Does The Keto Diet Work for Autoimmune Disease?

It seems like autoimmune diseases are popping up everywhere these days. As the incidence of diseases like Hashimoto’s thyroiditis, RA (rheumatoid arthritis), Lupus, Crohn’s disease, and MS (multiple sclerosis) continue to rise, the need for effective treatments also increases.

Diet and gut health are huge areas of opportunity when it comes to reducing inflammation and getting autoimmune diseases under control.

And research is showing some promise when it comes to autoimmunity and nutrient-dense diets filled with coconut oil, bone broth, vegetables, and pastured meats.

But is there one diet that’s best for autoimmune conditions?

Popular protocols like the AIP diet (autoimmune Paleo), which limits nightshade vegetables and food additives seems to be gaining traction, but where does a ketogenic diet fit in?

What Is Autoimmune Disease?

The health of your immune system dictates the health of every cell in your body.

Autoimmune disease is a growing issue in the U.S., with an estimated 50 million people currently diagnosed and over 80 types of autoimmune diseases identified[*].

With numbers like that, it’s highly likely that you know someone with autoimmune disease, or have autoimmune issues yourself.

So, what’s happening in your body when you have an autoimmune condition?

Let’s start by looking at what happens when your immune system is working optimally.

Under normal conditions, your immune system is always on the defense, looking for foreign substances like bacteria and viruses to attack and eliminate from your body. It’s an incredibly intricate and complicated system that’s meant to keep you healthy and shield you from outside invaders.

In the case of autoimmunity, your immune system starts to mistake healthy cells and tissue as outside invaders.

In other words, your immune system turns on you and starts a full-on attack.

Diseases like Hashimoto’s, multiple sclerosis, rheumatoid arthritis, and type 1 diabetes all fall under the autoimmune umbrella.

What Does “Root Cause” Mean?

The cause — or causes — of autoimmune diseases is still under investigation.

However, the main theory is that you are either genetically prone to an autoimmune disease or you’re not.

Then, there’s usually an incident, or a series of incidents, that trigger the condition to manifest.

That initial trigger is usually referred to as the “root cause.”

The trigger can come in many forms, like:

• A virus
• Infection
• Stress (both acute like a car accident, or chronic stress)
• Injury
• Pregnancy
• Chronic poor nutrition

One of the main potential root causes of autoimmune disease is poor gut health leading to leaky gut syndrome, which causes systemic inflammation.

This is where diet and nutrition come into play when it comes to preventing and healing autoimmune issues.

How A Keto Diet Addresses The Root Cause

Hippocrates said, “all disease begins in the gut,” and nothing could be more accurate when it comes to autoimmune disease.

Your gut is your first line of defense for your immune system — the initial barrier that keeps all unwanted substances out of your internal circulation.

Research shows that your gut microbiome and the integrity of your gut lining both play a key role in whether or not you’ll experience autoimmune disease[*].

One of the most effective ways to keep your gut happy is to eat a diet that reduces overall inflammation. And this is where the ketogenic diet can help.

How The Keto Diet Reduces Inflammation

The keto diet has been shown to decrease inflammation in your body by way of the ketone body BHB (beta-hydroxybutyrate). Ketone bodies are what your body makes when you get into a ketogenic state[*][*].

BHB helps reduce all over inflammation, but especially inflammation in your gut lining.

On the other hand, many of the staples of a conventional high-carb diet — refined carbohydrates, sugar, and gluten — are all known to cause inflammation in the gut.

Is Your Diet Flipping the Switch On Your Autoimmunity?

When it comes to genetics, it’s always a game of nature vs. nurture. You may have heard the term epigenetics, which describes your genes’ ability to turn on and off depending on environmental factors like sleep, exercise, and yes — the food you eat.

That means that just because an autoimmune disease runs in your family doesn’t mean you’ll get it.

It also means that your diet, stress levels, and overall lifestyle has a huge impact on whether or not your autoimmune disease will flare. In fact, research suggests an epigenetic component to most autoimmune diseases including multiple sclerosis, type 1 diabetes, rheumatoid arthritis and lupus[*].

So how can you optimize your lifestyle to stave off autoimmune disease?

Diet, sleep, movement, and stress management are all imperative.

Common Autoimmune Diseases And How Keto Might Help

Crohn’s Disease

Crohn’s disease is a chronic inflammatory bowel disease (IBD) in which your immune system attacks your gastrointestinal (GI) tract.

Most IBD sufferers experience immense pain, inflammation, and scarring. Some need life-changing surgeries for relief

It’s estimated that over 3 million adults in the U.S. suffer from IBD (either Crohn’s or ulcerative colitis)[*].

Because Crohn’s disease is a result of severe chronic inflammation in your gut, dietary interventions that decrease inflammation like the ketogenic diet can be used in an effort to heal your gut lining[*].

Although more research needs to be done, there is a published case report where the ketogenic diet was successfully used to treat symptoms and normalize the labs of someone with severe Crohn’s disease[*].

A healthy keto diet eliminates all foods that aggravate your gut lining — sugar, gluten, and refined carbohydrates — all while increasing anti-inflammatory pathways in your body.

Multiple Sclerosis

There are about 200 new cases of multiple sclerosis (MS) diagnosed in the U.S. each week and a recent study reported that nearly 1 million people in the U.S. are living with MS. That’s more than twice the number previously reported from 1975[*].

Even with numbers on the rise, scientists don’t fully understand what causes MS and there’s currently no cure for this disabling disease.

MS causes damage to nerves that are responsible for communicating between your brain and the rest of your body. This leads to symptoms like fatigue, pain, impaired coordination, weakness, loss of vision, and more.

So how might the ketogenic diet help people suffering from MS?

Some recent research suggests that MS may impair your brain’s ability to use glucose for fuel[*][*]. This means that all those carbohydrates you’re eating aren’t getting to your brain. And unless it has an alternative fuel source, you’re going to have some problems.

Ketones might help.

There’s also some evidence (in mice models) that by providing an alternative fuel source, the keto diet may be able to help with the neurodegenerative aspect of MS[*][*].

Specifically, the ketogenic diet helps increase energy production on a cellular level, which impacts the health of your energy power-houses, mitochondria.

People suffering from MS may have impaired mitochondrial function, so this boost in mitochondrial health could be an essential piece to managing MS symptoms and progression[*].

Lupus

Unlike RA and MS, which tend to attack specific areas of the body, Lupus is an autoimmune disease that can attack any part of the body.

Much like the other autoimmune diseases, Lupus can result in inflammation, swelling, and damage to your organs and joints. It’s reported that 5 million people around the world suffer from Lupus, and 16,000 new cases of Lupus are reported each year[*].

Studies have shown that Lupus can activate a specific immune system receptor (inflammasome NLRP3).

The activation of NLRP3 signals other inflammatory molecules in your body to activate and do what they do best — cause inflammation[*]. When this cascade continues, the inflammation can become chronic and lead to debilitating pain.

Luckily, when your body is in ketosis it can support the interruption of this cascade.

Here’s how:

• When eating a ketogenic diet your body makes an abundance of the ketone BHB (beta-hydroxybutyrate).
• One of the ways BHB has been shown to decrease inflammation is by inhibiting the NLRP3 inflammasome[*].
• This means that if you have Lupus and you’re eating a keto diet, you’re literally flooding your body with the very antidote to one of the main pathways that is causing your inflammation.

Rheumatoid Arthritis

About 1.5 million people in the U.S, have RA (rheumatoid arthritis), affecting almost three times as many women as men.

Like other autoimmune diseases that target specific tissues (like Hashimoto’s thyroiditis), RA causes your immune system to attack your joints.

This leads to inflammation, which causes swelling and, ultimately, thickening of the tissues lining your joints. It can even lead to cartilage and bone damage.

As you can imagine, it’s incredibly painful.

RA most commonly affects the joints in hands, feet, wrists, elbows, knees and ankles [*].

People with RA tend to have low levels of your master antioxidant glutathione[*]. This critical compound is a key player in your immune system, warding off free radicals and protecting your body from oxidative stress.

When oxidation in your body isn’t balanced with antioxidants like glutathione, inflammation can take over.

An autoimmune diet that controls inflammation and enhances antioxidant activity is essential if you’re suffering from RA.

Although human studies on the ketogenic diet and RA are still lacking, there are a few animal model studies showing that the ketogenic diet increases glutathione, and therefore, antioxidant activity[*].

This, combined with the known anti-inflammatory effect of the ketogenic diet makes a compelling case to give keto a try if you’re struggling with RA.

Psoriasis

Psoriasis is an autoimmune condition that affects your skin.

For most people, it causes red bumpy patches with white scales. It’s incredibly itchy and painful. While it can affect any area, it typically occurs on the elbows, knees, or scalp.

No one knows exactly what causes psoriasis, but like all autoimmune diseases,  your immune system and genetics seem to play a role. Typically, Psoriasis will develop between ages 15 and 25, and it affects both men and women equally [*].

Although no studies to date have looked specifically at the ketogenic diet and psoriasis, it has a lot in common with the other autoimmune diseases discussed. Mainly, flares are linked to inflammation and an overactive immune system.

Therefore, managing inflammation with an anti-inflammatory autoimmune diet (like the ketogenic diet) is an important step in managing the overall effects of psoriasis.

There’s also been a link between weight management and remission of psoriasis. It’s well known that your body fat can have a pro-inflammatory effect on your entire system.

If you’re struggling with psoriasis, or any autoimmune disease for that matter, any reduction in systemic inflammation in your body is helpful.

One case study focused specifically on the ketogenic diet as a tool for weight loss and psoriasis management in a woman struggling with moderate to severe plaque psoriasis [*][*].  

This case study is promising and will hopefully drive more research to uncover how the ketogenic diet can help those suffering with this painful skin condition.  

Foods To Avoid For Autoimmune Symptoms

If you’re following a low-carb ketogenic diet then you’re already avoiding many common gut irritants like corn and wheat, which is a great start.

On an autoimmune protocol, you’ll want to take that a step further to avoid any foods that might trigger an immune reaction, such as common allergens.

Here’s a list of foods to stay away from if you’re experiencing an autoimmune flare up or you want to heal your gut:

• All grains (wheat, oats, rice, quinoa, rye, millet, etc.)
• Dairy (common allergen)
• Eggs (common allergen)
• Legumes (hard to digest)
• Nightshade vegetables (tomatoes, eggplants, peppers, and potatoes), can be inflammatory
• All forms of sugar, including sugar replacements (except for occasional use of honey)
• Food additives
• Alcohol
• Check out the Ketogenic Diet Foods to Avoid for more info.

What To Eat For Autoimmune Symptoms

Focus on the high-quality, gut-friendly foods below and check out the Low-Carb Keto Food List for more info on keto-friendly foods.

• Healthy fats (grass-fed butter, ghee, coconut oil, grass-fed beef, avocados, olive oil, MCT Oil or MCT Oil Powder)
• Fermented foods (kombucha, kefir, kimchi, sauerkraut)
• Bone broth, offal
• High-quality organic meat and fatty fish
• Collagen protein
• Low-carb veggies (kale, spinach, bok-choy, collard greens, broccoli, cauliflower)
• Coconut milk (works great to replace dairy)

The Takeaway

Research into the keto diet and autoimmunity looks relatively strong if you’re suffering from MS, and definitely promising if you have lupus, RA, Crohn’s, or psoriasis.

The anti-inflammatory effects of keto can give a boost to the immune system, and in some cases work in direct opposition to autoimmune challenges.

Gut health is one of the major threads that connect all autoimmune diseases.

The ketogenic diet is known as an anti-inflammatory diet when you do it correctly — avoiding most packaged foods and sticking to high-quality meat, low-carb vegetables, and healthy fats.

Everyone’s body is different, so it’s always important to consult your doctor for medical advice if you’re thinking about changing your diet to assist in disease management. Like all things in life — diet is not a one size fits all.

Setting out on your keto adventure can be tricky in the beginning, especially if you’re already managing health issues.

If you’re trying keto for the first time check out the Keto Kickstart Program for a comprehensive 30-day step by step guide with tips, tools, recipes, shopping lists and more.