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A Year Later: Update on the Inexplicable Skin Rash

It’s been an entire year since I finished the first part of the Paleo Autoimmune Protocol and I feel like it’s time for another update. I started that whole thing because I had an inexplicable skin rash that showed up one November – now two years ago – and started spreading. It didn’t itch, it didn’t flake, it didn’t do anything except spread. When it also didn’t start to fade after a year, I went to the doctor and found out it was inflammation, possibly because of something or other.

Well, duh. I could have told them that. But they couldn’t tell me the cause and when the inexplicable skin rash decided to migrate to a spot right beneath one of my eyes, I decided I had to try something. That something was the Paleo Autoimmune Protocol – hereafter called the AIP – which is a very strict, healing diet and lifestyle. You avoid eggs, nightshades, grains, dairy, nuts, seeds (including seed-derived spices), alcohol, NSAID’s (like Aleve), food additives, and anything else that’s fun, while focusing on eating tons of greens, bone broth, fermented foods (like kefir and sauerkraut) and organ meats and getting enough sleep and exercise. It sucked.

But it worked.

Now, a full year later, my inexplicable skin rash is 99% gone. I can feel a little raised area where the first (and largest and most persistent) patch was, but aside from the biopsy scar (hiss) there is nothing to see. The big red patch on my leg after the egg reintroduction? Gone. The patch on my wrist and the inside of my elbow? Gone. All the little bits and pieces speckling my torso – gone gone gone. I would take a picture, but it would just be a picture of skin.

Not only that, but the AIP took away the big, oozing bumps I used to get on my rear and, although I’ve gotten a few small, irritating ones – exclusively when nightshades crept back into my diet, accidentally or intentionally – I haven’t had to utilize band aids like I used to. I’ve also been able to do sit-ups for the very first time in almost two years, because the inexplicable bump/awfulness at the base of my tail bone is finally healing.

Another big thing: I haven’t had a panic attack in going on three years now, and not even an anxiety attack in the last year. My depression was problematic in the latter half of last year, but during the stricter phase of the AIP it was nonexistent. I’m still figuring out why.

My diet has changed irrevocably, although it’s no longer as strict as the initial AIP introduction – nor should it be. I still eat a big heaping of greens for breakfast every day and make a batch of broth each week. I still mix pureed liver with meatballs and try to get in heart and tendon and tripe when and where I can. My coffee consumption is steady at one cup a day – literally a cup, I measure it – and I mostly drink herbal tea after that.

But I do partake in the occasional dairy – usually full fat milk, very rarely yogurt, more oftentimes amazing cheeses – and I go all out on the seed spices (MUSTARD YES). Although I officially reintroduced nuts ages ago, I eat far less of them than I did when I was just paleo and I actually tend to forget they’re even an option most of the time. I don’t have a problem with rice or oats, so those will sometimes make an appearance, but rarely. I also indulge in alcohol perhaps a little too often and haven’t been as good about saying no to baked goods as I had been in the past – a mental trade-off for having to avoid nightshades and eggs, I think, not that that makes it any better.

Overall, though, I’m glad I did it. I’m amazed at how thoroughly the inexplicable skin rash has vanished and I’m looking forward to the day where I can run my fingers over the place it was and wonder if it even happened.

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Patience is a Virtue: the Paleo Autoimmune Protocol

After I finished the 30-day super strict autoimmune protocol back in January, I wrote a somewhat lackluster recap & review of my experience. I noted at the time that some of my lack of results might be turned around over the coming months as I continued to (mostly) adhere to the diet and take extra special care of myself.

Now that it’s been over six months, I feel like I should amend my review.

The paleo autoimmune protocol is fucking amazing and magical.

I didn’t have the results I wanted after 30 days because it took a helluva lot more than 30 days to get the issues I have in the first place. Now that it’s been a wee bit longer, all of my skin issues are so much better. I could sing!

The tomatoes were a very strong reminder of just how far I’ve come. I mentioned they gave me a boil. One boil. A single one. Uno. Eins. Unum. Raz. And it was tiny, so tiny.

This is a big deal because before the AIP, I would have constantly two to three, and was dealing with up to five of these godawful things at a time. This recent one was a wee bit painful when I biked, but those old fuckers made it impossible to sit and I often had to plaster them with bandaids because they oozed. They got so bad that it was painful just to walk. When I first started getting them, I went to the doctor – as you do, right? But instead of getting any idea of wtf they were or how to deal with them, she chastised me for not being hygienic. That stuck with me for so long that when I went to the dermatologist for my inexplicable skin rash, I went out of my way to avoid mentioning the boils.

Not that the derm helped with the rash, anyway.

So these last six months, aside from one or three flairs, I’ve been boil free and it’s been wonderful. So good that I forgot how uncomfortable those little fuckers could be, in fact. If it means I can’t ever have salsa or hot sauce again, it’s a difficult deal, but I’ll take it.

But it’s the inexplicable skin rash that started me down this journey and the inexplicable skin rash that bummed me out the most at the end of January. I’ve updated on that rash since then, that it looked like it was improving, albeit slowly, but now I can confidently say that it is almost gone. The bit on my wrist that was flared for so long is now nothing but a small set of bumps I can only tell are there when I run my finger over them. The larger patch on my waist is now mostly just the biopsy scar and a small bump or two.

It looks so much better, guys. Even the dime-sized circle on my leg that I got with my last round of egg-trying has reduced itself to a teensy pinkish spot instead of the flaking red nastiness it had been. Another large, egg-sized spot on my leg that had been nasty and raised and ugly is completely vanished. I’m left with a few small rashes speckling my torso, but even those are slowly fading. I bet they’re all gone by November.

This weekend I even had a nasty flare across my stomach that had me in tears (one of many things…), but it’s all but gone already. Apparently, the faster I get back on track when they show up, the faster they go away. That helps explain why the original few have stuck around for so very long – I didn’t even see a doctor about them for over a year. But they’re healing. Slowly, oh so slowly, but they’re healing.

A few things I’ve noticed that seem to help them heal faster: being militant about drinking broth with gelatin. Not only do any cat scratches I might have received disappear quicker, but the rashes smooth out in leaps and bounds instead of plodding along, barely changing for weeks. The key thing seems to be gelatin; I’ve been drinking broth religiously since January, but it’s often chicken broth and it usually doesn’t gel on its own. But if I add a teaspoon of gelatin, suddenly I see those improvements in my skin almost right away. I wouldn’t have to add gelatin if I made proper bone broth all the time, but I’ve learned I don’t like the taste of bone broth and will avoid drinking it. So what’s the point of making it when I won’t drink it?

The other thing: extra coconut oil, often in the form of coconut fudge. I started making and eating these to help alleviate some of my intense hunger in the mornings – which has been working amazing btw – and as a bonus, I noticed my skin clearing up faster at the same time. I have no idea why, but I’ll take any excuse to keep eating these. They’re just that good.

This is all to say that if you’re in the middle of doing the Autoimmune Protocol and you haven’t seen the results you wanted yet, don’t lose hope. This shit takes time. Unfortunately, sometimes it takes a lot of time. But if you’ve stuck with it this far, it’s really fucking worth it to keep going. Even for people like me who don’t have a really bad condition, or one that’s been around for years and years, it can still take a while. It sucks, but it is definitely worth the relief and knowledge in the end.

I will still stick to my guns about only starting the AIP if you are really and completely convinced it could help, though. It is not a fun endeavor, and once you start you can’t really stop. Well, you can, but it’s a waste of your time. You have to keep going, you have to keep plugging on, and if you do – it is really fucking worth it.

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My Results (so far) with the Paleo Autoimmune Protocol

I’ve been doing the AIP for a good three, almost four months now. I’ve been focusing on stress management, getting lots of sleep, slow intermittent movement, and – the biggy – diet. I’ve been better at times than others at working on the first three parts, but I’ve been fairly consistent with diet and reintroductions the whole time.

The first few weeks were by far the hardest, as I learned how to adjust to the new restrictions. But I’ve since settled into a rhythm and am up to an almost paleo diet again. I started the AIP with a host of skin issues to clear up, but discovered the diet was helpful for some other issues as well. I suspect, however, that eating a diet free of gluten, excess sugar and highly nutrient dense may have had more to do with the latter than the removal of things like eggs and nightshades.

So, what changed exactly? Within the first month my HS had subsided dramatically. Heck, within a few weeks. With reintroductions, I’ve had a few flares and have since realized that it is definitely something I’m eating that causes the outbreaks. What, exactly, I haven’t pinned down yet, but I’m hopeful.

A chronic boil I’ve had for years has also (slowly, steadily) been getting better. This one doesn’t appear to be linked to any specific food, but more to just nutrient quality in general. Further research on my part has brought to light that its root cause might not be autoimmune, but clean eating still helps it heal.

Cycle-wise, my PMS has become nonexistent, my cramps manageable, and my cycles way more regular. I suspect this has more to do – again – with nutrient density and fewer simple carbs than any specific food. But again, we’ll see.

Last but not least, the main and central impetus that drove me to commit to this crazy restrictive diet was the chronic rash that had been slowly consuming my body. The last straw – a patch of rash under my eye – cleared up after a month on the AIP. Other patches have been steadily fading, including a bright red circle that was on my leg. Now I can only tell it’s still there if I run my hand across the area – the skin is still a little rough.

I should have taken more photos for documentation and proof, but, alas, I only thought to take a photo of the initial rash. As you can see below, it’s gotten a lot better:

january-29 april-228

The darker spot is my biopsy scar, which has proven invaluable for me in determining just how much it’s improved. Both photos were taken under the same lighting conditions with the same camera and had the same corrective color balances applied.

Although the rash is better, it still has a time to go before it’s fully healed. I’m hoping it doesn’t take another three months, but I also won’t be surprised. In the meantime, I will keep reintroducing things up to being fully paleo and keep an eye on it. My prime suspect is still eggs, since they still stand out with the most severe reaction so far.

But at least I have some proof that all this no-chocolate, no-Mexican, but lots of offal and bone broth super-strict eating is actually doing some good.

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Getting Sleep

march-24

Aside from avoiding certain foods and eating as nutritiously as possible, the Autoimmune Protocol stresses reducing lifestyle stress and getting a lot of really good sleep. I’ve prided myself in being good about sleep, at least moreso than my peers. But after the cocoa incident, I thought it might be a good time to reevaluate that as well as everything else.

As I mentioned, I not only had a flush of skin symptoms, but I started waking up in the middle of the night, my whole body electrified and ready to do something, anything but sleep. I usually wake up sometime in the middle of the night, but it’s easy to fall back asleep. Not these times. Even worse, I started waking up multiple times, getting charlie horses, and generally just having a difficult time of it.

Knowing how important good sleep is to staying healthy, I began researching what I could do to improve those nightly wake-ups. I already had magnesium, exercise, and going to bed on time down pat. Both of my computers have f.lux installed. I usually eat light in the evenings. I usually get sun during the day. I usually don’t have caffeine in the afternoon. Usually.

The internet suggested I set up a pre-sleep routine and I agreed that that was a good idea. So for a week I decided I would really focus on getting good sleep. I would do all those “usually” things every day with military precision and to those I would add a thirty minute wind-down time. No computer allowed in bed. Sleepy time tea and reading encouraged. Add to that five minutes of stretching and I’d see how it all went.

So for a week I made sure to go outside and get some sun every day. I didn’t have an afternoon tea. I made lunch my biggest and heaviest meal of the day. If I snacked after dinner, it was light carbs, like dried fruit. I set my phone alarm to remind myself to stretch. I stopped computing thirty minutes before bedtime and took my magnesium. No alcohol was allowed within two hours of sleeptime. I went to bed at the same time every day and woke up eight to nine hours later – whenever my body was ready. No alarm.

And it worked! That very first night and every night I made certain to hit all those notes after. I can’t put my finger on any one of the changes or focuses being the culprit, but the cumulative effect was a better night’s sleep. I woke up the first night but was able to go right back to sleep, and since then I’ve had a few nights where I didn’t wake up at all – at least, not until I was supposed to.

I hit all those things for a week, then slacked off to see what happened. The only things I continued to hit consistently were some amount of sun exposure every day, no computer in bed, and no afternoon caffeine. I think I can safely narrow it down to one – or all – of those three factors. But sleep is about so many variables throughout the day coming together just right, so I can’t really narrow it down. I can only tweak variables to make my sleep better in the long run.

What did I learn from this weeklong experiment? Well, for one, dialing in good sleep requires additional focus. There are things you do or don’t do throughout the day that can have an effect, as well as things immediately prior to bedtime. Having a routine helped a little, but it’s difficult to fit into my current lifestyle.

I also really, really love ditching the alarm. Before this experiment I was beginning to struggle with waking up more than usual. I had my alarm set thirty minutes after I usually wake up, as sort of a last ditch emergency measure, and I was constantly being woken up by it. So not only was I interrupting my sleep, but I was also truncating my morning considerably and having to rush a lot more than I liked. Now I consistently wake up right before 5am, and way before my alarm.

I also suspect daily sun exposure might be a whole lot more important than I’d previously suspected. It’s sometimes difficult to remember to take the time to go outside, especially when I work in an office environment, and especially when I prefer to use all my breaks to write, but it’s important.

Stretching, while nice, may not have helped much. I’m going to try to keep going with that anyway, because I am very bad at stretching, ever. I actually have harbored a not-so-secret dislike for yoga for years now, but I’m beginning to come around and understand how it might have a beneficial place in my life. Grudgingly. 😉

That said, there are a lot of factors which affect sleep, and so many of them individual. I’m going to try to keep a focus on sleep going as I progress through the AIP reintroduction period and figure out exactly what I need for some decent Zzz’s. It’s all just one big N=1 experiment, isn’t it?

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Paleo Autoimmune Protocol Recap & Review

For 30 days in January, I followed the paleo autoimmune protocol. I did this partially out of curiosity, and partially to clear up an inexplicable skin rash that had slowly been covering more and more of my body. At the time, I had two other skin issues which I hadn’t expected to clear up or be effected by the protocol – boils that may or may not be a mild form of HS and a very persistent lesion. All of these skin issues I’ve had for more than a year, with occasional and unpredictable flares. Cutting out the usual culprits – gluten, excess sugar, soy, corn etc – didn’t help, so I decided to try the AIP diet.

You can find all of my AIP-related posts – which include what I ate and how I felt each day – here.

The Paleo Autoimmune Protocol in short, is a paleo diet minus:
– Eggs
– Nuts (including nut oils, flours, & butters)
– Seeds (including seed-based spices & oils, chocolate & coffee)
– Dairy
– Nightshades (tomatoes, eggplants, chiles, etc and nightshade-derived spices like paprika, chili powder etc)
– Alcohol
– NSAIDS (like naproxen sodium, ie, Aleve)

But emphasizing:
– Bone broth
– Probiotics (yeah bacteria!)
– Lots of dark, leafy green veggies
– Grassfed meats
– Oily fishes
– Sleep
– Organ meats
– Moderate exercise
– More sleep

I revved up for the 30 days by looking up as many AIP friendly recipes as I could and getting excited about what I could eat, like sweet potatoes and avocadoes! But even with all that, and a month’s worth of mental prep, and having done elimination diets like the Whole30 before, it was still really really difficult.

And it’s still ongoing. Even in the reintroduction phase, you stick to a strict AIP diet most of the time.

So, how’d it go?

I want to say everything cleared up. I want to say nothing improved. I want to say that something very clear cut happened.

Unfortunately, it wasn’t that clear.

I felt pretty much as amazing as I usually feel when eating strict paleo. My energy levels evened out after the first week without coffee, my sleep was deep and good, my workouts steadily improved, and even when I got sick in the first week, I was only out of commission for a day. I had some digestive weirdness in the first two weeks, but that cleared up and everything is dandy now. I lost all of the bloat I’d gained over the holidays and a few pounds. My clothes are a little looser despite not trying to lose any weight.

But again, nothing I didn’t get on the Whole30 or strict paleo.

My skin issues? Eh. The inexplicable skin rash appeared to get better for two weeks, then refused to budge and even popped up a few new rashes. But my boils are much better and the lesion appears to be slowly, but steadily, improving.

I don’t know how to feel about these things – they are improvements, albeit small ones. But nothing as grand and amazing as I had hoped for and – perhaps naively – expected. All of these have been around for years and will likely just need more than 30 days to get better. Thankfully, reintroduction is still mostly strict AIP, so they will have more time. I will continue to monitor them closely.

Basically, the sheer difficulty of the diet didn’t show up in the results. I expected more because it was freaking hard, man. It’s one thing to think, oh, I can live without seed & nightshade spics. It’s another to go through paleo recipe after paleo recipe, turning them all down because of those spices. No tacos. No fancy burgers. No chili. No bacon-wrapped jalapenos. No almond cookies. No freaking chocolate.

I knew I’d reached a low point when I kept flipping past delicious amazing paleo recipes because each and every one had a deal-breaking non-substitutional ingredient and just started crying out of frustration. It’s one thing to focus on delicious food like avocadoes and sweet potatoes, but it’s another to have those almost every single day without much variation. I am, in effect, incredibly bored with food.

Paleo/primal eating seems to be sufficient for me to feel 95%. Continuing down the road of food restrictions and AIP is probably not worth the remaining 5%. I will still do the full reintroduction in order to avoid invalidating all the work I put into the AIP and also to give my body a little more time in case these skin issues really just need an extra month. Right now, though, I’m fairly convinced they aren’t autoimmune in nature – at least, not exclusively so. Thankfully, I’ll have a better idea about that if/when I manage to get pregnant, because pregnancy hormones repress the immune system and frequently cause autoimmune issues to go into remission.

Some tips for those who would try the AIP diet:

First of all, have you tried eating strict paleo? Or even the Whole30? If not, start there before you even consider AIP. Strict paleo already removes most of the prime autoimmune suspects and is sufficient 89% of the time (a number completely pulled out of my butt, btw). Check out the Whole30. Please.

If you’ve gone that route and stayed true for at least a year, and still have autoimmune symptoms, you might want to look into AIP. Write out your issues. Stare at them. Are these worth a full month of strict eating, as well as several months afterwards of dedication and reintroduction? Will you actually adhere and stick with it, without throwing in the towel in week two? Are you willing to commit?

If the answer to any of these is no – then maybe you should wait. Maybe now is not the time. Come back in a few months and reconsider. Because this will take unwavering dedication and is not worth doing half-assed. If you break it off in week two or even week three, it was a waste of your time. Life is too short for that.

Now, if you’re set on doing the AIP, give yourself enough time to prepare, both mentally and recipe-ially. I would suggest printing out the lists of what you can and can’t have and putting them somewhere prominent. Familiarize yourself way before you start. Keep them somewhere prominent, like on your fridge or at work. Or both!

Pick a month with as few social obligations and travel as possible. January was perfect for me, and winter in general is better because then, at least, tomatoes are not in delicious, mouth-watering season. But if you’re on the road all winter, maybe you should go with summer. Traveling while on AIP is doable but difficult and not worth the extra stress. Really.

Don’t. Deprive. Yourself. You’re already severely restricted, so don’t cut back on calories and don’t say no to treats you can – and want to – eat. Dried mango slices saved my sanity on more than one occasion and, yes, I probably ate way more than was really necessary. Eat until you’re sated.

Herbs. You can have herbs. Stock up on them. Double the garlic in every recipe. Add more ginger. Do it.

Roasted chicken is a godsend. Not only do you have three/four meals, you can make broth out of its delicious carcass.

Drink broth every day. Make a habit of it.

Let your friends know. Tell them they don’t have to accommodate you. Don’t expect them to. Then, if they do, weep with joy.

Pulverize the liver in a food processor and add it to your meatballs. Double the garlic. Thank me later.

Greens are your friend. Especially pre-washed and cut greens. They cook within minutes and go with everything. Eat them. Often.

Avocadoes are versatile and filling and a fine alternative to eating another. damn. apple. Find some quality olive oil and some tasty salt and liberally smother the avocado with both.

Coconut milk/cream is magical. Use it any time you’d use milk.

If you chop off your thumb, I won’t judge you if you have a little wine.

Plan in advance and make sufficient sauerkraut. It is easy, delicious, and a probiotic. It also goes well with burgers.

It’s okay to cry.

Next up, an AIP recipe round-up.

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Paleo Autoimmune Protocol, Day 30 (!)

For the month of January I’m following the paleo Autoimmune Protocol (AIP). It’s like a Whole30 – just minus eggs, nightshades, seeds & nuts. It’s a little insane, but the only way to truly find out if a skin issue I have is autoimmune in nature or not. For more information, see my preparation post.

Day 30? Really? I’m already on the last day? It seems like I was just at week two and despairing because I was tired of boring chicken and spice-less ground beef. Well then.

Wot I ate:
– Pot of black tea and a cup of broth
– Sautéed greens, sweet potato hash, and meatballs for breakfast
– Leftover beef soup, some blueberries & strawberries, and a cutie orange for snacks
– An avocado, cherry pot roast, arugula salad, and garlic roasted spaghetti squash for lunch
– Another cup of black tea for afternoon fortification
– A banana, tuna salad, and plantain chips for dinner

Dinner was kind of a thrown together on-the-road affair because we left straight from work to drive two hours to watch a live show of Welcome to Night Vale. I also didn’t get much sleep (BUT IT WAS TOTALLY WORTH IT), so we’ll see how reintro day one goes. 😛

All I’ve got planned for day 1 of reintroduction is some morning egg yolks. I should probably put my head down and think up some more, but I can’t quite get past the whole “I can finally eat something else!!” part. I know I want to make this breakfast cake, though. Either that’s some really good photography or it’s going to taste AMAZING.

I’ll see you on the other side.

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Paleo Autoimmune Protocol, Day 29

For the month of January I’m following the paleo Autoimmune Protocol (AIP). It’s like a Whole30 – just minus eggs, nightshades, seeds & nuts. It’s a little insane, but the only way to truly find out if a skin issue I have is autoimmune in nature or not. For more information, see my preparation post.

Wot I ate:
– A pot of black tea
– Sautéed greens, sweet potato hash, and meatballs for breakfast
– Kiwis, cutie oranges, broth and some beef soup for second breakfast
– Chicken “pad thai” for lunch
– Roast chicken for dinner
– Coconut cream over blackberries and folate for dessert

One of my skin issues has been doing some weird things the last few days. It had previously been a seeping wound (hoorah!) for several worrying months, then it calmed down to just a bump, but now it’s swollen with obvious liquid inside. I’m going to lean towards it being in the process of healing itself instead of freaking out, though. :/

Not much else to report – sticking it out for one last day, then I’ll decide how I feel and see how far I’ve come.

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