In this last of my series on the immune system, I’m looking at when our body attacks itself in an autoimmune disease, such as rheumatoid arthritis, type 1 diabetes, coeliac disease, autoimmune thyroid disease and many more. Indeed, scientists are discovering that there is an autoimmune component in very many chronic conditions, such as:

Diabetes type 1.5
Infertility
Guillain Barre syndrome
Urticaria, psoriasis, lichen planus
Alopecia
Chronic fatigue syndrome
Crohn’s disease and ulcerative colitis
Lupus
Endometriosis
Multiple sclerosis
ADHD
And at least 80 more

It is perhaps not so surprising that there are so many different autoimmune conditions, as it is normal for the immune system to make antibodies against our own body tissues. This is because the immune system makes antibodies to fit all types of proteins (it’s this huge variety that gives us such good protection) and these will, inevitably include some that are found in our own bodies…but there are systems in place that should prevent production of these antibodies and also prevent the immune system from reacting to things that are no threat (which obviously includes our own bodies!), as I described last week in my article on allergies.

Why might you develop an autoimmune condition?

There are several reasons why the immune system fails to remove antibodies that fit with our own body structures.

Genetic factors: in particular variations in the genes that control the “tags” carried on our body cells that label them as “self”, but also variations that affect how the immune system functions
External factors: such as gut health, nutrient deficiencies, aging, gluten sensitivity, stress, exposure to infections and toxins.

Of course, there is no way that you can change the genes you have inherited but you can change many of the external factors. There is a saying in functional medicine “genes load the gun but environment pulls the trigger” so, it’s important to realise that there is a lot you can do to reduce your risk of developing an autoimmune disease and to help keep the immune system in balance.

Gut health

As I’ve discussed previously, 80% of the immune system resides in the gut. It’s being increasingly recognised that the balance of gut bacteria can influence autoimmune disease. The gut bacteria can interact with the immune system to influence how reactive it is, some can cause inflammation in the gut, some can adversely affect the barrier function of the gut lining allowing proteins to cross into the bloodstream and trigger immune responses. Specific gut bacteria have been linked with an increased risk of developing autoimmune diseases.

As well as gut bacteria, other influences on gut health such as digestive functions, foods and toxins can be factors in development of autoimmunity. One important aspect is that, as I explained in my last post, some foods have protein structures that mimic those proteins found in our bodies…so-called “molecular mimicry”. If our digestion is not working well so that the proteins in these foods are not broken down properly to their smallest particles (amino acids) that cannot trigger an immune reaction, then these mimicking molecules can encourage production of antibodies which will be able to bind not only with the food protein but also with our body structures: autoantibodies.

Certain foods have been identified which have properties making them more likely to cause autoimmune conditions than other foods. For example, wheat and dairy. Wheat has many factors making it hard to digest (see Should you be gluten free? For details) and has been linked with several autoimmune conditions. Dairy, especially cow’s milk dairy, has been shown to contain protein structures that mimic insulin and may increase the risk of autoimmune types of diabetes. Molecular mimicry is very common: one study found around 50 food proteins that cross react with proteins in the pancreas that are targets for diabetes autoantibodies. The same authors discovered many food proteins that cross-react with autoantibodies for the thyroid.

Nutrient deficiencies

The most studied vitamin deficiency associated with autoimmune conditions is vitamin D, but it is also likely that low levels of B vitamins, selenium, zinc, magnesium and omega-3 fats could have an influence. These nutrients are involved in how the immune system works, especially in the aspects which regulate tolerance and which control inflammation.

Infections

Many different infections have been implicated in development of autoimmunity, including Helicobacter pylori (the cause of stomach ulcers), Klebsiella pneumoniae, hepatitis viruses, Epstein Barr (the virus that causes glandular fever), herpes viruses, Lyme disease, measles, mumps, rubella, Chlamydia, Campylobacter and more. The mechanisms may be due to molecular mimicry, influences of the infection on immune responses, and the infection penetrating tissues that normally have a low exposure to the immune system and bringing these to the attention of the immune system.

Toxins

A variety of chemicals and drugs have been found to be linked with autoimmunity including drugs, pesticides, fungicides, heavy metals and the toxins released from moulds.

Stress

Stress, whether emotional or physical has been shown to trigger and intensify autoimmune disorders. Stress disrupts immune function through several distinct pathways. As I’ve often discussed, chronic stress is the big problem. Long-term stress leads to long-term inflammation that encourages autoimmune disease. Once an autoimmune disease exists, both long-term and short-term stress will make things worse.

What you can do

The first step is always to look after your gut health. Ensuring good digestion and a healthy population of gut bacteria is key to keeping your immune system working properly and will also keep your barriers strong. With these in place, you will likely be able to eat at least some of any foods. If your gut health is not great, however, you may need to eliminate some foods at least in the short term. Any elimination diet is best done with some professional help as it can be a complicated process to determine which foods are problematic and for how long they can be eliminated while at the same time being sure to be getting all the nutrients you need.

This brings me to the second step of ensuring you are getting all the essential nutrients, especially those involved in the immune system as discussed here. Vitamin D is crucial, and is best obtained from sunlight: check out my article on getting your vitamin D to know how to optimise your levels.

Third, but equally important is to control stress. I’ve written an entire blog post on how to manage stress, you can find it here.

If you’re struggling with a misbehaving immune system, do get in touch to find out how I can help you to rebalance.