AIP Research Update: A Hashimoto’s AIP Study from Poland

Good news! The Autoimmune Protocol (AIP), an elimination and reintroduction protocol aimed at helping those with autoimmune disease identify food sensitivities and increase nutrient-density, continues to be the focus of medical research investigating its efficacy for specific autoimmune conditions. While AIP has been widely used in the autoimmune community since 2011 (see the

History of the AIP Movement), medical research into its efficacy began around 2015, with results of the first pilot study published in 2017. Since then, studies have been conducted using AIP as an intervention for inflammatory bowel disease (Crohn’s and ulcerative colitis), Hashimoto’s thyroiditis, rheumatoid arthritis, eczema, and psoriasis. If you’d like to learn more about previous studies, including what interventions were used and the results, check out the AIP Medical Research Review.

Today I’ll be highlighting the newest AIP medical study, Effects of Autoimmune Protocol (AIP) diet on changes in thyroid parameters in Hashimoto’s disease by a research team from Poland, Paulina Ihnatowicz, Jerzy Gębski, and Małgorzata Ewa Drywień [1]. This is the second study that has been conducted so far using AIP as an intervention to manage Hashimoto’s thyroiditis and certainly adds to our knowledge base of how to use the protocol for managing it [2]. Hashimoto’s is not only the most common autoimmune disease, but conventional treatment is rarely successful as many patients find that they continue to have symptoms even though their hormone levels have been “treated to target” [3].

Intervention details

For this study, 28 patients with Hashimoto’s thyroiditis were enrolled, with 20 of them completing the study. The average age was 35, with patients between 23-55 years old. Patients underwent initial testing, surveys, and dietary analysis, and then were prescribed individualized, 12-week dietary plans compliant with Core AIP Elimination. It should be noted that in contrast to prior studies using AIP, there was no use of a transition phase–participants made immediate transitions to the elimination diet [2].

In terms of testing completed at baseline and completion of the study, patients had their height and weight measured in a clinic, had lab draws for thyroid hormones (TSH, total and free hormones) and thyroid antibodies, an ultrasound of the thyroid, and they also completed surveys to capture symptom burden. Prior dietary intake was captured using a survey for analysis and comparison of prescribed AIP meal plans.

After initial testing, each participant was prescribed an individualized, 12-week Core AIP meal plan based on their anthropometrics (height and weight). They were instructed to continue all prescribed medications and supplements as before, and no adjustments were made to doses. Support was offered via monthly group coaching calls.

Results

Energy and macronutrient intake

A comparison of prior diet and prescribed AIP diet showed that energy intake (calories) was roughly the same before and after the study (2,067 to 1,997 calories). In terms of macronutrient intake, protein increased from 16.77% to 24.9% of total calories, which is an increase of roughly 85 to 125 grams per day (based on a 2,000 calorie intake). The increase in protein came primarily from decreased fat intake.

Micronutrient intake

Analysis of nutrient intake via prescribed AIP diet showed there was a broad increase in nutrient density during the intervention. Specific nutrient intake increases included Beta-carotene (550%), fiber (162%), folates (198%), long-chain fatty acids (262%), potassium (196%), vitamin A (341%), vitamin C (886%), with other nutrients like B vitamins, iron, zinc, and magnesium with considerable increases. The authors noted that analysis of some nutrients was complicated by supplementation, specifically magnesium, vitamin C, and potassium.

Biochemical thyroid changes

Blood test analysis showed Thyroid stimulating hormone (TSH) significantly decreased from a mean of 3.72 to 2.69. Free T3 and T4 significantly decreased, although both stayed within reference ranges (3.31 to 2.88; 1.36 to 1.20). Mean anti-TPO antibodies increased (210 to 293) and anti-Tg decreased (317 to 300), although these results did not meet statistical significance.

Physical thyroid changes

A comparison of thyroid ultrasounds before and after intervention showed the right lobe volume decreased by 5% and the left lobe volume decreased by 6%.

Weight and body composition changes

Anthropometric measurements taken before and after intervention showed that mean weight decreased from 69 kg to 65.5 kg (152 lbs to 144 lbs). Mean body fat percentage decreased from 33% to 29.5%, indicating that twice as much weight was lost from fat than muscle.

Symptom burden

Analysis of questionnaires showed a broad improvement of symptoms commonly reported by Hashimoto’s thyroiditis patients. The largest decreases were seen in the following areas:

1. 
   
2. Digestive function
3. 
   
4. Constipation – 36% to 11% (25% difference)
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6. 
   
7. Gas – 61% to 21% (35% difference)
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9. 
   
10. Flatulence – 61% to 29% (32% difference)
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13. Diarrhea – 29% to 7% (22% difference)
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16. Abdominal pain – 29% to 14% (15% difference)
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18. 
    
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20. Energy
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22. Tiredness – 82% to 29% (53% difference)
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24. 
    
25. Drowsiness – 64% to 21% (43% difference)
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27. 
    
28. Fatigue – 50% to 11% (39% difference)
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30. 
    
31. 
    
32. Mental
33. 
    
34. Impaired concentration – 71% to 18% (53% difference)
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36. 
    
37. Headaches – 39% to 11% (28% difference)
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39. 
    
40. Depression – 29% to 4% (25% difference)
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43. 
    
44. Pain
45. 
    
46. Muscle cramps