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

http://www.rodalewellness.com/join

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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womenshealth.gov/publications/our-publications/fact-sheet/autoimmune-diseases.xhtml#a

www.nlm.nih.gov/medlineplus/ency/article/000816.htm

www.niams.nih.gov/health_info/autoimmune/

www.autoimmune.pathology.jhmi.edu/whatis_disease.cfm

www.drhyman.com/blog/2010/07/30/how-to-stop-attacking-yourself-9-steps-to-heal-autoimmune-disease/

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www.report.nih.gov/categorical_spending.aspx

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www.my.clevelandclinic.org/health/healthy_living/hic_Stress_Management_and_Emotional_Health/hic_Fostering_a_Positive_Self-Image

www.nlm.nih.gov/medlineplus/ency/article/000816.htm

www.celiaccentral.org/gettested/

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www.mayoclinic.org/tests-procedures/ultrasound/basics/definition/prc-20020341

www.rheumatology.org/Practice/Clinical/Patients/Diseases_And_Conditions/Antinuclear_Antibodies_(ANA)/

www.mayoclinic.org/thyroid-disease/expert-answers/faq-20058114

www.mayoclinic.org/tests-procedures/complete-blood-count/basics/definition/prc-20014088

www.mayoclinic.org/tests-procedures/c-reactive-protein/basics/definition/prc-20014480

www.functionalmedicine.org/files/library/experience-life-functional.pdf

www.aarda.org/autoimmune-information/questions-and-answers/

www.arthritis.org/about-arthritis/types/rheumatoid-arthritis/treatment.php

www.ccfa.org/what-are-crohns-and-colitis/what-is-crohns-disease/crohns-treatment-options.xhtml?referrer=https://www.google.com/

www.my.clevelandclinic.org/health/drugs_devices_supplements/hic_Non-

Steroidal_Anti-Inflammatory_Medicines_NSAIDs

www.mayoclinic.org/steroids/art-20045692

www.ncbi.nlm.nih.gov/pubmed/17458395

www.ncbi.nlm.nih.gov/pmc/articles/PMC2592779/

www.rheumatology.oxfordjournals.org/content/51/suppl_6/vi37.full

www.rightdiagnosis.com/a/ai/prognosis.htm

www.merckmanuals.com/home/immune-disorders/allergic-reactions-and-other-hypersensitivity-disorders/autoimmune-disorders

Chapter2

www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume102005/No1Jan05/tpc26_116008.aspx

TenLessonsinCollaboration(presentation)byDeborahB.Gardner,PhD.

www.nlm.nih.gov/medlineplus/ency/article/001933.htm

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www.ccaom.org/faqs.asp

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www.amtamassage.org/findamassage/credential.xhtml

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www.reiki.org/FAQ/WhatIsReiki.xhtml

www.functionalmedicine.org/about/whatisfm/

www.nccih.nih.gov/health/integrative-health

www.nationalpartnership.org/research-library/healthcare/petm-presenter-manual.pdf

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TheWahlsProtocolbyTerryWahls,MD,pp.261–64.

Chapter3 www.gut.bmj.com/content/49/2/159.long

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ThePaleoApproachbySarahBallantyne,PhD,Ch5.

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Chapter4 YourPersonalPaleoCodebyChrisKresser,pp.227–28.

www.cdc.gov/features/dssleep

ThePaleoApproachbySarahBallantyne,PhD,pp.255–58.

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YourPersonalPaleoCodebyChrisKesser,pp.227–36,243–45,228–37.

ThePaleoApproachbySarahBallantyne,PhD,pp.131,144–57,151–53,157,257.

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Chapter5 YourPersonalPaleoCodebyChrisKresser,pp.241–45.

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Chapter6 www.apocpcontrol.org/paper_file/issue_abs/Volume8_No3/325-338%20b_Kruk14.pdf

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ThePaleoApproachbySarahBallantyne,PhD,pp.258–59.

YourPersonalPaleoCodebyChrisKresser,pp.214–15.

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www.well.blogs.nytimes.com/2014/04/30/want-to-be-more-creative-take-a-walk/?_r=2

www.scientificamerican.com/article/regular-walking-can-help-ease-depression

www.well.blogs.nytimes.com/2013/08/12/building-up-bones-with-a-little-bashing

www.health.howstuffworks.com/wellness/diet-fitness/exercise/benefits-of-walking5.htm

www.ncbi.nlm.nih.gov/pubmed/21364350

Chapter7 Social:WhyOurBrainsAreWiredtoConnectbyMatthewD.Lieberman,pp.39–70.

YourPersonalPaleoCodebyChrisKresser,pp.262–63.

www.thepaleomom.com/2014/12/health-benefits-connection.xhtml

www.heretohelp.bc.ca/sites/default/files/wellness-module-3-social-support.pdf

www.psychologytoday.com/blog/compassion-matters/201301/5-ways-maintain-lifelong-friendships

www.psychcentral.com/lib/why-friends-disappear-when-crisis-turns-chronic/

YourPersonalPaleoCodebyChrisKresser,pp.271–73.

www.jameslovelock.org/page34.xhtml

www.ncbi.nlm.nih.gov/pmc/articles/PMC2793347

www.ncbi.nlm.nih.gov/pmc/articles/PMC2793341

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www.ncbi.nlm.nih.gov/pmc/articles/PMC3699874

www.ncbi.nlm.nih.gov/pmc/articles/PMC3987044

www.ncbi.nlm.nih.gov/pmc/articles/PMC4276610/#B1-ijerph-11-12204

www.ncbi.nlm.nih.gov/pmc/articles/PMC4233975

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