I Refused to Try Autoimmune Elimination Diets — Here’s Why I Stand By That Decision
Turning down my doctor’s proposed elimination diet was met with resistance, but it was a complicated declaration of self-love worth celebrating.
Most people with autoimmune disorders like psoriasis eventually stumble into the topic of Autoimmune Protocol (AIP) diets. For years, people have relied on these lifestyle and dietary guidelines to pinpoint causes of inflammation, ease symptoms, and approach treatment holistically.
While many folks swear by their life-changing results, elimination-style experiments can open the door to additional health issues, and they remain disputed in terms of effectiveness.
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What is an autoimmune elimination diet?
AIP diets seek to remove potential inflammatory food sources (“restricted foods”) while increasing overall nutrient density. By stripping down to bare-bones ingredients, you create a blank slate to monitor your body’s inflammatory response to certain foods, so you know what to avoid long term.
With roots tied to the paleo diet, elimination protocols still play a role in modern autoimmune intervention, especially within functional medicine spaces.
As time passed and science progressed, the AIP diet branched into two versions: Core Elimination and Modified Elimination. Core guidelines strictly adhere to the original AIP restriction list, while Modified protocols allow more flexibility with potentially similar benefits. Both versions follow the same three stages:
transition (slowly eliminating restricted foods)
elimination (maintaining restrictions for 1 to 3 months)
reintroduction (adding back individual foods while tracking symptoms)
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My initial resistance to eliminating foods
I’m a “yes” person, admittedly. But when autoimmune elimination diets came up in my psoriasis research and discussions post-diagnosis, I wholeheartedly refused without hesitation — a strong reaction that was uncharacteristic of me.
Why such resistance? In fairness, plenty of information exists on the potential health benefits of AIP diets, such as an anti-inflammatory impact on the gut microbiome. And I truly do believe that dietary habits matter significantly to our overall health. My reason for putting my foot down was not that I was resistant to the challenge of a strictly structured meal plan, nor that I was stubborn out of closed-mindedness.
Rather, my refusal to try AIP-based interventions was an act of self-love.
Two years into psoriasis symptoms (but still a year from diagnosis), I visited a new allergist for solutions. After standard patch and prick testing for food and environmental allergens, my doctor prescribed her usual plan to tackle severe allergies: cutting all dairy, gluten, and known allergens from the patient’s diet. She explained how dietary habits can manifest as skin symptoms and outlined the benefits of eliminating certain food groups from my plate.
I was surprised that my results showed allergies to dozens of foods and nearly every type of mold, pet, dust, and pollen. If I were to follow her approach, I’d need to eliminate not only dairy and gluten but also nightshade vegetables, eggs, nuts, seeds, pitted and tropical fruits, avocado, soy, various spices, shellfish, pears, apples, kiwis, red meat, carrots, and caffeine.
Since I’d never had childhood allergies, my sudden itch and inflammation seemed odd. Uprooting my diet felt extreme and didn’t identify the root problem — it just quieted my symptoms. Granted, the doctor’s plan wasn’t as intense as core AIP guidelines — maybe that’s why my resistance surprised her so much.
Struggling with healthy eating before my psoriasis
Long before developing chronic illness symptoms, I struggled with my health in a very different way. As a perfectionistic teen, I inadvertently began associating my worth with objective achievements. Alongside low self-esteem, this became dangerous. In college, I quickly spiraled into depression and watched myself fade in the grasp of a severe eating disorder.
Anorexia distorted my malnourished brain, rationalizing self-destructive behaviors as benchmarks of success. After several years embedded in addictive restriction habits, I genuinely feared food and hated myself. My days revolved around calorie counting, food rituals, and overexercise.
At 19, I was pulled from campus on mandatory medical leave to enroll in intensive treatment. I spent the next several years fighting a disorder I had somehow convinced myself wasn’t real.
The path to eating disorder recovery is a wildly complex journey of unlearning and redefining. Treatment demands constant confrontation of the enemy: While recovery from substance misuse focuses on abstaining, eating disorders present a unique challenge since food is both the poison and the remedy.
As I always explain, relearning to eat after years of disorder is like being forced to write with your nondominant hand: frustrating because what used to be a simple task of muscle memory suddenly requires painstaking focus on the mechanics of drawing each individual stroke and letter.
It took me years to establish a healthy relationship with food and even longer to develop an identity independent of physical appearance. Now fully recovered, I have a strong allegiance to the intuitive eating practices that saved me. But no matter how long has passed, I still tread mindfully with life’s hurdles — not for lack of confidence in my stability but because I’ve seen how quickly a misstep can snowball into self-destruction.
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The fight for individualized care
It’s with this lived experience that I entered my allergist’s office in 2021.
Since food restriction of any kind presents a huge risk of eating disorder relapse, I told her that a diet was my absolute last resort. I explained that calculated meal replacements and elimination of even some foods would be dangerously triggering. I divulged my fear of another birthday spent in a hospital gown. I told her I don’t look at nutrition labels anymore. That recent grief made me unsteady.
Even so, I had to reiterate my refusal.
The doctor told me they make gluten-free waffles now. She couldn’t fathom a scenario where I’d improve without diet modification.
“You’ll never get relief if you’re unwilling to work with me,” she said. She was visibly exasperated.
I apologized for being a “difficult” patient but again asserted that my mental health was a priority. I wasn’t making excuses to resist her help; these were truly red flags of a perfect storm for relapse.
Unfortunately, many healthcare professionals don’t prioritize individualized care. Our fast-paced American healthcare system relies heavily on efficient, standardized treatment plans that can be repeated across patients. I needed doctors who were committed to the best interest of my overall health, not to time-saving pamphlets.
Complex health histories require tailored approaches to long-term care. There’s no shame in that, but since it’s not the norm, patients shoulder the burden of advocacy and assertive communication.
Choosing relief
While there’s anecdotal evidence of symptoms alleviated by AIP, there’s no clinical proof that elimination diets cure psoriasis or guarantee complete relief. Thus, most doctors take a multifaceted approach that includes medication. In my case, restrictive dietary intervention isn’t just inconvenient; it threatens my stability in ways I’m unwilling to gamble with.
I’ve found significant psoriasis relief using biologics without jeopardizing my mental health, so I stand proudly by my decision.
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Bottom line
We shouldn’t be forced to choose between mental and physical health, since one doesn’t exist without the other. Maybe someday a healthcare system will emerge that honors a patient’s mental and physical healthcare as strands of the same braid. Perhaps then, prioritizing my survival won’t be labeled “difficult” in exam rooms.
For now, I’m leaving restrictive diets in my old journal pages, where they belong.
Medically reviewed on December 20, 2024
