The Growing Incidence of Autoimmune Disease
The incidence of autoimmune conditions grows yearly, particularly rheumatic conditions, though there is limited scientific proof why the immune system inappropriately attacks itself. There are a variety of reasons that autoimmune conditions can be exacerbated, particularly stress, sun, or chronic disease conditions. With over 80 different types of autoimmune conditions, the most prevalent being multiple sclerosis, lupus, and rheumatoid arthritis, it may take several doctor visits before being formally diagnosed.
As a naturopathic physician, you always need to ask one question with any patient you see, “what is the underlying cause” and “what is the initiating factor”. For some individuals, autoimmune conditions may be hereditary, women are affected more commonly, as well as specific ethnic groups.
Studies have shown that the X chromosome has a higher significance of genes as compared to the Y chromosome; women are XX and men XY. Additionally, estrogen affects the immune system directly particularly for genetically susceptible individuals. It is important to look at the role hormones may have on an autoimmune condition if not regulated well. Hormonal blood testing can be completed as well as specialty tests for a comprehensive review of hormones and metabolites to clearly identify if there is a hormonal imbalance that can be properly addressed through hormone therapy, nutritional supplementation, diet and lifestyle. Some common herbs use to regulate hormones include vitex/chaste tree, DIM (found in cruciferous vegetables), and dong quai.
Leaky Gut and Food Sensitivities
In addition to hormones as possible triggers, gastrointestinal function must be looked at. Individuals with gastrointestinal issues like IBS have found to have more T cells and mast cells in their intestine as compared to others. T cells produce an immune response against pathogens; if imbalanced, your immune system does not function correctly. Also, leaky gut (a weak lining of the gastrointestinal tract) has been linked with higher incidences of autoimmune disease, e.g. lupus, and MS. The barrier of the gut must be supported to decrease inflammation, and consumption of processed foods, alcohol, and coffee will exacerbate conditions. Also, gluten and dairy have been found to be inflammatory and individuals with food sensitivities will be more affected. I would recommend reviewing food allergies and sensitivities to determine if there is a daily, aggravating factor on the system due to food consumption. You may want to consider high dose probiotics including spore-based probiotics. There are many varieties of probiotic types that can be recommended by a naturopathic physician or functional medicine doctor. Several supplements help to repair the gastrointestinal tract, for example, l-glutamine or deglycyrrhizinated licorice and pre-biotics like arabinogalactan, which is also an immune-modulator that may help.
Stress plays a huge role in autoimmune conditions. It causes inflammation and may be the initiating factor for an autoimmune flare-up. It exposes you to a greater chance of adrenal fatigue, insomnia and gastrointestinal issues. You must make the time to find something every day that brings you joy and provides a sense of happiness and calm. Even 5 minutes a day of meditation, prayer or other spiritual practice have been shown to have dramatic improvements on cortisol levels, serotonin, epinephrine and melatonin. A trained practitioner can help you to complete adrenal function tests to pinpoint exactly where you need supportive care for your adrenal glands. Adaptogenic herbs like ginseng, holy basil, ashwaganda and rhodiola may provide some symptomatic relief in addition to adrenal glandulars for stress. Lifestyle management is a key first point of care.
Infections and Molecular Mimicry
Why does the body mistakenly attack its immune system and is unable to differentiate self from non-self? It can be frustrating when you are not feeling better, when diet and lifestyle do not resolve your autoimmune conditions, and treatment is ridding of the pain but still hasn’t improved your energy. Something commonly overlooked, and what I’m going to spend most of my time discussing here, are infections as related to autoimmunity. In my practice, infections are a common root cause of autoimmune conditions, and when we address these infections patients’ autoimmune conditions begin to improve significantly.
There is a scientific term called molecular mimicry that has been associated with autoimmune conditions and shown to be a leading mechanism to induce autoimmunity due to parasites, bacteria, viruses, mycotoxins, metals and chemicals. It has long been linked to autoimmune disease but only most recently has gained attention. Molecular mimicry can trigger an immune response against what is called autoantigens. An autoantigen is a protein that is recognized by the immune system for people with autoimmune disease. A person can obtain an infection, like Epstein Barr virus, Strep or Mycoplasma, that has antigens that look similar to the person’s antigens. This resemblance of antigens by bacteria or viruses can activate T cells and thereby become autoreactive. This continual series of events can begin to create what is a called a loss of self-tolerance and serve as initiating factor for autoimmune conditions. Many people have multiple infections and exposures over their lifetime. It is important to continue to create and maintain a healthy lifestyle through diet, exercise, sleep and supplementation, if needed, to allow your body to get rid of them in a timely basis. Persistent infections that are not managed well can increase the possibility of initiating autoimmunity.
Let’s outline some examples of autoimmune conditions that have been connected to some infections. For the past 60 years, proposed mechanisms of etiology for multiple sclerosis (MS) link MS to persistent viral infections. Close to two dozen viruses have been found in the brains of patients with MS including ones like herpes, and retrovirus. Neurological lyme disease mimics many MS symptoms (e.g. headaches, stiff neck, memory and ability to process information, fatigue, coordination challenges) and can act to trigger MS.
Epstein Barr Virus (EBV) or herpesvirus 4, affects a majority of the population at large, over 90%. Research links its connection to systemic autoimmunity; particularly for conditions like lupus (SLE). Studies have shown patients with lupus having higher titers of EBV antibodies as compared to the healthy population. EBV causes T cells to produce more pro-inflammatory mediators (i.e. cytokines) for systemic autoimmunity. Studies have shown EBV antigen-1 having similar autoantigens in lupus which could possibly enable disease pathogenesis.
A more recently known autoimmune condition affecting children, (PANDAS) pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections and (PANS) pediatric acute-onset neuropsychiatric syndrome occurs due to an infection, like strep, that triggers an immune response that causes inflammation in a child’s brain. A child may have an acute onset of symptoms not previously seen like OCD, anxiety, tics, mood and temperamental changes, restrictive eating, declining abilities in math and writing, behavioral regression, sleep changes, urinary and sensory issues.
Conventional medicine may look at antibiotic use and antiviral drugs. It is important to be mindful of longer term use of these treatments on your system, particularly gastrointestinal system and long-term immune function. You should first get tested to see if some of these infections exist within your system and be fully evaluated. Here are some natural treatments to consider for support with infections and viruses.
Low dose immunotherapy (LDI)
LDI is a frequent therapy we use in our clinical practice at Fairfield Family Health and is an off-shoot from low dose allergen (LDA) created by Dr. Ty Vincent. Our office is the first in the state of Connecticut to provide low dose immunotherapy (LDI) for patients; there are approximately 200 practitioners in the LDI network. LDI helps the immune system restore balance by reducing inflammation caused by infections. LDI contains specific antigens, like Epstein barr, lyme, or strep, and it diminishes the abnormally activated TH2 immune system and creates immune tolerance and acceptance, rather than suppression.
Natural antibiotics and antivirals
There are many known natural antibiotics that can help to decrease infections. Research has demonstrated garlic’s impact on bacteria like E.coli. In other countries, honey is commonly used for wound and burn repair. A 2011 study demonstrated honey’s ability to inhibit 60 different kinds of bacteria and treat MRSA successfully. Goldenseal is one of my favorite natural antibiotics; it contains berberine (which is not safe for women who are pregnant or breastfeeding or infants). It supports issues related to the mucosal tract like respiratory, digestive and urinary issues. Oregano has been well studied for its effectiveness to boost the immune system and its antioxidant properties for both bacterial and viral infections. Elderberry syrup, Sambuca, is a popular antiviral used particularly during the cold and flu months. Licorice root is very effective for herpes and acute respiratory issues, but should not be taken by individuals with high blood pressure.
There are multiple approaches to get to the root cause of autoimmune conditions. It is important to have support through a trained professional like a naturopathic physician that can complete a full assessment, physical, blood work, specialty testing and recommend supplements that are specific to you and only you.
Dr. Jaquel Patterson is a nationally and internationally recognized naturopathic physician, sought-after speaker, and best-selling author. She is the Medical Director and Owner of Fairfield Family Health in Fairfield, a multi-disciplinary integrative medical practice. Her areas of specialty are Lyme disease, autoimmune conditions, anxiety/depression, and PANS/PANDAS. She’s the Immediate Past President of the American Association of Naturopathic Physicians. (203) 254-9957.