While we might like to pat ourselves on the back for staying late at work, exchanging sleep for to-do lists, and eating what’s quick and convenient, we’ve become our own worst enemy: rates of autoimmune disease have risen dramatically in the last three decades, mainly in Westernized societies.
While genetics do play a role in the development of autoimmunity, new research suggests that our environment might be the bigger culprit. While our Western diet and stressed-out, sleep-deprived lifestyle do increase our risk of autoimmunity, take heart in knowing that making healthy, informed choices can equally alter the course of disease and significantly improve quality of life.
- The incidence of autoimmune disease has increased at yearly rates ranging from 3.7 to 7.1 percent between 1985 and 2015.
- The incidence of autoimmunity has risen alongside the growing consumption of food additives and the expansion of commercial food processing.
- High body mass index (BMI) and Western dietary habits constitute risks for autoimmunity.
Like a home security system, our immune system is designed to keep dangerous intruders out, while keeping us safe inside. When all is functioning well, the immune system identifies bacteria, viruses, parasites, cancerous cells, and harmful substances from the environment, and marks them for destruction by activating inflammatory pathways.
But when the body loses its capacity to distinguish between self and “non-self,” it loses tolerance to its own cells. If the body doesn’t recognize itself, it initiates those inflammatory pathways and begins to self-attack in a state of autoimmunity. It’s a bit like our home security alarm sounding off for no apparent reason, and at 3 o’clock in the morning to boot!
The challenges of diagnosis
Depending on the organs being attacked, autoimmunity presents differently in each person; common autoimmune conditions include Hashimoto’s disease, Graves’ disease, rheumatoid arthritis (RA), celiac disease, irritable bowel disease, multiple sclerosis (MS), lupus (SLE), and type 1 diabetes.
Based on symptoms, doctors order blood tests, imaging, or a biopsy. Since autoimmunity can affect nearly all systems, it’s notoriously complex and challenging to arrive at a conclusive diagnosis.
Resilience to stress
- Psychosocial stress from demands placed on productivity has been identified as a risk factor for autoimmunity.
- Mindful breathing exercises can be helpful for managing myasthenia gravis, a chronic autoimmune neuromuscular disease that causes weakness in skeletal muscles, and they can reduce stress in those without autoimmunity.
A multifactorial disease
While there is no definitive cause of autoimmunity, evidence suggests that stress, sleep disturbance, low psychological well-being, solvent exposure, smoking, Epstein-Barr infection, and low vitamin D status are associated with an increased risk of autoimmune diseases. Research suggests that, when triggered by these environmental factors, the autoimmune process likely begins in the gut.
A window into the gut
The gut is home to about 70 percent of the immune system. Its role is to absorb nutrients from food, while maintaining a barrier between the self and the external environment. The gut maintains this delicate balance between immune reactivity and self-tolerance via tight junctions between intestinal cells.
But environmental triggers can irritate those tight junctions, and when this happens, immunological proteins from food and harmful compounds from the external environment can pass between the intestinal cells, against which the immune system lodges a response that eventually attacks its own cells.
Gluten, small intestinal bacteria, food additives, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin have all been found to increase intestinal permeability. Alterations in intestinal permeability have been associated with autoimmune diseases, including MS, type 1 diabetes, RA, and celiac disease.
Supplementing with the amino acid glutamine may also help reduce intestinal permeability.
To reduce gut permeability, start by avoiding gluten, sugar, and food additives, all of which are generally understood to be inflammatory. Cooking at home whenever possible and eating whole foods rather than processed can help you take ownership of what goes into your body.
Having a diversity of good bacteria in the gut is also helpful for warding off autoimmunity. Probiotics (good bacteria) help induce regulatory T-cells, whose role is to maintain immune tolerance.
But infection, antibiotics, some pharmaceuticals, and even high-fat diets can negatively affect the microbiome, which impairs the induction of regulatory T-cells. Changes in gut microbiota have been associated with MS, SLE, and celiac disease, and are very likely to contribute to other autoimmune conditions.
Supplemental probiotics and prebiotics (dietary fibre that feeds probiotics) have been shown to be helpful in inducing regulatory T-cells and can be helpful in suppressing autoimmunity.
Curcumin can also induce regulatory T-cells and has been shown to be helpful for myasthenia gravis, MS, SLE, and RA.
Healing the root cause
Identifying why there’s gut barrier dysfunction in the first place helps treat autoimmunity at its source. Check with your natural health care practitioner, who can offer comprehensive stool analysis, food sensitivity testing, and screening for small intestinal bacterial overgrowth and latent infection, all of which can be helpful in identifying your personal triggers of immune intolerance and obstacles to healing.
Since we’re the products of our environment, we need to do what we can to stay immune to the stressors of our modern lifestyle. Choosing sleep over checklists, downtime rather than overtime, and whole foods over processed can substantially reduce our risk of autoimmunity and change the trajectory of our lives.
Supporting your child through autoimmunity
- Build a collaborative health care team, including an immunologist, pediatrician, and naturopathic doctor.
- Avoid food additives and processed foods in favour of home-cooked meals.
- Encourage stress-relieving activities for your child, including meditation, play, and journalling.
Sleep it off
- Sleep is involved in maintaining immunity, and sleep loss activates inflammation in the body.
- Disturbed or disordered sleep increases the risk of autoimmunity, particularly lupus, rheumatoid arthritis, Sjogren’s, ankylosing spondylitis, and type 1 diabetes.
- Cognitive behavioural therapy and tai chi can reverse the inflammatory signalling associated with insomnia.
Dr. Cassie Irwin, ND, practises functional medicine through virtual consultations and in Vineland, Ontario, to optimize quality of life with autoimmunity and chronic illness. drcassieirwin.com; @drcassieirwin