Autoimmune Disorders

Celiac Disease. Hashimoto's Thyroiditis. Rheumatoid Arthritis. Multiple Sclerosis. Type I Diabetes. SLE (lupus). These are all examples of autoimmune disorders that have all drastically increased in incidence over the past several years, particularly in industrialized countries. Autoimmune disorders occur when a portion of our immune system develops a reaction to our own tissue. It is estimated that 1 in 12 women in North America will be diagnosed with an autoimmune disorder in her lifetime (middle aged women are, in fact, the fastest growing population of those afflicted with an autoimmune disorder). Less conservative estimates state that 1 in 5 people in North America have an autoimmune related disorder. As the incidence of these diseases have increased so dramatically, so has public interest, as well as modern research. Until recently, there was no umbrella category for autoimmune disorders as there is for cancer; people were treated by their family doctor or the appropriate specialist, depending on the specific disorder. As a result of this, diagnosis is often delayed and people are left struggling for months and even years before having the diagnosis, and treatment, that they need.

The current typical approach to autoimmune disorders focuses primarily on managing symptoms with a variety of anti-inflammatory medications and often the use of chemotherapeutic drugs, as well as powerful immunosuppressive drugs with such potential side effects as leukemia and lymphoma. Reducing inflammation is, of course, key to symptomatic relief but these drugs do not address the cause of these conditions and some of the current research indicates that some may actually worsen the pathology. Early diagnosis seems to be very important when it comes to effectively managing an autoimmune disorder, but as I mentioned, it's often delayed because of vague clusters of symptoms, or a lack of awareness of autoimmune pathology and testing. Additionally, as many women are of childbearing age when they begin to show symptoms of an autoimmune disorder, symptoms may come and go in a manner that makes them difficult to describe. Pregnancy can also mask autoimmune disorders, and cause a remission in those who have previously been diagnosed. Autoantibodies are the most predictive screening tool available for determining whether or not an autoimmune process is present, and specifically, which disorder is responsible. Delayed diagnosis leads to increased damage to organs involved, and potential long term effects.

Beyond early detection, optimizing function of the gastrointestinal (GI) mucosal immune system, and eliminating pathological agents in the GI tract, through the use of antimicrobial agents if necessary, is becoming evident as an important step in treatment of all of these disorders. Several links have been supported between specific bacterial overgrowths and autoimmune disorders, which suggests that stool analysis may be an appropriate tool for screening for this pathology. Additionally, food sensitivity testing may be a beneficial in determining which foods may be creating inflammation in the GI mucosa, and thus causing a flareup of the autoimmune disorder. Within the GI tract, there is another concept that Naturopathic Doctors have been discussing for decades which is finally getting some much needed support from research, and that is intestinal permeability ("Leaky Gut Syndrome"). A link has been demonstrated between intestinal permeability and the pathogenesis of all autoimmune disorders, beyond just celiac disease.

Treatment for autoimmune disorders are so varied, depending on the specific type of disorder and the type of care provider someone has. Certainly, if diagnosis is delayed and inflammation and thus symptoms are severe, a cycle of anti-inflammatory agents may be necessary. Clearly someone with an autoimmune disorder needs access to specialists, and hopefully there will be more and more autoimmune disorder specialists as research further uncovers the common cause of these disorders, but in addition, it's imperative to see someone who will offer supportive (and preventive) treatments focused on promoting growth of healthy flora, eliminating pathogenic flora, reducing inflammation, repairing intestinal permeability and modulating the immune system. Initial interventions may include food sensitivity testing, and then elimination of trigger foods, supportive nutrients and herbs, possibly antimicrobial and antiparasitic therapy, and likely vitamin D therapy. It has become clear that there is a link between vitamin D deficiency and prevalence of autoimmune disorders, but vitamin D has also emerged as a powerful immune modulator in addition to being protective of the intestinal mucosa, thus reducing permeability (and leaky gut).

Autoimmune disorders certainly vary in severity and wax and wane over the course of someone's life, but managing an autoimmune disorder is a lifelong journey that may require significant diet and lifestyle changes. Be aware of autoimmune disorders. If you think you may be suffering from one, ask your doctor about it and discuss whether or not it may be appropriate to screen for it using the predictive autoantibodies. If you have already been diagnosed with an autoimmune disorder, seek out a provider (or better yet, a complimentary team of providers) who will treat all of the different aspects of the disease.

Be well, and have a happy and healthy holiday season!

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