Paleo Autoimmune Protocol for RA

Medically Reviewed by David Zelman, MD on September 13, 2023
3 min read

Could eating like a caveman help with your rheumatoid arthritis?

There isn't a specific diet that's proven to help with RA. But some people say a strict form of the Paleo diet makes their achy joints feel better. It's called the Paleo Autoimmune Protocol or AIP. The idea is to flood your body with nutrient-rich foods and stay away from ones that might make your condition worse.

If you're seriously thinking about changing your diet, talk to your doctor first. RA and the medications that treat it can make it hard for you to get the nutrition you need. You don't want to make that worse.

The Paleo diet is based on what early humans may have eaten in the Paleolithic era. That's more than 2 million years before modern farming began.

In the Stone Age, people ate only what they could hunt or gather. Farming changed that. Once it started nearly 10,000 years ago, dairy, grains, and beans became staples in the diet.

Paleo "friendly" foods include:

  • Eggs
  • Fermented vegetables and fruits
  • Fish and seafood
  • Fruits and veggies (most of your plate should be plant-based)
  • Grass-fed meat (including organ meat)
  • Nuts and seeds

Paleo "unfriendly" foods include:

  • Dairy products
  • Grains (including corn, wheat, pasta)
  • Refined and processed foods (like sugar, soda, pizza, packaged foods)
  • Legumes (like beans and lentils)
  • Vegetable oils


One large study showed that a "Western" diet heavy on red and processed meat, refined grains, fried foods, and sugars raised the risk of getting RA. People who ate a diet filled with fruits, veggies, and lean proteins were less likely to have it.

But the AIP takes Paleo a step further. It works on the theory that certain foods can bother your gut and cause inflammation (swelling), which also happens with autoimmune diseases like RA.

With AIP, you follow the Paleo diet. But you also stop eating the following for a while:

  • Alcohol
  • Eggs
  • Fruit juices and many sweeteners
  • Nightshade veggies (tomatoes, eggplant, potatoes, peppers, tomatillos, etc.)
  • Nuts
  • Seed-based spices (fennel, dill, sesame seeds, and others)
  • Seeds (including cocoa and coffee)

If you start feeling better after 3 or 4 weeks, you bring back these foods one at a time. Watch for a reaction for a few days before adding another one to your diet. Stop eating the food if:

  • Your RA comes back or gets worse
  • Your stomach hurts or you have bowel changes, heartburn, or other intestinal distress
  • You're low energy or tired
  • You have headaches or dizziness
  • You have a runny nose
  • You notice skin changes (rashes, acne, etc.)

AIP isn't just about food. Your lifestyle choices also matter. Getting the sleep you need, managing stress, exercising, and staying socially active are all important.

More research is needed to see if the Paleo diet or the AIP is really a good choice for people who have RA. Because these diets don't include many foods that give you essential elements like fiber, calcium, and certain vitamins, they may not be good for you in the long run.

A Mediterranean-style diet may help with your RA because it also fights inflammation. You mainly eat foods from that region such as fish, poultry, unsaturated fats like olive oil, fruits, veggies, and whole grains.

Omega-3 fatty acid, mostly found in fish but also in walnuts and green leafy vegetables, can ease inflammation and make swollen painful joints feel better. Adding olive oil to foods rich in omega 3's may be even more helpful, according to some studies.

Antioxidant vitamins found mainly in fruits, veggies, and some nuts also may prevent tissue damage. A study from the Netherlands showed that people said they had fewer swollen and painful joints 10 weeks after starting a diet heavy in certain antioxidants.

These are the key antioxidants and where you can find them:

  • Vitamin A:green leafy veggies, chicken, turkey, carrots, pumpkin, sweet potatoes
  • Vitamin C:citrus fruits, plums, Brussels sprouts, red peppers
  • Vitamin E:peanut butter, sunflower seeds and oil, avocados, milk, whole grains
  • Selenium:Brazil nuts, cottage cheese, tuna, beef

RA can break down cartilage. That's the flexible tissue in your joints that keeps your bones from rubbing together. Certain nutrients can help repair and protect it:

  • Vitamin B5:potatoes, beans, bananas, turkey, fish, and liver
  • Vitamin B6:chickpeas, chicken, pork, trout, sunflower seeds, spinach, tomatoes
  • Copper: oysters, squid, and other seafood; beef liver; cashews and other nuts; soybeans; lentils; cocoa
  • Zinc: lobster, chicken, beans, raisins, chickpeas, yogurt, cheese

Some chemicals found in plants called flavonoids may help make your joints feel better. Apples, green and white tea, grapes, and red wine are rich in them.