsbelowtohelpyoubrainstormsomewaysinwhichyoucanpracticegreaterawarenessofyourpresentexperience.
●WhileI’mwashingdishes,whatdoesthetemperatureofthewaterfeellike?
●WhileI’mtalkingwithalovedone,amInoticingthespecialqualitiesofhis/hervoice?
●WhileI’moutforadailywalk,whatsmalldetailsofthesceneryhavechangedtoday?
●WhileI’meatingmymeal,whattexturesandaromasdoIfindsatisfying?
●WhileI’msittingdownatmydesk,whatisenergizingmeabouttheworkahead?
●WhileI’mdriving,whatamInoticingabouttheroadconditions?
●WhileI’mlyingdownforthenight,howdoesmybodyfeel?
●WhileI’mplayingwithmychild,amInoticingthespecialaspectsofhis/herface?
●WhileI’mlisteningtomusic,amInoticingacertaininstrumentorvoice?
●WhileI’mcookingdinner,whatcanIimagineaboutthefarmerswhogrewmyfood?
Ofalloftheareasofstressmanagement,cultivatingahealthyrelationshipwithtechnologyisonethatIcontinuetostrugglewith,eventoday.Iamconstantlyfeelingtheneedtocheckemail,Facebook,andothernotifications,waitingfortasksto“drip”in,andclutteringmybrain
email,Facebook,andothernotifications,waitingfortasksto“drip”in,andclutteringmybrainupwithfutureto-dos.WhenIamnotmanagingwellinthisarea,Ifindmyselffeelingfrazzled,stressed,notsleepingwell,andmorelikelytomakepoorlifestyleordietarychoices.Littlehabitslikeonlycheckingemailtwiceadayduringworkhours,onlycheckingsocialmediaonceadayatpredeterminedtimes,andnevercheckingemailorsocialmediafirstthinginthemorningorbeforebedgoalongwayathelpingmestaybalanced.IalsofindthatmyconnectionswithmyspouseandfamilyaremuchmoremeaningfulwhenIamnotdistractedbythistechnology.Itisacontinualstruggle,butIfindwhenIgiveattentiontothesepractices,myhealthflourishes.
Don’tLetStressManagementStressYouOut!Itseemslikealot,right?Managingyourstressisabigjob,it’strue.Ittakes
vigilanceandcommitmentandtime.Certaintechniquesformanagingstressmightnotfeellikegoodmatchesforyou.Doyoufindyourselfdreadingyourdatewiththatnextguidedmeditationmoduleyou’vebeenworkingon?Itshouldn’tbethatway!Tryyourbesttotakethingsastepatatime,slowlychangingyourmind-set
aroundstressmanagementandthenputtingnewtoolsintouse.Considerplanning“tastetests,”whereyouchoosetwoorthreedifferenttechniquesandthentrythemshort-term(nopressuretocommit!)justtoseeiftheyfeelcomfortableandenjoyabletoyou.Justbecausehalftheworldisgoingnutsforyogadoesn’tmeanthatithastoworkforyou,too.Maybeafewhoursaweekinaworkshopbuildingmodelairplanesismoreyourstyle.Chapter9offersideasforhowtoincorporatestressmanagementslowly,makingthehabitofusingthesetechniquesmoremanageable.Bottomlinehere—don’tletstressmanagementstressyouout!That’stotallynotthezenthingtodo!
CALLTOACTIONThepurposeofthischapteristoshowyouthat,afternourishmentandrest,learningtobreatheiscruciallyimportanttoalife.Perfectingyourapproachtostressreductionisnosmalltask.It’salsonotataskweever
finish.Managingyourstressislikedoingthelaundryortakingoutthetrash:Itmustberepeatedregularlyoritwillpileupandhavenegativeconsequencesonyouandyourhealth.Mountainsoflaundryareunsightlyandmoundsoftrasharesmelly!Unmanagedstressleavespeopleandtheirbodiesinaverysimilardisarray.
CHAPTER6
Move
“Lackofactivitydestroysthegoodconditionofeveryhumanbeing,whilemovementandmethodicalphysicalexercisesaveitandpreserveit.”—PLATO
Ourancestorsspentmostoftheirtimeontheirfeet,goingaboutthedailytasksthataffordedthemfoodandshelter.Whilecivilizationhasbroughtaboutradicalchangesthathavepositivelyimpactedthewaywelive,theextenttowhichithasenabledustobephysicallyinactiveiscausingdisastrousconsequencesinourhealth.Thehumanbodyisdesignedtomove!Unlessyouareafarmer,youdon’thavetoworryabouttendingyourcropsorfeedingyourlivestock.Today,youcangetyourgroceriesdeliveredtoyourdoorwithoutevenleavingthecomfortofyourcouch.Thismayseemlikeaconvenientsolution,butthewaymodernsocietyoutsourcesmanyofthephysicaltasksnecessaryforlifetakesatoll.TheminimumamountofweeklyexerciserecommendedbytheCentersfor
DiseaseControlandPrevention(CDC)forhealthyadultsis2½hoursofmoderateexercise(likewalking)and2sessionsoffull-bodystrengtheningexercises,or1¼hoursofintenseexercise(likerunning)and2sessionsoffull-bodystrengtheningexercises.Only1in5Americanscurrentlymeetstheserecommendations,meaningthat80percentofusarenotgettingtheminimumamountofmovementweneedtobehealthy.Inaddition,manyexpertsarguethattheCDC’srecommendationsareonlyscratchingthesurfaceofwhatyourbody’struemovementneedsare.Ifyouhaveanautoimmunedisease,gettingthemovementyouneedislikely
tobemoredifficult.It’sashame,whenstudiesshowthatthosesufferingfromautoimmunediseaseswhogetregularexercisehaveahigherqualityoflifeandmentalhealththanthosewhodon’t,evenwhenphysicallimitationslikepainorfatigueareaccountedfor.Eventhoughitcanbedifficultgettingpastthesebarriers,managingtobeactiveenoughprovidesuswiththeenhancedhealthandwell-beingthatisnecessaryforlivingwithchronicillness.Inthischapter,you’lllearnwhyyouneedtoprioritizemovementaswellasfindsomecreativesolutionsforgettingstartedandintegratingactivityintoyourroutine.
WHYDOYOUNEEDTOMOVE?Theprimarymotivatorformostpeopletoexerciseisthepositivephysicalchangesthatcomewithbeingfit—weightloss,musclegain,andanimprovedbodycomposition.Mostoften,wearemotivatedbyadesiretobethinandlookattractive,neitherofwhichisaclearindicatoroftruehealth.Thereareother,andwe’dargue,morecompellingreasonsformakingsureyouaremovingyourbodyinawaythatissupportiveofvibranthealth,andnotinthepursuitofanunrealisticbodyimage.Herearesomeofthebiggestreasonswhyyouneedtomakemovementapriority.
●ITPREVENTSDISEASE.Thosewhoexerciseregularlyhavealowerchanceofdevelopingheartdiseaseanddiabetes,havingastroke,gettingcertainkindsofcancers,becomingobese,anddevelopingotherhealthproblems.
●ITSTRENGTHENSBONES.Certaintypesofmovement(likewalkingandrunning)increasebonemineraldensityandpromotebonestrength,preventingosteoporosis(boneloss).
●ITSTRENGTHENSYOURBODY.Regularexercisestrengthensyourmuscles,tendons,ligaments,andjoints,makingeverydayactivitieseasiertoachieve.
●ITMAINTAINSASTRONGANDHEALTHYHEART.Regularexerciseincreasesaerobiccapacity(theabilitytotakeinanduseoxygen)andlowersriskfactorsleadingtoheartproblems.
●ITPROMOTESTHEFLOWOFLYMPH.Yourlymphaticsystem,anetworkofvesselsandnodesthathaveimmunefunctions,lacksapump(liketheheartforthecardiovascularsystem)andisdependentonthemovementofyourmusclesandjointstomovefluidsaroundthebody.Thisisnecessaryforproperdetoxificationandimmunefunction.
●ITPROMOTESFLEXIBILITY.Especiallywhenyouengageinawidevarietyofmovements,exercisepromotesahealthyrangeofmotioninyourjointsandflexibilityinyourmuscles.
●ITHELPSMANAGESTRESS.Movingappropriatelycanbeagreatoutletforstressmanagement,nottomentionawholelotoffun!
●ITIMPROVESSLEEP.Physicalactivitycanincreasesleepqualityandduration.
●ITINCREASESCONCENTRATIONANDFOCUS.Thosewhoexercisetendtobemoreproductiveandon-taskthanthosewhodon’t.
●ITKEEPSYOUHAPPY.Exercisepromotesemotionalwell-being,happiness,andreducesanxietyanddepression.
Asyoucansee,engaginginanexerciseroutinecanhelpwithacoupleofthefactorswe’vealreadytalkedaboutinChapters4and5—RestandBreathe.Thisshouldbemotivationtotakesmallstepstomakeimprovementsinalloftheseareasinsteadofjustone,astheyarelikelytohaveapositiveimpactoneachotherandresultinamoreprofoundshift(forputtingitalltogether,seeChapter9).
WHYISEXERCISEDIFFICULTFORTHOSEWITHAUTOIMMUNEDISEASE?Thosewithautoimmunediseasetendtobemoreinactivethanhealthyindividuals,foravarietyofreasons.Youmaysufferfrombarrierstomovementstemmingfromthesymptomsofyourdisease,likejointpain,musclepain,andfatigue.Or,youcouldsufferfrommentalhealthissues,likedepression,whichcanfunctionasabarriertomovementbecauseofthelackofmotivationthatcomeswithit.Yourkeyplayermaynothaveinformedyouonwaysyoucansafelyincorporatemovementintoyourroutineormayhavejustignoredthetopicaltogether.Familyandfriendsmaymaketheassumptionthatyoucan’tordon’twanttoengageinphysicalactivitybecausetheyhavealimitedunderstandingofyourdisease.Allofthesefactorscanaddup,makingitevenmoredifficultforyoutofindanexerciseroutinethatyouloveandissupportiveofyourhealingprocess.Eventhoughthoseofuswithautoimmunediseasemayfaceuniquechallenges
whenconsideringaddingmovementintoourroutines,itisworthwhilenottoignorethisaspectofthehealingjourney.Attheveryminimum,movementisnecessaryforessentialbodyprocesses,asoutlinedin“WhyDoYouNeedto
Move?”.Ifyouareinthebeginningstagesofanautoimmunedisease,incorporatingexercisemayhelpslowtheprogressionofyourdiseaseandkeepyouhealthierlong-term.A2015literaturereviewfoundthatthemostcommonbarrierstoexerciseforthosewithrheumatoidarthritisweretheveryissuesthatresearchshowsarepositivelyimpactedbyexercise—painandfatigue!Often,theveryreasonswearen’tabletoexercisecanbeimprovedbyexerciseitself.Beforeyoulaceupthoserunningshoesandheadoutthedoor,we’dliketoget
themessageacrossthatexercise,ormovementasweliketocallit,forthosewithautoimmunediseasemaylookdifferentthanwhatyoutypicallythinkof.Whileintenseactivitieslikeworkingoutatthegym,running,andcyclingareallgreatformsofexercise,youmaynotbecapableofthosekindsofworkouts.Andthatisokay!We’llbeofferingsomecreative,autoimmune-friendlysolutionstothemovementproblemasweworkthroughthis.
MOVINGTOOMUCH?Whileitmayseemthat,byandlarge,oursocietyhasaproblemwithpeoplemovingtoolittle,thetruthisthatthereisasizableproblemwithpeoplemovingtoomuch.Youmaythinkthere’snodownsidetomoving,thatthereisno“toomuch,”buttherearerepercussions.AsSarahBallantyne,PhD,pointsoutinherbookThePaleoApproach,thebenefitsofexercisecanbemeasuredinaU-shape.Excessivemovementleadstodisregulatedcortisol(thestresshormonefromChapter4),increasedsusceptibilitytoimmune-relateddiseases,andleakygut.Overexerciseforapersonwithautoimmunediseasecanbeharmfulbecauseofinflammationandimmunesuppression,whichincreasesymptomsofdisease.Signsofoverdoingit,beyondtheobviouslikefatigue,pain,decreased
performance,andtheneedforincreasedrecoverytime,canrangefrominsomniatolowlibidotolossofmenstruationandevendepression.Youmightalsonoticethatyouaremoresusceptibletoillness,especiallyupper-respiratoryinfections.Thosewithautoimmunediseasemightexperiencemorefrequentflares.Sowhydopeoplefeelcompelledtomoveexcessively?Thereasonsarevariedandinmanycases,overlapping.
●WEIGHT-LOSSSTRUGGLES.Somepeopleoverdoitinanattempttoshedrealorimaginedextrapounds,believingthatiftheycanjustworkoutenough,they’llreachthe“perfect”weight.Insomecases,beingoverweightmightactuallyberelatedtoanunderlyinghealthproblemthatmustfirstbeaddressedandcan’tbeexercisedaway.Forinstance,weightgainisoftenasymptomofHashimoto’sthyroiditis.
●BODY-IMAGESTRUGGLES.Strugglingwithbodyimageveryoftenoverlapsweight-lossstruggles.Simplyput,apersonmaybelievethatherbodyisnotacceptableasitisandfeelaneedto“sculpt”itintoa“perfect”shape.
●CARDIOOBSESSION.Thisparticularformofoverdoingit,usinglong-durationaerobicexerciseorcardio,canalsogohandinhandwiththeweight-lossstruggle.Apersonmaybelievethatthefastestwaytoweightlossistoburnasmanycaloriesaspossible,sometimesrunning,hittingthetreadmillorellipticalmachine,orattendinggruelingstationarycyclingclasses,tothepointofexhaustion.
●FADWORKOUTS.Occasionally,peoplefeelpressuretojointhelatestworkoutcraze,eveniftheparticularroutineistoomuchforthemorjustnotagoodfit.ItmightbethattheneedtokeepupwithfriendswhoareintoP90X,CrossFit,orBikramyogaisdrivingapersonbeyondwhatisbeneficialforhim.
●STRESSMANAGEMENT.Insomecases,apersonmaynotfeelthathehasanyothereffectivemethodsofmanaginghisstress.Hemayrelysolelyandexcessivelyonexercisingashisoutlet,ratherthanlookingforwaystoreducestressormanageitwithabalanceofactiveandrestingmethods.
●ACHIEVEMENTFOCUS.Athletescanbeparticularlyvulnerabletodoingexcessiveexercisethatisfocusedonachievement.Iftheyseetheironlyvalueinanexternalreward,likerunningthemostmarathonsorwinningthemostweight-liftingcompetitions,thetendencycanbetoovertrain.
●EXERCISEADDICTION.Exerciseaddiction,alsocalled“activitydisorder,”isreal.Thisisexcessive,purposelessphysicalactivitythatgoesbeyondusualroutinesandimpairsratherthanimproveshealthandwell-being.Apersonfacingexerciseaddictionisuncomfortablewithrestandwillworkouttotheexclusionofalmostallotherareasofherlife,eventothepointofdanger.
Iamarecoveringactivityaddict.Myresponsetotheearlysignsofautoimmunediseaselikefatigue,jointpain,andlackofrecoverywasactuallytopushmybodyandincreasemyworkoutsinanattempttomanagesymptomsandstress.Backthen,Ididn’townacarandcycledtowork,liftedweightsafewdaysatthegym,attendedafewyogaclasses,aspinclassortwo,andrannearlyeveryday.Iwouldgothroughphasesofintenseexerciseandthenburnout,crashingforafewdaysorweeks,andthenstartthecyclealloveragain.Ahugewake-upcallformewaswhenIcouldnolongerridemybikeupalargehillonmydailycommute.Icouldnotbelievethatwithalloftheexerciseandstrength-trainingthatIwouldactuallybegettingweaker.WhatIwasexperiencingwastheearlywarningsignsofmusclewastingand
gettingweaker.WhatIwasexperiencingwastheearlywarningsignsofmusclewastingandfatigue.Recoveryformemeantreevaluatingallofthesehabitsandreplacingthemwithmore
sustainable,health-supportingactivities.Thatbeingsaid,Istillconstantlyhavetocatchmyselffromfallingintotheoldhabitofmovingtoomuch.Insteadofmanagingmystressthroughintenseworkouts,Ichooseqigong,yoga,andwalking.Inolongeraspiretorunmarathonsordocenturybikerides.Instead,Ihavemadeacommitmenttomovemybodyinawaythatstrengthensitbutdoesnotcauseexcessharmorstress.
TipsforThoseWhoMoveTooMuchIfyoufindyourselftendingtowardmovingtoomuch,thesearesometipsthatwillhelpyoutoneitdownanotchandenableyourbodytoheal.
●LOOKFORROOTCAUSESOFWEIGHT-LOSSRESISTANCE.Ifyouhavetroublelosingweightanduseintenseexercisetomanageit,youmaywanttotalktoyourkeyplayeraboutunderlyinghealthissuesthatcouldbestandingintheway.Forinstance,thelackofthyroidhormoneinHashimoto’sthyroiditiscanleadtoweight-lossresistancethatisdifficultorimpossibleto“out-exercise.”
●FINDBODYACCEPTANCE.Yourbodyisperfectjustthewayitis.Movementshouldbedoneforoptimalhealth,nottoforceourbodiesintoanunrealisticmold.
●FINDAGENTLERORMOREAPPROPRIATEWAYTOWORKOUT.Swapoutsomeofthosehigh-intensityworkoutsforactivitiesthatareeasieronyourbody.Forinstance,youcantradeyour30-minuterunforanhourwalk,oryourCrossFitworkoutforpoweryoga.
●GIVEYOURBODYMORETIMETORECOVER.Especiallyifyoufindyourselffeelingsoreandfatiguedonaregularbasis,giveyourselfadayortwobetweenmoreintenseactivities.
●LOOKFORAMOREAPPROPRIATEWAYTOMANAGESTRESS.Ifyouarelookingtointenseexercisetohelpmanageyourstress,tryfindingastress-managementactivitythatisalsorestorative.Turndownthevolumeonyourroutineandgoforawalk,dosomestretching,ordance.Therearewaysyoucanmanageyourstressthroughmovementwithoutoverdoingit.
●LETGOOFACHIEVEMENT.Prioritizethegoaltobestsupportyourbody’shealthinsteadofrunningthatmarathonorcompetinginabikerace.Lettinggooftheideathatyoualwaysneedtobeachievinganexternalrewardwillgiveyoumorespacetojustbewhoyouareandmoveinawaythatfeelsright.
●GETHELPFOREXERCISEADDICTIONOROBSESSIVETENDENCIES.Ifyoufindyourselfaddictedtoorobsessedwithexercise,youshouldbeevaluatedbyaprofessionalandhaveherhelpguideyourrecovery.Commoninthosewhohavestruggledwitheatingdisordersinthepast,thisisasignthatyoumayneedsomeadditionalsupporttobreaktheaddictivecycle.
FitspoandShameFitspirationor“Fitspo”isabuzzwordthatstandsfor“fitnessinspiration.”Itisthesharingofimagesonsocialmediaofactive,strong,usuallyleanwomen(andoccasionallymen),alongwithaninspiringmessagepromotingexerciseand/ordietinordertoachievean“ideal”body.Themessagessaythingslike“Strongisthenewskinny”or“Pukingisacceptable,quittingisnot.”Othershaveslogansacrossasexyfemalebodythatread“Don’tquituntilyou’reproud.”Fitnessinspirationissupposedtomotivatepeopletowardhealth,butthe
imagesaccompanyingthemessagesareoftenextremelyunrealistic.Themessagesthemselvesoftenborderonbullying,like,“What’syourexcuse?”or“Yourbodycanhandlethepain,tellyourmindtoshutup.”Theideathatwecannotbegoodenoughunlesswehaveachievedtheunattainableorworkedourselvestothepointofburnoutisenormouslyharmful.TheinsinuationwithFitspoisthatyoushouldfeelagreatdealofshameifyou
don’tmeasureuptothestandardbeingpresented.Thiscanbeparticularlydamagingtothosewithautoimmunedisease,whomayalreadybedealingwithnegativemessagingfromthosearoundthemaboutwhetherornottheyare“reallysick.”Workingtowardincreasedhealthisaworthygoal,butitneednotcarrywithitsuchadestructiveburden.Bealerttothisculturalmisinformationaboutfitness,andchallengethosenegativethoughtswithbalance.Findtherightlevelofmovementforyourbody,autoimmunediseaseappropriatelyaccountedfor,andenjoybeingactive.Noexposuretoabusive“motivation”required!
MovingTooLittle?Thebenefitsofgettingenoughphysicalactivityarewellunderstood.Ourbodiesweremadetomoveandmoveoften.Thatregularmovementiskeytoachievingandmaintaininggoodhealth.Justlikethereisadownsidetomovingtoomuch,theothersideoftheU-shapedcurverevealsthenegativeimpactoftoolittlemovement.Whenyouaren’tgettingenoughphysicalactivity,yourimmunesystemiscompromised,yourresistancetostressisdecreased,andyourcircadianrhythmiseasilythrownoff.Despitetheobviousbenefitsandcleardisadvantages,forsome,getting
Despitetheobviousbenefitsandcleardisadvantages,forsome,gettingenoughexerciseintotheirlivesisaseriouschallenge.Thesechallengescanrangefromperceivedbarrierstosignificantphysicalimpediments.Especiallyforthoseofuswithautoimmunedisease,itcanbehelpfultoexplorethereasonsthatwemaybemovingtoolittle.
CommonBarriers
Mostpeoplefindthattheirbarrierstomovementfallintothe“excuses”category.Thesebarriershavesimplesolutionsthatcanbeeasilyapplied.
●Lackoftime
●Boredomordislikeofexercisesetting
●Lonelinessorlackofmotivation
●Badweather
●Workingadeskjoborlonghours
●Notseeingresults
ComplexBarriers
Sometimes,barrierstomovementarenotaseasilyresolvedandmayinvolvephysicalorvalidpsychologicallimitationsthatrequiremore-sensitivesolutions.Insomeofthesecases,consultingwithapersonaltrainerwhospecializesinautoimmunedisease,mobilitytraining,and/orbodypositivitymaybehelpful.
●PAIN/INJURY.Thisisthefirstbigfactorthatoftencomesupforpeoplewithautoimmunedisease.Moving,especiallywithdiseaseslikerheumatoidarthritis,mightactuallyhurt...alot!Autoimmunediseasesthataffectmobilitymightalsocontributetobeingeasilyorfrequentlyinjured.
●FATIGUE.Thisisthesecondbigfactorthatcomesupforthoseofuswithautoimmunedisease.Youmayfindthatyourdiseaseleavesyouwithonlyenoughenergyforverybasicactivity,andsometimesjustshoweringtakesallyouhaveforthatday.Sometimes,whenyoustartaroutine,youfindthatyouarequicklydepletedandunabletofinish.
●WRONGINTENSITYLEVEL.Duetosomeoftheculturalmisinformation,aswellastheinfluenceoffadworkouts,itcanbehardtodeterminetherightintensitylevelofphysicalactivityforyou.Thismaybeparticularlytrueifyouarecomingfromapreviouslyathleticlifestyleorfromacompletelysedentarylifestyle.Inbothcases,youmaybeoutoftouchwithhowyourbodycommunicateswhatis
appropriateversusinappropriate.See“ExerciseAssessment”forhelpfiguringoutifaworkoutisappropriateforyou.●INTERNALBELIEFS,FEAR,ORSHAME.Itisnotunusualforautoimmunediseasetoleaveuswithsomestronginnerthoughtprocessesaroundmovement.Youmaybelievethatyouarenotcapableofincreasingyourfitnesslevel,beafraidofthepainorinjuryyou’veassociatedwithmovingandyourdiseaseinthepast,orfeelashamedthatyouaren’tabletobeactiveatapreviousleveloratthelevelexpectedbyhealthierfamilymembersorfriends.
●FEELINGOFBEINGOVERWHELMEDABOUTWHERETOSTART.Whatprogramshouldyoubedoinganyway?Itcanbehardtodeterminewhatkindofroutineisidealwhenyouarefirstbeginningtoimproveyourfitnesslevel,particularlyifyouhaveadiseasetofactorintoyourdecision.Feelingoverwhelmedcanleadtoastateofparalysis,whereyoufindithardtomoveforwardandsoremainunderactive.
TipsforThoseWhoDon’tMoveEnoughIfyoufindyourselftendingtowardnotmovingenough,herearesometipstohelpyoutroubleshootthebarriersthatarekeepingyoufromactivityandfindsomesolutions.
●SWITCHITUP!Ifyoufindyourselfgettingboredeasily,youdon’thavetodothesameactivitiesdayafterday.MaybeMondayyougoforalongwalk,Tuesdayyoutakeayogaclass,andWednesdayyouputonsomemusicanddancearoundthehousewhileyougetsomechoresdone.
●FINDABUDDY.Youmayfindthathavingapartnertoexercisewithmotivatesyoutocontinuewithyourroutine,plusyougetaboostfromthesocialactivity.Ifyourspouse,friend,orneighbordoesn’twanttogetactivewithyou,lookforasuitablepartnerviaanonlinenetworkorinyourcommunity.
●HAVEABACKUP.Ifyourworkoutisdependentontheweather,haveabackupinmindincaseconditionsarenotfavorable.Forinstance,ifyoualwayswalkinyourneighborhood,haveayogamatandaDVDathomeincaseraininterruptsyourplans.
●USEASTANDINGORTREADMILLDESKANDTAKEMOVEMENTBREAKS.Ifyousitatacomputerallday,whynottryastanding,treadmill,ormodular(combination)desktokeepyourpositionchangingthroughouttheday?
●ENROLLINACLASS.Forthosewhohaveissueswithcommitment,sometimesenrollinginaseriesorclasswillhelpmotivateyoutoparticipateandprioritizemovement.
●TAKEACTIONONPSYCHOLOGICALANDPHYSICALBARRIERS.Yourautoimmunediseasemaycauseissueswithmobility,andalthoughthingsmaychangeforthebetter,sometimesthisaspectisoutofyourcontrol.Workingwithapractitionerwhoisexperiencedwithmobilityissuescausedbyautoimmunediseasecanbehelpfulindeterminingthetypesofmovementthatarelesslikelytocausepainorinjury.Youcanalsodosomethingaboutyourinternalbeliefs,fear,shame,andfeelingoverwhelmedaboutexercise.Lookforaffirmingorconstructivewaystoaddresstheseissuesonyourownorwiththehelpofatherapist.
●AVOIDFEELINGOVERWHELMED.Startwithonetypeofactivitythatsoundsenjoyableandiswellmatchedtoyourfitnesslevel.Youcanalwayschangeifyoudon’tlikeitorfeellikeitisnotenough/toomuchforyourbodyatthistime.
●LISTENTOYOURBODY.Workingoutshouldmakeyoufeeltiredandsoretoacertainextent,butyouneedtobeconstantlycheckinginwithyourselftomakesureyouaren’tdoingtoomuchtoosoon.Whenindoubt,beextracautious,startslow,andrampuptheintensityatacomfortablerate.
●GETHELPFROMANEXPERT.Ifyoufeelunsureaboutstartinganexerciseroutine,thereisalwaystheoptiontoworkone-on-onewithapersonaltrainer.Ideally,youwouldlookforsomeonewhohasexperienceworkingwithautoimmunedisease,mobilitytraining,and/orafocusonbodypositivity.
Notmovingenoughhasn’talwaysbeenanissueforme.Priortodevelopingmyautoimmunediseases,Ienjoyedhikingandevenlongerbackpackingtrips.Whileitwasachallenge,thebeautifulwalksinnatureandtheprideincarryingeverythingIneededonmyownbackwerehugerewards,nottomentionthechancetoconnectwithfriends.Asmybodybecamemoreandmoremalnourishedwithundiagnosedceliacdisease,Ihadlessandlessabilitytoperformphysicallyatpreviouslevels.IstartednoticingthatIwasbreathless,light-headed,andshakyonly10to15minutesintoaworkoutofanykind.Ievenremembermyhusbandurgingmetoeatenergybarsnotonlyfollowingaworkout,butevenbeforedoinganything!Isimplyhadnoreserves,andIbecameafraidofexperiencingthosesensations.Eventually,Iavoidedmovementalmostaltogether.Tothisday,Istrugglewithmovementontheautoimmunewellnessjourney.AlthoughIamnotasdebilitatedasIoncewas,IfindmyselfhavingtoworkhardtoovercomethefearsthatIfeltaroundexertionwhileIwassick,andIoftenfindmyselftryingtotackleasenseofbeingoverwhelmedaboutrestoringphysicalfitness.Thejourneyiscomplex,andsomeareastakeusyearstomaster.
WhereAreYouontheMovementSpectrum?Thistestwillhelpyoudeterminehowhighofaprioritymovementistoyourhealingjourney.Giveyourselfonepointforeveryitemonthelistthatapplies,andthentotalyourscoreandseeyourresultsatthebottom.
__ Isitfor7ormorehoursperday.
__ Igetlessthan1hourtotalofmoderatephysicalactivityperday(likewalking).
__ Ialwaysdrivetowork,school,orothercommitments.
__ Idon’tspendanytimestretchingduringtheweek.
__ Idon’tdoanyactivitiesthatbuildmuscle,likeliftingheavyobjectsorbodyweightexercises,likepushupsorsquats.
__ Ihaveahealthconditionthatrestrictsmyabilitytomove.
__ Myworkdoesn’trequiremetobeonmyfeetatallduringtheday.
__ Idon’tmaketimetoexerciseduringtheweek.
__ Myfreetimeiscenteredaroundsedentaryactivities(likewatchingTV).
__ Idon’tenjoyexercise.
SCORING:Anyscorehigherthan4meansthatyoumayneedtoprioritizegettingmoremovementthroughoutyourday.Toensurethatyouaren’toverdoingit,see“ExerciseAssessment”.
EXERCISEIDEASFORTHOSEWITHCHRONICILLNESSAlthoughsometop-levelathletessufferfromautoimmunediseaseandstillfindthemselvesabletoperformatahighlevel(likeVenusWilliams),thisisrareandbyfaranexceptiontotherule.Ifyouhaveanautoimmunedisease,chancesarethatyouaregoingtodobetterwithmoderateexerciseinsteadofintenseexercise.Thegoodnewsisthatthismoderateexercisehasbeenshowntobejustashealthpromotingasintenseactivity,withouttheriskofinjury,burnout,andstress.Herearesomeideasthatcangetyoustarted.
●WALKING—Nomovementisassimpleandinnateaswalking,andthepossibilitiesareendless.Youcanwalkanywhereandfromafewminutestoa
fewhoursaday,dependingonyourfitnessandstrengthlevel.Webelievethisistheidealactivityforthosewithautoimmunedisease—seeTheBenefitsofWalkingsectionformoredetails.
●YOGA—Apracticethatintegratesbreathworkandstretchingthatpromotesflexibilityandstrength,aswellasrelaxation.Therearemanydifferenttypesofyoga,rangingfromgentleandrestorativetointenseandstrength-building.
●PILATES—Aseriesofcoreexercisesoriginallydevelopedtoberehabilitativethatimprovestrengthandflexibility.
●QIGONG—AnintegratedChinesesystemofposture,movement,andmeditationthatcanhelpwithstrength,flexibility,andpromotingrelaxation.
●TAICHI—AChinesemartialartspracticethatusesslowermovementsandhelpswithbalance,focus,andstrength.
●STRETCHING—Anyactivitythatfocusesonlengtheningthemuscles.StretchingcanbedoneonitsownorasacomponentofanotherexerciselikeyogaorPilates.
●SWIMMING—Gettingexercisewhileimmersedinwatercanbelessstrenuousandeasieronthejoints.Swimmingorwateraerobicscanrangefromgentletointensedependingonthetypeofworkoutyou’dliketoreceive.
●HIKING—Walkingonanaturetrailorintheoutdoorscanbeanexcellentwaytogetsomemovement.Itcanbesomethingassimpleasaflattrailaroundabodyofwaterorasstrenuousasbackpackingforacoupleofdaysinthewilderness.
●DANCING—Putonsomeofyourfavoritetunesandmoveyourbody!Dancingisoneofthemostfunandenjoyablewaystogetyourdailymovement.
●LEISURELYCYCLING—Takeyourbikeforaspinaroundtheneighborhoodormakethecommitmenttostartridingtowork.
●MARTIALARTS—Therearemanydifferenttypesofmartialartspracticesthatfocustovaryingdegreesonstrength,flexibility,coordination,meditation,andbreathworkandcanbeanenjoyableandchallengingwaytogetmovementintoyourroutine.
●REBOUNDING—Useaminireboundingtrampolinetogentlybounce,gettingamaximumworkoutforminimumeffort.
Asanystay-at-home-parentcanattest,beingmobileandactivethroughout
yourdaydoingerrandsandhouseworkdefinitelycountsasmovement!Infact,ifyoufindyourselfatalldisabledbyyourcondition,simpleeverydaytaskssuchasloadingthedishwasherorworkinginyourgardencanbeaconsiderableworkout.Othersmayoutsourcesomeofthisworktoacleaningcompany,nanny,orotherfamilymemberstogivethemmoretimetowork(mostoftenatthatdeskjob!).Don’tunderestimatetheimpactthatbeingactiveathomecanhaveonyourmovementneeds.Often,theseactivitiescanservemultiplegoals—creatingacleanlivingenvironment,preparinghealingfoods,orplayingwithchildrenorpets.
EXERCISEASSESSMENTThisisachecklisttohelpyoudetermineiftheexerciseroutineyouareengagedinmaybenegativelyimpactingyourhealth.Noteallofthestatementsthatapplytoyou,tallyyourscore,andseeyourresultbelow.
◻ Iamsorethesamedayoftheexercise.
◻ Iamsorethedayaftertheexercise.
◻ Iamsoreformorethanadayaftertheexercise.
◻ IfeelexhaustedorlikeIneedanaplaterinthedayfollowingexercise.
◻ Ican’tdocertainactivitiesaftertheexercise.
◻ IfindthatIhaveahardtimegettingmotivatedtodotheexercise.
◻ Ihaveahardtimegettingthroughtheexercisebecauseofpainorfatigue.
◻ Ifindmyselftiredorsoreduringtheexercise.
◻ Ifrequentlyfindmyselfgettinginjuredasaresultofexercise.
◻ Ifindthesamelevelofworkoutgettingmoredifficult,noteasier.
◻ Ifindthattheexercisecausesflaresofmyautoimmunedisease.
◻ Igetshakyorlight-headedinthemiddleoforimmediatelyfollowingtheexercise.
SCORING:Anyscorehigherthan1or2maymeanthatyourcurrentlychosenactivityistoointenseordepletingforyourneeds,andyoumayconsidertransitioningintoatypeofactivitythatismoregentle.Sometimes,aless-intenseexerciseisoptimallong-term,oryoumayfindyourselfbeingabletoincreaseintensityovertime.
EVERYDAYACTIVITIESTHATKEEPYOUMOVING●Doinghousework
●Cooking
●Gardening
●Walkingyourdog
●Walkingyourkidstoschool
●Walking/cyclingtowork
●Runningerrands
●Playingwithchildren
●Shopping
●Doinghomeimprovements
THEBENEFITSOFWALKINGAdiscussionabouttypesofmovementbestforthosewithchronicillnessisnotcompletewithoutgivingsomeextraattentiontowalking—webelieveitcanbethebestexerciseforthosewithautoimmunediseaseandchronicillness.Thestructureofourbodiesisdesignedtoenablebipedalmovement,orbeingonourfeet(asopposedtositting).Stillneedsomeconvincingwhywalkingisanoptimalactivity?Checkoutthelistbelow.
●IT’SMODERATEIMPACT.Walkingislowerimpactthanrunning,butnotsolowthatitdoesn’tprovidemuchbenefitinbuildingbonedensity,likecyclingorswimming.
●IT’SSIMILARTOHOWOURANCESTORSMOVED.Theyspenttheirtimeworkingontheirfeet,walking,andgatheringfoods.Ourbodiesareadaptedtothistypeofmovement,yetmostofusspendmoretimesittingthanstandingorwalking.
●ITDOUBLESASASTRESS-REDUCTIONEXERCISE.Walkingcanberelaxing,especiallywhenyoumakeanefforttobemindfulofyoursurroundings.Sincemostofuswithautoimmunediseasearestrugglingtomanageourstress,weneedallthehelpwecanget!
●ITEXPOSESUSTOSUNLIGHT,FRESHAIR,ANDNATURE.Allofthesecomponentshelpregulateourimmunesystemsandmanageourstress(seeChapter5).
●ITCANBEANACTIVITYTHATBUILDSCOMMUNITY.Walkingcanbeenjoyedwithothersandisagreatalternateactivitytogoingoutforamealordrinkwithfriends(especiallywhenyouareintheeliminationphase!).
●ITTAKESMINIMALINVESTMENT.Theonlythingyouneedisagoodpairofshoes!Noexpensivegym,trainer,orfancyequipmentisnecessary.
●ITKEEPSUSHAPPY.Studiesshowthataregularwalkingroutinehelpskeepdepressionandanxietyatbay.
●ITISGOODFORLYMPHATICFLOW.Althoughthelymphaticsystemhaslotsofvessels,itlacksapumpandisdependentonmovementforlymphflowanddrainage.
●ITCANBESCALEDTOYOURNEEDS.Youcanwalktheblockinyourneighborhoodortryahikeonamorechallengingpath.
●ITCANBEDONEANYWHERE.Thepossibilitiesareendless—walkclosetowhereyoulive,inanearbynaturepreserve,onthebeach,orinashoppingmall.
Itissurprising,givenalloftheevidenceinfavorofwalking,thatmostpeopledon’tseekitoutorevenconsideritexercise.Gettingstartedwithawalkingroutineissimple—justgetagoodpairofshoesthatfityouwellandprovidethesupportyouneed,andyouareonyourway!Aimtotakeshortwalksinitially,evenstartingwith5to10minutes,andthenbuilduptoanhourormoreperday.Youcanrotatewalkingalonemindfully,listeningtomusicorapodcast,orwithabuddy—changingupthescenerykeepsboredomatbay.Yourroutinecanbeaslittleorasmuchasyourbodyallows;thekeyisjusttogetoutthereanddoit!
MovementSolutionsfortheWorkplaceManypeoplefinditdifficulttogettheamountofmovementtheyneedwhentheyworkatraditionaldeskjob,sittinginfrontofacomputerorbeinginanofficeeveryday.Unfortunately,studiesshowthata30-to60-minuteworkoutbeforeorafterworkdoesnot“undo”thestresscausedtothebodybysitting.Trysomeofthesesuggestionstohelpmitigatethetollthatworkingadeskjobcantakeonyourbody.
●CONSIDERANONTRADITIONALDESK.Treadmilldesks,standingdesks,andmodular(combination)desksareallalternativestothetraditionaldeskandcanbehelpfulsolutions.Moreimportantthanwhichtypeofdeskyouchooseisthatyouarechangingyourpositionthroughouttheday.Chronicstandingcanbeasdetrimentalaschronicsitting,sothebestsolutionoftenincludesavarietyofoptionstochangeitupperiodically.
●TAKEFREQUENTBREAKS.Atleastafewminuteseveryhour,makesuretogetup,walkaround,anddosomesimplestretching.Youwillbeamazedattheimprovementinyourmuscletension,fatigue,mentalclarity,andenergylevelswhenyouprioritizethesemovementbreaks,nomatterhowbusyorstressful
yourdayatworkis.
●SWITCHUPYOURCHAIR.Havingayogaballhandytoreplaceyourregularchairoccasionallycanhelpyouremembertositupstraightandengageyourcoreasyouwork.Youcouldalsotryotheroptionslikeakneelingchair.
●WALKORBIKETOWORKANDDURINGBREAKS.Ifpossible,walkorbiketoworkandtrytousesomeofyourbreaktimetogetonyourfeetandmovearound!Enlistacoworkersoyouhaveabuddytokeepyouontrack.
FINDINGBALANCEWITHMOVEMENTJustasyourneedsinotherareas(likesleepandstressmanagement)changeovertime,yourmovementneedsandabilitiesarealsolikelytoebbandflow.Itis
time,yourmovementneedsandabilitiesarealsolikelytoebbandflow.Itisimportanttotakestockofyourcurrentstresslevel,yourphysicalcapabilities,whetherornotyourautoimmunesymptomsareflaringup,andyourgeneralresilienceatanygiventime.Constantevaluationandadjustmentallowyoutotakeadvantageoftimeswhenyourhealthisparticularlyrobustanddialbackwhenenergyneedstobedivertedtohealing.Livingwellwithautoimmunediseasemeansbeingflexiblewhenyourbody
callsforrest.Afteraperiodofstrength,itiseasytoexperienceprofounddisappointmentandfrustrationifphysicalcapabilityisagainlimitedduetoyourdiseaseoranunexpectedillness.There’snoshameindemonstratingversatilityinresponsetothoseneeds.
CALLTOACTIONWearecreatedformovement.Fromourpowerfulbrainssendingthemillionsofimperceptiblesignalsrequired,allthewaytoourverybonessupportingthewholeendeavor,literallyeveryfiberisdesignedfortheoftenundervaluedmiracleofmovement.Fitnessofbothbodyandmindcannotbemaintainedwithoutappropriatephysicalactivity.Itisuptoustotakeadvantageofourextraordinarybodiesandlearntomovetheminthebestways.Inthischapter,weexploredwhymovingmattersandhowtoomuchortoolittleofit,
especiallyforthosewithautoimmunedisease,canbedetrimental.Thetoolsoutlinedherecanhelpyoufine-tuneyourbody’smovementneedsandhopefullydiscoverideasforgettingactive.We’veplacedspecialemphasisonwalkingasanidealfitnessroutineforautoimmunedisease,becauseitrequiresalmostnothingtostartandcaneasilybescaledtoyouruniqueneeds.Itisasurprisinglysimpleandempoweringstepontheautoimmunewellnessjourney.AsBritishhistorianG.M.Trevelyansaid,“Ihavetwodoctors,myleftlegandmyright.”
CHAPTER7
Connect
“Aloneandwithoutlove,wedie.Lifeitselfisasdependentonrelationshipswithothersasitisonfood.”—M.N.BECK
Therearetwoareasinlifeinwhichconnectionisessentialinordertogainandmaintainourbesthealth—otherhumansandthenaturalworld.Wearenotseparatefromeachother,orfromourenvironment.We’vedividedthischapterintotwosections,onedevotedtoeach,sothatyoucanlearnaboutandexplorecultivatingtheseconnections.
CONNECTINGWITHPEOPLEWehaveallexperiencedthehurtfromthelossofconnectiontoothers,whetheritisthroughdeathorsomeothercircumstance.Manyaresurprisedtolearnthatourbrainsexperiencethistypeofemotionalpainjustlikephysicalpain.Theverysameregionofourbrainsresponsibleforprocessingphysicalpainisalsoresponsibleforprocessingsocialpain.Itisnowonderlosingalovedoneorabreakupisoftendescribedas“beingkickedinthegut,”or“beingbrokenhearted.”Ourbrainsexperienceitthatway!NeuroscientistMatthewLieberman,PhD,wroteaboutthisfindinginhis2013book,Social:WhyOurBrainsAreWiredtoConnect.Itwasn’tjustthatthebrainsawthesetwokindsofpainthesameway—thetwokindsofpaincanevenbemanagedthesameway.FurtherresearchbyDr.LiebermanshowedthatTylenolcoulddullsocialpaininmuchthesamewayasitdullsphysicalpain.Whydoesitmatterthatourbrainsgroupphysicalandsocialpaintogether?Itdemonstratesonanextremelybasiclevelthatourconnectionwithotherhumanbeingsisfundamentaltoourhealth.It’ssovitalthatourbrainsregisterbothlargeandsmallthreatstothatconnectionasliterallypainfulevents.It’ssimple!Ourneedforconnectiontootherhumanbeings,astrongsocialsupportnetwork,isamustforgoodhealth,justlikenourishingfood.
ROBUSTSUPPORTNETWORKSANDACHIEVINGWELLNESS
Ourbrainsseethelossofconnectionwithotherpeoplejustlikethelossofalimb—botheventsareregisteredaspain.It’snotjustavoidingpainthatmakesadequatesocialsupportimportant,asthere’sevenmoreevidencethatsocialsupportmatterstoourhealth.Onestudyrevealedthatsmokingupto15cigarettesadaypredictedlessaboutyourlikelysurvivalthanalackofsocialsupport.(Wearenotencouragingyoutogopickupapackhere!)Ourpositiverelationshipswithothershavebeenshowntolowercortisol,thestresshormonewetalkedabout,andincreaseoxytocin,ahormoneresponsibleforstimulatingoursenseofcalmandconnection.Beyondthat,it’snosecretthatlonely,isolatedpeopleexperiencegreaterlevelsofstressanddepression,bothofwhichcarrynumerousnegativehealthconsequencesoftheirown.Weneedothersnotjusttoavoidpain,buttomitigatehealthrisksandencouragewellness.Beinghappyandhealthyisnotasolitarypursuit.Thisisevenmoreaccurateif
youarestrugglingwithautoimmunedisease.Theupsanddownsofchronicillnessrequireustobravelyrevealourvulnerabilityandfindotherswhomwecanrelyonforhelpandsupport.Youaremorelikelytomakethedietaryandlifestylechangesweadvocateinthisbooksuccessfullywithinaloving,caringcommunity.Donotunderestimatehowsignificantthatnetworkiswhenitcomestohealingandachievingwellness.Findyourtribeandaskthemtoshowupforyouasyouundertakethisjourney!
SUPPORTNETWORKEVALUATIONYoursupportnetworkistheentirecommunityofpeoplearoundyouwhovalueyouandhelpprovideforyourphysicalandemotionalneeds.Thisnetworkusuallyoperatesunder“mutualobligation.”Inotherwords,youbothgiveandreceivesupport.Thefourmaintypesofsupportareemotional,practical,sharingpointsofview,andsharinginformation.Havingbothdepth(afewveryclose,intimatepeople)andwidth(alargenumberofcasualfriendsandprofessionals)inyournetworkprovidesasenseofsecurity,belonging,andbufferingagainstthestressesoflife.Ifyouoftenhavethesensethatyoursupportnetworkisnotstrongenoughorarewondering
ifyou’llhaveadequatesupportasyouundertaketheautoimmunewellnessjourney,itcanbehelpfultoevaluateit.Thefollowingquestionnairecanhelpyoudetermineifyouhavearobustsupportsystemorifyoushouldtakeproactivestepstoimproveit.Giveyourselfonepointforeveryboxthatappliestoyouandtallyyourscoreatthebottom.
◻ WhenIaminneed,therearepeoplethereforme.
◻ IgetthesupportIneedfrommyfamily.
◻ Isharemyupsanddownsandreceivecomfortfromafewkeypeople.
◻ IgetthesupportIneedfrommyfriendships.
◻ Therearekeypeopleinmylifewhotreatmyneedsandfeelingsasimportant.
◻ Icancountonmyfriendsandfamilytohelpmemakedecisionsandworkthroughproblems.
◻ IhavepersonalandprofessionalcontactsthatIcanrelyontohelpmewithpracticalproblems(likefixinganappliance).
◻ Ihavepeopleinmylifewhoareproudofme.
◻ ThereareseveralpeopleIcantalktowhenIamfeelinglonelyordepressed.
◻ IhavesomeoneinmylifewithwhomIfeelcomfortablesharingintimatepersonalproblems.
◻ Iregularlyspendtimewithmyfamilyandfriends.
◻ Ihavefriendswhoarethereforme,evenwhenit’snotfun(likeanearlymorningtriptotheairportorpackingupamovingvan).
◻ Thereareothersinmylifewhocometomeforpracticalhelpandsupport.
◻ IfIwereinneedofcaretaking,therearepeopleinmylifewhowouldhelpfillthegaps.
◻ TherearepeopleinmylifewhomItrustandwhoseemeastrustworthy.
◻ Ihavepeopleinmylifewhohonorimportantevents(likebirthdays).
◻ Ihavepeopleinmylifewhowouldbethereformeintheeventofacrisis.
SCORING:Anyscorelowerthan12meansthatyoumayneedtoprioritizestrengtheningyoursupportnetwork.Thefollowingsectionsgiveyousomeideasabouthowtoachievethat.
BUILDINGASUPPORTNETWORKWeknowintuitively,throughcountlessstudies,loadsofepidemiologicaldata,andlaboratorytesting,thatastrongsupportnetworkmattersgreatlytogoodhealth.Evenso,atonetimeoranother,allofusmayencounteraperiodwhereournetworkisinadequate.Maybeyou’vejustmovedfarfromhome,oryou’vebecomeanewparent,oryou’retacklingaspecificissuethatyourexistingnetworkisn’tfamiliarwith—therearemanyreasonsforneedingtoimprovethedepthorwidthofyoursupportnetwork.Nobodyeversays,“Geez,Ijusthavewaytoomanycaringpeopleinmylifewhoarewillingtohelpmeout!”Ifyoufindyourselfneedingtoboostyourconnectionswithothers,hereare
sometipsonbuildingthatsupport.
●TAKERISKS.Thereisnoopportunitytomeetnewpeopleandpossiblydeveloprewardingrelationshipsifyoudon’tgoforit.Joingroups,acceptinvitations,trynewactivities,andjustgenerallybeopentomeetingmorepeople.
●SPEAKUP.Unlessallyourfriendsandfamilymembersarepartofapsychicnetwork,theywon’tknowwhatyouneedunlessyoutellthem.Learnhowtocommunicateyourneedssothatthosearoundyoucanaddressthem.
●BRANCHOUT.Useyourexistingnetworktoformnewconnections.Askthosearoundyoutointroduceyoutointeresting,funpeopletheyknowandwhotheythinkyoumightenjoygettingtoknow,too.
●LETGO.Theremightbeafewrelationshipsinyourcirclethataren’tveryhealthy.Identifythoserelationshipsandlookatwaystobreakthenegativetieorreducetheimpactithasonyou,sothatyouareopenforhealthierconnections.
●MAPIT.Ifyouaren’tevensurewhatkindsofsupportyouaremissingorwhereyoumightfindthatsupport,sitdownandfigureitout.Forexample,ifyouhavelotsofpracticalsupport,butnotmuchemotionalsupport,lookingforagroupoffolksdealingwiththesameissueswouldgreatlystrengthenyournetwork.
●CHILLOUT.Wemeetnumerouspeopleoverthecourseofourlives,butonlysomeofthembecomepartofournetworkandevenfewerbecometruefriends.Formingmeaningfulconnectionstakestime;don’tbeimpatient.
●TREASUREIT.Strongrelationshipsarenotone-sided.Besureyoufindwaystocontributetoyourimportantrelationshipsandtellthosespecialpeoplehowmuchyouappreciatetheminyourlife.
MAINTAININGKEYSUPPORTRELATIONSHIPSYoumayhaveagreatsupportnetworkbutalsorecognizethatafewimportantrelationshipsneedalittle“maintenance.”Creatinglasting,healthyrelationshipsrequireseffort.Hereareafewideasonstrengtheningthekeyconnectionsinyourlifesothatyoucancountonthemoverthelonghaul.
●LOVEEQUALSTIME.Besureyoumanageyourtimeinawaythatallowsyoutofocusontheimportantpeopleinyournetwork.Maketimetogooutwithyourbestfriend,playwithyourchild,orhaveadeeptalkwithyourpartner.Ifyoudon’tmaketimetonurturetheserelationships,theywilldeteriorate.
●DON’TBEABULLYORAWIMP.Assertivenessisexpressingyourneedsandfeelingswhilerespectingothers’needsandfeelings.Itisawaytocommunicatewithoutbeingaggressiveorpassive.Beingopenandhonesthelpsreduceconflictsandmisunderstandingsinyourrelationships.
●KEEPYOUREARSOPEN.Oneofthemostimportantthingsthatcloserelationshipsofferisbeingheard.Knowingthatsomeonecaresaboutyouandiswillingtopayattentionasyoushareyourjoysandsorrowsisvital.Besureyouarefocusedandusinggoodlisteningskillswhenyouareinteractingwithyourlovedones.
●GETOUTOFYOURCOMFORTZONE.Toomuchroutinecanallowimportantrelationshipstogrowstale.Peopleoftengrowcloserwhentheyareinnew,unfamiliarsituationstogether.Takearock-climbingclasswithyoursisterortrylearninganewlanguagewithyourpartner.Anybigorsmallchangecanhelpyoubondmoredeeply.
●SAYSORRYANDACCEPTAPOLOGIES.Admittingmistakesandaskingforforgivenessaswellaslettinggoofinjurieswhensincereapologiesareofferedmakefortrusting,enduringrelationships.Theloveyoucouldbepouringintoakeyconnectionisrobbedbytheenergyrequiredtowaitonsayingsorryorholdontoawrong.
ADDRESSINGUNSUPPORTIVERELATIONSHIPSIt’snosecretthatrelationshipswithfamilymembersandclosefriendswillbeimpactedbyachronicillness.Mostofusintheautoimmunecommunityhavedealtwiththechallengesofrelationshipsthatbecomestrainedaroundongoinghealthstruggles.Onepsychologist,MarieHartwell-Walker,EdD,writesthatthismayhappenbecauseourculturedoesnothavemethodsforacknowledgingpersistentillnessoracontinualhealthcrisis,unliketheritualswehavearound
persistentillnessoracontinualhealthcrisis,unliketheritualswehavearoundtemporaryillnessordeath.Somepeoplemaytakeitpersonallyifyoucannolongergooutasoftenordon’thavetheenergyforactivitiesthatweresharedbefore.Othersmaymistakenlybelieveyourdiagnosisis“catching,”orsomemayfeelhelplesssotheystopreachingoutatall.Stillothersmaybetooinvolvedintheirownlivestomaketimeforhowyouarechanging.Surprisingly,seekingwellnessthroughmajordietaryandlifestylechangescanhavesimilareffectsonyourrelationships.Yourchangingprioritiesmaybeperceivedasthreateningbysomeofthoseclosetoyou.Ortheymayhavestrongjudgmentsaboutthenewstepsyouaretakingtodealwithyourautoimmunedisease.Itcanbehelpfultohavesomewaystohandleunsupportivefamilyorfriends,
whetheryouaredeepintoyourautoimmunebattleormakingempowerednewdecisionsonyourwaytowellness.
●GIVETHEMTIME.Formanyofusintheautoimmunecommunity,theroadtodiagnosisisverylong,oftenmeasuredinyears.Decidinghowtorespondtoyourdiseasecanalsobealengthyprocess.Itmaytakethoseclosetoyoujustasmuchtimetounderstandandacceptanewversionofyou.Youhavebeensteadilyalteringyourviewofyourselffromtheonsetofsymptoms,buttheirviewofyouhasnothadtoprogressatthesamepace.Trytopatientlygivethemtime.
●NOTEVERYONECANGIVEYOU“COMPLETE”SUPPORT.Adjustyourexpectationsabouthowmuchsupportthepeopleclosetoyouwillbeabletoprovide.Therearevaryingdegreesofseveritywithautoimmunediseases,butforallthosedealingwithit,anautoimmunediseaseislifechanging.Weallwantcompleteloveandunconditionalsupportwhilewelearntomanageourchronicillnesses.However,therealityisthattheamountandkindofsupportthepeoplearoundyouwillbeabletoofferwilldiffer.Trytoacknowledgethepositivesupportthatisofferedbyeachperson,allowingittoforma“whole,”andletgoofyourwishesformore“complete”supportfromeveryone.
●FINDOTHERSWHO“GETIT.”Seekoutacommunityofpeoplegoingthroughthesamediseasechallengesorworkingtowardwellnesswithsimilarapproaches.Thereisvaluablesupportthatcomesfrominteractingwithotherswhounderstandbecauseofpersonalexperience.Thatsupportcanhelpfillgaps.
●WHATDOESYOURGUTSAY?Beingawareofyourinstinctsaboutthepositiveornegativeenergygeneratedbysomepeopleiscrucial.Ifyoufeelbadaboutyourself,slightlydepressed,orlikeinteractionsareuncomfortablyforcedwhenyouarearoundaparticularperson,itmightbetimetogettothebottomofwhythatrelationshipissostrained.Maybeheisactuallyexperiencingsomething
difficult,too,andyoucouldhelp.Ormaybehehastakenyourillnessornewlifestylechangepersonallyandneedstobereassuredthatyoustillvaluehim.
●ALWAYSCHOOSETORESPECTYOURSELF.Iftherearepeopleinyourlifewhoarenotonlyunsupportive,butactivelysabotagingyoureffortstocopewithyourdiseaseorheal,standupabouttheunacceptabletreatment.Letthemknowthatiftheyareunabletounderstandoroffersupport,youcanacceptthat,butthatyouwillnotacceptbeingactivelyundermined.Negativerelationshipscanbeamongthemajorfactorsthatneedtochangeinawellnessjourney.Youmayreconsiderwhetherornotcontinuingtherelationshipisappropriate.
ANAUTOIMMUNE-FRIENDLYSOCIALLIFEHavingoneormoreautoimmunediseasesdoesnothavetomeantheendofyour
sociallife.Ifyou’reabouttoundertaketheautoimmunewellnessjourney,neverfear!Despitemakingthebigchangesweadvocateinthisbook,youcanstillhaveafulfillingsociallife.Havingachronicillnessandseekinghealingdoesn’tmeanwe’refuddy-duddies!Socializingcanandshouldremainapriority.Itcementstheconnectionstoothersthataresocriticaltogoodhealth,andit’sjustplainfun!Herearesomeideasfordevelopinganautoimmune-friendlysociallife.
●JOINAHOBBYGROUP.Acting,knitting,stampcollecting,birdwatching—thelistofoptionsisendless,evenifyourenergylevelsneedtobeconserved.
●PLANADINNERPARTY,POTLUCK,ORPICNIC.Theseoptionsallowyoutohandlethemenuorbringyourownfood,ifyouhaverestrictions.
●MEETFORTEA,KOMBUCHA,ORFRESHSMOOTHIES.Ifcoffeeatthelocalshoporadrinkatthelocalbarisn’tanoption,therearelotsofalternatives.
●GOONANATUREWALKORHIKE.Naturewalksandhikesaregreatwaystocombineconnectionstonatureandpeople,andyoucanthrowinarestingpoint,ifnecessary,totakeinthesightsandsounds.
●MAKEANARTORCRAFTPROJECTTOGETHER.Thereare“paintyourownpottery”storesalloverthecountry,oryoucouldgrabsomesuppliesandhosta“creativejuices”partywithfriends.
●FINDACAUSEANDVOLUNTEER.Theresearchissolidaboutthehealthbenefitsofvolunteering,anddoingitwithotherscoulddoublethejoyofgiving.
●LISTENTOORPLAYMUSICTOGETHER.Lookforopportunitiestogoseeyourfavoritebandwithyourpartneror,ifyouplay,gettogetherwithotherstojam.
●MAKEA“LAUGH”DATE.Laughingisliterallygoodforyourhealth,soplanafunnymovienightorgoseealivecomedyshow.
●JOINORSTARTABOOKCLUB.Bookclubsareoneoftheeasiest,mostinexpensivesocialactivities,whilealsogenerallybeinglow-keyandgeneratinglotsofinterestingdiscussionwithothers.
Thislistofideasisjustastart—youcoulddoalmostanyactivityyou’dlike.Therealkeystoenjoyingagreatautoimmune-friendlysociallifeareplanningandpreparation,soyourfoodandrestneedsaremetbeforeorafteractivities,clearcommunicationwithotherssotheyknowwhatyouarecapableofhandlingatanygiventime,andanopenmindaboutfuninallofitsforms.
WhenIwasdiagnosedwithceliacdisease,IwassorelievedtoknowwhatwaswrongthatIdidn’tspendmuchtimethinkingabouthowitwouldimpactmyconnectionswithothers,butitendeduphavingahugeimpact.IdecidedtostartseekingoutfolkswhounderstoodwhatIwasgoingthroughandaddingthemtomysupportnetwork.Itookrisksandputmyselfoutthereinnewways,especiallythroughsocialmediaconnections,aplaceIhadneveractivelysoughtfriendshipsbefore.Soon,IfoundMickeyandotherpeoplelikeher,andvirtualfriendshipsblossomedintoreal-worldconnections.Today,Iamproudtobepartofanenormouscommunityofpeoplehealingfromautoimmunediseasethatliterallyspanstheglobe.IhaveacoregroupoffriendsIcangotowhenIneedtoventaboutorwanttocelebratemyautoimmunedefeatsandwins,butthereisanevenwidersystemofpeopleIcanmeetupwithforpotlucks(wherenobodythinksit’sweirdifI’mextracarefulaboutgluten!),acupoftea,oranicewalk.Mysociallifeisveryactiveandfulfilling.Autoimmunediseaseactuallyenhancedit!
CULTIVATINGBALANCEWe’vetalkedaboutbalanceinrelationtodietinChapter3—learningtowalkthelinebetweenfoodasmedicineversusfoodasfearisanimportantpartofthisprocess.Wealsotouchedontheideaofbalanceinmanagingstressandfindinganidealamountofmovement.Whydowecomebacktothistopicsooften?Itallcomesdowntohomeostasis.Homeostasisistheself-regulatingprocessthatbiologicalsystemsusetomaintainstability.Ourbodiesareceaselesslyworkingtoachievethisinordertokeepoursystemsrunningsmoothly.Weseebalanceasintegraltotheautoimmunewellnessjourneybecauseitisintegraltoexistence.Whenwespeakaboutbalanceinthischapter,wemeanfindingawayto
acknowledgeyourautoimmunediseaseandhonorthebattleyourbodyisfighting,whilenotallowingillnesstobecomeyouridentity.Wearealsoreferringtotheplacewhereyoucanbeempoweredbyyourwellnessjourneywithoutlettingitdominateyourlife.Illnessasanidentity,orhealingasyouroneandonlyinterest,closesyouofffromconnectionwithothers.Withouttheseconnections,yourlifeisoutofbalance.Howyoupersonallywillachievethisbalancewillbeuniquetoyou.Eachof
usmuststrugglewiththisaspectofillnessandhealingonourown.Intermsofmovingawayfromillnessasyouridentity,itcanbehelpfultotryviewingthesupposeddisadvantagesofthediseasethroughanotherlens.Perhapsmakingaparadigmshift,achangeinassumptions,willallowyoutorecognizepositivethingsthathavecomeintoyourlifeasaresultofillness.Maybeyou’vebecomemoreresilient,oryouhaveasharpersenseofhumor.Similarly,illnesscanprovideperspectiveonwhatyouwanttoachieveinlife.Whenitcomestoourinterestsbeingdominatedbythepursuitofhealing,it
Whenitcomestoourinterestsbeingdominatedbythepursuitofhealing,itcanhelptorememberthatthewholereasonforhealingistousethatrenewedenergytoexpand,ratherthancontract,yourlife.Remindingyourselfthatyourmethodsofhealingaren’tyardsticksformeasuringeveryotheraspectoflifehelpsyoumaintainbalance.Evenwe,withcareersinthisfieldandautoimmunediseasesofourown,don’tspendeveryminuteofeverydayonthesetopics.ColinWright,anauthorandinternationalspeaker,said,“Extremesareeasy.
Striveforbalance.”Weagree.Balance—homeostasis—takesworktoachieve,butitisbestforyouandyourconnectionstothoseyoulove.
CONNECTINGWITHNATURE“Studynature,lovenature,stayclosetonature.Itwillneverfail
you.”—FRANKLLOYDWRIGHT
Therelationshipbetweenhumanbeingsandthenaturalworldrunsdeepduetoourhunter-gathererpast—beforecitiesemerged,weconsideredthenaturalworldhome.Humanshavealwayshadtohavearelationshipwithnature,whetherthatwasexperiencingordealingwiththeelements,cultivatingtheland,traveling,orusingnaturetocreateanddevelopahigherqualityoflife.Thisnaturalworldhasprovideduswithrichnessinitsresourcesandopportunities,aswellashardshipanddifficultiesduetoitsunpredictabilityandinabilitytobecontrolled.Asmuchascivilizationandtechnologyhaveremovedmanyofusfromnature,wearestilldependentonittosustainourlives—wecannotlivewithoutthesun,soil,wind,andwater.Despitenotknowingtheexactreasonwhy,humansseemtobebiologically
drawntonature.Peoplereportfeelingmorecalm,atpeace,andrelaxedwhentheyareinanaturalenvironment.Researchonoutdoorexposureandhealthhasshownclearbenefits,fromloweringstresshormones,bloodpressure,andheartratetoincreasedimmunefunction.Onepossiblereasonfortheseeffectsisbecauseofhowinherentlystressfuloururban,modernlivescanbe.Itseemsinnateforustofeelatpeaceandcomfortedbythenaturalworld.Howexactlydoesnatureaffectus?Weexperienceitthroughavarietyofour
senses—especiallyvision,smell,touch,andsound.Whenweareinanaturalenvironment,weviewtheplants,trees,andlandscape,andwesmellthecompoundsreleasedbytheplantsandtrees.Wealsofeeltheunevengroundbeneathourfeetoronsurfaces,likebarkandleavesontreesandplants,andhearthesoundsofthewindinthetreesandtheanimalsthatinhabitthelandscape.Thesesensesproducechangesinourbrains,whichhaveapowerfuleffectonouremotionsaswellasourphysiology.Natureisasoothing,healingforcethatcanbeusedtoenhanceourhealthandwell-being.AsnaturalistandauthorJohnMuirwrote,“Thousandsoftired,nerve-shaken,over-civilizedpeoplearebeginningtofindoutthatgoingtothemountainsisgoinghome.Wildernessisanecessity.”
ForestBathingSHINRINYOKU,translatedas“takingintheforestatmosphere”or“forestbathing,”hasbecomeapopularhealthpracticeinJapanforbetterrelaxationandstressmanagement.Itisthemostpopularformalnatureactivityaimedatachievingbetterhealthpracticedaroundtheworld.TheForestAgencyoftheJapanesegovernmentintroducedtheconceptofshinrinyokuin1982,andtherehassince
beenextensiveresearchintothehealthbenefitsofsuchapractice.Afterisolatingindividualelements,researchershavepostulatedthatthesehealthbenefitscomefromexposuretotheodorsofnature,thesoundsofstreamsandanimals,andviewsoftheforestscenery,bothindividuallybut,moreprofoundly,whenexperiencedtogetherwithotherpeople.Thisresearchindicatesthatevenshortexposurestonaturecanprovidethe
followinghealthbenefits.
●Increasedphysicalactivity
●Lowerlevelsofdepression
●Increasedsleepquality
●Regulatedimmunefunction
●Improvedmoodandemotionalhealth
●Loweredcortisolandotherstresshormones
●Loweredbloodpressureandheartrate
●Increasedparasympatheticactivity(associatedwithrelaxationandlessstress)
●Loweredsympatheticactivity(associatedwithstressstates)
●Betterrecoveryfromstress
TheJapaneseareawareofthesehealthbenefitsandencouragetheircitizenstoengageinthispracticeinanefforttoelevatepublichealth.Thenewsofpositivestudyresultshasspreadthepracticeworldwide.Howdoyoudoit?Justsimplyfindyourselfaforestwhereyoucanbeinnature,eithersittingorwalkingtotakeinthescenery.Youmayliketomeditateorpracticemindfulness,takeastroll,orenjoyapicnicwithafriend.It’sthateasy!
DurationofExposure
TheJapaneseresearchonshinrinyokuindicatesthatevenashortdurationoftimespentintheforest(1to3hours)canproducebeneficialphysiologicalaswellasemotionalchanges.Itisdefinitelyworthwhiletoconsidergettingsomeexposuretonatureafewtimesaweek,ifnotdaily.Ifyousetyourselfupright,thiscandoubleasanotherhealth-promotingactivitylikeexercise,stressreduction,orconnectingwithaclosefriendorfamilymember.Itcouldbeassimpleastakingyourmorningwalkatalocalnaturepreserveorparkinsteadofonthetreadmillatthegym!Althoughmanystudieshaveshownbenefitfromshortdurationsoftimespent
intheforest,a2009studyfoundthataweekendcampingtripproducedincreasedimmunefunction.ThepartoftheimmunesystemthatwasboostedwastheNKcells,thosethatareintegralindetectingandeliminatingcancercellsaswellaspathogens.Thebestpartwasthatnotonlydidtheparticipantshavealargeincreaseinimmunefunctionwhentheyreturnedbutalsotheycontinuedtoshowaboostoveramonthafterthetripwasover!Asimilarstudycomparedaweekendvacationinacityversusanaturalsetting,withaccommodations,activity,andfoodallthesameasacontrol.Theparticipantswhospentthedowntimeinanurbanenvironmentgotnoboostinimmunity,whilethosevacationinginanatural,tree-filledsettinghadapositiveeffect.Makinganefforttobeinnatureforanextendedperiodoftimecancertainlyhelpyoulivehealthier,evenifyouareonlyabletodoitoccasionally.
ConnectiontoOtherAspectsofHealth
Beinginnatureisverycloselyconnectedtotwootheraspectsofhealth,movementandstressreduction.Itcanalsohaveaprofoundimpactonathird,sleepquality.A2014studyinFinlandshowedthatpeoplehadagreatersenseofwell-beingandbettersleepqualitywhenexercisingthesameamountinnatureasopposedtoindoors—onereasontogetyourmovementoutsideasopposedtoatthegym!Incorporatingtimeinnaturewithsomeotherhealth-promotingactivitiescanhelpyoumaximizeyourefficiencywhileprioritizingyourhealing.Forinstance,takingawalkintheforestwithagoodfriendhelpsyoumanageyourstress,moveyourbody,connectsocially,sleepbetter,andconnectwithnature—killfivebirdswithonestone!
WhataboutYourIndoorEnvironment?
Inmodernlife,itisalmostimpossibletogetawayfromspendingtimeindoors,andyoushouldconsideroptimizingyourindoorenvironmentaswellasgettingoutinnature.Biophilicdesignisthatwhichincorporatesconnectiontotheoutdoorsinanindoorenvironment,throughnaturalventilationandmaterials,naturallighting,outdoorviews,landscaping,andinteriordesignsthatmimicnature.Whileresearchhasbeenfocusedmostlyontheworkplace,studiesshowthatindoorplantsarecorrelatedwithhigherproductivity,areductioninindoorairpollution,andimprovedmoods.TheJapanesehavedoneextensiveresearchaboutisolatingforestqualitiesand
reproducingtheirbeneficialeffectsindoors,liketheuseofessentialoilsornaturalwoodsurfaces.Onestudyfoundthathavingaroompaneledin45percentnaturalwoodproducedsimilareffectsonstressreduction,andyetanotherfoundthatinhalingtheessentialoilsofcedarorcypressproduceda
similareffect.Ifitisnecessaryforyoutospendalotoftimeindoors,itmaybeprudenttoconsidersomeofthesefindingswhendesigningordecoratingyourhomeorworkspace.
I’vealwaysbeenaloveroftheoutdoors,anditbecamedifficulttoremainconnectedtonaturewhileIwasinthedepthsofmyautoimmunecrisis.Inthosedays,Iattemptedtogetoutsideonceaday,andeventhoughIlivedinanurbanenvironment,groundingmyfeetinthesmallpatchofgrassinmybackyard,listeningtothebirds,andfeelingthebreezeonmyskinalwaysenergizedme.Ialsocultivatedalotofhouseplants,whichkeptmyindoorspacebrightandlivelyevenwhenIcouldn’tmakeitoutdoors.Whentheweatherwasnice,Iwouldeatoutsideasmuchaspossibleandworkintheyardgrowinglettuceandherbs.AsIgainedstrength,myshortneighborhoodwalkswereabletotakemetomylocalarboretumforamoreimmersiveexperience.IdiscoveredthatbeinginnatureissohealingtomethatIhavesinceleftthecityandmovedtoamoreruralenvironment.Although,inthosebeginningstages,thereweremanybarrierstoconnectingwithnature(illness,weather,livinginanurbanenvironment),makingitapartofmyroutinehelpednourishmyspiritandmanagemystress,anditisahabitIcontinuetocultivatetoday.
HowtoStartConnectingwithNature
Cultivatingaconnectionwithnatureissomethingthatisaprocess—startwithsomesmallchangesliketakingyourlunchbreakinanearbyparkorwalkingafewtimesaweekinanaturepreserve.Asyoureawakenthatconnection,youmayfindyourselfseekingdeeperexperienceswiththenaturalenvironmentliketheoccasionalcampingtriporcabinvacation.Thebestwaytoconnectistofindthewaythatfeelsgoodtoyou—forinstance,itmightbebestforyoutoliedownandlistentothesoundsofnatureinsteadoftakingastrenuoushike.Anyeffortyoucanmaketoincludenatureintoyourroutineonaregularbasis,especiallyincombinationwiththeotheraspectsofahealthylifestyle(suchasmovement,stressmanagement,orcommunity),willbenefityourhealingprocess.Herearesomeideasforhowtogetstarted.
●FINDYOURLOCALGREENANDOPENSPACEANDUSEITOFTEN!Youlikelyhaveaparkoropenspacewalkingdistancefromyourhomeorworkthatcanbeusedforexercise,relaxation,orenjoyingamealwithfriendsorfamily,evenifyouliveinanurbanarea.Makeanefforttovisitthisspaceasoftenaspossible,weatherpermitting,inordertoreapthebenefitsofmaintainingthatconstantconnectiontonature.
●FINDYOURLOCALNATUREPRESERVEORHIKINGTRAILS.Ideally,thisisalocationthatisstilleasilyaccessible(within20to30minutesfromyourhomeorwork)butprovidesyouwithalargerandmorenaturalenvironmentthanalocal
parkforlongerwalksandtoprovideminimaldistractions.
●MAKEYOURINDOORENVIRONMENTMORENATURAL.Usehouseplantstogreenupyourindoorenvironmentandcleanyourair!Largewindowsthatletinplentyofnaturallightaswellasgreeneryandnaturefromoutsidecanalsohelp.Diffuseessentialoilsfoundintheforest(likecedarorcypress)tosimulatetheexperience.
●PLANFREQUENTNATUREDAYTRIPS.Trytogetoutinnatureforalongerperiodoftime,say2to3hoursatleastonceaweek.Someideasareasfollows:
●Plananoutdoorpicnic.
●Playagameorsportatthepark.
●Goforalongwalkinanaturepreserve.
●Takeahikeonalocaltrail.
●PLANSOMEEXTENDEDTIMEINNATURE.Dependingonhowadventurousyouare,youcanplanto“roughit”foraweekendorlonger.Somemaypreferlodgingwithakitchen,especiallywhencomplexdietaryneedsareconsidered.Whateveraccommodationsyoudecideon,theimportantpartistheimmersioninnatureaswellasdisconnectionfromtechnologyandthepaceofmodernlife.Plantodothisatleastonceortwiceperyear.Someideasareasfollows:
●Backpacking
●Carcamping
●Glamping(luxurycamping)
●RVcamping
●Vacationinginacabin
●CONSIDERLIVINGWHERENATUREISMOREACCESSIBLE.Thisisnotachangethatispossibleforeveryone,butthenexttimeyouarelookingforanewlivingsituation,consideritsaccessibilitytolocalparks,openspace,hikingtrails,naturepreserves,andnationalparks.
CALLTOACTIONInthischapter,welookedattheimportanceofconnection,topeopleandtonature.Ourinterdependenceonothersandthenaturalenvironmentissoobviousbutveryoftenoverlooked.Thisisespeciallytruewhenitcomestotheirimportancetoourhealth.Itissoeasytodismisshowmuchahugorsunlightmatters,butthetruthisthatnoneofuswould
havemadeit,healthyandwhole,frominfancytonowwithoutthem.Understandingthesignificanceofconnectiontoothersandnature,evaluatingthestrengthofthoseconnections,andlearningwaystoenhancebothyoursupportnetworksandyourlinkstothenaturalworldarestepsthatwillpaydividendsonyourwellnessjourney.Althoughwepresenteditlast,webelievetakingtimetoconnectisessential,notjustanafterthought.AuthorBryantMcGillsumsitup:“Thereisadeepinterconnectednessofalllifeonearth,fromthetiniestorganisms,tothelargestecosystems,andabsolutelybetweeneachperson.”Wecannotbehealthywithoutconnection.
CHAPTER8
Recipes+MealPlan
You’vefinallyarrivedatthefunpartofthebook—ourcollectionofnutrient-denseanti-inflammatoryrecipes!AlloftheserecipesarecompliantwiththeeliminationphaseoftheAutoimmuneProtocolandavoidgrains,legumes,dairy,eggs,nuts,seeds,andnightshade-familyvegetablesandspices.Betteryet,theyincludehealingfoodsthatcontainpowerfulnutritionaimedatrestoringhealthandstrengtheningyourbody!AsyoulearnedinChapter3,thereisawidespectrumofpossibledietaryinterventionsforthosewithautoimmunedisease.Whetheryourgoalisjusttostarteatinggluten-freeortodiveinwiththeeliminationphase,thischapterwillserveasanincredibleresourceforyou.
Ifyouarenewtocookingforyourself,shortontimeorenergy,orwanttomaximizeyourtimespentinthekitchen,youareinluck—theserecipesaresimpletoexecute,don’tcontainalotofhard-to-findingredients,andstorewellintherefrigeratororfreezertohelpyougetaheadofthecurve.Mostofthemareone-pot,makingcleanupabreeze.Weknowhowlivingwithautoimmunediseasecanzapyourenergy,andcookingyourselfwholesomemealsshouldnotbejustanotherdrain!Bestofall,theserecipeswillkeeptherestofthefamilyhappy,too,whetherornottheyeatarestricteddiet.Ifyouarejustgettingyourfeetwet(seetheSlow-and-SteadyTransitionGuide)orjumpinginrightaway(seetheCold-TurkeyTransitionGuide),youwillfindsomethingofvaluehere.Inadditiontotherecipes,you’llfinda4-WeekMealPlanattheendofthechapter,completewithshoppinglists,toollists,pantrybasics,andaguideonselectingfood.Let’sgetcooking!
Anoteaboutbreakfast:You’llnoticethattherecipesincludedhereareafardeparturefromwhatiscommononthestandardAmericandiet.Choosetonourishyourselfwithacomplete,nutritiousmeal,evenifitcomesintheformofsoupforbreakfast.Eventhoughthiswayoflifeisn’tfamiliar,othercultureshavebeenenjoyingitforcenturies!
Recipes
BASICSBoneBroth
RenderedAnimalFat
NUTRIENT-DENSESTAPLESBacon–BeefLiverPâtéwithRosemaryandThyme
FermentedVegetables
GelatinGummies
BREAKFASTButternutBreakfastBake
Nutrivore’sBreakfast
GreenBreakfastSoup
DoublePorkPestoPattieswithWiltedChard
SOUPSANDSTEWSBalsamicBeefStew
ThaiSeafoodChowder
HiddenLiverChili
Lemongrass-ScentedChickenStew
BeefCurrySoup
MAINDISHESMoroccanChickenThighswithApricotsandOlives
Apple-BeetBurgerswithParsnipFriesandHorseradishSpread
LambTaginewithCauliflower“Rice”
EmeraldSalmonwithZestyGreenSauce
Citrus-GingerBrinedPorkRoast
SpatchcockedChickenwithTurmericVeggies
HerbedSeafoodBakewithBacon-RadicchioSalad
SALADS
CurriedChickenSalad
Cold“Noodle”andSalmonSalad
SteakSaladwithSpringVeggies
TunaSaladwithAvoorGarlic“Mayo”
TREATSRoastedStoneFruit
LemonPieDateBalls
Granitas
RaspberryPudding
No-BakeLemon-Vanilla“Cheesecake”
BASICS
BONEBROTH
TIME:8TO24HOURSMAKES:3TO4QUARTS
4quartsfilteredwater
2(ormore)poundsbonesfromagoodsource(knuckleandmarrowbonesworkwell,butyoucanuseanytype)
2tablespoonsapplecidervinegar
1bayleaf
STOVETOPMETHOD
1Placeallingredientsinalargestockpotorslow-cookerandbringtoaboil.Lowertheheatsothewaterisbarelysimmering;cover.
2Occasionallyskimthesurfaceforanyscumthatmayappearduringcooking.
3Cookforatleast8hoursandupto24hours,beingsuretocheckperiodicallytoensurethatthebrothisstillatabaresimmer.Thelongeryoucookthebones,themorerichandnutritiousthebrothwillbe.
PRESSURECOOKERMETHOD
1Placeallingredientsinapressurecooker,makingsurenottoexceedthefillline.Lockthelidandplaceoverhighheatuntilthecookercomestohighpressure,thenturndowntothelowestsettingthatwillmaintainthispressure(youmayneedtouseaflametamer).
2Letthebrothcookfor3hours,thenturnofftheheatandletthebrothdepressurizeandcoolnaturally.
WHENTHEBROTHISFINISHED(USINGEITHERMETHOD)
Letcool,thenstrainandportionthebrothintocontainersforstorage.Aftertheliquidisstrained,pickthroughanybonesthatarestillintactandsavethemtoaddtothenextbatch,tossingthosethatfellapart.(Youcanusuallygetafewbatchesoutoflargerbeefknucklebones,whilechickenboneslastonlyfor1or2batches).Youcanrefreezeusedbonesifyouarenotreadytomakeanotherbatchofbrothimmediately.
STORAGE:Keepsforaweekintherefrigerator.Alsofreezeswell.
VARIATION:Therearemanywaystovarybonebroth,suchasbrowningthebonesintheovenbeforecookingoraddingsomeherbsandspicesorvegetableswhileitiscooking.Weliketoavoidsaltingthebrothsothatitdoesn’timpacttheamountofsaltusedintherecipes.Thebrothcanalsobeboiledtoreducesothat
itisconcentratedandstoresmoreeasily.Asyoucontinuetomakebroth,youwillgetintoaflow,andcanmakeitaccordingtoyourpreference.
SOURCING:Bonesshouldnotbeexpensiveordifficulttofind.Thebestsourceisafarmeryoutrust,maybeatafarmers’marketorthroughacommunitysupportedagricultureprogram.Ifyoudon’thavethosesourcesavailabletoyou,alotofnatural-foodstoressellbonesfromgrass-fedmeat—besuretoaskthebutcherifyoudon’tseeanyavailable!Also,youcanstartabaginyourfreezerforstoringanybonesfromthemeatyouconsume.Justtossthemintothebag,andfreezetomakebrothatalatertime.Feelfreetouseanytypeofbones,eveniftheyhavebeenpreviouslycooked,tomakebroth—beef,lamb,chicken,andturkeyallworkwell(itisokaytocombinetypes).Ifyou’dliketopurchasealready-madebonebroth,checkoutResources.
RENDEREDANIMALFAT
TIME:2TO4HOURSMAKES:ABOUT2CUPS
1poundanimalfat,cold(lard,tallow,duckfat,orsuetworkswell)¼cupwater
1Cutthefatintosmallpieces—ideallysmallerthan1inch.Placetheminalargecast-ironpotoraslow-cookerwiththewaterandturntheheattothelowestsetting.
2Letthefatcookonlowforanhourorso,stirringeverysooften.
3Oncethereisaconsiderableamountoffatmelted(maybeathirdtoahalfofthesolidfat),strainmostofitthroughafine-meshstrainerintoanotherpotandsetasidetocool,leavingabout¼cupinwiththesolidfatandsetaside.Placetheremainingunrenderedfatbackonthestove.Continuedoingthisuntiltherearejustsolidsandnounrenderedfatleft.
4Onceallofthefatisinthesecondpotandwarmenoughtobeliquefiedbutnotstillhot,transferintoaglassjarforstorage.
STORAGE:Keepsforafewmonthsintherefrigerator.Alsofreezeswell.
NOTE:Youcantakethesolids(thecracklings)leftinthepotaftertherenderingprocessandbakethemfor20minutesat400°F.(Thismightalsoproducesomeextrarenderedfat!)Theymakeagreatcrunchysnackorsaladtopping.
SOURCING:Makesuretousefatfromhealthyanimals—thosethathavebeenraisedonpastureandfedanappropriatediet.Thesearelikelytohavethebestfattyacidprofileandnutrition.Youcaneithersavebitsoffatcutofffromlargerpiecesofmeattorenderorgetfatfromyourbutcher.SeeResourcesforsourcinganimalfatorpurchasingitalreadyrendered.
NUTRIENT-DENSESTAPLES
BACON–BEEFLIVERPÂTÉWITHROSEMARYANDTHYME
TIME:35MINUTESMAKES:ABOUT2CUPS
6slicesbacon(checkingredientstoensureitisgluten-andnightshade-free)
1smallonion,minced4clovesgarlic,minced
1poundgrass-fedbeefliver,rinsed,dried,andslicedinto2-to3-inchpieces2tablespoonsmincedfreshrosemary
2tablespoonsmincedfreshthyme⅓cupcoconutoil,melted
½teaspoonseasaltFreshherbs,forgarnish
Carrotorcucumberslices,forserving
1Cookthebaconslicesovermediumheatinacast-ironskillet,flippingasneeded.Cookuntilcrispy.Transfertoapapertowel–linedplatetocool,reservingthefatinthepan.
2Addtheonionsandcookonmedium-highheatforabout5minutes,stirring.Addthegarlicandcookforaminute,thenaddtheliver,rosemary,andthyme.Cookfor2to5minutesperside,oruntiltheliverisnolongerpinkinthecenter.Setasidetocoolforafewminutes.
3Transferthemixtureintoablenderorfoodprocessorwiththecoconutoilandseasalt.Processuntilitformsathickpaste.
4Placethepâtéintoasmallbowl.Chopthecooledbaconintothebowlinfinepiecesandcombine.
5Garnishwiththefreshherbsandservewithvegetableslices.
STORAGE:Keepsintherefrigeratorforseveraldays.Alsofreezeswell.
NOTE:Thisrecipeisdifficulttomakeinastandardblender;youreallyneedahigh-poweredmachinewithatamperforbestresults.Alternately,youcoulduseafoodprocessor.
FERMENTEDVEGETABLES
TIME:20MINUTES,PLUS2TO3WEEKSFORFERMENTATIONMAKES:2QUARTS
4–5poundscabbage(about2heads)2tablespoonsseasalt,ormoreifneeded
YOUALSONEED
2(1-quart)glassjarswithairlocksTamper(optional)
Cleanfermentingweightsorstones
1Finelyshredthecabbageandplaceitinabowlinbatches,sprinklingeachbatchwithalayerofseasalt.Whenyouarefinishedwiththeshredding,useyourhandstomassagethecabbagewelluntilitbreaksdownandbecomessoft(about10minutes).Letitsitfor10minutestoreleaseitsjuices.
2Packthecabbageverytightlyintojars,pushingallofitdownuntilitiscompletelysubmergedbyitsownjuices(atamperishelpfulhere).Leaveabout1½inchesofheadspace,andaddsomeadditionalbrine(madebydissolving1teaspoonseasaltin1cupwater)ifthereisnotenoughliquidtofullysubmergethecabbage.Placefermentingstonesontoptoweighdownthecabbage,tightenthelidandensuretheairlockisinstalledproperly(refertotheinstructionsthatcamewithyourunit,astheycanvary).Itispossibletofermentwithoutanairlock,justbesureallofthecabbageissubmerged,andcheckitoftentomakesureitisn’tspoiled.
3Letthecabbagefermentatroomtemperaturefor2to3weeks;duringthistime,thevegetableswillbubblealittleandintensifyinflavor.Ifanyscumappears,removeitwithaspoon.Tasteitstartingat2weeks,andwhenthetasteistoyourliking,youcanremovetheairlockandweights,putaregularlidonthejars,andstoreintherefrigerator.
STORAGE:Fermentedvegetableswillkeepforafewmonthsintherefrigerator.
VARIATION:Thepossibilitiesforvaryingyourfermentedvegetablesareendless—youcanusedifferenttypesofcabbage,carrots,beets,garlic,ginger,andmanyothervegetablesindifferentcombinationstomakearicharrayoftastyprobioticfoods.CheckResourcesforlinkstogreatwebsitesdedicatedtofermentation.
GELATINGUMMIES
TIME:15MINUTES,PLUS8HOURSTOSETMAKES:2TO3DOZEN
POMEGRANATE1½cupspomegranatejuice
2lemons,juiced⅓cupgrass-fedgelatin
¼cuprawhoney
BLUEBERRY1½cupsblueberryjuice/extract
2lemons,juiced⅓cupgrass-fedgelatin
¼cuprawhoney
CITRUS-GINGER1cuporangejuice(from3–4oranges)
½cuplemonjuice(from6–8lemons)⅓cupgrass-fedgelatin
¼cuprawhoney1teaspoongroundginger
1Tomakeoneoftheflavoroptions,beginbycombiningthefruitjuicesinasmallsaucepanandsprinklingthegelatinontop.Donotstir.Setasidefor5to10minutes,untilthegelatinhas“bloomed”orabsorbedalloftheliquid.
2Meanwhile,addthehoney(andginger,ifmakingCitrus-Gingeroption)toasmallbowlwithapourspout.
3Whenthegelatinhasbloomed,placeitonthestoveandturnontheheattothelowestsetting.Heatfor30secondsto2minutes,stirringconstantlywithawhisk,untilcompletelyliquidandthegelatinhasdissolved.Becarefulhere,asyoudonotwanttheliquidtosimmerorgethotterthanitneedsto—thiswillcausethegummiestostink.
4Immediatelypourthegelatinmixtureintothecontainerwiththehoneyandstirtocombine.Pourintosiliconemoldsorthebottomofasmallroastingdish.
5Letchillfor8hoursintherefrigerator.Ifyouusedmolds,placetheminthefreezerfor5minutes;thiswillmakethemreleasemoreeasily.Ifyouelectednottousemolds,sliceinto1-inchsquaresandserve.
STORAGE:Keepsforaweekortwointherefrigerator;donotfreeze.
NOTE:Lookforhigh-quality,grass-fedgelatinonlinefromeitherGreatLakesorVitalProteinsandgummymoldsatvariousonlineretailers(seeResources).
VARIATION:Thisrecipetastesgreatwithvariousfruitjuices,althoughthosethataremoreconcentratedandtart(cranberry,forexample)tastebest.Pineapplejuicewon’tworkbecauseithasenzymesthatbreakdownthegelatin.
BREAKFAST
BUTTERNUTBREAKFASTBAKE
TIME:1HOUR,20MINUTESSERVES:4TO6
1½poundsgrass-fedgroundbeef
3leeks,whiteandlightgreenpartsonly,chopped2teaspoonsgroundcinnamon,divided
1teaspoonseasalt½teaspoongroundcloves
½teaspoongroundginger1butternutsquash,peeledandcutinto1½-inchchunks(about4cups)
2sweetapples,coredandchopped(about2cups)¼cupcoconutoil,melted
3tablespoonschoppedfreshparsley
1Preheattheovento400°F.
2Brownthegroundbeefinaheavy-bottomedskilletonmedium-highheat,makingsuretostiroccasionallytoensureevenbrowning.Whenthebeefisfullycooked,spoonintoalargebowl,reservingthejuicesinthepan.
3Turntheheattomediumand,inthesamepanwiththereservedjuices,sautétheleeksuntiltender,about4minutes.Add1teaspoonofthecinnamon,thesalt,cloves,andgingerandstirtocombine,cookingjustuntilfragrant.
4Addtheleekmixture,squash,apples,andcoconutoiltothebowlwiththebeef,andstirtocombine.Pourintoa9by13-inchbakingdish,covertightlywithfoil,andbakefor45to50minutes,oruntilthesquashistender.
5Removethefoilandsprinklewiththeremainingteaspoonofcinnamonandtheparsley.
STORAGE:Keepsforaweekintherefrigerator.Alsofreezeswell.
VARIATION:Ifyoucan’tgetyourhandsonbutternutsquash,feelfreetouseadifferentvariety(likeacorn),orsubstitutesweetpotatoes.
NUTRIVORE’SBREAKFAST
TIME:1HOUR,15MINUTESSERVES:6TO8
VEGETABLES2largesweetpotatoes,cutinto1½-inchchunks(about6cups)
2tablespoonssolidcookingfat,melted½teaspoonseasalt
1bunchofkale,stemsremovedandfinelyshredded
PATTIES2poundsgrass-fedgroundbeef
¼cupgrass-fedbeefliver,groundorgrated(seeNotes)1tablespoonmincedfreshoregano
1tablespoonmincedfreshrosemary1tablespoonmincedfreshthyme
1teaspoonseasalt½teaspoongarlicpowder
¼teaspoononionpowder
1Preheattheovento400°F.
2Placethesweetpotatoesinalargebowlwiththecookingfatandseasalt,andstirtocombine.Transfertoabakingdishandplaceintheoven,cookingfor30minutesandbeingsuretostironceortwice.
3Whilethesweetpotatoesarecooking,addallofthepattyingredientstoalargebowlandcombineusingyourhands.Forminto6to8patties,placeonaplate,andsetaside.Ifyouarepreppingtheuncookedpattiestocooklater,placetheminastoragecontainerseparatedwithslicesofwaxpaperandplacethemintherefrigeratorforstorage.
4Whenyouarereadytocookthepatties,placeaskilletonmediumheat.Whenitishot,addthepattiestothepan,andcookfor10minutes,flippingonceortwice,untilcookedthrough.
5Addthekaletothesweetpotatoesandstirtocombine.Placebackintheovenandcookforanother5minutes,oruntilthesweetpotatoesaresoft.Serveeachpattyonabedofkaleandsweetpotatoes.
STORAGE:Preppedpattieskeepfor3to4daysintherefrigerator;cookedpattieskeepfor5to6days,andthevegetableskeepforaweek.
NOTES:Ifyouaregoingtobatch-cookthisrecipe,itisbesttoprepthepattiesandcookthemfreshasyoueatthem(itonlytakes10minutesinthemorning!).Ifyouneedthemtolastlongerthanafewdays,youwillwanttocookthembeforestoringintherefrigeratororfreezing.Wefindthattheytastebestwhencookedfresh.
Insteadofpreparingthelivereverytimewemakethisrecipe,weliketohavesomegratedorshreddedliveralreadyfrozenandreadytogo.Takeachunkoffrozenliverandeitherusetheshredderbladeonyourfoodprocessororaboxgratertoprocessit,andthenfreezein½-poundbatchestoaddtothepattiesorotherrecipeslikeourHiddenLiverChili.
GREENBREAKFASTSOUP
TIME:2HOURS,30MINUTESSERVES:8TO10
1large,wholepasturedchicken(5–6pounds)
1bayleaf1tablespoonapplecidervinegar
1tablespoonseasalt+additional,totaste2tablespoonssolidcookingfat
1onion,chopped4clovesgarlic,minced
⅓cuppeeledandmincedfreshginger(3-to4-inchpiece)2largesweetpotatoes,choppedinto1½-inchchunks(about6cups)
2largezucchini,choppedinto1½-inchchunks(about2cups)1bunchSwisschard,stemsandleavesdividedandchopped
2cupsbuttonmushrooms,thinlysliced1bunchgreenonions(endsremoved),thinlysliced,forserving
1lemon,cutintowedges,forserving
1Beginbycleaningthechicken(rinseitundercoldwaterandremoveloosebitsoffatandothertissue).Placeitinalargestockpot.Ifitdoesn’tfit,youwillhavetocutitintohalvesorquarters(kitchenshearshelphere—startbycuttinguponesideofthebackbone).
2Addthebayleaf,vinegar,and1tablespoonseasalt.Fillthepotwithcoldwateruntilthechickenisjustcovered.Bringtoaboil,andthencovertightlyandlowertheheattoabaresimmer.Cookuntilthemeatistenderandfallingoffthebone,60to90minutes—thelowerthesimmer,themoretenderthechickenwillcomeout.Skimthesurfaceofthebrothtoremoveanyscumthatmayappearduringcooking.
3Removethechickenfromthepotandsetasidetocool.Pourthebroththroughafine-meshstrainer,beingcarefultosavethebrothinanotherpot!Discardthebayleaf.
4Placetheemptypotbackonthestove,addthesolidcookingfat,andturntheheattomedium.Whenthefathasmeltedandthepanishot,addtheonionsandcook,stirring,for7minutes,oruntiltranslucent.Addthegarlicandgingerandcook,stirring,foranotherfewminutes,untilfragrant.
5Whiletheonionsarecooking,removethemeatfromthechickencarcass,shreditwithtwoforks(CAUTION:hot!),andsetitasideinabowl.KeepthebonestoaddtoyournextbatchofBoneBroth.
6Addthesweetpotatoesandbrothbacktothepot,bringtoaboil,andthen
coverandturndowntoasimmer.Cookfor10minutes.
7Addthezucchini,chardstems,andmushrooms,andcookforanother5minutes,oruntilthevegetablesaretender.Turnofftheheatandstirinthechardleaves.
8Carefullytransferhalfofthesouptoablender,blendfor30seconds,andtransferbacktothepot.Alternately,youcoulduseanimmersionblendertoblendabouthalfofthevegetables.(CAUTION:Makesureyouhaveablenderthatcanhandlehotliquid,andmakesuretouseatowelabovethelidtoprotectyourhandsfromgettingburned.)9Returntheblendedliquidtothesouppot,withthechicken.Addsalttotaste.
10Serveeachbowlgarnishedwithgreenonionsandasqueezeoffreshlemonjuice.
STORAGE:Keepsforaweekintherefrigerator.Alsofreezeswell.
NOTE:Dependingonthesizeofchickenyouhave,thisrecipemaytakeafairlylarge(7-to8-quart)souppot.Ifyoursisn’tthatlarge,youwillwanttouseasmallerchicken(2to3pounds)andscaledownthesweetpotatoes.
DOUBLEPORKPESTOPATTIESWITHWILTED
CHARD
TIME:25MINUTESSERVES:4
1cuppackedbasil⅓cupoliveoil
1teaspoonlemonjuice1clovegarlic,minced
1poundpasturedgroundpork4slicesbacon,minced(checkingredientstoensureitisgluten-andnightshade-free)
2largebunchesrainbowchard,toughstemsremoved,leavescutintolongribbonsSalt,totaste
1Placethebasil,oliveoil,lemonjuice,andgarlicinablenderorfoodprocessorandprocessonhighuntilsmooth.Setaside.
2Placethegroundporkandbaconinalargebowl,addthebasilmixture,andcombineallingredientsbyhand.Form4largepatties.
3Preheataheavy-bottomedskilletonmedium-highheat.Whenthepanishot,addthepattiesandcookfor5to7minutesperside,untilcompletelycookedthrough.Removeandsetaside,reservingthejuicesinthepan.
4Turntheheatdowntomedium,andaddthechardtotheskillet.Don’tworryifitdoesn’tallfitinitially—youcancontinuetoaddchardasitwilts.Cook,stirring,untilthechardiswiltedandtheliquidevaporates,7to8minutes.Seasonwithsalt.
STORAGE:Prepped,uncookedpattieskeepfor3to4daysinthefridge;cookedpattieskeepfor5to6days,andthewiltedchardkeepsforabout2days.Freezebetweenslicesofwaxpaperforlong-termstorage.
NOTE:Ifyouarefollowingthisrecipeasapartofthemealplan,cookthepattiesaswrittenbuthalvethechardportion,usingonlyonebunchofchard.Cookthesecondbunchfreshonthethirdday—itonlytakesafewminutes!
SOUPSANDSTEWS
BALSAMICBEEFSTEW
TIME:50MINUTESTO8HOURS,DEPENDINGONCOOKINGMETHODSERVES:6
1½poundsgrass-fedbeefstewmeat
1tablespoonseasalt2tablespoonssolidcookingfat
1onion,chopped3clovesgarlic,minced
1tablespoonmincedfreshthyme2largesweetpotatoes,peeledandchopped(about6cups)
6carrots,peeledandchopped(about3cups)2ribscelery,chopped(about1cup)
1½cupsBoneBroth½cupbalsamicvinegar
2tablespoonscoconutoil
1Placethemeatinasmallbowlandcoatwiththesalt.Heatthesolidcookingfatinaheavy-bottomedskilletonmedium-highheat.Whenthefathasmeltedandthepanishot,addthestewmeat.Cookfor5minutes,turningoccasionallyforevenbrowning.Placethebrownedmeatinthebottomofaslow-cookerorpressurecooker.
2Turntheheatdowntomediumandaddtheonionstotheskillet,cookingfor7minutes,untiltranslucent.Addthegarlicandthyme,andsautéforanothercoupleofminutes,untilfragrant.Turnofftheheatandaddtothemeatintheslow-cookerorpressurecooker.
3Addthesweetpotatoes,carrots,celery,and1cupofthebrothtothemeatmixtureandcookonlowfor8hoursorhighfor4hours,ifusingaslow-cooker.Alternately,cookfor35minutesunderhighpressureusingapressurecooker.
4Addtheremaining½cupbroth,thevinegar,andcoconutoiltotheskilletusedfortheonionmixture.Bringtoaboil,turndowntoasimmerandreducebyhalf.Placeintherefrigeratorasthestewcooks.
5Whenthestewisfinishedcooking,stirinthevinegarmixtureandservehot.
STORAGE:Keepsforaweekintherefrigerator.Alsofreezeswell.
NOTE:Usearefinedcoconutoilforthisrecipetoavoidanoverlystrongcoconutflavor.
THAISEAFOODCHOWDER
TIME:40MINUTESSERVES:6
6cupsBoneBroth1piece(1-inch)freshginger,peeledandgrated
1lime,zested(zestreserved)andcutintowedges4clovesgarlic,minced
1tablespoonseasalt2whitesweetpotatoes,peeledandcutinto1½-inchchunks(about4cups)
1tablespoonsolidcookingfat2cupsshiitakemushrooms,sliced(usebuttonmushroomsifyoucan’tfindthem)
1bunchgreenonions(endsremoved),chopped1largeheadofbokchoy,chopped
1poundshrimp,peeled,deveined,andtailsremoved½poundfirmwhitefish(likecodorhalibut),chopped
1(14-ounce)canfull-fatcoconutmilk(checkingredientstoensurenothickenersoradditives)
1cuppackedbasil,chopped
1Combinethebroth,ginger,limezest,garlic,seasalt,andsweetpotatoesinalarge,heavy-bottomedpot.Bringtoaboil,reducetoasimmer,andcookfor12minutes,uncovered.
2Meanwhile,heatthesolidcookingfatinaheavy-bottomedskilletonmediumheat.Whenthefathasmeltedandthepanishot,addthemushroomsandgreenonions.Sautéuntilthemushroomsaretender,about4minutes.Stirthemushroommixtureandbokchoyintothebrothmixture.
3Stirintheshrimp,fish,andcoconutmilk.Bringbacktoasimmerandcookforanotherfewminutes,untiltheshrimpandfisharecookedthroughandappearopaque.
4Servewithbasilandlimewedges.
STORAGE:Keepsforafewdaysintherefrigerator.
HIDDENLIVERCHILI
TIME:1HOUR,15MINUTESSERVES:6
3–4slicesbacon(checkingredientstoensureitisgluten-andnightshade-free)1yellowonion,chopped
4clovesgarlic,minced2cupsBoneBroth
1teaspoonseasalt3parsnips,cutinto1½-inchchunks
2carrots,chopped4ribscelery,chopped
¼cupfreshoregano,minced2poundsgrass-fedgroundbeef
2(15-ounce)canspumpkinpuree(checkingredientstoensurenothickenersoradditives)½poundgrass-fedbeefliver,groundorgrated(seeNote)
1lemon,juiced1½tablespoonsgratedfreshginger
Avocadoslices,forgarnish
1Addtheslicesofbacontoalargeheavy-bottomedpotonmediumheat,andcook,turningwhennecessary,untilcrispy,about10minutes.Setasidetocool.Crumble,leavingthefatinthepan.
2Addtheoniontothepanandcookfor5to7minutes,stirring,untiltranslucent.Addthegarlicandcookanother3minutes,untilfragrant.
3Addthebonebroth,seasalt,parsnips,carrots,celery,andoreganotothepot,bringtoaboil,andturndowntoasimmer.Cook,covered,for20minutes.
4Meanwhile,brownthegroundbeefinaskilletonmedium-highheat,beingsuretostiritoccasionallysothatthemeatisbrownedevenly.
5Addthepumpkin,groundbeef,andlivertothepotwiththevegetablesandcookforanother10minutes,untilthevegetablesaretender.
6Addthelemonjuiceandfreshginger,andservegarnishedwithavocadoslicesandcrumbledbacon.
STORAGE:Keepsforaweekintherefrigerator,withouttheavocado.Alsofreezeswell.
NOTE:Insteadofpreparingthelivereverytimewemakethisrecipe,weliketo
havesomegratedorshreddedliveralreadyfrozenandreadytogo.Takeachunkoffrozenliverandeitherusetheshredderbladeonthefoodprocessororaboxgratertoprocessit,andthenfreezein½-poundbatchestoaddtothischili.
LEMONGRASS-SCENTEDCHICKENSTEW
TIME:2HOURSSERVES:8
1large,wholepasturedchicken(5–6pounds)1bayleaf
4stalkslemongrass2tablespoonssolidcookingfat
1onion,chopped1piece(2inches)freshginger,peeledandminced
1piece(2inches)freshturmeric,peeledandminced1largebutternutsquash,peeled,seeded,andcubed(about6cups)
1lemon,juiced1teaspoonseasalt
1bunchcilantro,stemsremovedandroughlychoppedAvocado,forgarnish(optional)
1Beginbycleaningthechicken(rinseitundercoldwaterandremoveloosebitsoffatandothertissue).Placeitinalargestockpot.Ifitdoesn’tfit,youwillhavetocutitintohalvesorquarters(kitchenshearshelphere—startbycuttinguponesideofthebackbone).
2Fillthepotwithcoldwateruntilthechickenisjustcovered.Addthebayleaf,cover,andbringtoaboil,turningdowntoabaresimmer.Cookuntilthemeatistenderandfallingoffthebone,60to90minutes.Thelowerthesimmer,themoretenderthechickenwillcomeout.Skimthesurfaceofthebrothtoremoveanyscumthatmayappearduringcooking.
3Meanwhile,sliceofftherootendsofthelemongrassstalks,aswellasthegreenpart5to6inchesfromthebottom.Taketheflatpartoftheknifeandpressdownonthelemongrassonthecuttingboard—thisiscalledbruisinganditwillhelpreleasetheoilsandflavorthestew.Setasidewiththeotherspices.
4Removethechickenfromthepotandsetitaside.Pourthebroththroughafine-meshstrainer,beingcarefultocatchthebrothinasecondpot!Discardthebayleafandsetthebrothaside.
5Placetheemptystockpotbackonthestoveandheatthecookingfatonmediumheatuntilitismeltedandthepotishot.Addtheonions,andcookforabout5minutes,stirring,untiltheybegintosoftenandbrownslightly.Addthelemongrassstalks,ginger,andturmeric,andcookforafewmoreminutes,
stirringtoensurethattheydon’tburn.
6Addthebutternutsquash,reservedbroth,lemonjuice,andseasalttothepot.Bringtoaboilandthenturndowntoasimmer.Cookfor5minutes.
7Meanwhile,usetwoforkstoremovethemeatfromthechicken(CAUTION:hot)andsetaside.KeepthebonestoaddtoyournextbatchofBoneBroth.
8Removethelemongrassstalksfromthestew,andaddthechicken.Cookforanother5to10minutes,oruntilthesquashisjusttender.
9Whenthestewisfinished,turnofftheheatandstirinthecilantro.Servegarnishedwithfreshavocado,ifusing.
STORAGE:Keepsforaweekintherefrigerator;freezeswell.
NOTE:Dependingonthesizeofchickenyouhave,thisrecipemaytakeafairlylarge(7-or8-quart)souppot.Ifyoursisn’tthatlarge,youwillwanttouseasmallerchicken(2to3pounds)andscaledownthebutternutsquash.
VARIATIONS:Don’thavewintersquash?Thisstewtastesgreatwithcarrots,butyouwillneedtoextendthecookingtimeinstep6to30minutes.Don’thavefreshgingerorturmeric?Substitute1teaspoondriedgingerand1teaspoongroundturmericforfresh.Don’thavetimetocookthechicken?Useacleanrotisserieorpreviouslycookedchickenand4quartsofbonebrothandskipsteps1,2,and4.
BEEFCURRYSOUP
TIME:1HOUR,45MINUTESSERVES:4
2tablespoonssolidcookingfat1½poundsgrass-fedbeefstewmeat
1largeyellowonion,chopped3clovesgarlic,minced
1piece(1½inches)freshginger,peeledandminced1½cupsBoneBroth
½cupwater1tablespoonapplecidervinegar
1teaspoonseasalt+additionaltotaste4largeparsnips,choppedinto1½-inchchunks
3largecarrots,chopped1tablespoongroundturmeric
⅛teaspoongroundcinnamon1(14-ounce)canfull-fatcoconutmilk(checkingredientstoensurenothickenersoradditives)
1bunchkale,stemsremovedandchopped1bunchcilantro,stemsremovedandroughlychopped
Juicefrom1lime
1Heatthesolidcookingfatinalargeheavy-bottomedpotonmedium-highheat.Whenthefathasmeltedandthepanishot,brownthestewmeatfor5to7minutes,stirringonceortwicetobrownevenly.Removetoaplateandsetaside.Ifyourpotistoosmalltofitallofthestewmeatonthebottomwithouttouching,brownintwobatches.
2Turntheheatdowntomediumandaddtheonions.Cookfor7minutes,oruntiltranslucent.Addthegarlicandgingerandcookforanothercoupleofminutes,stirring,untilfragrant.
3Addthebonebroth,water,vinegar,1teaspoonseasalt,andbrownedmeattothepot.Bringtoaboil,cover,andthenturndowntoabaresimmerandcookfor30minutes.Checktomakesurethestewiscookingataverylowsimmerandnotboiling;thiswillensurethatthemeatstaystender.
4Addtheparsnips,carrots,turmeric,andcinnamontothepot.Cookatabaresimmerforanother45minutes,oruntilthevegetablesarejusttender.
5Addthecoconutmilkandkaletothepot.Continuetocookatabaresimmerforanother10minutes,beingsuretostiracoupletimesasthekalecooksandreducesinsize.
6Turnofftheheat,stirinhalfofthecilantroandallofthelimejuice,andsalt,totaste.Servewarm,garnishedwiththeremainderofthecilantro.
STORAGE:Keepswellintherefrigeratorforaweek.Alsofreezeswell.
VARIATIONS:Can’tfindparsnips?Userutabagasorturnipstoswitchthingsup!Thisrecipealsoworkswellwithalternategreens(likecollardsorchard)aswellaslamborgoatinsteadofthebeef.
MAINDISHES
MOROCCANCHICKENTHIGHSWITHAPRICOTSANDOLIVES
TIME:1HOUR,15MINUTESSERVES:4
2tablespoonssolidcookingfat
2poundspasturedboneless,skin-onchickenthighs1onion,chopped
1piece(1½inches)freshginger,peeledandminced3clovesgarlic,minced
3largecarrots,chopped5ribscelery,chopped
1cupBoneBroth½cupdriedapricots,quartered
½cupgreenolives,halved(withoutpimento)1lemon,endstrimmed,halvedlengthwise,andthinlysliced
¾teaspoonseasalt½teaspoongroundturmeric
¼teaspoongroundcinnamon1tablespoonmincedfreshoregano
1Heatthesolidcookingfatinalargeheavy-bottomedpotonmedium-highheat.Whenthefathasmeltedandthepanishot,addthechickenthighs,skin-sidedown,cookingononesidefor3to5minutesoruntiltheskinisgoldenbrownandcrispy.Don’tfusswiththemtoensurethattheygetcrispy!Removefromthepanandsetaside.
2Turntheheatdowntomedium.Addtheonions,andcook,stirring,for5to7minutes,oruntiltranslucent.Addthegingerandgarlic,andcook,stirringforanothercoupleofminutes,untilfragrant.Addthecarrotsandceleryandcook,stirring,for5moreminutes.
3Addthebonebrothtothepot,alongwiththeapricots,olives,lemon,seasalt,turmeric,andcinnamon.Stirtocombine.Addthechickenbacktothepot,nestingitintothevegetablesandliquid,crispy-skin-sideup,andsprinklewiththeoregano.Itmayseemlikethepotdoesn’thavealotofliquid,butthechicken
willsoftenupandbecomemorejuicyasitcooks.Turndowntomedium-low,cover,andsimmerfor20minutes.Rearrangethechickensothatitisjustnestedintothevegetables(thereshouldbemoreliquidnow)andcoverandsimmerforanother10minutes,oruntilthechickeniscookedthrough.
4Servewarm.
STORAGE:Keepsintherefrigeratorforaboutaweek;alsofreezeswell.
APPLE-BEET BURGERS WITH PARSNIP FRIES
ANDHORSERADISHSPREAD
TIME:50MINUTESSERVES:4
FRIES2poundsparsnips,peeledandslicedinto“fries”
2tablespoonsseasalt2tablespoonssolidcookingfat,melted
BURGERS
1poundgrass-fedgroundbeef½cupgratedbeet(about1smallbeet)(seeNote)
½cupgratedsweetapple(about1smallapple)¼cupmincedwhiteonions
1teaspoonsmokedseasalt2teaspoonsmincedfreshthyme
SPREAD
½cuppeeled,gratedfreshhorseradish¼cupmincedfreshchives
1tablespoonapplecidervinegar1teaspoonhoney
3tablespoonsoliveoil
1Preheattheovento425°F.Linetwobakingsheetswithparchmentpaper.
2Placetheparsnipsinalargebowlandtosswiththesaltandfat.Spreadevenlyonbothofthebakingsheets,andplaceintheovenfor25to30minutestocook,tossingonce.
3Whiletheparsnipsareintheoven,combinealloftheburgeringredientsinalargebowlandmixbyhandtocombine.Forminto4largepatties.
4Heatthegrilloraheavy-bottomedskilletonmedium-highheat.Whenthegrillorpanishot,cookthepattiesfor8minutesperside,oruntilfullycooked.
5Combineallofthespreadingredientsinasmallbowlandwhisktogether.Setaside.
6Wheneverythingisfinishedcooking,servewarmwiththehorseradishspread
ontopoftheburgers.
STORAGE:Pattiesandparsnipskeepfor5to6days;spreadkeepsfor2to3days.
NOTE:Becauseofthecolorofthebeets,theseburgersmayappearundercookedwhentheyaredone.Whenindoubt,useathermometertomakesuretheyreach155°Finternally.
LAMBTAGINEWITHCAULIFLOWER“RICE”
TIME:50MINUTESTO8HOURS,DEPENDINGONCOOKINGMETHODSERVES:4
1poundlambstewmeat1tablespoonseasalt
4tablespoonssolidcookingfat,divided½cupdriedapricots,halved
½cupprunes,halved½cupraisins
¾cupBoneBroth2tablespoonsapplecidervinegar
2tablespoonslemonjuice1teaspoongroundcinnamon
1teaspoongroundginger1teaspoongroundturmeric
1smallredonion,diced1headcauliflower,roughlychopped
1Placethestewmeatinasmallbowlandcoatwiththesalt.
2Place2tablespoonsofthesolidcookingfatinaheavy-bottomedskilletonmedium-highheat.Whenthefathasmeltedandthepanishot,addthestewmeat,turningeveryfewminutestoensureevenbrowning.
3Placethestewmeatandtheremainingingredients,exceptthecauliflower,intoaslow-cookerorpressurecooker.Cookonlowfor8hoursorhighfor4hours,ifusingaslow-cooker.Cookfor35minutesunderhighpressureusingapressurecooker.
4Beforethetaginefinishescooking,processthecauliflowerinafoodprocessorbypulsinguntilrice-sizegranulesform.Becarefulnottooverprocess.Setaside.
5Placetheremaining2tablespoonsofsolidcookingfatinaheavy-bottomedskilletonmediumheat.Whenthefatismeltedandthepanishot,sautéthecauliflowerfor5minutes,stirring,untilsoft.
6Servethetagineoverthewarmcauliflower.
STORAGE:Keepsforaweekintherefrigerator.Freezeswell.
EMERALD SALMON WITH ZESTY GREENSAUCE
TIME:45MINUTESSERVES:4
SALMON1crownbroccoli,choppedinto1½-inchpieces
½bunchasparagus,stemmedandcutintothirds1bulbfennel,choppedinto1½-inchpieces
2tablespoonscoconutoil,melted¾teaspoonseasalt,divided
1poundwild-caughtsalmonfillet
SAUCE1bunchcilantro,stemsremoved(about1cup)
2clovesgarlic,roughlychopped1piece(½inch)ginger,peeledandroughlychopped
⅓cupoliveoilJuiceandzestof½lemon2tablespoonswater
¼teaspoonseasalt
1Preheattheovento425°F.Placethebroccoli,asparagus,andfennelinalargebowl.Addthecoconutoiland½teaspoonoftheseasalt,andstiruntilallofthevegetablesarecoatedinoilandsalt.
2Transferthevegetablestoalargerimmedbakingtrayordish,makingsuretheyarearrangedevenly.Placeintheovenandcookfor10to12minutes,oruntilthevegetablesarejustsoftened.
3Makeaspaceforthesalmoninthemiddleofthebakingdishbymovingthevegetablestotheoutside.Placethesalmoninthebakingdish,sprinklewiththeremaining¼teaspoonseasalt,andarrangethevegetablesaroundit.Placeintheovenandcookfor10to15minutes,oruntilthethickestpartofthesalmonisopaqueandflakeseasilywithafork(thecookingtimewillvarydependingonhowthickthefishis).
4Meanwhile,placeallofthesauceingredientsinablenderandblendonhighfor30seconds,untilthoroughlycombined.
5Servethevegetablesandsalmonwarm,drizzledwithagenerousportionofthegreensauce.
STORAGE:Salmonkeepsforacoupleofdaysintherefrigerator;vegetablesandsaucewillkeepforaweek.Saucefreezeswell.
VARIATION:ThisrecipeworksgreatwithBrusselssproutsinsteadofbroccoli.
CITRUS-GINGERBRINEDPORKROAST
TIME:4HOURS,PLUS6TO8HOURSFORBRININGSERVES:4TO6
BRINE8cupswater,divided
½cupchoppedfreshginger½cupseasalt
1tablespoonorangezest1½cupsorangejuice
1tablespoonapplecidervinegar2–3poundspasturedporkroast
RUB
1tablespoonorangezest1tablespoonpeeledandgratedfreshginger
¾teaspoonthyme2clovesgarlic,minced
VEGETABLES
1butternutsquash,peeledandchoppedinto1½-inchchunks(about4cups)1poundcarrots,peeledandchopped(about4cups)
1cuppackedfreshbasil⅓cupoliveoil
2teaspoonsorangejuice2teaspoonsorangezest
½teaspoonseasalt1clovegarlic,minced
1Tomakethebrine,boil4cupsofthewaterwiththeginger.Allowtocoolandmixwiththeremainingbrineingredients(includingtheremainingwater),excepttheporkroast.Placetheroastinalargecoveredpot(slow-cookerinsertsworkreallywell),pourthebrineliquidoverit,andcover.Placethepotintherefrigeratorfor6to8hours(seeNote).
2Draintheroastanddiscardthebrine.Rinsetheroastwithcoolwater,patdry,andplaceinaroastingpan.Setaside.
3Preheattheovento225°F.
4Placealloftherubingredientsinafoodprocessororblenderandprocessfor
30seconds,oruntilcombined.Coattheentireroastinthismixture.Leavingthefatcapfacingup,placetheroastintheoventocookfor3hours,oruntiltheinternaltemperaturereaches145°F.
5Whiletheroastiscooking,placethesquashandcarrotsinalargebowl.Processthebasil,oliveoil,orangejuice,orangezest,seasalt,andgarlicinafoodprocessororblenderuntilsmooth.Pouroverthevegetablesandstirtocoat.Placethevegetablesinasinglelayeronabakingsheet.
6Whentheroastisfinished,removefromtheoven,tentwithfoil,andallowtorestfor20minutesbeforecarving.Turntheoventemperatureupto400°F.Roastthevegetablesintheovenfor30minutes,stirringoncehalfwaythroughforevenbrowning.
7Carvetheroastasthevegetablesfinishcooking,andservetogether.
STORAGE:Keepsforaweekintherefrigerator.
NOTE:Don’texceed8hoursofbriningforthisrecipe.
SPATCHCOCKED CHICKEN WITH TURMERIC
VEGGIES
TIME:1HOUR,30MINUTESSERVES:4
2poundsrutabagas(about2),choppedinto1-inchchunks5largecarrots,choppedinto1-inchchunks
1greenapple,coredandchoppedinto1-inchchunks2tablespoonssolidcookingfat,melted
1½tablespoonsmincedfreshthyme½teaspoongroundturmeric
1½teaspoonsseasalt,dividedGroundcinnamon
1pasturedchicken(4–5pounds)½teaspoongarlicpowder
½teaspoononionpowder
1Preheattheovento425°F.Placethechoppedrutabagas,carrots,andapplesintoalargemixingbowl.Addthecookingfat,thyme,turmeric,½teaspoonoftheseasalt,andapinchofcinnamon,andstiruntilwellcombined.
2Transferthevegetablestoalargerimmedbakingtrayordish,makingsuretheyarearrangedevenly.Setaside.
3Rinsethechickenthoroughlyundercoldwater.Placethechicken,breast-sidedown,inthesink,andusingapairofkitchenshears,cutalongthebackbone,startingjusttotherightofthetailandthenendingattheneck.Repeattheprocesstotheleftofthetail.Removethebackboneandreserveforbroth-making.Withthechickenstillbreast-downinthesink,lookforthesternum—alargepieceofcartilageinthemiddleofthebreast.Pierceorcutitwiththeshears.Now,flipthechickenover,flatteningthebreast.
4Drythechickenoffthoroughlywithpapertowelsandplaceitontopofthedishwiththevegetables.
5Combinetheremaining1teaspoonseasalt,garlicpowder,onionpowder,andapinchofcinnamoninasmallbowl.Sprinkleoverthechickenandrubtocoatevenly.Makesuretocovereverylastbit!
6Bakefor50minutes,andthencheckfordonenesswithathermometer—cook
untiltheinternaltemperaturemeasuredatthethickestpartofthebreastis165°F.Dependingonthesizeofthebird,itcouldtake90minutesormoretocook.Ifyounoticethewingsstartingtoburn,coverthemwithfoilastherestofthechickencontinuestocook.
7Servewarmwiththepanjuices.
STORAGE:Keepsintherefrigeratorforaboutaweek.
VARIATION:Youcanuseturnipsorparsnips,ifyoucan’tfindrutabagas.
HERBED SEAFOOD BAKE WITH BACON-
RADICCHIOSALAD
TIME:25MINUTESSERVES:2
SEAFOOD1poundmussels,scrubbed(seeNote)
1poundlittleneckclams,scrubbed(seeNote)½poundrawjumboshrimp,deveined
FreshthymesprigsFreshmarjoramsprigs
Freshoreganosprigs3clovesgarlic,minced
1tablespoonseasalt2tablespoonsoliveoil
1tablespoonchoppedfreshparsley
SALAD3slicesbacon,friedcrispandcrumbled
1pear,coredandchopped1smallheadradicchio,chopped
1headendive,chopped1tablespoonoliveoil
1tablespoonwhitebalsamicvinegar
1Preheattheovento450°F.Linealargebakingsheetwithparchmentpaper.
2Placetheseafoodonthebakingsheetandtopwiththethyme,marjoram,andoreganosprigs,garlic,andseasalt.Placeintheovenandroastfor15minutes,oruntilmostoftheshellshaveopened.Ifanymusselsorclamsremainunopened,discard,asthismayindicatetheyarebad.
3Whiletheseafoodisroasting,combineallofthesaladingredientsinaservingbowlandtosstocombine.
4Youwillknowtheseafoodisfinishedcookingwhentheshrimpispinkandopaque.Removefromtheoven,transfertoaservingdish,drizzlewitholiveoil,andsprinklewithparsley.Servewiththesaladontheside.
STORAGE:Shellfishandsaladdon’tkeepwell,soservefresh.
NOTE:Tocleanshellfish,startbydiscardinganybrokenshellsandrinsingundercoldrunningwater.Transfertoalargepotofcoldsaltedwaterandrefrigeratefor30minutes.Insteadofstrainingtheshellfish,liftthemindividuallyoutofthepotsothatthesedimentstaysatthebottom.Ifthereisanydebrisorare“beards”onthemussels,pinchthemoffbeforecooking.
VARIATION:Thisrecipecaneasilybedoubledtoserve4people.Itisextremelyeasy,butlookselegantandsophisticatedforadinnerparty.
SALADS
CURRIEDCHICKENSALAD
TIME:45MINUTESSERVES:4
SALAD
1tablespoonsolidcookingfat1½poundspasturedchickenbreasts
1cupBoneBroth4ribscelery,finelychopped
2largecarrots,finelychopped1greenapple,coredandfinelychopped
½redonion,minced2clovesgarlic,minced
½cupcurrantsorraisins½poundmixedsaladgreens,forserving
Chives,finelychopped,forgarnish
DRESSING¾cupoliveoil
Juiceof1lemon1teaspoonapplecidervinegar
1teaspoongroundturmeric¾teaspoonseasalt
½teaspoongroundcinnamon
1Heatthesolidcookingfatinaskilletovermediumheat.Whenthefathasmeltedandthepanishot,cookthechicken,top-sidedown,for5to7minutes,oruntillightlybrowned.
2Flipeachpieceofchicken,addthebroth,cover,andlowertheheatsothatitsimmers.Cookfor15to20minutes,oruntiltheinternaltemperaturemeasuredatthethickestpartofthebreastreaches165°F.
3Meanwhile,combinethecelery,carrots,apples,onions,garlic,andcurrantsorraisinsinalargebowlandsetaside.
4Placeallofthedressingingredientsinasmallbowlandwhiskuntilwellcombined.Addtothebowlwiththevegetables,stirtocombine,andsetaside.
5Removethechickenfromthepanandsetasidetocool.Onceitiscoolenoughtohandlesafely,orusingtwoforks,shredthebreastmeat.
6Addthechickentothebowlwiththevegetablesanddressing,stirwelltocombine,andserveonabedofsaladgreens,garnishedwiththechives.
STORAGE:Keepsforseveraldaysintherefrigerator.
COLD“NOODLE”ANDSALMONSALAD
TIME:35MINUTESSERVES:4
SALAD1½poundswild-caughtsalmon,cutinto4servings
Seasalt,totaste4greenonions,chopped
2largezucchini½bunchradishes,endsremovedandverythinlysliced(about1½cups)
DRESSING
2cupschoppedparsley¾cupoliveoil
Zestandjuiceof½lemon2teaspoonsmincedcapers
1Preheattheovento400°F.
2Placethesalmon,skin-sidedown,onabakingsheetandseasonwiththeseasalt.Topwiththegreenonions.Bakefor15minutes,dependingonthethicknessofthefillet.Totellifitisfinished,itsfleshshouldnolongerbetranslucent,anditshouldflakewithafork.
3Whilethesalmonisbaking,“spiralize”thezucchiniusingaspiralizertooloravegetablepeelertomakelongribbons.Placeinalargebowl,andaddtheradishes.
4Placeallofthedressingingredientsinajar,closethelidtightly,andshaketocombine.Pourthedressingoverthezucchinisalad,andtosstocombine.
5Servethesaladtoppedwiththesalmon.
STORAGE:Keepsfor2to3days;storedressingseparately.
STEAKSALADWITHSPRINGVEGGIES
TIME:20MINUTESSERVES:4
SALAD1bunchasparagusspears,woodyendsremoved,choppedinhalf
3cupspackedmixedgreens1cupquarteredartichokehearts(canned,packedinwater,anddrained)
1poundgrass-fedbeefsteak(ribeyeorNewYorkstripworkswell)Seasalt
1tablespoonsolidcookingfat
DRESSING½cupoliveoil
2tablespoonsredwinevinegar1smallshallot,minced
3clovesgarlic,minced
1Placetheasparagusinapotandcoverwithwater.Bringtoaboilonhighheatwiththelidon.Immediatelyremovefromheat,drain,andsetaside.
2Placeallofthedressingingredientsintoajar,closethelidtightly,andshaketocombine.Setaside.
3Addthegreens,artichokes,andasparagustoalargeservingbowlandtosstocombine.
4Movetheovenracktothetopandpreheatthebroiler.Rubthesteakonbothsideswithsalt,totaste.
5Heatthesolidcookingfatinthebottomofacast-iron,ovenproofskilletonhighheat.Whenthefathasmeltedandthepanishot,searthesteakfor30secondsoneachsideandcarefullymovethepantotheoven.Broilthesteakfor2minutesperside.
6Whenthesteakisfinished,moveittoaplate,looselytentwithfoil,andallowtorestfor5minutes.Slicethesteakasthinlyaspossible.
7Addthewarm,thinlyslicedsteakandhalfofthedressingtothesaladingredientsandtosstocombine.
8Servewiththeremainingdressingorstoreitinanairtightjarintherefrigerator.
STORAGE:Keepsfor3daysintherefrigerator,dressingandsaladstoredseparately.
TUNASALADWITHAVOORGARLIC“MAYO”
TIME:20MINUTESSERVES:3OR4
AVOCADOMAYO1avocado
½cupoliveoil¼cupwater
½lemon,juiced1clovegarlic
½teaspoonturmeric½teaspoonseasalt
GARLICMAYO
½cupcoconutconcentrate,warmed(alsoknownascoconutmannaorcoconutbutter;seeNote)
½cuphotwater
¼cupoliveoil3–4clovesgarlic
¼teaspoonseasalt
SALAD1(12-ounce)cantuna,drained
3ribscelery,finelychopped1carrot,finelychopped
3radishes,finelychopped½cupgrapes,halved
1tablespoonmincedfreshdillFreshsaladgreens
1Placeallofthemayoingredientsfortheflavoryouchooseinablenderandblendonhighforaminuteortwo,untilathicksauceforms(whenfreshlymade,itshouldresembletheconsistencyofconventionalmayo).Ifthesauceistoothick,thinwithwateruntilthedesiredconsistencyisreached.
2Combinethetuna,celery,carrots,radishes,grapes,anddillinabowlwiththemayoandstirtocombine.
3Serveontopofabedoffreshsaladgreens.
STORAGE:Keepsforafewdaysintherefrigerator.Garlicmayowillhardenin
therefrigeratorbutsoftensupafter20minutesatroomtemperature.
NOTE:Inordertomeasurethecoconutconcentrate,itisbesttosoftenitinawarm-waterbathbeforeuse,asitissolidatroomtemperature.Forbrandrecommendations,seeResources.
TREATS
ROASTEDSTONEFRUIT
TIME:35MINUTESSERVES:4
½orange,juiced(about2tablespoons)
1tablespooncoconutoil,melted¼teaspoongroundginger
¼teaspoongroundcinnamon¼teaspoonseasalt
2firmpeaches,quarteredandpitsremoved2firmnectarines,quarteredandpitsremoved
1Preheattheovento425°F.Placethejuice,coconutoil,ginger,cinnamon,andseasaltinamediumbowlandwhisktocombine.
2Addthefruittothebowlandstiruntilevenlycoatedwiththemixture.Placethepiecesoffruitonaparchmentpaper–linedbakingsheet,givingthemplentyofspacebetween,sprinklingwithremainingliquid(ifthereisany!).
3Cookfor20minutes,oruntiltheedgesarebrownedandthefruitissoft.Servewarm.
STORAGE:Keepsforafewdaysintherefrigerator.
NOTE:Ifthefruitismoreripethanfirm,itmaytakeonly10minutestocook.Makesuretocheckinwhilecooking,ifyourfruitisalreadysoft!
VARIATION:Thisrecipeworkswellwithotherstonefruit,likeapricots,aswellasothertypesoffruitlikeapplesandpears(althoughyouwillwanttodecreasethetemperatureto375°Fandincreasethecookingtimeupto20additionalminutesforthesevarieties).
LEMONPIEDATEBALLS
TIME:15MINUTESMAKES:8
Zestof1smalllemon¼cupunsweetenedcoconutflakes
½teaspoonseasalt1tablespoonlemonjuice
2cupsdates,pitted½teaspoongroundginger
1wholevanillabean,minced2tablespoonscoconutconcentrate(alsoknownascoconutmannaorcoconutbutter;seeNote)
1Combinethelemonzest,coconutflakes,andseasaltinashallowbowlandsetaside.
2Combinetheremainingingredientsinafoodprocessor,andpulsetoprocessuntila“ball”forms.Ifthemixtureisstilltoodry,add1teaspoonofwateratatimeuntilitdoesforma“ball.”
3Rollthemixtureintoapproximately8smallballs,andthenrollthroughthelemonzestmixturetocoat.Placeonaparchmentpaper–linedplate,andtransfertothefreezerfor5minutestoharden.
STORAGE:Transfertoanairtightcontainerforstorageintherefrigerator.Keepsforacoupleweeks;alsofreezeswell.
NOTE:Inordertomeasurethecoconutconcentrate,itisbesttosoftenitinawarm-waterbathbeforeuse,asitissolidatroomtemperature.Forbrandrecommendations,seeResources.Ifyoufindyourselfsensitivetovanillabeanseeds,scrapeouttheseedsandjustusethepod.
GRANITAS
TIME:15MINUTES,PLUS4HOURSTOCHILLSERVES:4
KIWI-LIME
4kiwifruits,peeledandchoppedJuiceof1lime
¼cupsimplesyrup(seeNote)¼cupunflavoredcoconutwater
STRAWBERRY“MARGARITA”
2cupshulledandchoppedstrawberriesJuiceof1lime
¼cupsimplesyrup(seeNote)¼cupunflavoredcoconutwater
PIÑACOLADA
2cupschoppedpineappleJuiceof1lime
½cupunflavoredcoconutwater
1Addallingredientsfortheflavoryouaremakingtoablenderorfoodprocessorandprocessuntilsmooth.
2Pourintoa9by13-inchbakingdishandplaceinthefreezer,beingsuretorakewiththetinesofaforkevery30minutesfor4hours,oruntila“slushy”consistencydevelops.
STORAGE:Freezeswellforseveralweeks.
NOTE:Tomakesimplesyrup,inasmallsaucepan,bring1cuphoneyand1cupwatertoaboil;simmeruntilthehoneycompletelydissolves,about3minutes.Removefromtheheatandletcoolcompletely.Syrupstoresinaglassjarforupto1monthintherefrigerator.
RASPBERRYPUDDING
TIME:15MINUTESSERVES:4
3ripeavocados1¾cupsfrozenraspberries
¼cuprawhoney3tablespoonsorangejuice
½vanillabean,minced(seeNote)¼teaspoonseasalt
Raspberries,forgarnishMintleaves,forgarnish
1Placeallingredientsinafoodprocessororahigh-poweredblenderandmixuntilthoroughlycombined,about30seconds,stoppingtoscrapedownthesides,ifneeded.
2Servegarnishedwithraspberriesandmintleaves.
STORAGE:Keepsintherefrigeratorforafewdays,butlosesitscolor.Freezeswell.
NOTE:Ifyoufindyourselfsensitivetovanillabeanseeds,scrapeouttheseedsandjustusethepod.
VARIATION:Youcansubstituteotherberriesforthisrecipe—strawberriesandblackberriesbothworkwell.
NO-BAKELEMON-VANILLA“CHEESECAKE”
TIME:1HOUR,PLUS24HOURSTOSETSERVES:8
CRUST1½cupsdriedfigs(about7ounces)
½cupdrieddates(about2½ounces)½cupunsweetenedcoconutflakes
1tablespoonarrowrootstarch1tablespoonmeltedcoconutoil+additionalforgreasingthepan
Pinchofseasalt
FILLING1cupfilteredwater
2teaspoonsgrass-fedgelatin1cupcoconutconcentrate,melted(alsoknownascoconutmannaorcoconutbutter;seeNotes)
½cuprawhoney,melted½cuplemonjuice(fromabout4lemons)
2tablespoonslemonzest(fromabout2lemons)1wholevanillabean,minced(seeNotes)
¼teaspoonseasaltFreshfigs,forgarnish
Mintsprigs,forgarnish
1Placethedriedfigs,dates,coconutflakes,arrowroot,1tablespooncoconutoil,andseasaltinafoodprocessorandprocessonhighuntilathick,sticky,homogenouspasteforms(30to45seconds).Greasean8"springformcakepanwithadditionalcoconutoil,addthecrustmixture,andspreadevenlyintothebottomofthepanwithyourfingers.Putitintherefrigeratortocoolwhileyoumakethefilling.
2Placethewaterinasmallsaucepanandsprinklethegelatinontop,givingitafewminutestoabsorbsomeoftheliquidand“bloom.”
3Meanwhile,combinethecoconutconcentrate,honey,lemonjuice,lemonzest,
vanillabean,andseasaltinablenderorafoodprocessorandblendonhighfor30secondstocombine.Setaside.
4Placethesaucepanwiththegelatinonthestoveandturntheheatonlow.Heatthemixtureverygently,stirring,onlyabout30secondsoruntilthegelatinhasdissolvedcompletely.Donotletitgetmorethanlukewarm.
5Addthegelatinmixturetotheblenderorfoodprocessorwiththerestofthefillingingredientsandblendagain,onhigh,untileverythingiswellincorporated.
6Pourontothecrustandcoolintherefrigeratoruntilfirm,about24hours.
7Garnishwithfreshfigsandmint,ifdesired.
STORAGE:Keepsforaweekintherefrigerator.Keepcoolforbesttexture.Donotfreeze.
NOTES:Inordertomeasurethecoconutconcentrate,itisbesttosoftenitinawarm-waterbathbeforeuse,asitissolidatroomtemperature.Forbrandrecommendations,seeResources.Ifyoufindyourselfsensitivetovanillabeanseeds,scrapeouttheseedsandjustusethepod.
VARIATION:Iffreshfigsaren’tinseason,feelfreetomakethiscakeanytimeofyearusingotherfreshfruitasagarnish.Berriesorstonefruitwouldbegreatoptions.
4-WeekMealPlan
INTRODUCTIONIfyou’dliketogivetheAutoimmuneProtocolatry,itisbesttosetyourselfupforsuccess.Whatdoesthatmean?Thedifferencebetweenmakingithappenandsuccumbingtotemptationonlyafewdaysinisagoodmeasureofplanningandpreparation.Ifyou’vedonetheworktomakesureyourkitchenisfreeofalloftheinflammatoryfoodsyounolongerwanttobeeatingandhavereplacedthemwithhealing,nutrient-densemeals,therewillbelesschanceofstrayinginweakermoments.Trustus—havingbeenthere,planningisthekeytosuccessinmakingtheselong-termdietarychangesstick.Plus,onceyoustartfeelingbetter,itwillbemoremotivationtocontinue!
Thetwobigsecretstobeingpreparedfortheeliminationphasearemealplanningandbatch-cooking.Mealplanningisthepracticeofmappingoutyour
mealsfortheweekandlettingthatguideyourshoppinglistandcookingdays.Batch-cookingisthepracticeofcookinglargebatchesofrecipestobeenjoyedlater,asawaytomaximizetimespentinthekitchen.Nobodywantstofeellikeashort-ordercook,preparingthreemealsadayfromscratch,especiallywhenotherfamilymembersareinvolved!Usingthemagicalcombinationofmealplanningandbatch-cooking,youcanreduceyourtimeinthekitchentofourorfivesessionsperweek,whilestillprovidingyourselfallofthefoodyouneedforeverymeal.Inordertotakealloftheplanningandguessworkoutoffiguringoutwhatto
eat,wehaveincludeda4-weekmealplanalongwithallofthesupplementalresourcesyouneedtogetstarted—pantrybasics,shoppinglists,afoodselectionguide,andatoollist.Makesuretoreadalloftheaccompanyingmaterialinthischapter,asitincludesimportantinformationforpersonalizingandmakingthemostofyourprotocol.
DISCLAIMER
Dietarychangescanprofoundlyimpactyourhealth,and,becauseofthis,itisimportantforyoutospeakwithyourdoctororkeyplayerforadvicebeforeimplementinganydietarychangestoseeiftheyarerightforyou.
NotesabouttheMealPlanandShoppingList●AlloftherecipesincludedinthemealplanaresuitablefortheeliminationphaseoftheAutoimmuneProtocol—nograins,beans,legumes,dairy,eggs,nuts,seeds,ornightshadevegetablesorspices.
●Themealplanfeeds1personfor4weeks,accountingforgenerousservingsoffoodatmealtimesandtoeatassnacks.Inthebeginning,itisimportanttomakesuretohaveanabundanceoffoodtoavoidasituationwhereyouarehungryandthereisnothingtoeat!Ifyoufindthatthequantityistoomuch,youcaneasilyfreezesomeservingsofsoupsorstewstoeatlater(andthenjustthink—youwillbethatmuchfurtherahead!).
●Wehaveaccountedfor4to6ouncesofmeatpermealintheshoppinglistsandrecipes.Ifyouwanttoeatmoreorless,youcantweakthislevelaccordingly.Noneoftherecipesissospecificthataslightchangeinmeatquantitywillmakeadifference.
●Ifyouwillbefeedingmorethanjustyourself,youwillneedtomake
adjustmentstothemealplan(likeaddingsomeportionsorsidestothemeals).
●Thetwice-weeklyshoppinglistsincludeallofthefoodcalledforonthemealplan(notincludingoptionalsnacks)andassumethatyouwillbecookingmidday(lunch)onSundaysandend-of-day(dinner)onWednesdays.
TimeManagement●Mealsthatneedtobecookedfromscratcharenotedinboldtypeandthoseinregulartypehavealreadybeenpreppedandcookedandonlyneedaquickreheatorassembly.Youcaneasilyglanceattheweekandseewhichmealtimeswillrequiremoretimeforpreparation.Youcanexpecttodomorecookingintheeveningsandonweekendsandlittlecookingfromscratchatbreakfastorlunch.
●Notethatacoupleoftimesaweek,thereareindicationstothawportionsofpreviouslyfrozenmealsforthefollowingday,orcookmealsforthefollowingday.Forthelatter,youcanchoosetocookthesebreakfastsfreshinthemorning,orprepthemthenightbeforeifyoulacktimeearlyintheday.
●Planonspendingsometimebatch-cookingontheweekendfortheupcomingweek.Ifyoudon’tworkatraditionalworkweek,shiftthedayssothatthebigcookingdaysfallwhenyouhavemoretime.
●Ifyouarerenderingyourownsolidcookingfatand/ormakingyourownBoneBroth,scheduleatimetodothisbeforeyouembarkonthemealplansoyouhavethoseingredientsready.Theywillbecalledforintherecipes,soplanahead!
●Youwillneedtobudgetenoughtimetomaketwotripstothegrocerystoreduringtheweek.Ifyouwouldliketogathereverythinginonetripthatisfine,justtakeintoaccounthowlongthemeatwilllastintherefrigeratorandsetafreezingandthawingscheduleifitisgoingtobetoolongbeforecooking.
StoringandReheatingFood●Beforeyoubeginbatch-cooking,makesurethatyouhaveenoughstoragecontainers.SeetheToolListsectionformoredetails.
●Toreheatmeals,youcanuseaskillet,pot,oven,ormicrowave,whateverisyourpreference.Ourfavoritewayistouseanoven-safeglasscontainerinalow(300°F)ovenfor20minutes.
●Forthemealsthataretobefrozen,ifyouareusingglass,makesuretouseno
largerthanawide-mouthpintjarfilledappropriatelytothefreezeline.Anyjarwithshoulders,orlargerthanthis,islikelytocrack.●Tothawfrozenmeals,placethecontainerinawarm-waterbathforacoupleofhoursordirectlyintherefrigeratorfor24hours.
OtherNotes●Payattentiontothepantryitemssectionontheshoppinglistandmakesurethatyouarekeepingtheminstock—thingslikegarlic,spices,cookingfats,andsoon.Therecipesinthemealplanwillcallonthoseitemsfrequently,andtheywon’tbeincludedontheregularshoppinglist.
●Payattentiontothetoollistandmakesureyouhavealloftheitemsrequired.Wedon’tcallforanyunusualorexpensiveequipment,butthereareafewcommontoolsyouwillwanttomakesureyouhaveinyourkitchen,aswellascontainerstostoreyourmealsinoncetheyarecooked.
●Ifyouhaveanysensitivitiesorfoodpreferencesbeyondwhatisomittedintheeliminationphase,themealplancanserveasaframeworkforyoutocustomize.Manyoftherecipescomewithsubstitutionideas.
SnacksandTreats●You’llnoticethemealplandoesnotincluderecipesforsnacks.Snackstendtobehighlyindividual,withsomepeopleneedingthemandothersfinewiththreegenerousmeals.Inordertominimizewasteandtomakethemealplanfitmorepeople’sneeds,wehaveleftyouwithgenerousportionsthatcanbeeatenassnacks,oryoucanfreezetheleftoversandhavesomeeliminationphase–friendlysnacksaround,likefruit.
●Treatsarebestleftforspecialoccasions.Toomuchsugarcanseriouslyunderminehealing.Ifyoucan’tlivewithoutatreat,youcanmakeoneofthetreatrecipesearlierinthischapter,buttrytolimitittoonceortwiceamonth,especiallywhenyoufirstbegin.
Autoimmune Wellness Handbook 4-WeekMealPlan
WEEK1BREAKFAST LUNCH DINNER ALSOPREP
PREPDAY GreenBreakfastSoup
TunaSaladwithAvoorGarlic“Mayo”
BoneBroth(freezeallbut3cups)
MONDAY GreenBreakfastSoup
TunaSalad BeefCurrySoup
TUESDAY GreenBreakfastSoup
TunaSalad BeefCurrySoup Freeze3servingsGreenBreakfastSoup
WEDNESDAY GreenBreakfastSoup
TunaSalad BeefCurrySoup ButternutBreakfastBake
THURSDAY ButternutBreakfastBake
BeefCurrySoup
LambTaginewithCauliflower“Rice”
FRIDAY ButternutBreakfastBake
LambTagine SpatchcockedChickenwithTumericVeggies
SATURDAY ButternutBreakfastBake
LambTagine SpatchcockedChicken
SUNDAY ButternutBreakfastBake
SpatchcockedChicken
EmeraldSalmonwithZestyGreenSauce
DoublePorkPestoPattieswithWiltedChard
WEEK2BREAKFAST LUNCH DINNER ALSOPREP
MONDAY DoublePorkPestoPatties
SpatchcockedChicken EmeraldSalmon
Thaw2cupsBoneBroth
TUESDAY DoublePorkPestoPatties
EmeraldSalmon HiddenLiverChili
WEDNESDAY DoublePorkPestoPatties
HiddenLiverChili CurriedChickenSalad
THURSDAY DoublePorkPestoPatties
CurriedChickenSalad HiddenLiverChili
Thaw3servingsGreenBreakfastSoup
FRIDAY GreenBreakfastSoup
CurriedChickenSalad HiddenLiverChili
SATURDAY GreenBreakfastSoup
HiddenLiverChili Citrus-GingerBrinedPorkRoast
Thaw1cupBoneBroth
SUNDAY GreenBreakfastSoup
MoroccanChickenThighswithApricotsandOlives
Citrus-GingerBrinedPorkRoast
Nutrivore’sBreakfast,BoneBroth(ifneeded)
WEEK3BREAKFAST LUNCH DINNER ALSOPREP
MONDAY Nutrivore’sBreakfast
MoroccanChickenThighs
Citrus-GingerBrinedPorkRoast
Thaw2cupsBoneBroth
TUESDAY Nutrivore’sBreakfast
MoroccanChickenThighs
Citrus-GingerBrinedPorkRoast
WEDNESDAY Nutrivore’sBreakfast
MoroccanChickenThighs
BalsamicBeefStew
THURSDAY Nutrivore’sBreakfast
BalsamicBeefStew
Lemongrass-ScentedChickenStew
Thaw3servingsGreenBreakfastSoup
FRIDAY Nutrivore’sBreakfast
Lemongrass-ScentedChickenStew
BalsamicBeefStew
SATURDAY Nutrivore’sBreakfast
Lemongrass-ScentedChickenStew
BalsamicBeefStew Thaw1cupBoneBroth
SUNDAY GreenBreakfastSoup
EmeraldSalmonwithZestyGreenSauce
Apple-BeetBurgerswithParsnipFriesandHorseradishSpread
BoneBroth(ifneeded)
WEEK4BREAKFAST LUNCH DINNER ALSOPREP
MONDAY GreenBreakfastSoup
EmeraldSalmon Apple-BeetBurgers
Freeze3cupsGreenBreakfastSoup
TUESDAY GreenBreakfastSoup
EmeraldSalmon Apple-BeetBurgers
PorkPattiesThaw3servingsofchickenstew
WEDNESDAY DoublePorkPestoPatties
Apple-BeetBurgers
Lemongrass-ScentedChickenStew
Thaw2cupsBoneBroth
THURSDAY DoublePorkPestoPatties
Lemongrass-ScentedChickenStew
BeefCurrySoup
FRIDAY DoublePorkPestoPatties
Lemongrass-ScentedChickenStew
BeefCurrySoup
SATURDAY DoublePorkPestoPatties
TunaSaladwithAvoorGarlic“Mayo”
BeefCurrySoup Thaw1servingGreenBreakfastSoup
SUNDAY GreenBreakfastSoup
TunaSalad BeefCurrySoup
Week1ShoppingList
PANTRYITEMSSolidcookingfatofyourchoice(lard,tallow,duckfat,etc.;seeRenderedAnimalFat)
Coconutoil
Extra-virginoliveoil
Full-fatcoconutmilk(BPA-andthickener-free)
Rawhoney
Applecidervinegar
Balsamicvinegar
Onionpowder
Garlicpowder
Bayleaves
Seasalt
Groundturmeric
Groundcinnamon
Groundcloves
Groundginger
Yellowonions
Freshgarlic
Freshginger
SUNDAY
1large,wholepasturedchicken(5–6pounds)
2poundsbones(seeBoneBroth)
1½poundsgrass-fedbeefstewmeat
1(12-ounce)cantuna,packedinwater
2largesweetpotatoes
4largeparsnips
1poundcarrots
1bunchcelery
2largezucchini
1bunchSwisschard
1bunchkale
1bunchradishes
6ouncesfreshsaladgreens
2cupsbuttonmushrooms
1avocadoorcoconutconcentrate*
1bunchcilantro
Freshdill
1bunchgreenonions
1lime
2lemons
½cupgrapes
WEDNESDAY1½poundsgrass-fedgroundbeef
1(4–5pounds)pasture-raisedchicken
1poundlambstewmeat
1butternutsquash
2rutabagas(or4parsnips)
1poundcarrots
1smallredonion
1headcauliflower
3leeks
1bunchfreshparsley
2sweetapples
1greenapple
1greenapple
½cupdriedapricots
½cupprunes
1½cupsraisins
Freshthyme
1lemon
*dependingontherecipevariationyouchoose
Week2ShoppingList
PANTRYITEMSSolidcookingfatofyourchoice(lard,tallow,duckfat,etc.;seeRenderedAnimalFat)
Coconutoil
Extra-virginoliveoil
Full-fatcoconutmilk(BPA-andthickener-free)
Rawhoney
Applecidervinegar
Balsamicvinegar
Onionpowder
Garlicpowder
Bayleaves
Seasalt
Groundturmeric
Groundcinnamon
Groundcloves
Groundginger
Yellowonions
Freshgarlic
Freshginger
SUNDAY
2poundsgrass-fedgroundbeef
1poundpasturedgroundpork
1poundwild-caughtsalmonfillet
½poundgrass-fedbeefliver
1poundbacon
3parsnips
1poundcarrots
1crownbroccoli
1bunchasparagus
1bulbfennel
2largebunchesrainbowchard
1bunchcelery(ifneeded)
1bunchcilantro
Freshbasil
Freshoregano
1avocado
2lemons
WEDNESDAY2–3poundspasturedporkroast
2poundsboneless,skin-onchickenthighs
1½poundspasturedchickenbreast
1poundcarrots(ifneeded)
1bunchcelery(ifneeded)
1redonion(ifneeded)
6ouncesfreshsaladgreens
½cupgreenolives(withoutpimento)
Freshthyme(ifneeded)
Freshoregano(ifneeded)
½cupdriedapricots
½cupcurrantsorraisins
6oranges(or1orangeand1½cupsorangejuice)
1greenapple
2lemons
Week3ShoppingList
PANTRYITEMSSolidcookingfatofyourchoice(lard,tallow,duckfat,etc.;seeRenderedAnimalFat)
Coconutoil
Extra-virginoliveoil
Full-fatcoconutmilk(BPA-andthickener-free)
Rawhoney
Applecidervinegar
Balsamicvinegar
Onionpowder
Garlicpowder
Bayleaves
Seasalt
Groundturmeric
Groundcinnamon
Groundcloves
Groundginger
Yellowonions
Freshgarlic
Freshginger
SUNDAY2poundsgrass-fedgroundbeef
1½poundsgrass-fedbeefstewmeat
¼poundgrass-fedbeefliver
2poundsbones(ifneeded)
4largesweetpotatoes
2poundscarrots
1bunchcelery(ifneeded)
1bunchkale
Freshrosemary
Freshoregano(ifneeded)
Freshthyme(ifneeded)
WEDNESDAY2(4–5pounds)pasture-raisedchickens
2largesweetpotatoes
1largebutternutsquash
2largezucchini
2cupsbuttonmushrooms
1bunchSwisschard
1bunchgreenonions
4stalkslemongrass
Freshturmeric(usegroundifyoucan’tfindfresh)
1bunchcilantro
1avocado
2lemons
Week4ShoppingList
PANTRYITEMSSolidcookingfatofyourchoice(lard,tallow,duckfat,etc.;seeRenderedAnimalFat)
Coconutoil
Extra-virginoliveoil
Full-fatcoconutmilk(BPA-andthickener-free)
Rawhoney
Applecidervinegar
Balsamicvinegar
Onionpowder
Garlicpowder
Garlicpowder
Bayleaves
Seasalt
Groundturmeric
Groundcinnamon
Groundcloves
Groundginger
Yellowonions
Freshgarlic
Freshginger
SUNDAY1poundgrass-fedgroundbeef
1poundpasturedgroundpork
1poundwild-caughtsalmonfillet
½poundbacon
2poundsparsnips
1beet
1crownbroccoli
1bunchasparagus
1bulbfennel
½poundfreshhorseradish
2largebunchesrainbowchard
1bunchcilantro
Freshthyme(ifneeded)
Freshchives
Freshbasil
1apple
1lemon
WEDNESDAY1½poundsgrass-fedbeefstewmeat
1(12-ounce)cantuna,packedinwater
4largeparsnips
1poundcarrots
1poundcarrots
1bunchcelery(ifneeded)
1bunchradishes
1bunchkale
6ouncesfreshsaladgreens
1bunchcilantro
Freshdill
1avocadoorcoconutconcentrate*
1lime
1lemon
½cupgrapes
*dependingontherecipevariationyouchoose
TOOLLISTHereisalistofallofthekitchentoolsyouwillneedtohavehandyinordertofollowthe4-WeekMealPlan.Noneisoutoftheordinary,butitisimportanttomakesurethatyouhaveeverythingyouneedbeforeyougetstarted.We’vealsoincludedalistofoptionaltoolsthatmakesometasks(likemakingbroth)easier,butaren’trequired.
●Cuttingboard
●Sharpknife
●Largestockpot
●Skillet
●Largeroastingdish
●Bakingsheet
●Mixingbowls
●Blender
●Colander
●Glasscontainersforfoodstorage
●Parchmentpaper
●Assortedmixingspoons
●Ladle
●Spatula
●Timer
●Measuringspoons/cups
●Potholder
●Kitchentowels
●Pressurecookerorslow-cooker
●Boxgrater
Optional●High-poweredblender
●Foodprocessor
●Pressurecookerorslow-cooker(asanadditionaltool)
●Extrastockpot
●Wide-mouthpintjarsforfreezingfood
PANTRYGUIDEInordertogetyourkitchenreadyfortheeliminationphase,werecommendfollowingourthree-steppantryprepmethodforweedingoutallofthefoodsthatarelikelytemptations,aswellasreplacingthosefoodswithnutritiousalternatives.
Step#1:Getridofallofthe“badstuff.”Thefirstthingyoushoulddoisboxupallofthefoodsyouareunlikelytobeeatingagainanytimesoon—thingslikebreads,pastas,flour,sugar,refinedvegetableandseedoils,andanythingprocessedthatincludesfoodchemicalsandlongingredientlists.Donateittothefoodpantry,andgetitoutofthehouseassoonaspossible.
Step#2:Storeallofthe“maybestuff.”Therearelikelyfoodslurkinginyourpantrythatwillbeoff-limitsduringtheeliminationphase,butyoumaybeabletoreintroducethemwithsuccesslater.Insteadofpreemptivelytossingtheseingredients,wesuggestpackingthemupin
Insteadofpreemptivelytossingtheseingredients,wesuggestpackingthemupinaboxandplacingtheminaclosetorsomewhereinconvenient,tominimizetemptation.Thiswouldincludethingslikegluten-freeproductscontainingnutsandseeds(likespices,nutbutters,orjusttherawnutsandseedsthemselves),nightshades,coffee,andchocolate.Noneedtogiveawayortossifyoumightbeabletohavethemagaininthefuture!Wehighlyrecommendactuallygettingtheseitemsoutofsightinsteadof
lettingthemsitinyourcabinetswhileyouundertakeyoureliminationphase.Puttheminabox,tapeitup,andburyitinaclosetsomewhere.Thereisnothingworsethantheunnecessarytemptationofthatchocolatebarsittinginyourcupboardbeggingtobeeaten!
Step#3:StockyourpantrywithAutoimmuneProtocol–friendlyingredients.Withallthatroomyoujustmade,investinsomeingredientsyouwillbeusingforcookingeliminationphase–friendlymeals.Whileyoudon’tneedtogooutandpurchaseeverythingonthislist,ataminimumyouwillwantsomecookingfats,vinegar,someherbsandspices,andsomebakingingredientsshouldyoudecidetoincorporatebakingintoyourroutine.Notethatwedon’tcallformanyofthesebakingingredientsintherecipesinthisbook,butyoumaywanttousethemforexperimentingorfollowingotherelimination-phasetreatrecipesyoufind.Thetruthis,settingupyourpantryfortheAutoimmuneProtocolispretty
simple,andyoudon’thavetotrackdownabunchofexoticingredientstomakeeatingthiswaywork.Wesuggestfocusingmostlyonfindingavarietyofhigh-qualitycookingfatsandspicestoworkwith,ratherthangettinghunguponalternativeflours,sweeteners,andsnacks(whichcanbequiteexpensive!).We’veprioritizedthislistwiththeingredientspercategorywethinkaremost
commonineliminationphase–friendlyrecipes,withsomementionofadditionalingredientsyoumaywanttoconsider.Forproductrecommendationsforsomeoftheseingredients,seeResources.
AlternativeFlours
●ARROWROOTSTARCH/FLOUR—Thisstarchworkswellforthickeningsaucesorgravies,aswellasbaking.Mostpeoplearefamiliarwiththesmalljarsofitinthespicesection,butitisavailableforamuchbetterpriceinabulk,baggedform.
●CASSAVAFLOUR—Thisflourisanewcomeronthesceneandseemstocreate
greattexturewhenusedinplaceofregularflour.
●COCONUTFLOUR—Thisisacommonreplacementinallergen-freebakingthatcanbedryanddifficulttoworkwith.Mostrecipesuseablendofthisflourwithastarchlikearrowrootortapioca,whichgivesitabetterconsistency.Cautionshouldbeusedforthosewhohaveacoconutsensitivityordon’tdowellwithinulinfiber.
●TAPIOCASTARCH/FLOUR—Thisstarchissimilartoarrowrootandofteninterchangeable.Likearrowroot,itcanbeusedtothicken,aswellasforbaking.
●Lesscommonfloursincludeplantainflour,tigernutflour,andsweetpotatoflour.
Sweeteners
●COCONUTSUGAR—Thisisaniceoptionwhengranulatedsugariscalledfor,insteadofaliquidone,inarecipe.
●HONEY—Raw,unpasteurizedhoneyisnicetohaveonhandtosweetenteaandmakeoccasionaltreats.Becautious;differenttypesofhoneycanhavedifferenttextures,greatlyaffectingtheoutcomebakedgoods.
●MAPLESYRUP—Thedeliciousflavormaplebringsisundeniable,andhavingsomegradeBinthepantryfortreat-makingcanbehandy.
●Lesscommonsweetenersincludecoconutsyrup,maplesugar,anddriedfruit(likedates,raisins,etc.).
CoconutProducts
●COCONUTFLAKES—Large-flakecoconutisnicetoeatasasnack(it’sdelicioustoasted!)andthesmall-flakecoconutcanbeusedtomakehomemadecoconutmilk,aswellasbakedgoods.
●COCONUTMILK—Ifyoudon’thaveahigh-poweredblendertomakeitathome,thickener-freecoconutmilkpackedinBPA-freecansisaniceoptiontohaveforusinginsauces,smoothies,andcurries.(BPAisanendocrine-disruptingchemical.)●COCONUTWATER—Whileprobablytoosweettodrinkregularly,itisnicetohaveonhandasarehydrationbeverageshouldsomeoneinthefamilycomedownwithastomachbug.ItisalsousedintheGranitasrecipe.
●COCONUTWRAPS—Theseareafunoptionforaquickmeal;justwrapandgo!
CookingFats
●AVOCADOOIL—Thisisanicealternativetooliveoil,andthesamequalityand
bottlerequirementsapplybecauseitalsoeasilyoxidizes.
●COCONUTOIL—Agreat,neutral-flavoredfatthatisnicetouseforcookingandcanbeusedasthesolidcookingfatcalledforinourrecipes,shouldyounothavehigh-qualityanimalfatstorenderyourself.
●EXTRA-VIRGINOLIVEOIL—Trytofindahigh-quality,cold-pressed,organicoilthatisstoredinanopaquebottle.
●RENDEREDSOLIDCOOKINGFAT—Thisisoneingredientyoucan’tgowithout,asyouwillneeditforcooking.MakeyourownusingtheRenderedAnimalFatrecipe!Lard,tallow,andduckfatallworkwellhere—ifyoucan’tmakeyourown,checkoutResourceforsourcingoptions.
●Lesscommoncookingfatsincludepalmshorteningandredpalmoil(choosesustainablyharvested).
PreservedMeat
●BEEFJERKY—Makeyourownorbuyabrandthatdoesnotcontainnightshades,soy,orgluten.
●CANNEDFISH—Buytuna,salmon,sardines,oroysters,packedinextra-virginoliveoilorwaterandnotinBPA-linedcans.Makesurethattheydonotcontainoff-limitspicesorsoybeanoil!
●EPICBARS—Thesearegreatpemmican(fatandprotein)barsthathaveamuchsoftertexturethanjerkyandmakeagreatsnack.
●GELATIN—Thisisaniceingredienttouseasagut-healingsupplement(alotoffolkswillstiritintotea)ortotexturizeallergen-freedesserts(suchasNo-BakeLemon-Vanilla“Cheesecake”).
AssortedFoodsandFlavorings
●OLIVES—Ifyoucanfindthemcuredwithsaltonlyandnotcitricacid(derivedfromcorn),thesemakeanexcellentsnack.Bewareofpimentosorothernightshadeingredients!
●FISHSAUCE—Usethistoaddumamitodishes(cautiontothosewithhistamineintolerance!).
●COCONUTAMINOS—Thisisacoconut-basedsoysaucereplacementthatyoucanuseinastir-fry.
●APPLECIDERVINEGAR—Werecommendhavingatleastonevinegaronhandtoaddtoyourmeals,andthisisanall-aroundstandoutthatcomplementsmany
flavors.
●Otherflavoringsincludebalsamicvinegar,whitewinevinegar,redwinevinegar,andcookingwine.
Spices
●DRIEDHERBS—Thyme,rosemary,dill,oregano,marjoram,andsageshouldgetyoustarted.Driedherbsaren’tnearlyastastyasfresh,buttheyworkgreatinapinch.
●GROUNDSPICES—Turmeric,ginger,garlic,cinnamon,andonionareagreatstarthere.Youcanusethesetomakeyourowneliminationphase–friendlycurryblendinsteadofusingtheusualnightshadeandseedspiceversion.
●SALT—Itisnicetohaveafewdifferenttypesofsaltonhand.Agoodall-aroundseasaltisamustinanykitchen.Trysomefunoptionsliketruffleseasaltandsmokedseasalttoaddsomeadditionalflavor.
●SEAWEED—Therearemanytypesofseaweedsyoucanusetomakeeliminationphase–friendlysushi(likenori),orjustablendofflakestosprinkleontopofdishes.Thisisagreatwaytoaddflavorandnutrientstoyourmeals.
●CAROBPOWDER—Youcanusethisingredienttomakechocolate-liketreats.
Snacks
●SWEETPOTATOCHIPS—Lookforabrandthatiscookedincoconutoilinsteadofseedoils.Thesearegreatforplanetravelorroadtrips!
●PLANTAINCHIPS—Youcanfindtheseinbothsweetandsavoryvarieties(usingeitherripeorgreenplantains).
●SEAWEEDSNACKS—Thesearefunforwhenyouareonthego!
SELECTINGFOODSThereisnoquestionthathigher-qualityfoodsconfergreaterhealthbenefits.Thewaylivestockisraisedorproduceisgrowndoesaffectitsnutrientvalue.ThosenutrientsarethefocusoftheAutoimmuneProtocolandareexactlywhatabodyhealingfromautoimmunediseaserequires.Thatsaid,wearewellawarethatthesefoodsareoftenhigh-pricedand,inmanycases,notallthateasytotrackdown.Wouldn’titbeamazingifeverybudgetwerebigenoughandeverykitchenwaswithinafewmilesofanorganicfarm?Alas,weknowthatisn’treality!Beforewestartexploringhowtoselectthebest-qualityfood,wewantto
emphasizethatitismoreimportanttojuststart.Whilequalitymatters,lettingthepursuitofperfectionpreventyoufromundertakingthisjourneytowellnessismuchworsethaneatingany“lessthanideal”foods.SeeResourcesfortipsonsourcingfoodsmentionedbelow.
Meats/Fish
●GOOD:Ifyoucan’taffordorsourceorganicgrass-fedorpasturedmeatsorwild-caughtseafood,focusonbuyingleanercutsofconventionallyraisedmeats(trytomakesuretheyarestillhormone-free).Addorganmeatsandfishtoyourdiet.Conventionallyraisedorganmeatisinexpensiveandstillverynutrientdense,andfarmedfishisbetterforyouthannofishatall.Alsoconsiderwild-caughtcannedsalmon,tuna,andsardines,whicharecheap,butpackedwithnutritionalvalue(besurecannedfishisfreeofsoyandspices!).Limithowmuchconventionallyraisedpoultryyoueat,sinceithasthelowestvalueintermsofnutrition.
●BETTER:Ifyoucanaffordorsourcesomeorganicgrass-fedorpasturedmeatsorwild-caughtseafood,focusonbuyingfattycuts.Thefatintheseanimalsisgreatforyou!Thinkfattyroastsandsalmonfillets.Youmightalsobeabletofindhigh-qualitygroundmeatonsalefromtimetotime.Ifso,stockupandfreezeit.
●BEST:Gettingallyourmeatandseafoodorganicgrass-fedorpasturedandwild-caughtisideal.Findfarmersorfishmongersfromwhomyoucanbuydirectlyinbulkinordertosavethemostmoney,whilegettingthehighestquality.Askaboutbuyingbeef,pork,orlambinwholes,halves,orquarters.Youmightbeabletosharethemeatwithagroupoffriendsifyoudon’thaveenoughfreezerspaceordon’thavetheneedforthelargequantities.Thisway,youcantakeadvantageofthelowerbulkpriceandhigherqualitymeat.
Fruits/Vegetables
●GOOD:Ifyoucannotgetallorganicfruitsandvegetables,startwiththeEnvironmentalWorkingGroup’slistsof“dirtiest”and“cleanest”produce(seeResources).Theselistsareavailableontheirwebsiteandpublishedannually,revealingthemostpesticide-ladenfruitsandvegetablesversusthosethathavelesschemicalresidue.Theselistsareknownasthe“DirtyDozen”andthe“CleanFifteen.”Focusonavoidingthoseonthe“DirtyDozen”list.Youcanalsowatchforsalesonorganic,local,in-seasonproduce,asitisusuallymoreeconomicaltobuythisway.Finally,checkoutfrozenvegetables.Freezingpreservesnutrientsandislowercost.
●BETTER:Ifyoucanaffordsomeorganicproduce,focusonorganicversionsofthoseonthe“DirtyDozen”listandroundoutvarietywithnonorganicfruitsandvegetablesfromthe“CleanFifteen”list.Also,besuretoshopyourlocalfarmers’market,lookingforgreatdealsonorganic,localproduce.Ifyoufocusonlocalproduce,youmayfindthatyourbudgetcanaccommodatemorethanalittleorganic,sinceshippingcostsarenotpartofthepremiumyouarepaying.
●BEST:Getallorasmuchofyourproduceaspossibleorganic,local,andin-season.AgreatwaytodothisisbyjoiningaCSAwithalocalfarmer.CSAstandsfor“CommunitySupportedAgriculture.”Itiswhenyoupayforashareofafarmer’sproduceatthebeginningofaseasonandthenhavethatsharedeliveredorpickitupweeklyduringharvest.Fillinvarietyatthefarmers’market,aco-op,ornaturalfoodstore.
Fats/Oils
●GOOD:Itisreallybesttoavoidrefinedvegetableoilsasmuchaspossible.Ifyourbudgetdoesn’thavealotofroomforhigh-qualityfatsandoils,focusonjusttwostaples:coconutoilandoliveoil.Afatthatissolidatroomtemperatureisbestforcookingathighheat.Usethecoconutoilforapplicationslikeroastingorstir-frying.Afatthatisliquidatroomtemperatureisbestforcolduses.Usetheoliveoilfordressingsortodrizzleasatopping.Lookfortheoliveoiltobecold-pressedandinanopaquebottle,andbuybothinbulk,sinceitwillbemuchcheaperandyou’llberelyingonthemsomuch.
●BETTER:Ifyoucanaffordsomehigher-qualityfatsandoils,lookforpasturedanimalfatstoaddtothecoconutandoliveoil.Thesefatsaresolidatroomtemperatureandgreatformixingupflavorsandnutrientsinroasting,stir-frying,etc.Ifyouarewillingtorenderyourownlard(porkfat),tallow(beeffat),orduckfat(seeRenderedAnimalFat),youmaybeabletopurchaselargequantitiesofthefatfromafarmerverycheaply.Oncerendered,youcanstorethefatintherefrigeratororfreezer.Youmightalsoconsideraddingavocadooilforvarietyincolduses.
●BEST:Theidealwouldbepurchasingavarietyofpasturedanimalfats(renderingyourownorpurchasingalreadyrendered),inadditiontopalmshortening,palmoil,andcoconutoil,allofwhichcanbeusedforhigh-temperaturecooking,plushavedifferentnutritionalbenefitsandflavors.Alsohaveonhandveryhighqualityoliveandavocadooilforcolduses.
CHAPTER9
LifestyleGuide+Exercises
Hereitis—thefinalpiecetoputtingtogetherawell-roundedlifethatputswellnessatthetopofthelist.Thisisourplanforhowtobringallthebasiccomponentsofsleep,stressmanagement,exercise,andyourrelationshipswithothersandnatureintoyourlifewithintention.Noteveryoneneedstopourhimselforherselfintoeveryoneoftheseareas—youmayhavemovementhandled,butconnectionislacking.Othersmayhavestrongrelationships,butneedtonsofworkonrest.Whereveryouare,thisplanislaidouttomeetyourneedsandhelpyoutakethispartofthepathtobetterhealthmanystepsfurther.Itisourhopethatthiswonderfulresourcewilltaketheburdenoutofoverhaulingyourhabits.
Weunderstandthatlifewithautoimmunediseasecanleaveyoufeelingincapableofmakingthesmallestchange,letalonelearningtoslowdownandexerciseandimproveyourrelationships.Whenwestartedtounpackthatchallenge,wehadarealization.Aworld-classmarathonerdoesnotstarttheraceinasprint.Shebuildsupslowly,sothatshecancompletetherace,ratherthanburnoutearly.Itisthattechniquethatwe’veusedindesigningthisplan.You’llfindthateachstepitselfissimple,andthroughagentleprocessoflayering,youareabletoaccommodateeachchangewithease.Youdon’tneedabunchoffancyequipment,andattendingapriceyworkshopisnotrequired.Notrainers,coaches,ormentorsarenecessary.Thepreparationlistisshortandmostlycenteredonthingsthatareprobablyalreadyhangingaroundyourhouse.Youhavewhatittakestostartthetransformationnow!
12-WEEKLIFESTYLEPLANWhenstartingthisjourneytolivingwellwithautoimmunedisease,itcanseemthatundertakingdietarychangesarethemostdauntingtask.Anyonewhohasgonethroughthisprocessforanyprolongedperiodoftimewilltellyouthetruth:Lifestylechangesarefarandawaythehardesttoimplement.We’vefoundthattakingverysmall,almostmicro-sizestepsisthekey.Havingaplanthatbuildsovertimeisnotonlymoreachievable,butalsomoresustainable.Youwill
notrealizethebenefitsoflifestylechangesifyoudon’tpracticethemoverthelong-term.Withthisinmind,weusea12-weekprocesstobuildafirmfoundationthatincorporatesallthebasicsandgivesyouachancetotryoutthemanylifestylesuggestionswemakeinthisbook.Thisway,youcandiscoverwhichroutinesbestsupportyourhealingprocess.
DISCLAIMERDependingonwhereyouarewithyourphysicalfitness,thewalkingandstretchingroutinelaidoutheremaynotcurrentlybeappropriateforyou.Changestoyourlevelofphysicalactivitycanprofoundlyimpactyourhealth,and,becauseofthis,itisimportantforyoutospeakwithyourdoctororkeyplayerforadvicebeforeimplementinganexerciseroutine.
Hereareafewthingstonoticeabouttheplan.
●Adifferentareaoffocusisintroducedeachweekforthefirst4weeks.Week1isRest,Week2isBreathe,Week3isMove,andWeek4isConnect.
●Atthebeginningofeachweek,you’llhave1newactivityinthe4areasofRest,Breathe,Move,orConnecttoworkon,followedbyseveraldaysofrepeatedimplementation.Forinstance,inWeek1youhave5daystoaddresshowcomfortableyourbedandbeddingareinordertostartmakingsmallstepstobetterRest.
●Weeks5through8haveyoutaking1newstepadayinanindividuallifestyleareaatthebeginningoftheweek,followedby6daysoftacklingall4areasforafewminutesatatime.Thisallowsyoutoslowlyadjustyourday-to-dayscheduleinordertoaccommodateyournewfocusonoverallwellness.Wefindthisismucheasierthansuddenlybeingforcedtocarveouthoursyoudon’thave.
●InWeeks9through12,yougraduallyspendlessandlesstimeputtingnewstepsintoactionandinsteadputmoreandmoretimeintothedailypracticeofresting,breathing,moving,andconnecting.Bytheendofthe12-weekprocess,withallthebasicsaddressed,youarereadytostartfine-tuningyourlifestyletoputyourhealthfrontandcenter.
Wecantellyouwithconfidence—planningandconsistentpracticearewhatmakelong-termlifestylechangessuccessful.Youwillnoticewitheachweekthattheseseeminglyinsignificantactionsarebuildingintoadramatictransformation.Itistheincentivethatwillkeepyoufueledandfocusedforthejourney!
Week1
REST BREATHE MOVE CONNECT
MONDAYDAY1
DothesleepassessmentinChapter4.
Noactivitythisweek
Noactivitythisweek
Noactivitythisweek
TUESDAYDAY2
Isyourbedandbeddingcomfortable?Ifnot,usetherestoftheweektoaddressthisissue.
WEDNESDAYDAY3
Comfortablebed/bedding
THURSDAYDAY4
Comfortablebed/bedding
FRIDAYDAY5
Comfortablebed/bedding
SATURDAYDAY6
Comfortablebed/bedding
SUNDAYDAY7
Comfortablebed/bedding
IfafterdoingthesleepassessmentinChapter4,youfindthatworkingonRestisalowpriorityforyou,moveontotheBreatheactivitiesinWeek2.IfyoufindthatworkingonRestisamoderatepriority,lookaheadattheRestactivitiesoutlinedintheplanandfocusontheonesthatmostapplytoyou.IfyoufindthatworkingonRestisahighpriority,startwithWeek1activities.Thisweekmayseemoverlyslow,eventedious,buttakeyourtime.
Week2
REST BREATHE MOVE CONNECT
MONDAYDAY8
Arealltheelectronicsremovedfrom
Dothestressassessmentin
Noactivitythisweek
Noactivitythisweek
removedfromyourbedroom?Ifnot,usetherestofthisweektoaddressthisissue.
Chapter5.
TUESDAYDAY9
Electronicsremovedfrombedroom
Takethe“Identify”stepofChapter5.
WEDNESDAYDAY10
Electronicsremovedfrombedroom
5minsmeditation
THURSDAYDAY11
Electronicsremovedfrombedroom
5minsmeditation
FRIDAYDAY12
Electronicsremovedfrombedroom
5minsmeditation
SATURDAYDAY13
Electronicsremovedfrombedroom
5minsmeditation
SUNDAYDAY14
Electronicsremovedfrombedroom
5minsmeditation
IfafterdoingthestressassessmentinChapter5,youfindthatworkingonBreatheactivitiesisalowpriorityforyou,moveontotheMoveactivitiesinWeek3.IfyoufindthatworkingonBreatheactivitiesisamoderatepriority,lookaheadattheBreatheactivitiesoutlinedintheplanandfocusontheonesthatmostapplytoyou.IfyoufindthatworkingonBreatheactivitiesisahighpriority,startwithWeek2.Youwillstartmeditationthisweek.Doalittlereadingonlineforthebestwaystostart.Guidedmeditations,meditativemusic,orevenmeditationappsorprograms(manyofthemfree)canhelpyoustartthispractice.Itisbestifyouchooseaconsistenttimeeachdaytodoyourmeditationexerciseaswell.
Week3
REST BREATHE MOVE CONNECT
MONDAYDAY15
Isyourbedroomasdarkaspossible?Ifnot,usetherestofthisweektoaddressthisissue.
Takethe“Examine”stepinChapter5.
DotheexerciseassessmentinChapter6.
Noactivitythisweek
TUESDAYDAY16
Darkbedroom 6minsmeditation
Walkfor5minstoday,followedwithstretchingfor5mins,foratotalof10mins.
WEDNESDAYDAY17
Darkbedroom 6minsmeditation
10minsmovement
THURSDAYDAY18
Darkbedroom 6minsmeditation
10minsmovement
FRIDAYDAY19
Darkbedroom 6minsmeditation
10minsmovement
SATURDAYDAY20
Darkbedroom 6minsmeditation
10minsmovement
SUNDAYDAY21
Darkbedroom 6minsmeditation
10minsmovement
IfafterdoingtheexerciseassessmentinChapter6,youfindthatworkingonMoveactivitiesisalowpriorityforyou,moveontotheConnectactivitiesinWeek4.IfyoufindthatworkingonMoveactivitiesisamoderatepriority,lookattheMoveactivitiesoutlinedintheplanandfocusontheonesthatmostapplytoyou.IfyoufindthatworkingonMoveactivitiesisahighpriority,startwithWeek3.Theeasywalkingandstretchingroutineherebuildsover10weeksfromextremelyminimalactivitytoafullhouraday.Allowyourselftofeelgoodwiththeverymeasuredstartanddon’tpushaheadtooquickly.Allyouneedisapairofgoodshoes.Ideasforaddressingthedarknessofyourbedroomareinvestinginblack-outshades,placingducttapeoverlightsourcesthatcan’tberemovedfromyourbedroom,orusinganeyemask.
Week4
REST BREATHE MOVE CONNECT
MONDAYDAY22
Isyourbedroomcoolandquietenough?Ifnot,usetherestofthisweektoaddressthisissue.
Takethe“Eliminate”stepinChapter5.
Walkfor10minstoday,followedwithstretchingfor5mins,foratotalof15mins.
DothesupportnetworkassessmentinChapter7.
TUESDAYDAY23
Cool,quietbedroom
7minsmeditation
15minsmovement
Lookoverthe“BuildingaSupportNetwork”sectioninChapter7.Chooseoneofthosetipstotakeactiononthisweek.
WEDNESDAYDAY24
Cool,bedroomquiet
7minsmeditation
15minsmovement
“Building”step
THURSDAYDAY25
Cool,bedroomquiet
7minsmeditation
15minsmovement
“Building”step
FRIDAYDAY26
Cool,bedroomquiet
7minsmeditation
15minsmovement
“Building”step
SATURDAYDAY27
Cool,bedroomquiet
7minsmeditation
15minsmovement
“Building”step
SUNDAYDAY28
Cool,bedroomquiet
7minsmeditation
15minsmovement
“Building”step
IfafterdoingthesupportnetworkassessmentinChapter7,youfindthatworkingonConnectactivitiesisalowpriorityforyou,eitherlookaheadatthenature-centeredConnectactivitiesoutlinedintheplanandfocusonthemorgivemoreenergytotheareasofRest,Breathe,or
Move.Ideasforaddressingthecoolnessandquietofyourbedroomareusingafan,settingthethermostattoaround65°Fovernight,gettingawhitenoisemachine,and/orwearingearplugs.
Week5
REST BREATHE MOVE CONNECT
MONDAYDAY29
Haveyousetaconsistentbedtime?Ifnot,usetherestofthisweektoaddressthisissue.
Takethe“Prioritize”stepinChapter5.
Walkfor15minstoday,followedwithstretchingfor5mins,foratotalof20mins.
Lookoverthe“MaintainingKeySupportRelationships”sectioninChapter7.Chooseoneofthosetipstotakeactiononthisweek.
TUESDAYDAY30
Consistentbedtime
8minsmeditation
20minsmovement
“Maintaining”step
WEDNESDAYDAY31
Consistentbedtime
8minsmeditation
20minsmovement
“Maintaining”step
THURSDAYDAY32
Consistentbedtime
8minsmeditation
20minsmovement
“Maintaining”step
FRIDAYDAY33
Consistentbedtime
8minsmeditation
20minsmovement
“Maintaining”step
SATURDAYDAY34
Consistentbedtime
8minsmeditation
20minsmovement
“Maintaining”step
SUNDAYDAY35
Consistentbedtime
8minsmeditation
20minsmovement
“Maintaining”step
Bythefifthweek,you’llhaveworkedineachlifestylearea.Thisweekyoumightwanttoconsiderusingapedometeronyourwalks,ifcountingstepsismotivationalforyou.Intermsofcalculatingyourconsistentbedtime,besurethatitgivesyouaminimumof8hourstosleep.
Week6
REST BREATHE MOVE CONNECT
MONDAYDAY36
Doyouhaveabedtimeritual?Ifnot,usetherestofthisweektoaddressthisissue.
Takethe“Practice”stepinChapter5.
Walkfor20minstoday,followedwithstretchingfor5mins,foratotalof25mins.
Lookoverthe“AddressingUnsupportiveRelationships”sectioninChapter7.Chooseoneofthosetipstotakeactiononthisweek.
TUESDAYDAY37
Bedtimeritual 10minsmeditation
25minsmovement
“Addressing”step
WEDNESDAYDAY38
Bedtimeritual 10minsmeditation
25minsmovement
“Addressing”step
THURSDAYDAY39
Bedtimeritual 10minsmeditation
25minsmovement
“Addressing”step
FRIDAYDAY40
Bedtimeritual 10minsmeditation
25minsmovement
“Addressing”step
SATURDAYDAY41
Bedtimeritual 10minsmeditation
25minsmovement
“Addressing”step
SUNDAYDAY42
Bedtimeritual 10minsmeditation
25minsmovement
“Addressing”step
You’llnotethatyouaredoing10wholeminutesofameditationadaynow!Ifyouwanttodomoreinthecomingweeks,thatisfine,butsoonwe’llstarttryingotherBreatheactivities.Ideasforaddressingyourbedtimeritualarestoppingelectronicusage2to3hoursbeforebed,turningdownthelightsinthehouseatsunset,usingamber-coloredglassesbeforebed,andimplementingself-careandcalmingactivitiespriortobed.
Week7
REST BREATHE MOVE CONNECT
MONDAY Haveyousetaconsistent
Takethe Walkfor30minstoday,
Lookover“An
DAY43aconsistentwaketime?Ifnot,usetherestofthisweektoaddressthisissue.
“Reframe”stepinChapter5.
minstoday,followedwithstretchingfor10mins,foratotalof40mins.
Autoimmune-FriendlySocialLife”inChapter7.Chooseoneofthosetipstotakeactiononthisweek.
TUESDAYDAY44
Consistenttimewake
10minsmeditation
40minsmovement
“SocialLife”step
WEDNESDAYDAY45
Consistenttimewake
10minsmeditation
40minsmovement
“SocialLife”step
THURSDAYDAY46
Consistenttimewake
10minsmeditation
40minsmovement
“SocialLife”step
FRIDAYDAY47
Consistenttimewake
10minsmeditation
40minsmovement
“SocialLife”step
SATURDAYDAY48
Consistenttimewake
10minsmeditation
40minsmovement
“SocialLife”step
SUNDAYDAY49
Consistenttimewake
10minsmeditation
40minsmovement
“SocialLife”step
Thisweek,youcancontinueyour10-minutemeditationroutine,butyoucanalsonowstarttryingotherwaysofmanagingstress.Youarealsomakingabigjumpthisweekwiththewalkingandstretchingroutine.Ifgoingfrom25minutesadayto40seemstobetoomuch,makeasmallerchange.Youmightalsoconsiderfindingawalkingpartnerthisweek,sinceitwouldbegreatforconnectingtoothers.Listeningtopodcastsormusicwhileyouwalkcanalsoenhanceyourexperience.Intermsofcalculatingyourconsistentwaketime,besurethatitgivesyouaminimumof8hoursofsleep.
Week8
REST BREATHE MOVE CONNECT
MONDAYDAY50
Doyouhaveamorningritual?Ifnot,usetherestofthis
Takethe“Accept”stepinChapter5.
Walkfor35minstoday,followedwithstretchingfor
Lookatthefirsttwotipsinthe“Howto
restofthisweektoaddressthisissue.
stretchingfor10mins,foratotalof45mins.
StartConnectingwithNature”sectioninChapter7.Chooseoneofthosetipstotakeactiononthisweek.
TUESDAYDAY51
Morningritual Play 45minsmovement
“Nature”step
WEDNESDAYDAY52
Morningritual Play 45minsmovement
“Nature”step
THURSDAYDAY53
Morningritual Play 45minsmovement
“Nature”step
FRIDAYDAY54
Morningritual Play 45minsmovement
“Nature”step
SATURDAYDAY55
Morningritual Play 45minsmovement
“Nature”step
SUNDAYDAY56
Morningritual Play 45minsmovement
“Nature”step
TheBreatheactivitythisweekistotryplay.Ifactiveplaydoesnotseemdoableforyou,trycoloring,playingwithclay,orbuildingwithLegos.Rememberhowyoulikedplayingasachild,andgiveitashot.You’llalsobeginConnectactivitiesthatemphasizenature.Don’tdiscountthepowerofthisstep.Ideasforaddressingyourmorningritualaregettingoutsidefirstthinginordertogetexposuretosunlightorinvestinginalight-therapylampinordertostartsignalingyourbraintoproducethecorrecthormones.
Week9
REST BREATHE MOVE CONNECT
Ifyouare Walkfor40
MONDAYDAY57
Ifyouarecontinuingtostrugglewithsleep,considertalkingwithyourhealth-careprovider.Usetherestofthismonthtotroubleshoot.
Beginworkingonthe“Alter”step,ifnecessary,inChapter5.
Walkfor40minstoday,followedwithstretchingfor10mins,foratotalof50mins.
Lookatthethirdtipinthe“HowtoStartConnectingwithNature”sectioninChapter7.Considersmallchangestotakeactiononthisweek.
TUESDAYDAY58
Troubleshootsleep
Journal 50minsmovement
“Indoor”step
WEDNESDAYDAY59
Troubleshootsleep
Journal 50minsmovement
“Indoor”step
THURSDAYDAY60
Troubleshootsleep
Journal 50minsmovement
“Indoor”step
FRIDAYDAY61
Troubleshootsleep
Journal 50minsmovement
“Indoor”step
SATURDAYDAY62
Troubleshootsleep
Journal 50minsmovement
“Indoor”step
SUNDAYDAY63
Troubleshootsleep
Journal 50mins.movement
“Indoor”step
Thisweek,you’llseethatyou’vetakenallthebasicstepswithRestandcanstarttroubleshootinganyremainingsleepproblemswithyourkeyplayer,ifthisareacontinuestobeproblematicforyou.You’llalsostartworkingonaltering,ifnecessary,anyareasofyourlifethataremajorsourcesofstressthatwerenotsuccessfullyaddressedusingothersteps.Thiscouldpotentiallybeahugeprocessandshouldbeundertakenwiththesupportofyourhealth-careteam,includingatherapist.
Week10
REST BREATHE MOVE CONNECT
MONDAY Troubleshootsleep
Ifthe“Alter”stepwas
Walkfor50minstoday,
Lookatthe
DAY64sleep stepwas
necessary,youmaystillneedtimetoworkonthisstep.
minstoday,followedwithstretchingfor10mins,foratotalof60mins.
fourthtipinthe“HowtoStartConnectingwithNature”sectioninChapter7.Startplanninga2-to3-hournaturedaytrip.
TUESDAYDAY65
Troubleshootsleep
Listentomusic 60minsmovement
“DayTrip”step
WEDNESDAYDAY66
Troubleshootsleep
Listentomusic 60minsmovement
“DayTrip”step
THURSDAYDAY67
Troubleshootsleep
Listentomusic 60minsmovement
“DayTrip”step
FRIDAYDAY68
Troubleshootsleep
Listentomusic 60minsmovement
“DayTrip”step
SATURDAYDAY69
Troubleshootsleep
Listentomusic 60minsmovement
“DayTrip”step
SUNDAYDAY70
Troubleshootsleep Listentomusic 60mins
movement“DayTrip”step
Ifalteringanyareaofyourlifetobettermanagestresswasnecessary,fromthispointforward,youmayneedagreatdealoftimetotroubleshoothowtomakethosechanges.Thatsaid,therearestilldailythingsyoucantrytohelpmanagestress.Inadditiontoyour10-minutemeditationroutine,youmighttrylisteningtomusicthisweek.You’vealsoreachedafullhourofactivityaday!Finally,you’llstartworkingonhowtospend2to3hoursweeklyjustsoakinginthenaturalenvironment.
Week11
REST BREATHE MOVE CONNECT
MONDAYDAY71
Troubleshootsleep
Trymassageoracupuncture
Startfindingwaystoincreasemovementat
Lookatthefifthtipinthe“HowtoStart
movementatyourworkplaceandthroughoutyourday.
ConnectingwithNature”sectioninChapter7.Startplanninga2-daynaturetrip.
TUESDAYDAY72
Troubleshootsleep
Tryacupuncturemassageor
Increasemovement
“2-DayTrip”step
WEDNESDAYDAY73
Troubleshootsleep
Tryacupuncturemassageor
Increasemovement
“2-DayTrip”step
THURSDAYDAY74
Troubleshootsleep
Tryacupuncturemassageor
Increasemovement
“2-DayTrip”step
FRIDAYDAY75
Troubleshootsleep
Tryacupuncturemassageor
Increasemovement
“2-DayTrip”step
SATURDAYDAY76
Troubleshootsleep
Tryacupuncturemassageor
Increasemovement
“2-DayTrip”step
SUNDAYDAY77
Troubleshootsleep
Tryacupuncturemassageor
Increasemovement
“2-DayTrip”step
AbigstepthisweekintermsofBreatheactivitieswillbetotryoutsomethinglikemassageoracupuncture.You’llalsostartthinkingaboutnewwaystoincreaseexerciseinyourlifeandhowtoincreaseyourtimeinnaturewitha2-daytrip.Involvefriendsandfamilyinthisplan;makeitfuntodiscoverhownatureimpactsyourwellness.
Week12
REST BREATHE MOVE CONNECT
MONDAYDAY78
Troubleshootsleep
Trymindfulness Increasemovement
Ifyou’vebeenworkingona2-daynaturetrip,youmaystillneedtimetoworkonthisstep.
TUESDAYDAY79
Troubleshootsleep
Trymindfulness Increasemovement
“2-DayTrip”step
WEDNESDAYDAY80
Troubleshootsleep
Trymindfulness Increasemovement
“2-DayTrip”step
THURSDAYDAY81
Troubleshootsleep
Trymindfulness Increasemovement
“2-DayTrip”step
FRIDAYDAY82
Troubleshootsleep
Trymindfulness Increasemovement
Fine-tunelifestyleaccordingtoyourpreferences,budget,andneedsinordertomaximizewellness.
SATURDAYDAY83
Troubleshootsleep
Trymindfulness Increasemovement
“Fine-Tune”step
SUNDAYDAY84
Troubleshootsleep
Trymindfulness Increasemovement
“Fine-Tune”step
Youhavereachedtheendoftheprocessandbroughtallthebasicsintoyournewwellnesslifestyle.Fromhereon,thisprocessisaboutfine-tuningaccordingtoyourpreferences,budget,andchangingneeds,sothatyoucanmaximizelivingwellwithautoimmunedisease.
LIFESTYLEPLANPREPARATIONLISTHereisalistofallofthetoolsandsuppliesyoumayneedinordertofollowthe12-WeekLifestylePlan,arrangedin4-weekblocks.Noneofthemisunusual,butitishelpfultomakesureyouhaveeverythingyouneedbeforegettingstarted.We’vealsoincludedalistofoptionalitems,whichmakesomeactivitieseasier.Forproductrecommendationsforsomeofthesetoolsandsupplies,seeResources.
Weeks1–4●PenandpaperfortakingassessmentsanddoingtheBreatheactivities●Timerfortimingmeditationandexerciseroutines
●Walkingshoesforexerciseroutines
Optional(you’llonlyneedtheseifyoufindtheyhavetobeaddressedforproperRestorBreatheactivities)
●Newbedand/orbedding●Black-outshades,ducttape,eyemask
●Earplugs,whitenoisemachine,fan●Guidedmeditations,meditationmusic,ormeditationapps/programs
Weeks5–8●Clockfornotingconsistentbedtimesandwaketimes●Journal
●Playitems(coloringbooks,coloredpencils,clay,Legos,etc.)
Optional(you’llonlyneedtheseifyoufindtheyhavetobeaddressedforproperRestorMoveactivities)●Amberglasses
●Light-therapylamp●Pedometer
●iPod/headphones
Weeks9–12●Nonewmaterialsarerequiredatthispoint.
Optional(you’llonlyneedtheseifyoufindtheyhavetobeaddressedforproperMoveorConnectactivities)●Backpackandwaterbottle
●Campinggear●Houseplants
●Essentialoils
Conclusion:PuttingItAllTogether
Implementingthechangeswetalkaboutinthisbookwilltaketimeandpersistence.Thisundertakingdoesnothappeninweeksorevenmonths—bothofushavebeenengaginginthisprocessformanyyearsnowandarecontinuingtotroubleshootandedit,asnecessary.Thebeautyofadoptingadietandlifestyletemplateinsteadofaprescriptionisthatyoucanadjustyourhabitsandroutinesbasedontheebbandflowofyourchangingdailylife.Intimesofhighstressorflare,you“battendownthehatches.”Youtightenyourapproachtothedietandlifestyleaspectsofthisprocessinordertorestorebalance.Intimesofeaseorgoodhealth,you“unfurlthesails.”Youembraceamoreexpansiveapproachthatallowsyoutoenjoy,experiment,andexperiencetheboundariesofwellnesswithautoimmunedisease.Thisiswhattheebbandflowwilleventuallylooklike,but,inthebeginning,youneedtomethodicallyfollowtheprocess,fromstarttofinish.Inthisbook,we’vepresentedyouwithsevenpowerfulstepsonthe
autoimmunewellnessjourney:inform,collaborate,nourish,rest,breathe,move,andconnect.Inadditiontoawealthofinformationtoguideyouractions,we’vegivenyouallthetoolsandresourcesyouneedtogetstarted,likemealplans,recipes,alifestyleguide,andself-assessments.Thesechanges,whilepowerfulontheirown,aresynergisticandcombinetoformacomprehensiveapproachthatwillrevolutionizeyourhealingprocess.Gradually,youwilllearnhowtointegratethebestofmedicalcarewiththeseDIYmodifications.Usingthetoolspresentedheretodefineyourpersonalprioritiesonthisjourneywillhelpyoupinpointwhichactionsaregoingtobemosttransformativeforyou.Havingwalkedthispathourselves,ourgoalistomakethisprocesseasierandmoreactionable.Oneimportantthingwewanttoemphasizeaswecometotheendofourtime
together,isthatperfectionismhasnopartinthisprocess.Letgooftheneedtodoitallrightstraightoutofthegate.Takethisslowly,patientlyputtingonefootinfrontoftheother.Ifyouhitastumblingblock,reevaluate,regroup,andmoveforwardwithyournewknowledge.It’snotaboutdoingeverythingperfectly;itisaboutunderstandingthateffortovertimewillproducechange.Watercutsthroughrockandmakesitswaytotheseanotbyknowingtheexactroute,butthroughpersistenceovertime.Whenwestartedtomakethesechangesinourownlives,tobehonest,the
informationoverloadmadeitfeellikeweweredrinkingfromafirehose.Thisprocessisunfamiliaranduncomfortableatthestart.We’vebeeninyourshoes!
processisunfamiliaranduncomfortableatthestart.We’vebeeninyourshoes!Ourculturemakesthesedietaryandlifestylemodificationsmoredifficult;bychoosingtohealinthisway,youwillbegoingagainstthestream.Youaretakingresponsibilityforyourhealthinasocietythatsays,“Justtakeapill...andstopforfastfoodonthewayhomefromthepharmacy.”Fromthatperspective,yourealizethattheadjustmenthereisnotjustaboutreorganizingyourscheduleoryourkitchenoryourfoodbudget...it’salsoaboutshiftingwhatyouseeasnormal.Itisokaytohavesomemeltdowns,because,inallhonesty,thisisgoingtobeoneoftheharderthingsyou’veeverdone.We’reheretotellyouitreallydoesgeteasierwithtime!You’llhaveitwired
soon,and,ashealingtakesholdandenergyreturns,youwon’tbelieveyouthoughtthatanyotherwaywasnormal.Hanginthere!Thereisagrowingcommunityofpeoplewhoareundertakingthesechangesandshiftingthewayautoimmunediseaserecoveryisachieved.Ifwedidn’tbelieveitwasworthit,ifwehadnotexperiencedincrediblehealingourselves,ifwehadnotwatchedhundredsofotherpeopleexperiencethesame,wewouldnothavetackledthisproject!Thefinalchapterofthisbookmarksthenextchapterofyourlifewith
autoimmunedisease—onethatisfilledwithempowerment,action,wellness,andvitality.Youarelikelytouncoverapartofyourselfthatyoudidn’tknowexisted.Ourhopeisthatthetoolsandresourcesfoundinthisbookwillhelpyoumakeinformed,practicalchoices,andthat,onceyourhealthisrestored,youwilladdyourvoicetotherevolutionaryshiftthatisunderwayintheautoimmunecommunity.Weinviteyoutotakeownershipofyourjourneyandjoinusinpioneeringthisnewera.Thisiswellnessthatoutlaststhehype!
Gratitude
DavidAltandMaggeeHunt,forlovingmedelicately,butexpectingmetobeastoughasnails.NoahTrescott,forgivingsomuchofyourselfsothatIcouldcompletethis
project.Icouldnothavemadeitwithoutyourservice,insight,andtoughlove.CharlotteDupont,forherunique,inspiringphotography.Yourtouchadds
depthtothisprojectthatwecouldnotcommunicatewithwords.Thanksforwakingupwhimsical.RoseSullivan,BrianSullivan,LoriMiller,andGaryandLynnetteClark,for
supportingusaswewonbackourhealthandthroughthejourneyofwritinganotherbook.SarahBallantyne,forherresearchanddevelopmentoftheAutoimmune
Protocol,aswellasforallowingustouseitinthisbook.Yourworkchangedourlivesandinspiresusdailytospreadtheword.TerryWahls,RobbWolf,andChrisKresser,forprovidingvaluable,
accessibleinformationthathastransformednotonlyourlives,butmanyotherlives,andhelpedinformthisbook.GraceHeerman,formanagingourworktasksandsocialmediawhilewriting
thisbook.Wearesoproudtohaveyouonourteam!ThePulicefamily,forgenerouslyallowingustocookandtakephotographs
forourbookattheirbeautifulranch.Wewantedtocommunicatehealing,andyourhomeisoverflowingwithit.CelesteFineandJohnMaas,fortheirrepresentationandsupportthroughout
thisprocess.Wearegratefulforyourprofessionalguidance.MarisaVigilanteandherteamatRodale,forhelpinguscreateabookthat
wouldaccuratelyconveythedepthofourpassionandbeavaluabletoolforothers.YrmisBarroeta,BobbyChang,MoyaChang,TitusChiu,NatashaFallahi,
SusanMcCauley,FelixMadrid,StephanieMadrid,MaryCloos,KatieSullivan,RoseSullivan,JasonHandler,StacyPulice,Jordan,andAmanda,formodelingforusandparticipatinginphotoshootsforthebook.ThecommunityofAutoimmuneProtocolbloggers,forcollaboratingwithusto
writeaboutautoimmunehopeandhealing.Wecountourselvesluckytobechangingtheworldwithpeoplelikeyou.Ourreadersandsupporters,forbeingwillingtotryawholenewapproachto
wellness.Youhaveenergizedthisprojectandmotivateusdaily.Withoutyour
enthusiasm,thisbookwouldnothavebeenpossible.
Resources
AUTOIMMUNEDISEASEORGANIZATIONSAmericanAutoimmuneRelatedDiseasesOrganizationwww.aarda.org
ArthritisFoundationwww.arthritis.org
CeliacDiseaseFoundationwww.celiac.org
Crohn’sandColitisFoundationofAmericawww.ccfa.org
Endometriosis.orgwww.endometriosis.org
Graves’DiseaseandThyroidFoundationwww.gdatf.org
Hashimoto’sAwarenesswww.hashimotosawareness.org
InternationalFoundationforAutoimmuneArthritiswww.ifautoimmunearthritis.org
LupusandAlliedDiseasesAssociationwww.nolupus.org
LupusFoundationofAmericawww.lupus.org
MyastheniaGravisFoundationofAmerica,Inc.www.myasthenia.org
TheMyositisAssociationwww.myositis.org
NationalAlopeciaAreataFoundationwww.naaf.org
NationalMultipleSclerosisSocietywww.nationalmssociety.org
NationalPsoriasisFoundationwww.psoriasis.org
PlateletDisorderSupportAssociationwww.pdsa.org
SclerodermaFoundationwww.scleroderma.org
SjögrensSyndromeFoundationwww.sjogrens.org
ThyroidChangewww.thyroidchange.org
AUTOIMMUNEPROTOCOLONLINERESOURCESAutoimmunePaleowww.autoimmune-paleo.com
ThePaleoMomwww.thepaleomom.com
PhoenixHelixwww.phoenixhelix.com
AUTOIMMUNEPROTOCOLRECIPEBOOKSTheAlternativeAutoimmuneCookbookbyAngieAltwithJeniferBeehler
TheAutoimmunePaleoCookbookbyMickeyTrescott,NTP
TheHealingKitchenbyAlaenaHaber,MS,OTR,andSarahBallantyne,PhD
HeWon’tKnowIt’sPaleobyBre’annaEmmitt
NourishbyRachaelBryant
ThePaleoApproachCookbookbySarahBallantyne,PhD
SimpleFrenchPaleobySophieVanTiggelen
CONNECTAutoimmuneProtocolMeetupGroupswww.autoimmune-paleo.com/meetup
DiscovertheForestwww.discovertheforest.org
NationalParkFoundationwww.nationalparks.org
NationalParkServicewww.findyourpark.com
TheWildernessSocietywww.wilderness.org
FINDINGADOCTORAcademyofIntegrativeHealthandMedicinewww.aihm.org
TheAmericanAssociationofNaturopathicPhysicianswww.naturopathic.org
AmericanBoardofIntegrativeHolisticMedicinewww.abihm.org/search-doctors
AmericanCollegeforAdvancementinMedicinewww.acam.org
CanadianAssociationofNaturopathicDoctorswww.cand.ca
TheInstituteforFunctionalMedicinewww.functionalmedicine.org
InternationalCollegeofIntegrativeMedicinewww.icimed.com
PaleoPhysiciansNetworkwww.paleophysiciansnetwork.com
PrimalDocswww.primaldocs.com
RevivePrimaryCarewww.reviveprimarycare.com
FOODSOURCINGAzureStandardofHealthyandAbundantLivingwww.azurestandard.com
EatWildwww.eatwild.com
EnvironmentalWorkingGroupwww.ewg.org
LocalFarmMarkets.orgwww.localfarmmarkets.org
LocalHarvestwww.localharvest.org
NationalFarmersMarketDirectorywww.nfmd.org
ThriveMarketwww.thrivemarket.com
USWellnessMeatswww.grasslandbeef.com
VitalChoiceWildSeafoodandOrganicswww.vitalchoice.com/shop/pc/home.asp
WildFermentationwww.wildfermentation.com
FURTHERREADINGAdrenalFatiguebyJamesWilson,ND,DC,PhD
TheAutoimmuneSolutionbyAmyMyers,MD
DigestiveHealthwithRealFoodbyAglaéeJacob,MS,RD
Hashimoto’sThyroiditisbyIzabellaWentz,PharmD,FASCP
TheHiddenPlaguebyTaraGrant
MoveYourDNAbyKatyBowman,MS
ThePaleoApproachbySarahBallantyne,PhD
ThePaleoSolutionbyRobbWolf
TheWahlsProtocolbyTerryWahls,MD
WhyDoIStillHaveThyroidSymptoms?WhenMyLabTestsAreNormalbyDatisKharrazian,DHSc,DC,MS
WhyIsn’tMyBrainWorking?byDatisKharrazian,DHSc,DC,MS
You’reNotCrazyandYou’reNotAlonebyStaceyRobbins
YourPersonalPaleoCodebyChrisKresser
INGREDIENTS/SNACKSArtisanTropicwww.artisantropic.com
BareBoneswww.barebonesbroth.com
Braggwww.bragg.com
CoconutSecretwww.coconutsecret.com/index.xhtml
EdwardandSonswww.edwardandsons.com
Epicwww.epicbar.com
Fatworkswww.fatworksfoods.com
GreatLakesGelatinwww.greatlakesgelatin.com
Jackson’sHonestwww.jacksonshonest.com
Kasadrinoswww.kasandrinos.com
McCormickGourmetwww.mccormick.com/gourmet
MissionHeirloomwww.missionheirloom.com
NaturalValuewww.naturalvalue.com/product/organic-coconut-milk
Nutivawww.nutiva.com
Otto’sNaturalswww.ottosnaturals.com
OurAmazonstorewww.autoimmune-paleo.com/amazon
PaleoAngelwww.paleoangel.com
ThePureWrapswww.thepurewraps.com
RealSaltwww.realsalt.com
RedBoatFishSaucewww.redboatfishsauce.com
Salt,Fire,andTimewww.saltfireandtime.com
Seasnaxwww.seasnax.com
TropicalTraditionswww.tropicaltraditions.com
VitalProteinswww.vitalproteins.com
KITCHENTOOLSBamboospoonswww.autoimmune-paleo.com/bamboospoons
BerkeyFilterswww.berkeyfilters.com
Cuisinartwww.cuisinart.com
GIRspatulawww.productofgir.com
Gummymoldswww.autoimmune-paleo.com/gelatinmolds
InstantPotwww.instantpot.com
LodgeCastIronwww.lodgemfg.com
Spiralizerwww.autoimmune-paleo.com/spiralizer
ThermoWorkswww.thermoworks.com
Vitamixwww.vitamix.com
MOVEMENTAltrawww.altrarunning.com
Bodyimagewww.theperformingwoman.com
ReboundAirwww.rebound-air.com
Vivobarefootwww.vivobarefoot.com
SLEEPAirpurifierwww.autoimmune-paleo.com/airpurifier
Ambientnoisemachinewww.autoimmune-paleo.com/noisemachine
Blue-lightblockingglasseswww.autoimmune-paleo.com/blueblockers
Blue-lightblockingsoftwarewww.justgetflux.com
Lighttherapylampwww.autoimmune-paleo.com/therapylamp
STRESSMANAGEMENTHeadspacewww.headspace.com
MountainRoseHerbswww.mountainroseherbs.com
ResilienceAcademywww.resilienceacademy.com
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www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Antinuclear_Antibodies_(ANA)/
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www.mayoclinic.org/tests-procedures/c-reactive-protein/basics/definition/prc-20014480
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Chapter2
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Chapter7 Social:WhyOurBrainsAreWiredtoConnectbyMatthewD.Lieberman,pp.39–70.
YourPersonalPaleoCodebyChrisKresser,pp.262–63.
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YourPersonalPaleoCodebyChrisKresser,pp.271–73.
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www.ncbi.nlm.nih.gov/pmc/articles/PMC4276610/#B1-ijerph-11-12204
www.ncbi.nlm.nih.gov/pmc/articles/PMC4233975
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