The ultimate guide to the AIP Reintroduction process – understand when you're ready to reintroduce foods, what foods you can reintroduce and when, and how!

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When To Start AIP Reintroductions

One of the most asked questions is “When am I ready to start reintroducing foods while on the AIP Diet?”

The answer?

Usually after at least 30 days and when you're feeling significantly better.

If you've had a large reduction in your symptoms – or if your lab tests show a large reduction in autoimmune antibodies, it may be time to start.

Fear of AIP Reintroductions

A very common problem is that you start feeling significantly better from your symptoms, perhaps better than you've felt in decades, and you don't want to take ANY chances to feel badly again.

At this point you know that the AIP elimination phase foods treat you well but the reintroduction foods are a big unknown!

While this is common, it is something that can keep you extremely restricted and make it harder to have a social life, travel, eat out, etc, so it's best to just rip off the bandaid and try some things!

To help you overcome any fear you may have read, How to Overcome the Fear of AIP Reintroductions.

AIP Reintroduction Stages

Dr. Sarah Ballantyne, the creator of the Paleo Autoimmune Protocol (AIP Diet), has developed a specific schedule to follow.

This is based on foods that are at first typically well-tolerated after healing and then increasingly become less tolerated and/or more likely to cause leaky gut.

NOTE: It may be tempting to go out of order, it's usually recommended to follow this schedule so that you have the best success.

The following is the latest as of the May 2019 changes to the schedule.

(You can get a free printable of this AIP Reintroduction Stages in my Paleo & AIP Freebie Library)

Stage 1

Egg Yolks (not the whites)

Beans/Legumes with Edible Pods: green beans, peas, runner beans, snow peas, sugar snap peas, wax beans, bean/legume sprouts

Fruit and Berry-Based Spices: Allspice, Black Pepper, Caraway, Cardamom, Juniper, Peppercorns, Star Anise, Sumac

Seed-based Spices: Anise Seed, Annatto Seed, Black Caraway, Black Cumin, Celery Seed, Coriander Seed, Cumin Seed, Dill Seed, Fennel Seed, Fenugreek, Mustard, Nutmeg, Russian Caraway

Nut and Seeds (oils only): Macadamia, Sesame, Walnut Nuts and Seeds: Chocolate, Cocoa, and Coffee (occasional basis)

Dairy (ideally from grass-fed sources): Ghee

Stage 2

Nuts and seeds: Almonds, Brazil Nuts, Cashews, Chestnuts, Coffee (regular basis), Hazelnuts, Macadamia Nuts, Pecans, Pine Nuts, Walnuts, Cacao, Chia, Chocolate, Cocoa, Flax, Hemp Seeds, Pistachios, Poppy, Pumpkin Seeds, Sesame, Sunflower, or any other flavors, flours, butters, oils, and other products derived from them

Egg whites (or whole eggs)

Dairy (ideally from grass-fed sources): Butter and Butter oil

Alcohol (small quantities): Gluten-free beer or hard cider (8 oz or less), Wine (5 oz or less), Fortified Wine (3 oz or less), Liqueur (3 oz or less), Gluten-free Spirits (1 oz or less)

Stage 3

Nightshades (limited): Bell Peppers (aka Sweet Peppers), Eggplant, Paprika, Potatoes (peeled)

Dairy (ideally from grass-fed sources): Buttermilk, Cheese, Cottage Cheese, Cream, Cream Cheese, Curds, Dairy-Protein Isolates, Heavy Cream, Ice Cream, Kefir, Milk, Sour Cream, Whey, Whey-protein Isolate, Whipping Cream, Yogurt

Beans/Legumes: Split Peas, Lentils, Garbanzo Beans (Chickpeas). Note: Beans may be more tolerated if soaked and fermented.

Stage 4

Nightshades or spices derived from nightshades: Ashwagandha, Cayenne Peppers, Cape Gooseberries, Chili Peppers, Chili-based Spices, Garden Huckleberries, Goji Berries, Ground Cherries, Hot Peppers, Naranjillas, Pepinos, Pimentos, Potatoes (unpeeled), Tamarillos, Tomatillos, Tomatoes, Wolfberries

Gluten-free Grains, Psuedo-grains, and other grain-like substances: Aramanth, Buckwheat, Corn, Fonio, Job's Tears, Kamut, Millet, Oats, Quinoa, Rice, Sorghum, Spelt, Teff, Wild Rice (grains may be tolerated more when soaked and fermented)

Legumes and Beans: Adzuki Beans, Black Beans, Black-eyed Peas, Broad Beans, Butter Beans, Calico Beans, Cannellini Beans, Fava Beans, Great Northern Beans, Italian Beans, Kidney Beans, Lima Beans, Mung Beans, Navy Beans, Pinto Beans, Peanuts, Note: Legumes may be tolerated more when soaked and fermented

Alcohol (moderate quantities): Gluten-free Beer or Hard Cider, Wine, Fortified Wine, Liqueur, Gluten-free Spirits

The AIP Reintroduction Process

To start reintroductions, you pick a food from Stage 1.

Eat a small nibble of the food. If you are reintroducing a spice or powder, dip your finger into it to get a small amount and then lick off of your finger.

Wait 15 minutes.

If you have any reactions STOP and read the instructions below. If there are NO reactions, eat a larger bite of the food or 2 dips of your finger into the spice.

Wait 15 minutes.

If you have any reactions STOP and read the instructions on the next sheet. If there are NO reactions, eat an even larger bite of the food or 3 dips of your finger into the spice.

Wait 2-3 hours.

If there are NO reactions, eat a normal portion of the food and wait 3-7 days. Do not reintroduce any other new foods and do not eat this food again during that period.

If you have NO reactions after 3-7 days, you can bring that food back into your diet and then repeat the process with a new food.

Note: I typically recommend that you wait AT LEAST 7 days in between foods for Stage 4 foods, if not even longer, as sometimes these take longer to reveal any issues. 

If You Have ANY Reactions

If you have any reactions at all, stop and do NOT include this food back in your diet at this time.

Wait at least 7 days until you feel as you did before you tried to introduce this food.

Depending on the severity of your reaction you may want to go back to the elimination portion of the diet until you feel better.

This could potentially take a long time if you had a particularly strong negative reaction.

If it was just a minor reaction though, it's typically ok to continue eating the foods up to where you last left off (prior to this food you had a reaction to).

Example: If you had reintroduced all Stage 1 foods and almonds from Stage 2 successfully, but then had issues with reintroducing egg whites, go back to eating all Stage 1 foods + almonds. 

In either case, it's extremely important to wait until you feel better before you continue so you can determine if you react to the next food or not.

Skip this food when you restart and if you are able to move onto the next phase.

If there is another food from this same food group, skip that as well. For example, if you had a reaction to ghee in Stage 1, do not try to reintroduce butter in Stage 2.

If You Aren't Sure If You've Had A Reaction

One common problem is not being sure if you reacted!

If this happens, make sure you note it in your journal and make the decision whether to include it into your diet or not.

However, if you do include it, keep a watchful eye out for that symptom(s) again.

If it continues to happen and/or gets worse, go back to the reintroduction point before that food and wait until you don't feel that symptom anymore.

Then skip over that food and continue onto the next reintroduction.

If you aren't sure you had a reaction, it may be helpful to wait a bit longer and maybe having it at least one more time before reintroducing a new food.

Intolerance May Not Be Forever

Do not lose hope if you react to a food.

A reaction just means you cannot tolerate it at this moment.

It's possible with more healing that you may be able to successfully reintroduce it.

For example, when I first did AIP I could not eat paprika without getting mildly depressed for days after. This happened for almost a full year before I was able to eat it without any reactions.

My advice is to wait at least a few weeks before re-trying a failed food though. (and a few months for a larger reaction)

Sometimes though you may not want to reintroduce a food after a particularly strong reaction and that's totally fine.

Common Reactions

These are some of the most common food reactions you may experience while reintroducing foods on the AIP Diet.

Digestive:

Bloating
Burping
Constipation
Diarrhea
Gas
Heartburn
Nausea
Stomach Pain
Undigested Food in Stool

Fatigue

Low Energy Levels
Afternoon energy dips

Sleep:

Trouble falling asleep
Trouble staying asleep
Waking up throughout the night
Not feeling rested after sleep

Pain*

Joint
Muscle
Tendon
Ligament
*common with nightshade reintros

Skin:

Flushing Rashes Hives Itchiness Acne Breakouts

Mood:

Anger
Anxiety
Depression
Irritability
Low-Stress Tolerance
Tearfulness
Rage

Miscellaneous:

Dizziness
Coughing
Headache
Itchy Eyes, Mouth, or Ears
Lightheadedness
Phlegm, runny nose, postnasal drip
Racing Pulse
Sneezing
Return of Autoimmune Symptoms (or worsening)

Additional Things to Note with the AIP Reintroduction Process

The following are some additional things you should keep in mind or do while following the AIP Reintroduction Process for the most success.

Keep a Journal

It's best to keep a journal throughout this process.

This way you can write down any foods you are eating and reintroducing, anything else out of the ordinary (less sleep, more stress, more exercise, etc) and the symptoms you might be experiencing.

This comes in handy with a lot of the more subtle symptoms or ones that don't necessarily show up for a few days.

I've got a printable journal you can purchase and print yourself, or you can buy my pre-printed one off of Amazon).

Stage 4 Reintroduction Reactions May Take a While To Show Up

Some reactions to Stage 4 foods in particular may take a long time to really show up.

For example, if a few weeks after reintroducing some grains you have a flare-up of your symptoms, try removing the Stage 4 foods for at least a week.

See if you feel better. If not, you might have to go back to the elimination phase for a bit if you really feel poorly.

And then if you try reintroducing the grains again, go very slowly on the reintros, perhaps only one new grain a month.

I often tell my clients to take at LEAST a week to try out each Stage 4 food, if not even longer.

There Often May Be Certain Amounts You Tolerate

You also may have to play around with the amount and frequency of eating these foods if you want to include them in your diet on an on-going basis.

Sometimes you may be able to tolerate eating something every day with no issues, and sometimes it may only be tolerable if you eat it a few times in a month.

My Own Personal Example

For example, I noticed I didn't have any immediate reactions if I ate oats. Yet if I had them a lot in a month I'd start to feel my Hashimoto's symptoms creeping back.

So I played around with the frequency over the following months until I didn't notice any issues.

Now I know not to eat them more than 5-6 times in a month.

Frequently Asked Questions About the AIP Reintroduction Process

What if I have severe or anaphylactic allergies to something, should I try to reintroduce it?

Do not attempt to reintroduce anything that you might have a severe or anaphylactic allergy to.

The reason you react to these is different than the reason you react to foods due to a leaky gut and unfortunately, this reason will not go away.

What if I had to eliminate other foods beyond the normal AIP ones?

If you had to eliminate some additional foods during the elimination phase, like high-FODMAP foods or an elimination-compliant food you were having reactions to, try reintroducing those first before moving onto Stage 1 foods.

However, if you had eliminated high-FODMAP foods and still react once you reintroduce them, you might want to get in contact with your healthcare provider and see if anything else is going on (like SIBO – diet alone will not heal SIBO).

Is there such thing as an occasional tolerance to a food?

Sometimes you may tolerate a food on an occasional basis but not on a regular basis.

This should be easier to determine when you journal, but it may require a bit of experimentation and trial and error.

For example, I seem to do ok with chickpeas (garbanzo beans) a few times a month but more than that I start to get reactions. Also see my oats example above.

What if I don't want to reintroduce a particular food?

There may be several foods you might not WANT to reintroduce, and that's ok.

This often happens with stage 4 foods, particularly some of the grains, legumes and dairy, especially if you've reacted to these foods in the past.

This is a totally individual process and do what works for you.

How long does the AIP Reintroduction process take?

This is highly individual, depending on how well you tolerate the foods you reintroduce, but at the very least it will most likely take a few months.

Do I have to reintroduce EVERY spice before moving onto the next stage?

Unless you have a reaction to any of the spices, I usually say trying out 3-4 spices individually from each category seems to be sufficient, though you may want to separate out and do each of the nightshade-based spices individually as those tend to cause more issues with people.

Again, keeping a journal of what you've eaten will help you determine the cause if you suddenly have reactions.

Printable AIP Reintroduction Stages Guide

Remember, you can get a free printable PDF showing which stage and food to reintroduce during AIP in my Paleo & AIP Freebie Library (under the AIP Diet section).

Related Posts You Might Like

The ULTIMATE Guide to the AIP Diet – Everything You Need to Know to be Successful

AIP Food List – Remind yourself what you can and cannot have on the elimination part of AIP

How to Overcome the Fear of AIP Reintroductions – I linked to it above, but here it is again. Don't be scared!

AIP Chai Latte – enjoy a delicious beverage while figuring all this out đŸ™‚

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