Autoimmune disease: root causes and key strategies
By Abby Vallejo, RD
Autoimmune disease is a condition in which the body’s immune system mistakes its own healthy tissues as foreign and attacks them. Autoimmune diseases are the 3rd most common category of disease in the United States after cancer and heart disease and include over 80 disorders. Most autoimmune diseases cause inflammation, although the particular disorder will determine the symptoms and parts of the body that are affected. The common feature of any autoimmune disease is the immune system upregulating to the point where it starts attacking healthy cells in the body, thus causing tissue damage and inflammation. Common symptoms – which may come and go and change in severity – include aches, pains, swelling, digestive disturbances, skin issues and fatigue, among others.
Autoimmune may best be described as a “mosaic disease”, a term first coined in 1989 by immunologist Yehuda Shoenfield. This is because the disease is often like a mosaic, with similar starting causes rearranged in different patterns, meaning that there are common factors that feed the disease but it will manifest differently depending on the individual. There is a female predominance, meaning women have a higher incidence and prevalence of autoimmune diseases than men, and 85% or more patients of multiple autoimmune diseases are female. Another feature is poly-autoimmunity. It is common for a person to have more than one autoimmune disease in their lifetime. Other than that, there seem to be 3 key factors that contribute to the development of autoimmune diseases:
Imbalance in immune regulation (when there’s more “killers” than “peacekeepers” in the immune system, in a healthy person with a regulated immune system this ratio is 50-50)
This can happen due to exposure to toxic chemicals, poor microbiome health or the new presence of microorganisms – live bacteria can breach body barriers into tissues and organs, upregulating a pro-inflammatory state of the immune system, causing “danger signals”. Tissue state is very important in regulating autoimmunity and necrotically dying calls are a signal of danger to the immune system, leading to a cycle of:
Tissue damage → upregulation of immune reaction → immune misdirection (attacks self) → more tissue damage → more immune upregulation → more attacks on self
These microorganisms that migrate into tissues and organs are known as “stealth pathogens”, and can be in the mouth, stomach, blood, lungs, bladder, brain and gut. More than one type of pathogen can trigger autoimmune disease, however, particular microbes are associated with certain disorders. For example, a key pathogen in triggering the autoimmune disease Rheumatoid Arthritis is the Epstein Barr virus, and another is Proteus Mirabilis, a pathogen that causes urinary tract infections. In fact, there is a correlation between UTI infections and Rheumatoid Arthritis, and studies have confirmed that 90 days of cranberry juice decreased disease activity in women with this autoimmune disorder.
But this process involves much more than just a virus or bacterial infection like a UTI. There are multiple factors at play, and to become autoimmune, one also needs at least 2 or more “hits” of the following:
Self and non self similarity – pathogens often produce proteins that mimic host proteins, getting confused as “self” and thus going undetected
Danger signals – defense reaction of immune system to dying/damaged tissue
Self reactive T cells in tissue
Person has a specific human leukocyte antigen (HLA) allele (genetic predisposition)
Mechanisms that regulate the immune response are not fully functional
Another very important contributing factor to autoimmune diseases is poor gut health. When there is a loss of beneficial microbes, reduced microbiome diversity leads to a reduced function of the gut barrier, making it easier for opportunistic/pathogenic microbes to overgrow and breach the gut barrier – a condition known as “leaky gut”. When this happens, our immune system gets involved due to the higher pathogen load, and can become hyper vigilant and over stimulated when dealing with repeated and chronic immune challenges (one of the factors that leads to autoimmune). Thus it is very important to have a healthy microbiome with good microbe diversity and a healthy gut lining to protect from barrier breaches. Prebiotics (from fiber) are especially important because they make short chain fatty acids like butyrate which bind to immune cells interleukin 10 and have a protective and anti-inflammatory effect.
Gut barrier disruptors that damage our gut barrier include:
Antibiotics and other drugs
Disruptors (ie. gluten, pesticides, toxins)
Autoimmune diet can help with symptoms and management:
No fried food
Plenty of fiber (ie. psyllium, oat bran, gum arabic, butyrate)
Key strategies and herbs for autoimmune management:
Eliminate stealth pathogens if present – licorice, thuja, St John’s Wort, eleuthero and cat’s claw for viruses; myrrh, berberine, garlic, sage and cat’s claw for bacteria
Eliminate gut dysbiosis – “Weed” – berberine, andrographis, oregano oil, anise oil, and “Feed” – prebiotic fiber, probiotics (at least 2 hours apart from “weed” herbs, or can be done on different days)
Heal gut barrier – DGL, meadowsweet, chamomile, slippery elm and marshmallow
Support immunity and immune modulation – echinacea, astragalus, medicinal mushrooms, rehmannia, hemidesmus, bupleurum, feverfew
Support adrenals and HPA axis – Licorice and rehmannia, adaptogens
Resolve chronic inflammation/reduce danger signals – essential to resolve inflammation, clear dead cells so tissue can heal – curcumin, boswellia, ginger
Detoxification – Nrf2 detox pathways/reduce oxidative stress – turmeric, green tea, rosemary, grape seed, garlic, gotu kola, milk thistle
Protocol is usually done initially for 3 months, then 1 month per year as maintenance for stealth pathogens and gut dysbiosis. Herbs for inflammation and immune support/modulation may be taken for long term management. If you are on prescription medications check for any potential interactions with your health care practitioner or pharmacist.
Webinar: Autoimmunity: the Immune Puzzle by Dr Kerry Bone for MediHerb
Book: Bone, Kerry. Functional Herbal Therapy: A Modern Paradigm for Clinicians. 2021 Aeon Books Ltd, London.
Journal: Desai MK, Brinton RD. Autoimmune Disease in Women: Endocrine Transition and Risk Across the Lifespan. Front Endocrinol (Lausanne). 2019 Apr 29;10:265. doi: 10.3389/fendo.2019.00265. PMID: 31110493; PMCID: PMC6501433.
Journal: Thimóteo NSB, Iryioda TMV, Alfieri DF, Rego BEF, Scavuzzi BM, Fatel E, Lozovoy MAB, Simão ANC, Dichi I. Cranberry juice decreases disease activity in women with rheumatoid arthritis. Nutrition. 2019 Apr;60:112-117. doi: 10.1016/j.nut.2018.10.010. Epub 2018 Oct 10. PMID: 30553231.
Abby Vallejo, RD, CPT
Abby Vallejo graduated from the University of Wisconsin at Green Bay with a degree in Human Biology & Dietetics and went on to do her Dietetic Internship with Wellness Workdays, based in Hingham, Massachusetts. Abby is also a Certified Personal Trainer and enjoys training and counseling clients one-on-one to help them achieve their wellness and fitness goals. Abby worked in the vitamin and supplement industry while pursuing her nutrition degree and was delighted to return after earning her credential as a Registered Dietitian. She is passionate about balance, wellness and all things holistic. In her free time she enjoys going to the gym, traveling and spending time outside in nature.