Today I want to briefly discuss how I now approach an individual with an autoimmune condition. Autoimmune means the body attacks itself. Unfortunately autoimmune conditions are on the rise as noted in this article from 2015 (The World Incidence and Prevalence of Autoimmune Disease is increasing, Lerner A et al, 2015. doi:10.12691/ijcd-3-4-8).
In conventional medicine, autoimmune diseases are usually seen by separate specialities eg rheumatologists for rheumatoid arthritis, endocrinologists for thyroid conditions and type 1 diabetes, gastroenterologists for coeliac disease and neurologists for multiple sclerosis.
Through a functional medicine lens, we look at the whole individual and see the body as interconnected. In considering why an autoimmune condition may start, we look at a four legged stool of: environmental triggers, genetic predisposition, weak, imbalanced immune system and intestinal permeability. Many times we will start with good gut health, often supporting the affected body part with prescribed autoimmune treatment while necessary, and addressing lifestyle and environmental triggers that are contributing to the immune system acting like an overwhelmed, cornered animal.
From Dr Terry Wahls, MD: “Chronic stress and resulting sympathetic dominance will then lead to chronically lowered levels of immune organ activity, higher levels of immune dysregulation and the inability of the immune system to react to threats appropriately.”
So what can be environmental triggers?
- Poor quality foods
And what can contribute to intestinal permeability?
- Medications including the oral contraceptive pill, NSAIDs including Nurofen (Ibuprofen)
- Imbalance in gut bugs – dysbiosis – overgrowth of bad gut bugs
- Candida overgrowth
- Vitamin D deficiency
- Glyphosate (active ingredient in RoundUp)
Why might the immune system be weak or overwhelmed?
- Multiple competing infections – Epstein Barr virus, Candida
- Toxicity – eg mercury
- Nutrient depletion – Vitamin A, D, K (all fat soluble vitamins), Zinc
- Stress – high cortisol
What might cause long term immune system activation
- Gluten and Intestinal permeability
- Food sensitivities
- Gastrointestinal dysbiosis (gut bug imbalance)
- Nutrient deficiency
- Overt toxicity
- Ongoing stress
How would we start to address an autoimmune condition in an individual?
- Put in what’s needed for this unique person
- Gut health strengthening – soothing and healing supplements, probiotics
- Nutritional support where there are known nutrient imbalances
- Eating hygiene
- Good hydration
- Regular bowel movements
- Take out what’s harmful for an individual
- Excessive exercise
- Medications contributing to intestinal permeability
- Stress – raised cortisol (stress hormone) increases intestinal permeability
- Foods that can cause intestinal permeability eg wheat – gluten is proven to cause increased intestinal permeability with undigested food able to access the whole body
- Create an environment for healing
- Sleep. Soundly. Regularly.
- Clean air, water and thoughts.
- Eat real foods that don’t confuse the immune system eg GMOs and chemical laden Foods
Have you heard of Salutogenesis?
It means the Origin of Health and was newly added to the Merriam and Webster Dictionary in 2019.
You may be more familiar with the term Pathogenesis which means the Origin of Disease.
Isn’t it interesting to see terminology we are more familiar with in our current disease (health) care model?!
At Braid Health we are passionate about maintenance of health, prevention of disease and where possible reversing a condition (eg type 2 diabetes, pre-diabetes, acid reflux disease to name a few).
In keeping with the Good Gut Health theme, let’s start at the top with what fundamental part of digestion starts in the mouth, and get a little more familiar with the workings of the stomach, including acid-reflux, Vitamin B12 and mineral absorption.
Sit down to eat: Sitting down and taking several deep breaths before starting a meal encourages the parasympathetic nervous system (Rest and Digest) to kick in, readying the digestive system to receive nourishment and digest it well.
Mouth: Chew chew chew!
You may have heard me say this in a workshop – our mouth is the only part of our digestive system that has teeth. It is vital for good digestion to chew solids well so they are a liquid before swallowing them. This also stimulates the mouth to release a digestive enzyme, salivary amylase, which starts to break down carbohydrates in the food.
If you feel stressed, don’t eat! The Sympathetic Nervous System (fight and flight) is activated and blood flow is diverted away from the digestive system.
Embracing good Eating Hygiene is a great start to improve digestion.
- Sit down to eat
- Take a few deep breaths before eating
- Chew chew chew
- Hydrate mainly between meals, not at mealtime
- Cherish the time spent with others/gratitude for the meal
- Check the bowl – undigested food can be very obvious!
What happens in the stomach?
Not a single one of the trillions of cells in our body can be nourished and function properly if the digestive system is malfunctioning.
In the stomach, proteins are broken down to their constituent parts, amino acids, and minerals are unbound from proteins. The minerals that depend on adequate stomach acid include zinc, iron and magnesium. If someone has inadequate stomach acid, this can show up on standard blood tests reflecting a lack of these minerals. Vitamin B12 also requires sufficient stomach acid for it’s binding factor to be released. B12 is essential for a wide wide range of functions in the body including detoxification, circulation, nerve health and energy.
Reasons why someone might have insufficient stomach acid include:
- Taking acid suppressing medications eg Nexium, Rennies, Mylanta
- Excessive alcohol intake
- Nicotine (smoking)
- Diabetes medications eg Metformin
The common condition acid reflux has many common causes including:
- Medications eg birth control pills, NSAIDs (Nurofen)
- Proton Pump Inhibitors eg Nexium (These cause low stomach acid and magnesium deficiency)
- Magnesium deficiency
- Helicobacter pylori (stomach bacteria) overgrowth
- Food sensitivities
Antacid medications eg Rennies are treating the symptom not the root cause. Long term use of antacids makes stomach acid reflux worse!
Wellness begins in the gut
(because we must nourish every cell). Chewing is key to start good digestion. Beyond the mouth there are no teeth!!
Gut feelings and the gut-brain axis are real
(enteric nervous system; vagus nerve connection; sleep & mood highly affected by gut status).
Disease begins in the gut
(major protective frontier: home to 2/3+ of immune system and often where imbalance and dysregulation begins).
Microbial genes outnumbers our genes by 300X
(our health depends on their health & balance, and they regulate our bodies in many ways).
We are what we eat, digest and absorb
(not just “what we eat”; many things can interfere with this process we take for granted e.g. stress, hypothyroid, stress, various medications).
Eating hygiene matters. A. Lot.
Stress has a major impact on gut function and health
(shuts down digestive secretions and impairs both motility and immune function).
Sit down to eat.
Take 5 deep breaths before you start your meal.
Chew mouthfuls many times until the solids make a liquid.
Drink liquids AWAY from meals.
Constipation and diarrhoea are symptoms of gut dysfunction, not illnesses in themselves
(take both seriously; if chronic can lead to major complications). How long is your transit time?
Acid reflux is almost never caused by excessive stomach acid overall
(rather it is acid in the wrong place, and at times triggered by insufficient acid)
Digestion is vital!
(e.g. stomach acid, bile production and concentration, pancreatic enzymes; often the gateway to the physical breakdown observed in the senior population, impacted by Type 2 Diabetes, various drugs)
“Wear-and-tear” on the gut lining can have a long-lasting impact
(e.g. NSAIDs, pesticides, antibiotics, steroids, mercury, intestinal permeability, coeliac disease, microbial overgrowths e.g. SIBO – Small Intestinal Bacterial Overgrowth)
Last week I gave a brand new presentation on Stress at the Central West Women’s Health Centre. There were lots of questions at the end and surprise at the connections between stress and our bodies.
Did you know gut bugs, both friendly and unfriendly, respond to changes in stress hormones? Our immune system is intimately connected with our gut microbes, and is also affected by stress hormones.
In acute stress (running away from a predator), our immune system is UP-regulated in anticipation of infection.
In chronic stress (lasting longer than 6 weeks), our immune system is DOWN-regulated meaning we are more vulnerable to infections.
The microbial balance in the gut changes which can affect neurotransmitter production.
Stress also affects our genes. In pregnant women, chronic stress can change the microbial community in the birth canal which can impact the bugs a baby is first in contact with.
Stress also affects DNA repair (telomerase activity) and women with highest levels of perceived stress compared with low stress have shorter telomeres. This has the average equivalent of at least one decade of additional ageing.
So what can you do about this?
Meditation may slow genetic ageing and enhance genetic repair by promoting telomere maintenance
Box breathing is easy to do and can be done anywhere!
Breathe in for a count of 4, hold for 4, breathe out for 4, hold for 4. Repeat for 4 to 6 rounds.
Lie down with your legs up the wall or calves resting on a chair, thighs vertical for 2-10 minutes for a gentle inversion.
And maybe consider this saying “Not my circus, not my monkeys” – the downfalls of trying to control what is not ours to control.
Maybe someone is trying to give you their problem to sort out/take on board.