When we see a person that has an autoimmune disease of any name, the goal really is to discover the cause (the reason ‘why’) of the immune dysregulation and make every effort to correct that. If you don’t support and modulate your immune system you will NEVER improve your physiology and the disease will simply progress to complete destruction and then begin to attack other organs and systems.
It is important to understand that an autoimmune disease is a ‘state’ that the immune system is in. It is NOT a disease of an organ; and even though it is given a multitude of names depending on the tissue currently affected, it is a STATE of the immune system attacking the tissue it was meant to protect.
As in all autoimmune conditions, there is tissue destruction at the site of inflammation (immune attack); the reason the organ is dysfunctional is because the immune system is attacking the tissue. We first need to address the mechanism involved. Most autoimmune diseases may have some type of genotypic component, i.e., there may be a latent gene that the individual has carried in an unexpressed state for a period of years until some ‘event’ that triggered a immune response suddenly ‘turned on’ the gene. If this exists, and the autoimmune disease truly has genetic components, the practitioner’s job is to rightly manage the patient to diminish the immune response and calming the attack. Once a gene is expressed, it will always stay ‘turned on’. We will walk you through procedures to keep it ‘calmed down’ to stop the destruction mode. Other processes can ‘turn on’ an autoimmune attack like environmental compounds, some types of endocrine imbalance, toxic chemical exposures, abnormal stress responses, antigen responses, as well as the person’s preexisting genotype. So, the combination of all these things and some genetic susceptibility leads to an autoimmune disorder.
Usually the immune system is slowly attacking the tissue over several years. And then, the person eventually has a great enough destruction that brings about symptoms that lead them to seek some type of doctor. In the case of Hashimoto’s (autoimmune thyroid), they often get diagnosed with hypothyroidism because their TSH is high. And then, the TSH is managed by hormone replacement but no management for the immune response is initiated because it was never assessed. In the case of other autoimmune disorders, the patient is often misdiagnosed for years, even decades; and they are left laden with multitudes of drugs attempting to suppress their symptoms.
Autoimmune disease may better be defined as a ‘hyper-immune’
response against an Antigen
that cannot or will no die!
The autoimmune response is an inflammatory response, which produces chemicals called cytokines, which are part of the body’s natural defense system against outside invaders. The body’s immune system may be separated into a Th1 and a Th2 response. The Th1 response may be thought of as the police force, the body’s initial strike force against an invader or what is called an antigen. It’s really more like an undisciplined police force which has one mission – to KILL something! When an antigen (something it decides is an ‘enemy’) is present, the Th1 system fires and kills the virus; should the bug be of a nasty persuasion and strong enough to resist the Th1 response, the Th2 system kicks in, creates antibodies against the virus, tagging them so appropriate white blood cells can finish them off. A person with an autoimmune disease has this process stuck in the ‘on’ position, either hyper-Th1 or hyper-Th2, which prolonged, destroys the tissue where the antigen is recognized. Remember, your immune system just wants to kill something! It’s like the Tasmanian Devil and will sacrifice self-tissue for the survival of the organism (you).
Other things that are found with autoimmune processes are decreased hepatic (liver) and biliary (gallbladder and bile ducts) clearance. When we look at the detoxification pathways of the body we understand there exists Phase I and Phase II pathway. Both these phases are highly nutrient dependant and the Gastro-Intestinal disturbances, decreased gut motility, and decreased absorption rates in the autoimmune patient decreases the ability for them to do the very thing they NEED to get better – Detoxify!
Many have said, “You are what you eat.” More appropriately, “you are what you absorb.” Since one absorbs both nutrients and toxins through skin and through the lungs, diet is not the only way one might absorb vicious poisons. An even more appropriate statement might be, “You are what you do NOT detoxify!” Since the process of detoxification is taking place on a constant basis through these Phase I and Phase II pathways in the liver, it is what one CAN’T detoxify that becomes a part of us and makes us sick.
The purpose of these pathways may be simplified as the liver taking non-soluble solutions and chemicals and converting them to water soluble components that can then be expelled through the digestive tract, the urinary system, the skin via sweat, and the lungs. Problems come in with autoimmune disorders. Phase II conjugating enzymes can’t mature in autoimmune disorders and the detoxification potential over a period of time will be compromised. Compromise the detoxification pathways and the chance of the patient ridding them of the antigen that is causing this entire reaction goes down exponentially.
Hence, both the traditional medical and the traditional alternative models of care are doomed to failure. The most important battle to fight is to calm down their immune response and stop the destruction.
The “new model” we are proposing is simply to be more specific. If an autoimmune disease is a hyper-Th1 or hyper-Th2 attack against an antigen, doesn’t it make sense to do everything possible to find out what the antigen is, attempt to remove it and calm down the Th1 or Th2 dominance? I’m no rocket scientist, but this makes sense to me. It’s logical and possible to find the specific biochemical pattern perpetrating the response so we can determine how we treat them.
Angela’s Story
Angela, a seventeen year old senior in high school has suffered her share of teenaged teasing. She started gaining weight in sixth grade and no matter what she has done to stop the process, the pounds have been adding up. Her mother and she have been in Weight Watchers 3 times, she’s tried Jenny Craig, joined a gym and even joined the school’s cross-country team, all leaving her discouraged, exhausted, and shamed. She has learned to live with her problem and excels in mathematics. She hopes to be a teacher some day. Angela’s parents are divorced and her mother partly blames her failed marriage on her daughter’s weight problems. She has taken Angela to the medical doctor but the simple and incomplete blood tests performed were “normal” and more shame was piled onto the heap of a stressed physiology.
Midway through her senior year, Angela’s mother was referred to a functional medicine doctor who ran a more complete thyroid panel, including TSH, T4, T3, reverseT3, T3 uptake, and thyroid antibodies. Suspecting an Autoimmune thyroid from the symptoms alone, the doctor also ordered a fecal parasitological test and stool and gene testing for soy, gluten, egg, casein, and yeast. The testing was expensive but the doctor seemed confident and Angela and her mother were ecstatic just to find someone who would take a thorough assessment of her situation.
It’s cases like this where I tell my patients that we HOPE something in the tests come back positive. We need to know what is going on in order to treat the patient. Discovery, the preparation before the battle, is the secret to winning the battle. While I was in college and professional school, I ‘earned a living’ painting houses over the summer. I’d walk door-to-door in the older neighborhoods of the sleepy, rural, river town I grew up in and asked homeowners if they needed any painting done. I was never short of work; one hundred year old houses are in constant need of repair. I learned quickly that to do the job right did not mean I needed to just slap some paint on the chipping lapboard. There were at least a dozen coats of color over that four inch siding and preparation for a new coat would be the biggest battle. It was the preparation that was the hardest work. Scraping aged paint down to smooth wood bloodied my knuckles and cramped my fingers. It didn’t take more than one under-bid job to realize that the preparation was going to take much longer than anticipated and cost me more than time.
I learned much from my summers of painting that equates to treating autoimmune conditions. Preparation is more than half the battle – you have to spend the time and money to discover the cause of the disorder. Dig until you find the gold!
Luckily for Angela, she found a doctor who never gave up. Her thyroid antibody test came back negative, which would indicate to most doctors that she was NOT autoimmune. But he knew that if she was autoimmune, Th1 dominant, her hyper-firing Th1 system would be suppressing the Th2 antibody production – she still may be a Hashimoto’s patient, the digging didn’t stop. Specific cytokine testing was ordered while they waited for the results of the stool antigen and gene tests. Sure enough, Th1 cytokines were elevated and a CD4:CD8 ratio was imbalanced; Angela is suffering from an autoimmune disease! That week the stool testing results came back and at least one antigen was identified – Angela was autoimmune gluten! She carried two gluten genes and they were both expressed (turned-on).
Finally some answers. A detailed plan of elimination, detoxification, and Th1/Th2 immune regulation could be undergone. Angela’s doctor (and new best friend) made sure that further testing to determine the effect on other tissue was done so he could support every down-regulated system to give her the most comprehensive support possible and the greatest chance of success.
Angela and her mother had similar questions, concerns, and frustrations regarding their problem that we see from most patients: “Why didn’t my doctor test for this?” “Why wouldn’t anyone else believe me?” Believe me when I say that we’ve even had patients take their test results back to their primary care doctors to be told that they are crazy and the problem is all in their head. I’ve seen doctors even have the gall to write them a prescription for Prozac on the spot. What is wrong with these people!? It’s like a painter slapping another coat of paint over chipping wood – it will look good at a distance but just another example of shoddy work.
Vanessa’s Story
Thirteen years ago Vanessa was diagnosed with Systemic Lupus Erythematosus (SLE) or Lupus for short. Her problems began long before her diagnosis after the birth of her first child, Ashley, when she was just 18 years old. Lupus is defined as a chronic, inflammatory autoimmune disease. It frequently affects the skin, joints, kidneys, but, like autoimmune diseases do, it affects multiple organs. Symptoms vary from person to person, and may come and go. Since autoimmune diseases are either a hyper-firing Th1 or Th2 response, it is when that system is most active that the person experiences the most symptoms. This is why patient’s symptoms seem to wax and wane. The condition may affect one organ or body system at first and then progress to involve others. Almost all people with SLE have joint pain, arthritis and chronic fatigue. The joint pain is usually in the fluid filled joints like the fingers, knees, and hips. These joints have joint capsules which are sacs made up of essential fatty acids, prone to accept antigens and therefore common attacks of the immune response.
Vanessa’s youth was troubled; both her father and mother were alcoholics and Vanessa ran away from home at age 16. She bounced in and out of relationships, got pregnant at age 17 and was unwelcome in an attempt to return home. She had her baby while living at a shelter. Her increased stress, use of experimental drugs, emotional depression and the accompanying fluctuations that pregnancy brings the Th1/Th2 immune response may all have been contributors to the autoimmune ‘switch’ being turned on. Her symptoms have gradually gotten worse over time and even though God intervened in Vanessa’s life when she got saved at a youth rally when Ashley was just 5 months old and she now is happily married, the disease has progressed.
Once an autoimmune disease has turned on, there is no turning it off. Traditional medicine had given Vanessa little hope and just prescriptions to fill. She tried multiple medications with some relief but different side effects. It wasn’t until she found care with a functional medicine doctor who understood the autoimmune process that she began to take the upper hand against her disease. “It was the first time I ever understood what Lupus was,” she commented, “I thought I was just doomed with a genetic disease that I’d have to live with the rest of my life. The last 3 months since starting care has been remarkable. I feel like I have a new life.”
Vanessa’s story is commonplace. Autoimmune patients feel helpless and hopeless; they have basically been given a death sentence by modern medicine with no alternative but symptom suppressant drugs. There is hope, and if you just keep digging and asking better and more pointed questions, you can find the answers; but you just might have to ask different people.
