What exactly is an autoimmune disease? Simply put this is a condition in which your own immune system attacks your own tissues. Normally, your white blood cells that make up your immune system protects your body against harmful substances. These substances can consist of viruses, bacteria, fungi, other microorganisms, toxic compounds released by these organisms, environmental toxins, cancer cells, blood/tissue from outside of the body. All of these substances are considered antigens. Antigens are mostly protein in nature and stimulate some of your white blood cells to produce antibodies. Other white blood cells directly attack these antigens. The combination of antibodies and various immune cells helps to destroy or neutralize these foreign antigens.
However, with autoimmune diseases, your immune system can not clearly distinguish proteins along the surface of your healthy body tissues and the foreign antigen proteins. As a result, the immune system begins to destroy normal tissues. It also causes abnormal growth of the tissues and disrupts normal function of thtissue or organ affected by this autoimmunity. Autoimmune diseases are most often found throughout the body and are not confined to a single organ. Some of the tissues affected are, blood vessels, connective tissue, nerve tissue and nerve synapses, endocrine organs like the thyroid, pancreas, joints, muscles, red blood cells and more. The autoimmune disease “assigned” to a particular patient is usually based on the primary organ or tissue type affected by this autoimmune process. As an example, if it is affecting the joints it is referred to as rheumatoid arthritis. Remember, autoimmunity is never confined to a single organ or tissue it is a body wide immune system imbalance.
STATISTICS OF AI
The Institute of Health estimate 23.5 million Americans suffer from autoimmune (AI) diseases and the rates are progressively increasing. To give you an idea of the rates of AI to other diseases it is estimated that 9 million Americans have cancer and 22 million have heart disease. So, autoimmune disease is very common. The NIH also estimated the cost to treat AI to be 100 billion, cancer 57 billion and heart and stroke 200 billion. However, research funding in 2003 for AI was 591 million, cancer 6.1 billion and heart/stroke 2.4 billion. AI is also one of the top 10 leading causes of death in female children and the 8th leading cause of death of all women. Women are twice as likely to develop AI versus men. In men the following AI diseases are more common, type 1 diabetes, ankylosing spondylitis and myocarditis. One other interesting finding with AI is that these diseases are more common in northern climates especially the northwest of the United States.
DISEASES ASSOCIATED WITH AUTOIMMUNITY
There are about 40 well documented and accepted AI diseases. However, it is now believed that there really are about 80-100 different types of autoimmune diseases. The list seems to continue to grow as research progresses. The most common AI disease is rheumatoid arthritis. It is very common in adults 50 and older. 1 in 28 women and 1 in 59 men will develop RA.
We will list and briefly discuss some AI diseases. Some of which you may have heard of and others you probably have not.
Addison’s – this effects the adrenal glands and their ability to produce many hormones. This leads to salt craving, muscle weakness, low blood pressure, extreme fatigue, depression and much more.
Autoimmune hepatitis – causes scarring and damage to the liver.
Celiac Disease – exposure to wheat, barley, and rye which contains proteins that stimulate the immune system leading to damage of the small intestine.
Diabetes Type 1 – damage to the beta cells in the pancreas resulting in the inability to produce insulin. There is also research coming out leading to autoimmune origins even with type 2 diabetes which is the most common form of diabetes.
Graves and Hashimoto’s – these both involve the thyroid gland. Graves is associated with hyperthyroidism and Hashimoto’s is associated with hypothyroid.
Hemolytic anemia – the immune cells destroy red blood cells.
Idiopathic thrombocytopenic purpura – this results in damage to your platelets and causes excessive bruising, bleeding and a rash with red or purple dots.
Inflammatory myopathies – this usually involves inflammation and weakness of the muscles. This can lead to tripping, falling ,difficulty swallowing and muscle fatigue.
Multiple sclerosis – the protective coating of the nerves in the brain and spinal cord. This leads to multiple neurological symptoms.
Psoriasis – inflammation to the skin leading to thick, red, scaly patches often found near joint areas and the head.
Rheumatoid arthritis – swelling, stiffness, pain and damage to the joints.
Scleroderma – abnormal connective tissue growth of the skin and blood vessels.
Sjogren’s – inflammation to glands that produce moisture like the tear glands, salivary glands and mucous glands.
Systemic lupus erythematosus – widespread damage to skin, lung, heart, kidneys and more.
Vitiligo – loss of normal skin pigmentation.
SYMPTOMS AND SIGNS OF AUTOIMMUNITY
There are some similar symptoms that a number of AI diseases share in common, but there are others that are different. The differences often have to do with the main organs and/or tissues being affected by the immune system. Often the initial symptoms are, fatigue, dizziness, low grade fever , difficulty concentrating and a little later it is often accompanied by muscle/ joint pain with muscle weakness. Generally, if these symptoms persist, they may be early warning signs of autoimmunity. Here are some of the other symptoms:
- Anxiety, depression, insomnia, memory problems and difficulty focusing.
- Heat/cold intolerance, rapid heart beat, palpitations, numbness and tingling in extremities.
- Swollen glands and inflammation.
- Recurrent rashes, hives, dry skin/eyes, and mouth sores.
- Abdominal pain, diarrhea, and blood/mucous in stool.
- Changes in blood pressure, vertigo, fainting and headaches.
- Susceptibility to infections, yeast overgrowth and allergies.
- Recurrent miscarriages and blood clots
TRIGGERS AND CAUSES OF AUTOIMMUNITY
Although all of the exact causes are not totally known. Research to date has shown several things that cause the immune system to attack the body. Basically, there is a intricate interplay between our genes, our biochemical/ hormonal balance, external environment and our immune cells. Alessio Fasano, M.D., pediatric gastroenterologist, research scientist and founder of the Maryland Center for Celiac Research, believes there are three things all autoimmune diseases have in common: 1) genetic susceptibility 2) antigen exposure 3) leaky gut or increased intestinal permeability. Recall from a previous newsletter, that about 70- 80% of our entire immune system resides in the gut!
There are several genetic tests that can accurately determine the increased probability of developing certain autoimmune diseases. The probability of AI does increase especially if others in the family have AI. However, just because you may have genetic tendencies this does not mean you will develop the disease.
The next important factor are antigens or triggers. One of the first triggers are various infections caused by viruses, bacteria, yeast/fungi and other microorganisms. These infections can be acute, sub acute or chronic. They may also be the type that you are totally unaware of and could be found in your teeth, sinuses or in the gut.
Other triggers can be due to environmental toxins like heavy metals, air pollutants, petroleum by products, pesticides, plastics, artificial sweeteners, food additives, toxic waste products from fungi and other organisms and many others. Some other “toxins “are actually due to internal biochemical imbalances. This can be due to a lack of antioxidants that may lead to excessive free radicals. Improper methylation or hormonal imbalance are also important factors affecting the immune system.
Chronic mental, emotional and physical stress can also be another important trigger. It is well known fact that many flare ups of autoimmune symptoms occur in conjunction with episodes of stress.
Antigens which are mostly protein in nature also trigger the imbalance in the immune system. Antigens may be airborne, contact the skin, or consumed in the form of food “allergens”.
Another huge factor leading to autoimmunity has to with a hypermeability of the intestines. This may be caused by usage of antibiotics, NSAID (like Advil, Alleve, Celebrex), chemotherapy, other medications, imbalanced microflora, overgrowth of yeast and other microorganisms or food sensitivities. The leaky gut leads to improper liver function, passage of harmful compounds and microorganisms into the blood/lymph and eventual lead to immune system imbalance.
TRADITIONAL TREATMENTS FOR AI DISEASES
One of the first medications used are anti inflammatories. This would consist of Ibuprofen, aspirin, naproxen. These medications simply attempt to reduce inflammation by blocking certain enzymes. Furthermore, they generally worsen the hyperpermeability of the intestines which can lead to the continued cycle of autoimmunity.
The next group of medications employed are steroidal hormones such as prednisone. These medications can be quite effective by depressing the immune system. However, they have huge systemic effects on the body such as weight gain, increased blood sugar, increased blood pressure, insomnia, osteoporosis and many others.
The next group would be disease modifying antirheumatic drugs (DMARDS) such as methotrexate, . Methotrexate blocks folic acid usage and disables the immune system. However, this medication also affects all other cells in the body. It can also cause inflammation of the stomach, oral ulcers and intestinal upset.
Lastly, would be the biologicals, such as Enbrel, Humira, Orencia, and Remicade. They disable the immune system. They also lead to many side effects , especially other infections. Long term effects are unknown.
ALTERNATIVE AND NATURAL TREATMENTS
One of the first things that often has to be addressed is a hyperpermeable gut or leaky gut. To detect such a problem, we may run a simple urine test and a complete stool analysis. The stool analysis in particular can detect the overgrowth of yeast, bacteria or other microorganisms. These overgrowths often are responsible for causing a leaky gut and need to be eliminated. We often utilize different herbal combinations and occasionally may need some pharmaceuticals. Often using different natural compounds to heal the lining of the intestines and to detoxify the intestines along with the liver are necessary. Another important component is to restore the normal microflora with various prebiotics and probiotics. Utilizing different kinds of fermented foods can also be helpful to assist in restoring a normal balance of the microflora. Restoring the small and large intestines as well as the upper digestive system is critically important in helping with restoring immune system balance.
Addressing adrenal gland and other hormonal imbalances are very important. This can be done with a salivary hormone analysis, sometimes blood and using applied kinesiology muscle testing. The ratios of adrenal hormones of cortisol and DHEA is extremely important as well as the daily fluctuations of cortisol. Cortisol in particular has a tremendous effect on the immune system and the production of a protective antibody found along the lining of the digestive and respiratory tract called secretory IgA. Estrogen and testosterone also play important roles in influencing the immune system balance.
The proper levels of antioxidants, vitamin D, glutathione, omega 3 fats, omega 6 fats and others are another important factor. There are different blood tests to evaluate this along with muscle testing.
Lastly, there are some relatively new blood tests that can detect specific immune system attacks against various tissues and organs in the body. We then can see the extend of autoimmunity in the body.