Autoimmunity, the inappropriate targeting and attacking of healthy body cells by the immune system, is an abnormal process which may be expressed in many ways and which encompasses over a hundred conditions, among them rheumatoid arthritis, systemic lupus erythematosis (SLE), multiple sclerosis, Hashimoto’s thyroiditis and Grave’s disease, celiac disease, ankylos- ing spondylitis, myasthenia gravis, psoriasis, and Sjogren’s disease. Although there is wide variation in the symptoms and course of indi- vidual autoimmune conditions, the common denominator for all of them is the misuse of immune power towards self, which, depending on the type of autoimmune condition, may either cause damage in
a localized way to specific body tissues, or systemically, to multiple tissues and organs throughout the body. While some autoimmune conditions have a genetic component, the degree to which the ge- netic tendency is expressed can be significantly altered by lifestyle, environment and nutrition.
Inflammation and Autoimmunity
It’s unfortunate that the immune system gets all the blame here, because while it’s true that autoimmune conditions are the result of an immune system with an attitude problem, to focus only on the “immune system gone bad” neglects the important issue of why? The useful and healing question to ask is, “Why is my immune system fighting me? What has caused my best protection against dangerous microbes to become so confused and hostile that it turns against the body it has been so beautifully designed to defend?”
The simplest answer to these questions seems to lie in the pro-
cess of inflammation. The inflammatory connection to autoimmunity, both as a cause and an effect, is clearly established, so no matter what autoimmune diagnosis you may have, both conventional and natural therapies emphasize ways to reduce inflammation in the body. In doing so, inflammatory triggers for immune misbehavior
are reduced, symptoms are lessened, and the progression of the disease is slowed or stopped. Without exception, however, conven- tional anti-inflammatory medications are trailed by a large shadow of side-effects and often serious risk to health. Finding ways to lower the level of inflammation and immune hyper-reactivity using natural approaches makes sense and can be extremely effective.
It’s no coincidence that a varied, nutrient-dense, unprocessed diet containing an abundance of fruits, vegetables, and healthy fats is strongly protective against inflammation and autoimmune processes. Effective supplements for autoimmune disease deliver to the body high-potency versions of the anti-inflammatory nutrients found in a healthy diet.
Omega-3 Essential Fatty Acids
Omega-3 fatty acids, found in high concentration in oils derived from fish and other marine life, and in certain vegetable oils such
as flax and hemp oil, may be the most fundamental supplement approach to cooling the heat of inflammation and autoimmunity. These healthy fats oppose the inflammatory effects of the Omega-6 fatty acid, arachidonic acid, which the modern diet provides in great excess (up to six times more than is healthy) and which skews our systems toward increased inflammation. The healthy Omega-3 fatty acids, EPA and DHA tip the balance in the body away from pain and inflammation, and help normalize immune system and cell mem- brane functions.
In a human study, Omega-3 fats inhibited the autoimmune response of B- and T-lymphocytes in patients with systemic lupus erythematosis (SLE), and protected against free radical-induced dam- age to kidneys, a common disease manifestation of SLE. Flaxseed oil, which is 50-60% Omega-3 fatty acids, actually decreased the numbers of specific autoimmune antibodies associated with SLE and improved kidney function in another study. (Therapeutic dosages of flax oil are 2-4 Tbs. per day.)
Although flax and hemp oil have a high level of the Omega-3s, they are present in a form which requires that they be converted
by the body into the anti-inflammatory fatty acids EPA and DHA, and there is reason to suspect that many people don’t perform this conversion well. For this reason, fish oil, which comes with EPA
and DHA fully formed and ready to go to work, is the supplement I most often prescribe. Look for a high-quality, concentrated fish oil product, independently assayed for toxins and stabilized to reduce rancidity (when opened, the contents should not smell strongly of fish); enteric coated forms can reduce repeating and mild stomach discomfort sometimes associated with fish oils – though these issues can also indicate a poor quality supplement. A product with “triglyc- eride bound” EPA and DHA may improve absorption. Therapeutic amounts of combined EPA and DHA are 2,000 to 5,000 mg. per day in 2-3 divided doses with meals. This is not the dose of fish oil, but rather the dose of EPA and DHA together; also, while both EPA and DHA have anti-inflammatory effects, many practitioners including myself use a higher ratio of EPA to DHA when prescribing for anti- inflammatory support.
Because of their ability to quench inflammatory free radicals, antioxidants are an important part of the natural medicine approach to autoimmune disease. Multiple studies have shown that low serum levels of antioxidants are associated with autoimmune diseases such as Lupus and Rheumatoid Arthritis (RA). Vitamin E (a Gamma to- copherol form), vitamin C and the complex of flavonoids associated with C, green tea catechins, proanthocyanidins, alpha-lipoic acid, beta-carotene, coenzyme Q10, selenium – all may be of benefit in helping to rebalance the immune system.
The idea of taking probiotics (healthy GI tract microbes) to treat immune disease may seem a little far-fetched, but animal and human studies are indicating that onset, progression, length of remissions, and survival in autoimmune diseases such as rheumatoid arthritis, lu- pus, and multiple sclerosis may be positively affected by taking pro- biotic supplements. This is partly attributable to the roles probiotics play in promoting better microbe balance in the gut and in maintain- ing a healthy intestinal lining, thereby lessening overstimulation of the immune response by unhealthy bacteria, yeasts/fungi, intestinal parasites, or other antigenic triggers to the immune system. How- ever, an important factor seems to be the direct effect of beneficial digestive tract microbes on the development of a healthy, balanced systemic immune system.
You’ve probably heard of taking enzyme supplements with meals to improve digestion, but specific proteolytic (protein digest- ing) enzymes can also be used to reduce triggers of inflammation and autoimmunity. When taken between meals, they are absorbed into the bloodstream where they go to work on protein substances in blood and tissues which promote inflammation and the autoimmune response. Good enzyme formulas for this purpose may contain chymotrypsin, trypsin, bromelain, proteases, serratiopeptidase, or rutin in various combinations, and are enteric coated to pass through the stomach for absorption in the small intestine. Doses range from 3 tablets twice daily to 4 or more tablets three or four times daily; they should be taken at least 45 minutes before or 2 hours or more after a meal.
This compound, which gives the yellow color to the spice turmeric, has shown ben- efit in animal and human studies for rheuma- toid arthritis, scleroderma, multiple sclerosis, psoriasis, and inflammatory bowel disease; a 2010 animal study showed promise for scle- rosing cholangitis, an autoimmune disease of the liver and bile ducts with limited conven- tional treatment options. Curcumin dem- onstrates many immune-regulating effects, which include reduction of inflammatory cytokines and the potent inflammatory sig- naling agent NF-kappa-B, antioxidant effects, and enhanced activity of liver detoxifica- tion pathways. There are currently available two good-quality versions of curcumin: one which has been standardized to contain 95% of the three most active curcumenoids; and
a second product which provides curcumin bound to phosphatidylcholine, which should increase bioavailablility.
Beta-sitosterol (BSS) and a related compound, sterolin (BSSG), are fats found in plants which help to balance the overactive immune response of autoimmune disease, and also support a healthy adrenal response to stress. While this is still more motivation to eat plenty of vegetables and fruits, there
are supplements available which provide these phytosterols in highly concentrated form. In my practice, I use a product which contains 20 mg. of sterols (BSS), and 200 mcg. of sterolins (BSGG).
Be kind to your immune system and it will be kinder to you.
Why not give your immune system some TLC? One of the best ways to show it some tender loving care is to begin a program for another kind of TLC – Therapeutic Lifestyle Change. Improving diet, drinking plenty
of clean water, minimizing inflammatory foods (foods which trigger a sensitivity re- sponse and which contribute to blood sugar imbalance), reducing environmental toxin exposure, exercising, learning techniques
for reducing stress, addressing sleep issues
– these lifestyle habits are the foundation
of a balanced, strong, but not over-reactive immune system. By combining a healthy lifestyle with targeted supplemental sup- port, you can do much to quench the fires of autoimmune disease.
Debra Gibson, N.D. practices naturopathic family medicine in her Ridgefield, CT office. She can be reached at 203-431-4443 or at email@example.com. See ad on page 28.