Autoimmune diseases - the environmental approach to treating
(By Dr Sarah Myhill and Craig Robinson)
Autoimmunity occurs when the immune system has made a mistake. The immune system has a difficult job to do, because it has to distinguish between molecules which are dangerous to the body and molecules which are safe. Sometimes it gets its wires crossed and starts making antibodies against molecules which are "safe". For some people this results in allergies, which is a useless inflammation against "safe" foreign molecules. For others this results in autoimmunity which is a useless inflammation against the body's own molecules. These are acquired problems - we know that because they become much more common with age.
It is likely we are seeing more autoimmunity because of Western lifestyles, diets and pollution. Chemicals, especially heavy metals, get stuck onto cells and change their "appearance" to the immune system. In this respect they act as haptens - see Wikipedia article on Haptens - to switch on inappropriate reactions.
How auto-immunity may be switched on
Viruses and chemicals: autoimmunity may be switched on by viruses or exposure to chemicals, in particular pesticides and heavy metals. The result is a useless inflammation which causes symptoms wherever the inflammation arises. This inflammation will be made much worse by poor antioxidant status. See Antioxidants. Having poor antioxidant status is a disease amplifying process.
Molecular mimicry - the idea here is that the body makes antibodies against food or bacteria in the gut which then, through sheer chance, cross react with the body's own molecules. So for example ankylosing spondylitis is thought to be caused by molecular mimicry against klebsiella bacteria in the gut and those antibodies then cross react with spinal ligaments - one has to be a particular tissue type for this to happen namely HLA B27 positive. There is some evidence to suggest that rheumatoid arthritis may be partly due to molecular mimicry with bacteria proteus mirabilis and tissue types HLA DR1 and 4. Clinically one sometimes sees arthritis following viral infections (pallindromic rheumatism) and this too may be molecular mimicry. Please see "Autoimmunity in Rheumatic Diseases Is Induced by Microbial Infections via Crossreactivity or Molecular Mimicry" here - Article by Taha Rashid and Alan Ebringer published in Autoimmune Diseases Volume 2012 (2012), Article ID 539282
Have a look at The Gluten Thyroid Connection where it is suggested that gluten sensitivty results in autoimmune thyroid disease.
The following combinations have been shown:
- Epstein Barr Virus with genotype HLA DR-15 puts one at risk of multiple sclerosis
- EBV and HLA DR3 puts one at risk of autoimmune thyroiditis
- EBV and HLA DR4 puts one at risk of autoimmune cardiomyopathy
- EBV and HLA DR7 - puts one at risk of primary biliary cirrhosis
- EBV and HLA DR7 plus smoking puts one at risk of rheumatoid arthritis and multiple sclerosis
- EBV has been associated with 33 autoimmune diseases, including systemic lupus erythematosis and Sjogren's syndrome
- CMV (cytomegalovirus) has also been associated with autoimmune reactions
- Helicobacter pylori infection is associated with idiopathic thrombocytopeonic purpura (ITP), systemic sclerosis, Crohn's disease and Guillain–Barré syndrome and other vasculitic conditions
- Eradication of H pylori has resulted in resolution of ITP and also anti-phospholipid syndrome
- BUT H. pylori infection is protective for childhood asthma
- Wegener's granulomatosis may be switched on by staphlococci in the nose
- Antibodies against yeast (saccharomyces cerevisiae) ie ASCA are predictive of developing Crohn's disease
- ASCA is associated with arteriosclerosis- this too may be an autoimmune disease
- Parasitic worms are protective against many forms of autoimmunity. They have a proven track record in Inflammatory Bowel Disease. For further information see Candidate diseases for helminthic therapy
- Malaria is protective against SLE
- Vaccination may well increase risk of autoimmunity
- Swine flu vaccination has been followed by epidemics of Guillain–Barré syndrome and narcolepsy.
Many chemicals are immune adjuvants and "turn on" the immune system. One example is that hay fever rates in Japan are much higher in the cities than the countryside although pollen counts are much higher in the countryside! It is diesel particulates that make the difference - they act as adjuvants to switch on an immune response against grass pollen.
Vaccinations all contain immune adjuvants (without which they do not work!) such as mercury (thiomersal,) aluminium, squalene (a toxic lipid) or whatever. These have the potential to switch on the immune system to trigger allergies and/or autoimmunity. My personal view is that the evidence for the benefit of the annual flu vaccination is probably out-weighted by potential damage and so I no longer recommend this for my patients. Instead I direct them to Viral infections - good nutrition is highly protective against viral infection.
Pesticides are very good at switching on allergy and probably autoimmunity as well. They too are immune adjuvants.
Heavy metals such as nickel and mercury also seem to activate the immune system.
Silicone. Silicones and other synthetic materials are widely used in surgery and cosmetic surgery. Many are strong adjuvants - ie they switch on the immune system. Silicones will migrate out of implants and distribute widely throughout the body to switch on allergies and/or auto-immunity. Devices may be contained in silicone such as pacemakers. Also think of breast implants, repair mesh for hernias, micro-chips, contraceptive devices, injected silicones for body contouring etc. See Silicone Breast Implants and Injections. Some people react to surgical suture material!
Prescription drugs which are of course chemicals! Practolol, a beta blocker, was taken off the market because it could trigger retroperitoneal fibrosis - now thought to be an autoimmune disorder. Hydralazine, another drug for blood presssure, may induce systemic lupus erythematosis.
Hormones Dydrogestone, a synthetic progesterone, can trigger autoimmune hepatitis. Indeed female sex hormones have profound effects on the immune system and explain why autoimmunity is much more common in women than men.
Treatment of Auto-immunity
Conventional medicine uses steroids and immuno-suppressives to suppress this useless inflammation. But suppressing the immune system is a risky business, making patients more susceptible in the long term to infections and possibly cancer.
The environmental approach can be used to treat autoimmunity in the following ways:
Reduce the infectious load through diet and probiotics
By treating the upper fermenting gut. See Fermentation in the gut and CFS
Get rid of adjuvants by doing detox regimes
- Do a good chemical clean up and detox regime. Please see Toxic Problems and in particular Do A Good Chemical Clean-Up: chemicals make you fat and fatigued!
- Multiple Chemical Sensitivity - Detoxification - how to reduce your chemical load using physical methods and micronutrients. Please see Detoxification - an overview
- Detoxing and Treatment of Multiple Chemical Sensitivity (MCS): - see Chemical Poisoning and Multiple Chemical Sensitivity (MCS) - how to reduce the body load
- Detoxing - Far Infrared Sauna (FIRS)
- Silicones cannot be got rid of in this way - they are large tough molecules which cannot be broken down by enzyme systems nor can they be excreted.
(Please see Vitamin D - most of us do not get enough)
Vitamin D has profound immune modulating properties. Vitamin D is made in the skin through the action of sunlight on cholesterol. Sunshine has marked pro-inflammatory properties so when it lands on the skin vitamin D is made from cholesterol - which counteracts this tendency to pro-inflammation. Thus vitamin D has profound anti-inflammatory effects locally in the skin - it then diffuses into the rest of the body where it modulates inflammation there. Vitamin D is probably the most powerful nutritional tool we have in the fight against auto-immunity.
Although vitamin D is present in some foods, it is there in such tiny amounts that changing one's diet hardly makes any difference in vitamin D levels. It is all about getting enough sunshine and failing that one simply has to take supplements. I like everybody to take at least 2000i.u. daily and for people with autoimmunity give them up to 50000i.u. weekly. This is roughly equivalent to an hour of good sunshine daily landing directly on the skin of someone in shorts and T-shirt. The incidence of autoimmunity increases in people who live away from the equator with the best example of this being multiple sclerosis. Please see My online shop webpage on Vitamin D3 powder
The strongest antigens appear to be gluten, milk protein and probably yeast. Sugar and refined carbohydrate are similarly pro-inflammatory. Everybody with autoimmunity should aim to do a Stone Age Diet. More often I now prescribe the ketogenic diet - please see Ketogenic diet - the practical details and My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds.
Essential fatty acids
Broadly speaking, the omega 3 and 6 fats feed into hormone and prostaglandin pathways, which tend to suppress inflammation so:
- take evening primrose oil (4 capsules daily). See also VegEPA and Nutritional Supplements - what everybody should be taking all the time even if nothing is wrong
- take cod liver oil (4 capsules daily). Must be filtered oil: cod liver oil needs filtering to remove pesticides, check with your supplier. Eat oily fish.
Good anti-oxidant status protects against many of the malign effects of inflammation. See Antioxidants
Low dose naltrexone
The idea here is to boost one's own production of opiates (endophines). This is achieved by giving a tiny dose of a morphine blocker naltrexone (4mgs, compared to a therapeutic dose of 50mgs) in the evening. This partly inhibits endogenous morphine production but that is followed by a rebound increase in endogenous production. See the external link LOW DOSE NALTREXONE and also Low dose naltrexone
Thyroid and adrenal function
Both thyroid and adrenal hormones have immune modulating effects. Well worth getting both checked! See Thyroid and Thyroid profile: free T3, free T4 and TSH AND also Adrenal Gland - the gear box of the car (DHEA and cortisol) – underactive and Adrenal stress profile - salivary. Indeed pregnenolone 50-100mgs taken daily used to be the treatment of choice for rheumatoid arthritis and is indicated in most auto-immune disease. See Life Enhancement Pregnenolone Review
- Magnesium test - red cell
- Thyroid profile: free T3, free T4 and TSH
- Adrenal stress profile - salivary
- Nutritional Supplements
- Chemical Poisoning and Multiple Chemical Sensitivity (MCS) - how to reduce your daily exposures
- Viral infections
- Fermentation in the gut and CFS
- Do A Good Chemical Clean-Up: chemicals make you fat and fatigued!
- Detoxification - an overview
- Chemical Poisoning and Multiple Chemical Sensitivity (MCS) - how to reduce the body load
- Detoxing - Far Infrared Sauna (FIRS)
- Stone Age Diet
- Low dose naltrexone
- Adrenal Gland - the gear box of the car (DHEA and cortisol) – underactive
- Vitamin D - most of us do not get enough
- Silicone Breast Implants and Injections
- Ketogenic diet - the practical details
- My book The PK Cookbook - Go Paleo-ketogenic and get the best of both worlds.
- Wikipedia article on Haptens
- The Gluten Thyroid Connection
- Article by Taha Rashid and Alan Ebringer published in Autoimmune Diseases Volume 2012 (2012), Article ID 539282 - "Autoimmunity in Rheumatic Diseases Is Induced by Microbial Infections via Crossreactivity or Molecular Mimicry"
- Candidate diseases for helminthic therapy
- LOW DOSE NALTREXONE
- Life Enhancement Pregnenolone Review
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