My website should have been named FunctionalHealth4Autoimmune, because sadly in my office, we uncover a lot of autoimmune issues. According to the American Autoimmune Related Diseases Association, 50 million Americans suffer from some type autoimmune disease. It has become more common than heart disease which affects around 22 million, and even cancer at 9 million, per the National Institute of Health.
Researchers have identified 80-100 different autoimmune diseases and suspect at least 40 additional diseases of having an autoimmune basis. Autoimmune disease is one of the top 10 leading causes of death in female children and women in all age groups up to 64 years of age, so this is pretty serious stuff.
Studies also indicates that having one autoimmune disease makes you susceptible to developing others, so it is really important to uncover issues early and keep the immune system nice and calm.
So what is autoimmune disease?
Our body is designed to detect and protect against foreign invaders. But what happens if the immune system becomes so dysfunctional that it starts to attack our perfectly healthy cells, tissues, organs, etc.? That’s potentially how autoimmunity works. I say potentially as there are a few schools of thought.
Why does this happen? Theory 1
The most common theory is that someone is born with a genetic susceptibility to a particular disorder. This doesn’t necessarily mean that they will develop the disease, but if they are exposed to certain risk factors over a period of time, the genes may turn on causing the immune system to attack whatever the thing is that the gene expresses for. Over time, loss of function in that area occurs and disease develops. Keep in mind, autoimmunity could affect anything produced by the body: cells, tissues, organs, gland, enzymes, hormones, etc.
To understand how this works, let’s look at autoimmune thyroid. Hashimoto’s thyroiditis affects 1 to 2 percent of people in the United States and is found more often in women.
Say you have a genetic weakness with one of your genes such as CTLA4 (one of several associated with thyroid), and you really enjoy eating bread, lots of bread. Or maybe you are really low in vitamin D (or have an issue with the VDR gene which makes it difficult for you to utilize). Or you have blood sugar or estrogen swings, some undiagnosed infection, or some other risk factor that causes this gene to turn on. All of the sudden, your thyroid is not just a gland, but a beast the immune system must slay. And as it tries to defend you, it creates inflammation which causes your thyroid to stop effectively producing hormones. Suddenly, you are gaining weight, losing hair, getting cold, and feeling dogged tired. Finally, you go to see the doctor and they check your TSH and low and behold, it comes back high (see my thyroid article to see why this test is not enough!). They put you on hormones which seem to help, for a short time. But since the underlying cause is an issue with the immune system attacking your thyroid gland and not the gland itself, these hormones do nothing to address root of the problem, which is inflammation.
With a little inflammation, your thyroid may not work so well. But what if there is a lot? Hormones may spill out of excessively inflamed tissue and the next thing you know you are having symptoms of hyperthyroidism due to too many hormones being released. And so the game begins, the degree of functionality affected by the amount of inflammation present.
How does this happen?
We are born with an innate immunity called the Th1 response. After we encounter a specific pathogen or antigen, we also create antibodies so that the next we see them, we can easily recognize and destroy them. This is called the Th2 response. These two are designed to help when appropriate for their type and back off when they are not needed, maintaining a balance–just like a seesaw.
In addition, our immune system is regulated to send help when needed and suppress itself when the job is done. This is referred to as the Th3 regulatory immune system.
With autoimmunity, our bodies start to make antibodies against our own self. In addition, dysregulation of the immune system may occur. There may be imbalance with the Th1/Th2 response and/or the Th3 system forgets when to itself turn off. These conditions can lead to an inappropriate inflammatory response called Th17, which ends up ramping up the immune system even more.
Why does this happen? Theory 2
It turns out the immune system may be taking a bad rap in regards to autoimmunity. Instead of being overactive, maybe it is just doing its job by protecting us from “stealth” pathogens such as cell wall deficient bacteria (CWD) like mycoplasma or mycotoxins. Biofilms can also be a contributing factor, but we are going to skip that for now.
There are lots of types of bacteria living in our gut, but CWDs goes unnoticed since they are only 1/100th the size of a normal cell. They act as scavengers by releasing toxins to digest and recycle the garbage left behind by degenerating cells and tissues. CWDs are unable to make cholesterol for themselves so they are commonly located in our cholesterol rich areas such as our brain, muscles, thyroid, liver, glands, joints, and nerves.
Most bacteria, viruses, or fungi have cell walls which make them susceptible to antibiotics. CWD have this amazing ability to shape shift and even shed their cell walls depending on their environment (pH, temperature, oxygen, etc.). This means that many of the antibiotics and immune system tricks that kill other pathogens don’t work against CWD.
Case studies have implicated these microbes in almost every chronic human degenerative, inflammatory, and autoimmune disease. Mycoplasma and Ureaplasma have been found in about 70% of those with Sjogrens and 40% lupus. In addition, the majority of autoimmune conditions may also have a h. pylori CWD co-infection.
But, aren’t CWD friendly? Just like a party, things can get out of hand…..
Increased levels of CWD are seen in folks with increased metabolic acidity. This may be caused by a combination of dietary choices, chlorinated water, compromised mitochondria (that lead to production of more acids and less energy), and gut dysfunction which lowers the ratio of good/bad bacteria leading to fermentation. In addition, CWD could enter the body through overuse of drugs such as antibiotics, synthetic estrogens, and statins, which are really just CWD mycotoxins. Even our food supply contributes with its mycotoxin containing foods like stored moldy grains and nuts as well as antibiotic fed livestock.
This leads to the proliferation of CWD since they love a high acidic, anaerobic environment. And as these colonies continue to grow in unnaturally high quantities, they require more and more cholesterol. Where do they get it? From healthy cells in those critical locations which have been shown to be the birthplace of autoimmune dysfunction. If that isn’t enough, the toxins produced by CWD may even be more damaging.
The high levels of DNA antibodies and autoantibodies seen in those autoimmune could indicate CWD and/or their toxins destroying cellular DNA causing both it, and the remaining debris to be marked by the immune system for destruction. As more and more cell are destroyed, inflammation increases, tissue is destroyed, loss of function occurs, and the immune system goes into overdrive.
So could some autoimmunity really just be a response to a cascade of CWD infected, cholesterol depleted, dying cells? And might the Th1/Th2 imbalance be the required response based on the CWD’s current morphology?
Why does this happen? Theory 3
Another theory that has validity is an underlying virus or retrovirus. For example, EBV can cause an overreaction of B lymphocytes causing folks with a genetic issue with a CD8 T cell deficiency to be at risk.
Michael P. Pender, MD, PhD, of the University of Queensland proposed that autoimmune is “based primarily on the unique ability of EBV to infect, activate, and latently persist in B lymphocytes, including autoreactive B cells.”
He referenced a sizable body of epidemiologic evidence suggesting that EBV infection was a prerequisite for the development of both lupus and multiple sclerosis — two quite different autoimmune diseases.
“Most people who were interested in this concept thought the connection was through molecular mimicry, whereby a person would mount an immunologic response to components of EBV that resembled structures in the brain in MS or anti-double stranded DNA or other lupus antigens for lupus. This immune response intended to control EBV then by ‘friendly fire’ could lead to organ damage.”
Dr. Hedberg outlines this well. He states there are 8 steps leading to autoimmune conditions induced by EBV.
Step one is a genetic CD8 T cell deficiency. The second, the primary EBV infection. Step three is a decreased cytotoxic CD8 T cells control of the infection. Step four is an increased EBV load and increased anti-EBV antibodies. Step five is EBV infection in the target organ. For example, EBV could enter “organs such as the thyroid gland and germinate in that area maintaining a low-grade infection. Other examples would be the salivary glands and Sjogren’s, the gut and Crohn’s disease, etc.. Step six is clonal expansion of the EBV-infected B cells in the target organ. Step seven, infiltration of autoreactive T cells into the target organ.”
Why does this happen? Theory 4
As we mentioned in our posts on microbiome and leaky gut, without healthy gut flora to maintain a healthy gut barrier and immune system, we will have a hard time keeping our immune system under control.
Autoimmune = 1+2+3+4?
Scientists are now beginning to understand the the huge impact the human biome has on genetic expression and degenerative disease and there is no doubt that some autoimmune issues are a result of expressed genetic weaknesses. But might there also be a “pseudo-autoimmune” as well caused by pathogenic load and an immune system just trying to do its job? And could viral load also contribute cellular debris to possibly feed the CWD? If so, each would require a different protocol to affect change.
Clinically, we have seen positive response to stubborn autoimmune and health conditions by simultaneously supporting Th1/Th2/Th3/TH17 activity while addressing CWD, biofilms, and potential viral load.
So you talked about risk factors, what are they?
The following have been associated with leading to the expression of autoimmune conditions….
- Gluten issues: linked in the scientific literature to 55 diseases so far
- Insulin surges: See articles under Blood Sugar Conditions
- Estrogen surges: See Estrogen Dominance for more info.
- Viral, bacterial, or fungal loads including CWD and biofilm
- Heavy metals
- Vitamin D deficiency: See Vitamin D for more details
- Iodine excess (controversial)
- NF-κB uncoupling: protein that helps code for DNA and regulate immune system
- Overworked immune system leading to leaky gut. See Leaky Gut for more info.
What are some common autoimmune disease?
- Addison’s disease
- Celiac disease
- Graves’ disease
- Hashimoto’s thyroiditis
- Multiple sclerosis
- Myasthenia gravis
- Pernicious anemia
- Reactive arthritis
- Rheumatoid arthritis
- Sjogren syndrome
How can we support autoimmune issues?
Many times, we find that providing cofactors for the Th3 regulatory helps to correct proper function. Other times, we may need support the non-dominant Th1/Th2 side (as long as the body is not fighting a current infection).
But what it is all about is reducing inflammation. By uncovering/minimizing these sources, eradicating infections/biofilms, regulating blood sugar and adrenals, etc., you give your immune system a relative vacation, so that when faced with a real pathogen, it can do the job the way it is supposed to.
We have found that autoimmunity may be effectively managed via diet, reduction of inflammatory loads, avoidance of triggers, stress management, and directed supplementation.
Is there a diet for autoimmunity?
This is super important. If your healthy diet becomes inflammatory by eating foods that unknowingly affect your immune system, you may just be adding fuel to the fire. It is really important to find triggers that promote inflammation as well as CWD and yeast overgrowth in the gut that could lead to intestinal permeability. By calming inflammation in the gut, you will be able to better calm inflammation throughout the body. Checkout my article, Food Sensitivities and Leaky Gut for more details.
In addition, diets high in sugar and carbohydrates may be have a greater susceptibility to glycation, or attaching a sugar molecule to a protein. If a protein gets oxidized, it changes shape and may confuse the immune system into thinking it is a foreign invader. Again with increased inflammation, loss of function occurs.
Eating a diet containing a better pH balance provides a better environment to reduce CWD colonies.
Avoidance of gluten and gluten “cross cousin” foods is essential. Please refer Cyrex Labs, array 4 for a list of foods. In addition, latex foods have also been shown to upregulate autoimmune so maybe you should think twice before eating that banana.
What are the best supplements for autoimmunity?
Vitamin D, essential fatty acids, Glutathione ( for those without a GSR SNP), and multivitamin that supports other genetics SNPs are important for helping re-regulate the immune system. Opioids, obtained through appropriate exercise may also help. Individualized support of the TH1/TH2, decoy glandulars, CWD and biofilm support is best done under the guidance of a functional medicine professional. In addition, some folks have responded well to low dose naltrexone through a licensed MD.
How can you test for autoimmune disease?
I believe that it is best to order a comprehensive blood test and perform a Functional Blood Chemistry Analysis to find underlying causing that may be contributing to inflammatory issues. In addition, inflammatory markers such as CRP, SED rate, antibody and autoantibody tests are suggested. Cyrex Labs has a great panel for testing for many common autoimmune conditions. A bit expensive, but worth every penny if you have unexplained health issues. And finally, a test for EBV wouldn’t be a bad idea.