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!
It is estimated that 25% of the world’s adult population has Metabolic Syndrome (Met Sy) (1). This is a very common syndrome and I want to empower you to take a preventative approach to minimise your risks of developing Met Sy.
Essentially it represents 5 variables which increase “cardiometabolic risk”.
- Obesity (BMI >30)
- Raised fasting glucose (blood sugar)
- High triglycerides
- Low high density lipoprotein (HDL)
- High blood pressure
Fundamentally central obesity (apple shape) is associated with insulin resistance. This means cells are not responding to insulin as they usually do, moving glucose from the blood stream into cells. When there is excess insulin secreted from the pancreas:
- Excess glucose (sugar) is stored as fat and energy levels drop
- Testosterone and cholesterol levels increase
- Fat burning is reduced and diabetes risk increases
In obesity, the extra fat causes inflammation, can result in high blood pressure, clotting and adverse blood fat profiles. It acts like a metabolic organ of it’s own, producing inflammatory factors that affect whole body health.
So what action steps can you take to decrease your risks of metabolic syndrome?
- Exercise more
- Lose weight – between 5-10% weight loss can increase HDL and reduce blood pressure and blood sugar levels
- Avoid trans fats – these are not recognised by the body – commonly found in baked goods eg pastries and deep fried foods.
- Cut back on refined carbohydrates or processed foods
- Stop smoking
- Alcohol in moderation – no more than 1 drink per day for women and 2 drinks per day for men is recommended.
Metabolic Syndrome and Mental illness
The incidence of obesity and Met Sy in people with mental illness compared with the general population is:
- More than two times higher in women
- Almost twice as high in men
This reflects the brain effects of vascular and hormonal changes with metabolic syndrome (2)
At Braid Health, we take a preventative and proactive approach to health. Metabolic Syndrome is a condition we look out for in our clients and routinely do comprehensive blood panels and detailed functional pathology testing. We aim to empower our clients through education, discussion and implications of results of testing, and use science-based approaches to optimise their health.
Who to test and when?
- Asymptomatic men >45y
- Asymptomatic women >55y
- In Maori, Pacific and Indo-Asian people start 10 years ie
- asymptomatic men >35y
- asymptomatic women >45y
- If there are multiple risk factors begin 10 years earlier.
- Long term steroid or antipsychotic treatment
- BMI>30 or BMI >27 for Indo-Asian people
- Family history of early onset type 2 diabetes
- Personal history of gestational diabetes mellitus
- Ischaemic heart disease (heart attack or angina) (3)
1. Anagnostis P et al 2009
2. Allison et al 2009