Autoimmune Disease

The number of people suffering with autoimmune conditions is rising. The current medical literature lists between 80-100 autoimmune conditions. Some of the more common ones are Hashimoto’s Disease, Rheumatoid Arthritis (RA), Grave’s Disease and Lupus.

Once diagnosed with an autoimmune condition many believe that their only option is to manage the symptoms and wait for a cure. 

Whilst these conditions affect different parts of the body such as your joints in RA or your thyroid gland in Hashimoto’s, they all involve dysregulation in your immune system.

Stages of Autoimmunity

It can take many years for an individual to eventually get an autoimmune diagnosis and that is because it can take time for autoimmune conditions to develop.

It is helpful to think of autoimmunity in stages:

Stage 1 – Silent Autoimmunity

Antibodies present but no signs or symptoms of disease

Stage 2 – Reactive Autoimmunity

Elevated antibodies with symptoms, but no clinically significant loss of tissue.

Stage 3 – Autoimmune disease

Elevated antibodies with symptoms and significant measurable tissue damage.

Shift to a Functional Medicine approach

When it comes to autoimmune disorders, traditional medicine tends to focus on stopping attacks and managing symptoms.

This may be accomplished by using pharmaceutical drugs to depress the immune system, reduce inflammation, or alleviate other symptoms. Sometimes this is necessary and can provide much needed relief for patients. When other approaches fail, it may be the only recourse that remains.

However, these treatments are occurring after the fact. They focus on stopping attacks in progress and relieving the symptoms of the attack. While this can help, if you want restore true health, then you need to figure out WHY the immune system went from functioning normally to attacking your body.

Something happened to cause your body to go into this abnormal state of hyper-immunity. That is the focus of functional medicine. The functional medicine approach is not as concerned with the symptoms of a particular disease as much as it is with the underlying cause of the disease.

When the body functions properly, symptoms diminish, and illness is no longer reactive.

Autoimmune Disease

An autoimmune disease, by definition, is when your immune system mistakes healthy cells as a threat and responds by attacking them.  While traditional medicine may treat different autoimmune disorders as separate and distinct, the functional medicine approach views them on a continuum.

There are many, many disorders caused by autoimmunity. Some of the most prevalent include the following:

• Hashimoto’s disease – the immune system attacks the thyroid, leading to an underactive thyroid (known as hypothyroidism) and interrupting hormone production
• Multiple Sclerosis (MS)– the immune system attacks the protective covering of nerves (myelin). This creates scar tissue on the nerves and interrupts messages sent along the nerves to the brain and spinal cord.
• Rheumatoid arthritis (RA) – the immune system attacks the joints. The lining of the joints are impacted resulting in painful swelling and joint deformity. It can also lead to damage in other parts of the body, including the skin, lungs, eyes, heart and blood vessels.
• Grave’s disease – the immune system attacks the thyroid, leading to an overactive thyroid (known as hyperthyroidism). This also affects hormone production.
• Lupus -the immune system attacks tissues and organs. Lupus can affect the skin, kidneys, joints, blood cells, brain, lungs, and heart.

These are all conditions where the immune system is attacking otherwise healthy cells. A functional medicine practitioner isn’t as concerned with what’s being attacked as much as why the attack is occurring, and this can be different for each person.

That means that 2 people both of whom are suffering with Hashimoto’s can have completely different reasons for developing the disease.

Click the following link for a full list of current known autoimmune conditions

https://www.aarda.org/diseaselist/

Common Symptoms of Autoimmune conditions

Fatigue

Joint pain and swelling

Skin problems

Digestive symptom – Bloating, pain, diarrhoea and or constipation

Multiple food sensitivities

Recurrent infections

Poor sleep

Low Energy

Irritability

Brain fog / Headaches

Common factors involved in Autoimmunity

Food sensitivities and unresolved gastrointestinal conditions.

We are learning more and more about gastrointestinal health and its impact on overall health. This is more complicated than just looking at food sensitivities or taking some probiotics. One has to consider the barrier function of the gut. By its nature the gut lining has to be somewhat permeable as that is how the nutrition from your food enters into the body. Unfortunately this barrier function of the gut lining can be compromised by many factors such as inflammation, infections (even low level), stress and allow undigested foods and other pathogens to enter the blood stream which provokes the immune system.

Barrier Dysfunctions

There is a lot of focus on the barrier function in our gut and you may have heard the expression “leaky gut”, this is when your gut lining has become damaged and is starting to let inappropriate pathogens in.  Or another way to look at it is the tight junctions between cells that maintain the barrier function of the gut are starting to fall apart.

 The interesting thing is that we have other barriers to pathogens in other part of the body – such as the barrier in our lungs or nose and throat (nasopharyngeal) which also have to maintain tight junctions to stop pathogen from entering the body. Likewise the Blood brain barrier which stops inappropriate molecules entering the brain can also become “leaky”.

Chronic Viral or bacterial Infections

Throughout your life, you’ve been exposed to a variety of viral infections including, the flu, chickenpox, HPV (human papillomavirus), and mononucleosis, to name a few. Once contracted, they can stay with you for the rest of your life, going in and out of dormant states. Chickenpox is a classic example. We get chickenpox, deal with the symptoms, and then it will go dormant and can live within our nerves for decades. As we age, and our immune system’s ability to protect our body decreases and the chickenpox virus can resurface as shingles.

Scientists have long suspected that viruses may be linked to the development of autoimmune disorders. Some people are simply better able to tolerate the low-level viruses than others. If you’re a person who is not able to tolerate the viruses, or if your immune system is otherwise compromised, it can trigger the hyper-immune state that leads to autoimmune dysfunction.

Toxic Environment

Toxicity is another common problem in today’s world. Whether we realize it or not, toxicity levels in our environment and within our bodies are on the rise. We are exposed to toxins in the air we breathe, water we drink, and on the foods that we eat. Additionally, many of the products in our home are made from chemicals whose health impact have not been fully tested and may be negatively impacting our health.

In some instances, toxic exposure can damage or alter your body on a cellular level. These changes can make it such that your body mistakes these cells as foreign tissue and the immune system goes on the attack. In other cases, the effect is less direct, causing chronic inflammation, which in turn, leads to hyper-immunity.

Nutrient Deficiencies

Your body is a complex machine. When it does not have the proper amount of key nutrients as fuel, it cannot function properly. Unfortunately, the average Western diet is woefully low in nutritive foods, contributing to many of the chronic conditions we see today.

I could list many vitamins and nutrients that play a role in immune dysfunction, including vitamins A, D, and K as well as Omega 3s, Iron, Zinc, Magnesium, and Selenium. But before you head to the supplement aisle, it’s important to know what’s happening in your body. A functional medicine practitioner will test to see which nutrients are below the optimal level in your body and then recommend ways to increase them, both naturally and through supplementation.

There is another factor to consider here, and that’s the difference between “normal” and “optimal” levels of any nutrient. Let’s use vitamin D as an example. When testing a population for vitamin D levels, the results of thousands of individuals are charted. Researchers will use that data to determine the “normal” level of vitamin D across the population. These results indicate that vitamin D concentrations in the low 30’s would be “normal”. However, research shows that the “optimal” level of vitamin D is actually between 50-75.  This can lead to many patients believing that their “normal” levels of vitamin D are sufficient, when in fact they are not.

Conclusion

We don’t have all the answers or fully understand autoimmune conditions and the reasons for people developing these conditions is multifactorial and can differ for each person.

There are a number of dietary, nutrition and lifestyle that can have a significant effect on the progression of autoimmune conditions. Knowing early where you are in the stages of autoimmunity, not ignoring seemingly minor symptoms can all help you to put into place interventions to help support your immune system and manage any symptoms that you are having.