Autoimmune disease (AID) refers to a group of chronic inflammatory conditions characterised by an inappropriate immune response in which the immune system produces auto-antibodies to an endogenous antigen. Autoimmune disease may be systemic as with lupus or restricted to certain organs as with Hashimoto’s thyroiditis.
AID worldwide has significantly increased over the past 20 years and has more than tripled in Australia in the last decade. It currently affects around 5% of people in Australia, with women affected far more commonly than men.
Types of Autoimmune Disease
There are dozens of different autoimmune diseases. Symptoms will depend on the organs or tissues affected. Some of the more common ones include:
- Alopecia areata: loss of hair from some or all of the body, mainly the scalp
- Ankylosing spondylitis: affects joints of the spine and sacroiliac joint, causing fusion and rigidity
- Antiphospholipid syndrome: provokes blood clots in arteries and veins
- Autism: new research is suggesting that autism may be auto-immune in origin
- Chronic fatigue syndrome/fibromyalgia: possibly auto-immune in origin
- Celiac disease: affects villi of small intestine
- Crohn’s disease: inflammatory bowel disease affecting entire colon wall, mostly the lower ileum
- Dermatitis herpetiformis: affects skin, particularly elbows, knees, back and neck; associated with celiac disease
- Type 1 diabetes: affects pancreatic beta-cells causing insulin deficiency
- Goodpasture’s syndrome: affects kidneys and lungs
- Grave’s disease: affects thyroid gland, causing hyperthyroidism
- Guillan-Barre syndrome: affects peripheral nervous system
- Hashimoto’s thyroiditis: affects thyroid gland, causing hypothyroidism
- Multiple sclerosis: affects myelin sheath in neurons of brain and spinal cord
- Myasthenia gravis: affects muscles, especially those around the eyes
- Parkinson’s disease: affects dopamine-generating cells in the central nervous system
- Pernicous anaemia: affects parietal cells in stomach, leading to B12 deficiency
- Psoriasis: affects keratinocytes
- Rheumatoid arthritis: musculoskeletal disorder affecting connective tissue in joints
- Schizophrenia: may be triggered by autoimmune reaction in brain cells
- Sjogren’s syndrome: affects exocrine glands, primarily the salivary and lacrimal glands
- Systemic lupus erythematosis (SLE): systemic disorder affecting skin, joints, kidneys, lungs, heart, brain and blood cells
- Ulcerative colitis: inflammatory bowel disease, affecting mucosa of large colon
- Vitiligo: affects melanocytes
Causes of Autoimmune Disease
The exact cause of autoimmune disease is poorly understood but is generally agreed to be multifactorial, involving a combination of genetic, environmental, hormonal and immune factors. It appears that autoimmune disease occurs in genetically susceptible individuals after exposure to certain environmental factors, especially certain microorganisms or toxins.
Other factors may include nutritional factors, gut dysbiosis and stress. In our Perth clinic of Advanced Functional Medicine we have yet to see an autoimmune case where gut dysbiosis, intestinal permeability and/or diet and lifestyle where not significant driving factors of the disease.
In auto-immune disease, it is thought that environmental triggers initiate production of inflammatory cytokines which then activate Th1 and Th17, which then attack self-antigens.
Defects in the T regulatory cells fail to inhibit the attack, leading to inflammation, antibody production and tissue damage.
The body confuses and marks healthy cells as pathogenic and mounts an attack on these healthy cells.
Risk factors of Autoimmune Disease
- Genetic predisposition: only thought to account for a minority of cases. It is important to note that not everyone with genetic mutations associated with AID clinically manifests the disease. Of those who do, there is a wide variation in the progression and severity of the disease.
- Female: account for 75% of auto-immune disease
- Viral, bacterial and mycoplasma infections: of all the environmental factors known to induce autoimmunity in susceptible individuals, infections are the most significant. Infections can trigger autoimmunity via molecular mimicry and bystander activation. Agents include Klebsiella pneumoniae, Staphylococcus aureus, Streptococcus pyogenes, and coxsackie B virus. These are pathogens we commonly uncover in our patients through investigation into gut health.
- Exposure to toxic metals and chemicals e.g. smoking, hair dyes, environmental and occupational pollutants, medications, recreational drugs, personal care products, cleaning chemicals, pesticides, food additives, persistent organic pollutants (POPS)
- Gut dysbiosis and increased intestinal permeability: the microbiota is intricately involved in the regulation of immune homoeostasis. Researchers have proposed that host microbes play a critical role in chronic inflammatory diseases, particularly autoimmune disease.
- Dietary factors e.g. gluten, casein, excess fructose, excess salt, vitamin D deficiency, high omega-6:omega-3 ratio, cross reactivity of other foods etc.
- Food allergies and sensitivities
- Inflammatory environment: causes dysregulation of T regulatory cells
- Exposure to parasites, candida and endemic infectious diseases
- Psychological stress: has been shown to increase the risk of autoimmunity
Investigations & Testing Considerations
- Comprehensive Blood Chemistry
- Auto-antibody testing
- Intestinal permeability
- Advanced Stool Testing
- Hair tissue mineral analysis
- Vitamin D3 & B12
- Pathogen testing
- Comprehensive metabolic blood
TREATMENT STRATEGY FOR AUTOIMMUNE CONDITIONS
- Regulate immune response
- Identify and treat any parasite, bacterial, fungal and pathogenic infections
- Reduce antigenic load (food antigens, toxins, pathogens)
- Reduce inflammation and oxidative stress
- Optimise intestinal microflora and promote intestinal repair
- Promote tissue repair
- Support and correct digestive and liver function
- Bowel / liver detoxification: very useful in autoimmune disease
- Stress management
Diet plan guidelines for Autoimmune conditions
- Follow an Autoimmune Paleo Diet (AIP)
- Reduce antigenic load
- The major antigens found to be linked to autoimmune diseases are gluten and casein. A gluten-free or gluten-free, casein-free (GFCF) diet is a must, this is incorporated in the AIP diet which we commonly recommend
Supplements that support Autoimmune conditions
- Prebiotic/probiotic supplement: prebiotics are important to support growth of beneficial bacteria; probiotics should be strain specific e.g. L.plantarum 299V, B.lactis
- B12 – major support nutrient in Autoimmune disorders
- Curcumin – anti-inflammatory and antioxidant
- Vitamin D3 – (depending on status): needed for immune regulation
- Antioxidant complex: Vitamins A, E, zinc, selenium, n-acetyl cysteine, alpha-lipoic acid, CoQ10 etc
- Glutamine – to repair intestinal lining
Herbal medicine treatment that supports Autoimmune conditions
- Immune regulation: echinacea, astragalus, reishi, shitake
- Anti-inflammatory: turmeric, ginger, boswellia, licorice, bupleurum
- Anti-oxidant / tissue repair: turmeric, St. Mary’s thistle, rosemary, schisandra, green tea, bilberry, gingko, gotu kola, grapeseed
- Digestive / liver support: gentian, centaury, barberry, dandelion root, St Mary’s thistle
- Repair gut wall: goldenseal, calendula, slippery elm
FUNCTIONAL MEDICINE TREATMENT OF AUTOIMMUNE CONDITIONS
The above nutritional, dietary and herbal considerations will assist in supporting someone suffering from an Auto-immune disease. To fully heal or put the disease into complete remission a functional medicine approach is required. Investigating and identifying underlying root causes of the disease and resolving infections, viral load, gut pathogens, nutrient imbalances, parasites etc. is vital in the treatment of the disease.
At our Perth clinic of Advanced Functional Medicine we specialise in treating a wide range of autoimmune disorders with great success. Our comprehensive approach uncovers a variety of underlying root causes and allows us to treat the body as a whole rather than just focusing on symptomatic relief as with traditional health care models.
If you or a family member are suffering from an autoimmune disorder we would love to hear from you, what AI condition are you suffering from and how have you treated it? Please write a comment below.Book Appointment