An essential part of treating autoimmune disease involves eliminating foods that one is sensitive to and/or cutting out the foods that commonly initiate immunological reactions. I use IgG antibody testing and/or IgE antibody testing to determine foods that one is reacting to. This is a good method to test food allergies. (Scratch testing via your doctor is not accurate enough to detect for food sensitivities.) Please go to rmalab.com to read a detailed report on food allergy testing. Because the goal is balancing the immune system, foods that are causing an immunological reaction must be eliminated. In many cases, a simple blood spot test can detect these foods that you’re reactive to.

Celiac disease is an autoimmune disease that occurs in 1 in every 100-200 people. 97% of people that have it go undiagnosed. After eating substances that contain gluten, absorption in the small intestine occurs and these proteins interact with the antigen-presenting cells in the lamina propria causing an inflammatory reaction that targets the mucosa of the small intestine. Some people have minimal symptoms but if severe, this can cause involve multiple organ systems and cause an increased risk of some malignancies. Common signs and symptoms of cd include diarrhea, fatigue abdominal pain, weight loss, abdominal distention, canker sores, dermatitis herpetiformis, flatulence, irritability and mood swings.

Consider having your doctor test for it, if you are symptomatic and/or  have autoimmune hepatitis, primary biliary cirrhosis, unexplained elevations in transaminase levels, unexplained iron deficiency anemia, infertility, osteoporosis, and Vitamin D or calcium deficiency. If people do not want to pay for IgG testing (and this is not a test for cd anyways), they can ask for a celiac screen from their doctor. The TTG antibody test is the recommended single serologic test for cd screening but your medical doctor will be up on comprehensive testing that is recommended. Testing would certainly be warranted if you suspect you have a problem with gluten. 

Secondary symptoms that may be related to celiac disease include depression, migraines, epilepsy,  anxiety, unexplained recurrent miscarriages, and autoimmune thyroid disease. A review paper in a top medical journal listed 55 ‘diseases’ that can be caused by eating gluten and autoimmune diseases are at the top of the list therefore I recommend cutting out gluten if you have any type of AI disease. Gluten grains include wheat, barley, rye, spelt, kamut, triticale, and oats. Hidden sources can be found at www.celiac.ca.

Gliadin is a protein in gluten containing grains that once broken down can be absorbed through a leaky gut situation and can cause X-reactions in the body (for instance, it is believed a component of gliadin once broken down mimics the components of the myelin sheath thereby causing a  X-reaction with myelin in the cns leading to destruction of myelin.)This is a theory but certainly I have experienced this firsthand> the last two MS attacks I had I consumed gluten (pita bread the first time and a gluten wrap the second time) when I had been avoiding it for a long time. I thought I could try it because I was feeling so good. I have since been off it and am feeling good again.

Gluten sensitivity is believed to occur in 40% of people. In North American culture, some people eat wheat at every meal, toast for breakfast, sandwiches for lunch and pasta for dinner. The more you eat something the more likely your immune system will be sensitized to it. Wheat is convenient; it is readily available, inexpensive and tastes good. The problem is for many people, eating gluten causes inflammation preventing proper utilization and absorption of nutrients found in other foods. Gluten sensitivity has been linked to fatigue, weight gain and weight loss, irritable bowel syndrome, canker sores, GERD and ADHD. If you have early onset dementia or osteoporosis, think about the possibility of a problem with gluten.

Why is there a problem with gluten? Grains have been introduced much later than other food groups in terms of our evolution; it is believed that we don’t have the genes to properly digest grains especially gluten. People of European descent may be particularly susceptible to this intolerance. Wheat in North America has a higher gluten content than that found in Europe- lucky us-heavy note of sarcasm! Not everyone is bothered by gluten but some are and it is important that you are aware of that especially if you suffer from an AI disease.

Life can go on without gluten. There are plenty of gluten free grains so please get familiar with them. Corn, amaranth, buckwheat, millet, quinoa, rice, sorghum, and teff are great alternatives to gluten and cooking the grain versus consuming the flour is optimal for a whole foods diet. I will continue to talk about diet with regards to AI in my next post…

With autoimmune disease, there is often an underlying trauma (physical, emotional) as previously mentioned. There is also commonly a breach of the mucosal integrity resulting in dysbiosis. Dysbiosis is a condition with microbial imbalances on or within the body. Your own ‘terrain’ is so important to consider for microbial balance. Factors such as poor diet, exposure to toxins, medications, and chronic stress can affect your terrain predisposing it to dysbiosis. Dysbiosis might show up in the form of ‘bad’ bacteria, yeast, viruses, fungi or parasites. Correcting this dysbiosis is key in the treatment of AI disease.

In a healthy body, there is a balance between the Th1 (T cell) and Th2 (B cell) parts of our immune system. In virtually every AI disease there is either a Th1(T cell upregulation) or Th2 dominance (B cell up regulation). This theory is not always set in stone but it is a starting point. Th1 dominant conditions include psoriasis, rheumatoid arthritis, sjogren’s syndrome, lichen planus, celiac disease, crohn’s disease, H. pylori ulcer, multiple sclerosis, autism, hashimoto’s and grave’s disease. Th2 dominant conditions include atopic eczema, allergic dermatitis, scleroderma, allergies, asthma, ulcerative colitis, chronic sinusitus, S.L.E., multiple chemical sensitivity and many cancers. It is important to note whether the AI disease is Th1 or Th2 dominant because knowing that influences your treatment guidelines.

Many therapeutic supplements can promote either Th1 or Th2 thus self prescribing can in fact, work against you because you may unknowingly support the branch of the immune system that is already upregulated. For instance, factors that can induce Th1 cytokines and thus suppress Th2 include garlic, gingko biloba and chlorella. These things would not be ideal if you have a Th1 dominant condition but are better in many cases for Th2 dominant conditions. Since most people have no idea which branch of their immune system is dominant, they can actually make their condition worse by taking over the counter immune boosters. Factors that can stimulate Th2 and thus suppress Th1 dominant conditions include green tea, curcumin, and pycnogenol. These factors are more ideal for Th1 dominant conditions.

All these factors must be taken into account when you are addressing autoimmune diseases. The goal is to optimize balance within the immune system as best as possible. Treating dysbiosis and optimizing bacterial flora is important as is choosing supplements which support the particular branch of the immune system which is out of balance. The Th3 branch of the immune system which we have not discussed can help modulate both Th1 and Th2 and thus restore balance. There are supplements that support Th3 and are safest no matter what branch of your immune system is upregulated. I would love to support you in your journey to find balance. Feel free to book an appointment to discuss these things in person (232-1283). In the next post, I will talk about a diet that best supports anyone with an AI disease.

Canadians have one of the highest rates of autoimmune disease prevalence in the world. Normally the immune system does not attack the self. In autoimmune disease, the immune system loses its ability to distinguish self  vs. non-self molecules and attacks its own cells. The attack can be directed to a specific tissue (eg pancreas with diabetes type 1) or a large number of tissues (eg heart, lung, kidney, etc with systemic lupus erythematosus ).

There are many theories as to how and why autoimmune diseases originate. Some of them include genetic predisposition, microbial infections, heavy metals, vaccinations,and other toxins in the environment (drugs, hormones, toxins).Females are much more likely to develop an auto-immune illness due to higher estrogen levels which can alter immune response. Stress can play a role in the development of an autoimmune disease. Scientific studies have shown that stress-triggered neuroendocrine hormones lead to immune dysregulation which results in AI disease by altering and amplifying cytokine production (messenger molecules that direct other immune cells). Stress can definitely aggravate autoimmune disease so overall balance in the face of stress is incredibly important in the management of any AI disease.

The initial diagnosis of an autoimmune disease may be missed as patients often present with vague or non-specific symptoms like fatigue, joint pain, low grade fever or generalized achiness. It is important as a patient to be persistent with your medical doctor if you just don’t feel right. Often there is something going on so don’t ignore your symptoms even if they are vague. Trust your intuition. The first time I went to my doctor because I didn’t feel quite right, there was nothing found and I was made to feel like I was a hypochondriac. Bloodwork that can help pinpoint an autoimmune disease would include ANA, presence of Rheumatoid Factor, anti DNA antibodies, C-reactive protein amongst others.

One can speculate that somewhere in the history there was a trauma; this is often during childhood. The trauma can be emotional as well as physical specifically involving the gastrointestinal system. With a leaky gut situation, the self and non-self are in contact. All autoimmune disease patients have had a breach of the mucosa of their intestines at some time which has resulted in an immune system that does not react appropriately when an antigen is presented at the intestinal level. I will use myself as an example to illustrate this particular scenario. I had a serious clostridium difficile infection when I was 16 years old which required hospitalization and IV antibiotics for a week. I went on to develop an autoimmune disease in my early twenties (that I did not know about until I was in my 30’s). The point is I had an infection which compromised my gastrointestinal integrity and had I known about the necessity of supporting my gastrointestinal lining back then, I don’t believe I would have developed an AI disease.

There are many factors that can support the gut lining otherwise known as gastrointestinal integrity- the best one being probiotic bacteria.  Specific strains of probiotic bacteria can influence the balance of the immune system and help regulate it. Healing the gut is imperative if you have an autoimmune disease.Addressing dysbiosis is crucial and I will talk about this next in part 2. If you have an autoimmune disease and want to discuss complementary approaches to treatment of it, please book an appointment to discuss. I always recommend that my patients also have a medical doctor for co-management of serious disease.