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Autoimmune Disorders part 2

by Holly C. Berman, EAMP, MSOM

According to the latest research, 3 factors must be present for autoimmune disease to occur:

1. Genetic inheritance

2. Intestinal permeability

3. Trigger factor or precipitating event or illness

The meaning of genetic inheritance is obvious and I want to mention some very new, emerging science in this field called epigenetics. Epigenetics is the study of changes in organisms caused by modification of gene expression rather than alteration of the genetic code itself. This brings up the age old question of nature vs. nurture.  Nature being genetics and nurture being the environment.  According to epigenetics, nurture would be more vital when in comes to gene expression.  Several interesting books have been written on this subject, including Biology of Belief by Bruce Lipton and Super Genes by Deepak Chopra, among many others. According to epigenetics, it is the environment that determines gene expression. We can manipulate this environment, with diet, lifestyle, even our thoughts and emotional environment.

We seemingly have the most control over the second factor, intestinal permeability, or leaky gut syndrome. Intestinal permeability can include and/or cause SIBO, Candida, Irritable Bowel Syndrome, gastritis, H. Pylori and/or other digestive issues. In 2009, Dr. Alessio Fasano, a researcher, published an article linking leaky gut to autoimmune disease and in 2014, Izabella Wentz, PharmD, published a terrific book about Hashimoto's Thyroiditis, which lays out Fasano's 3 factors that must be present for autoimmune disease to develop in detail. She gives very helpful guidelines on how to diagnose and treat as well. I found her book very thorough on the physical side of autoimmune disorders, but lacking in the emotional component. I have added a fourth factor, the emotional component and will talk about it in depth later in this article.

There are many potentially helpful diets for leaky guy or intestinal permeability and for autoimmune disease. I have found it most effective to suit the diet to exactly what digestive issues are going on. Subtle differences in these diets can make a huge difference in a person's symptoms. SIBO, (Small Intestine Bacterial Overgrowth), responds best to the Specific Carbohydrate Diet (SCD) or the Gut and Psychology Syndrome Diet (GAPS). Candida requires an anti-candida diet. IBS, (Irritable Bowel Syndrome), and inflammatory bowel diseases, such as Chron's, respond best to a low FODMAP diet.

I have found that Fibromyalgia responds well to the removal of dairy products and sugar and that upper gastro-intestinal symptoms respond best to removal of dairy products. Some pain and arthritic conditions such as Rheumatoid Arthritis and Ankylosing Spondylitis respond well to the removal of nightshades, (tomatoes, peppers, potatoes, eggplant, tobacco and even goji berries), and to the inclusion of high dose anti inflammatory enzymes. I have also had a few patients whose illness was rooted in an emotional trauma and have seen them make thriving recovery with little or no dietary changes at all, but with deep work on an emotional level.

In general for autoimmune disorders, Wentz and the many practitioners in her circle advocate the Paleo diet, specifically the autoimmune paleo diet, which is paleo, (no grains, legumes, dairy, refined sugars, modern vegetable oils or processed food chemicals), with the addition of no eggs, nuts, seeds, nightshades, no more than 20 g fructose/day, no alcohol, NSAIDs, non nutritive sweeteners, including stevia, emulsifiers, thickeners and other food additives. I have tried the Paleo diet briefly several times and did not do well. I do not enjoy so much animal protein and gain weight when I eat too much and I do well with whole gluten free grains like rice, quinoa and oats.

Myself and everyone in the alternative autoimmune disease world seems to agree that the complete and permanent removal of gluten is absolutely necessary. Gluten is a protein found in some grains, (wheat, spelt, kamut, rye and barley). It is often used as a stabilizing agent in processed foods, mayonnaise, salad dressings, beauty products, medications & supplements. The immune system is rooted in the gut, within our GALT, or gut associated lymphoid tissue. This GALT reviews the proteins like gluten as they move through the digestive system for potentially harmful substances. In people with gluten sensitivity, the GALT identifies it, (gluten), as dangerous and produces antibodies to attack both it and the enzyme that breaks it down. Gluten causes gut cells to release zonulin, a protein that breaks apart the tight junctions holding the intestines together. This leads to leaky gut. Leaky gut allows toxins, microbes, undigested food particles and antibodies to escape the intestines and travel thru the body via the blood stream and attack other organs and/or body systems from the skin to the thyroid to the brain. This is why gluten is associated with autoimmune diseases and why celiac sufferers are at risk for developing them. I have seen patients who have no digestive symptoms associated with eating gluten, but who feel better, (ie...have more energy), when they avoid it.

Other commonly allergenic and/or trigger foods include corn, dairy, soy, eggs and sugar. Some of these go with particular disorders ( affects the thyroid). Water quality is vitally important as well: drink and bathe in only chlorine and fluoride free water, (Brita filtering pitchers DO NOT remove fluoride). I help patients find the diet that is appropriate for them and encourage them to stick to it as best they can, even while traveling or dining out. Eating disorders are commonly, especially with special diets, so please, just do the best you can and don't beat yourself up for not being perfect. I am serious about this.

There are many delicious gluten free alternatives on the market nowadays and fresh especially here in Seattle, (eateries include Flying Apron, Nuflours, Great Harvest, Capitol Cider, etc...). Check them for other ingredients you are trying to avoid, (ie...corn, soy, etc...), and for vegan dairy alternatives. Go into social settings prepared, (eat before at home and/or bring your own treats, snacks, etc...), and don't be shy about asking questions when dining out, (even vegan milk in coffee shops can be an issue due to carageenan, which aggravates Irritable Bowel Syndrome).