Thanks for joining us for episode 62 of The Ancestral RDs podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show!

Today we are answering the following question from a listener:

“Can you suggest an alternative plan for trying Autoimmune Paleo that will be effective in identifying food sensitivities? I have HPA axis dysfunction and am a recovering orthorexic. It would be very difficult from a stress and financial perspective, as well as calorie needs perspective to cut eggs, dairy (I eat raw milk and conventional organic cheese, kefir and yogurt), grains (I eat quinoa and buckwheat), nightshades (white potatoes are a good starch for me), and nuts, and seeds all at once. Cutting dairy and eggs at the same time would be especially tough.

Can you suggest a plan for elimination and reintroduction for my situation that would alleviate the stress and strict limits, yet also accomplish the goal of finding intolerances and healing any leaky gut? I am not currently diagnosed with an autoimmune disorder, but I do have recurring skin issues that may be autoimmune in nature. Thanks.”

Do you want to try an Autoimmune Paleo diet but are overwhelmed just thinking about it? You’ve come to the right place! Many people understandably rethink the idea when faced with considering the possible stress on their lifestyle.

An elimination diet such as Autoimmune Paleo is good way to determine if a food sensitivity could be contributing to a health condition. At the same time, diets are not once size fits all and the best way to apply them largely depends on the person and his/her current lifestyle factors.

Listen today as we share insight into approaches that can lessen the stress involved with the Autoimmune Paleo diet and discuss other significant but often overlooked variables that could be affecting a health condition regardless of diet.

Here’s what Laura and Kelsey will be discussing in this episode:

• The importance of considering the pros and cons of a restrictive diet like Autoimmune Paleo
• Ways to reduce financial, mental, and other stress on your lifestyle while going on an elimination diet
• How being on a restrictive diet like Autoimmune Paleo for too long is not optimal, especially when dealing with orthorexia
• Benefits of reducing foods one at a time when beginning an elimination diet
• Why skin problems make it hard to gauge progress on an elimination diet
• Strategy for slowly removing possible problematic foods from your diet
• Strategy for the reintroduction phase of the diet
• The value of specialized testing in taking the guesswork out of experimentation and avoiding the stress associated with an elimination diet
• Other significant but overlooked variables that may be contributing to your condition regardless of diet
• Importance of gaining perspective on other stressors in your life that may be priority to address before considering an elimination diet
• The benefits of working with a nutrition professional to help you through the process from determining if the Autoimmune Paleo Diet is a wise choice for you to navigating the diet according to your individual needs

Links Discussed:

• KettleAndFire.com – Use the code AncestralRDs for a 15% discount off your first order of Kettle and Fire bone broth!
• Episode 53 of the Ancestral RDs Podcast includes a discussion of  managing the expense of eating to heal and provides tips to maximize nutrient intake while on a tight budget.

TRANSCRIPT:

Kelsey: Hi everyone. Welcome to episode 62 of The Ancestral RDs. I’m Kelsey Marksteiner and with me as always is Laura Schoenfeld.

Laura: Hey everybody.

Kelsey: How are you doing today, Laura?

Laura: Oh good, just recovering from a pretty exciting week in Nashville on vacation, which was awesome.

Kelsey: I know, I saw some of your Instagram posts. It looked so fun.

Laura: Half of them were at bars because I was in a bachelorette party. I never go out. I mean I go out sometimes, but if I do go out it would be for like one or two drinks and then I’m home by 11. So you can imagine being out with a bunch of girls celebrating a bachelorette party. We were out pretty late most nights.

Kelsey: Yeah.

Laura: Also apparently bars close at 3 am in Nashville.

Kelsey: Wow!

Laura: It was funny, there was one night I was really tired and it was like 1:30. I’m okay at least we’re going to leave soon, it’s almost time for the bar to close. Then I was like oh no, wait a second, it closes at 3! I was just like, I have to go, I literally can’t handle this. It’s just funny because I’m usually in bed at home by no later than 11 and being out that late kind of made me feel like I was in college again or something.

Kelsey: Yeah, no kidding.

Laura: But we had a really good time. Nashville is awesome. All the bars that we went, well not all of them, but a lot of them that we went to all had live music every night. It felt like there was some kind of festival going on, but that’s literally just how Nashville is where there’s so much live music, which I always love. Everyone is super friendly there.  I’m used to that kind of atmosphere being in the South. But it was weird to be in such a touristy place where everyone was so friendly.

Kelsey: Yeah.

Laura: Because usually when you’re in touristy areas all the locals are like get away, leave us alone. Whereas I feel like in Nashville, people were really excited to have visitors. There was probably 100 bachelorette parties that we ran into.

Kelsey: Oh my God.

Laura: It was crazy. Yeah, apparently it’s the number one location for bachelorette parties in the country.

Kelsey: Really?

Laura: Yeah. Who knew, right?

Kelsey: Interesting.

Laura: But it was a lot of fun. I had the bachelorette party on the weekend, and we got a lot of pool time, and then when out for dinner, and drinks, and dancing, and all that which it’s been a long time since I did anything like that. I really like dancing.

Kelsey: I know, I do too. I love excuses like that, weddings, stuff like that. I’m like, yes! I get to dance!

Laura: Well that is what was fun about the live music is a lot of times it felt like we were at a wedding because it was like live bands playing cover songs basically.

Kelsey: Yeah.

Laura: So it kind of felt like a wedding. The first night we were there, we hadn’t even planned on going out that late. We were just like let’s go check out Broadway, which is the honkey tonk bar area.

Kelsey: Mm hmm.

Laura: And we ended up staying out super late and dancing the whole night. I had my phone with me, which has a pedometer on it and I was just curious to see what step count we had from all the dancing that we did. My step count for that day was literally 22,000 steps, which is crazy. It’s like 10 miles.

Kelsey: Wow.

Laura: We literally did 10 miles of dancing, which it’s been a really long time since I did that, but it was super fun. Then I got to do a yoga class with my instructor that I went on those two surf and yoga retreats with in other countries.

Kelsey: Oh cool.

Laura: She owns her own studio in Nashville so I got to go to one of her classes which was fun. It was very odd to be in an actual studio with her as opposed to like in the middle of the jungle somewhere in Central America.

Kelsey: Right. Hopefully it brought some of those feelings back though.

Laura: Yeah, it was really cool. I was in Nashville for about 8 days. So the first 4 or so are with the bachelorette party and then the second 4 my boyfriend came down from Ohio to hang out and we did more of like low key stuff as opposed to going out super late.

Kelsey: You needed a break.

Laura: Yeah, I was like already pretty tired by the time he showed up. I was like, I promise we’re going to have fun, but we need to kind of take it easy for today because I’m really tired. We did some cool things like we went to this big waterfall park where we went and did some hiking and swimming. The waterfall was really pretty, it was humongous. Then also we did a whisky distillery tour, which I really like whisky.

Kelsey: Oh, that’s cool.

Laura: Yeah, and it was all a bunch of history about the distillery and about Tennessee whisky in general.

Kelsey: Mm hmm.

Laura: It was actually really cool all the history surrounding the distillery and then we got to obviously taste some whisky which was really good. What other fun things did we do? Oh I was mentioning to you before we got on the call today that I feel like from a food perspective, I literally just had no food restrictions at all when I was there, which was really interesting because at first I was like, oh I’m going to try to eat the way that I would normally eat. But eventually I was like oh whatever, forget it, I’m just going to eat what I want and not worry about it. For me, “going off the rails” is I had pizza twice when I was there, I had some biscuits with breakfast twice I think. What else did I have? I’m trying to think. Oh, I had hot chicken, which is if anyone’s been in Nashville, they know that that’s a Nashville thing. But it’s like, I don’t know if it’s totally fried chicken because I don’t think it was KFC style breaded.

Kelsey: Yeah.

Laura: But it was definitely of some kind of fried chicken. That was not something I normally eat.

Kelsey: Mm hmm.

Laura: I had a lot more alcohol than I would normally have. I’m trying to think if there’s any….I had dairy in my coffee. So I got a latte at this kind of famous coffee shop which was mostly milk.

Kelsey: Yeah.

Laura: Normally I usually just add a little cream to my coffee. I don’t do a latte.

Kelsey: I know, I’ve been doing more lattes lately because they’re just so freaking good.

Laura: The milk thing usually, I don’t know, I say usually affects me. But it’s just so funny, I was kind of putting myself in the position where I’m like, okay well if my stomach gets messed up by this, whatever, I’ll just deal with it.

Kelsey: Mm hmm.

Laura: The night we got home from dancing we were all starving because as you can imagine, if you dance for 10 miles, you get pretty hungry.

Kelsey: Yeah.

Laura: It was 2:00 in the morning and all the girls were like let’s get pizza. I was like oh no. They ordered Papa John’s and got it delivered. I was like okay maybe I’ll just have some cheese off the top. And then I started to eat the cheese and I was like never mind, I’m eating this. So I ate 2 slices of Papa John’s pizza which was not something I would normally do. But I was in my head thinking, okay whatever, if I have a stomachache tomorrow, whatever, it’s fine. Honestly, nothing happened.

Kelsey: Yeah.

Laura: It was really weird because pizza tends to be one of those things that does bother me. I don’t know if it’s like a psychosomatic thing at this point, or what happened, but literally had no problem eating it.

Ironically the only time I had a stomach issue the whole time I was there was what I think was from getting some chicken salad at Whole Foods. My boyfriend and I did that hike and we brought food with us because they weren’t going to have anything out there. We got some chicken salad, and crackers, and things like that to bring with us. I think he said he had a little bit of a stomachache, but I felt really sick on the drive home and I’m pretty sure it was from the chicken salad. Which just goes to show you, things that you think are going to bother you like pizza, or bread, or dairy, or whatever the things that you might think normally affect you, it’s not necessarily going to happen.

Kelsey: Right.

Laura: Whereas things like chicken salad from Whole Foods, I eat that stuff all the time. There’s no reason that should bother me, but that was what actually mostly affected my stomach to the point where I was like feeling really ill and I had to get Pepto Bismul. It was just a really weird experience because I kind of went into everything being like, alright, well if this messes up my stomach, it’s fine, I’ll just deal with it. And nothing bothered my stomach, you know?

Kelsey: Yeah.

Laura: And I’m not saying that I would do that all the time. I don’t want to eat fried chicken and pizza all the time because that doesn’t seem like a great balanced diet. Probably wouldn’t let me be a very good role model for my clients.

But it was just really odd because I think I was just having so much fun, and in such a good mood, and I was with some of my best friends from college. As far as bachelorette parties go, it was like zero drama, which is always a nice surprise when you get a bunch of random girls together. Then time with my boyfriend, it was all just so fun that I feel like my mindset was just so positive that the food thing wasn’t even an issue.

Kelsey: Yeah.

Laura: I don’t know. It was a very interesting experience for me because I think even being more flexible with my diet than I ever was in the past, well I should say in the last like, I don’t know, 10 years or something. There’s still things that I try to not to eat because I feel like oh well I know that tends to bother my stomach.

Kelsey: Right.

Laura: I just don’t want to deal with that right now. But it’s just funny because things that I normally would not do well with, I was fine.

Kelsey: Yeah.

Laura: So just a very eye opening experience to how mindset, and emotions, and social eating, and that kind of stuff can affect how you digest your food.

Kelsey: Yeah.

Laura: I mean sometimes our bodies are just weird too, to be honest. I’ve been trying to figure this one out for a long time. For me, and I’m sure I’ve talked about this a little bit before on our podcast, I can’t eat yogurt. It just makes me feel kind of sick for some reason. At first I thought that was a lactose thing, but then I can have a latte and it doesn’t bother me at all, like no issues what so ever.

Kelsey: That is really weird.

Laura: Yeah, and I still have no idea why that is. Maybe I need to try yogurt some more. Maybe I don’t have any issues with it and it was just this kind of fluke thing that happened a couple times and I just associated it with me being sensitive to it in some way.

But yeah, it’s really weird and I feel like our bodies can just be strange sometimes and maybe it was a mindset thing for me at that point. I don’t know. I always tell my clients you have to make sure that the thing that you are avoiding, you are avoiding because you been able to replicate that kind of experience with it and it’s actually an issue.

Laura: Mm hmm.

Kelsey: I’ve been able to replicate it, but I haven’t had it in a long time. So now I’m like, maybe I should try it again and see if I can tolerate it now. But yeah, it is interesting how much mindset can have an effect on the way that your body treats things. Maybe at that point I was just kind of against dairy in a lot of ways and my body was like, oh I guess I’m against dairy too. I don’t know. We’ll see.

Laura: That’s very scientific.

Kelsey: Yeah. Can you tell that I’ve really researched this a lot?

Laura: Have a study about your body deciding to be on the same page.

Kelsey: Right. My brain is like, hey body, this is how we feel about dairy, so please act accordingly.

Laura: It’s funny, I was mentioning to you before we got on the call also that…not that I care, because I think right now I’m not very concerned about my weight. This is probably the most body happy, body positive that I’ve been in my, honesty I would say my entire life even though I’m not as fit as I was in college or anything like that. But I have lost weight in the last year, which I think combination from the strength training programming that I’m doing, and then also eating appropriately, and I don’t think I’m under eating, or over eating, or eating foods that are specifically Paleo or anything like that. Honestly, my diet has been as loose as it’s been. But I’ve been interested to watch how my weight has been affected by various inputs. So for example, I find that my weight tends to go up a pound or two right after a tough workout.

Kelsey: Mm hmm.

Laura: If I train on a Monday, usually Tuesday I’ll weigh more than I weighed on Monday. Or if I’m dehydrated, obviously I’ll weigh a little less. But it was funny because I was curious because I didn’t really do any formal exercise other than the yoga class when I was in Nashville for that week. I honestly ate things, like I ate as much I wanted, I ate fried foods, breads, way more alcohol than I normally have.

Kelsey: Yeah.

Laura: And I had desserts and all this stuff. I was like alright, well let’s see what the damage was. I’m curious to see what my weight has done after that week. And I had actually lost 2 pounds since the day that I left, which again, I don’t care. It’s not that big of a deal. It’s not like I’m trying to lose weight. But I weighed the least that I’ve weighed in like 4 years the day after I got back from Nashville.

Kelsey: Wow.

Laura: I just was laughing to myself because I’m like I’m sure it was a combination of being a lot of walking, and especially when I eating with my boyfriend, I wasn’t finishing my plate. I was eating what I wanted and then basically just dumping everything else onto his plate because he’s twice my size. I’m like, here you can finish that, or try that, or eat this. Literally I was like giving him half my food. But it wasn’t like I was not eating on purpose, it was just kind of oh I had what I wanted.

Kelsey: Mm hmm.

Laura: I had 2/3 of my biscuit and I don’t want the whole thing, so here you go, eat this. It was just funny because it was like as much as I was not exercising and eating whatever I wanted…like we had ice cream a couple times, literally anything…that was what lead to a couple pounds of weight loss. And like I said, I had basically hit my lowest weight that I’ve been since, I want to say like 2012 or something.

Kelsey: Wow.

Laura: Yeah. It’s just really funny and I feel like I work with so many clients that are struggling so hard to lose weight and the concept that not working on it is when it happens is so hard for people to believe. I honestly might have been skeptical of it too except for that’s what I have experienced in the last couple months. Basically I’ve lost like 8 to 10 pounds in the last 2 months from not even trying and just being distracted. I don’t know.

It’s just really funny because I feel like people try so hard and they get so frustrated because it’s like I’m working so hard on this, and I’m eating so clean, and I’m exercising so much! And honestly, I’m starting to come to the conclusion that trying too hard is just as bad as not trying hard enough.

Kelsey: Yeah, I think that’s totally true. The more that I work with clients and work on this stuff myself too, the more I realize that not thinking about things is so much more helpful a lot of the time. Because I’m sure you get this same thing, you get clients that you can tell they’re so in their head about all of this stuff and it just causes them stress first of all, which they don’t even necessarily perceive.

Laura: Mm hmm.

Kelsey: And I think that’s true for anything that you’re working really hard toward and you’re always thinking about it. Even though know it doesn’t necessarily feel like a stressor, I think it really acts like one. As soon as you sort of put that out of your mind, or like you said, you’re distracted by something else that’s going on in your life, and things are good, and you’re just happy, and you’re enjoying your life, even if you’re eating things…like I was saying to you that I had Chinese food yesterday because of extenuating circumstances as well. We got home really late because we drove a friend home. We were hungry, and that was the only thing open, and hey, I like to eat Chinese food sometimes. Sue me. So whatever. And that’s fine and I don’t beat myself up about it. It doesn’t happen all the time, but it’s something that I make allowances for and I just don’t really care. I think that can be a useful mindset as much as that sounds weird to just not care about kind of stuff.

Laura: Yeah, well honestly I feel like sometimes when people care too much, then they start to do self-punishment if they go off their plan.

Kelsey: Right.

Laura: I mean it’s funny. It’s like we call ourselves the Ancestral RDs and it’s like we probably eat a decent amount of things that wouldn’t considered appropriate for an “ancestral diet.”

Kelsey: Right.

Laura: I don’t know. I think both of us have gotten to this place where we realize things are more important than diet and exercise. I think diet and exercise is just a small piece of your total health puzzle, and even health is not the most important thing in the world. That’s something that for me the last year or so, that point has been driven home for me that my health, yeah it’s important, I don’t want to be unhealthy, and I don’t want to treat my body like crap, and I don’t want to go out drinking every night until 2:00 in the morning or something.

Kelsey: Right.

Laura: That’s not what I’m saying. But I also have realized that for me, my social life and my relationships are defianatly number one.  I guess I should say actually my spiritual life is probably number one, but the relationships around that has been my highest priority in the last year or so and that has just been so life changing for me. It’s just so liberating to able to go out and eat whatever and not worry about it. Then when I grocery shop, yeah I still get vegetables, and meats, and potatoes, and sweet potatoes, and fruit and stuff. I don’t go and buy fried chicken for dinner.

Kelsey: Right.

Laura: But it’s just nice to not have this weird food rules or arbitrary restrictions that affect how I can socialize with people when I’m out.

Kelsey: Mm hmm.

Laura: Or how I can experience a city that I’m traveling in. We’ve talked about this a lot, but I almost feel like we have to keep talking about it. Because first of all, we want to be good role models for people. And second of all, I feel there’s a lot other health professionals that don’t either amdit that they admit that they do this kind of stuff or they just don’t do it.

Kelsey: Right.

Laura: I don’t always think that’s an appropriate way to teach others and expect people to live.

Kelsey: Yeah. I always wonder that about other health professionals. I’m like, do they eat Chinese food really at night sometimes?

Laura: Do they eat Papa John’s pizza at 2:00 in the morning after dancing for four hours? I don’t know. Maybe not.

Kelsey: Hey, it works for us, whatever. And you really do just have to figure out what works for you.

Just going back to your comment for a second there about health not being necessarily the number one thing that you need work on in your life. I think that’s a lesson that I’ve learned over the last or so too because I have a health condition, and yeah, I could spend every minute of my waking life working really hard to make it to make it less bad or get rid of it completely. I don’t know if it’s every going to go away.

But to me that never seemed worth it because, like you said, I prioritize my relationships and my social life. There are just other more important to me. Yes, I want to be as healthy as I can, but I’m not going to kill myself trying to be super, super healthy when maybe that’s just not in the cards for me. Maybe that’s a bad choice and maybe I’ll change my tune on that at some point. But at least for me right now, that doesn’t feel worth it.

Laura: Right.

Laura: I mean the question would be what’s the return on that investment even?

Kelsey: Right.

Laura: If you are socially isolating yourself because you’re like, I need to be on this exact diet, and avoid this many foods, and not go out past 9:00, and all that stuff, it’s like the question is would that even actually make a significant impact on your health to the point where it would be worth it?

Kelsey: Right.

Laura: There’s pros and cons to every choice you make and perhaps that choice would actually make you feel physically worse because the relationships part of things is a contributing factor to your health as well.

Kelsey: Mm hmm.

Laura: If you‘re super stressed out all the time because you’re, like I said, socially isolated and so focused on your health that you don’t do anything else, and you don’t have any fun, and you’re never happy, that’s not necessarily a positive thing for your body.

Kelsey: Right.

Laura: And it’s not even guaranteed to make you feel better. This is something that you and I see all the time with a lot of our clients where it’s like they’re so focused on the health piece that everything else is just on the back burner and they’re not even seeing improvements because their body is not getting the positive experiences from relationships, and fun, and play time, and that kind of stuff that we need basically.

Kelsey: Yeah.

Laura: It’s not just about enjoying your life. A big component of health is our ability to have fun, and be in relationships, and have positive emotions. It maybe doesn’t sound very scientific, but I think there’s a lot of evidence that…and we already talked about this in a recent podcast…that there is a lot of evidence that all that stuff can be just as important, if not more important than your weight, or your smoking status, your diet, and that kind of stuff.

I don’t know if people ever get bored about us talking about this stuff, but I do think that there needs to be balance, and there needs to be certain people that have influence sharing this kind of stuff with people because it makes other people feel like they have permission to do it as well and it’s not unhealthy to make those choices.

Kelsey: Yeah. I’m totally with you.

Laura: Cool.

Kelsey: Alright, so now that we’ve talked for probably far too long.

Laura: Never!

Kelsey: Let’s jump into our question. But before we do that, here’s a word from our sponsors.

Alright. Welcome back. Let’s see, our question today is:

“Can you suggest an alternative plan for trying Autoimmune Paleo that will be effective in identifying food sensitivities? I have HPA axis dysfunction and am a recovering orthorexic. It would be very difficult from a stress and financial perspective, as well as calorie needs perspective to cut eggs, dairy (I eat raw milk and conventional organic cheese, kefir and yogurt), grains (I eat quinoa and buckwheat), nightshades (white potatoes are a good starch for me), and nuts, and seeds all at once. Cutting dairy and eggs at the same time would be especially tough.

Can you suggest a plan for elimination and reintroduction for my situation that would alleviate the stress and strict limits, yet also accomplish the goal of finding intolerances and healing any leaky gut? I am not currently diagnosed with an autoimmune disorder, but I do have recurring skin issues that may be autoimmune in nature. Thanks.”

Laura: This is a good question based on our discussion a few minutes ago.

Kelsey: Yeah.

Laura: Just because, I mean this is a big type of client that you and I work with where people have food sensitivities that they feel like need to try an elimination diet, or they need to try something like an Autoimmune Paleo approach. But they also realize that those restrictive diets cause them stress, they may tend to under eat, they may actually have some financial restrictions that would make it hard to eat that way.

Kelsey: Mm hmm.

Laura: So there’s a lot of things that those diets can affect beyond just, oh just eat Autoimmune Paleo and it’ll be fine. What would you suggest for this person if you were working with her?

Kelsey: I would probably start by saying that you really need to think about any sort of these diets as a short term thing. I do think there’s this idea that any kind of diet like this, especially if it’s for a specific type of condition, needs to be a lifelong thing. While that may be the case for some people, again I do think you to think about the pros and cons. Is sticking to a strict Autoimmune Paleo diet going to help you more than being able to go out and eat some of these things sometimes with your friends? Or things like that.

Just to start off with, I would say I’m not even necessarily sure that someone who probably would maybe get a little less symptoms from being on an Autoimmune Paleo diet should even do that for life. But in general, my perspective about these sort of diets is they should be short term. The whole idea, in my eyes at least, is to determine if there is a sensitivity to one or more of these so that you know which ones you need to not eat on a consistent basis rather than saying all of these foods are terrible for people with autoimmune disease and I’m not going to eat any of them.

Laura: Mm hmm.

Kelsey: With that in mind, I would recommend just because she has this history…I’m assuming this is a woman, I think it is a woman.

Laura: Yeah.

Kelsey: I think because of her history with the orthorexia and the financial concerns, I would probably say that she should work on reducing these things one at a time just so it doesn’t feel so strict so immediately from the orthorexic perspective.

From a financial perspective too because it means that you kind of need to do this less intensely, which in a lot of ways usually means more expensive. If she had to switch out everything, she couldn’t finish up things that she currently has. It would just feel like a big financial strain all at once.

I do think she probably needs to do a strict Autoimmune Paleo for like a month because it’s a skin issue. That’s really going to be the only way to see if it makes difference just because skin issues tend to really, really tough to notice any difference and it takes a long time to notice any difference. In fact, I brought this up to Laura. I was like I would say two weeks. Then she said it’s a skin condition, are you sure? I was like, yeah, you’re right. We need to do this longer.

Laura: Mm hmm.

Kelsey: Skin issues I would have to say are probably one of the hardest things to deal with just because there’s so many inputs. There’s so many variables that can play a part in skin issues. They take a long time to clear up and it’s hard to tell what thing is working that you’ve changed.

I would say taking things out one at a time. So let’s say eggs are the easiest for this person to take out, I would start with that. Then take out grains if that’s the next easiest thing. Kind of slowly work her way to a strict Autoimmune Paleo diet so that it doesn’t feel so sudden and so strict all at once. Then once she’s there, give that a month. See if anything changes with the skin. She may notice that things are changing in a positive way with her skin prior to even getting to the strict Autoimmune Paleo diet.

Laura: Right.

Kelsey: That’s sort of why I recommend that slow approach because there may be something that she takes out, like let’s say it’s eggs, a big part of it is eggs and once she takes that out, and if it’s the first thing she takes out, she notices a big difference. She could still continue with getting to the strict Autoimmune Paleo diet to see if there’s anything else playing a role here, but she would know pretty quickly that something is causing an issue.

You could do it two ways. You could say, okay, what’s the easiest thing for me to start with by taking out? Or, what is something that I think there may be an issue with that I want to just see what that does first on its own by taking that out? That’s a question I ask my clients a lot. Which would you rather do? Do you want it to be easier at first just to kind of ease yourself into it? Or is there something that you think probably an issue, but you‘ve never done an elimination diet with taking that out before and you just want to start with that to see if it makes much of a difference?

Laura: Mm hmm.

Kelsey: It sort of depends on your mindset, and how you want to do these things, and your background, and the health condition that you’re dealing with. Given the orthorexic background here, I would probably say start with the easiest thing because, again, I don’t want to rush this person into feeling like her diet is really restricted.

But once she gets to the strict Autoimmune Paleo diet, yes, it’s going to be a little bit more expensive. I’m sorry, that’s just kind of how it goes. I would encourage you to as you’re slowly taking things out, maybe save a little bit of extra money so that by the time you get to your strict Autoimmune Paleo diet and you know you’re just going to do that for a month basically, you have that budgeted out and you just know it’s going to be a little bit more expensive.

There’s unfortunately no real easy way around that. You could probably go back to some of our podcasts talking about how to make the Paleo diet a little bit less expensive or good ways to manage the expenses of a Paleo diet. That could be helpful. But in general, yes, it’s going to be a little bit more expensive and I would just tell you to kind of save up as you’re working towards that so it’s not as much of a financial burden at that time.

Then you can start adding things back in. I would probably start with the things that you think you do fine with. And this is if you have a good response. If you’re eczema or whatever skin issue gets better over that month of being on a strict Autoimmune Paleo diet, then we know something is working.

If it doesn’t get any better or it’s unclear, you could extend it little bit. But I wouldn’t extend it more than another month. If by the end of the second month, there’s still no difference, I would just move on to the reintroduction phase. Maybe things will get worse, and maybe you didn’t notice that it got any better, or you notice an even worse flare comes when you add something back in. That’s a clue as well.

Skin issues can be related to a lot of other things. Like I was taking about before, there’s a lot of variables with skin issues. It could be something that’s physically irritating it causing it to happen. It can be related to the HPA axis dysfunction that this person mentioned. There’s just a lot of other things going on. It could be gut issues that are unrelated to food sensitivity. It could just be this person has SIBO, or this person has a parasite, or a pathogen, or something that is triggering the immune system to have this sort of reaction.

Lots of other things to think about which is why I would say if there’s’ no improvement, I wouldn’t necessarily be worried about that. I would be thankful in fact. I would just say, yay! I don’t have to necessarily worry about any of these things. I wouldn’t just continue on it indefinitely just because you have some sort of autoimmune disease.

Laura: Mm hmm.

Kelsey: That’s just my feeling. I would start with adding things back in starting with whatever you think you are going to do fine with, and then keep going toward the things that maybe you feel like could be an issue.

Let’s say when you first took out grains, quinoa in particular, you’re like oh I think my skin got a little better, but it’s hard to tell. Then that’s what the reintroduction is for is to kind of confirm that. If when you add back quinoa, you get a little bit of a flare or something happens that makes your skin a little bit worse, you can say oh okay, I think quinoa is an issue.

At that point, if you eat something that makes your skin worse, take it out again. Continue eating whatever foods you had already added back in at that point before you ate the quinoa. See if things get better. They should if you take out the quinoa. It might take a little while. Again, skin is slow to respond. So if you ate something, you reintroduced something that caused a problem, take it out. But you may have to wait another month on that kind of diet until your skin calms down again. So just keep that in mind.

But then from there, you can do one of two things. If you really want to be sure that quinoa was the issue, you can do it again. My philosophy is that things have to be reproducible. But if that sounds terrible to kind of continue all this for another month to get that back to normal, your skin, you can wait until way later to do that.

If you didn’t want to reintroduce it twice in that moment, I would say, okay, just go to the next thing. So go to buckwheat. Things tend to cause issues for people in groups. If quinoa was an issue for you, it caused a flare, buckwheat could potentially be an issue. For example, like nightshades. Again, if one of them causes an issue, it’s more likely than other things that another nightshade would cause an issue rather than like dairy or specifically kefir. Keep that in mind, pay a little bit closer attention if you already reacted to something in that group of food before. Try the buckwheat, see what happens. If you’re fine with it, move on. If not, again sort of repeat that process of getting back to normal skin and then introducing the next thing.

It can be a long process, clearly. Skin unfortunately, like we’ve said, is very slow to respond so it kind of drags out this reintroduction process if you are reacting to things. But it’s one of the best ways to know if you are responding to these kinds of foods and then you know pretty much for life. You can always come back to it a year or six months down the road and see if you’re still responding to it in the same way, but you at least have a much more clear path of what foods you need to be eating. Then you can always revisit that if you feel like you’ve gotten better in lot of ways and you just want to re-test that.

Laura: Mm hmm.

Kelsey: That’s a long answer.

Laura: But I think it’s important to cover all the nuances as far as what would make sense. Honestly I feel like this person would really benefit from working with someone in this situation because it can be really hard to make these decisions on your own and also figure out how do I know what to remove? Or how do I know what to bring back in? Or is this normal? Is this not normal?

One thing I want to mention is with this particular situation where she has a history of orthorexia and HPA axis dysfunction, obviously being on a restricted diet is not optimal.

Kelsey: Yeah.

Laura: That’s not really where we want her to be and we wouldn’t want her to be on a strict Autoimmune Paleo diet for a long period of time like you mentioned.

Two things that I’d like to add as far as the conversation is concerned, one would be I know that she said finances are a little bit of a concern right now, but as far a potentially less drawn out and stressful way to do this that could be helpful would be to get some testing done. I would actually suggest that she get a Cyrex Array 4 done in this situation because a lot of the foods that she’s mentioning like eggs, dairy, the gluten free grains, nightshades like potatoes…I don’t remember if nuts and seeds are on Array 4, but I know that those other ones are…she could get that Cyrex Array 4 done and see if there are any foods that come up as being immunogenic for her. Maybe there’s just eggs that come up, and she can just remove eggs and see how that goes for a couple of months.

The reason I like that approach, not that Cyrex tests are foolproof or that food sensitivity testing is just the only way to do things, it just takes out that experimentation piece, which for someone with orthorexia can be really hard to know the difference between an actual food sensitivity and a coincidence, or a psychosomatic result.

Like we were just talking about before, I think I’m sensitive to pizza, but I didn’t have a reaction both times I ate it last week. So the question is, okay am I really sensitive to pizza? Not that pizza is like a specific protein that you would be sensitive to, but the question is maybe that is just mental. Or maybe it’s dose dependent, maybe I just can’t have pizza every day and it’s just once or twice a week would be fine.

So the Cyrex test takes a little of the guess work out of it and if you have a very strong reaction to something you can assume that okay, that probably is exasperating this autoimmune type condition.

Kelsey: Mm hmm.

Laura: The Array 4 is certainly not cheap, but as far as the cost benefit is concerned, it might be better for her to spend a little money and get the test done, and not go through this two month process of removing foods, adding them back and being questioning.

Kelsey: Yeah, and it could end up being cheaper too if you think about it.

Laura: Possibly.

Kelsey: Yeah and maybe thinking about it as cheaper mentally too. What is more taxing to you?

Laura: Right, not just financial cost, but emotional and mental cost, and time cost, and all that stuff. We can’t just say the only value is money. Obviously if she’s super stressed out from this process and the Cyrex test would be less stressful for her, then that is something I think that has value. That might be something this person should consider and maybe just look into the testing and see if that’s something that she can squeeze into her budget.

Or the other thing that I wanted to mention was that, like you said before, it’s possible that none of these foods are actually even the issue. I mean if she’s been in this super stressful situation, has HPA axis dysfunction, either has orthorexia or did have orthorexia, the stress in itself could have been exacerbating all the skin issues.

Kelsey: Right.

Laura: I definitely experience that where I go through a stressful period and my skin and just like loses it.

Kelsey: Oh for sure.

Laura: Like just freaks out. It’s funny because it’s like I think certain foods affect it, but like I said this week no problems with my skin, absolutely none. I’m just like alright, that makes no sense. But it’s one of this things that the stress of all this stuff could be what’s causing the symptoms in the first place. So I just want to keep that on the table because I wouldn’t want someone to become more stressed through this process and then potentially even exacerbate the symptoms if stress is one of the major causes.

Kelsey: Right.

Laura: That’s something to keep in mind as well. And again, working with someone can help you determine what the cost and benefit of this type of approach would be.

Kelsey: Yeah, and well I was going to mention that working with someone in a scenario like this, I get a lot of people coming to me saying I think I probably need to try an Autoimmune Paleo diet or insert any said diet here. We go through our first consultation together and a lot of my job at that point becomes, okay, do I really think that that is, like you like to say, Laura, the lowest hanging fruit? Or is there something else that we should tackle first that may have a bigger impact on whatever they’re dealing with.

In a case like this, I would ask this person about their current stress level, like how are you dealing with the HPA axis dysfunction? Is there anything we can do to affect that that may further affect your skin in a positive way? Or like I was talking about before, are there other issues going on? Is there SIBO? Is there a pathogen? Can we kind of pick out those things that maybe are going to have way more of an effect on this person’s skin than these seemingly sort of random foods?

Laura: Or maybe there’s foods that she’s not eating.

Kelsey: Right.

Laura: For example, liver maybe she’s not getting a lot of vitamin A in her diet. There’s more than just elimination that can be beneficial.

Kelsey: Yeah. Absolutely. Especially with the orthorexic background, I do think that’s a very valid piece of advice to consider even if it’s just going to your doctor who’s covered by insurance or something and sort of talking through this stuff, again if they’re open minded. I don’t know. But if they’re at least semi functional medicine minded they can probably say, well I think rather than doing an elimination diet you might be better off reducing your work stress or something like that.  But just having another person…I mean I would definitely recommend going to someone like Laura and I who really has experience with this stuff, but even like a friend or someone just kind of explaining this stuff, like am I talking about how stressed out I am all the time? Because sometimes you can’t see it yourself.

Laura: Mm hmm.

Kelsey: So it is important to sort of get perspective on what stuff might actually be causing or at least making your symptoms worse. I know finances are an issue here, so I don’t want to recommend that they do something that’s totally out of their budget, but just getting that perspective I think is really important whether you’re like journaling and kind of realizing it for yourself, or if you’re talking to a friend and just asking like, do I seem stressed out lately? I feel like I can’t see it myself necessarily and my first instinct is to go on this restrictive diet to help my condition, but maybe that’s not the right move at this point. I don’t know.

I think perspective is really, really important when you’re coming from that orthorexic background. It may be worth that money to figure that out. But we don’t know the details of your budget, or finances, or anything, so we’re just giving the best advice we can thinking that finances are somewhat of an issue. But if it is in the budget to see someone, I do think that given the orthorexic background, that’s a really, really good choice.

Laura: Yeah, this is tough situation. It’s one of those things that we’ve seen the autoimmune approach help people, but we’ve also seen it really cause a lot of problems because of the restrictiveness of it. So there’s no real black and white answer here. There’s going to be three or four different options for you as far as the approaches you can take. Yeah, working with someone would be really helpful. But if you’re going to do it alone, then just really think about okay, what’s the best idea for me in this particular time of my life?

Kelsey: Mm hmm.

Laura: Is doing a restrictive diet really the best option? Or can I focus on some other areas of my life that may not be food related but could still be affecting my health.

Kelsey: Right, and often those are the harder things to deal with and that’s why everybody likes to focus on food because it’s a controllable thing that we can deal with. There are things that we can do manage stress, to work on improving our social relationships, all that kind of stuff. It’s often harder than controlling your diet, but the payoff is often way, way better.

Laura: I think that’s a good place to stop with this question. But thank you so much for submitting that. This person I believe was actually a member of our Paleo Rehab program. I know she said that our program helped a lot with the orthorexia and improving her health, but it sounds like she’s still dealing with some lingering skin issues. Hopefully she finds the relief she’s looking for.

Kelsey: Anyway, thank you for joining us everybody. We’re always happy to have you here. If you want to submit a question to the podcast, go to TheAncestralRDs.com and click the contact tab and you can submit a question that way. You can also join us on Facebook. We have a Facebook group that you can ask questions through and we can answer the questions that are submitted there. Thanks for joining us and we will see you here next week.

Kelsey: Alright. Take care, Laura.

Laura: You too, Kelsey.

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