What exactly is going on in AUTOIMMUNE DISEASE?
Autoimmune Disease is part of the rising tide of chronic illness affecting the developed world. I learned this all too well myself over 10 years ago during my diagnosis with Crohns Disease, so have been intensively studying the condition and associated autoimmune conditions and their underlying causes for the past few years of which there are too many to mention here.
It wasn’t my intention to specialize in gut health and autoimmunity. It has happened this way partly because of my own experience with Severe Fistulisng Crohns, and partly because there were so many unanswered Questions that arose after my initial diagnosis that no one had answers for.
I knew there had to be a reason for my health ending up where it did yet when I asked why all I was told was ‘there is no cause – there is no cure’. You see your doctor is telling you that you will be on medication for the rest of your life to suppress symptoms for which there is no medical explanation and when you ask what about diet? The response is ‘eat whatever you want’ Food has nothing to do with your condition. Now this is what really sparked my journey of discovery because I was simply unhappy with the vagueness and lack of scientific rationale for why I ended up where I did.
So what exactly is Autoimmunity?
In autoimmunity, we are led to believe the immune system gradually mistakenly attacks the body’s own tissue, creating inflammation, damaging and deforming tissues in the body, which leads to pain and loss of function. What we now know is that complex interactions between genes, presence of an infection or toxin or ongoing exposure to food antigens and issues with the ‘switching off’ of inflammation (again genetically programmed) but environmental factors can exacerbate this process can lead to the disease process that results from this improper immune response called an autoimmune disease. In IBD – Inflammatory Bowel Disease there are 2 possible explanations.
- It’s a natural response to an abnormal ‘invasion’ of a microbe
- Its an aberrant or abnormal response to normal commensal microbes in the Gastrointestinal tract.
I wont focus alone on IBD in this short explanation but as it makes up a large portions of the clients I see in clinic on a daily basis and I’m so closely acquainted with it I feel its fitting to spend a little time explaining a little more about the disorder.
Crohn’s disease (CD) is 1 of 2 disorders classified under Inflammatory Bowel Disease (IBD). Prevalence and incidence of IBD is steadily increasing in all areas of the world, and some claim that it has become a global disease. Rates of IBD are rising in South Korea, India, Lebanon, Iran, Africa, Thailand, and the French West Indies, in parallel with the westernization of these areas.
CROHN’S & THE ROLE OF DIET
CD can affect any part of the gastrointestinal system, but the most common affected area is the ileum. This was the main site of my disease which had spread rapidly both into the large and small bowel. The immune system can mistakenly recognizes commensal gut bacteria that aid in mucosal functions as invaders, and signals for an immune response that leads to chronic inflammation of the intestines. CD is an inflammatory condition, and the majority of symptoms stem from the patient’s continuously inflamed digestive tract. Over time, the overactive immune response and inflammation leads to a variety of gastrointestinal symptoms, such as abdominal pain, distention, bloating, fatigue, diarrhea or constipation, blood in the stool, weight loss, and perianal disease. Other complications include fistulas, strictures, abscesses, perforation, and malnutrition.
Diet may play a role in CD pathology. Fructose and lactose often remain un-absorbed in the lumen of the small intestine, hence reaching the colon and becoming fermented by bacteria. This produces a number of abdominal symptoms, such as bloating, cramping, pain, and distention. Carbohydrate malabsorption is a common feature of patients with gastrointestinal difficulties.Previous studies have shown that reducing consumption of fructose and lactose by omitting fermentable carbohydrates from the diet can reduce abdominal symptoms. Other studies have linked abdominal symptoms and pain to dairy and grains, especially wheat and rye, as well as to excess fiber intake.One study looked at pre-illness diets of people diagnosed with Crohn’s and found that compared to controls, people who were diagnosed with Crohn’s ate significantly more refined sugar and less dietary fiber and raw produce. Another retrospective study, examining how dietary habits play a role as risk factors for Crohn’s, found that participants who were diagnosed with CD had a significantly higher intake of refined carbohydrate and starch. Because of the potential role of dietary habits in the development, progression, and maintenance of CD symptoms and pathology there can be benefit in supporting CD clients with a dietary intervention that focuses on the possible underlying factors mentioned above and using testing where necessary to help personalise the approach, such as SIBO – Small Intestine Bacterial Overgrowth as an example.
My approach to Autoimmune Disease:
If you have an autoimmune disease that affects a specific tissue, such as your joints, your gut (like me) or your thyroid, your conventional advice will probably be focused on the area of your symptoms. However, the real issue lies in the immune system. If you have an autoimmune thyroid condition, this is often not driven primarily by malfunction at the thyroid but most commonly the answer lies within the immune system. Until the balance of the immune system has been addressed and restored, it will continue, no matter how much thyroid medication you take.
Addressing the underlying immune system disturbance in autoimmunity is rarely as simple as identifying a single ‘magic bullet’ trigger. In some cases, identifying the environmental trigger and removing it can make a tremendous difference, it just takes time, and commonly a deeper level of investigation often involving specific testing.
I feel very passionately about this area of health as so much can be done to take back control of your health and improve the situation once you have the right tools in your tool kit. I see my role as helping make these tools (from functional medicine tests, bio energetic screening technology, dietary strategies) to help un root some possible drivers of your ongoing symptoms and take some ‘pressure’ off your system and empower you to make the changes to help support improved balance.
The following areas are vitally important pillars of health as they all impact immune system function and balance, and are areas that we can work on or adjust in order to impact the way the immune system works.
- Immune system reactions to food proteins
- Gut health
- Infectious agents such as viral or bacterial infections
- Pro-inflammatory / Anti-inflammatory foods
Where we begin?
- Get the foundations of good health in order – Due to the role inflammation plays in the autoimmune cascade by first looking at food reactions (possibly doing a food elimination or more specific approach based on your specific condition) and focusing on the inclusion of non allergenic, phytonutrient (colourful) foods, looking at your sleep quality and quantity due the role sleep plays in helping the immune system self regulate and repair the body and of course and stress levels. Stress management by careful selection food and nutrients that can support a more appropriate stress response and looking at ways to help in the regulation of the perception of stress. This is such an individual process that we always start with the basic steps and assess how you respond over time.
- I may also discuss completion of functional medicine tests to look deeper into your gut health to better understand the ‘inner terrain’ of your gut ecosystem. The development of these incredible tests over the past decade helps Nutrition Practitioners like me to get a snapshot of any bacterial, yeast and parasitic overgrowths and/or the lack of presence of beneficial strains. The gut is the heart and soul of your immune system. I believe that anyone with an active autoimmune disease may have a component of intestinal permeability (leaky gut) and quite likely imbalances in the bacteria found there, both of which need to be corrected to restore immune health.
- We may need to look for different antibodies in the blood, or investigate hidden infections.
- And if we have addressed all of these things and you’re still experiencing symptoms, then it’s likely that we need to consider and investigate toxins.
This is a basic outline of my approach, but I consider every patient individually and will adjust the thinking and approach to fit each person and their history.
To read more about what a consultation entails please refer to my consultations tab.
Lastly, I do know from personal experience how overwhelming a diagnosis of autoimmune disease can be, and again I would like to really emphasize that there is so much that you can do to change your health in a positive way and its never too late to make positive changes.