Autoimmune disorders are on the rise in the westernised world. You, or someone dear to you, might be struggling with symptoms that wax and wane, or a health problem that seems to have struck out of nowhere. Many autoimmune diseases are considered “invisible” because you can’t see the underlying pain that’s causing the outward disability.
Examples of autoimmune disease include:
These diseases all have one thing in common: your immune system is over-reacting and damaging tissues in your body as a result of this behaviour. This happens because your body is trying to fix a problem caused by your environment and is constantly fighting to gain the upper hand. And when we don’t have the correct support in place or the environmental issue remains, your own tissue is collateral damage and over time such extensive inflammation takes place that you end up with a disease.
What causes autoimmunity in the first place?
Autoimmunity is generally understood to be a perfect storm of multiple variables, with three main components needed to result in autoimmunity: genetic predisposition, so called leaky gut and an environmental trigger of some kind. Usually the genetic predisposition and leaky gut are present, and then autoimmunity is triggered by a specific event that tips your immune system over into aggressive reactivity. For example, you may have intestinal permeability that gives you little to no symptoms, until your trigger event: perhaps a period of great stress.
And what if there is no trigger you can recall? If there was never a moment where you felt ‘well’, what would your trigger be?
What are Autoimmune Antecedents?
If your health was represented by a set of old fashioned scales, perfectly balanced weights would symbolise optimum health. If you then piled more weight into one side, the delicate balance is interrupted, and that side tips downwards. These are your predispositions, some of which are with you from birth.
Your predispositions are characteristics that make you more susceptible to developing an autoimmune disease. Predispositions or antecedents can impact your health, but they don’t automatically guarantee that you develop a chronic autoimmune disease, unless they are combined with one or more autoimmune triggers.
If you add one more large weight on the same side, what happens? Yes, the scale is more imbalanced than ever. The last weight symbolises an autoimmune trigger, which can tip an an already out-of-kilter immune system into chaos.
Predispositions can be genetic, or acquired over time. There is not one singular autoimmune gene responsible. In scientific studies there’s quite a focus on identifying the specific genes that increase susceptibility, though there are others as well:
The HLA gene family contains instructions on making certain human leukocyte antigens that can tell the difference between invading proteins (viruses and bacteria) and the body’s own tissues. There are many possible variations to HLA genes, but some variants have been linked to developing autoimmune diseases, particularly type 1 diabetes and coeliac disease.
The P53 gene directs the body into making a specific protein that regulates cell cycle. P53 is commonly known as “tumor protein P53” because the protein it generates acts as a suppressor, fighting the creation and growth of both benign and cancerous tumors. However, P53 is underexpressed in autoimmune patients, which indicates that in these patients, immune cells keep dividing and multiplying, and are rarely triggered into dying – a natural and necessary part of the cell life cycle.
The IL10 gene contains instructions to create a cytokine, an inflammatory messenger secreted by immune system cells, that normally reacts to foreign invaders, and signals to t-cells that they need to address them. A specific mutation of the IL10 gene has been found in caucasian lupus patients. Further research needs to be undertaken to establish the exact connection between IL10 gene differences and autoimmune disease.
A lot more research in needed in this area in general, to better understand the role of genes in the outcome of autoimmunity (fun fact, my baby sister is a geneticist who did her PhD research into autoimmune genetics!).
Intestinal permeability is a much discussed predisposition. Naturopathic medicine has been discussing leaky gut for a long time, and it was widely dismissed as hokum by conventional medicine for many years. But, thanks to a now very famous Coeliac disease researcher called Alessio Fasano, the mechanism of leaky gut has been identified and this process is now much better understood and acknowledged.
A delicate balance in the digestive system is crucial to your health. Leaky gut is more accurately known as intestinal hyper-permeability and when it occurs, your gut wall is unable to filter just nutrients and water to your blood stream. Instead, the gaps in your intestinal wall become larger – and food debris, bacteria, and toxins slip in to join your bloodstream. Your gut wall is basically like the bouncer at a nightclub, it’s supposed to allow some things to pass, but not others. We want properly digested food particles, vitamins, nutrients and water to pass into the body, but we want to leave waste and larger particles behind in the gut. Leaky gut leads to inflammation in the body and immune system and is considered essential to developing an autoimmune disease, because as a result of this increased traffic of large particles into the body, your immune system is on a constant high-alert against the unwanted and potentially dangerous matter that is regularly passing up into the body.
Environment burden is also a crucial predisposition. While there is some focus on preserving planet Earth from the damage humans have inflicted on it, I believe that if more people knew the extent of how living with chemicals and pollution affected the human body, we would be making better progress.
Post World War II, the US and other western countries increased industrialism and the manufacture of new chemicals. Since then, untested chemicals – byproducts of manufacture – are discharged into the environment, joining bodies of water and our water supplies. You inhale the smallest pollutant particles everyday from the air, take in plastics and pesticides via your food, slather them on your skin and hair and even your couch and bed are soaked with toxic chemicals from flame retardants and other chemical treatments. The result of this onslaught of environmental chemical exposure, is your immune system may already have been working at full capacity before your trigger event. This is often known as environmental toll.
4 Types of Autoimmune Triggers
A trigger is the incident or factor that provokes the signs and symptoms of an illness. Triggers can be sudden and sharp, like an aggressive virus. Or they can be subtle, barely noticable – like feeling uncomfortable after eating gluten.
This is one of the reasons a functional medicine practitioner takes a timeline of your health during your first appointment. Although it may seem like a negative exercise to list all your health concerns and issues, it can be an extremely rewarding and enlightening, particularly if it leads to identifying an autoimmune trigger.
Autoimmune triggers can be loosely divided into four categories:
Inflammatory reactions to foods –
A western diet can be a component of autoimmune disease, and foods containing gluten can promote inflammation. Celiac disease is identified as an autoimmune disease. Food immune reactivity can cause complications.
Epstein-Barr virus in particular is a notorious trigger for autoimmune disorders. It’s not just viruses though: bacteria and parasites are also triggers. Chronic infections like Lyme’s Disease have a large impact on your immune system.
Environment: pollution and toxins –
A specific exposure to chemicals, heavy metals, or mold, often thanks to a location change in home or work.
There are many kinds of stress that we experience, but our body only has one stress response, which is a flood of stress-hormones (adrenaline and cortisol) in the body. Stress directly changes the way our immune system works, and is also pro-inflammatory which makes us more susceptible to all illness including autoimmunity. We have normalised stress in western society, but it’s very damaging and corrosive to the body and ‘just’ stress can be the tipping point between healthy and disease.
These triggers can tip an already overworked, overextended immune system into developing an autoimmune disease.
Epigenetics is especially fascinating in relation to autoimmune disease. Epigenetics is the study of biological processes that switch genes on and off. Yes, you read that right – your gene expression is not set in stone And these changes can affect your chances of developing an autoimmune disease.
Your genes can be made dormant or active by:
This list looks pretty similar to the list of triggers, doesn’t it?
Your personal experience, lifestyle, diet and exposure to pollutants have a huge impact on your immune system. For some people, the trigger, that magic bullet after which you have never been well, will be really clear. But for others the road to autoimmunity is long and littered with events that each contributed to the immune burden.
Why Should I Know My Autoimmune Trigger?
It can take months, often years, to reach a formal diagnosis of autoimmune disease. You may have silent autoimmunity, or a doctor who minimises your symptoms. Even then, a diagnosis may bring up more questions – what caused your illness in the first place?
Many patients with autoimmune diseases are desperate to know their specific trigger, the magic bullet that left them that way. It’s understandable – knowledge and being able to label something can help with acceptance, and be a way to gain control over your body and begin advocating for yourself.
But it can take a long time to figure out your magic bullet, and there’s no guarantee that you may discover your exact trigger. We can use testing to identify infections, hormone imbalances, allergies, and raised immune cell counts. Food intolerance can also be explored. But remember… autoimmunity does not happen overnight.
It’s very important when you are working towards reclaiming healthy function of the body, to know what your individual triggers have been, as they will need to be addressed, BUT there might not be a single factor, such as an infection or toxin that you can deal with to switch you back to health. As part of the process, you may need to address everything – triggers, predispositions, mental health, and sources of stress.
And sometimes the line between your triggers and your predispositions is blurry, particularly in the case of environment, or genetics versus epigenetics.
Finding out your magic bullet can be very useful as part of your overall journey with autoimmune disease – that is, if you have one! But it’s also only the beginning. Realistically, you need to reassess your diet, your surroundings, your relationships and the way you deal with stress as part of making real progress and permanent health change.
Autoimmunity can be overwhelming. I have dealt with it myself and in my clinic all day every day, and we are learning new information all the time! I hope you find much support and useful information on my site, facebook page and instagram to help you navigate this journey. I am working to provide as many resources as I can to support as many people as possible to be symptom free with a great quality of life, and my free download on the first 5 steps to take is a great place to start if you are new to this journey!
Wishing you all the best of health.