Autoimmune Conditions - What are they and what can we do about it?
Historically, autoimmune conditions were considered rare, but it has now been shown that about 5-8% of the population is affected, the majority of which are women.
What is autoimmunity?
Put simply, it's when the immune system becomes overactive and attacks its own tissues instead of fighting off pathogens.
There are upwards of 100 distinct autoimmune conditions (many people use the term "disease" instead, but I prefer not to), with symptoms widely varying depending on the tissues affected. The most common autoimmune conditions are Type 1 Diabetes and autoimmune thyroid conditions, but others commonly identified include Lupus (SLE), Rheumatoid arthritis, Celiac disease, Crohns and Ulcerative Colitis, Psoriasis, and Addison's disease (the real "adrenal fatigue").
In practice I commonly see antibodies to thyroid and many people are surprised to know that anywhere from 80-90% of all thyroid issues are related to an autoimmune problem. Unfortunately, it is not common practice to have antibody testing run in the conventional model of healthcare.
The auto-antibodies that are produced in autoimmune conditions can sometimes appear up to 20 YEARS before symptoms ever present themselves. That's why testing for them can be so valuable to help implement interventions that may stave it off indefinitely.
What causes it?
It's a complex multi-factorial condition where genetic, environmental, hormonal, and immunological factors are all considered important in their development.
Ultimately, it's environment and lifestyle that play the most important role --- we know this because with identical twins, if one has an autoimmune condition the other will only have it anywhere from 12% to 67% of the time. Keep in mind too, that these comparison studies looking at twins are also comparing people who have not done anything to try to minimize the risk of getting it. If they did, those percentages would be much less -- I'd love to see research on what it would be!
We like to use the saying - "Genes load the gun, and environment pulls the trigger." We know through the field of epigenetics that we are not locked into our genetic code ---- that signals that come in through food, air, water, and all the things we get exposed to can turn certain genes on or off. I like to think of the genetic code like a switch board, where the more favourable, health-promoting behaviours will flip the switch of "good" genes to "on", and the "bad" genes to "off".
Can it be treated? Yes, but prevention is always easier! Treatment is determined by who is on your healthcare team is. Having a diverse spread of providers produces the best results (this applies to any health condition), and this also depends on the patient. For example, if stress is a big issue, then perhaps a meditation coach, therapist (or hypnotherapist!) or massage therapist may be an important support addition. For someone else who really struggles with meal planning, a holistic nutritionist may be of huge benefit.
Conventional medicine treatments are limited to medications (or surgery), but can absolutely be necessary depending on the circumstance. If someone has Addison's disease for example, they require lifelong cortisol since the adrenal gland cannot produce enough of it. Additionally, certain autoimmune conditions can become exceedingly inflamed and require the use of strong anti-inflammatories and/or immunosuppressants or other disease-modifying drugs. The medications do not treat the real underlying cause, but they do control the symptoms.
Naturopathic/Functional medicine treatments look at all the potential underlying triggers and work to correct or optimize for them. The question we always want to ask with any health condition is WHY has it occurred. Being labelled with an autoimmune condition tells us nothing about why it happened for that individual.
Here are some of the factors considered:
Infections (viruses, parasites, bacteria, fungal, protozoal) - it is well known that various pathogens can trigger the immune system to attack certain tissues that "look like" the pathogen (ie: Prevotella copri bacterium in the gut has been found in 75% of new-onset rheumatoid arthritis patients)
Toxin and chemical exposures - including the workplace, home, renovations, mold and mycotoxins, food, water, air, mercury fillings, heavy metals, glyphosate (toxic herbicide on many foods), etc
Diet and Food sensitivities - this invariably plays a role in everyone
Gut health - many believe that "leaky gut" is a required factor in order for autoimmune conditions to develop, but regardless, all health begins in the gut and is central to recovery/improvement
Nutrient status - if important nutrients are missing, it's impossible to build health
Hormone profile - depending on the individual, can be full thyroid panels, salivary/urinary cortisol, full sex hormone profile
Metabolic profile - how well the body is eliminating and using urinary markers to help highlight areas of dysfunction
Genetics - different gene profiles need different support in different ways
Stress and unresolved emotional issues - studies have found up to 80% of patients report uncommon emotional stress before onset, additionally, unresolved emotions are held in the body creating an ongoing stress state (even if only subconscious)
Environment - this relates to stress, but looking at living arrangements, relationships with co-workers/family/friends, actual housing -- anything that puts unhealthy stress on the mind and/or body
Sleep - non-restorative sleep can be linked to any health condition
There's lots to consider, which also means there's lots of areas to intervene on!
Autoimmune conditions are very complex and they cannot be "cured" because even if the condition is corrected for, the predisposition for it will always exist. But that certainly doesn't stop us from reeling it in!
Pro tip: Anyone with an autoimmune condition should be on a gluten-free diet. If you want to be ambitious and do whatever you can to dial down the condition, implementing the Autoimmune Paleo Diet ("AIP Diet") is advised. It's not for the faint of heart but it can be transformative!