Food is medicine. And when you suffer from mold illness, also known as biotoxin illness or Chronic Inflammatory Response Syndrome (CIRS), proper nutrition can play an essential role in recovery. But if you’ve tried everything to manage your symptoms and still struggle to maintain a normal quality of life, certain foods, specifically those high in amylose, may be your poison.
So today we’re discussing the no-amylose diet, an evidence-based dietary intervention that is part of the Shoemaker Protocol for biotoxin-related illness. Eliminating amylose can help some CIRS sufferers reduce the severity of their symptoms as well as recover more quickly when used during certain steps of the Shoemaker protocol. In this article, we’ll dive deeper into a no-amylose diet, who should consider it, how it influences inflammation, where it fits into the Shoemaker Protocol, what you can and cannot eat for it to work for you, and some alternative or complementary diets.
By the end, you’ll feel fully empowered to make your next meal amylose free.
What Is the No-Amylose Diet?
The no-amylose diet is simply a diet where foods high in amylose are eliminated. Amylose is a complex carbohydrate, a type of resistant starch1 found in most grains, legumes, tubers, root vegetables, and a variety of other high-glycemic index foods. When amylose is broken down in the mouth by salivary amylase, high levels of sugar enter your bloodstream. And when it enters the digestive tract, your pancreas pumps out insulin to lower blood sugar..
The main goal of the no-amylose diet is to avoid the rapid rise in blood sugar and resulting flood of insulin that enters the bloodstream after eating high-amylose foods because this process increases systemic inflammation in people with CIRS. But there are complex metabolic processes at play involving the endocrine and immune systems with leptin serving as the interface between metabolism and the inflammatory response.2
The Science Behind the No-Amylose Diet
The no-amylose diet is based on the science of resetting the expression of genes that regulate insulin and leptin. These two work together at the cellular level, producing a metabolic response that helps transport glucose through cell membranes.3 With mold or CIRS, biotoxins damage leptin receptors, disrupting leptin binding, which can increase or prolong membrane permeability.
This creates an open door for an upregulated flow of leptin and insulin in addition to other proinflammatory cytokines such as tumor-necrosis factor-alpha (TNF-α), interleukin-1 (IL-1) and interleukin-6 (IL-6). With more cytokines circulating, the low-grade chronic inflammation characteristic of CIRS is further exacerbated 4,5 as noted by several Shoemaker-protocol biomarkers. Increased matrix metalloproteinase-9 (MMP-9) and low vascular endothelial growth factor (VEGF) are two that can be corrected with help from the no-amylose diet.6
In addition, disrupted leptin binding means more leptin is created to compensate. This causes the body to store more fatty acid in fat cells, leading to the weight gain common in CIRS. By eliminating high-amylose foods, you give leptin receptors an opportunity to reset and thereby re-regulate the permeability of the cell membrane, the release of insulin, the production of leptin, and the circulation of other pro-inflammatory cytokines. As an added benefit, you can lose weight more quickly with the no-amylose diet, even if you’ve reached a plateau with diet and exercise, because you;re addressing the root cause.
Who Should Use the No-Amylose Diet?
Before your stomach turns at the thought of another elimination diet, you should know that adhering to the no-amylose diet is not as difficult as you might think. There’s no real measuring or calorie counting. Instead, you can enjoy delicious meals and snacks as long as they are amylose free. We’ll talk more about allowed and forbidden foods below and the simple daily formula you can follow to stay on track. But first, let’s find out if you’re a good candidate.
It’s important to note that not everyone needs the no-amylose diet. Amylose is not an enemy for most healthy people. In fact, there are evidence-based benefits of amylose, including its effectiveness as a prebiotic. Since it is resistant to digestion in the small intestine, it’s able to travel all the way to the large intestine where it’s fermented and supports the growth of the probiotics Bifidobacterium and Lactobacillus, which contribute to a healthy microbiome.7
So who is the no-amylose diet for? According to Dr. Ritchie Shoemaker who created the no-amylose diet based on his own research, people who should go on the no-amylose diet are those with CIRS who have increased levels of:
- Matrix metalloproteinase-9 (MMP-9)
- Plasminogen Activator Inhibitor 1 (PAI-1)8
Elevated levels of each of these is a biomarker for inflammation in CIRS. So if these numbers are higher than normal, the Shoemaker protocol indicates treatment with the no-amylose diet combined with either high-dose Omega-3 fatty acids or the diabetic medication Actos, although its use is becoming less common due to side effects and the increased risk of bladder cancer with long-term use.9
- MMP-9: An enzyme that breaks down and repairs tissues in order to support a healthy immune response. But when the biotoxin pathway is overburdened as it is in CIRS, it leads to elevated inflammatory cytokines, which, in turn, cause neutrophils and macrophages (white blood cells) to release more MMP-9.10
Elevated MMP-9 leads to increased permeability or “leaky” blood vessels, allowing inflammatory agents to move around more easily throughout the body, including into the brain, lungs, nerves, muscles, and joints, causing classic CIRS symptoms such as brain fog, fatigue, muscle pain, and post exercise exhaustion. The no-amylose diet together with high dose Omega 3 fatty acids or Actos works to lower MMP-9 by upregulating peroxisome proliferator-activated receptors (PPAR-gamma), causing insulin sensitization and enhanced glucose metabolism.11
- Leptin: Released by fat cells in response to food intake and functions as both a hormone and a cytokine, contributing to bioregulation or homeostasis by diminishing the sensation of hunger and fostering feelings of fullness. But when the leptin receptors in the brain are damaged, cytokines bind to them, causing leptin to be blocked from binding. In turn, dysregulation of the proopiomelanocortin (POMC) pathway occurs, which reduces the production of melanocyte stimulating hormone (MSH).
MSH deficiency can cause cognitive impairment, headache, muscle ache, unstable temperature, and difficulty concentrating. It is also related to lower endorphin production, which means increased pain sensitivity. These are symptoms you may be all too familiar with if you have CIRS. But high dose Omega 3 fatty acids or Actos can reduce leptin when paired with the no-amylose diet, giving the body the break it needs to reset the expression of genes that regulate insulin and leptin resistance.
- PAI-1: Elevated plasminogen activator inhibitor 1 (PAI-1) is another biomarker of CIRS. When you get a cut or scrape, your body forms a clot to stop the bleeding. Plasminogen activator is what helps to break down these clots. But when PAI-1 is elevated, plasminogen activator can’t work properly, which can lead to a buildup of clots in your blood vessels. This is dangerous because your blood can’t flow as easily through the vessels, potentially leading to heart attack or stroke. And when combined with MMP-9, PAI-1 can increase clot formation and arterial blockage.12 The effect of high-dose Omega 3 or Actos and the no-amylose diet can reduce the cardiovascular risk of MMP-9 and PAI-1 by upregulating peroxisome proliferator-activated receptor (PPAR-gamma).
In conclusion, once the MMP-9, leptin, and PAI-1 biomarkers are normalized, the no-amylose diet is no longer indicated in order to continue with the Shoemaker Protocol. With that said, many continue with the diet because it dramatically reduces their symptoms while they continue the protocol or manage their healing on their own, providing increased energy, less joint pain, improved cognition, better mood, and increased well-being. Many also adjust the diet to be low-amylose, slowly reintroducing amylose one food at a time to assess tolerance and reaction.
Foods to Avoid on the No-Amylose Diet
The list of so-called forbidden foods is clearly outlined by Dr. Shoemaker. While the MMP-9, leptin, and PAI-1 biomarkers are elevated, adherence to a strict no-amylose diet is best for you. This allows your provider to move forward with the Shoemaker protocol as soon as these levels are corrected. During strict no-amylose, the following foods should be completely eliminated:
- Roots and tubers including white and sweet potatoes, beets, peanuts, carrots, and other vegetables that grow underground. (Onions and garlic are the exception)
- Bananas (the only forbidden fruit)
- Wheat and wheat-based products including bread, pasta, cakes, and cookies
- Foods with added sugar, sucrose, corn syrup, or maltodextrin
The no-amylose diet is a gluten-free diet, although a bit more restrictive, as rice products are not allowed. But, as you can see, it’s not so limiting that you can’t enjoy a variety of foods, a meal out, or a potluck. There are some delicious alternatives to these restricted foods like cauliflower rice and almond flour for baking.
Foods You Can Eat on the No Amylose Diet
All other foods not on the forbidden list are allowed. And the 00-2-3 rule can serve as a daily guide to what you should be eating on the no-amylose diet. It translates to zero amylose, zero sugar, two servings of at least 6-8 ounces of protein each day,13 and three servings of above-ground vegetables and fruit every day. Here are the foods we get the most questions about regarding the no-amylose diet. All of these are, in fact, approved:
- Corn (including tortillas and chips, but go for non-GMO)
- Aromatic onions and garlic (exception to the below-ground forbidden food rule)
- A variety of veggies that grow above the ground, like lettuce, tomatoes, spinach, kale, chard, turnip greens, collard greens, and more. Mix and match with peas, cucumbers, celery, peppers, cabbage, squash, and other options for a delightful meal
- Nutritious beans of all kinds (if you can tolerate them)
- A rainbow of fruits that offer essential vitamins and minerals (just skip the forbidden bananas)
- Meat, fish, and poultry for protein and essential nutrients
- Eggs for a tasty and filling breakfast or snack
- Healthy fats and proteins from nuts and nut butters (not peanuts…they’re a legume and not a nut and actually grow underground)
- Sunflower, squash, and pumpkin seeds
- Dairy products can be a part of your diet if you tolerate them. Look for options with low sugar content
Again, the no-amylose diet provides plenty of variety so that you won’t be hungry and can enjoy delicious, high-quality, healing meals.
Alternative and Complementary CIRS and Mold Diets
When it comes to nutrition and healing from mold or CIRS, there seems to be one constant…no one diet works for all people with the same or similar diagnosis. And even in the case of the individual, the eight or ten foods that were tolerated without causing a histamine reaction or symptom flare for a patient for months might be the foods they can’t tolerate the next day. The takeaway here is that you are the expert on what works for you.
While the no-amylose diet can be helpful for some people with mold illness or CIRS, it may not be suitable or desirable for everyone. Here are a few other diets that may be worth considering:
- Low Histamine Diet: This diet restricts foods that are high in histamine, an organic compound involved in immune response that can trigger allergy-like symptoms, including headaches, rashes, and digestive issues. It’s often recommended for people with histamine intolerance or mast cell activation syndrome.
- Autoimmune Protocol (AIP) Diet: This diet eliminates foods that are known to be common triggers of autoimmune diseases, such as grains, legumes, dairy, and nightshade vegetables. It also emphasizes nutrient-dense foods that support gut health and immune function.
- Ketogenic Diet: This low-carbohydrate, high-fat diet puts the body into a state of ketosis, where it burns fat for energy instead of glucose. It has been shown to have therapeutic benefits for a range of conditions, including epilepsy, type 2 diabetes, and neurological disorders.
- Carnivore Diet: This diet involves consuming only animal products, such as meat, fish, eggs, certain dairy products, and eliminating all plant-based foods. Advocates claim that it can help with various health issues, including autoimmune diseases, mental health problems, and gastrointestinal disorders.
These diets may not be appropriate for everyone, and you should always consult with a healthcare professional before making any significant changes to your diet. Additionally, it is also essential to understand that healing from mold or CIRS involves more than just diet and nutrition — it requires an integrated approach that includes avoidance, detoxification, lifestyle changes, and, ideally, other holistic therapies. Finally, it’s important to remember that the no-amylose diet is a temporary measure if you’re following the Shoemaker protocol. So while you may need to avoid amylose for a while, once your MMP-9, leptin, and PAI-1 biomarkers have normalized, you can re-introduce amylose into your diet. And even if you find that you do better with no amylose as you continue to heal, it does not mean you have to eliminate it for the rest of your life.
If you are suffering from mold or CIRS and looking for ways to improve your health, the no-amylose diet is definitely worth a try whether you’re following the traditional Shoemaker protocol or using another approach. It is a simple and effective way to reduce inflammation, restore balance, and support the body’s natural ability to self-regulate. Just remember that it’s not a one-size-fits-all solution. Additionally, there are other diets — such as the low histamine diet, AIP diet, ketogenic diet, and carnivore diet — that may be suitable alternatives. As always, this is not medical advice and you should consult with a knowledgeable healthcare provider. Ultimately, the key is to find the diet and lifestyle changes that work best for you.