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Autoimmune Gut-Support Protocol (5R Framework)

Dr. Mark Hyman's 5R gut-repair framework applied to autoimmune support (remove, replace, reinoculate, repair, rebalance), as a complement to standard rheumatology or specialist care, not a cure.

🛡️
Functional Medicine Physician · The Doctor's Farmacy
Not endorsed · Based on the published work of Mark Hyman
Daily time
Ongoing
Steps
6
Difficulty
Intermediate
Sources
3
View the steps →
What it is

Based on The Dr. Hyman Show ep1038 (June 2025) with Dr. Elizabeth Boham and Raja Dhir of Seed Health. The 5R framework aims to support gut-immune health. This is offered as gut-health support, not a treatment for autoimmune disease.

Why it works
Gut-immune crosstalk is real and cited: intestinal barrier dysfunction (leaky gut) is associated with several autoimmune conditions in published immunology reviews. What is NOT well-supported, and is explicitly rejected on this page, is the claim that fixing the gut reverses autoimmune disease.
The evidence
Sources
Published work by Mark Hyman, cited straight to the source: long-form episodes, clips, peer-reviewed papers and their own writing. Select any to view it here.
1
The 5R Protocol — The Dr. Hyman Show #1038 (with Dr. Elizabeth Boham & Raja Dhir)
Podcast
2
The Dr. Hyman Show #1038 show notes
Article
3
Partners in Leaky Gut Syndrome: Intestinal Dysbiosis and Autoimmunity
Paper · Frontiers in Immunology, 2021
Source viewer
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The protocol
Clinical strong human trials Mixed some or emerging evidence Commercial weak or unproven, sold widely Equipment / Test not an evidence claim How we grade →
Remove

Eliminate common inflammatory triggers (gluten, dairy, ultra-processed food) for a defined trial, then reintroduce one at a time

Trial period

Identify individual triggers.

The Dr. Hyman Show #1038
For this step
No product needed
Replace

Add digestive enzyme support with meals if needed

With meals

Supports digestion during repair.

The Dr. Hyman Show #1038
For this stepMixed
Digestive enzymes
A broad enzyme blend taken with meals, if needed
Reinoculate

Eat colorful polyphenol-rich plants plus a multi-strain probiotic and fermented foods

Daily

Supports a diverse microbiome.

The Dr. Hyman Show #1038
For this stepMixed
Multi-strain probiotic
Alongside colorful plants and fermented foods
Repair

Support the gut barrier with glutamine, zinc and vitamin A

Per guidance

Nutrients involved in intestinal barrier integrity.

The Dr. Hyman Show #1038
For this stepMixed
L-glutamine + zinc + vitamin A
Nutrients involved in intestinal barrier integrity; use per clinician guidance
Rebalance

Manage stress (meditation, breathwork) and protect sleep

Ongoing

Supports the parasympathetic nervous system and gut-immune axis.

The Dr. Hyman Show #1038
For this step
No product needed
Keep your specialist in charge

Use this alongside, never instead of, your specialist's care

Ongoing

This does not reverse or cure autoimmune disease.

The Dr. Hyman Show #1038
For this step
No product needed
Is this for you?
Good fit if
  • People with autoimmune conditions wanting gut-health support alongside specialist care
  • Anyone interested in the evidence-honest version of the gut-immune connection
  • Not a treatment or a way to reverse autoimmune disease
Cautions
  • This is informational gut-health support alongside, never instead of, care from a rheumatologist or your treating specialist; it is not a treatment and does not reverse or cure autoimmune disease
  • Do not stop, taper or change any immunosuppressant or disease-modifying medication based on this content; that decision belongs to your specialist
  • Supplements and lab testing Dr. Hyman references may be available through businesses he has a commercial interest in
  • If you have a diagnosed autoimmune condition, work with your care team before starting any elimination diet
  • Gut-immune crosstalk is a real area of research; claims that fixing the gut alone reverses autoimmune disease go beyond current evidence
  • Educational only, not medical advice
Related protocols
Update history
  • July 3, 2026 Protocol published.
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Not medical advice. This page is for education only and is not a substitute for professional medical care. Consult a qualified clinician before changing your health routine.
Independent curation. YourProtocol.ai is an independent platform. This protocol is based on the publicly available work of Mark Hyman and is not created, reviewed, endorsed by, or affiliated with Mark Hyman or Functional Medicine Physician · The Doctor's Farmacy.

Autoimmune Gut-Support Protocol (5R Framework)
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