Autoimmune disease - how did we get here?Feb 17, 2022
Did you know that over the last 10 years the incidence of autoimmune diseases has overtaken that of infectious diseases in developed nations, and that women are affected in far greater numbers than men, with a ratio of about 4:1?
Autoimmunity is the aberrant reaction of our own immune system to self-antigens (autoantigens), meaning that our immune system views our own tissues as ‘foreign’, mistakenly attacking them (self) and thus creating localised and/or systemic (whole body) damage.
There is a misalignment in the body-heart-mind communication with self.
There is a distinct feeling of 'unsafety' and a lack of support, connection and resources within the body, from skin to within.
Genetic background seems to play a limited role - instead, epigenetic changes due to nutrient status, environment and lifestyle - especially stress, and of more recent interest in the scientific literature recently, early life stress - are key.
When it comes to genes, obviously women have XX sex chromosomes, while men have XY sex chromosomes.
It has been suggested that women are at a FAR greater risk for the development of autoimmune diseases because the X chromosome codes for 800-900 genes. This pales in comparison, in both size and gene coding, to the Y chromosome, which has undergone rapid evolutionary degeneration and is these days far, far smaller than what it used to be, only coding for about 60 genes.
So what that means is these 800-900 genes in each X chromosome in women, essentially a double dose of genes, have a greater amount of immune-related genes as well as immune regulatory genes that can have epigenetic changes.
Keep in mind also that the evidence shows dysregulated oxidative stress, caused by the imbalance between reactive oxygen species (ROS) production and the inability of our antioxidant systems to continue to neutralise them, contributes greatly to the damage of cell structures and molecules vital for healthy functioning (such as lipids, proteins and DNA, thereby altering epigenetic mechanisms), ultimately contributing to the pathogenesis and progression of many dis-eases, including autoimmune.
Clinical, laboratory, and imaging criteria, plus pathology elements are utilised for the classification and diagnosis of systemic autoimmune diseases (AI), although there are many clinical challenges in regards to diagnoses, education, comorbidities, and effective treatment strategies.
Autoantibodies are a distinctive hallmark and have a prominent position in the classification criteria of many autoimmune diseases, and research suggests metabolic health influences the incidence, pathophysiology, and management of all AI disease types.
I think it is unquestionable that our nutrient status, including how, why and where they are utilised and metabolised, plays a role in the initiation and progression of AI.
Nutrients are our foundational building blocks!
As adults we choose what nutrients enter our body… although it is our (often unconscious) stress response - ie our nervous system - that dictates what occurs to those nutrients in our digestive system, and beyond. It is often our unconscious stress response that dictates eating habits too!
Deficiencies or excesses, or inability to utilise correctly, of macro and micro nutrients and other food additives can lead to a reduction in the performance of our immune system functioning, as well as in microbiome diversity, composition and function, creating unfavourable immunological states.
Perhaps you have heard of IMMUNONUTRITION, which involves immunity, nutrition, inflammation, infection, and injury?
This is a fairly recent development in the fields of therapeutic strategies that regain immune homeostasis and alleviate inflammatory diseases, utilising specific food, bioactive compounds, and microbial products. It is certainly a methodology that I favour with my clients.
NOTE - Nutritional screening and an in-depth understanding of plasma biomarkers is generally missing in western medicine.
Unfortunately, screening for both AI pre and current disease status is far from routine due to the lack of funding for dis-ease prevention and wellness care, as well as inconclusive evidence for definitive biomarkers, including nutrients and microbiome status.
Many people developing autoimmune processes usually experience vague or easy to ignore symptoms such as low energy, ongoing fatigue, poor appetite, rashes, sore muscles, and swollen joints. Mild signs are commonly overlooked, leading to a delayed diagnosis.
The age of onset and the manifestation and presentation of the various AI conditions differs remarkably, so there are no effective umbrella ‘one size fits all’ markers and treatments, even once you have (eventually) a diagnosis.
There are more than 100 types of AI diseases, with over a third of these being disorders of the nervous system directly - however, all will be indirectly related. Our nervous system is the record keeper of every experience we have ever had, from pre-birth onwards, and connects every single body part and system, so it makes sense that a dysregulated nervous system will have remarkable flow on effects.
The onset and progression of these multifactorial disorders are influenced by epigenetics (which genes are switched 'on' or 'off' or how dialled up or down they are), hormones, environmental and lifestyle factors (for example, adverse childhood events, stress levels, nutrition, toxin or pathogen exposure) and microbiome communities - all of which are influenced by our nervous system.
Interestingly, the newest neuroscience research shows that immune responses can, and are, stored by neurons in our brain - specifically, in the small and poorly understood insular cortex, which is part of some very complex neural circuitry involving our autonomic nervous system (of which our vagus nerve plays an important role), limbic structures, the higher cortex and basal ganglia. Reactivation of these insular cortex neurons (via inflammation and metabolite signalling) can lead to re-instigation of peripheral inflammation and immune dysregulation.
The afferent vagus nerve is responsible for transmitting information from our visceral organs (think stomach, the large and small intestines, gall bladder and liver, the pancreas, appendix, kidneys, adrenal glands, the spleen and the peritoneum) to brain regions, such as the hypothalamus, amygdala, and the insular cortex. The vagus nerve is part of autonomic nervous system, our bidirectional Brain-Gut-Microbiome (BGM) System, and plays a huge role in our health.
A low vagal tone (as assessed by low heart rate variability), has been clinically observed in all types of painful and inflammatory diseases, including autoimmune, as well as others such as fibromyalgia.
The vagus nerve - the primary supporting nerve of our parasympathetic (or rest, digest, repair connect) nervous system - also has a modulatory influence on our emotional memory formation! It truly is a structural link between physical, mental and emotional health, as well as playing a huge role in gut health.
The impact of a dysregulated digestive system and imbalanced gut microbiome in the pathogenesis of autoimmunity is increasingly recognised, with evidence mounting in both animal and human studies. Different microbiota, as well as the molecular by-products (including neuroactive metabolites) they produce, can signal the vagus nerve, impact inflammation status, as well as cross both the gut and blood-brain barriers.
If you'd like to understand more about how and why the gut plays such a huge role in health, you'll love my Holistic Digestive Instensive Course (available for you to dive into right now). Remember that our nervous system is the driver of what occurs in our gut, so my Nervous System course would also be incredibly beneficial for you as well!
What is vital to recognise (and understand, especially if you are working with clients!) is that our nervous system, immune system, hormonal system, digestive and and microbiome systems - and also our emotions/stress levels - are interdependent, communicating 24/7, each system co-regulating and influencing the other.
Any disturbance to these intricate associations can lead directly and significantly to immunological dysregulation (alongside nervous, hormonal and microbiome dysregulation, it all goes together).
Dysregulated immune responses will result in inflammation.
Ongoing inflammation results in oxidative stress, cell injury, tissue injury, organ injury and subsequently can cause autoimmunity, allergy and even cancer.
On a cellular level it is T and B cells, as well as Regulatory B and T cells (known as Bregs and Tregs), T helper cells (Th1, Th2, Th17, and Foxp3+) and T follicular helper cells (Th9, and Th22) that all play important roles in the pathogenesis of various autoimmune inflammatory disorders. Existing Western medicine treatments and approaches focus on SUPPRESSING the dysregulated immune response, which eventually increases the ongoing risk of infections, or even cancer.
As always, science does its best to reduce the disease process down to its smallest parts, hoping to impact these components to create positive upstream effects. As always, I believe it is always the WHOLE individual that is part of any dis-ease process…. You cannot separate components of genetics, epigenetics, metabolism, cells, nutrition, lifestyle, environment, beliefs, habits, and more from the whole.
I cannot overemphasise the critical role our nervous system, as the driver of systemic body responses, plays in AI. It is NOT just about gut health! It is not just about cell dysregulation, or nutrients. It is about all 4 Aspects of Self - the physical, mental, emotional and spiritual components that drive that person to live, eat, sleep, move, think, be and do in their unique way!
There are other ways to support the body than just pharmacologically forced immunosuppression, in my opinion.
Modifiable factors include;
NUMBER 1! Creating safety and support within the nervous system
What, when and how you eat
What, when and how you sleep
What, when and how you exercise/move What, when and how you connect with nature What, when and how you connect with others
Assess & treat underlying nutritional, metabolism and microbiome markers (eg nutrient deficiencies and excesses, dysbiosis)
Assess genetic and epigenetic factors that may be influencing AI process. Assess individual engagement and coherence of all body senses. Consideration of lifestyle/environmental choices and impact upon the interconnectedness of health and wellbeing across self, the collective, and our planet.
Human health has been remarkably altered through a 24/7 lifestyle, stress levels, artificial light exposure, social and cultural conditioning/programming, disconnection from nature/self/breath, our nutrition has been dramatically altered in response to aggressive pesticide use, toxin production, industrialisation, and more.
We all need to be self-accountable for these shifts. All change begins with us!
I think it odd that although this is a growing public health burden, both here at home and globally, the root causes - particularly the effects of stress, and particularly with women - are rarely discussed.
Perhaps you are one of these people, or someone in your family... and I deeply feel for you, for the lack of knowledge and support that may have been your experience.
These will shift your entire perspective on health and dis-ease.
Love to hear your thoughts and/or questions!