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Dr Sharma Diagnostics



Autoimmunity – A Functional Medicine Approach


An autoimmune disease is a condition in which your immune system mistakes your own body tissues for foreign of invading material, toxins or infection, and ‘attacks’ proteins and cells that are in fact harmless, useful and make up your structure and functional metabolism.

This is the out-come of an over-active and misguided protective response of an immune system ‘thinking’ that it is doing the right thing.

Functional Medicine considers that not enough research has been made into underlying cause. As autoimmunity can attack different parts of the body, different specialists tend to deal with the affected area and not with the underlying dysfunction of the immune system.

An autoimmune condition of the thyroid (Hashimoto’s disease) will be seen by an endocrinologist and those with rheumatoid arthritis will see a rheumatologist. Coeliac patients consult a gastroenterologist and those with psoriasis a dermatologist and so on. Conventional GPs & specialists most often prescribe steroids in the initial acute phase to quell the overactive immune response, and then specific medication such as immune suppressive drugs, pain killers, thyroxine replacement etc., to reduce the effects of the disease.

The 3 most common of the many, many autoimmune diseases that Functional Medicine doctors are faced with are:
  • Thyroid disease – Hashimoto’s (Autoimmune Hypothyroid) & Grave’s disease (Autoimmune Hyperthroid)

  • Pernicious anaemia (leading to Vitamin B12 deficiency

  • Inflammatory Bowel Disease

  • Other conditions that are often brought to our attention include psoriasis, rheumatoid arthritis, multiple sclerosis, lichen planus & systemic lupus erythematosus (lupus)


Theories behind causes of autoimmunity

There are many possible causes of autoimmunity and these can interrelate with each other. The following gives an overview explaining which tests/investigations and treatments can be considered.

The main problem lies in a heightened immune activity, which can be triggered by the following:
  • A “Leaky gut”. Minimally 50% of the immune system cells are based in the gut at any time. Please see the attached information sheet for more detail. When bowel flora are reduced and foods, bowel bacteria, viruses and yeasts irritate the bowel wall, they not only allow material to enter the gut wall and blood stream, which triggers immune response, but they can interfere with receptors in the system.

  • Molecular mimicry. As described in the leaky gut information, proteins that enter the bloodstream can look like our own proteins that make up our body tissues, and the immune system attacks us by mistake.

  • Infection. Severe or long standing (chronic) infection can lead to an ‘Upregulation’ of chemical messengers from specific white blood cells tell me immune system as a whole to ramp up its activity.

  • Inflammation. When infection or toxins attach tissues or cell membranes immune system will try and attack and remove these. In doing so tissues and cell proteins become altered and the body mistakenly starts to attack what it thinks is not ‘self’.

  • Stress & Hormones – adrenaline and other stress hormones can up regulate the immune system. To counteract stress the body produces cortisol which can suppress the immune system, leading to increased damage and further inflammation. When cortisol is required, progesterone levels can be reduced and as progesterone suppresses certain immune responses, infection can, once again, be worsened. Another hormone which, is part of the stress pathways, called DHEA can also influence immunity
  • Toxins – Metals, environmental pollutants, food allergy, particularly grain proteins such as glutens and gliadins, can trigger leaky gut and inflammation.

  • Genetics. As humans evolved, specific genes developed to control our immune response. Environmental toxins and certain infections, as well as stress hormones, can attach to our genes/DNA in what is now known as ‘epi-genetics’ leading to alteration of our immune response.


Relevant investigations

Any tests or investigations should only be considered if it is likely to alter diagnosis or therapeutic approach. In the case of autoimmunity, it is important to try and highlight one of the theoretical underlying causes so that therapy can be specifically aimed and designed. In my opinion the following tests are of importance:

A leaky gut test - see accompanying information.

Comprehensive digestive stool analysis (CDSA). If a leaky gut is shown to be present or if the history of development of the autoimmune issue has any association with bowel infection or the use of antibiotics, then establishing whether bad bacteria, yeasts or other fungi and parasites are present is important. Such stool tests indicate what compounds may remove these organisms and also tell us if there is enough of the beneficial bacteria such as Lactobacillus and bifidobacteria. CDSA will also highlight inflammation in the gut and measure a compound known as secretory IgA which reflects both bowel and general immunity.

Tests through blood and urine establish if an individual is toxic or if the immunity is sensitised to heavy metals and many common toxins to which we are exposed through the environment.

Blood tests to highlight chronic infection can be followed by specific tests, such as those for Lyme disease and its co-infections including herpes and Epstein-Barr virus (EBV).

Testing for food intolerance can be considered if an individual has a history of recognition of health issues associated diet.

Adrenal stress profiling and measuring neurotransmitters not only gives evidence of a stress response that is being poorly controlled but can also advise on what natural therapeutic options can be considered to bolster the calming and relaxing neurohormones that can quell excessive immune response.


Therapeutic considerations

It is always important to establish healthy lifestyle, diet and nutrition and exercise. Each area influences immune response as does, perhaps most importantly, a healthy Psycho-spiritual approach to life.

Once underlying cause is established through consultation, medical history and examination and/or through tests and investigations then integrated treatment needs to be aimed at a combination of any of the following:

Bowel health

Stress response

Detoxification

Diet and possible food exclusions.

Anti-inflammatory therapy

Anti-infective treatment.


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