AutoImmune Disease Causes

autoimmune disease

What Is Autoimmune Disease?

Autoimmune disease causes do exist, after all, there has to be a cause of a disease! This article will explore what auto immune disease are and the likely causes of this group of diseases.
Auto-immune conditions constitute a large group of diseases which basically have their origin in faulty immune function. Your immune system is a very complex network of cells and cell components that normally work to defend the body. Normally, the immune system is capable of differentiating “self” from “non-self” tissue. However, when a person has an autoimmune disease, the immune system mistakenly turns on itself, targeting cells, tissues and organs of your own body. Many different autoimmune diseases exist, each one affecting the body in different ways. For example, in rheumatoid arthritis the smaller joints of the hands are attacked by the immune system, in multiple sclerosis, the autoimmunity reaction is directed against the nervous system and the brain whereby the fatty surrounding of nerves are slowly impaired and destroyed (myelin sheath), in Crohn’s disease it is the large bowel which becomes inflamed and reactive to the immune system. Auto-immune conditions are often characterised by periods of remission (absence of symptoms) and “flare-ups” (when symptoms cause real problems).
Although many of the individual autoimmune diseases are quite rare, as a group of about 80 diseases they do afflict many New Zealanders, and particularly women (80%) more so than men.
Auto immune patients often consult natural medicine health care professionals particularly naturopaths, herbalists, acupuncturists and massage therapists and many also seek help from osteopaths or chiropractors for structural problems such as joint, neck and back pain. Many such patients typically have been diagnosed several years ago, have visited various doctors and specialists and may have been prescribed various drugs including anti-inflammatory and immune-suppressive drugs. I have found that in many cases the patient consulted their health care practitioner previously with non-specific symptoms ranging from ongoing lethargy, fatigue and a general low motivation, low-grade pain or inflammation, joint pains or muscle aches, anxiety and depression, numb hands or feet, heart palpitations, and many more. Because the symptoms are low-grade at this stage, such symptoms may well have become overlooked for several years and symptomatically treated with drugs. These signs and symptoms are potential indicators that the immune system may have turned upon itself, causing ”auto” immune conditions. The big problem with auto-immune disease is that there is no 100% clear cut cause, so drugs are commonly used to control symptoms, and all too often the patient is stuck with the same immune malfunction for years, along with a whole bunch of extra symptoms (side-effects) to contend with. And that is the time when they visit us; they still have the original complaints often masked by drugs, and now have developed side effects which they come in with.

Auto Immune Disease Diagnosis

There is no single test to diagnose auto-immunity. It is a complex disorder and it can be difficult to diagnose. To assist with a diagnosis, the practitioner should take a full medical history, including any family history of auto-immunity. They should discuss the nature and severity of current symptoms experienced and should conduct a thorough assessment. Blood tests are commonly performed and a urine sample will may also be analysed to check for kidney involvement. Do you have symptoms and don’t feel satisfied with the diagnosis? Then go and visit somebody else who takes more of an interest in your case.
 

blood testThe ANA Blood Test

The antinuclear antibody test (ANA) test detects the presence of auto-antibodies (your immune system fighting your own body). This test is positive for example in 95% of lupus (SLE) cases, and it is important blood test marker to determine many other autoimmune diseases. If the test is negative, many types of auto-immune diseases are unlikely.
I have found that once auto-immunity is diagnosed medically, the case is often “closed” in the sense that a drug-based regime including pain relievers, hormones, or immune-suppressant drugs are prescribed and usually recommended for life. Drugs “control” the symptoms so conveniently, why bother to go any further and try to establish a cause or help the patient to improve the quality of their life? It’s just that either the practitioner or the patient placed the condition in the “too hard basket” and settled for second best. Most patients can be helped and improved, some considerably. I never said cure, I said improve, and in my clinical experience most  cases of auto-immunity can be improved to some extent, some quite remarkably to the point where the person lives a normal life without medications. You’d be surprised at how good your body can respond to “alternative” treatments of auto-immunity, and you thought that you were condemned to a “life sentence” including drugs forever after visiting the specialist ?

Conventional Treatment

Conventional treatment involves monitoring the condition, preventing flares and treating the symptoms with drugs when they occur. Commonly, anti-inflammatory drugs form the mainstay of treatment, along with steroids for the flare-ups.

Anti-inflammatory medications

(such as aspirin) or non-steroidal anti-inflammatory drugs (NSAID’s) are usually recommended to help to reduce pain and inflammation. There are many natural options for inflammation, which I will discuss in more detail in Part 2 of this series.

Corticosteroid (steroid) medications

These are commonly used in the treatment of moderate to severe cases and work by “suppressing” inflammation. They can be given as tablets or as a cream, or injection. Examples are prednisone, hydrocortisone and dexamethasone. I am not a fan of these drugs as I have seen the grief they have caused many patients over the years. There is no doubt that they work, they can help with the pain very quickly – but you quickly gain dependence on them and some find it very hard to “come down”  in dosage. Adverse effects are generally related to dose and duration of treatment, and can increase steeply once the dosage exceeds 7.5 mg of prednisone daily. Adverse effects include osteoporosis,Increased susceptibility to infection, cataracts, weight gain, increased appetite, bruising, hirsutism (facial hair), flushing, acne and redistribution of body fat creating the typical moon face and “buffalo hump” on the back. It sounds like taking steroids long term could make you look like something right out of the Rocky Horror Picture Show.  Your adrenal glands may suffer from this immune suppression on steroids, and good advice is to support the adrenal glands with appropriate herbs and nutrients whilst you are taking steroids, more about this next month.

Immunosupressive medications

These help to “dampen down” the abnormal response of the immune system. Examples of these medications include azothiaprine, methotrexate and cyclophosphamide. These drugs are quite strong indeed, toxic to the body and should be only used for short durations. I’d recommend a liver and kidney cleanse after you have finished a course of these drugs to ensure an adequate clearance from the body.

Stress and toxins are two major contributors

Household_ToxinsConventional medicine does know that auto-immune flares are likely to be triggered by factors such as sunlight, increased stress and some medications.Where are all these immune problems coming from? Why does it seem that half of us getting sick with coughs and colds and allergies, and the other half it seems are coming down with an auto-immune problem or cancer? Apart from a whole bunch of other minor reasons, I would put an increasingly poor immunity down to two basic things: 1. Stress (we do too much, expect too much, and we stress far too much) and 2. Toxins in our everyday lives & pollution in our environment (currently in excess of 70,000 chemicals exist in our environment). As I mentioned, there are many other potential causes, but stress and toxins appear to be two of the largest triggers. The problem with these two big potential causes which arises is that the patient’s stress responses (generally adrenal gland depletion) are not recognised or treated in a medical setting, and toxins are rarely if ever considered to be an issue as a contributing factor in the development of any chronic disease, including conditions such as autoimmunity.

Depression2_2Stress

Dr. James Wilson, author of “Adrenal Fatigue, the 21st Century Stress Syndrome” mentions that most of the symptoms of auto-immune problems can be attributed to inflammatory processes involving sub-optimally functioning adrenal glands. The adrenal gland produces a powerful hormone called cortisol which quickly acts to remove and prevent redness and swelling and inflammation of nearly all tissues. This is the hormone which stops mosquito bites from flaring up, your bronchial tubes and eyes from swelling shut from allergens, and stops mild scratches from becoming what would like you’ve been attacked by Jack the Ripper. Cortisol also helps your liver to release stored glucose (stored energy) which helps you to maintain a smooth even flow of energy throughout the day. That is why many people with auto-immune problems are so tired.
The common identifying factor in most autoimmune diseases is a destructive processes called inflammation which will eventually cause the destruction of cells and tissues specific to the type of auto-immune disease he person has. So how can stress eventually cause an auto-immune condition? Stress causes eventual depletion of adrenal function, which results in the body’s inability to counter inflammation (poor cortisol levels – your body’s own powerful steroid).
In auto-immune reactions white blood cells attack parts of your body as if they were the enemy, and in most auto-immune reactions the cortisol levels your body produces are inadequate for the degree of reaction taking place in the particular tissues of your body. This is exactly one of the reasons why strong corticosteroids (Prednisolone, Prednisone, etc) are prescribed by your doctor with all diseases involving a very strong inflammatory process, particularly auto-immune diseases. And doctors (and patients too!) love it – the pain goes away like magic. But honestly, don’t you feel a bit ripped off? A bit like Inland Revenue accidentally overpaying you by several thousand dollars, it feels awesome at first, you pinch yourself because you think you are dreaming – but then there are the consequences and the payback.
It is certainly apparent that most people who suffer from auto-immunity issues have multiple hormone imbalances including adrenal and thyroid imbalances, yet the blood tests will most often say there is nothing wrong with the thyroid, and also the adrenal glands. In most cases, the adrenal glands need to be optimised first leading to repletion, good energy and eventual recovery. Adrenal recovery is a process akin to running a marathon. The process can long for some, are you an impatient person? Do you expect results right now ? With correct treatment, many patients will find some improvement in their adrenal health a matter of weeks, some in months, depending on their motivation to improve their health, the degree of pre-existing damage as well as the clinical skills of their health professional. The process can take anywhere from 2 months to 3 years even in the best of hands. I’d like you to bear in mind that auto-immunity is a long marathon, and your recovery should not be expected to be “a walk in the park”. You will not wake up in a week and be 100%, remember, it probably took your body a few years of slowly declining health to get here in the first place. Pace yourself and work on your overall health in small steps, gaining new ground gradually over time. Frustration and disappointments are very common and normal in clinical practice, so don’t beat yourself up please! Patience is the key, and during the recovery process, most, if not all, will go through a roller coaster type ride with advances and setbacks.

bad-sleepMany studies have shown a connection between stress and autoimmune disease

The best evidence so far for an effect of stress on autoimmune thyroid disease is the well known relationship between the onset of Graves’ disease (hyperthyroidism) and a major stress in a person’s life. Most of the recent case-control studies have supported stress as a factor that affects the onset and clinical course of Graves’ disease. Because the onset and course of autoimmunity is generally insidious, the effect of stress is often overlooked. Numerous human and animal studies have demonstrated that psychological and physiologic stressors induce various immune changes. Stress can affect the immune system either directly or indirectly through the nervous and hormone systems. This is why it is so important for your practitioner to take his or her time and look at your case “longitudinally”, i.e.; to go back to see what happened in your life, to see how stress could have affected your health over the years and what were the turning or defining points along the way which preceded the breakdown in your health. A ten minute visit to your local doctor will therefore generally mean that your diagnosis and treatment will be based rather on your presenting complaints, rather than considering any functional disturbances (adrenal fatigue) leading to the breakdown in your health. In my opinion, appropriate lifestyle changes are extremely important if you want to fully recover from adrenal stress, leading to adrenal recovery.

Rheumatoid arthritis: A case study

Don was a dentist from the UK who came to see us diagnosed with rheumatoid arthritis 6 yrs ago. He is 48yrs old, and when questioned about life before the diagnosis, he mentioned that his business partner ripped him off about 10yrs ago leaving him bankrupt, his wife left him for his best friend, his dog who was his faithful companion for 14 yrs had died around this time, and his father died not long after that. Each one of these events affected Don to some degree, increasing his stress and causing blow after blow to his adrenal glands which gradually became depleted. With this depletion over the years came the fatigue, less enjoyment in life, recurrent coughs and colds, sleeping disturbances, Don became more irritable and became increasingly more reliant on medications for the many small symptoms, for which his GP prescribed various drugs. But Don did not improve, he now relied on anti-inflammatory drugs to help him through the day and slowly started to develop pain in his arms and hands, his doctor now prescribed stronger drugs for the pain and inflammation. Still the pain was there, and in fact pain was now causing Don some problems in everyday life; even opening a bottle of pasta sauce became a real ordeal. After a few years on painkillers, the doctor ordered blood tests and then referred Don to a specialist who promptly prescribed yet stronger painkillers and Methotrexate™, a drug originally designed for cancer patients.
Now let’s go back to before the diagnosis, if the practitioner had worked out that Don was heading towards adrenal fatigue, measures could have been taken to rebuild his adrenal glands. This could have saved the patient pain and grief, not too mention wasted medical resources. Don needed to re-assess his lifestyle early on and make the appropriate changes. Do you have an auto-immune disease? Think carefully how stress may have affected you over the course of your life time. Did you suffer with events like Don? Did you have a divorce and property settlement, or perhaps not ever fully recovered from the death of a relation? Did you get “burned” with your business, perhaps redundancy or bankruptcy? Were you or are you a working mum or dad, involved day to day with the work grind, worry about paying the bills and have kids? Do you get the picture now? Draw a time line and see how this may correlate with the breakdown in your health and you may see a stress progression. Stay away from the health care professional who does not go into detail about past events which may have contributed to the breakdown of your health. Diagnosing and prescribing based purely on today’s symptoms is generally a waste of time in auto-immune conditions. The past needs to be assessed carefully, and an appropriate questionnaire will establish how you are today in comparison with the past. A well structured stress questionnaire can help uncover if your immune system is heading for a crash or not, and your natural health professional can help you here generally.

Toxins

Patients are not assessed generally for toxic residues in medical clinics, which is quite surprising, considering for example that studies in most western countries now indicate that the number of premature deaths for those aged over 30, due to vehicle-related air pollution, was greater than that due to the actual road toll itself. In 2002, Transport Minister Mark Gosche March stated that “Air pollution from vehicle emissions in New Zealand is a significant, but under-recognised cause of health effects ranging from illness to premature death”.

Three examples of toxin exposure autoimmune disease cases seen in my clinic:

House renovations

Ruth is in her late 50’s and was diagnosed seven years ago with lupus. About twelve years ago, Ruth completed extensive home renovations, including using a heat gun to remove the old (lead) paint and using extensive polyurethane refinishing on much of the native timber interior. Ruth is also a wine drinker, and enjoys two glasses of red most evenings. When we tested Ruth, we found very high levels of lead to be present along with several mineral deficiencies. She complained of headaches, stiffness and fatigue for almost a year before her diagnosis, and her blood tests revealed quite high anti-nuclear antibody levels.

Pest control gone wrong.

A 49yr old farmer came to the clinic after having consulted his doctor, and then referred to a neurologist to be told that he suffers from depression. Jim knew that something was not right, especially once his eyes started to really play up and become blurry and watery for no apparent reason. He came to the clinic complaining of dizzy spells and bad headaches which occurred along with blurry vision. About 15 years ago, Jim used a few “borer bombs” in his house as a pesticide treatment. He has never felt well since and now has just recently been diagnosed with a rare auto-immune condition known as myasthenia gravis.

Drug induced disease.

At least once a week we see somebody with a drug-induced illness. Last week we saw a 22yr old male who visited his doctor complaining of a sore shoulder last year. He was prescribed a powerful anti-inflammatory drug for a few months. After only 6 weeks of taking this drug, the young man developed a condition known as ulcerative colitis. Co-incidence?Chemicals (household chemicals, agricultural chemicals, pharmaceutical drugs, etc) have a wide range of effects on immune system function. Studies of thousands of immune compromised patients at the Environmental Health Center (Dallas, USA) have shown that persons with two or more pesticide compounds present in their serum have some form of immuno-toxicity, ranging from a decrease in ability to fight infections and tumours to allergies and autoimmunity. NZ Ministry of Health studies done in 2001 confirmed that each New Zealander has a minimum of 7 different chemicals in their blood, according to a study involving over 2000 people of all ages in four separate regions in NZ.
Chemicals produced by combustion (car fumes & exhaust emission) have depressing effects on the immune system. Organophosphate (OP) pesticides are still used widely throughout NZ, are toxic to the immune system. They have been found to cause decreased percentages of many different immune cells, and to induce high rates of autoimmunity. This elevation in autoimmunity is reflected by high levels of antibodies to many different tissues of the body, in addition to elevated anti-nuclear antibody level.(ANA). Similarly, immuno suppression has also been linked to heavy metals in the body. I have found lead, mercury, arsenic and cadmium to be the four main heavy metals which deposit in the body of auto-immune patients, causing problems over time. A Hair Analysis will reveal all.
The notion of chemically-induced autoimmune states is not new, since many chemicals are known to induce for example the onset of lupus. Some chemicals, including formaldehyde are thought to induce tissue-specific autoimmune reactions. Chemically-exposed individuals often present with elevated antibodies to certain body tissues. A study of 298 patients with exposure to industrial chemicals showed that they show either very low activity or very high activity of killer cells (NK), elevated antibodies generally as well as auto-antibodies against their own tissue.

Some immune experts classify auto-immunity as “Immuno-toxicity” and believe that it may be the major factor in the increasing rates of asthma, auto-immune disorders, allergies, cancers, and chronic viral infections world wide. For many individuals, this is basically from living in a more polluted world. Some individuals appear to be less able to clear the daily chemical exposure from the body than others, leading to a total load of toxins that exceeds the ability of the body to adapt. When the toxic load reaches this point, damage to certain organ systems can occur. Next article I will go into more detail about detoxification methods to improve auto-immunity.

Read Part 2 of the Autoimmune Disease Series: Autoimmune Treatment

 Ray Strand Book  What Your Doctor Doesn’t Know About Nutritional Medicine May Be Killing You
Dr. Ray Strand, a general practitioner for 25 years, turned his attention to nutrition in the mid-90s when traditional medical approaches failed to help his wife’s chronic fatigue. In his authorial debut, Strand preaches vitamins, minerals, fatty acids and other nutritional supplements with the zeal of a new convert.  Despite the alarmist title, those who suffer from or are at risk for heart disease, diabetes, cancer, auto-immune disorders and lung disease may want to weigh the evidence for themselves; Stand’s book is designed to provide an alternative perspective that aids in doing so, though it also includes various supplemental regimens he has devised.
 digestive wellness book Digestive Wellness: How to Strengthen the Immune System and Prevent Disease Through Healthy Digestion
Any book by Liz Lipski is worth buying and reading, I have several of her books and they are superb. You can see Liz talking on You Tube as well, she is highly regarded as one of the best in the industry. If you seek to be more proactive and involved in your health care decisions, this well-written, understandable book is an important place to begin the process.  Not only is faulty digestion directly responsible for a large number of gastrointestinal disorders, it can be indirectly responsible for a vast array of seemingly unrelated illnesses including arthritis, migraines, and auto-immune diseases. In “Digestive Wellness”, clinical nutritionist Elizabeth Lipski explains how your digestive system works and what can happen when it experiences complications. She covers all the common gastrointestinal disorders and offers her expert guidance on the newest advances in testing and diagnosis, nutrition, and natural therapies, including detoxification and self-care options for more than thirty common conditions.This book helps to identify and treat digestive complications such as: IBS (irritable bowel syndrome); GERD (gastroesophageal reflux disease); indigestion; gas bloating; constipation; celiac disease; hepatitis; inflammatory bowel diseases; and, more. “Digestive Wellness” offers practical information that will guide you toward better health. This new edition is extensively updated to include: new sections on hepatitis, cirrhosis, Barrett’s esophagus, and Behcet’s disease. It provides the latest information on food allergies, irritable bowel syndrome, probiotics, prebiotics, and the use of supplements and herbs. It offers advice on how healthy changes in diet and lifestyle can help you achieve a level of physical and emotional wellness you may have never experienced before

References:

(1)   Stress and Autoimmunity. Tetsuya Mizokami, Audrey Wu Li, Samer El-Kaissi, Jack R. Wall. December 1, 2004, 14(12): 1047-1055. doi:10.1089/thy.2004.14.1047.
(2)   Hicklin JA, McEwen LM, Morgan JE. The effect of diet in rheumatoid arthritis. Clin Allergy 1980;10:463.
(3)   Darlington LG, Ramsey NW, Mansfield JR. Placebo-controlled, blind study of dietary manipulation therapy in rheumatoid arthritis. Lancet 1986;1:236-238.
(4)   Broughton A, Thrasher JD. Chronic health effects and immunological alterations associated with exposure to pesticides. Comm Toxicol 1990;4:59-71.
(5)   Vojdani A, Ghoneum M, Brautbar N. Immune alteration associated with exposure to toxic chemicals. Toxicol Ind Health 1992;8:239-253.
(6)   Selgrade MK, Cooper GS, Germolec DR, Heindel JJ. Linking environmental agents to autoimmune disease. Environ Health Perspect 1999;107:S5811-S811.
(7)   Crinnion, WJ. Results of a decade of naturopathic treatment for environmental illnesses: a review of clinical records. J Naturopathic Med 1997;7:21-27.
 

Comments on this entry are closed.