Part II: Hidradenitis Suppurativa and The Paleo Diet

Hidraenitis Suppurativa | The Paleo Diet

Hi Dr. Cordain,

I’m not sure if you remember me- I was one of the women who interviewed you last August at the Ancestral Health Symposium in LA.

The reason I’m writing you today is 1) to thank you and 2) to ask you some questions. When we spoke, I asked you about Hidradenitis Suppurativa (HS). You told me that you suspected it had an autoimmune connection, but didn’t have any more information to add. I suffered from HS for over 20 years, Stage II, so I was very motivated to get rid of it for good. Once you mentioned “autoimmunity,” I went on an autoimmune Paleo protocol and my HS disappeared. With experimentation, I found my trigger- potatoes. I never would have known, or even tried the AlP, had you not mentioned autoimmunity. For that, I thank you from the bottom of my heart. 3) I had a guest post on about the issue (I’ve now been in clinical remission off medication for almost a YEAR) and am currently writing a book about it. My background is in Journalism, though, not science or any medical field, so I am quoting the hell out of your book, Robb Wolf’s book, and others.

1. I can’t find any documentation of HS being autoimmune in nature, except for what you told me in the hallway of the AHS building. Doctors currently treat it with antibiotics or don’t treat it at all. You did say when we spoke that you were going to look into it. Do you know of any medical literature that suggests that HS is autoimmune in nature?

2. When I experimented on myself by removing nightshades and went into remission, and then flared up when I reintroduced potatoes, did I not prove the autoimmune nature of HS in myself? I have been talking to other people who have been also putting their HS into remission by removing nightshades and it seems to be working across the board. Some have diagnosed wheat as their trigger, but the overwhelming majority of us have found nightshades to be the offender. I did do my elimination and reintroduction quite scientifically, but I’m not a scientist, so do my results “count” or are they just anecdotal?

3. You say that the white blood cells in our guts have become sensitized to proteins from bacteria or food or both. For people who have become sensitized to the bacteria, what options are available to them? Obviously antibiotics don’t work in this case, so would taking probiotics and something like Allimed (a garlic extract which has been shown to have antibacterial effects in the body) help? Since I didn’t have this particular problem, I would like to present options in my new book and help those who do. Obviously I am putting the dietary changes at the forefront of the treatment, but if those fail, then I would like to have another line of treatment, unless the dietary changes plus probiotics are enough if kept up in the long run (long enough to allow the gut to fully heal)?

That’s it! Thank you so much for your time and consideration. And thank you again for giving me the tools to change my life. I’ve had a few emails from people who say they want to kill themselves and I am driven to help them end their symptoms.


Tara Grant

Tara Grant has transformed from 235 pounds to 159 pounds since going Primal in 2009. Tara suffered a litany of serious health problems related to the Standard American Diet and repeated failures of western medicine to cure her. Empowered by the reclaiming of her health, Tara has made it her mission to inform and inspire others about Primal living. Her motto, “Empower. Enlighten. Evolve”, has been put into play in numerous ways! Her book, The Hidden Plague – A Comprehensive Guide to Surviving Hidradenitis Supprativa – details her struggle with this debilitating skin condition, and how sufferers can take matters into the own hands and heal naturally.

Tara is a veteran presenter of numerous PrimalCons, where she holds court detailing her Primal transformation from health to wellness. Tara is also a contributing writer for the Primal Blueprint Expert Certification program and is working with Carrie Sisson on her upcoming Primal Woman book. A dynamic speaker, Tara presents the Primal Transformation Seminar in numerous cities, and counsels individuals as a certified CHEK Holistic Life Coach. Tara holds a degree in Journalism from Carleton University in Ottawa, Canada and blogs regularly at She currently lives in Phoenix, Arizona with her husband Derek and their twin boys, Taylor and Gibson.

Dr. Cordain’s Response:

Hi Tara,

Let me dive into your questions. Specific white blood cells called dendritic cells process protein fragments (antigens) of gut bacteria and/or food antigens in a manner that may promote inflammation and autoimmunity in genetically susceptible people. When the gut becomes leaky, it allows these antigens to interact with dendritic cells and other immune system cells to set the stage for autoimmune diseases. Hence, dietary and environmental factors which promote a leaky gut need to be removed.

1. Nightshade plants contain a variety of compounds which promote a leaky gut, but also can be sources of immunological adjuvants (compounds used in vaccines to rev up the immune response).

2. Alpha tomatine in tomatoes has been demonstrated to be a powerful adjuvant.

3. Probiotics and Prebiotics represent good supplements for most people to promote and healthy gut flora and to reduce intestinal permeability. I know of one physician who healed his alopecia completely only after adopting Paleo and then adding probiotics. However, I also know of a few cases where probiotics may agitate the gut and make things worse.

4. Garlic has been used in traditional medicine for thousands of years to cure a variety of health problems. I haven’t examined the literature on the topic of autoimmunity and garlic, but garlic is a concentrated source of saponins which in most cases disrupt membrane function and can lead to a leaky gut.

In my most recent book, The Paleo Answer, I list all of the known dietary factors which promote a leaky gut.

Below are the references which led me to believe HS is a gut mediated autoimmune disease that has the potential to be improved or put into remission by contemporary Paleo diets – gluten free, dairy free, grain free, legume free, and nightshade free. In your case nightshades were the major triggering factor, and we believe it is because certain glycoalkaloids in tomatoes and potatoes may act to increase intestinal permeability and also contain certain immunological adjuvants (alpha tomatine in tomatoes) that up-regulate the immune response in genetically susceptible HLA haplotypes.

Good luck with your book!


Loren Cordain, Ph.D., Professor Emeritus


1. Rambhatla PV, Lim HW, Hamzavi I. A systematic review of treatments for hidradenitis suppurativa. Arch
Dermatol. 2012 Apr;148(4):439-46 Epub 2011 Dec 19.

2. Nazary M, van der Zee HH, Prens EP, Folkerts G, Boer J. Pathogenesis and pharmacotherapy of
Hidradenitis suppurativa. Eur J Pharmacal. 2011 Dec 15;672(1-3):1-8. Epub 2011 Sep 14.

3.Dreno B, Khammari A, Brocard A, Moyse D, Blouin E, Guillet G, Leonard F, Knol AC. Hidradenitis
suppurativa: the role of deficient cutaneous innate immunity. Arch Dermatol. 2012 Feb;148(2):182-6.
Epub 2011 Oct 17.

4.Brocard A, Dreno B. Innate immunity: a crucial target for zinc in the treatment of inflammatory dermatosis. J Eur Acad Dermatol Venereal. 2011 Oct;25(10):1146-52. doi: 10.1111/j.1468-
3083.2010.03934.x. Epub 2011 Jan 24.

5. van der Zee HH, de Ruiter L, van den Broecke DG, Dik WA, Laman JD, Prens EP. Elevated levels of tumour necrosis factor (TN F)-a, interleukin (IL)-1[3 and IL-10 in hidradenitis suppurativa skin: a rationale for targeting TN F-a and IL-1[3. Br J Dermatol. 2011 Jun;164(6):1292-8. doi: 10.1111/j.1365-
2133.2011.10254.x. Epub 2011 May 17.

6. van der Zee HH, van der Woude CJ, Florencia EF, Prens EP. Hidradenitis suppurativa and inflammatory bowel disease: are they associated? Results of a pilot study. Br J Dermatol. 2010 Jan;162{1):195-7. Epub
2009 Aug 14.

7. van der Zee HH, Laman JD, de Ruiter L, Dik WA, Prens EP. Adalimumab (antitumour necrosis factor-a) treatment of hidradenitis suppurativa ameliorates skin inflammation: an in situ and ex vivo study. Br J
Dermatol. 2012 Feb;166(2):298-305.

8. Giamarellos-Bourboulis EJ, Antonopoulou A, Petropoulou C, Mouktaroudi M, Spyridaki E, Baziaka F,
Pelekanou A, Giamarellou H, Stavrianeas NG. Altered innate and adaptive immune responses in patients with hidradenitis suppurativa. Br J Dermatol. 2007 Jan;156(1):51-6.

9. Hunger RE, Surovy AM, Hassan AS, Braathen LR, Yawalkar N. Toll-like receptor 2 is highly expressed in lesions of acne inversa and colocalizes with C-type lectin receptor. Br J Dermatol. 2008 Apr;158(4) :691-7. Epub 2008 Jan 30.

10. Schlapbach C, Hanni T, Yawalkar N, Hunger RE. Expression ofthe IL-23/Th17 pathway in lesions of
hidradenitis suppurativa. JAm Acad Dermatol. 2011 Oct;65(4):790-8.

About Loren Cordain, PhD, Professor Emeritus

Loren Cordain, PhD, Professor EmeritusDr. Loren Cordain is Professor Emeritus of the Department of Health and Exercise Science at Colorado State University in Fort Collins, Colorado. His research emphasis over the past 20 years has focused upon the evolutionary and anthropological basis for diet, health and well being in modern humans. Dr. Cordain’s scientific publications have examined the nutritional characteristics of worldwide hunter-gatherer diets as well as the nutrient composition of wild plant and animal foods consumed by foraging humans. He is the world’s leading expert on Paleolithic diets and has lectured extensively on the Paleolithic nutrition worldwide. Dr. Cordain is the author of six popular bestselling books including The Real Paleo Diet Cookbook, The Paleo Diet, The Paleo Answer, and The Paleo Diet Cookbook, summarizing his research findings.

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“14” Comments

  1. Pingback: How the Paleo Lifestyle Protects Against Food Allergies : The Paleo Diet™

  2. Hello,
    My name is Matthew, I have suffered from HS since i was 16 years old and am currently 30. I am a Registered Nurse working in a Surgical ICU Level I trauma center. I am currently going to school to become a CRNA (Nurse Anesthetist), therefore my medical background is very extensive. Ever since i was diagnosed with this autoimmune disease, i did extensive research, after being treated my my dermatologist. During my teen years, they excised, drained, and treated with every medication you could think of. Rifampin, clindamycin, doxycylin, Sulfa antibiotics, all isotretinoin drugs (i.e. accutane), thalidomide (which caused temporary polyneuropathy), Anti-TNF drugs (i.e. Humira, Enbrel), every topical cream you could think of, corticosteroids (short and long term–Temporary fix) Kenolog injections, x3 surgical excisions to the groin, axillary and buttocks. Finally My BIGGEST regret (RADIATION-therapy which i had done research on which showed some good results done in Europe.) It was a very low dose, and very precise but left me with some bald spots. Along this course i was attempting multiple other things, I became vegan for a year and a half, went from 256lbs to 180lbs, went to herbologist, acupuncture, chiropractors, Chinese medicine, and attempted to alter my diet, because i noticed out of everything diet was doing the most, but i continued to still have flare ups.
    Finally i came across a Paleo article online, I attempted to incorporate that along with foods i found to cause flare ups (nigh shade foods, potatoes being the WORSE, and recently discovered caffeine being one of them). Since i began this modified type of Paleo diet i haven’t had flare ups, I sometimes eat something that may cause a little pimple that hurts or recently had an abscess form on my axillary area, but it’s nothing compared to what it used to be and that was the first one i had since over a year.
    I am one HS patient who has been through it all and has the medical background to confirm some of the pathophysiology aspects of this horrible skin disorder. Another interesting topic i read up on was helminth therapy which i find interesting since it has to do with the patients GUT and the possible issues HS patients have with their GI tract. DO YOUR RESEARCH AND alter your diet, I noticed a lot of HS patients are overweight and don’t put in the hard work to alter their diet. Trust me i know what everyone goes through with this horrible disease, the pain, shame and radical medical treatment is no fun. I’d rather live a healthier life something YOU CAN CONTROL and eliminate foods that trigger this problem. MD’s refuse to listen to me when i mention DIET…. although I’m in the field that practices Western medicine, i really dont believe in most of it. Disease process and pharmaceutical treatment is a bunch of BS. Trauma and surgical interventions are wonderful and save thousands of lives. Anyways, good luck and I hope my experience helps.
    Matthew Rosales.

    • Matthew I wanted to thank you for being so honest. I am working towards a degree in the medical field but with my reoccurring HS flare ups I was worried this may not be possible. I don’t want my disease or skin disorder and bacteria to make a patient sick. I hope to continue my dream and help others. I haven’t seen any other person mentioning they work in the health care field with big boils and puss and trying to control it all the while working around sick people.

  3. Hidradenitis suppurativa is not only debilitating but it can be dehumanizing and humiliating for any sufferer. Now that we are

    aware that dietary changes can go a long way to improving the skin disorder, I hope every sufferer reading this post should try

    it out. More so, when orthodox medicine have not been discovered to cure hidradenitis suppurativa.

    For the first commenter (Tessie Saunders) who thought of committing suicide, that should not be considered at all. You can use

    your condition to bless mankind just like Tara Grant did. She saw her condition, experimented with herself to found out the HS

    triggers, avoided them and got healed.

    I guess she is well-known today not as a journalist but as an expert book author for HS cure. And guess what? She must be

    richer and famous now by using her skin disorder to discover how to cure hidradenitis suppurativa.

    Your health is your life!

  4. I have suffered from HS for over 10 years . It is very bad I can’t go 4 weeks without getting a break out. It started when I was 13 years old, also when my period started. I do smoke cigarettes and cannibs. Having HS is difficult because I can’t be myself .I’m always in pain. I just had an out break yesterday and is was hard to pick up my son. When I was pregnant I stopped smoking but still had out breaks about 5 times. I do eat a lot of jalapeño peppers and processed foods.
    I did read up on the paleo diet, and saw that this was a no no, but I was confused by all the medical terms of food that I should not eat, maybe someone could clear that up for me by putting that in clear terms for me, I would greatly appreciate that. I am greatly affected emotionally I have thought of suicide often, I don’t know what stage I am in all I know is that it is bad. Can someone please help ASAP. And should I also try probiotics. And please explain what a “leaky gut” is. I am desperate.
    Any help will be greatly appreciated. And reading what Tara wrote is what prompted me to get answers Thanks Tara so much.

    • As Hidradenitis suppurativa is characterized by severe inflammation, it is imperative that you keep the body in an anti-inflammatory state. This is achieved through the adoption of an anti-inflammatory diet, i.e. one high in anti-inflammatory foods and low in pro-inflammatory ones. For example, foods high in omega 3 fatty acids (such as oily fish like salmon and fresh tuna) stimulate the body to produce molecules (called eicosanoids) that combat inflammation.

  5. I have a neice Ashley who has HS. It is has literally robbed her of a normal lifestyle. As a family member it is extremely difficult to watch her suffer with this disease. I’m constantly praying and searching for information of some kind for her. She’s now 29. Two kids very good mother under the circumstances. Watching her bare this is painful and hurtful to our family. I informed her of the paleo diet. Dear God I pray it works!! Thank you.

  6. Pingback: Hidradenitis Suppurativa, Autoimmune Disease, and The Paleo Diet : The Paleo Diet™

  7. Nightshades! I eliminated everything, no more hidradenitis then I made the horrendous mistake of eating a spicy chilli soup with potatoes. next day terrible outbreak. I honestly think nightshade veges are a terrible terrible thing.

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