Can the Paleo Diet Help Fight Autoimmune Diseases?

Critics have dismissed the paleolithic, or “caveman,” diet as a fad, while its proponents have embraced the eating approach as a necessary return to the healthy simplicity of our ancient ancestors’ diets. But what’s the truth? And can this popular diet really help fight the inflammation that coexists with many autoimmune diseases?

Understanding the Basics of the Paleo Diet

First, know that paleo is an anti-inflammatory diet that aims to remove sugar, legumes, most dairy, grains, and refined vegetable oils like corn and soy oil. Essentially, paleo sets out to eliminate processed, so-called modern foods from our diets. Indeed, the paleo diet gets its name from its focus on the foods ancient hunter-gatherers relied on.

Some studies suggest that paleo really does offer benefits, like weight loss and more energy, while others show anecdotal evidence that eliminating inflammatory foods in the standard American diet — such as soda, chips, and cookies — as well as grains, legumes, and most dairy, can help people manage diseases like Crohn’s disease, ulcerative colitis, rheumatoid arthritis, psoriasis, and multiple sclerosis (MS).

Sounds great, right? Not so fast. Turns out, more research is needed before we can know for sure what effect this restrictive diet may have on autoimmune diseases, says Kelly Kennedy, RD, CDE, the staff dietitian at Everyday Health.

“Unfortunately, there just isn’t enough scientific evidence to clearly show that following a paleo diet would be helpful for improving symptoms of an autoimmune condition,” Kennedy says. “For some people, following the diet might help, but for others, it may not.”

Kennedy adds that while there may be some short-term health benefits that come from this kind of elimination diet, she recommends that people don’t think of paleo as a long-term solution. In part, that’s because the restrictive diet may lead to more risks than benefits.

“My main goal is to make sure that a diet is realistic and maintainable for the person who wants to follow it,” Kennedy says. “However, with the paleo diet, I actually wouldn’t recommend following it long term, simply because more research needs to be done and because it can contribute to nutrient deficiencies — something that people with autoimmune diseases are already at an increased risk of.”

If you’ve researched diets for autoimmune diseases online, you’ve likely come across the autoimmune paleo diet (AIP), which proposes to directly address gut inflammation that leads to autoimmune disease. This diet is sometimes called the autoimmune protocol diet, and depending on where you’re looking, they may be one and the same, or the paleo diet may be a type of an autoimmune protocol diet.

In any case, AIP is specifically geared toward reducing inflammation in the body that leads to flares for conditions like inflammatory bowel disease (IBD). (2) It focuses mainly on vegetables and meats, and tackles what some people in the holistic health community have dubbed “leaky gut,” which is believed to contribute to the chronic inflammation associated with autoimmune diseases. (It should be noted that the traditional medical community doesn’t recognize leaky gut, and published, peer-reviewed research on it is limited.)

But Kennedy says this diet plan similarly doesn’t have enough research behind it and notes that, just like the traditional paleo diet, it may lead to nutrient deficiencies.

“I would just want to make sure that they’re not eliminating more foods than they need to,” says Kennedy, cautioning against paleo or AIP. “Find what works for you personally, and stick with it.”

Still, some research supports the idea of using paleo to treat autoimmune conditions.

Here’s what you should know about paleo and its potential benefits for five well-known autoimmune conditions.

1. IBD

An estimated 3.1 million people have IBD in the United States. (3) One study found that an AIP diet can “improve clinical responses in (IBD).” The researchers monitored 18 adults with IBD who went through a six-week elimination diet followed by a five-week “maintenance phase.” At the end of the study, an endoscopy was performed on the people participating. While the study found significant improvement in some people’s symptoms after they went on the diet, two of the participants who had ileal strictures — a common complication of Crohn’s disease — before the study began experienced worsening symptoms.

The study authors cautioned that people need to keep in mind that each individual’s condition is different and that this kind of treatment requires “counseling and close follow-up.”

“Dietary change can be an important adjunct to IBD therapy, not only to achieve remission, but perhaps [to] improve the durability of response and remission,” the authors wrote. (4)

But Kennedy says more research would be needed to confirm this notion. “There is some research to suggest that [paleo] may help with IBD, but more and larger studies are needed before the true effects can be determined,” says Kennedy, adding that those studies would also need to be long term.

2. Skin Conditions Like Psoriasis and Eczema

Some paleo proponents cite the diet’s ability to curb inflammation as playing a big role in improving chronic skin conditions like psoriasis and eczema.

Kennedy notes that, as with IBD, current studies are limited. “Again, more research is needed,” she stresses, reiterating that a standard elimination diet is still the most recommended approach for helping with skin conditions such as eczema or psoriasis. In a 2017 survey of psoriasis patients, nearly 70 percent reported a favorable response to the paleo diet.

3. Multiple Sclerosis (MS)

Some current research suggests that paleo may help with MS. (5) The research — which looked at a small, uncontrolled pool of 13 people — suggests that people who adhered to the paleo diet, along with an exercise program and meditation, showed “significant improvement in fatigue.” But it’s unclear exactly which part of the treatment (exercise, diet, or meditation) actually helped people with their symptoms.

For this research, 10 out of 13 participants enrolled in a two-week study, then went on to be observed over a 12-month period. Eventually, eight people completed the study and six of them fully stuck with the paleo diet. The results were promising and suggested the need for more research down the line.

“While there are anecdotal success stories, the benefit remains to be proven in a scientific study,” Kennedy says.

4. Celiac Disease

The paleo diet includes only gluten-free foods, so it’s no surprise the plan is popular among people managing celiac disease, which is marked by gluten intolerance. But the paleo diet isn’t necessarily the best — and certainly isn’t the only — diet option if you’re managing celiac, Kennedy notes.

“For [those] diagnosed with celiac disease, the results are clear: Following a gluten-free diet is necessary to control symptoms. However, any other paleo diet limitations beyond this would not affect the disease symptoms,” Kennedy says.

5. Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis is an autoimmune disease that affects the thyroid gland, and symptoms can include weight gain, depression, and fatigue. Some people point to this being a condition that can be fought off with paleo. Why? A study suggests that a low-carbohydrate diet — which effectively is partially a paleo diet — may decrease thyroid antibodies that signify Hashimoto’s. (6) An additional study also showed AIP may decrease systemic inflammation and modulate the immune system. But as with all of these conditions, more research on paleo’s impact needs to be conducted.

If you have this condition, Kennedy urges you not to rush into paleo, arguing that there is not enough evidence out there to suggest it’s effective for treating your symptoms. She notes that it is important to consult your physician for proper Hashimoto’s treatment.

Kennedy says that transitioning from a standard American diet replete with junk food to an eating plan that focuses on whole foods, like fruits and veggies, will likely help you feel more energized and in a better mood.

But based on research so far, the overall health benefits of going paleo for managing autoimmune diseases remain unclear. Instead of using the restrictive diet, Kennedy recommends going your own way by eliminating and re-adding foods one by one to see what works best for you.

“Following a standard elimination diet — where several foods are eliminated and then added back one at a time — can be a helpful tool for determining which food or foods do affect symptoms [of an autoimmune condition],” she says. “The nice thing about an elimination diet is that it can help identify the foods that affect you personally, and then all other foods are added back to the diet. In other words, you’re minimizing how much is eliminated. On paleo, the foods are just ‘out’ and that’s it — with no hope of their return.”