By KHEYRNE DANU
Being stressed to the point of snapping doesn’t just happen mentally; it can also occur within your immune system. And while the complex nature of autoimmune diseases is baffling to many, the increase in autoimmunity has become a great cause for concern. Thankfully, current research is bringing us much-needed hope, and integrative medicine seems to be forging the way ahead in this important field of health.
What is autoimmune disease?
An autoimmune condition simply means that the immune system loses the ability to identify real targets and begins attacking healthy tissue. Normally, the immune system flares up in response to a pathogen such as a bacteria or virus; once these “bad guys” are cleared, it withdraws the troops and settles down. In autoimmune diseases, the pacifying immune cells, the regulatory T-cells (T-regs), are unable to do their job, leaving the warrior immune cells to continue the attack – except that, now, the attack is on the body’s own healthy tissue.
Today, over 80 different autoimmune conditions have been identified; rheumatoid arthritis, multiple sclerosis, Type-1 diabetes and HIV are some of the better-known diseases. In 1912, a Japanese surgeon, Dr Hakaru Hashimoto, identified autoimmune thyroiditis, but it wasn’t until the 1970s that the term “autoimmune disease” was coined by a group of European immunologists who discovered the underlying elements of lupus (the body’s immune system becomes hyperactive and attacks healthy tissue).
Grammy Award-winner Tony Braxton is one of over 1,5 million people suffering from lupus; 90% of those afflicted with this organ-degenerative condition are women. International tennis champion Venus Williams announced her withdrawal from the US Open in 2011 when she was diagnosed with Sjogren’s syndrome, and Kim Kardashian is currently dealing with psoriasis, an autoimmune condition of the skin.
The broad variety of autoimmune presentations makes it difficult to pinpoint basic symptoms. Consistent pain, fatigue and inflammation in the body, including organs and joints, are the most common symptoms; digestive problems are a large factor, including bloating, heartburn, cramps or irritable bowel syndrome; recurrent miscarriages are also seen.
The organ-specific conditions tend to be more rapid in progression, whereas others tend to “simmer” for quite a few years. Blood tests for immune cells TH1, TH2 and TH17 can be done to determine whether an autoimmune condition is present.
The Roots of The Disease
According to South African immunologist Professor Patrick Bouic, autoimmune conditions are activated by a combination of a fragile or weak gut, environmental factors and genetics. When Bouic isn’t teaching immunology at Stellenbosch University, you will find him in his lab at Synexa Life Sciences, passionately diving into the story of autoimmunity and infertility.
Even though genetics do play a role in autoimmune conditions, Bouic is clear that genes do not carry the life sentence we are led to believe. “Autoimmunity is a lack of regulation. There is a genetic component, but it’s epigenetic,” he notes. “You might carry the genes, but if your terrain and your environment are controlled by a healthy lifestyle, you don’t develop the disease.” According to Bouic, we can turn our genetic switches off.
It All Starts In The Gut
In integrative medicine, the gut is seen as the gateway to health. “After failed IVF treatments, 40% of my fertility patients with autoimmune disorders fall pregnant naturally the moment we address the gut,” says Bouic. The gut does more than just digest one’s food; it hosts a large part of one’s immune system, called the “gut microbiome”. This complex network of bacteria acts as an organ in and of itself. Bouic says: “The role of the microbiome is to train your immune system to react in the right way.” In autoimmunity, pathogenic bacteria take hold of the microbiome, distorting communication and impairing the immune system; this state is known as dysbiosis.
The result of dysbiosis is “leaky gut” syndrome. Tightly knit intestinal walls weaken, allowing food particles and other foreign molecules to seep into the bloodstream. Proteins in these rogue particles often look similar to proteins within the body (molecular mimicry), such as gluten in wheat or casein in dairy. An overactive immune system can easily attack similar proteins within our body, causing tissue damage.
Interestingly, it has been noted that babies born vaginally gather their “starter kit” of gut flora from the birth canal, unlike caesarean babies, who are born with sterile guts. In June 2011, an article on autoimmunity was published in the journal Clinics in Perinatology. It stated: “Concurrent with the trend of increasing caesarean births, there has been an epidemic of both autoimmune diseases such as Type-1 diabetes, Crohn’s disease and multiple sclerosis, and allergic diseases such as asthma, allergic rhinitis and atopic dermatitis.”
It is now known that caesarean-born babies need a probiotic swab at birth. Considering South Africa has the highest caesarean rate in the world, at 76%, it is surprising that probiotic swabs are not normal practice.
There are many possible environmental catalysts capable of weakening the integrity of the immune system. Some viruses such as HIV, TB, herpes and Epstein Barr are capable of activating a downward immune spiral, and pathogenic bacteria such as klebsiella are found in people with rheumatoid arthritis or ankylosing spondylitis.
Remarkably, it is often debated that antibiotics are not always the answer, but rather part of the cause; while a healthy gut is equipped to fight off pathogens, antibiotics may damage one’s healthy microbiome.
In the last century, chemicals and pharmaceutical medication have become a normal part of our lives, but how often do we question their safety? According to Bouic, the biggest enemies of the gut are antibiotics, chronic medication and over-thecounter drugs. “We have created a generation where a mother will think that a doctor is terrible for not giving her child antibiotics,” explains Bouic. “That was a very clever doctor; unnecessary antibiotics just suppress the immune system. We are abusing chronic medication and it’s destroying our guts,” he adds.
A study on autoimmune disease published in Archives of Toxicology in July 1989 said: “A variety of drugs and environmental chemicals have the potential to unintentionally impair components of the immune system.”
In addition, petrochemicals, pesticides and heavy metals have been found to mutate the structure of our cells, causing the immune system to attack these “foreign” invaders.
Stress An Extra Component
“Long-term overexposure to stress hormones accounts for 75% to 90% of all primary-care visits in the US,” explains Dr Bridget Briggs, California-based hormone specialist. The adrenal glands produce anti-inflammatory hormones for our immune system. Unfortunately, stress misinforms the body, making it believe that there is a constant stream of potential dangers on the way; this overworks the adrenals and diminishes hormone production.
“If stress hormones don’t normalise, it keeps the immune in a chronic inflamatory state,” says Briggs. “It only takes five nights of diminished sleep for the hormonal system to slide off kilter, and a solid eight hours of sleep are essential to reset the immune-adrenal balance.”
Why Are Women Suffering The Most?
A shocking 75% of those diagnosed with autoimmune conditions are women. Notes Briggs: “Oestrogen is immune-aggravating for 70% of women with autoimmunity.”
Research on sex hormones and autoimmunity published in Lupus by Sage Journals in September 2004 showed that sex hormones play an important role as modulators of the autoimmune disease onset and perpetuation. Oestrogen is pro-inflammatory, and the antagonist progesterone is a natural immune-suppressor. The liver processes all hormones, breaking them down (methylation) and kicking them out.
“Methylation is essential for autoimmune,” says Briggs. If oestrogen ends up recirculating in the blood, you have ‘oestrogen dominance’, which lays the ground for autoimmunity and weight gain. Oestrogen-increasing factors include environmental toxins, junk food and high animal fat intake. Supplementing with a cruciferous vegetable extract called I3C (indol-3 carbinol), for men and women, can help the liver to clear oestrogens.
Around 90% of people diagnosed with underactive thyroid conditions are actually suffering from the autoimmune condition Hashimoto’s thyroiditis; there are 20 times more women with Hashimoto’s than men. In Hashimoto’s, the immune cells mistakenly attack healthy thyroid tissue, and gluten has been found to play a large role in this condition. Regrettably, Hashimoto’s is rarely tested for and the wrong medication can easily be prescribed. Unlike underactive thyroid, iodine can actually exacerbate Hashimoto’s thyroiditis.
Changing The Autoimmue Story
Time for change
Autoimmune diseases can be harsh, yet a good treatment and lifestyle plan can turn this story around. Bouic feels that allopathic autoimmune medications are useful in severe cases.
Cape Town-based rheumatologist Dr Rehana Bhorat co-runs the Arthritis Clinical Research Unit in Pinelands with Dr Cathy Spargo. Together they have been running trials on autoimmune medications for the last 10 years. Bhorat says: “Results have been very good, with most patients responding very well and being able to return to normal lives.” They prescribe disease-modifying anti-rheumatic drugs (DMARDs) as well as biologic therapies for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and lupus. Bhorat emphasizes to her patients the importance of no smoking and following a healthy diet low in processed foods.
The intestines are the biggest immune organ in the body. It makes sense that diet makes a difference. Healing the gut microbiome means adding in good bacteria: the probiotics. Bouic emphasises: “Get as wide a variety as possible.” The gut needs as many different probiotic strains as possible, from supplements and fermented foods.
Certain lectins and gluten found in grains, pulses and nightshade plants (tomatoes, potatoes, peppers and aubergines) have been found to aggravate leaky gut. An alkaline environment prevents inflammation and supports the function of our immune cells. Good alkalising nutrient-dense foods include avocados, coconut, olives, cold-pressed plant oils, vegetables and leafy greens; nuts, seeds and fish are also packed with essential fatty acids and proteins. Bouic, Briggs and Bhorat all prescribe supplementation of vitamin D3 and omega-3 fish oil. Resveratrol (found in berries) and curcumin (found in turmeric) are two of Bouic’s favourite supplements, known to decrease inflammation and support the reversal of autoimmune disorders.
“We have to resolve the root cause, otherwise patients will not be able to heal from this condition,” explains Bouic. “Integrative medicine practitioners usually start with the gut, train the immune cells not to react to themselves, and balance the endocrine hormones, especially the adrenals.”
Being one of the fastest-growing conditions today, it is surprising how many people are left to suffer either from lack of diagnosis or from limited treatment.
The message that comes with autoimmune disease is ringing loud and clear:
“Question everything,” Bouic insists. Science is moving fast and the latest research is rolling out fantastic results.
Curing The Incurable
Dr Sly Nedic found her whole world upside down after being diagnosed with a combination of debilitating autoimmune diseases. Being a pediatric doctor and a single mom, she ended up collapsing with adrenal fatigue and neurological problems. Nedic consulted with specialists who diagnosed her with fibromyalgia, lupus, hashimoto thyroiditis and multiple sclerosis!
A high dose of corticosteroids (cortisone) and immunosuppressants (similar to chemotherapy) were proposed. “I was told the progression of systemic Lupus had unpredictable outcomes, especially if it moved to my kidneys. The message was clear: I have an incurable autoimmune problem.” This finality was unacceptable to Nedic. “I was not prepared to give up, I wanted to be able to look after my four-year-old daughter. I needed to focus on all aspects of my life that contributed to the development of autoimmunity, rather than taking one miracle drug.”
Testing out the limited natural medicines available 15 years ago, she learnt through her own suffering and improvements. Through phytonutrients, a low GL organic diet, yoga and meditation, Nedic began to establish equilibrium and restore her body.
After six months the fatigue began to lift and she flew to the US in search of a cure. Her cousin, a well-known nutritionist, took her through a detoxification process.
“He soaked off my artificial (acrylic) nails, threw all my make-up in the dustbin and bought me a new set of organic make-up.” He gave her supplements of glutathione, NFk B neutralization and adaptogen herbs. Nedic has realised the impact high stress and toxicity have on her body. “At the end of every day I ask myself: have I been kind enough to my Body Mind and Soul?”
After rediscovering her vitality, she opened a holistic medical practice, 8th SENSE in Sandton, which specialises in anti-aging, genetic testing and integrative medicine.
Dr. Sly Nedic