The Rise of Autoimmune Diseases: A Modern Epidemic?

Many people I see in my practice are surprised to learn that their symptoms may be due to a malfunction of their immune system. These kinds of conditions include digestive and bowel disorders, migraines, obesity, chronic fatigue, skin disorders, arthritis, as well as those that are generally labeled as autoimmune diseases such as diabetes, rheumatoid arthritis, asthma, multiple sclerosis, lupus, scleraderma, Hashimoto’s, and Sjogren’s. All of these are becoming more common. Many have doubled or tripled since 1950, creating major health risks for many patients.

Western Medicine’s approach to treating these diseases focuses on managing symptoms with various anti-inflammatory medicines.

It often includes the use of chemotherapeutics and very potent immunosuppressive medications that have serious potential side effects (such as leukemia and lymphoma). While these approaches admittedly can provide substantial symptomatic relief to the patient, they do not treat the cause of these conditions. Some research suggests that these approaches may even result in furthering the pathologic process.

Modern research into autoimmune phenomena suggests that radically different approaches may be required to reverse these trends. One preventive approach is to focus on very early detection using predictive autoantibody testing. Another is to optimize the gastrointestinal mucosal immune function and the microbiome (the whole environment inside our gut) through the eradication of infectious agent triggers with antibacterial therapy (herbs and/or medications) and possibly the therapeutic use of beneficial parasitic agents.

These approaches have long been used in Functional and Naturopathic Medicine, but they have now become hot topics in mainstream medical journals and research centers in immunology and gastroenterology. A friend of mine at SRI recently shared an engaging conversation with me about the research they are doing in this field.

So, why is all this important to YOU?

There are now numerous associations that have been firmly established between specific autoimmune diseases and specific dietary-derived antigens along with the overgrowth of pathogenic (bad) bacteria in the gut. Some of the links between specific bacteria and autoimmune diseases have been known for a long time, but more are rapidly being established in current research.

Western medicine has not generally tested autoimmune patients’ food sensitivities or GI bacterial flora using stool analysis. But these two areas are essential in the evaluation and treatment for better health outcomes.

Lists of specific gut microorganisms and their associated autoimmune disorders are available in the published literature. For example, oral bacterial infections with porphyromonas gingivalis (the primary cause of periodontal disease) play a role in many cases of autoimmune rheumatoid arthritis. Other organisms directly related to rheumatoid arthritis include proteus, citrobacter, klebsiella. And, klebsiella is often associated with ulcerative colitis, Crohn’s disease, and ankylosing spondylitis.

Auto immune thyroid disorders also have been linked to bacterial infections – namely overgrowth of yersinia enterocolitica.

Nevertheless, we must remember that there is no universal causality because autoimmune phenomena are very complex and seem to be potentially fueled by a multitude of antecedents, triggers, and mediators.

Dietary antigens play a major role.

It may be no coincidence that the dramatic rise in autoimmune diseases has paralleled the ever increasing consumption of poor-quality modern processed foods that disrupt the gut micro balance and introduce many antigens. Another contributing factor seems to be the hyper-hygiene we have adopted with anti-bacterial soaps, lack of exposure to the earth and the natural environment.

Early diagnosis of auto-immune disruptions can help prevent their progression to full blown disease and its associated damage to the body’s organs and systems. Screening tests can detect many of these imbalances early, allowing for preventative treatment. This is the focus of Functional Medicine, which at least helps in slowing down the disease process if not reversing the trend toward disease which we see in many cases.

Some researchers have proposed that 3 things must be present for any autoimmune disease to manifest:

1) an environmental trigger (antigen), 2) genetic susceptibility, and 3) intestinal permeability. The easiest to control is the intestinal permeability or prevention of “leaky gut.” Leaky gut has been recognized for decades in Integrative Medicine, but Western Medicine has only recently focused on it. Normally, the intestinal epithelial barrier with its intercellular tight junctions controls the equilibrium between tolerance and immunity to foreign antigens. When this equilibrium gets distorted through the development of microscopic holes in the intestinal wall that can leak proteins and other small molecules, both intestinal and extra-intestinal autoimmune disorders can occur. One major regulator of this process is vitamin D, which helps to maintain normal permeability of the gut wall so as to prevent proteins from entering into the body thru a leaky gut and trigger the autoimmune system.

Inexpensive tests for predictive antibodies continue to be developed and over time could become part of a standard preventive medicine check-up. Many of you already have had the thyroid peroxidase antibody and anti-thyroglobulin antibody tests.

Another test you can do right now is for food sensitivities/slow allergic responses that trigger some of the processes we have been discussing. Though no test is 100% accurate in this area, we do have some that are very informative and give you a roadmap of what foods you need to eliminate in order to avoid imbalances in your body. Some tests also cover environmental allergens and chemical allergens. Finally, stool tests can be used to determine the health or imbalance of your gut environment, which can tell us what treatment may be needed to improve your gut function. Many insurance companies are now paying a major portion of the costs of these tests.

Prevention has so much potential in helping us maintain a balanced body and healthy immune system.

I know firsthand, for there was a time when my thyroid antibodies were elevated and I took on the challenge of doing everything possible to change that and lower my risks of developing a full-blown auto-immune disease. I did it, and if that is your issue, I know you can, too.

Here’s to our continued good health and well-being!

Jane Kennedy, CFNP, MN, MPH

About Jane