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
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.
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
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.
Rates of illnesses are thought to have risen
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.”
Search for answers
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 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
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.
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.”