Chronic inflammation and autoimmune disease

The incidence of autoimmune diseases is rising making it more common than it was several decades ago. All autoimmune diseases combined is the number two cause of chronic illness in America and the third leading cause of Social Security disability claims following heart disease and cancer. According to the National Institutes of Health, autoimmune disease affects far more patients than the 9 million Americans who have cancer and 16 million with coronary artery disease.

Interestingly, autoimmune disorders occur almost exclusively in industrialized countries. People in developing countries who do not live in sterile environment, do not use chemically manufactured home and lifestyle products in their households and do not eat a diet of chemically processed foods generally do not get these diseases.

In fact, according to a recent research, children who grew up on a farm and had lots of contact with domestic animals, have stronger immune systems and are also less likely to develop any autoimmune disease later in their lives.  Exposure to bugs, infections and dirt trains children’s immune systems to recognize and protect its own body from the foreign agents.

There is no single cause for autoimmunity. Genetic factors, environmental triggers and infectious agents interact with an individual’s immune system in many complex ways. However, even people who are not genetically predisposed can also develop autoimmune disease.

Chronic inflammation is the main consequence of an autoimmune reaction and occurs when the anti-inflammatory response of the body is impaired.

The immune system is intended to recognize and protect all cells and tissues of our body. At the same time it has to identify, attack and eradicate all foreign invaders such as viruses, bacteria, parasites, foreign cells and fungi that can be harmful. In autoimmune diseases, this process goes out of control and the immune system mistakenly attacks the body itself destroying the healthy tissue it was designed to protect.

Conventional approach to treat inflammation

Both under- or overreaction of the immune system in response to the foreign invader is followed by hidden inflammation that most people could not feel and which is the root cause of all chronic illnesses such as diabetes, obesity, cancer, dementia, autoimmune and heart disease. These real health problems arise when the inflammation becomes chronic and not when the body shows a normal response to the acute types of inflammation.

Acute inflammation such as allergy, rush, hives, injury or sore throat is a normal appropriate response of the body’s defence system to infection or trauma. In conventional medicine common anti-inflammatory drugs such as aspirin, ibuprofen or steroids are prescribed for acute inflammation. However, most of them interfere with immune response and result in many drug side effects that can be even deadly in some cases.  

Conventional medicine believes that prescription drugs are the only way to fight the disease and if there is no medication for some health conditions then no solution is offered. Drugs do not address the causes of disease and can provide patients only with a partial solution to autoimmune conditions due to its complexity, multiple dysfunctions and variety of symptoms.

There are no any effective treatments for most autoimmune conditions offered by mainstream medicine that can stop its progression. The specialists are focused on the different organs prescribing medications for each of them and/or every particular symptom.

At the autoimmune conditions, the tissue is attacked because it is unhealthy. Once it is targeted the immune system memorizes it and continues to destroy it as if it would be a foreign invader. In this situation, immunosuppressive drugs such as prednisone or any other form of hormone cortisol slows the attack and reduces inflammation only to come back as a new flare up after the drug is discontinued. The affected tissues remain unhealthy and it still gets attacked and the destruction progresses.

In some autoimmune conditions such as Hashimoto’s disease the corticosteroids and other pharmaceutical immunosuppressive drugs are usually not prescribed for reducing the inflammation because the side effects outweight the benefits. Dr. Kharrazian uses natural medicine for modulation and balancing of the immune system in Hashimoto’s.

At Hashimoto’s, thyroid drugs can help to lower TSH and reduce inflammation of the thyroid gland. Cortisol containing medications such as prednisone or hydrocortisone are common for treatment of adrenal fatigue, Addison’s and thyroid eye diseases which often accompany Hashimoto’s.

Holistic approach to inflammation

A holistic approach to healing chronic inflammation and autoimmune disease is based on finding all triggers that cause the dysfunction and helping to balance the immune system by removing them. This approach is intended to evaluate the body as a whole and heal systemic inflammation that can affect multiple organs at the same time. Addressing the causes can help people who have unexplained symptoms and multiple health issues that are linked together by inflammation. Holistic medicine gives a possibility of remission, healing and even reversal in some cases that were diagnosed early.

C-Reactive Protein (CRP) is a simple blood test that measures the degree of inflammation in the body. This test indicates if the inflammation is present but it does not point to a particular cause or organ. If this marker is elevated, your doctor should investigate the possible causes for the inflammation using specific lab tests. After it is found, the CRP test can be used for the monitoring of treatment effectiveness.

Hashimoto disease is the most common form of inflammation of the thyroid gland (thyroiditis) which is followed by goitre and can result in complete thyroid dysfunction with time. If you have Hashimoto’s and elevated CRP it can be due to one or more of the following inflammatory factors:

1. Acute inflammation of the thyroid gland. Interestingly, CRP test cannot be used to identify inflammation in every autoimmune condition. For example, CRP test does not show positive in patients with Hashimoto’s and celiac diseases unless an acute inflammation is present and/or the condition is severely undertreated.

2. Another inflammatory associated autoimmune disease such as rheumatoid arthritis, lupus and alopecia which often accompany Hashimoto’s. About 50% of Hashimoto’s patients develop one or more of other autoimmune diseases during their lifetime that indicates systemic inflammation. Moreover, people with Hashimoto’s are prone to have polygrandular disorders when more than one gland is affected. Other conditions linked to high CPR levels are cancer, Alzheimer’s and heart diseases.

3. Chronic and hidden infections such as bacteria, viruses, yeasts or ticks. In patients with Hashimoto’s thyroiditis infections are very common and either trigger an autoimmune reaction or cannot be eradicated by the impaired immune system due to the disease.

Bacterial infection and autoimmune flare ups require different treatments. In conventional medicine the immediate use of antibiotics is needed for the bacterial infection while immunosuppressive drugs to reduce the inflammation are prescribed for many autoimmune diseases such as multiple sclerosis, thyroid eye disease and sarcoidosis to name a few. The wrong choice between these two treatment approaches can aggravate the condition.

Early differentiation in diagnosis between infections and autoimmune disease is difficult because of the similar clinical presentations and laboratory findings. The white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) level are not always helpful because these markers are elevated not only in infectious conditions, but also when the underlying autoimmune disease flares.

One recent study showed that the CRP levels are significantly higher in patients with infection than in those who have an autoimmune disease flare up. However, the inflammatory signs can be masked in the case of hidden inflammation and the CRP level can be decreased with corticosteroid therapy or immunosuppression, which are basic treatments for many autoimmune conditions.

4. Poor diet which includes sugars, refined carbohydrates, certain types of fats, processed and nutritionally deficient foods. People who are overweight  and/or have blood sugar irregularities such as hypoglycemia, insulin resistance, diabetes, metabolic syndrome X tend to have higher than normal CPR levels. Hypoglycemic diet can help to balance blood sugar and reduce inflammation.

5. Chronic and hidden allergies to food and environmental compounds, usually plants, microorganisms, metals and other materials. Typical examples are seasonal rhinitis or hay fever from airborne pollens, allergic conjunctivitis, acute skin allergy, dairy and gluten intolerance. All of them are exaggerated but otherwise normal response to certain environmental substances or foreign allergens. In this way allergies are fundamentally different from autoimmune diseases. The autoimmune reaction can be triggered by a variety of environmental factors, however the immune system attacks self-antigen in its own tissue.

6. Environmental triggers such as toxins, mercury, pesticides (link to environmental triggers). We continue to surround ourselves with thousands of chemicals whose properties and influence on us we do not yet fully understand.

7. Lack of exercise. The immune system responds well to exercise and tolerable level of physical activity is recommended with certain precautions. Moderate amount and intensity exercise generally bring favorable changes while overtraining as well as long lasting and strenuous physical activity are considered to have immunosuppressive effects for a certain period of time even after the exercise. These changes during and after exercise can be partly explained by a general response to stress and high cortisol levels.

Exercise can reduce stiffness and joint paint, increase muscle strength, endurance and flexibility. It also helps to lose weight, improves mood and well-being. However, there are many types of exercise that can actually make you feel worse. It is important to pay attention to signals from your body, do not push too hard and choose the right type of exercise if you have hypothyroidism.

8. Stress causes an initial stimulation of the immune system activity and mental ability that last for a few minutes. During the periods of chronic stress integrity of the immune system becomes negatively affected leading to:

  • General suppression of the immune system  causing cell break down that can lead to a variety of allergies, recurrent yeast infections, systemic inflammation, depression, dysbiosis, certain forms of cancer and autoimmune conditions
  • Shrinking of the thymus gland which is one of the key immune tissues of the body. Here is how to restore it
  • Suppression of the white blood cells ability to secret chemical messengers such as interleukins and interferons causing the disturbances in the communication between various cells of the immune system and diminishing their ability to fight invasive pathogens and infections effectively.
  • Cortisol can send a signal to many cells of the immune system to shut off and die.

Immunosupressive drugs can be effective only for a short period of time because the use of high or moderate doses for prolonged periods results in the same tissue breakdown and metabolic imbalances that occur in person under chronic stress.  Because of this reason people with autoimmune diseases tend to experience flare ups and an increase of their symptoms when they are under the long-term stress.

All these inflammatory factors are individual for each person and have to be established by a qualified doctor. Life style, environment and infections have different impact on the immune system of each person and can lead to different autoimmune diseases and many other chronic illnesses based on their genetic predisposition.

There is a nutritional approach to healing inflammation. You can read about Foods that heal inflammation in lesson 10 of the Nutritional guide for Hashimoto’s disease and hypothyroidism. Subscribe here for FREE!

P.S. Read more in Hashimoto’s disease and Thyroid Inflammation Treatment

References:

The autoimmune epidemic: Bodies gone haywire in a world out of balance – and the cutting-edge science that promises hope by Donna Jackson Nakazawa, Simon and Schuster, 2008

The autoimmune connection: Essential information for women on diagnosis, treatment, and getting on with your life by R. Baron-Faust, J.P.Buyon, McGraw-Hill Professional, 2004

The prevalence of elevated serum C-reactive protein levels in inflammatory and noninflammatory thyroid disease. Thyroid. 2003 Jul;13(7):643-8.

Living well with autoimmune disease: what your doctor doesn’t tell you – that you need to know by M.J. Shomon, HarperCollins, 2002

The inflammation syndrome: Your nutrition plan for great health, weight loss, and pain-free living by J.Challem, Wiley, 2010

Serum procalcitonin for differentiating bacterial infection from disease flares in patients with autoimmune diseases. J Korean Med Sci. 2011 Sep;26(9):1147-51

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