Autoimmune Disease and Inflammation

The immune system is the body’s first line of defence against bacteria, viruses and other pathogens, as well as against environmental toxins that may harm the body. The immune system is made up of a complex network of cells, tissues, and organs, as well as biochemicals. Together and in concert, the components of the immune system help maintain a healthy body by launching an inflammatory response, the first line of defence of the immune system against pathogens, damaged or cancerous cells, toxic compounds, and other harmful stimuli. An inflammatory response, or Inflammation, consists of particular types of immune cells called inflammatory cells and cytokines, which aim to find, trap and destroy the invading pathogen, toxin or rouge cell. Inflammatory responses are also launched whenever there is a bruise or cut in the skin or other body parts. Immune cells rush to the site of injury to heal the damaged site.

Under normal circumstances, in a healthy body, inflammatory responses only occur when needed to fix a problem, such as an invading pathogen or a damaged body part. The inflammatory response stops once the pathogen is cleared or the wound is healed.

However, inflammatory responses can sometimes go haywire and persist for long periods, sometimes attacking the body’s healthy cells. Chronic Inflammation, which occurs when an inflammatory response does not stop and persists in the body, can lead to disease. Chronic Inflammation can occur due to different factors, including autoimmune disorders, chronic exposure to environmental toxins, untreated and unresolved infections or injuries, and certain lifestyle factors. Among these factors, autoimmunity and associated autoimmune diseases are a growing health problem that affects more than one million Australians, according to government figures. Autoimmune diseases occur when the immune system attacks healthy cells within the body, damaging the body.

If left untreated, autoimmune Inflammation, chronic Inflammation, and autoimmune diseases can lead to serious health problems. Suppose you suffer from chronic Inflammation or an autoimmune disease, for example. In that case, you may experience symptoms like abdominal or chest pain, fatigue, pain in the joints, and fever or skin rashes, among other symptoms. Chronic Inflammation and autoimmune diseases can also be associated with certain diseases, like Alzheimer’s disease, asthma, certain cancers, heart disease, rheumatoid arthritis (RA), type 2 diabetes, celiac disease, and many other conditions.

Drivers of Autoimmunity and Inflammation

Autoimmunity, autoimmune Inflammation, and chronic Inflammation can be caused or influenced by a wide range of factors, some of which are found within the body and others from the environment.

Causes behind chronic Inflammation – one of the most common causes behind chronic Inflammation is autoimmunity or the presence of an autoimmune disease. The immune system of people who suffer from an autoimmune disease is not usually working. It can mount immune responses against different body parts, such as the skin, joints, organs, blood vessels, or nerves. Specific social, psychological, environmental, and biological factors can also influence chronic Inflammation. These factors include obesity, gut dysbiosis, physical inactivity, chronic infections, chronic stress, environmental toxins and poor sleep (Figure 1). Over time, chronic Inflammation can lead to a wide range of health problems, including metabolic syndrome, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), cardiovascular disease, cancer, depression, autoimmune diseases, neurodegenerative diseases, and other conditions (Figure 1).

Figure 1. To be re-made by AUSCFM. As shown on the left, the most common triggers of SCI (in a counter-clockwise direction) include chronic infections, physical inactivity, (visceral) obesity, intestinal dysbiosis, diet, social isolation, psychological stress, disturbed sleep and disrupted circadian rhythm, and exposure to xenobiotics such as air pollutants, hazardous waste products, industrial chemicals and tobacco smoking. As shown on the right, the consequences of SCI (in a clockwise direction) include metabolic syndrome, type 2 diabetes, non-alcoholic fatty liver disease (NAFLD), cardiovascular disease, cancer, depression, autoimmune diseases, neurodegenerative diseases, sarcopenia, osteoporosis and immunosenescence.

Causes behind autoimmunity – Multiple potential factors are thought to increase the risk or influence autoimmunity in the human body. For instance, a person’s genetic makeup can predispose them to develop certain autoimmune disorders, like type 1 diabetes. The most common causes or drivers of an autoimmune disease include:

• Exposure to certain environmental factors, like pathogens or toxins
• Intestinal permeability and immune dysregulation
• Certain medications, like antibiotics or statins
• Smoking
• Having a previous autoimmune disease, which increases the risk of developing a second autoimmune disease
• Obesity
• It is being female. Females are more likely to develop certain autoimmune diseases (Figure 2).

Common autoimmune conditions

• Rheumatoid arthritis occurs when the immune system attacks the cells found in joints, causing Inflammation, pain, and stiffness in the elbows, knees, and other body parts. Common symptoms include joint swelling, stiffness, and fatigue.
• Multiple sclerosis is when the immune system attaches the cells that cover nerve cells (the myelin sheath) in the central nervous system. Common symptoms include numbness, weakness, problems with balance and trouble walking, among others.
• Type 1 diabetes – where the immune system attacks cells in the pancreas, responsible for the production of insulin, a hormone that regulates blood sugar levels. If left untreated, patients experience high blood sugar levels, which can lead to damage to the heart, kidneys, eyes and nerves. Common symptoms include excessive thirst and hunger, frequent urination, fatigue, etc.
• Systemic lupus erythematosus (SLE), or lupus – where the immune system attacks cells in different parts of the body, causing swelling and pain. Some common symptoms associated with SLE include body aches, skin rashes, brain fog, fatigue, and hair loss.
• Coeliac disease (CD) is when the immune system reacts to the presence of gluten, a protein found in wheat and other grains used to make bread. Over time, this gluten reactivity damages the cells lining the small intestine. People with CD can experience symptoms like diarrhea, fatigue, weight loss, bloating and gas, abdominal pain, nausea and vomiting and constipation, among others.
• Inflammatory bowel disease (IBD) is a term used to refer to a pair of conditions characterised by chronic inflammation of the gastrointestinal (GI) tract: Crohn’s disease and ulcerative colitis. Some common symptoms associated with both of these conditions include rectal bleeding, chronic diarrhea, abdominal pain, bloody stools, abnormal weight loss, and fatigue.
• Hashimoto’s thyroiditis occurs when the immune system attacks cells from the thyroid gland. Some common symptoms associated with this condition include constipation, weight gain, thinning hair, and chronic fatigue.

How are autoimmune disorders or chronic Inflammation diagnosed?

Generally, autoimmune diseases, autoimmune Inflammation, and chronic Inflammation are challenging for a GP to diagnose by following a conventional medicine approach. Part of the problem is that these conditions have multiple and sometimes non-specific symptoms, leading to misdiagnoses.

At AUSCFM, our doctors will invest all the time and diagnostic resources needed to understand your health background, current symptoms, and underlying drivers of disease. Below, we describe the main steps followed at AUSCFM to diagnose your condition.

• As a first step, one of our doctors will assess your health history using comprehensive questionnaires that delve into every aspect of your health and lifestyle.
• We build a comprehensive list of symptoms, past and present, which we link to potential drivers of disease.
• We also consider the medications and supplements a patient is currently taking or has taken in the past.
• We assess the potential influence of heavy metals, biotoxins, and other potentially harmful elements found in the environment.
• Finally, we evaluate a patient’s medical history to identify any evidence of allergies or immune reactivity to foods or other factors.

When a patient is suspected to have an autoimmune condition, we can prescribe one or more of the following diagnostic tests:

• Antinuclear antibody (ANA) test – this approach uses state-of-the-art clinical testing for the presence of antinuclear antibodies or ANA, which are a signature of autoimmune diseases. Patients with elevated levels of ANA are likely to have an autoimmune disease. However, this test alone cannot establish that you suffer from autoimmunity. Hence, additional tests are performed.
• Inflammatory markers—This approach relies on identifying markers of Inflammation in the blood. The most common test used here is the erythrocyte sedimentation rate (SR) test.
• Blood count abnormalities—Your AUSCFM doctor will check for evidence of anaemia (low red blood cells) or leukopenia (low white blood cells), two hallmarks of autoimmunity, through specific blood tests.
• Complete a thyroid panel—this approach will assess the health of your thyroid gland and test your levels of thyroid hormones and antibodies.
• Autoimmune serologies – this approach relies on testing the blood serum for markers associated with autoimmunity.
• Gluten antibodies—This approach relies on state-of-the-art blood testing that detects the presence of antibodies against gluten. Patients who test positive for this test may have celiac disease or other related conditions and require further testing to confirm their condition. Follow-up testing may involve an endoscopy or biopsies of the small intestinal tissue to confirm or rule out celiac disease.
• Blood count abnormalities—This approach involves testing for multiple aspects related to health, including liver and kidney function, heavy metal toxicities, and vitamin and mineral leve
• Gut testing—This approach uses stool samples to establish if you have an imbalance in the composition of your gut microbiome. Alterations to the optimal balance of your gut microbiome are strongly linked to a wide range of potential pathologies. This test can point to the presence of Gastrointestinal Inflammation, Dysfunction of the Gastrointestinal Tract, infections, and abnormal Intestinal Permeability (leaky gut).
• Autoimmune reactivity test—This approach employs a state-of-the-art antibody-based test for the presence of 24 antigens associated with autoimmune conditions. Using this test, we can obtain evidence for the involvement of dozens of potential autoimmune diseases.

Table 1. Differences between conventional and functional medicine approaches.

Inflammation and Autoimmune Disease Treatments – What is the Functional Medicine Approach?

At AUSCFM, we employ a holistic approach to treating autoimmune Inflammation, chronic Inflammation, and autoimmune disease. This is the crucial difference between the “conventional approach” and the Functional Medicine approach to health care (Table 1).

Based on our comprehensive diagnostic approach, we create a patient-centred autoimmune disease treatment plan that will tackle your condition from the inside out. Our ultimate goal is to resolve the underlying pathologies driving your symptoms so you can be restored to optimal health.

Our autoimmune disease treatment plan depends on your specific condition, and may involve the use of:

• Medical-grade anti-inflammatories to reduce Inflammation.
• Supplements that are specific for a particular autoimmune disease.
• Nutrition supplements to correct any micronutrient deficiencies.
• Botanicals or probiotics to normalise the balance of the gut microbiota.
• A personalised nutrition plan that aims to restore the optimal function of your body.

At AUSCFM, you will be led by doctors with ample experience using high-quality dietary supplements and can prescribe the type and dosage of a supplement that is right for you. Our doctors will also monitor your nutritional status with advanced testing approaches, ensuring your body has the nutrients it needs.

The importance of food and nutrition for Inflammation and autoimmune disease

For patients who suffer from autoimmune Inflammation, autoimmunity or chronic Inflammation, diet is an essential factor to consider. An optimal diet that includes wholesome and immune-friendly foods can significantly and positively impact your health and quality of life. In turn, common foods, such as refined sugars, conventional dairy and what products, and packaged/processed foods, may be highly reactive for your immune system, worsening your symptoms and making you feel worse.

At AUSCFM, we advocate for a whole-food diet that includes the following:

• Well-sourced fatty fish (wild-caught, not farmed)
• Pastured meat
• Plant-based proteins
• Antioxidant-rich fruits and vegetables, organically sourced
• Nuts and seeds

Such a diet aims to provide your body with the essential micronutrients needed to support optimal immune function while also helping reduce levels of Inflammation.

For certain patients with more severe autoimmune presentations, we recommend following an autoimmune paleo diet. In this diet, we eliminate foods that irritate the gut lining, such as grains, beans, legumes, seeds, nuts, eggs, and nightshade vegetables.

The importance of exercise inflammation and autoimmune disease

Regular exercise has multiple benefits, such as improving circulation and boosting the production of anti-inflammatory chemicals. Cardiorespiratory fitness, for example, is associated with longevity and improved survival rates. Regular exercise can also improve your muscle mass, help stimulate the formation of new mitochondria, and improve your metabolic health.

At AUSCFM, we aim to create patient-specific exercise routines targeting cardiovascular health, strength training, and therapeutic movement.

The importance of stress inflammation and autoimmune disease

Chronic stress is a well-known driver of internal Inflammation in the body and is particularly important for patients who suffer from an autoimmune disease, autoimmune Inflammation or chronic Inflammation. People with stress-related disorders, for example, have been shown to have an increased risk of developing an autoimmune disease, research shows. Likewise, people diagnosed with post-traumatic stress disorder have a well-established link to conditions like metabolic syndrome, atherosclerotic cardiovascular disease, and autoimmune diseases, research shows.

At AUSCFM, we recommend evidence-based stress-reduction approaches, such as meditation and other mindfulness-based practices. Research shows that these practices, for example, have been shown to reduce the activity of genes associated with Inflammation to immune diseases, autoimmune Inflammation, and chronic Inflammation, which are growing problems in Australia and around the world. Identifying and managing these conditions requires a holistic approach to health care, which involves comprehensive testing, management, and treatments using a patient-centred approach.

Relying on medications that treat symptoms and lower Inflammation by suppressing the immune system is not enough and will not fix your real health problems. At AUSCFM, we rely on evidence-based approaches to assess your health and identify the underlying drivers of your symptoms. Our treatment approach seeks to address your underlying pathologies, improving your health from the inside out.

References

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Mayo Clinic. Celiac disease. https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220

Song, H., Fang, F., Tomasson, G., Arnberg, F. K., Mataix-Cols, D., de la Cruz, L. F., … & Valdimarsdóttir, U. A. (2018). Association of stress-related disorders with subsequent autoimmune disease. Jama, 319(23), 2388-2400.

Hori, H., & Kim, Y. (2019). Inflammation and post‐traumatic stress disorder. Psychiatry and clinical neurosciences, 73(4), 143-153.