I just returned from another scintillating weekend with the Institute for Functional Medicine, learning the latest research in autoimmunity this time. Functional medicine is a bridge between western medicine and the science base and a whole systems approach that historically was just taught to nurses. Doctors are trained in medical school to think of symptoms and how to work backwards from the symptom, while nurses are educated to think of the person within the context of their environment, what they think, how they respond to stress, and even what their spirituality and culture are. Functional medicine is a perfect model for the advanced practice nurse practitioner (ARNP)!
This particular course about autoimmune disease is timely because autoimmune disease and inflammation rates are at an all time high. I am seeing more eczema, asthma, Sjogren’s Syndrome, rheumatoid arthritis, multiple sclerosis, scleroderma, Crohn’s disease, ulcerative colitis, irritable bowel syndrome, celiac disease, Hashimoto’s hyroiditis, cancers, high cholesterol, etc…than I have ever seen in 26 years of medicine. What is the deal? Why haven’t we figured this out yet? Part of the problem is because we used to think that autoimmune diseases were genetic, were “not compatible with life”, and had no known etiology. Well, it turns out that we are all on the verge of overt autoimmunity. It’s only because of the incredible dance of a very complex immune system that we don’t have symptoms of inflammation all of the time.
In 1999 the National Institute of Environmental Health Sciences held a conference on autoimmunity and inflammation. At the conclusion of the event, where most prominent researchers in this field presented information, they issued a press release saying:
“Mild forms of the autoimmune response probably occur naturally in most people. But, for people with a predisposition to autoimmunity, environmental factors, such as toxic chemicals, drugs, bacteria or viruses, may trigger a full-fledged response.”
Press release: September, 1999
www.nih.gov/news/pr/sept99/niehs-28.htm
The above mentioned environmental factors also include diet, stress response, and daily routine. It is now known that the statin drugs that are prescribed to lower cholesterol can trigger autoimmune disease! Not only that, but cholesterol deposit in the arteries called atherosclerosis, is actually an autoimmune response of the body to low density lipoprotein.
Autoimmunity is actually just localized inflammation in a given part of the body, like the joints (rheumatoid arthritis), or in the gut (Crohn’s disease), or the thyroid (Hashimoto’s disease), or the eyes (scleroderma), or the skin (eczema), and so on. In the end, it’s more about inflammation than it is about genetics (although genetics do play a role). Why is there inflammation? What can we do to get rid of it?
As I have said many times on this blog site, all roads seem to lead to the gut and end in the endocrine system. Why does an infant have eczema? I have a two year old I am treating for atopic dermatitis now in my practice. In the interests of time and energy for the mother, we chose to do a complete stool analysis immediately rather than eliminating a lot of foods to see if we could clear him up. His stool analysis turned up a virulent bug called Clostridium difficile, also known as "C. diff". This is a species of Gram-positive bacteria of the genus Clostridium that causes diarrhea and other intestinal disease when competing bacteria are wiped out by antibiotics. It is widely known in the medical field to be the most common cause of antibiotic associated diarrhea and is treated very seriously as it can lead to pseudomembranous colitis, a severe infection of the colon, often resulting from eradication of the normal gut flora by antibiotics. The C. difficile bacteria, which naturally reside in the body, become overpopulated: The overpopulation is harmful because the bacterium releases toxins that can cause bloating and diarrhea with abdominal pain, which may become severe. Latent symptoms often mimic some flu-like symptoms.
This little guy’s parents did not want to treat the C-diff., or the other many bacteria that are in his gut, they just wanted to use diet and probiotics. However, like most cases of sever gut dysbiosis, this young fellow already had severe colitis because of the toxins mentioned above that are “off gassed” by the damaging overgrowth of “bad bugs”. Not only did he have severe dysbiosis and inflammation in his intestines, but also food allergies.
This is a very common scenario with autoimmune disease. Autoimmunity and inflammation are not normally caused by one thing, but are multi-factorial. The trick becomes finding the triggers and controlling the ones that can be controlled and mitigating those that cannot be controlled.
10 Tips for uncovering and curing inflammation and autoimmunity:
1. Have your medical provider do labs that include inflammatory markers, hormone levels (don’t forget DHEA), nutrient levels (don’t forget vitamins like D and B and minerals), a celiac panel, IgE, and especially a stool test.
2. Remember that dysbiosis doesn’t just happen in the gut, but also the mouth, sinuses, genitourinary system, skin, environment, and can be parenchymal. These areas might need to be cultured.
3. Go on an elimination diet. You can control your food choices. A good elimination diet will clear up 80% of autoimmunity and inflammation without further intervention.
4. Utilize the plant pharmacy that abounds with anti-inflammatory botanicals that do not have the gut damaging side effects of non-steroidal anti-inflammatories or steroids.
5. You will HAVE to kill off the bad bugs and there are natural microbicides that can do this, again without the gut damaging side effects of antibiotics.
6. Your medical provider will need to restore your immune system to normal function again. This can be started by controlling your dietary intake; a good medical grade protein powder shake as a meal replacement for a few days can get this started quickly.
7. Immunomodulation can be achieved by detoxing harmful estrogen build-up or getting rid of toxic xeno-estrogens from the body. DHEA is a hormone that can help restore order in certain people.
8. Damage control may be necessary if the inflammation has gone unchecked for too long. Again, there are many choices for your medical provider to choose from to heal your gut lining, restore flexibility to the joints, put out the fire in the eyes; it just depends on what is going on.
9. Restoration of nutrients. There are many micronutrients that aid in the treatment of inflammation and autoimmune responses in the body. Selenium, Co-Q-10, essential fatty acids, probiotics, zinc, iodine, NAC, ALA, and many more. Again, it is essential to be under the care of a medical provider who can discern what is going on before taking supplements.
10. Pancha Karma quickly returns the body to homeostasis when there is an inflammatory flare gone wild. Pancha Karma is an Ayurvedic detox program that includes a week or more of body work, dietary changes, and detoxification and rejuvenation that cannot be matched for its instant results. It is what I believe cured me of rheumatoid arthritis 15 years ago.
No two people have immune systems that respond exactly the same. An individualized treatment plan and diagnostic pathway is essential to uncovering the cause of the root inflammation; only then will you have a true cure. Until then, you will be chasing symptoms.
