A look at the au­toim­mune epi­demic

LU­PUS, MUL­TI­PLE SCLE­RO­SIS AND TYPE 1 DI­A­BETES ARE JUST SOME OF THE MANY AU­TOIM­MUNE DIS­EASES. BUT WHAT DOES THE TERM MEAN? AND WHAT’S BE­HIND THEIR RISE? SARA BUNNY TAKES A LOOK

Good Health (Australia) - - Content -

Whether you’re avoid­ing that chesty cough do­ing the rounds at the of­fice, sport­ing a burn on your fin­ger from last night’s cook­ing mishap, or you’ve rubbed your eye straight af­ter hold­ing onto the handrail on the shop­ping mall es­ca­la­tor, our im­mune sys­tem is al­ways hard at work. It pro­tects us from the bil­lions of bac­te­ria we share our lives with, goes into bat­tle when a virus comes our way, and works around the clock to safe­guard our health so our body can func­tion at its best. Our in­cred­i­ble abil­ity to heal and fight in­fec­tion has helped to en­sure our species’ sur­vival through­out the ages, and no ma­chine or syn­thetic medicine has yet been able to repli­cate the power of our nat­u­ral im­mu­nity.

But just as the body can put up a fight when our health is at risk, it can also wage war against it­self. There are thought to be around 100 dif­fer­ent au­toim­mune ill­nesses in ex­is­tence, but each shares a com­mon link – they all arise from the body’s im­mune sys­tem mis­tak­enly at­tack­ing its own healthy cells. Con­di­tions such as lu­pus, rheuma­toid arthri­tis, type 1 di­a­betes, coeliac dis­ease, in­flam­ma­tory bowel dis­ease and mul­ti­ple scle­ro­sis fall into the au­toim­mune dis­or­der cat­e­gory, and while the symp­toms can be man­aged, there is no known cure. Across the world, rates of au­toim­mune ill­nesses are thought to have risen up to seven per cent a year for the past three decades – and it’s a wor­ry­ing trend that’s left ex­perts scratch­ing their heads. Ge­net­ics can be a fac­tor – some types of au­toim­mune dis­eases run in fam­i­lies – but new re­search into epi­ge­net­ics has fo­cused more on the ways in which cer­tain genes can get ‘switched on and off’ due to en­vi­ron­men­tal fac­tors.

The­o­ries to ex­plain the trig­gers for this mys­te­ri­ous group of ill­nesses have led med­i­cal ex­perts to look at ev­ery­thing from en­vi­ron­men­tal tox­ins; low lev­els of vi­ta­min D; the hy­giene hy­poth­e­sis (liv­ing in in­creas­ingly ster­ile en­vi­ron­ments); and cer­tain types of in­fec­tions to close in on a pos­si­ble cause. Mean­while, oth­ers in the health field are fo­cused on the way in which life­style fac­tors like diet and stress lev­els can ag­gra­vate or im­prove the symp­toms of au­toim­mune ill­nesses.

Ex­act fig­ures for how many peo­ple are af­fected by au­toim­mune dis­ease are hard to pin down, but sev­eral re­ports in­di­cate that they col­lec­tively af­fect be­tween five and 10 per cent of the de­vel­oped world’s pop­u­la­tion.

The in­flam­ma­tory fac­tor

While symp­toms can vary hugely from per­son to per­son, au­toim­mune dis­eases share one com­mon fea­ture – higher lev­els of in­flam­ma­tion in the body. It might not be pos­si­ble to re­verse or cure an au­toim­mune ill­ness, but there’s grow­ing ev­i­dence that eat­ing a diet rich in anti-in­flam­ma­tory foods can help.

“Man­age­ment is the key word when it comes to au­toim­mune con­di­tions,” says reg­is­tered clin­i­cal nu­tri­tion­ist Natalie Brady. “From a di­etary per­spec­tive, this is all about re­duc­ing in­flam­ma­tion as much as pos­si­ble.”

Natalie says a back-to-ba­sics ap­proach, like choos­ing nat­u­ral whole­foods and fo­cus­ing on colour­ful fruits and veges, is a good place to start

and keep­ing gluten at bay can be a key piece of the puz­zle for many au­toim­mune suf­fer­ers.

“Gluten is the big­gest thing to avoid, for any in­flam­ma­tory con­di­tion,” Natalie ex­plains. “The main is­sue with gluten is that it in­creases gut per­me­abil­ity, which can make us more prone to a con­di­tion called ‘leaky gut’. There’s a lot of re­search around about the link be­tween gut health and au­toim­mune con­di­tions, so any­thing to sup­port gut health can be a mas­sive ben­e­fit to au­toim­mune suf­fer­ers.”

Dairy, pro­cessed sugar, re­fined carbs and al­co­hol can also have an in­flam­ma­tory ef­fect for some, although how far you have to go to re­duce these in the diet de­pends on the in­di­vid­ual, and is up for de­bate among pro­fes­sion­als.

“My per­sonal ap­proach would be to re­move gluten and pro­cessed sugar com­pletely, be­cause of that gut per­me­abil­ity fac­tor, and limit dairy in the ini­tial stages,” says Natalie. “It’s of­ten best for peo­ple to think, ‘Right, let’s have a big diet and life­style over­haul’ be­cause you re­ally want to get in there and re­duce any­thing that might cause an in­flam­ma­tory re­ac­tion. Opin­ions vary a lot, but I think that if we’re hav­ing just a lit­tle bit of gluten ev­ery other day, it’s not giv­ing the body a chance to heal.

“I al­ways rec­om­mend a whole­food diet for at least six to eight weeks, prefer­ably 12 weeks, then as­sess­ing it af­ter that. It de­pends a lot on the per­son and the spe­cific type of au­toim­mune ill­ness, but it of­ten takes 12 months to see a big dif­fer­ence, longer if the symp­toms are re­ally se­vere. It can re­ally come down to the in­di­vid­ual per­son and their mo­tives to change their diet.” Due to the many types of au­toim­mune ill­nesses, the wide range of po­ten­tial trig­gers and huge vari­a­tions in dis­ease pro­gres­sion and symp­toms, get­ting a de­fin­i­tive di­ag­no­sis can be dif­fi­cult.

“It’s such a mas­sive topic, there’s lots

Au­toim­mune dis­eases can’t be cured, but they can be man­aged with med­i­ca­tion like an­ti­in­flam­ma­to­ries or treat­ment for de­fi­cien­cies (like in­sulin), phys­i­cal ther­apy, high-dose im­muno­sup­pres­sion, and surgery in some cases.

Women are more likely to be af­fected – in fact, fe­male sex hor­mones are listed as an en­vi­ron­men­tal trig­ger. Au­toim­mune dis­eases are also listed as one of the top-10 causes of death in women aged 65 and younger in the US.

of re­search to sug­gest things that can help, but it’s still such an un­known field,” Natalie ex­plains. “The re­search around it is im­mense, just stay­ing on top of all of that is dif­fi­cult in it­self.”

While the statis­tics for this cor­ner of

the world are un­clear, the Amer­i­can Au­toim­mune Re­lated Dis­eases As­so­ci­a­tion says up to 50 mil­lion peo­ple in the US are af­fected, with an av­er­age five-year wait to re­ceive a di­ag­no­sis.

On our shores, Natalie says thy­roid re­lated is­sues are among the most com­mon au­toim­mune com­plaints she sees at her clinic. “It’s across the board, from over­ac­tive thy­roid con­di­tions like Graves’ dis­ease, to Hashimoto’s thy­roidi­tis, which is an un­der­ac­tive thy­roid, and it’s all re­lated to when an­ti­bod­ies pro­duced by the im­mune sys­tem at­tack the thy­roid gland,” she ex­plains. “I haven’t seen any of­fi­cial num­bers but I do think there are a lot of peo­ple out there with im­mune dys­reg­u­la­tion is­sues. Other con­di­tions I see of­ten are chronic fa­tigue syn­drome and rheuma­toid arthri­tis. For some peo­ple, it may be chronic low-grade in­flam­ma­tion, and it can be years be­fore they de­velop spe­cific symp­toms. It may be a case of in­flam­ma­tion slowly in­creas­ing with things like stress.”

And while diet can play a key role for many peo­ple when it comes to deal­ing with symp­toms, Natalie says stress is a ma­jor part of the equa­tion.

“I know that with my chronic fa­tigue clients, it’s of­ten about manag­ing their stress more so than any­thing else. It’s such a huge trig­ger. Stress can sup­press what is known as our T-helper cells, which are linked to our im­mu­nity cells. Long-term high lev­els of cor­ti­sol can cause a lot of prob­lems.

“It’s hard to talk about au­toim­mune dis­or­ders in gen­eral terms, but I think all of the most com­mon au­toim­mune is­sues can ben­e­fit from re­duc­ing the in­flam­ma­tory load, lim­it­ing stress, and mak­ing sure we have a diet that is high in an­tiox­i­dant-rich whole­foods.”

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