As this article began to form, it became quickly apparent the scope of this topic is much broader than could possibly be covered in one post – one could actually spend years researching and writing a series of books. By the time the later volumes were finished and published, the early volumes would likely (hopefully!) need updates and editing because of new research and advances in care. Autoimmune and Chronic Inflammatory disease are quite possibly the next epidemic in health care – according to Amy Myers M.D. the incidence of autoimmune disease has tripled over the past 50 years (3)! What follows serves as an introduction to a series of articles to be posted over the next several months.
What causes chronic inflammation and autoimmune disease?
The simple explanation is that chronic inflammation and autoimmune disease comes from a breakdown in the immune system. The immune system is our body’s natural defense against things that are “not us” – pathogens such as bacteria, fungi, viruses, and parasites. A part of the immune system’s response is inflammation, which is often the initial response of the body’s defense system for fighting off invaders. Inflammation and immune response go hand in hand. A critical part of a healthy immune system function is to be able to identify our own cells and the things we ingest in order to function (food, etc.), and to differentiate them from things that don’t belong and can harm us. This quickly becomes a very complex process involving multiple systems and many different moving parts: T-cells, B-cells, immunoglobulins, antigens, different types of white blood cells (or leukocytes), compliment proteins, and more (1). Digestive juices and enzymes play a role as well. This is a complex system of checks and balances. When this system is overworked and burdened by too many things entering our systems, we can experience chronic inflammation or autoimmune disease. Please keep in mind this is a gross oversimplification of this process.
A big part of this defense system is identifying and tagging things that enter our system. A good analogy is of a “lock and key” system by which our immune system is able to figure out what doesn’t belong and destroy it. The pathogens that invade our bodies each have unique sets of proteins in their cell walls, which are the “locks” in our analogy. Our body’s defense system is adaptive and produces thousands of “keys,” or antibodies, which should (theoretically) only fit into a matching lock. Each antibody is a match for a specific cell protein (or group of proteins), which is why our body has to produce so many different types of antibodies. These antibodies attach themselves to cells by matching their specific “key” to the specific “lock” of a foreign object in our bodies. Once these antibody-keys bind to the cell’s protein-lock, the system then signals our “immune warriors” to come and destroy or “eat” the invader identified by the antibody. Inflammation is part of the process by which these defensive elements are initially brought to the areas where the invaders are discovered.
Autoimmune disease occurs when our immune system is so overwhelmed or overactive it can no longer effectively distinguish “self” from “not-self.” Similarities in some of the protein-locks of our own cells and tissues cause an antibody-key to bind to our own tissues and signal our “immune warriors” to come attack our own bodies! Some of this is genetic in nature, however about 75% of this is adaptive response to things in our environment (3). In our modern age things like GMO’s, thousands of new pollutants, chemicals used in growing, harvesting, and processing foods, additives in our food and water, pesticides, new cross-breeds of wheat and other crops, antibiotics, molds, fungi, bacteria, and more are all evolving or being introduced at an incredible rate never before seen in history. Our immune systems are struggling to keep up. The more our system has to identify and address, the greater likelihood the system will be overwhelmed and breakdown. This leads to chronic inflammation, pain, and autoimmune attacks. Keep in mind that chronic inflammation can be present without a full-blown autoimmune disease, but having chronic inflammation greatly increases the chance of an autoimmune response. Additionally, having one autoimmune condition triples the likelihood of getting another (3).
What happens when we have chronic inflammation or we get an autoimmune disease?
There are many different systems and tissues that can be effected and therefore there are many different ways these conditions express themselves. Some of the symptoms we experience from this overactive autoimmune and inflammatory response include: headache, seizure, ADD/ADHD, anxiety or depression, insomnia, fatigue, gas, bloating, constipation and diarrhea, menstrual irregularities, weight loss or gain, pain, rash, itching, flushes, and many more symptoms of increasing severity (3). There are literally hundreds of different symptoms that are elements of hundreds of different autoimmune conditions, depending upon which systems of your body are involved. Some examples of autoimmune disease include: Rheumatoid Arthritis (RA), Lupus, Hashimoto’s Thyroiditis, Fibromyalgia, Chronic Fatigue (CFIDS or Myalgic Encephalomyelitis), Multiple Sclerosis (MS), Type 1 Diabetes, Interstitial Cystitis (IC), Crohn’s Disease, Psoriatic Arthritis, and many more. Unfortunately, it is unusual that a person has only one autoimmune condition; patients often present with multiple autoimmune conditions. This speaks to the systemic nature of these often debilitating diseases. Often patients will see multiple specialists – one or two for each of the different organs or parts of the body under attack.
Unfortunately, the vast majority of doctors use a treatment approach that is designed to suppress symptoms, to suppress the immune response, or both. This often includes using some fairly harsh drugs such as: steroids, NSAIDS (Non-Steroidal Anti-Inflammatory Drugs), DMARDS (Disease-Modifying Anti-Rheumatic Drugs), and Biologics (3). Each of these classes of drugs can provide some temporary relief, although sometimes they are not effective at all. The pharmaceuticals also often induce side effects that may actually be worse than the disease they are treating. Some side effects of these treatments include: nausea/vomiting, insomnia, muscle pain, irregular heartbeat, weight loss or gain, heart failure, joint pain, psoriasis, liver failure, susceptibility to flus and infection, breathing difficulty, and much more (3). Ironically, some of the side effects of the medications are a worsening of the very symptoms the disease itself causes. This treatment approach often requires a constant change in medications, dosages, or drug combinations as side effects increase and the drugs become less effective in suppressing symptoms or suppressing immune response.
Treatment can become a game of “whack-a-mole” in which doctors chase symptoms and side effects with varying degrees of success. Additionally, because patients with multiple conditions (as is most common) may have multiple specialists, care is often not unified into a systemic approach, and can become a hodgepodge of different approaches, each with its own challenges and side effects. Sometimes different doctors will disagree or give conflicting opinions. To make matters worse, doctors will often tell patients “you will just have to learn to live with this,” referring to both unresolved symptoms and drug side effects. Further, there are indications that some subtypes of depression (and likely other mental health conditions) can be attributed to inflammation, as opposed to being strictly a neurological/biochemical imbalance (2). It is no small wonder that people living with these conditions often become anxious or depressed, and come to feel things are hopeless.
One of the most difficult aspects of these conditions is the deep mental and emotional toll they have on those living with autoimmune disease and chronic inflammation. People who suffer from conditions such as Chronic Fatigue, Fibromyalgia, depression, anxiety, and ADD, for example, are often not taken seriously at first by their friends and family, or even their doctors. There are no casts, stitches, or obvious outward signs of an illness or injury – it is an “invisible” illness. It makes it difficult for others to understand why their friend or loved one stops participating in social activities, has problems at work, or possibly even cannot work or go to school any more. For many years, doctors would look at lab reports on urine and blood, MRI’s, etc., and not find anything “out of order.” They would tell their patients that there was nothing wrong with them. People suffering from these conditions were then often given psychiatric referrals – as if the symptoms they were experiencing were “all in their head.” Even if their condition has finally been correctly identified, they often become isolated; this is for several reasons. Imagine being so fatigued and in pain that the simple act of walking from the bedroom to the kitchen or bathroom created such pain and exhaustion that you were literally bedridden for the remainder of the day. Imagine the feeling of being a “burden” on a loved one because of your challenges. Going out with friends? Family events? These simple tasks for many of us can become virtually impossible to navigate for those living with an autoimmune condition. Losing your job or a career you love? Being “labeled” with a mental illness diagnosis? It can really change your entire sense of who you are and how others may perceive you. This lack of understanding and empathy unfortunately includes many doctors and other healthcare professionals. This is why organizations such as Millions Missing have formed – to help people living with autoimmune conditions find support among those who understand firsthand how debilitating these diseases can be, and how isolating they are due to lack of “mainstream” understanding. Support groups also serve to share information and experiences about treatments, solutions, or lifestyle adaptations that work or don’t work.
What can we do?
Treating the symptom or suppressing the immune system is not treating the root of the problem – it is suppressing the signs that a deeper problem needs to be resolved.
If you or someone you know suffers from these symptoms, there is some hope. In spite of what many doctors will say, there are ways to treat these conditions, and you should not have to learn to live with side effects or suffer with symptoms. There are better options out there for you than simply accepting it.
New evidence and clinical experiences suggest the best long-term approach in the treatment of Autoimmune Conditions and Chronic Inflammation is multi-factorial, but may be fundamentally about proper nutrition – what you take into your body. We need to try to eliminate as many of the substances as possible that are triggering your immune system to attack your own body. Treatment may also include some combination of acupuncture, Chinese herbal medicines, lifestyle changes, functional medicine, and whatever other supports are needed. This includes mental and emotional support. Finding new, “outside the box” ways for you to regain function, to reduce your suffering, and to regain hope is critical in restoring health and wellbeing! While symptomatic relief is important, the goal is to balance your immune system and restore your body’s natural abilities to maintain and heal itself.
Even though there should be immediate benefits from treatment, it is not a “quick fix” approach. It is the “long game” that matters most and that will eventually provide the best outcome. This approach is why Acupuncture and Chinese medicine are often much stronger in the treatment of chronic illness, while modern, allopathic medicine is great for acute care. Ideally, the integration of the two approaches leads to the best acute and chronic care to the benefit of the patient.
However, the bigger picture is not only about effective treatment; in the long-term, we need to focus on prevention. Until we start focusing on resolving the deeper issue of prevention, millions of people will continue to suffer with these debilitating, “invisible” diseases.
(1) Hou, CMD L.Ac. DiplAc. DiplCH. (NCAAOM), Wanzhu, Xu, CMD L.Ac. DiplCH. (NCAAOM), Guanpi, Wang, M.D., Hanjie. (2011). Treating Autoimmune Disease with Chinese Medicine. London: Churchill Livingstone Elsevier.
(2) Müller, N. (2006). The cyclooxygenase-2 inhibitor celecoxib has therapeutic effects in major depression: results of a double-blind, randomized, placebo controlled, add-on pilot study to reboxetine. Molecular Psychiatry (2006) 11, 680–684. doi:10.1038/sj.mp.4001805; published online 21 February 2006. Retrieved February 18, 2017 from the Nature.com website: http://www.nature.com/mp/journal/v11/n7/full/4001805a.html
(3) Myers, M.D.,Amy. (2015). The Autoimmune Solution: Prevent and Reverse the Full Spectrum of Inflammatory Symptoms and Diseases. New York: HarperCollins Publishers, Inc.
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