What To Eat If You Have An Autoimmune Disease: An MD's Top 4 Principles

When I take care of a patient with autoimmune disease, or a pre-autoimmune condition, I look first for nutritional insufficiencies and deficiencies because they are common. They occur from eating the typical Western diet: inflammation, celiac, imbalanced gut microbes, and food sensitivities.

Micronutrients are essential dietary elements—vitamins and minerals—that you need for physiological function and optimal health, like B vitamins and magnesium. The amount you need varies depending on life stage—you'll need more as an adolescent and in pregnancy and usually less as you age.

You may wonder how toxins and autoimmunity relate to each other. We get hit by toxins daily—they are found in makeup, skin creams, furniture, water bottles, and cleaning products in the home.

Much of the toxins work to disrupt your delicate hormone balance, and while one toxin on its own may not be enough to cause symptoms, the cocktail of many at once can be enough to cause problems with hormones and blood sugar1 such that increased inflammation is triggered. In someone who is vulnerable to autoimmunity, this can sometimes be a trip wire to cause illness.

I find that about half of my patients have sluggish detoxification pathways that they inherit, leading to a buildup of toxins in the body. These toxins get stored in fat instead of being correctly excreted in urine, stool, and sweat, so one of our first tasks together is to improve detoxification while also reducing toxic load, starting first with food and then moving on to lifestyle.

Blood sugar problems can be common in autoimmune disease, including Type 1 diabetes, autoimmune thyroiditis, and likely others as well. When we look to the root cause, sometimes it is related to increased stress and perhaps underlying trauma leading to adrenal glands that produce excess cortisol. High cortisol raises blood sugar and can also trigger a greater immune response.

The typical spiky blood sugar response to food can be seen in someone like me, who has a significant trauma load and stress. I eat an apple (or some other food with a substantial amount of carbohydrates), and it triggers excessive insulin release. My blood sugar rises steeply from the apple and then crashes from the exaggerated insulin release so that I have a big spike of glucose that goes way up and then way down. You can see these types of responses in a device like a continuous glucose monitor.

As the unsung hero of autoimmune recovery, fiber helps you detoxify because it binds to toxins in your gut and escorts them to the door—out of your colon and into the toilet. It can also help prevent you from reabsorbing them. When you eat foods that are rich in dietary fiber, like fruits and vegetables, the gut microbiota ferments the fiber into beneficial molecules called short-chain fatty acids, which have anti-inflammatory effects as shown in the massive study by the Women's Health Initiative2 (whose results on hormone replacement therapy have been revisited and partially debunked but which still hold merit for other findings).

While I agree that the gut is at the root of autoimmune disease, and the best way to upgrade the gut is with food, we are still a long way from knowing exactly what works best. And food isn't the only tool in your toolbox, as there are many other environmental, social, and lifestyle issues that we now know can promote chronic inflammation, potentially leading to cardiovascular disease, cancer, diabetes, chronic kidney disease, neurodegenerative disorders, and autoimmunity3.