Inflammation is "hot" topic in medicine. It appears connected to almost every known chronic disease -- from heart disease to cancer, diabetes to obesity, autism to dementia, and even depression. Other inflammatory diseases such as allergies, asthma, arthritis, and autoimmune disease are increasing at dramatic rates. As physicians we are trained to shut off inflammation with aspirin, anti-inflammatory medication such as Advil or Motrin, steroids and increasingly more powerful immune suppressing medication with serious side effects. But we are not trained to find and treat the underlying causes of inflammation in chronic disease. Hidden allergens, infections, environmental toxins, an inflammatory diet, and stress are the real causes of these inflammatory conditions.
Autoimmune diseases, specifically, now affect 24 million people and include rheumatoid arthritis, lupus, multiple sclerosis, thyroid disease, inflammatory bowel disease, and more. These are often addressed by powerful immune suppressing medication and not by addressing the cause. That's like taking a lot of aspirin while you are standing on a tack. The treatment is not more aspirin or a strong immune suppressant, but removing the tack.
It you want to cool off inflammation in the body, you must find the source. Treat the fire, not the smoke. In medicine we are mostly taught to diagnose disease by symptoms, NOT by their underlying cause. Functional medicine, the emerging 21st paradigm of systems medicine teaches us to treat the cause, not only the symptoms, to ask the question WHY are you sick, not only WHAT disease do you have.
I recently participated in a group discussion with a conventional doctor, a rheumatologist, and patient with an autoimmune disease, and one of my patients who was cured of a complex autoimmune disease by addressing the causes. The focus of the other doctors, however, was on how to suppress the inflammation with medication, not finding and treating the cause. Functional medicine is a different way of thinking about disease that helps us understand and treat the real causes of inflammation instead of finding clever ways to shut it down. Medicine as it is practiced today is like taking the battery out of a smoke detector while a fire burns down your house!
When my patient described how he cured his autoimmune disease by finding and eliminating the causes of inflammation in his diet and environment, it was dismissed as a "spontaneous remission." In the face of a paradigm-shattering medical case, these docs were hardly curious and quickly dismissive, describing what was shared as anecdotal.
My patient on that panel, a hard-working 46-year old father of three was once so inflamed he could barely function. By treating the underlying causes of his inflammation he is now in vibrant good health, enjoying his life with his kids and fully capable of caring for them.
Stories like these (and the many others I have shared in my blogs, books, and on television) are not anecdotes but a giant compass pointing us in the direction we should be looking to find answers to our health problems.
In today's blog, I will explain what autoimmunity is, how inflammation spirals out of control, describe some of the underlying causes for these fires in the body, and provide you with nine steps to cool the fires of inflammation and overcome conditions that range from allergies to arthritis and more.
Autoimmunity: What it is and How it Occurs
We are facing an epidemic of allergic (60 million people), asthmatic (30 million people) and autoimmune disorders (24 million people). Autoimmune diseases include rheumatoid arthritis, lupus, multiple sclerosis, psoriasis, celiac disease, thyroid disease, and the many other hard-to-classify syndromes in the 21st century. These are all autoimmune conditions, and at their root they are connected by one central biochemical process: A runaway immune response also known as systemic inflammation that results in your body attacking its own tissues.
Your immune system is your defense against invaders. It is your internal army and has to clearly distinguish friend from foe -- to know you from other. Autoimmunity occurs when your immune system gets confused and your own tissues get caught in friendly cross-fire. Your body is fighting something -- an infection, a toxin, an allergen, a food or the stress response -- and somehow it redirects its hostile attack on your joints, your brain, your thyroid, your gut, your skin, or sometimes your whole body.
This immune confusion results from what is referred to as molecular mimicry. Conventional approaches don't have a method for finding the insult causing the problem. Functional medicine provides a map to find out which molecule the cells are mimicking.
Interestingly, autoimmune disorders occur almost exclusively in developed countries. People in poor nations without modern amenities like running water, flush toilets, washing machines, and sterile backyards don't get these diseases. If you grew up on a farm with lots of animals, you are also less likely to have any of these inflammatory disorders. Playing in the dirt, being dirty, and being exposed to bugs and infections trains your immune system to recognize what is foreign and what is "you."
In this country, autoimmune diseases when taken all together are a huge health burden. They are the eighth leading cause of death among women, shortening the average patient's lifespan by eight years. The annual health care cost for autoimmune diseases is $120 billion a year representing nearly twice the economic health care burden of cancer (about $ 70 billion a year). (i)
Unfortunately, many of the conventional treatments available can make you feel worse. Anti-inflammatory drugs like Advil, steroids, immune suppressants like methotrexate, and the new TNF-alpha blockers like Enbrel or Remicade can lead to intestinal bleeding, kidney failure, depression, psychosis, osteoporosis, muscle loss, and diabetes, not to mention overwhelming infection and cancer.(ii)
When used selectively these drugs can help people get their lives back. But they are not a long-term solution. They shouldn't be the end of treatment, but a bridge to cool off inflammation while we treat the root cause of the disease.
There is another way to deal with autoimmune conditions. Let me share the same story I told the doctors on that panel.
Recovering from Autoimmunity: Addressing the Root Causes of Inflammation
My patient Sam ended up on a long misadventure through the medical system before he came to see me. For years he went from doctor to doctor getting all kinds of labels for his problems but no real help in treating them.
This hard-working, once healthy trade professional had suddenly developed a series of inflammatory conditions including chronic sinus and prostate infections. Many doctors gave him many antibiotics for these infections.
Shortly thereafter, he developed severe chest pains and went to the emergency room. While he was there, doctors found swollen lymph nodes and told him he had lymphoma, a form of cancer. For three weeks he lived in despair until the biopsy results came back. It turned out he didn't have cancer but an autoimmune disease. Which autoimmune disease? The doctors weren't quite sure ...
He had many abnormal blood test results -- like low white blood cell and platelet counts, high levels of auto-antibodies of all types (antibodies that attack our own tissues), high immunoglobulins (the foot soldiers of the immune system), and autoimmune thyroid disease. But doctors had a hard time putting their finger on what was wrong. They couldn't label him.
Meanwhile, Sam developed metabolic syndrome and weight gain (pre-diabetes) as a result of the runaway inflammation in his body.
Here is a quote from one his specialist's notes:
"Whether he has lupus or Sjogren's syndrome is a bit unclear. Regardless, he merely needs observation and no therapeutic intervention at this time."
This unfortunately is all to common. What exactly did they plan to observe, how bad he felt? Or would they just wait for him to get worse before intervening?
That's when he came to me. Using a functional medicine approach, a new way of thinking about the underlying causes and imbalances in chronic disease, I began by asking Sam some simple questions. Then I went hunting for toxins, allergens, and infections -- all common causes of inflammation -- and found the real causes of his symptoms. He had taken so many antibiotics that altered his gut flora or bacteria and promoted yeast overgrowth. Fungus and yeast flourished in his body, growing between his toes, on his toenails, in his crotch, and scalp. He had Helicobacter pylori bacteria in his gut. He had a leaky gut and reacted to many foods, including dairy and gluten. He was exposed to toxins at his job and had high levels of mercury. And he had chronic sinus infections.
So we went to work cleaning house. I treated his yeast with anti-fungals and the H. pylori with antibiotics, got rid of his food allergies, fixed his gut, detoxified him from metals, and cleaned up his sinuses. Then I helped heal his immune system by supporting it with nutrients. I gave him zinc, fish oil, vitamin D, herbs, and probiotics, and put him on a clean, whole-foods, allergen free, anti-inflammatory diet.
At his next follow-up visit, I asked Sam how he was doing, expecting him to say that he felt a little better. However, his response surprised even me. He said he felt fine.
"What about the fatigue?" I asked.
"I have great energy."
"What about the bloating and gas?"
"Nope."
"What about the reflux?"
"Gone."
"What about your sinuses and chronic phlegm?"
"All clear."
"What about your memory and concentration problems?"
"All better."
And he lost 15 pounds.
When his labs came in, they confirmed what he told me -- they were all back to normal. His white cells increased and his immune markers calmed way down.
Sam's results simply reflect the application of a new model of thinking about problems called Functional medicine -- it's a way to get to the root of health problems and treat the underlying causes of what ails you instead of suppressing symptoms with medications.
If you have an autoimmune disease, here is what you need to think about and do.
Nine Steps to Treating Autoimmune Disease
1. Check for hidden infections -- yeast, viruses, bacteria, Lyme, etc. -- with the help of a doctor, and treat them.
2. Check for hidden food allergens with IgG food testing or just try The UltraSimple Diet, which is designed to eliminate most food allergens.
3. Get tested for celiac disease, which is a blood test that any doctor can do.
4. Get checked for heavy metal toxicity. Mercury and other metals can cause autoimmunity.
5. Fix your gut. For details, see my blog on irritable bowel syndrome.
6. Use nutrients such as fish oil, vitamin C, vitamin D, and probiotics to help calm your immune response naturally.
7. Exercise regularly -- it's a natural anti-inflammatory.
8. Practice deep relaxation like yoga, deep breathing, biofeedback, or massage, because stress worsens the immune response.
9. Tell your doctor about Functional medicine and encourage him or her to get trained -- go to www.functionalmedicine.org for more information and to get a copy of the Textbook for Functional Medicine.
Give these steps a try -- and see if you don't start feeling less inflamed. As I said earlier, the answers are right in front of you. Treat the underlying causes of your illness and you will begin to experience vibrant health once more.
Now I'd like to hear from you...
Have you been diagnosed with an autoimmune disease?
How is your doctor treating you?
Have you been frustrated by the medical advice that you've been given?
What steps have you taken to get to the root of the problem, and what have your results been?
Please leave your thoughts by adding a comment below.
To your good health,
Mark Hyman, M.D.
References
(i) Nakazawa, D. (2008). The Autoimmune Epidemic. Simon & Schuster. New York.
(ii) Siegel, C.A., Marden, S.M., Persing, S.M., et al. (2009). Risk of lymphoma associated with combination anti-tumor necrosis factor and immunomodulator therapy for the treatment of Crohn's disease: a meta-analysis. Clin Gastroenterol Hepatol. 7(8): 874-81.
Mark Hyman, M.D. is a practicing physician, founder of The UltraWellness Center, a four-time New York Times bestselling author, and an international leader in the field of Functional Medicine. You can follow him on Twitter, connect with him on LinkedIn, watch his videos on YouTube, become a fan on Facebook, and subscribe to his newsletter.
Follow Mark Hyman, MD on Twitter: www.twitter.com/markhymanmd
David Katz, M.D.: Considering 'Liberation Therapy' for MS
I have HCV and some type of Autoimmune disease which has yet to be diagnosed because the Cleveland Clinic was trying to treat me with Interferon. I was not able to continue the Interferon because of an acute drug reaction. They have nothing to tell me and I am left to do nothing. And they cannot tell me anything about the Autoimmune problem. Plus I have cryoglobulinanemia. So I just have to endure the way I feel. I have been looking into natural treatments. This seems to be my only option.
God bless you for your willingness to see things in a different way medically! Most people and doctors won't. Mischelle Bowser
My journey to health is on this website:
http://www.journey-with-crohns-disease.com/
How is your doctor treating you? I have been to about 4 different doctors and have been treated horribly. I have lost all faith in health care providers. The lack of compassion and care have been an eye opener to me & almost cost me my life
Have you been frustrated by the medical advice that you've been given? yes, they've told me that Remicaid is my last option. After that, their only suggestion is to have my colon removed (at 32 years old!!)
What steps have you taken to get to the root of the problem, and what have your results been? I have tried all the meds and the steroids. I tried a diet that was amazing and it kept me on track for a while but then I had a flare up that made me lose 20 lbs in 3 weeks. I couldnt even hold down water. I tried to be patient with doctors (because they know what they are talking about, right) and give the med's time to work but I was now anemic and I thought I was dying. I admitted myself into the hospital. After 2 blood transfusions, several bags of potassium, and a remicaid treatment, I was able to leave. I get Remicaid IV every 8 weeks and it has been a life saver, however I'm now concerned about the long term effects. Any advise would
Scleroderma, in 2007
How is your doctor treating you?
A dermatologist who is a "scleroderma specialist" prescribed cellcept, which I took for a handful of months.
I take Revatio for Reynaud's.
I was on the antiobiotic protocol (IV clendamycin then 100mg minocycline MWF) but my body cannot handle mino so I recently stopped (drug-induced lupus)
Have you been frustrated by the medical advice that you've been given?
Naturally. I bounced from doc to doc before my diagnosis. Was told I had VEINOUS INSUFFICIENCY because my body had ballooned, couldn't wear shoes, etc. Dernatologist who diagnosed me through observation and biopsy denied symptoms I had were related to scleroderma. My rheumatologist and primary do lots of blood work and other tests (PFT, stress echo, heart catheter) but I feel uncomfortable talking with them about "alternative" treatments.
What steps have you taken to get to the root of the problem, and what have your results been?
Even though mino made me "the bad kind of sick" (it makes you sick initially) I was being cured rapidly as well. :( Will look into Lyme, fungus and other possible infections. I have been adopting an anti-inflammatory diet. It's a work in progress.
Honestly, I am overwhelmed. I feel like I need someone to hold my hand through this and help me figure it out. It's hard to juggle all this with my real life: work, commuting, now school.
Yes, I've been diagnosed with Psoriatic arthritis (and, of course, psoriasis). I've dealt with Hashimoto's thyroiditis since age 13.
Treatment for my PA has been thus: first in thumb, got two cortisone shots, better. Then in feet (worse in right foot). After two visits with podiatrist who kept saying he'd never seen PA that looked like this, and his prescribing rest, ice, and designer footwear (boot), had to beg for the cortisone shot in left foot which helped tremendously. He has palmed me off onto a rheumatologist, which I can't get into until mid-September, but I don't have high hopes. Podiatrist suggested fusing the toes of the feet so that the PA wouldn't have joints to attack or maybe putting me on immune suppressants. Not gonna happen. I will do whatever it takes, and am already looking at acupuncture and dietary changes. Functional medicine is great if you have the financial means. We are retired military and our insurance doesn't cover functional medicine doctors in our area. We are also both currently unemployed. So it will be up to me to fix myself with diet, meditation, sliding scale acupuncture, etc.
I already avoid wheat and chemicals when I can. Looks like for a while it will be a raw diet for me until I see what is going on. Luckily I live in an area where you can actually grow food, so the produce will have some nutrition in it.
The other thing that causes autoimmune problems is refined sugars, because sugar kills the production an sensitivity signalling of the lymphocytes, so as a result the inflammatory messangers have to over-compensate.
In other words - cut out all the carbs, alcohol, refined sugars - cut out all the factory-farmed animals that get no sunlight and are fed corn. Instead - eat only animals that lived outdoors and were grass fed - this changes to omega 6/3 balance of the animals, and the vit. D levels, etc. and you should be doing the same. You need vit. D, omega 6/3 balance, high protien and low carbs. carbs should mainly be complex carbs - stick to brown rice for ex. wheat and corn will give you problems.
http://www.functionalmedicine.org/index.asp
Click on the link for "Find a FM practitioner". You should be able to locate a doctor in your area who uses the same methods as Dr. Hyman (who is himself a leading practitioner of Functional Medicine).
I am taking prednisone, Humira and Methotrexate for the arthritis. I haven't done anything myself to try to change anything, other than trying to lose weight and I am no longer working at a stressful job (I am unemployed). I have read that there is no specific diet for rheumatoid arthritis, although I have a diet heavy in bread and dairy products. It's really frustrating to now be dependant on prednisone and having to give myself shots every 10 days for Humira and every 7 for Methotrexate.
How is your doctor treating you? I am currently on Enbrel.
Have you been frustrated by the medical advice that you've been given? One inept physician that obviously misdiagnosed me, told me I had Spinal Stenosis! I run three times a week, how on EARTH could that even be a possibility!?
What steps have you taken to get to the root of the problem, and what have your results been? My diet and exercise routine include staying away from gluten and other inflammatory foods, everything organic, no red meat unless free range, and a lot of running, yoga, and slight weight training. I maintain a healthy lifestyle and am able to live my life as if I don't have anything wrong with me. It's all about attitude and determination! I have three beautiful children and a very supportive husband, I am blessed and happy regardless of my diagnosis!
I also have RA and have treated it a lot like you. I don't know many who have, but I think it is important that people know that we are out there and they are not doomed to a life of disability and drugs if they so choose. I have started a blog about my experience healing RA with a functional medicine appraoch that you may be interested in. I would love your input!
Best of luck to you!
-PMT
http://flareandbackagain.wordpress.com/
Between the recommendations of my doctors and the advice of my mother (a nutritionist), I began taking probiotics, Samento (cat's claw -- an antimicrobial that treats yeast among other things), flax seed oil, magnesium, and vitamin D. I also began exercising more regularly, and took a new job with a much lower stress level. This helped tremendously, but I still felt very fatigued and needed about 12 hours of sleep a night in order to shake the sleepiness. So my rheumatologist prescribed hydroxychloroquine, which has helped me regain my normal energy level. My ANA is still slightly elevated (no change since the initial diagnosis), even though I have done everything in your nine steps. So perhaps not a cure-all, but my doctors are very happy with my stability, and I feel great!
Treating illnesses the natural way (when possible) and finding the root of the problem is certainly the way to go! Thanks for your column.
Inflamation/pain/dizziness/insomnia/weight gain/neuropathy, That they once again are giving me *it's all in your head* diagnose same way they did before the CREST diagnoses. Diabetes/Neg MRI/Cats of brain neg Allergies, only mold showed up. so TIREd of doctors I could scream.