MY QUESTIONS ARE:
What is a way to attempt to think globally about autoimmunity so I can consider as many potential causes when beginning a diagnostic and therapeutic approach?
ANSWERS:
- Autoimmune cause areas to consider
– Multiple cause areas can be considered and identified
– Generally in most autoimmunity there are multisystem considerations
- Follow therapy, investigations and outcomes
– Lab and Imaging
– Treatment and therapeutic trials
– Outcomes and re-assessment
*The rest of this post involves specific questions and answers regarding healthcare treatment and management and can only be viewed in the healthcare subscriber area.
ANSWERS:
A very brief outline of autoimmune considerations based on a great deal of research and outcomes of hundreds of cases:
First things to assess in autoimmunity (AI) ’cause’ analysis: (In no particular order)
A.) Chronic infections and history of infections:
– Common AI trigger remotely
– The entire HHV series should have IgG assessed for Hx of exposure (most common AI viral triggers)
– Consider other chronic triggers (C&M pneumoniae, ASO for Strep, Candida…)
– GI dysbiotic imbalance / chronic infections / parasites etc…
— Feed into malabsorption
— Increase IgE and A in many cases
— Imbalance systemic immune response
B.) Hormonal imbalances:
– Common and often insidious
– Thyroid, including Hashimoto’s, high rT3/Thyroid resistance, poor T4–> T3 conversion
– Adrenal especially elevated cortisol states and later low circadian cortisol
– Poor glycemic control stressing the adrenal system
– High estrogen / low progesterone
– High DHT
C.) Nutritional and Genomic:
– Poor EFA balance and intake
– High glycemic diet
– Inadequate intake and / or absorption of co-factors (trace mineral and vitamins)
— Suspect inflammatory diet / food intolerance / gluten etc
— Assess diet and absorption
– Poor endogenous antioxidant systems (SOD/GST/NAT) can check SNP’s
– Poor GI maintenance (consider methylation SNP’s / IgA dysfunction and SNP’s)
D.) Allergy:
– Allergy / Atopy history
– Undiagnosed allergy / Hx of high IgE and or defects in IgG and A
– Assess IgG/A/E SNP status
E.) Toxicity:
– Common and in AI patient may have less “tolerance” for toxins
– Chemical and Metal can disrupt immune balance
– Evidence of metals effecting TH1/2 balance
– People with MCS (who commonly have or develop AI) are known to have poor toxin elimination
F.) Anything else that can change the ReDox balance in the body and disrupt the normal immune cyclic balance
Therapy and outcome:
A.) Labs:
– Follow any positive AI or other labs
– Especially those that are marginal positives or “undetermined” in significance
B.) Treatment:
– Treat what you find. Focus on GI and ReDox balance as well as any obvious active infections early on.
– If SNP’s exist work to balance them nutritionally as best possible
– If endocrine issues are present Tx as tolerated and until balance is achieved
– Once the above are addressed (or in process) then consider detoxification
– Old infections may need no “treatment” as they are likely a remote cause, but do watch for signs and symptoms of flares (especially in the HHV and GI / Mucosal infections) and treat as needed.
C.) Outcomes:
– If early (i.e. an early undetermined ANA elevation) I have seen labs and many symptoms resolve in under a year.
– If of long duration you may only be able to improve the overall health of the person and slowly work on deeper issues.
– If anatomical damage / changes exist (joint, alopecia, and depositions in tissue…) they may diminish or never resolve even if all underlying issues resolve.
Other related content:
- Autoimmunity Anderson