Autoimmunity

T his article takes a closer look at autoimmune conditions. Many people don't quite understand what they are or how they can affect our health. I discuss the different types of autoimmune conditions, the symptoms to look out for, and what to do if you suspect you might have autoimmunity, or have already been diagnosed.

Over 15 million people in the UK are living with a long-term health condition. A long-term health condition (or chronic disease) is a health condition for which there is no known cure, and which is managed with drugs and other treatments. Long term chronic health conditions are non-communicable, which means the problem is systemic (something has gone wrong inside the body of the person with the chronic condition) and cannot be transferred from person to person. Examples of long term, chronic health conditions include cancer, diabetes, cardiovascular disease, chronic respiratory conditions and autoimmune conditions.

What is autoimmunity?

Autoimmunity is the process whereby the body’s immune system starts to attack itself, resulting in tissue damage. Which cells are attacked determines the autoimmune disease and its symptoms. Today there are more than 100 confirmed autoimmune diseases and many more are thought to have an autoimmune component. These include:

Crohn's disease
Ulcerative colitis
Celiac disease
Diabetes
Multiple sclerosis
Lupus
Psoriasis
Hashimoto’s thyroiditis
Grave’s disease
Vasculitis
Rheumatoid arthritis
Irritable bowel disease
Ankylosing spondylitis

Symptoms associated with early stages of autoimmune disease

There are many symptoms that are associated with autoimmune conditions. If you are experiencing many of these, they could be a tell tale sign that you have, or are developing, an autoimmune condition. However, as with most health conditions, these are only indicators and shouldn't be taken as a diagnosis on their own. Signs to look out for include:

Allergies
Anxiety and depression
Digestive problems
Fatigue
Gallbladder disease
Memory problems
Migraines and headaches
Muscle or joint pain
Muscle weakness
Skin problems
Thyroid problems
Weight loss resistance
Yeast infections

What causes autoimmunity?

Genetic susceptibility: inherited genes determine the likelihood of an individual’s immune system producing self-targeted antibodies.

Environmental triggers: infections such as parasites, viruses, bacteria and yeast/fungi, heavy metal toxicity, chemical exposure, air/water pollutants, certain foods etc.

Diet and lifestyle: Researchers have found that increased intestinal permeability (leaky gut) is present in EVERY autoimmune disease for which is has been tested. Many diet and lifestyle factors such as gluten, food intolerances, stress, infections (bacterial, fungi etc), poor diet, anxiety and intensive exercise increase intestinal mucosal permeability, enhancing entry of undigested food particles, bacteria, and bacterial toxins into the systemic circulation, provoking systemic inflammation, and triggering numerous diseases.

So, while we cannot control our genes, we do have control over what we eat and how we live. Many individuals with autoimmune conditions discover that when they make changes to their diet and lifestyle, this results in a reduction of their symptoms, halting the progress of the disease and, in many cases, even putting it into remission.

First steps when an autoimmune condition is suspected

When symptoms appear more specific to a certain autoimmune condition, such as Celiac disease or Hashimoto’s, specific antibodies are tested. However, when symptoms are non-specific such as chronic fatigue, fibromyalgia or depression, a doctor may suggest an antinuclear antibody test (ANA). However, given the low specificity of ANA for autoimmune disease, it is important to understand the limitations of a positive test result. A positive ANA is not diagnostic of an autoimmune disease and most individuals with a positive ANA may not even develop an autoimmune disease in the subsequent 3 years if they are asymptomatic at the time of testing. It can take many years, from the production of autoantibodies, for the relative disease to develop.

How a Nutritional Therapist approaches suspected autoimmunity

I often employ a process called Cyrex testing when trying to assess for autoimmune conditions. The first important determinant with a client suspected of autoimmunity is whether they are producing autoantibodies. The Cyrex Array #5 Multiple Autoimmune Reactivity Screen tests whether autoantibodies are present and is more specific than an ANA test. This is the first, and usually best step to recognise and prognose many autoimmune conditions.

The development of an autoimmune disease may be influenced by genetic vulnerability, immune system response to environmental exposures (toxic chemicals, anti-genic foods, infectious agents, etc) and intestinal permeability. Studies have shown that there is a higher chance of developing autoimmunity with intestinal inflammatory conditions. Since there are so many autoimmune diseases, and so many of these disorders show similar symptoms, it can be difficult for the healthcare professional to pinpoint the specific disorder. As a result, many patients are not diagnosed until the level of organ damage from the autoimmune mechanism has advanced enough to cause clinical complaints and poor health. The Cyrex Array #5 tests all relevant autoimmune antibodies to minimise the risk of missing a potential autoimmune condition. Once autoantibodies have been detected, the next step is to ascertain what triggered the immune system to produce antibodies in the first place. This is where the other Cyrex screen tests become important, testing for more specific factors, such as leaky gut (Array 2), wheat/gluten autoimmunity (Array 3), food immune reactivity (Array 10), chemical immune reactivity (Array 11) and pathogen associated reactivity (Array 12), to mention a few of the tests offered by Cyrex labs.

Interpreting the results

What, for example, is the purpose of the Array 12 test? When a pathogen invades a human host, it can cause flu-like symptoms, such as diarrhoea, fatigue and high temperature. Once the initial symptoms pass, people often assume that the pathogen has been eradicated. However, it is common for the pathogen to remain hidden in the cells, where it can become reactivated, all the while excreting harmful biotoxins. To make matters more complicated, many people acquire and carry a pathogen without ever experiencing the physical symptoms. Although the acute infection stage can be serious, sometimes it is the lingering, reactivating pathogen that can significantly alter a person's health. This explains why disease severity is not necessarily determined by the number of bacteria or pathogens in the body, but more with the magnitude of the immune response.

The presence of IGg antibodies in a test allows us to determine that an acute infection has been overcome at some point, but also the liklihood that the responsible pathogen still resides in the cells. By assessing IgG antibodies against pathogens, an experienced nutritional therapist can identify pathogens that are contributing to autoimmune processes. It is typically the silent pathogen that slowly damages the host tissues, causing autoimmune disorders such as the ones mentioned above.

The Chemical Immune Reactivity Screen (Array 11) provides a method of assessing antibodies of certain chemicals bound to human tissue thus contributing to an autoimmune cascade, whereas the Multiple Food Immune Reactivity Screen (Cyrex Array 10) helps to identify whether certain foods are triggering a person’s symptoms. Leaving food immune reactivities undetected can result in an autoimmune reaction, potentially developing into an autoimmune disease.

It is not possible to control our genetic makeup. However, it is possible to control lifestyle choices and to avoid many harmful environmental factors. To avoid the environmental triggers that affect a peron's immune system, it is important to identify those factors to which their immune system is reacting to.

Once the specific antibodies have been identified, we can begin the detective work to isolate the triggers. Here are a few examples:

Hashimoto’s has been linked to antibodies to gluten.
Ankylosing spondylitis has been linked to antibodies to Klebsiella
There is molecular mimicry between C.albicans and human tissue antigens such as thyroid, adrenal and reproductive organs.
Chronic and acute endocarditis, an infection caused by certain germs entering the bloodstream and settling in the heart lining, has also been linked to C.albicans.

How does an Autoimmune Protocol Diet Help?

The aim of the Autoimmune Protocol Diet is to introduce an eating style featuring food selections and vital nutrients that calm down inflammation, support normal functioning of the immune system and promote healing, especially in the case of a ‘leaky gut’.

Watch out for my next article explaining the Autoimmune Protocol Diet and which foods are the most important to remove and to include in order to help address an autoimmune cascade.