Autoimmunity
Recently I attended a talk by Dr Tom O’Bryan, another functional medicine practitioner and author of ‘The Autoimmune Fix’. The prevalence of autoimmune disease is rapidly increasing in the developed world, but I wondered how much is actually understood about the concept and so it inspired this blog post!
What is autoimmunity?
As we all know, our immune system attacks and eliminates ‘foreign’ objects within our body, which prevents them from harming us. In the process it produces inflammation. [Did you know that ca. 70% of our immune system is in our gut?] Autoimmunity is when our immune system mistakes our own normal cells for ‘foreign’ and starts attacking them; i.e. it dysfunctions. This can happen anywhere in the body: in the brain, blood, thyroid, pancreas, bone, skin, intestines… Just as the normal immune attack is carried out by antibodies, or immunoglobulins (Ig); similarly, autoantibodies are responsible for carrying out an autoimmune attack.
There are currently more than 80 autoimmune diseases and if you have one, you have an increased likelihood of getting another. Some of the most well-known ones are: rheumatoid arthritis, psoriasis, Coeliac disease, Hashimoto’s thyroiditis, type 1 diabetes, multiple sclerosis, inflammatory bowel disease, lupus and possibly autism, fibromyalgia and ME/CFS. However, there is the danger that scientifically unexplained conditions presenting with inflammation and/or a dysfunctional immune system, will be given the ‘autoimmune’ label, due to the lack of other answers; but may yet turn out to be just chronic infections.
Can we test for it?
Just as we can test for immune reactions by checking antibody levels, such as looking at IgE levels if we suspect the presence of allergy, so too can we measure autoantibody levels if we suspect the presence of an autoimmune disease. But it doesn’t just have to be once symptoms are present. Autoantibodies are elevated years before symptoms show; so if there is a history of autoimmune disease in your family, you can get tested and take action long before clinical development.
What causes it?
Basically, we don’t know yet…but a common consensus from current research is that it’s down to a combination of genetic susceptibility and environmental triggers. It runs in families, where for example one member might have type 1 diabetes, whilst another suffers from rheumatoid arthritis. But being genetically susceptible is only half the story: environmental triggers are then thought to ‘switch on’ the autoimmune response. These triggers take many forms, but are typically toxins; for example UV radiation, solvents in cleaning products, plastics, asbestos, smoking, vehicle exhaust and other air pollutants, pesticides and herbicides, food additives, or heavy metals such as mercury found in large fish like tuna and swordfish. As toxins accumulate in the body in fat tissue, being overweight is also linked.
Another big environmental trigger is my old favourite, stress. A 2018 study found that stress-related disorders were significantly associated with the risk of subsequent autoimmune disease. Other significant theories of causation include low Vitamin D, ‘leaky gut’ and the ‘hygiene hypothesis’ (click to read separate post explaining this).
And finally…
This is too complex a subject to do justice to here. There is so much that is not yet understood and we are far from a cure. However, many case studies and scientific trials demonstrate that a reduction or cessation in progression, and sometimes a reversal, of the disease can be achieved through toxin reduction, an anti-inflammatory, personalised diet, stress management and other lifestyle changes.