Stress and Autoimmunity (Part IX)

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Stress is something that is unavoidable.  We will all experience stress on a daily basis in some way shape or form.  Stress can be anything from mental and emotional stress to exercise and food sensitivities.  All of these things have a breakdown mechanism in the body that elicits the the same physiological response.  Stress activates the autonomic nervous system and you can’t control this.  It’s very difficult to recognize that is happening and actually stop it.  For example, when you lie, your body has a stress response.  This is the reason people say “Secrets keep you sick.  Or Secrets kill.”  This is the exact reason we use lie detector tests!  You can tell your conscious brain to settle down or you’re not nervous all day long, but most of the time, if it is stressful, you still express stress physiologically.  Your palms get sweaty, your voice may waver, your heartbeat increases, and you breathe a little more rapidly. We use those to our advantage to detect stress but what about the hormonal response?  The release of cortisol, the decrease in immune cell production, the disruption in hormones and catecholamines?

The more you experience stress, the more your body runs on sympathetic (fight or flight) dominance.  This leaves you feeling like you wish you could just disappear tomorrow.  Maybe disappear to an island far far away where you could be in silence.  This is often why most people cry at the thought of coming back from vacation.  You body is exhausted from living in this state and if you fall asleep on the couch an hour after coming home from work, you know what that exhaustion feels like.  This is probably hitting home for a lot of you right now in a very doom and gloom way.  Why? Because heaven forbid you have an autoimmune disease, feel there’s no way to get away from stress, you are slowly killing yourself, and there’s nothing you can do about it.  I’m here to tell you that without changing your situation at all, you can reduce stress.

The most important thing you have control over is your thoughts.  They will creep in and try to dictate, but simply recognizing that and repeating what’s really happening in that moment, you won’t get carried away by “what ifs. ”  I see this a lot with people when it comes to work relationships.  A boss said something the wrong way so the employee gets instantly freaked out that they may lose their job, and if they lose their job they will have no money, if they have no money they will lose their home, if they lose their home then their kids will get taken away, then they will have no insurance and they’ll just die because they won’t have any healthcare options for their illness.  STOP!  If this is the type of road your mind takes you down, get good at recognizing when you start down the path.  Bring yourself back to present.  Close your eyes and breathe deeply in one nostril and out the other.  Do not let yourself entertain ideas of things that may or may not happen UNTIL THEY HAPPEN.  The funniest part is that I have asked every single person whether any of these things have actually happened and not a single one has lived this story.  All that time slowly killing our cells over something that has no real likelihood of happening!

Step one is controlling your thoughts from spiraling down a path of worst case scenarios.  The second step is to smile and laugh.  EVEN FAKE ONES.  You heard me right.  There’s also a proverb that laughter is the best medicine because it REVERSES the physiology of the stress response.   You could say that it’s impossible to be stressed and joyous simultaneously.  Go to a funny movie, watch a hilarious youtube video, talk to your friend about old time shenanigans, go to a comedy show.  Smile at everyone you see.  When they are real, they have a huge impact.  When they are fake, they STILL have the same impact.  Laughing reduces cortisol, soothes the nervous system, and improves hormone regulation.  In our society, we tend to become more and more isolated by technology and busy schedules.  Keeping your social connections is so important.  It is not a luxury.  It’s actually good for your health!  I may even dare to say that having a beer with a good friend has more positive effects on your physiology than negative despite the fact that your consuming glutinous alcohol!  That’s how important these things are to your health.  Even a tough love doctor is telling you laughing with friends is possibly more important than what you eat in some instances!

That brings me to the third thing that you can do to reduce stress.  Exercise outside.  We can make this life scenario even more appealing by saying “Go for a walk with a friend, tell stories, laugh, and “touch” goodbye.”  I say “touch” because anything from a hug, a high five, a kiss, whatever, it all has a positive impact.  Movement helps distract the nervous system from obsessive behavior.  It likes to move forward.  You see this with dogs, too.  They are much more behaved in a pack, walking because it is calming to their nervous system.  We are animals, too.  Going to a group fitness class is the same thing.  Moving with friends, laughing, and making connections.  Doing some of this outside is that much better because of the air quality and restorative nature of nature.  No pun intended. ;)

The last and final thing you can do is engage in physical touch.  In my profession, I would be touching people all day long.  However, sometimes patients would come in and that would be the first touch they experienced all day.  I am not a touchy feely person, but that doesn’t mean I don’t experience the same physiological effects of touch.  I’m just more choosy about who I touch! hehe, I couldn’t resist.  Back on track.  Hug your child or spouse goodbye, hug a friend when you see them, get a massage, go to the chiropractor, hire a professional cuddler (that really does exist), have sex or kiss your partner.  These things are not luxuries either!  They are hugely necessary to our well-being as humans.  They counteract stress.  We are hardwired to need touch.  Think about yourself as a child.  Everyone wanted to hold you, give you kisses, touched you constantly to help you maneuver the world.  Then you became a little more developed and touch can be misconstrued as sexual so it happens a little less.  That is until you go looking for it from a teenage boy/girl.  What if you find yourself as a single adult.  You may literally go days without touch.  Heck, the way we greet people in ANY country has to do with TOUCH.  Maybe its a handshake or a kiss on the cheek.  May it’s a hug.  It has and always will be imperative to normal nervous system function.

These are simple, free, yet hard things for some people.  For those less expressive, it may be good to start with the thoughts and movement.  From there start planning social activities to get out there and connect with friends and family!  If you are a single person with an autoimmune disease, even seeing a massage therapist can gain you touch benefits.  Hope you guys are enjoying the series as it is coming to an end!  I will have one final article to address a few questions people had for me.  If you have a question you would like answered in that article, please let me know!

 

Autoimmunity and Exercise (Part VII)

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At this point in the autoimmune series, you can understand why I was reluctant to write an article in the first place! It is so complex, complicated, and multifaceted. So, if I were going to touch on another lifestyle change someone can easily implement, it would be exercise. Unfortunately, exercise is one category where you can have too much of a good thing, especially if you suffer from autoimmunity. There is a point where movement is healthy, beneficial, and will IMPROVE your immune system. On the flip side, if someone’s system is under extreme demand, their adrenals are shot, and they are often stressed, you can easily overdo it. Then the question becomes, what types of exercise are best, and how much.
Exercise is very closely related to your adrenals and the production of cortisol. Cortisol is a steroidal hormone that helps you keep up with stress and is important in the fight or flight response. These spikes in cortisol production should be short-lived and not chronic by any means. However, many of us live stressful, hectic lives and some add tons of exercise on top of it. This is a recipe for adrenal fatigue, and if you want to read more on that, click here.  The more intense you exercise, the more cortisol you release.  This disrupts something we call the HPA axis, which is important in regulating hormones and the immune system.   The types of exercise that stimulate the HPA Axis disruption the most are chronic cardio and and high intensity exercise.  That means that if you have an autoimmune disease, you may be doing more damage than good if you try to run marathons (or any long distance) or Crossfit.  It doesn’t mean you can’t participate in these workouts, but it does mean you need to be smart about it!  Resistance training does not have the same effect on cortisol if it is practiced alone.  This means that weight lifting or body weight movements at lower intensities may be a great option for those with autoimmunity or adrenal fatigue! If you decide to participate in physical activity that is too strenuous for your body to keep up with the cortisol production, guess what, you can CAUSE LEAKY GUT.  We talked about how leaky gut is how this whole thing got started in the first place!  It’s a classic case of too much of a good thing.  Balance is key and more doesn’t always mean better.

As far as how exercise affects the immune system, it can cause a huge inflammatory response.  Any exercise someone does at more intensity that usual for longer than usual, is mobilizing neutrophils and natural killer cells.  This type of exercise also stimulates phagocytosis and increases the production of inflammatory compounds.  In studies, we see that following acute exercise,  the number of T and B cells (immune cells) drop below the levels they were BEFORE every working out.  This quickly recovers if someone has adequate recovery time.  However, if there isn’t sufficient days between these types of workouts, then it is common for athletes to get sick!

Now we understand that we may need to back off the intensity, how often should we be working out if we have an autoimmune condition?  I like to say High Intensity work should not be done more than 2 times a week.  That would include intervals, Crossfit, intense cardio.  You should leave at least 2 days between those sessions for proper cellular repair and recovery.  In between, yoga, walking, leisurely biking are all amazing, repairing options.  You can also add some resistance training  like weight lifting or body weight movements like squats, push ups, pull ups, etc to the mix.  The key here is to keep your heart rate down when you are avoiding high intensity.  This may mean doing less initially which seems counter-intuitive because we all want to look good naked. However, chronic cardio and too much high intensity activity are driving your adrenals into the ground.  Once that happens, your body will begin taking building blocks from hormone production in order to try to keep up with cortisol production.  It doesn’t care how fertile you are, heavy your periods are, or how horny you are if it is trying to survive a flight or flight experience! As far as our genetics are concerned, stressful situations are life and death.  That is why de-stressing is so important.

If you have cut out gluten, upped your fat soluble vitamins, addressed you stomach acid, and quit taking miscellaneous medications, this could be your next step in the equation.  Exercise should be a positive challenge to the body.  If overdone, it most definitely acts in the opposite direction.  Choose something FUN.  I like group classes because community makes every second fun for me.  I really enjoy sports. Join a sports club.  Take family walks.  Movement does not have to be a dreaded to-do on the endless list.  It should and could be something you ENJOY and LOOK FORWARD TO!  If you haven’t found that type of movement yet, then keep searching.  Different strokes for different folks.  The more you can do outside, the better, too.

Vitamin Deficiency and Autoimmunity (Part V)

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For this section, I am going to focus on fat soluble vitamins specifically, which means vitamin A, D, E, and K. Fat soluble vitamins can be stored for later use unlike water soluble vitamins and tend to be the most deficient in the American diet for various reasons.  Each one of the fat soluble vitamins has potent effect on the immune system and therefore, deficiency in any of them, can put us on the path to immune system disorders (if we aren’t already there).  Fat soluble vitamins are found widely in animal products, so this tends to be a sticking point in the world of plant power.  Don’t worry though, even if you are a vegetarian, you can still get these vitamins without having to eat meat.  If you are a vegan, however, this may a trickier component to address.

Vitamin A. Vitamin A is important in the scope of autoimmunity because it is important for maintaining mucosal barriers.  You know just how imperative this is for the avoidance of leaky gut which is the precursor to every autoimmune disease if you read my previous articles.  Vitamin A also plays a major role in inflammation due to its connection with neutrophils, macrophages, and natural killer cells.  If someone has depressed immune system due to Vitamin A deficiency, they are at great risk for repeated infections.  One can always turn to supplements, but I would rather have someone get this nutrient through food.  I will never quit saying “food is medicine.”  You can find it in grassfed butter, liver, and pastured egg yolks.  If the animals producing these products are not eating their appropriate diet, however, these are not present in nearly the same quantities.  This is the reason I hit home the idea of food quality being worth every penny.

Vitamin D. Vitamin D is my favorite to talk about because most patients come to me with standard blood work including vitamin D.  This is a testament to the agreement among most all health professionals how important it is! We have the most research on Vitamin D; therefore, we know it plays key roles in the expression of over 200 genes and the proteins associated with those genes.  We need it for mineral absorption and bone health.  Vitamin D is essential for healing via its pathways that help cell growth.  AND, it is important in immune system regulation.   Vitamin D is so closely linked to autoimmune diseases that it has been suggested the deficiency may be the  CAUSE (via environmental trigger) of lupus, diabetes type 1, MS, rheumatoid, psoriasis, and IBD.  We see geographic implication too when we consider RA.  We know for a fact that stats show higher rates of RA the further away from the equator.  Why would this matter?  Because most Americans are relying on sunlight as their source for Vitamin D production.  It is synthesized from cholesterol found in the cell membranes of skin cells when we absorb UVB rays from the sun. Someone reading this may be thinking “Great!  I’ll go get some Vitamin D supplements today!”  I wish it were that easy.  Vitamin D works alongside other fat soluble vitamins in addition to plant nutrients  and hormones.  Just taking a Vitamin D supplement doesn’t address the increased need for the other nutrients.  This gets crazy and complex in the world of supplementation.  You’d take 1,000 supplements and still not touch all the things you get from real food.  Additionally, if you didn’t address the dietary aspects like wheat, then you are ingesting foods that actually reduce Vitamin D in the body! Lifestyle matters.  There is no shortcut to going outside in the sun, ingesting healthy fat sources, and avoiding toxins and inhibitors.  Let me repeat: there is NO DRUG OR SURGERY that can make up for a lifestyle issue.  Period.  *Vitamin D levels for someone with an autoimmune disease need to much higher than the general population; therefore, being within normal range is not adequate!

I’m going to skip Vitamin E and say a quick word on Vitamin K because this one tends to be gaining clout in the health industry. Vitamin K is also essential for bone and tooth health and studies are being done on its link to osteoporosis for this reason.  It also plays a role in protecting against oxidative damage and regualtes the immune system.  Unlike other fat soluble vitamins, you can get this from fermented foods in addition to pastured animal products!  Bacteria produce this when they are doing their job and therefore, your bacteria in your gut can also make Vitamin K in your small intestines by converting K1 that they find in your leafy greens!  Let’s hope you haven’t been taking antibiotics regularly, or you may be at a deficit here, too.  Your bacteria levels are so important, and anything working against them is also helping the disease pathways catapult.

So, let’s just think about this full circle for a moment.  You were born with genes that give you a predisposition for some of this.  However, you don’t have it expressed necessarily unless you create the right environment.  You create that environment by taking antibiotics, heartburn meds, staying away from the sun (or blocking it), lacking grassfed animal products in your diet, eating things like wheat (possibly every meal!), and we haven’t even talked about the connection of stress! or exercise!  or sleep! or chemical exposure! You can now see why we have taken a massive wrong turn in our society when it comes to our food supply providing us nutrients, our lifestyles prioritizing stressful and depleting behaviors, and then our tools for correction are not addressing the underlying causes.  That is why we are not getting better.  That is why people get sick and stay sick.  That is why, despite the fact that I am ONE PERSON, I am on a mission.  Even if you read this and never do anything about it, I have done my job.  I am not here to make a decision for you.  But if you choose the same decision given all the information, then at least it’s informed decision making.  That’s more important to me than anything.

Intestinal Permeability and Autoimmune Disease (Part II)

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I have written several articles about our bodies being hotels for bacteria, and when the bacteria levels are balanced and the microorganisms are happy, we are healthy.  These bacteria make up so much of our immune system, its hard for me to fathom why we haven’t placed more focus on their role in studying disease.  It’s gaining traction, and therefore most people have heard the buzz phrase “leaky gut” thrown around somewhere.  In this article, we are going to discuss what it actually is, and how it has to do with autoimmunity.

Let’s start with the basics.  From your mouth to your anus, you have one long tube with stops along the way.  The mucosal barrier that keeps food in the tube, and not in your tissue, it technically ON THE OUTSIDE!  I know it sounds crazy, but that tube running down the middle of your body is an exterior surface. It’s comprised of a single layer of cells; that’s it!  Pretty amazing if you think about how food goes in one and end and comes out the other.  After food goes in your mouth, it has stops along the way and one of them is in the small intestines.  The small intestines is where most of your nutrients are absorbed into the body. The way nutrients get into the body through the section of tubing we call the small intestine is by specific breakdown that occurs via acid, enzymes, bile salts, and bacteria.  Proteins are broken down into their lego parts, amino acids.  Fats are broken down into fatty acids, and carbs are broken down into simple sugars. Once food is broken down into its simplest form, it’s ready for transport into the body.

In order to get into the body, digested nutrients have to cross that single layer of cells called enterocytes.  On the other side of the wall lives blood vessels, lymph vessels, and immune cells of the gut.  The amino acids, simple sugars, minerals, and water soluble vitamins (like B vitamins) are transported via blood and the fatty acids and fat soluble vitamins (like A, D, E, and K) are transported through the lymph. A leaky gut occurs when there is damage to that single layer of cells and things that shouldn’t be able to cross over, do.  This damage can occur by sections of cells themselves being damaged, or the bonds between them being broken. When this happens, now we have things like pathogens, incompletely digested proteins, bacteria, and toxic substances entering the territory where immune cells live.  The immune cells immediately recognize them as foreign and plan an attack.  However, if any of them get through that line of defense, now we have them floating in the bloodstream. The body frantically tries to clean it all up, and this produces a fairly global inflammatory state.

I think it’s worth mentioning that those undigested proteins stimulate a part of the immune system that produce IgE antibodies.  Food allergies that cause difficulty breathing, swelling, ER visits…those are due to this IgE response.  This is a TRUE allergy.  However, when antibodies such as IgGs are produced, this is what we call a food sensitivity. The reason we call it a sensitivity is because the immune response produces symptoms of allergies for example, fatigue, mucus drainage, inflamed sinuses, and possibly even things like eczema.  This is what doctors are testing for when they do a blood panel for food allergies!  If you have ever had a food allergy/sensitivity test and it came back with a list of crazy amounts of foods like chicken, spinach, strawberries, etc., you are most likely NOT allergic to those foods.  This is nothing more than a IgG production because food proteins got into spaces they don’t belong.  Once you heal the gut and keep those foods from crossing the gut lining, your body will QUIT producing antibodies against them.  I see this all the time when I work with food allergies.  You can absolutely resume eating most of those foods without issue as long as appropriate care has taken place.  I got off track….back to the antibodies. Of those antibodies being produced, some can be autoantibodies.  When cytokines (chemical messengers) are released, it stimulates both the innate and the adaptive immune system.  This pokes the bear of the adaptive immune system that can result in an autoimmune disease.  If you remember from the previous article, this is where amino acid sequencing can get confused for our own tissues.

I hope I didn’t lose anyone with crazy words, but I think this connection between how the food we eat gets to places it shouldn’t, and the immune response that results is an important one to know!! Why? Because autoimmune diseases live in about 50 million DIAGNOSED people and cancer is only 12 million.  Heck, heart disease is 25 million!  Needless to say, this costs our country more than just $100 billion dollars in direct care costs, it is costing us our quality of life!  Anytime I have a patient that is able to go about their day without worrying about the symptoms of an autoimmune disease, I do a happy dance.  It gives them their life back!  This is priceless.  In the upcoming articles, I will talk about which foods can create the perfect storm, and other lifestyle factors that damage that single layer of cells that keep the good stuff in and the bad stuff out.  These are things you CAN CONTROL!  I’m getting pumped up…can you tell…welcome to what it feels like to be in the audience when I give a talk.  I just can’t help myself….

How does an Autoimmune Disease Actually Happen?

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Without the audience having an in depth knowledge of the body, this can be a confusing process to explain.  However, I’m going to put on my teacher hat and try my best to explain how your body could ever be so confused that it begins to attack it’s own tissues resulting in diseases such as Multiple Sclerosis, Rheumatoid Arthritis, Crohn’s, Psoriasis, Hashimoto’s, etc.  Even though these diseases are present in different systems within the body, the same mechanism of trigger initiates the cascade.  Every autoimmune disease is an IMMUNE SYSTEM disorder.  However, most people focus on the system involved by taking thyroid medication for Hashimoto’s, creams for psoriasis, digestive aids for Crohn’s, and the list goes on.  Most of the heavy duty medications on the market for these problems are immunosuppressants.  That means their entire job is to dampen the ability of the immune system to function in hopes it will quit attacking itself.  This has a nasty side effect of also leaving patients vulnerable to sickness because their immune system is being shut down (hence the fine print in commercials saying not to take them if you are sick, in contact with the sick, etc.)  Many patients will say “Isn’t there a way to help this WITHOUT shutting down my immune system?!”  The answer is “absolutely,” but you will not find those methods in medication.  I hope now you are asking “HOW?!”  Let’s look at how it happens to try to address that question later…

Proteins: Proteins are the building blocks of life.  They are made up of things called amino acids and we use about 20 different amino acids to build every single kind of protein that we need.  Based on how you put the amino acids in sequence, you can create different kinds of proteins.  These creations make up the cells of your organs, your hormones, and the antibodies we call immunoglobins.  You may have heard of some of these amino acids without even knowing it!  We have all heard of tryptophan around Thanksgiving because people blame the sleepiness on it’s presence in turkey.  Maybe you’ve heard of Glutamine if you are in the fitness industry.  Perhaps phenylalanine has popped up as you search the risks of artificial sweeteners?  These amino acids are essentially the legos that make up parts of your structure.

Well, these proteins tend to have a lot of similarities to the proteins in other life forms such as animals, plants, and even viruses.  For heaven’s sake, we have 67% DNA similarity to an earth worm!  Like I’ve said before, this is why biological principles are important to know; we all exist under the same fundamentals!  Small sections of these proteins are recognized by antibodies.  This is the recognition system for our immune system to be able to ID, tag, and get rid of foreign invaders by recognizing specific amino acid sequences present on the protein structure.  When the antibody binds to one protein, it’s common that it will also attach to other proteins containing a similar sequence. This is a good thing if those other proteins are also foreign invaders, but it’s a bad thing if the other protein happens to be our own tissue.

Don’t worry though, we have a quality control system.  Because of so much shared DNA sequencing, this happens all the time!  It happens in everyone really.  However, we have a process called “selection,” that allows T and B cells to recognize self and they are destroyed.  This is all happening in the bone marrow and the thymus gland (hence T and B cells, haha…ok, not funny).   It can also happen via suppression where certain T cells shut down autoantibody production from any cells that may have escaped the first check.  In a healthy individual, this system of checks and balances works beautifully!  However, for those with autoimmune conditions, the body has a breakdown in the second process and simply can’t keep up with the quality control process of destruction.  Let’s just say your employee came in drunk and is no longer paying attention to the bad specimens rolling through!   So, it’s not really a problem with the body making antibodies against itself, because everyone does that.  It’s more about a faulty system in the ability to keep them at a minimum.

Once this breakdown occurs, it’s much easier for the body to then create another autoantibody to a different tissue, which is why so many autoimmune patients can then get another autoimmune disease fairly easily.  When enough damage has occurred to the tissue being targeted, you will start to express systems of the disease.  This is when you show up at the doctor with digestive distress due to Crohn’s, or unbearable joint pain due to Rheumatoid, or heaven forbid the neurologic symptoms of MS.  Here is where the fork in the road happens.  How do you treat it?  You can take medication to address the symptoms presenting, you can take an immunosuppressant to try and shut down your body’s ability to produce antibodies (to itself or to foreign invaders), or you can eliminate the triggers that cause the immune system to attack in the first place.

The environmental triggers for immune system attack can include anything from vitamin D deficiency, bacterial infections, silicone implants, chemical exposures, and yes, intestinal permeability (aka leaky gut).  Even though genes may create the perfect recipe for an autoimmune disease, the environmental triggers are really what start the cascade of events.  This is the reason why many people will say that genes load the gun, but lifestyle pulls the trigger.  This is why it is so important to be testing for underlying infections, nutrient deficiency, eliminating chemical exposure, and doing all we can to correct leaky gut.  If you correct intestinal permeability, you can reverse an autoimmune disease.  I have done this over and over with patients, and the changes in their quality of life and thought of such a different future makes me overwhelmed sometimes.  THERE IS ANOTHER WAY.  If you don’t believe that, then I can only imagine the thoughts that run through someone’s mind knowing it will only progress and get worse.  That part of my job breaks my heart.

The silver lining is that even though you can’t control your genes, you CAN control your lifestyle.  I will be writing a number of articles focusing on different aspects of this including the story of gluten, dairy, nightshades, and eggs in addition to the powerhouses I utilize with patients including ferments, broths, and organs.  I never know much to simplify my explanations to help someone understand the connection, so I have decided to go a little bit more in depth on the blog.  That way I have the easiest answer possible “Go take a look at the articles on the blog and let me know if you still have questions!”  For a professor, it’s like trying to teach 8 years of physiology in 30 seconds (because that’s how long you have until people tune you out if they aren’t understanding).  Good luck with that one!  I hope you enjoy, and if you have any questions you would like to make sure I touch on along the way, feel free to shoot me a comment!