Did you know that an autoimmune diet can affect bowel diseases? Today, we are happy to have Angie Alt, a successful author and the co-host of The Autoimmune Wellness Podcast , as he joins Dr. Justin Marchegiani in discussing this topic. Learn about the link between autoimmune diet and bowel disease, the Autoimmune Protocol Program, the common mistakes that people make when going on an autoimmune diet, and more. Watch and listen as they dig deep into the natural approach of treating bowel diseases here!
Angie Alt
In this episode, we cover:
03:40 Dietary Aspects of Autoimmune Protocol
05:30 Pitfalls
10:12 Autoimmune Diets to Improve Your Health
15:50 Curcumin and Autoimmune Protocols
22:15 Autoimmune Protocol for IBD
Dr. Justin Marchegiani: Alright. Let’s start it up. [long pause
Dr. Justin Marchegiani: Hey, guys. It’s Dr. Justin Marchegiani here. We have a phenomenal guest, Angie Alt from autoimmunewellness.com. Angie is an Autoimmune expert, specializes in autoimmune protocols, works with patients, kind of, in a group setting all across the country. We got some great updates today. We’re gonna talk a little bit more about the autoimmune diet, the pitfalls, how you can apply it to help improve your health, and also, we get some new research out on autoimmune diets for various bowel disease, which we’re excited to go over that, too. But in the meantime, Angie, how are you doing? Welcome to the show.
Angie Alt: I’m doing great. Thanks so much for having me, Dr. J.
Dr. Justin Marchegiani: Well, thanks for being here. So, first of, just tell the listeners a little bit more about yourself. How did you get into this nutritional field? And then, how did you make your way over to kind of an autoimmune protocol or template from a– you know, a diet approach. There’s so many ways. You can go Paleo, Autoimmune…
Angie Alt: Yeah.
Dr. Justin Marchegiani: …Vegan, _Rydes, Standard American.
Angie Alt: Yeah.
Dr. Justin Marchegiani: How did you make your way into that avenue?
Angie Alt: So, uhm– I got my start about six years ago. I had my third, uhm– and hopefully, final uh–
Dr. Justin Marchegiani: Yeah?
Angie Alt: …autoimmune diagnosis. So– [incomprehensible] and Celiac disease had been kind of haunting me for about eleven years at that point. Uhm– I had been all over the place trying to get help, and uhm– finally, we figured out what the problem was. And, i was told to go on a traditional gluten-free diet. Uhm– but that didn’t turn out to be enough to kind of get me in a better spot, because my– you know, my small intestine was so damaged and I was really malnourished by that point. So, uhm– I started hunting around, looking for better ways to restore my health,and uhm– I found the Paleo diet. I a– My first book actually was Robb Wolf’s “The Paleo Solution.”
Dr. Justin Marchegiani: Very cool.
Angie Alt: And there was like, one sentence in his book that said something about how people with autoimmune disease might need to take things a little bit further. And i thought, “Ohp– that’s me.” So, I started doing some more research and uhm– and that, at that time, Dr. Sarah Valentine at The Paleo Mom uhm– was starting to just, you know, do some research and some refining of this uhm– Autoimmune Protocol, AIP. And I said, “That’s me. I’ve got three autoimmune diseases. I’m gonna try this.” So, I jumped right in. And, you know, uh– three days later, a lot of the…
Dr. Justin Marchegiani: Uhmm–
Angie Alt: …mental and emotional health issues that I had been experiencing just seems to melt away. And, six weeks later, my gluten antibodies dropped by half, and six months later, it was like I had a new body. A year later, I changed everything about my life to focus on this and show other people how to do it.
Dr. Justin Marchegiani: Wow. So, how many autoimmune conditions do you have again?
Angie Alt: I have three.
Dr. Justin Marchegiani: Is that Lichen sclerosis and what’s the other two?
Angie Alt: Endometriosis and Celiac disease. Yup.
Dr. Justin Marchegiani: Wow! Unreal! And then, how much you were able to get a hundred percent resolution applying an autoimmune template to those conditions?
Angie Alt: Yeah. Pretty much. You know, Endometriosis is one of those diseases that sort of like, maybe or maybe not, uhm– the autoimmune list. You know, the research isn’t quite there to be sure that it’s autoimmune in nature.
Dr. Justin Marchegiani: Uhmn.
Angie Alt: Uuhm– But I kind of– I kind of handle it the same way that I do with my verified autoimmune diseases. And it’s been a little trickier to pin down. You know…
Dr. Justin Marchegiani: Hmm.
Angie Alt: …there’s little bits that I’m still dealing…
Dr. Justin Marchegiani: Right.
Angie Alt: …there, but in general– I mean, my health did 180-degree turn. [laughs] I’m in a totally different space when I was six years ago.
Dr. Justin Marchegiani: Awesome. And now, regarding having an autoimmune– you know, multiple autoimmune conditions, like you.mentioned, were there any other things that you looked at, outside of just having a foundational diet? Were you looking at blood sugar? Were you looking at adrenal issues or any infections, or any other things that could have been driving leaky gut outside of autoimmune foods?
Angie Alt: Yes. So, you know, what I did was uhm– I first just kind of worked on the dietary aspects of the autoimmune protocol. So, there’s an elimination period and a reintroduction period. And i just kind of focused on dialing that in at first, and then I added some lifestyle stuff. You know, I started to work on my sleep. I started to prioritize stress management, things like that. And then, uhm– you know, you come to this sort of Plateau area and I said, “Okay. there must be some underlyers that are preventing…
Dr. Justin Marchegiani: Right.
Angie Alt: …for their progress. So, I went and did some more testing, and uhm– I had SIBO, Small Intestinal Bacterial Overgrowth, uhm– which is not that uncommon for folks with autoimmune diseases, especially if you have uh– autoimmune that’s affecting your digestive tract. So, uhm– I went in and got treatment for that, and that helped me kind of gain some more ground and uhm– From there, I started to work on correcting some nutrient deficiencies that weren’t quite budging enough with diet alone, [crosstalk] you know.
Dr. Justin Marchegiani: Uhmn–
Angie Alt: So, things like uhm– improving my B12, improving my Vitamin D status, you know uhm– taking more Zinc– things like that– to kind of improve things and slowly but surely, uhm– I made my way forward. In terms of blood sugar and adrenal health, you know those two things are very interlocked. Uhm–
Dr. Justin Marchegiani: Totally.
Angie Alt: And, the autoimmune protocol diet alone, uhm– really helped me deal with that there. It was a very blood sugar balancing and I didn’t have to take too much of an aggressive approach outside of that.
Dr. Justin Marchegiani: That’s amazing.
Angie Alt: Yeah.
Dr. Justin Marchegiani: Now, I find that practitioners, they kind of have their various health challenges…
Angie Alt: Uhmn–
Dr. Justin Marchegiani: …to begin [crosstalk] with. And then they’re they’re able to figure out kind of the code to– or the right combination to crack the code, so to speak. They definitely go into being a– a– a practitioner, or a doctor or coach, in helping other people. They have a much different perspective, right? They tend to be more empathetic. They also kind of have navigated their way, you know, into the solution. So, they kind of have come across a lot of the pitfalls [crosstalk] that they have made it hard for you to be successful. Uhm– what do you think some of the pitfalls are? I tell you one that I see is a lot of people– let’s say, they eat this much food on their– on their, whatever that diet is. Let’s call it [crosstalk] the Standard American diet.
Angie Alt: Uhmn–
Dr. Justin Marchegiani: And then, they widdle away– let’s say, they find half of that food is maybe not compatible with an autoimmune template. And then, they don’t quite fill in the gap of the food that they’re missing now. So, they tend to go lower calorie, and [crosstalk] maybe enough fat,and they’re chronically hungry. That’s one pitfall I see.
Angie Alt: Yeah.
Dr. Justin Marchegiani: I’m just want to know your opinion on that and any other pitfalls that you see, too.
Angie Alt: Yeah. I– You have a really, really good point, Dr. J. That’s very common.
Dr. Justin Marchegiani: Yeah.
Angie Alt: Uhm– I think, you know, as you removed these foods during the elimination phase of autoimmune protocol, you know, you need to– you need to fill those blanks.
Dr. Justin Marchegiani: Yes.
Angie Alt: …just like you said. So, uhm– for instance, uhm– you know, one thing I see really often is, especially women, accidentally going too low-carb…
Dr. Justin Marchegiani: Uhmmn–
Angie Alt: …because they cut out all those grains. And the grains surely were drivers in some of their problems, but they need to fill that in with dense carbohydrate-rich vegetables. And they’re– they don’t realize that that’s what they need to be eating. So– And that could be really hard on the thyroid. Put a lot of drag on the thyroid can be tough for women in they’re uhm– you know, uh– menstrual cycle and everything. So, yeah. Y– You know– figuring out how to eat carbs without grains, that’s one pitfall that I see. Uhm– not filling in nutrient-dense foods…
Dr. Justin Marchegiani: Uhmn–
Angie Alt: …to replace those foods that you removed. So, bringing some bone broth on board, bringing fermented foods on board, bringing organ meats and– and seafood, uhm– and really pumping up your nutrient density. You know, you have to think about the autoimmune protocol as essentially fuelling your body to heal. And healing is a really intensive energy process. You need all those nutrients. Those are probably– those are probably the two biggies: forgetting to add while you’re eliminating and fr– and accidentally going too low-carb.
Dr. Justin Marchegiani: Got it. And I find some people, you know, because they have so much insulin-resistance happening, they– they do better going lower carbohydrate. But then there are people that are already at a relatively healthy weight, but then there’s a lot of inflammation and leaky gut and those are the ones, that I find, do get better. You know, adding some of those safer starches in there.
Angie Alt: Uhmmn, uhhm–
Dr. Justin Marchegiani: That’s something you noticed, too?
Angie Alt: Yeah, for sure. And, you know– I mean, one thing that I think some folks kind of forget to is like in co– in comparison to the Standard American Diet, AIP, the Autoimmune Protocol is already low-carb in comparison.
Dr. Justin Marchegiani: Totally.
Angie Alt: So, you don’t have to push it much further than that, unless– like you said, unless you have some specific conditions where you might need a push of a little bit further if you’ve got insulin resistance. You know, maybe for instance, woman with PCOS, they might want to try to go a little bit lower carb even so.
Dr. Justin Marchegiani: Nice.
Angie Alt: But, uhm–
Dr. Justin Marchegiani: Totally.
Angie Alt: There’s– there’s definitely a set of folks you need to be careful that they didn’t take that far. [sniffs]
Dr. Justin Marchegiani: Makes sense. So now, we’re adding in safer starches. Then we talk about safer starches because we’re trying to highlight, you know, carbohydrates that aren’t grain-based, so…
Angie Alt: Right.
Dr. Justin Marchegiani: …I’m gonna just throw out a couple of– You know, you can just tell me what some of your favorite are, and just let me know if they’re autoimmune-compatible. So, uhm– we have…
Angie Alt: Uhmn–
Dr. Justin Marchegiani: …sweet potatoes, which tend to be pretty good,…
Angie Alt: …Yeah.
Dr. Justin Marchegiani: Not white potatoes, right? White potatoes have the alpha-solanines. It can more on that autoimmune category, correct?
Angie Alt: Yup. Yup.
Dr. Justin Marchegiani: So, we have sweet potatoes. Uhm– we have cassava or yuca. Is that still okay in your book?
Angie Alt: Right. Ahuh. Yep.
Dr. Justin Marchegiani: The plantains, as well?
Angie Alt: Yup.
Dr. Justin Marchegiani: Squash, Jicama, Beets…
Angie Alt: Yup.
Dr. Justin Marchegiani: …sprouts, Rutabaga. Those are all kind of a net safe starch cat– category.
Angie Alt: Yup.
Dr. Justin Marchegiani: Any ones that I missed that you really like?
Angie Alt: Let see. I really like pumpkin. Uhm–
Dr. Justin Marchegiani: Hmmn– Yup.
Angie Alt: Pumpkin’s a little on the lower side in terms of the starches but it still makes it on to that list. Uhm– You know, there’s easy ones, too, like carrots, and…
Dr. Justin Marchegiani: Yup.
Angie Alt: …you know, uhm– turnips. Turnips kind of get a bad wrap ‘cause they’re really sulfur-rich, so they– they have like a strong flavor. But [crosstalk] they’re really good for you. [laughs]
Dr. Justin Marchegiani: Great. Any other carbohydrates you want to throw in there?
Angie Alt: None. I think– I think you named a lot of the ones that I’m regularly eating. You know, cassava is kind of different for us in North America, but it’s really, really common around the world and it’s a great substitute.
Dr. Justin Marchegiani: That’s great. And then, give me a run down with your opinion on fruits. So, we kind of have like our low– lower sugar fruits and our higher sugar. That kind of draw the line. Berries, you know– berries, blueberries, raspberries, strawberries, blackberries, lemon, lime, grapefruit, Granny Smith apples, kind of our lower. K ind of our moderate, like maybe our oranges, our regular apples…
Angie Alt: Uhmmn–
Dr. Justin Marchegiani: …maybe pear, maybe grapes. And then we kind of have like the tropical fruits above that. Mango, pineapple, papaya, those kind of things. Uhm– can you get a walk me through? How do you incorporate fruit into an autoimmune template?
Angie Alt: So, when you’re first starting on the autoimmune protocol, when you’re still on that elimination phase, you try to focus on eating lower sugar in general. [crosstalk] Even if that sugar comes from fruits, from fructose. Uhm– and the– you know, kind of advise uh– based on Dr. Valentine’s research was roughly 10 to 20 grams of fructose per day, which is around two to three servings [crosstalk] of fruit per day depending on the fruit you choose. So, like you said– like if you choose some of those higher glycemic fruits like, maybe some of the tropical fruits and above, then, you might eat a little bit less…
Dr. Justin Marchegiani: One serving.
Angie Alt: …uhm– ’cause– Yeah. One serving might be already 10 to 20 grams of fructose. But if you sti– stick with the berries, you can enjoy berries probably three times a day and still [crosstalk] not be in the 10 to 20 grams. So…
Dr. Justin Marchegiani: Loved it.
Angie Alt: Yeah.
Dr. Justin Marchegiani: Very cool. So, we have kind of like the carbohydrates we chatted about. We kind of made some recommendations there.
Angie Alt: Yeah.
Dr. Justin Marchegiani: The vegetables, it sounds like you’re pretty good with the veggies outside of maybe tomatoes, potatoes, [crosstalk] kind of eggplants…
Angie Alt: Yeah.
Dr. Justin Marchegiani: …potatoes, right? The nightshade category. So, veggies were pretty good, right?
Angie Alt: Yup. Yup.
Dr. Justin Marchegiani: Good. And then, meat. So, we have our– obviously, you know, fish, fowl, chicken, [crosstalk] beef. Trying to emphasize, kind of grass-fed organic. Is that true?
Angie Alt: Yeah. Definitely.
Dr. Justin Marchegiani: Yeah.
Angie Alt: You know, you– I don’t like to uh– you know– give anybody the idea that they have to kind of be in this perfectionist mindset…
Dr. Justin Marchegiani: Hmmn–
Angie Alt: …where they can only enjoy protein [crosstalk] if it has been grass-fed or pastured because, frankly, our system isn’t quite ready for the onslaught. Uhm– and we don’t have a lot of sources of grass-fed and pastured that we can easily get a lot of times. And, it’s more expensive and it takes time for people’s budgets to adjust to kind of focusing on food as the priority.
Dr. Justin Marchegiani: Right.
Angie Alt: So, you know, if you have to get conventionally-grown meats uhm– you know– proteins that are, you know, beef or– or pork, or chicken that’s been conventionally growing. If you try to avoid the fat on those meats, you know, trim it up a little. Well, that helps little bit with it. But, if you’re eating grass-fed and pastured. Enjoy the fat. It’s good for you.
Dr. Justin Marchegiani: Totally. So, if you have access to those higher quality meats, great. If you don’t, then…
Angie Alt: RIght.
Dr. Justin Marchegiani: That’s still an acceptable option. Now. in the autoimmune community– this question comes to me a lot. If, let’s say, the animals– let’s just say the– the cows are eating corn or grains to kind of fatten them up as their feed. Do any of those corn and grains get passed on to you if you eat those types of meats?
Angie Alt: Uhm– You know, according to the research that Dr. Valentine– you know– put forward, especially like in her book, “The Paleo Approach,” we don’t really have to worry about that with the proteins in that way. Uhm– We remove egg on the autoimmune protocol…
Dr. Justin Marchegiani: Uhmmn.
Angie Alt: …uhm– just because egg is a really common allergen that might be driving issues for a lot of folks, and it kind of has a way of sneaking across that gut lining pretty easily [crosstalk] due to its nature. But the other thing about egg is that the white can uh– take in…
Dr. Justin Marchegiani: Yeah, Avidin, right?
Angie Alt: …so– Yeah, yeah. It can take it soy from the feed that the chickens are eating.
Dr. Justin Marchegiani: Aaah–
Angie Alt: But when were talking about the beef uh– you know, the muscle meats from beef or pork, or something like that, we don’t have to worry too much about the grain or– you know, contamination. It’s not–
Dr. Justin Marchegiani: That’s good.
Angie Alt: It’s not the healthiest fruit. The animal’s not gonna be the healthiest for us, but it’s not really like a cross-contamination issue.
Dr. Justin Marchegiani: Awesome. I get that question all the time. I wasn’t quite sure how to answer. I always kind of said what you said, but I wasn’t a hundred percent sure on that. So, that really helps clarify that for me. That’s awesome.
Angie Alt: Yeah.
Dr. Justin Marchegiani: And then, give me the run-down with– so we talked about the eggs, right?
Angie Alt: Uhmmn–
Dr. Justin Marchegiani: So, we cut the eggs out. There’s potentially some irritating protein components in the whites.
Angie Alt: Uhmn–
Dr. Justin Marchegiani: So, let’s say if we’re– we cut the eggs out. Let’s say we’ve cut a lot of these things out for a while.
Angie Alt: Uhmn–
Dr. Justin Marchegiani: And we’re doing a reintroduction. Do you [crosstalk] typically– when I work with my patients, we reintroduce the yolks first…
Angie Alt: Uhmn–
Dr. Justin Marchegiani: …by themselves without anything else.
Angie Alt: Yep.
Dr. Justin Marchegiani: We keep them kind of lightly cooked. You kind of have that similar approach?
Angie Alt: Yeah. Yup. We start with the e– with the egg yolk. You know, the egg yolk is very very nutrient-dense part…
Dr. Justin Marchegiani: Right.
Angie Alt: …of the egg. And it’s– you know, eggs have a lot of great nutrient quality. So if you can get them back into your diet, it’s well worth it. So, we start with the yolk, and see how that goes. If the yolk goes well for you, then you know, maybe a couple of days later, you’ll start working on introducing the whole egg.
Dr. Justin Marchegiani: Great. So, typically, just to kind of list it off for everyone here at home. No grains, no dairy…
Angie Alt: Uhhmn–
Dr. Justin Marchegiani: …no nuts, no seeds, no nightshades– nightshades are tomatoes, potatoes, eggplants, peppers…
Angie Alt: Uhmmn–
Dr. Justin Marchegiani: …and no eggs.
Angie Alt: Uhmmn–
Dr. Justin Marchegiani: So, that’s kind of our list there.
Angie Alt: Yup.
Dr. Justin Marchegiani: We obviously then have kind of our spice section. So, anything it’s not [crosstalk] seed kind of spice-related, or pepper related, we’re also pulling those spices out too.
Angie Alt: Right. And, the seeds, you know, uhm– it’s uh– a m– a misconception that chocolate and coffee are beans. They are seeds. And so, they are also eliminated for a time. So, I know, want a coffee [inaudible]
Dr. Justin Marchegiani: Uuuuh– [laughs]
Angie Alt: Well, everybody’s bummed out but–
Dr. Justin Marchegiani: Totally.
Angie Alt: But yeah– And the legumes, also. So, like, you know– black beans chickpeas– things like that. Uhmn–
Dr. Justin Marchegiani: Got it. ‘Cause I was told– I think it was Dave Asprey said it one time, that coffee’s more on the family of fruit. Is that so– yo– you wouldn’t agree with that?
Angie Alt: I mean– you know, everything that I– you know, kind of follow in terms of the protocol’s, based on Sarah Valentine’s research…
Dr. Justin Marchegiani: Yes.
Angie Alt: …and that’s where that, you know, piece of information comes from. Coffee is not really eliminated because of caffeine on the protocol though.
Dr. Justin Marchegiani: Hmmn–
Angie Alt: You know, taking in a lot of caffeine isn’t probably best for your health, especially your adrenal health, but coffee isn’t really eliminated on that aspects. So, if you’re having trouble letting go of the coffee, you can kind of uhm– replace it with like caffeinated tea. It’s like a black tea or something, for a while while…
Dr. Justin Marchegiani: Got it.
Angie Alt: …while you start to kind of work on that.
Dr. Justin Marchegiani: Got it. So, the coffee and the chocolate, those are indeed the seed category?
Angie Alt: Right, right. Right.
Dr. Justin Marchegiani: Got it. Any other obscure spices we need to be aware of? What about curcumin? Can curcumin uhm– be used? Also, people talk about coconut. Is coconut a nut or can we still keep that in there? Like coconut milk smoothie or something.
Angie Alt: Uhmmn– So, curcumin– uh– it comes from turmeric, and turmerics defnitely in, as far as protocol’s concerned, it’s, you know, highly anti-inflammatory. And anti-inflamming is what everybody with autoimmune disease needs to do. So, yeah. You can definitely…
Dr. Justin Marchegiani: So, that’s okay?
Angie Alt: …incorporate it. Uhmn– uhm– And then, in terms of the coconut, coconut is not really a nut. Just like…
Dr. Justin Marchegiani: Yes. Peanuts.
Angie Alt: ..chocolate is not really a bean. Yes.
Dr. Justin Marchegiani: Just like peanuts, too. Peanuts are a legume, not a nut.
Angie Alt: Peanuts are a legume, not a nut. Yeah, exactly. So, it’s a little bit of a mis– misconception there, but– So, it’s really uhm– part of a family of– of uh– foods called drups that are kinds of related to grass.
Dr. Justin Marchegiani: Droops?
Angie Alt: Yes.
Dr. Justin Marchegiani: Say it again. Droops? Like D-R-O-O-P?
Angie Alt: D-R-U-P-S.
Dr. Justin Marchegiani: Oh!
Angie Alt: Uh– P-E-S. Drupes. So…
Dr. Justin Marchegiani: Knowledge bombs [crosstalk] today.
Angie Alt: It’s not really in that.
Dr. Justin Marchegiani: I love it.
Angie Alt: But [inaudible] about coconut is that it can be a [inaudible]. Some people are a little more sensitive to coconut than other [crosstalk] folks. So, you know the– you know, you might do fine with like coconut oil because it’s so refined and all those fibbers and everything are removed. But if you find that you’re having trouble with like, coconut meat, or coconut milk, it might be that it’s just a little too much for your system.
Dr. Justin Marchegiani: Totally. And also there’s some FODMAP potential uhm– irritation…
Angie Alt: Yep.
Dr. Justin Marchegiani: …with some of the coconut, too. You noticed the FODMAPs there?
Angie Alt: Uh– you know, I have not really struggled with that in terms of my own journey, with like SIBO…
Dr. Justin Marchegiani: Even with your SIBO, too?
Angie Alt: Yeah. Even with SIBO, I’m trying to eat low FODMAP, but that is definitely one thing I’ve noticed over the years working with the folks– is that the FODMAP foods, even in the presence of SIBO are kind of very individual.
Dr. Justin Marchegiani: Uhmn–
Angie Alt: Some folks tolerate more than others, and tolerate different kinds of FODMAPs more than others. The three biggies if you have SIBO– the three FODMAP foods that are probably gonna make almost everybody miserable are garlic, mushrooms and onions.
Dr. Justin Marchegiani: Mmmm– [nods] Totally agree. Yup. Hundred percent agree. And then just shifting back to the autoimmune spices,…
Angie Alt: Uhmmn?–
Dr. Justin Marchegiani: … are there any additional kind of obscure spices you want to say that you should nab? Is cinnamon okay?
Angie Alt: Yeah. Cinnamon’s totally fine. Uhm– you know, There’s things like uhm– Fennel seed, because it’s a seed…
Dr. Justin Marchegiani: Yep.
Angie Alt: …we don’t– we don’t do Fennel seed. Uhm– instead, you’d use like whole fennel. Uhm– we don’t do, uh– nutmeg but you can do mace. So, Mace is the outside of the nutmeg nut, and it’s uhm– kind of has that same flavor. It’s a little more mild than nutmeg, though. But you– so you can do that. I’m trying to think of anything else obscure out there. I’m sure…
Dr. Justin Marchegiani: Are teas okay?
Angie Alt: I’m sure s–
Dr. Justin Marchegiani: Are teas acceptable?
Angie Alt: Yeah.
Dr. Justin Marchegiani: Green tea, black tea?
Angie Alt: yeah. Tea is totally fine. Again, specially if you’re dealing with like uhm– adrenal health issues. You might want to take it easy on the caffeine, but tea is not a problem on the protocol.
Dr. Justin Marchegiani: How about mushrooms?.
Angie Alt: Mushrooms are fine. You know– If you’re– if you’re dealing with SIBO on top of autoimmune issues, you might want to take it easy on [crosstalk] mushrooms because they’re high FODMAP, but it’s not out on the– on the base protocol.
Dr. Justin Marchegiani: Wonderful. And is there anything else, any other foods that people mistake ass being autoimmune-friendly but aren’t?
Angie Alt: Uhm– [pause] Mistake as being autoimmune-friendly but actually aren’t. Uh– sometimes, we get a lot. I– I notice lately in the community, we get a lot of questions about Maca versus Matcha. So, Matcha…
Dr. Justin Marchegiani: Maca.
Angie Alt: …is green tea, and that’s fine. Maca is uh– an herb that can be a little bit immune-stimulating and definitely uh– can kind of jump the hormones. You know, and– and you might not want that in those early days of healing. You might want to keep the hormones kind of very quiet and even if you can. [laughs]
Dr. Justin Marchegiani: Got it. Got it. Perfect. Excellent. Loved that. Yeah. So, that’s a big question I get all the time, too. So, that’s great. Excellent. Any other autoimmune barriers that you want to mention that come up with the patients and people that you work with, that you’re constantly overcoming or repeating itself?
Angie Alt: I think probably just the biggest thing overall is that– you know, eating. Eating during the elimination phase of the autoimmune protocol is really different from how we eat in our Standard American Society, right? And I think it can be really, socially, a big barrier, and folks can feel really afraid of how their family and friends are gonna respond to them using this diet to heal. So, one thing we focus on a lot, for instance, in my group program is, “how to talk to others about why you’re doing it,” “how to explain in a succinct way what you’re doing,” and “how to just feel really empowered that you’re taking this really big ways for your health.”
Dr. Justin Marchegiani: Wonderful. And talk more about your group program. How does that work?
Angie Alt: So, I run a group program called SAD to AIP in SIX, as in Standard American Diet to The Autoimmune Protocol over six weeks. And we just do this gentle phase approach, where instead of just like cold turkey jumping in to the elimination phase of the AIP, which at– you know, we just went through that whole list of foods. It’s really intimidating to kind of do that cold turkey. And for a lot of folks, it’s not very sustainable to do a cold turkey. So, what we do instead is just gently eliminate one or two food groups per week, while we also add a nutrient-dense food, so that we don’t make that mistake of not adding in some uh– nutrient density. And also focus on one lifestyle habit per week to kind of tweak and perfect. Uhm– and then, by the end of the six weeks there in the full elimination phase, they’ve kind of got the lifestyle stuff on board, they’ve addressed the nutrient density in adding all those foods…
Dr. Justin Marchegiani: Yeah.
Angie Alt: …and then, they can start to carry that process forward and see if they can uhm– move that needle on their health and get to a point where they can start to reintroduce and individualize, kind of personalize, their diet.
Dr. Justin Marchegiani: That’s awesome. And, how do someone’s interested in this? How do they sign up with you?
Angie Alt: So, I ran the program four times a year. They can go to my website sadtoaip.com. Sad, S-A-D, to, T-O, aip.com. And uhm– right now, we’re not in enrollment. Right now, we’re in our first– first cycle of the year, the January cycle. The next enrollment starts March 1st for an April start date.
Dr. Justin Marchegiani: Awesome. And what’s that link one more time? We’ll put in the show and notes description, too.
Angie Alt: It’s www.sadtoaip.com.
Dr. Justin Marchegiani: Love it. Very cool. So let’s dig in, too. You also told me earlier that there was a recent study done on the Autoimmune Protocol with Inflammatory Bowel Disease. I have the abstract up. Talk to me about this study. How did it– How did it happen? I know you teamed up with another medical doctor to make this study uh– some to life. Walk me through, kind of, the work it took to even make this happen [crosstalk] and then go on some of the results of the study, too.
Angie Alt: That’s so funny.
Dr. Justin Marchegiani: Oh, by the way– By the way, uhm– people that are watching this live, feel free and chime me with some questions. At the end, we’ll go through and answer some of your questions. Try to keep all the questions pertinent to the autoimmune protocol.
Angie Alt: Yeah.
Dr. Justin Marchegiani: Awesome.
Angie Alt: Uhm– So, ab– I guess it was in December of 2015, uhm– my blog partner Mickey Trescott, uh– you know, we blog autoimmunewellness.com together. Uh– we were contacted by Dr. Konijeti uhm– at Scripps University. Sclipps– Scripps Clinic in San Diego. She’s a gastroenterologist there. And she said, that she had had a patient who came in and asked her if he could try the autoimmune protocol but he was dealing with really severe ulcerative colitis. And she said, okay. She would give him a little bit of time to give us a try but she was really concerned that it was time to move on to more aggressive treatment. And– so he went for it and he came back a few months later, and she did some more imaging studies and he was in clinical remission.
Dr. Justin Marchegiani: Wow.
Angie Alt: And she was so shocked. Just so surprised about this enormous turnaround that she decided she wanted to study this diet and find out what was up and she asked him for information, like where did he find it, about this information. So, he pointed her to our website and she saw that I had a group program, uhm– you know, the SAD to AIP in SIX Program, introducing folks to the diet. So, she contacted us and said I want to do this study, and I love to use your group program to on board the study participants into the process. And, of course, I said, “Yes, please. Like I’ll do anything you want me to, Doctor. I would love to help you study this diet.” It was the first ever study of AIP. So, we were really excited. Uhm– So we got started. She got uh– a grant put together, and then in 2016, we started the process. We took 15 patients through the process, uhm– slowly introducing them to the autoimmune protocol over six weeks. And then, we uh– walked through maintenance with them for five more weeks. And, by week 6, eleven of the fifteen were in clinical remission. So, that’s 73 percent. Uhm–
Dr. Justin Marchegiani: Wow.
Angie Alt: And they remained in remission during the whole process. And this was not uh– you know, like a wimpy bunch of folks with autoimmune disease, with inflammatory bowel diseases. They had either crohn’s or ulcerative colitis. Uhm– the average disease link for these folks was nineteen years. Uhm–
Dr. Justin Marchegiani: Whoah!
Angie Alt: A lot of them are on immuno– [crosstalk] you know, biologic drugs, trying to, you know, deal with autoimmune disease. They weren’t in remission despite the drugs. So, the diet really was the clincher, bringing them into remission. Uhm– and several of them were able to get off of their medications following the diet. So…
Dr. Justin Marchegiani: Amazing.
Angie Alt: …really excited.
Dr. Justin Marchegiani: We have the study at on screen. I’m not sure if everyone can see it or not. But I have it up on screen. It’s really interesting. So, fifteen patients with IBD. IBD is Inflammatory Bowel Disease…
Angie Alt: Uhhmn–
Dr. Justin Marchegiani: …typically, the big two are Crohn’s and ulcerative colitis, right?
Angie Alt: Fact. Uhuh.
Dr. Justin Marchegiani: [inaudble] …like these fit in that category?
Angie Alt: Uhm– I’m not sure that there’s any other that are kind of as well-known as those two.
Dr. Justin Marchegiani: Right. That makes sense. So you have 15 of these patients. They have like kind of a subjective questionnaire, and they also had calprotectin levels, right, which is a…
Angie Alt: Yeah.
Dr. Justin Marchegiani: …of gut inflammation?
Angie Alt: Yeah. Exactly. So, Dr. Konijeti and her team uhm– They measured all the kind of medical markers, right?– all the clinical stuff. So, they did scopes with an endoscopy. They also did uhm– colonoscopy scopes. They uh– took blood work. They– you know, for instance, they measured calprotectin, which helps measure with their inflammation. And uhm– they uh– they look to those symbols so they could kind of see what happened to their microbiome over time. Uhm– they kind of did all that clinical stuff. And then we also administered kind of quality of life surveys that are uhm– designed specifically for folks with IBD. So, it helps, you know, kind of measure things like uhm– “how often are they having bowel movements and how is that changing over time,” “how is their disease affecting their daily life and the activities they can do” and “how is that changing over time,” etc. So uhm– all of that information, all that data was also uhm– kind of looked at at the end. And the changes were just incredible. You know, uhm– clinically and self-reported, they– they were in a totally different space by the time we were done.
Dr. Justin Marchegiani: That’s amazing. So, so we have this male score, which is a kind of a subjective indicator…
Angie Alt: Uhmn–
Dr. Justin Marchegiani: …in this Harvey-Bradshaw score.
Angie Alt: Uhmn–
Dr. Justin Marchegiani: So, we have these [crosstalk] kind of subjective surveys or questionnaires that were filled out…
Angie Alt: Uhmn–
Dr. Justin Marchegiani: …to just to kind of give a run-down– so here. I think it says on the uhm– abstract, it went from a 5.8 to a 1.0 and on a male, in a seven to a 3.4 on the Harvey. So, big reduction in the calprotectin when from 471 to 112. So, I run a GI Map test. So, typically, in a lot of my patients, which is a test looking at gut infections. It also has the calprotectin marker on there, and typically, less than 50 is considered negative. But 471’s like still like eight or nine times above normal, so 471 to 112 is still a good 75 to 80 percent reduction and inflammation in just six weeks. That’s phenomenal.
Angie Alt: Yeah. It’s really phenomenal. I mean uhm– you know, it was just awesome to get to, you know, hear them reporting for themselves how much it was changing their lives. You know, these are people who have been dealing with this disease for– you know, some of them, more than 20 years. Uhm– and to finally feel like– you know, their quality of life is back. That was– is really rewarding. It was like– it was very exciting to get to participate in that study.
Dr. Justin Marchegiani: Amazing, and it’s really interesting. C reactive protein did not change much. That’s fascinating, but it makes sense ‘cause calprotectin is definitely that. It’s more of an inflammatory marker, specific to the gut.
Angie Alt: Uhmn–
Dr. Justin Marchegiani: Any thoughts on the overall systemic inflammation via the CRP marker not changing?
Angie Alt: You knnow, I think for some of them, uhm– there probably were some little tweaks that needed to be made over the [crosstalk] more long term…
Dr. Justin Marchegiani: Right.
Angie Alt: …uhm– to– to work on the CRP. You know, maybe their sugar intake was uh– still a little high, even though we cut out all the processed uh– sugars. They probably needed to work on that just a little bit more. Uhm– for some of them, there might be genetic issues that are at play there that we didn’t have in the scope of the skudy– stu– Excuse me– Scope of the Study to work on.
Dr. Justin Marchegiani: Yes.
Angie Alt: Uhm– you know, maybe for instance, there are some MTFR that needs to be handled something like that. Uhm, so, some– some of that maybe there, I also think that maybe I– I know for sure, there was at least one study participant who was working out probably too hard. [laughs]
Dr. Justin Marchegiani: Yeah.
Angie Alt: Uhm– and so, he was probably contributing to some inflammation in that way that I kept trying to say, “Hey. Like– It’s– Working out is still a stressor for the body. Slow down a little bit, so you’re body can heal and catch up. [laughs]
Dr. Justin Marchegiani: Totally. And it like– so how long did it take for this study to happen, start to finish? And, what was the cost of a study like this to make it happen?
Angie Alt: So, you know, I would have to go back and look at my invoice scene. I charged a little bit more than I normally do for my group program because I also brought in uhm– a registered dietitian, Amy Kubal, who helped me. ‘Cause you know…
Dr. Justin Marchegiani: Yeah. Amy.
Angie Alt: Amy’s got clinical experience, so Amy could help me uhm– some from that side of it. So we could [crosstalk] make specific changes in regards to disease and– and lab results and everything. Uhm– And then, uhm– I brought on another Health Coach, who has inflammatory bowel disease herself and got it to remission with the Autoimmune Protocol. So that– you know, she could really relate to them. It’s always great to have somebody who’s very empathetic. So, yeah. So, I pumped up my team a little bit, and we changed the program a little bit. We tailored it to be very specific to one diagnosis. Whereas, my program is usually, any autoimmune diagnosis. We made it specific to IBD. So– but even so, you can do this for so cheap. I mean, it– it– it really doesn’t– It’s nothing compared to the cost of medications.
Dr. Justin Marchegiani: Uhmn–
Angie Alt: You know…
Dr. Justin Marchegiani: Oh, totally.
Angie Alt: …you can really– Yeah. You can totally change people’s lives. And it was a total of eleven weeks. But they were in remission by week six. I mean…
Dr. Justin Marchegiani: That’s amazing. And I– I just kind of postulating. I imagine– you know, we’re not doing– you know, you guys weren’t doing Stool Testing, so there could have been infections going on there. There could still be low probiotic levels, or maybe even some malabsorption that maybe needed to be repleted with certain nutrients that maybe could have made accelerated results even more.
Angie Alt: Sure.
Dr. Justin Marchegiani: What do you think?
Angie Alt: Sure, of course. You know they weren’t doing stool samples but they weren’t doing– they weren’t doing Stool testing in that regard…
Dr. Justin Marchegiani: Uhmn–
Angie Alt: …like what you’re about, like a GI Map type of thing. And yeah. For sure, there could be some underlyers there that needed treatment, specially because they have IBD. You know, there could be uhm– issues with absorption and other things that need to be treated.
Dr. Justin Marchegiani: Phenomenal. Well, anything else you want to mention about the study before we head up a couple of listener questions?
Angie Alt: Uuhhm– I don’t think so. It was just– it was a really a great experience. It was an honor to get to participate in the first ever AIP study. It was small but it’s definitely proof of concept now. And I hope we get to do bigger ones. [laughs]
Dr. Justin Marchegiani: Phenomenal. Alright. Let’s hit these kind of rapid fire here.
Angie Alt: Okay.
Dr. Justin Marchegiani: First question: Can colitis or other IBD issues, Inflammatory Bowel Disease issues– Can they lead to other health issues?
Angie Alt: I mean, it’s not uncommon for people with one autoimmune disease if it’s not kind of aggressively treated and dealt with for them to develop more autoimmune diseases. So, for instance if you have ulcerative colitis, the possibility that you might develop, you know, rheumatoid arthritis or uhm– you know, psoriasis or something, is not really that far-fetched.
Dr. Justin Marchegiani: Great. And, what’s your opinion on other genotypes, like someone’s talking about HLA, right? Like of those HLA-DQ1 and 3 and 2 and 8, I think are more celiac ones. How does the genetics uhm– contribute or affect autoimmunity?
Angie Alt: You know, Dr. Terry Wahls said something that’s perfect all the time about this.
Dr. Justin Marchegiani: Uhmmn–
Angie Alt: She says the genes load the gun but environment pulls the trigger.
Dr. Justin Marchegiani: Phew! Yeah.
Angie Alt: Exactly. So, this is a really good way to think about this. So, if you have any of those uh– genotypes. You know, for instance, I have celiac disease, so i have HLA-8.
Dr. Justin Marchegiani: Uh!
Angie Alt: Uhm– you know, if you have those genotypes. Then you might be predisposed.
Dr. Justin Marchegiani: Uhmn–
Angie Alt: But if you can work on your diet and lifestyle, you may prevent that trigger from being tripped.
Dr. Justin Marchegiani: Totally. So, basically, we have control of the epigenetics that…
Angie Alt: Right.
Dr. Justin Marchegiani: …flip the genes off and on. So, if we managed– let’s say, the diet gene, the AIP gene, right, then that’s gonna affect those autoimmune genes from flipping on…
Angie Alt: Right.
Dr. Justin Marchegiani: …and activating the said [crosstalk]–
Angie Alt: Exactly.
Dr. Justin Marchegiani: Wonderful.
Angie Alt: Exactly.
Dr. Justin Marchegiani: Awesome. Patient writes here. Let’s see if we can connect it to the autoimmune approach here, but I have hypothyroid and a sluggish gallbladder. What do you suggest for diet and vitamins? Thoughts?
Angie Alt: Well, so first of all, with the hypothyroidism, I would, you know, really work with your doctors and do some antibody testing and try to clarify if that hypothyroidism is Hashimoto’s, which is the autoimmune version of hypothyroidism. A lot of times, folks are just told, “Oh, you’re hypothyroid.” But their doctors don’t do that extra layer of work to d– clarify if it’s an autoimmune disease. Uhm– If it is autoimmune in nature, yeah! I’d go for it and tr something like the autoimmune protocol. Oftentimes folks with uhm– Hashimoto’s need to have uh– some conventional and some natural approaches so, they might need some uhm– hormone replacement. Some thyroid hormone replacement.
Dr. Justin Marchegiani: Uhmn–
Angie Alt: that’s okay. If you work on the diet and lifestyle, in conjunction with th– thyroid hormone, it’s gonna be so much better. You’re gonna need a lower dose and it’s just gonna work a lot faster. Uhm– as far as the gallbladder goes, you know, there’s things you can do, dietarily to help support gallbladder health, and hopefully turn that around before you lose your gallbladder. So, you can do things like uh– eat lots of beets, uhm– improve the quality of the fats that are in your diet, so focusing a lot on olive oil, and other good quality saturated fats, like you know, pastured lard or pastured tallow. Uhm– avoid all those damaged low quality fats that are out there. Like in fried restaurant foods. Uhm– if you already lost your gallbladder, you might want to consider supplementing with something called ox bile.
Dr. Justin Marchegiani: Phenomenal. Excellent. Other person writes in here, saying that uhm– when they have– they have diagnosed for celiac but hen they eat eggs, they have this really bad taste in their mouth and they get diarrhea three to four hours later. Not really a question. Just more of a comment. But any thoughts on kind of egg and digestion. I know that’s an autoimmune food, too. Any thoughts?
Angie Alt: Uhmn– Yeah. I mean, there might be uhm– I thi– I believe egg is one of the uhm– foods on Cyrex’s list of possible cross-reactors to gluten. So, there might be a cross -reactor situation happening there. It could also just be that because of the damage from Celiac disease, you know, she hasn’t– she has increased sensitivity.
Dr. Justin Marchegiani: Yeah.
Angie Alt: And maybe with a little bit of healing dietary approach, in times you could reintroduce egg just fine.
Dr. Justin Marchegiani: And so, for reintroducing foods we have an issue, how long do you recommend to try it again? Should it be something we put on our list, maybe once every month or two to kind of try back in?
Angie Alt: I think it depends on how bad a reaction is.
Dr. Justin Marchegiani: Yeah.
Angie Alt: So, let’s say, you try to reintroduce a food, and you have a really bad flare from it. Like, your– all of your autoimmune symptoms kind of flare up and you’re in a really bad space. You might want to give it at least 30 days to let everything calm back down and let your body…
Dr. Justin Marchegiani: Yeah.
Angie Alt: …kind of go back to the uninflamed nice, calm, immuned space it was when you started to reintroduce the food. Uhm– if it’s a pretty mild reaction. I’d give it, you know, five days to seven days, and uhm– you know, really work on some healing. In the meantime, pump up that bone broth, stuff like that and then give it another shot.
Dr. Justin Marchegiani: Phenomenal. Excellent. I think we hit all of the major questions. I don’t see anything else there.
Angie Alt: Yehey!
Dr. Justin Marchegiani: Any other issues, or anything else you want to mention that’s yo– that we haven’t quite hit yet?
Angie Alt: Uhm– You know, for anybody in your audience whose a fellow practitioner uhm– of any kind, Mickey Trescott and Sarah Valentine and I started a program last year called AIP Certified Coach. It’s a training program for practitioners uhm– who want to coach the autoimmune protocol with their patients or clients. Uhm– We graduated our first class uh– in September and we have an enrollment coming up in March. And, we would love to have anybody join us. We had doctors and naturopaths and dietitians and fellow [inaudible] pharmacists. Uhm– It was really great, and people all over the world, so there was like lots of interesting discussion and cross-pollination with everybody, and we’d love to have uhm– any of those folks in your audience join us.
Dr. Justin Marchegiani: Was that aipcoach.com?
Angie Alt: aipcertified.com
Dr. Justin Marchegiani: aipcertified.com. Okay. We’ll put that in the show notes below. Anything else?
Angie Alt: Nope. I think that’s it.
Dr. Justin Marchegiani: Alright. Let’s get your links one more time. What’s the– the coaching link program again?
Angie Alt: My coaching program is sadtoaip.com. I blog and podcast with Mickey Trescott at…
Dr. Justin Marchegiani: Nice.
Angie Alt: …autoimmunewellness.com. Yep. You can find all our books and everything there. Uhm– and then, the coaching program for practitioners who want to learn about the autoimmune protocol is aipcertified.com.
Dr. Justin Marchegiani: Awesome. Well, thank you so much Angie for all these great information.
Angie Alt: Yeah.
Dr. Justin Marchegiani: Look forward to having you back soon and it’s so exciting, like seeing these things that we know that work, and then translating it to a real study that’s…
Angie Alt: Yeah.
Dr. Justin Marchegiani: …peer-reviewed, and seeing the information. I’m just curious, like what’s the– what’s conventional medicine people, in these fields thinking about the results of these studies.
Angie Alt: Well…
Dr. Justin Marchegiani: Are they kind of blown away? Or…
Angie Alt: Yeah. I remember when we got the results, Dr. Konijeti– you know, it was really exciting to get her first phone call with the first results. And she was like, “Oh, my gosh!” And she was just really blown away. And, you know– I– I knew anecdotally that was this good, but uhm– getting to see those ,hard numbers was really exciting. I think I probably told the doctor like, “I told you so,” or something. [laughs]
Dr. Justin Marchegiani: Yeah. I mean. Look the page. Did you see the– subjective results, some of the objective stuff, but it’s not– we’re not doing these– you know, scientifically validated surveys and all these things, and really measuring it all, and having a statistical significance attached to it. SO, I’m really glad that you uhm– that you really crystallized this. I’m gonna do a video on my p– my channel where I review this– this study again. I’m gonna go to the full study and really…
Angie Alt: That’d be great.
Dr. Justin Marchegiani: So, I appreciate– you know, all the great work that you’re doing and thanks so much. Look forward to having you back on the show again soon.
Angie Alt: Yeah. Thanks for your work, too, Dr. J.
Dr. Justin Marchegiani: Thanks Angie. Take care.
References:
Robb Wolf’s “The Paleo Solution”
The Paleo Mom’s Dr. Sarah Valentine’s, “The Paleo Approach”
https://www.thepaleomom.com/tpv-podcast-episode-106-paleo-approach-cookbook/ by Dr. Sarah Valentine
SAD to AIP in Six by Angie Alt
www.autoimmunewellness.com, with Mickey Trescott
Dr. Terry Wahls
Dr. Gauree Gupta Konijeti, MD
Autoimmune Protocol with Inflammatory Bowel Disease
“Coffee is a fruit…” by Dave Asprey
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