AUTOIMMUNITY – Stop the body’s attack on itself!
Autoimmunity or autoimmune conditions, relate to diseases (of which there are more than 80), where the immune system is attacking the body’s own healthy tissues and cells. This insult on the body by the immune system could be localized, to a specific organ or it could be systemic, effecting various parts of the body. This can change the way an organ or body systems functions and can cause damage and inflammation, resulting in many different symptoms.
CAUSES of AUTOIMMUNITY
There seems to be a genetic tendency toward autoimmunity. Not everyone’s autoimmunity is triggered by the same things, below are some of the very important areas that we investigate to assess what the major cause might be:
- Digestive issues are one of the most important areas to zone in on with autoimmunity, you may or may not know you have issues in this area, and thats ok because there are fantastic tests that can reveal this information for us (see below).
- Infection can also trigger autoimmunity and this ties in with some of the digestive investigations but also may not be isolated to this area.
- There is research which shows an association between heavy metal exposure, which can also be tested.
- Hormones imbalances are often missed in autoimmune investigations, particularly estrogen and prolactin issues.
- Many people with autoimmunity can have a problem with gluten (the protein found in many grains), and while it can be tricky to establish celiac disease from non celiac gluten sensitivity, we do our best to establish this from the start as management is different. Its worth noting that the gold standard diagnosis of celiac disease can only be done via a biopsy (endoscopy) through a gastroenterologist, whilst there are many people who have gluten issues who are not celiacs its good to know where you fit.
- Allergies and food intolerances can play a role in autoimmune conditions beyond just a gluten problem.
Understanding Your Immune System
Our immune system produces antibodies (also known as immunoglobulins) in response to antigens (foreign substance such as bacteria and viruses), this allows our immune system to easily identify and destroy a particular antigen. In autoimmunity the immune system produces antibodies against the nucleus of the body’s own cells, these antibodies are known as autoantibodies or antinuclear antibodies (ANA’s). It’s important to note that not all autoimmune conditions cause ANA levels to rise.
A blood test can determine the presence of ANA’s, if positive it will be commonly reported as a titre, starting weak, moving to higher titres, examples include 1:80, 1:160, 1: 320, 1: 640, 1: 1280, etc etc, the value along with clinical signs and symptoms provides significance to a positive result and progression of disease. ANA test results can be positive in people without any sign and symptoms of autoimmune disease and you may find that medically this not considered relevant. Considering that ANA’s can be present years before signs or symptoms appear, we consider that any ANA should not be dismissed and all the appropriate investigation begin, rather than a “wait and see” approach! A positive ANA will prompt further testing which may be able to narrow down autoimmunity in specific tissues such as thyroid antibodies etc.
What To Test?
It is really important to test certain areas which may be causing the problem or may help treat your autoimmune condition, we have a list of our non-negotiable tests and then others that we may add later if needed. Many times it can be really useful to improve certain nutritional markers, provide certain support and improve digestion and then move on to the next test if and when needed.
Examples of some tests:
ANA, vitamin D, thyroid antibodies, estrogen, prolactin, anion gap, white cells, inflammatory markers, zinc, selenium, mercury, lead, cadmium, stool tests (parasites, bacterial overgrowth, yeast, microbiome, short chain fatty acids), immunoglobulins, breath tests (Helicobacter pylori, small intestinal bacterial overgrowth SIBO), viruses just to name a few!
With heavy metal testing we need to decide if we want to check current exposure or past exposure. With all the testing, we like to start with easily accessible and inexpensive testing first, work in with GP’s when needed and then move on from there.
Autoimmune diseases will involve lifestyle changes and depending on the severity of the situation will depend on the extent of changes needed, it is certainly an area that is dependant on lifestyle medicine. With the correct testing treatment can be directed on the areas that will have the best impact.
Examples of AUTOIMMUNE DISEASES
Thanks to the Australian Society of Clinical Immunology and Allergy, the below is a very good list of autoimmune diseases:
Addison’s disease (adrenal), Autoimmune hepatitis (liver), Coeliac disease (gastrointestinal tract), Crohn’s disease (gastrointestinal tract), Diabetes Mellitis Type 1a (pancreas), Grave’s disease (thyroid), Guillain-Barre syndrome (nervous system), Hashimoto’s thyroiditis (thyroid), Multiple sclerosis (nervous system), Pernicious anaemia (stomach), Primary biliary cirrhosis (liver), Sclerosing cholangitis (liver), Myasthenia gravis (nerves, muscles), Ulcerative colitis (gastrointestinal tract), Antiphospholipid antibody syndromes (blood cells), Mixed connective tissue disease Dermatomyositis (skin, muscles), Polymyalgia rheumatica (large muscle groups), Polymyositis (skin, muscles), Primary Raynaud’s disease (blood vessels), Psoriasis (skin), Rheumatic fever Rheumatoid arthritis (joints, less commonly lungs, skin, eyes), Rheumatoid arthritis (joints), Scleroderma (skin, intestine, less commonly lungs, kidneys), Sjögren’s syndrome (salivary glands, tear glands, joints), Systemic Lupus Erythematosus (skin, joints, kidneys, heart, brain, red blood cells, other), Vasculitis disorders (are relatively rare and result from inflammation of blood vessels), Churg-Strauss syndrome (lungs, skin, nerves), Cryoglobulinaemia (skin, kidneys, nerves), Goodpasture’s syndrome (lungs, kidneys), Henoch-Schonlein purpura (skin, joints, kidneys, gut), Microscopic polyangitis (skin, kidneys, nerves), Wegener’s granulomatosis (sinuses, lungs, kidneys, skin), Behcet’s disease (mucous membranes, skin, eyes), Central nervous system vasculitis (brain) Kawasaki syndrome (skin, mucous membranes, lymph nodes, blood vessels), Polyarteritis nodosa (kidneys, gut, nerves, skin), Giant cell (temporal), arteritis (arteries of the head and neck), Takayasu arteritis (arteries of the head and neck), Vitiliago.