Autoimmune disorders are a source of serious suffering and interference with an individual’s life and goals. I am personally acquainted with the nightmare. Ten years ago, I suddenly went from running 90 miles per week and feeling great to extreme fatigue and an inability to climb a flight of stairs without shortness of breath. Some alarming lab results led to a diagnosis of autoimmune origin. After exploration of my options, I opted for a functional medicine evaluation and treatment with absolutely incredible results. I have since run numerous ultramarathons and experienced the best health of my life without the use of pharmaceutical drugs or any type of long-term treatment.
There is a good chance that you, or someone that you know, suffers from an autoimmune condition. In fact, more than 10 million Americans are known to be affected by autoimmunity and many more are suffering yet undiagnosed. The most alarming part of these statistics is that autoimmune conditions are generally poorly understood. The root cause is rarely treated so that progression can be halted or even reversed. This does not need to be the case. In this article, I will outline the functional medicine perspective on autoimmunity for you, and hopefully share some serious hope!
What is autoimmunity? Simplistically, this occurs when the immune system is triggered and begins to react to harmless or even beneficial things as if they are a threat. Most notably, in cases of autoimmunity, the immune system attacks “self”. This could include just about any part of the body! Some of the most common examples include attacks on the:
· Thyroid (Hashimoto’s thyroiditis and Grave’s disease)
· Joints (rheumatoid arthritis)
· Connective tissue (scleroderma)
· GI tract- this was my body’s target (Crohn’s disease and ulcerative colitis)
· Mucous membranes (Sjogren’s syndrome)
· Skin (psoriasis and vitiligo)
· Nervous system (multiple sclerosis)
· Liver (autoimmune hepatitis)
· Pancreas (type 1 diabetes mellitus)
· Blood vessels (systemic lupus erythematosus)
The effect of this self-directed immune attack is rampant inflammation that ultimately causes tissue destruction, pain, imbalances, and debility.
Why does this happen? This is the big question and the one that functional medicine is geared toward answering. Obviously, something flipped the switch and triggered the immune system to act this way! You should know that autoimmune flares are often as long as 10 years in the making from initial trigger to serious symptoms. Sufferers of Hashimoto’s thyroiditis, for example, may have symptoms for years (fatigue, weight gain, dry skin, hair loss, constipation) along with seemingly normal lab test results. All the while, inflammation is building and glandular destruction is slowly beginning to take place. This extended timeline means that discerning the root cause usually requires some real detective work. As you can imagine, it is important to intervene as soon as possible to save the tissue! Fortunately, we know that there are some common triggers to be on the lookout for. These include:
· Chronic Infections: This is a huge one. Many viral, bacterial, fungal, and other pathogens are super stealthy. They can successfully hide in the body after an initial infection for a lifetime if not addressed. These may include bouts of food poisoning, Epstein Barr virus (mononucleosis), Lyme disease, human papilloma virus (HPV), and many more. Such pathogens are able to remain hidden through the mimicry of an organ’s cells and therefore evade the immune system. Eventually, the immune system is tipped off that something is not quite right and attacks the entire organ or gland. This is a simplistic explanation of a super complex process, but the end result is autoimmunity, inflammation, and destruction of cells.
· Stress: We live in an increasingly high stress society, and it is therefore no surprise that autoimmune disorders are on the rise. When your body is under stress, your adrenal glands pump out cortisol as a protective mechanism. This is meant as a short-term response to a threat. When this demand continues chronically, however, there are detrimental effects on multiple systems as the body’s delicate balance is skewed. This is notable in the immune system which can start to act inappropriately: Enter autoimmunity. Stress was my personal trigger. It is no surprise that after going through a difficult divorce and raising 3 young children alone, as a single mother working nightshift at a stressful job, my body eventually could not take anymore. While stress was the main trigger, it led to a cascade of other issues (as is usually the case), which brings us to the next point.
· Gut Issues: This is not a surprising catalyst given that over half of your immune system lies in your gut! There is quite a lot of research supporting the fact that dysbiosis (an imbalance in the normal intestinal bacterial flora) is linked to immune dysregulation. In fact, there are known specific patterns that are most common in certain autoimmune conditions. Another consideration is the health of the gut wall. This huge barrier needs to be fully functioning and intact so that your body can absorb the correct parts of your diet at the proper location. Unfortunately, this barrier can be disrupted by factors such as stress, intestinal dysbiosis (which can also be caused by stress), poor diet, pathogens, and pharmaceuticals. This leads to the leakage of inappropriate substances into the blood stream, including undigested food particles. Your immune system is alerted that these do not belong and therefore attacks. This is why numerous food sensitivities may precede or accompany autoimmune disorders. During my functional medicine evaluation, I had a food sensitivity test done that showed reactions to nearly 50 foods! Currently, my only dietary restriction is dairy (which has been a long-term actual allergy for me). All other issues disappeared when destruction of my gut wall was halted and the lining was repaired.
· Toxicity: Damage to the immune system from environmental toxicity is a huge driver of autoimmunity. This is well studied, and a literature search will turn up extensive evidence of the link. Factors to consider include drinking water sources, occupational hazards, pharmaceutical drugs, and various chemical exposures. Things to think about when considering your toxic load are exposures to mold, heavy metals, paints and solvents, pesticides on food, plastics, personal care products, and many more.
· Genetics?: Autoimmune disease does have a genetic link, but just because you carry the gene does not mean that you have to express it. The triggers that we have been discussing are what (on a very basic level) turn the gene “on”. Continue reading for ways to avoid this as well as how to get out of trouble if it has occurred!
What can we do about it? Traditionally, treatments for autoimmunity include lifelong pharmaceutical drugs that powerfully suppress the immune system. They offer a way to slow down tissue destruction while managing symptoms. Unfortunately, these drugs do not treat the root cause of the condition and have very unfortunate side effects. Functional medicine treatment offers hope for the restoration of normal immune function and long-term freedom from disease.
As you have already seen, the first step is to identify the root cause. This can be accomplished with an extremely thorough history and, in some cases, diagnostic testing. Once the trigger (or triggers) are identified, they can be removed, treated (short term), and/or healed, and the body can then be repaired.
Options for healing include lifestyle modifications (see below), herbs, and nutritional supplements, among others. These can be used for treatment of chronic infections as well as immune modulation and optimization (not suppression!). A targeted detoxification program can be utilized along with ongoing support for the liver. The adrenal glands can be restored for a healthy stress response. The gastrointestinal tract should always be considered with interventions for healing the gut lining and restoring normal intestinal bacterial flora, while temporarily removing foods that may be contributing to inflammation. We can also calm this runaway inflammation while working on the underlying cause.
Ultimately, the autoimmune trigger will dictate the focus of treatment. In addition to ferreting out the root cause, restoration of target organ/gland health is very important. Functional medicine can help here too!
What can I do to get started? First, consider your lifestyle. Here are some tips:
· Work on stress reduction and management
· Get plenty of good quality sleep
· Eat organic, whole foods as part of a nutrient-rich diet
· Keep sugar to a minimum to avoid unnecessary inflammation
· Eat plenty of fiber
· Try to include fermented foods in the diet for natural probiotics
· Drink filtered water
· Eliminate obvious toxicities
· Exercise
If you have been diagnosed with an autoimmune condition, experience unexplained symptoms, or show positive antibodies on labwork without a diagnosis (this is how it starts!): Please consider a functional medicine evaluation as soon as possible. Catching the problem early is the key to saving precious tissue and experiencing full restoration of wellness. If you have been suffering for many years, there is still hope! Keep in mind that functional medicine can also work alongside traditional treatments. You can schedule a free 15-minute telephone consultation here to discuss your concerns. As a functional medicine practitioner, avid runner, and previous autoimmune sufferer, I would be honored to partner with you in your path to full health.