Genetics and Triggers Influence Autoimmune Response

When the body's defense system malfunctions

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Type 1 diabetes and multiple sclerosis don’t seem to have much in common. One involves the pancreas, the other involves the nervous system. And psoriasis, a skin condition, wouldn’t seem to be connected to the other two. Yet all of these and approximately 80-100 more diseases share a common root problem: an autoimmune response.

Autoimmune diseases involve almost every system of the human body. The underlying issue for all of these conditions occurs when a person’s immune system goes haywire. Human bodies have a series of defense mechanisms to protect us from dangerous foreign invaders, including bacteria, viruses and more. For some people, their immune systems will begin attacking their own organs, resulting in inflammation and damage.

“Basically, autoimmune diseases result when our immune systems lose the ability to differentiate proteins that belong to our body versus something else, such as bacteria,” explains Dr. Angela Carlson of Bear Creek Naturopathic Clinic in Medford. “Then the confusion causes the immune system to start making antibodies to our own proteins.”

Findings and factors

Research and experience have connected some of the dots among these diseases that can present very differently. Dr. P. Michael Stone of Stone Medical in Ashland says that there are three key factors underlying autoimmune diseases: genetics, increased permeability of the protective barriers and a trigger.

Autoimmune diseases have a genetic basis and tend to run in family clusters, though not necessarily the same disease. One person may have one kind and a relative may have another kind of autoimmune issue. What is inherited is the latent tendency for an autoimmune response, not the specific disease.

The second contributor is a compromised immune system, often due to environmental exposures or lifestyle decisions. In a healthy person, the protective barriers of the immune system, including the skin and linings of the intestine, sinuses and lungs are intact and doing their job. However, Stone explains, when those barriers have received insults from stresses such as medication, alcohol, injury, infection, certain pesticides and stress itself, the weakened barriers can allow proteins to cross over to the blood system.

If there is already a genetic predisposition and foreign proteins passing across the barriers, the next risk is a trigger. A variety of things can trigger the immune response, from stress to a food protein to an injury.

Diagnosis can be tricky

At this time, autoimmune diseases do not have their own category in Western allopathic medicine. Patients are referred to specialists that most nearly match up with the organ systems affected. For example, patients with rheumatoid arthritis go to rheumatologists. When some autoimmune diseases first manifest, symptoms can be vague and similar to other diseases. For some patients, finding the right diagnosis can be challenging.

“It’s important to recognize the frustrations around getting a specific diagnosis because autoimmune can be a gray area,” Carlton says. “However, from an alternative medicine perspective, the underlying management of the condition is all about balancing the immune system. We will address the gut initially, because so much comes down to the gut. We will want to optimize sleep, ensure a healthy diet and reduce environmental toxic input.”

Stone agrees that lifestyle choices play a significant role in the severity of autoimmune diseases. “In virtually all the autoimmune conditions, lifestyle–sleep, exercise, nutrition, emotions—plays a pivotal role in how severe a response occurs,” he says. “If the immune system is already cranked up, the allopathic approach is to prescribe immune modulators to try to suppress the reaction. However, if you haven’t removed the trigger, you’re not getting to the root cause.”

Both doctors agree that the sooner an autoimmune disease is recognized, the better the chances that lifestyle changes can improve or reverse some of the damage.

“With any symptoms such as joint pain, fatigue, swelling, brain fog, we should consider whether it is an immune response and look for the different markers,” Stone says. “A patient doesn’t have to have all of them to have an immune imbalance.”

A trending topic

Autoimmune diseases are not new. Using celiac disease as an example, there is evidence that it caused deaths 1,000 years ago, though it was only officially identified in 1952. What has changed is a more precise categorization as scientific and medical understanding has exploded.

Carlson anticipates that more patients will be diagnosed with autoimmune diseases for that reason and due to changes in environment. “We have had autoimmune diseases with us a long time, but today, we have more insults to our immune systems with the nature of the food supply, adequate chemicals in the soil, products we put on our skin, processed food, the general advent of a lot more chemicals in all aspects of our life,” she says. “The environmental component is significant.”

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More to Explore

Women significantly more at risk for autoimmune disorders

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Of the people who have identified autoimmune disorders in the U.S., 75% are women. Within diagnosed women, African American, Hispanic-American and Native American women have a higher statistical risk for some autoimmune diseases. Dr. Angela Carlson also noted that autoimmune conditions occur more frequently during women’s reproductive years. The physical stress and hormonal changes of pregnancy and childbirth can be the trigger for some patients.

Dr. P. Michael Stone added that compromised immune systems in mothers can lead to increased likelihood of immune issues in children. In one example, he made a correlation between childhood allergies and mothers’ use of acid blockers. “We know that 60% of pregnant women today are taking acid blockers,” he said. “Acid blockers decrease the breakdown of proteins and affect the gut flora. This can lead to more permeability, more proteins crossing the intestine, leading to increased allergies and asthma in their offspring.”

Autoimmune and autoimmune-related diseases

Local physicians Carlson and Stone said the most common autoimmune diseases they see in their practices are rheumatoid arthritis, psoriasis, Crohn’s disease and lupus. Carlson said the No. 1 autoimmune disease among patients at her practice is Hashimoto’s thyroiditis.

Some autoimmune diseases:

  • Alopecia areata
  • Amyloidosis
  • Cardiomyopathy
  • Celiac disease
  • Crohn’s disease
  • Endometriosis
  • Eosinophilic esophagitis
  • Graves’ disease
  • Guillain-Barre syndrome
  • Hashimoto’s thyroiditis
  • Kawasaki syndrome
  • Lupus (SLE)
  • Lyme disease, chronic
  • Meniere’s disease
  • Multiple sclerosis
  • Myasthenia gravis
  • Optic neuritis
  • Peripheral neuropathy
  • Psoriasis
  • Raynaud’s phenomenon
  • Restless legs syndrome
  • Rheumatoid arthritis
  • Type 1 diabetes (Juvenile)
  • Ulcerative colitis
  • Vitiligo

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