Introduction

Mickey Trescott holds a Master of Science in Human Nutrition and Functional Medicine and has been coaching since 2013. She's one of the key people behind the Autoimmune Protocol — co-founded Autoimmune Wellness, helped grow AIP into a globally recognized research-backed protocol, and co-created the AIP Certified Coach Practitioner Training Program. In this episode, she joins me to talk about her new book, The New AIP — covering the latest clinical research, the newly formalized Modified AIP pathway, and why so many women with autoimmunity are finally getting relief without having to give up every food they love.

Episode Highlights

AIP Is Not a Diet — It's a Template and a Process

One of the biggest misconceptions about AIP is that it's just another restrictive diet. Mickey explains why that framing misses the point entirely and what AIP is actually designed to do.

• AIP is best described as a template — a process you move through over roughly six months to a year, not a permanent way of eating
• The goal is personalized nutrition: figuring out what works specifically for your immune system, your conditions, and your body
• Lifestyle factors are a built-in part of the protocol — sleep, stress management, movement, and social connection all significantly impact outcomes
• The studies that produced impressive results were conducted on participants who addressed all of these areas, not just food

The IBD Studies: Clinical Remission That Rivals an $80,000 Biologic

The first major AIP research came out of Scripps in San Diego, focusing on patients with Crohn's disease and ulcerative colitis — many of whom had been sick for nearly two decades and had already failed conventional treatment.

• 19 patients with IBD (average disease duration of 19 years) completed a 6-week transition followed by an 8-week elimination phase
• 73% reached clinical remission by week 6 — before even completing the full elimination phase
• Remission was confirmed via colonoscopy and visual inspection of the gut lining, not just symptom questionnaires
• All participants who reached remission at week 6 maintained it through the end of the study
• A follow-up RNA analysis showed inflammation genes being down-regulated and tissue repair genes being up-regulated — evidence of healing at the cellular level
• The fact that remission happened before full elimination suggested that not everyone needs the most restrictive version of the protocol

The Hashimoto's Studies: Symptom Relief and Surprising Physical Changes

Two separate studies looked at AIP in Hashimoto's patients and both showed meaningful improvements — even when thyroid hormone levels stayed stable throughout.

• The first study, led by Dr. Rob Abbott, found significant symptom improvement and a 29% reduction in CRP (a blood marker of inflammation), with some participants needing less thyroid medication
• Up to 60% of Hashimoto's patients whose hormones are successfully treated still report daily symptoms — which is why symptom management, not hormone levels, is the key outcome measure
• A Polish study used controlled meal plans, DEXA scans, and thyroid ultrasounds to track outcomes over three months
• Participants lost an average of 8 pounds and 10% relative body fat without any calorie restriction — just by changing what they were eating
• Thyroid volume visibly decreased on ultrasound, suggesting reduced glandular inflammation

The RA Study and the Growing Body of Evidence Behind AIP

A recent rheumatoid arthritis study added to a growing body of research showing consistent results across different autoimmune conditions.

• 77% of RA participants showed clinical improvement using the RAPID3 questionnaire — consistent with IBD and Hashimoto's results
• Three out of nine participants reached clinical remission
• Across all conditions studied, roughly three out of four people see meaningful improvement from doing AIP
• The consistent pattern across IBD, Hashimoto's, and RA suggests AIP's impact extends beyond any single condition or mechanism

Core AIP vs. Modified AIP: What's Actually Different

The Modified AIP was formally introduced to AIP Certified Coach practitioners in January 2024 as a second, more accessible pathway through elimination — still likely to deliver strong results for most people.

• Core AIP removes: grains, dairy, eggs, nuts, seeds, legumes, pseudograins, and nightshade vegetables
• Modified AIP adds back: white rice, ghee, most legumes, pseudograins (quinoa, buckwheat), and seeds — while keeping out nuts, soy, and peanuts
• White rice is the most hypoallergenic grain; pseudograins are technically seeds with a different structure that most people tolerate well
• Modified AIP makes it easier to meet carbohydrate needs — especially important for athletes and active people
• A more accessible protocol leaves people with more bandwidth to manage sleep, stress, and the other lifestyle components that matter just as much as food

Elimination Timing, Reintroduction, and When to Troubleshoot

Staying in elimination longer does not yield better results — and you don't need to be fully healed before starting reintroductions.

• 30 days is the minimum for elimination, based on immunology research showing the immune system needs at least three weeks to reset
• Three months is the standard endpoint; staying on AIP for years without improvement is a signal that something else needs clinical attention
• About one in four people won't see results from AIP alone — that's information, not failure; it points to underlying issues that need to be addressed
• Working with an AIP Certified Coach or primary care provider around the three-month mark is strongly recommended
• Reintroduction is about identifying thresholds and quantity tolerances, not just black-and-white reactions — many foods will fall into a gray zone

Practical Cooking: Simple Tools, Real Ingredients, Real Life

Mickey designed the recipes in The New AIP with chronic illness in mind — limited energy, limited time, and a regular grocery store budget.

• 95% of the recipes require nothing more than a sharp knife, cutting board, pot, and a roasting dish
• Most recipes come together in 30–40 minutes from start to finish
• All ingredients are available at standard grocery stores year-round — nothing needs to be ordered online
• One-pot and one-pan meals are prioritized for people with limited capacity on high-symptom days
• The food is designed to be enjoyed by anyone at the table, not just the person following the protocol

Living With Autoimmunity Long-Term: Setbacks, Perimenopause, and the Long Game

Even after 15 years of deep expertise in AIP, Mickey navigated a new psoriatic arthritis diagnosis last year — and shares what managing a setback actually looks like when you know your body well.

• Mickey developed uveitis (inflammation of the iris) and was eventually diagnosed with psoriatic arthritis, 15 years after her original Hashimoto's and celiac diagnoses
• Perimenopause introduced new variables — including how estrogen affects histamine response and food sensitivities throughout the month
• Her response: go back to basics — nourishing foods, supplement routine, rest, and waiting with confidence rather than panic
• The long-term approach isn't about perfect protocol adherence — it's about "battening down the hatches" when things get hard and "unfurling the sails" when feeling good
• Healing continues to improve over time as the microbiome is supported and inflammation stays low — the baseline from elimination is just a starting point, not a ceiling

Notable Quotes from this Episode

The autoimmune protocol is for each individual person a way that they can figure out what works for them — which is just so the opposite of modern dietary advice. Everybody wants to know: are eggs good for everybody? Is dairy good for everyone? And the answer is, who are you? How is your immune system functioning?
Mickey Trescott

73% reached clinical remission in week six — which actually rivals the best drugs that we have for IBD, including like the $80,000 a year biologic. That was a really stunning result.
Mickey Trescott

Don't be doing AIP forever. It is something that works for a lot of people, doesn't work for some people. If it doesn't work for you, that is information. It doesn't mean you failed. You've learned something.
Mickey Trescott

When things get a little bit of engine trouble — something starts showing up — it's like batten down the hatches. That doesn't mean going back to the elimination phase. It just means doing all the things that we know make us feel good. And then when we're feeling great, it's unfurl the sails. Live a little.
Mickey Trescott

There's no prize at the end of the game for whether you took meds or didn't take meds. My goal for you is to feel your best — period.
Julie Howton