Hot sauce can certainly be included as part of a healthy Paleo lifestyle, depending on the ingredients. In general, hot sauces use chili peppers as the base, then add salt and vinegar, all of which are Paleo. The only thing you need to watch out for when buying hot sauce is the tendency to add sweeteners that might be off the Paleo menu. Always check your labels, and if they say corn or dextrose anywhere, you should probably pass it up.
The Health Benefits
That said, chili peppers have been studied for their health benefits. They come loaded with antioxidants and vitamin C. Capsaicin (the chemical that makes hot peppers hot) has even been studied for it’s possible anti-cancer effects.
Paleo and Auto-Immune Protocol
Of course, chili peppers are nightshades, so if you’re sensitive to nightshades, you’re better off avoiding all hot sauces. If you think you might be sensitive, the best way to know for sure is to eliminate all nightshades from your diet for at least a month, then slowly reintroduce them and note how they make you feel.
Even Mark Sisson agrees hot sauce can have a place in a healthy diet.