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Long COVID Doesn’t Need to be Exhausting

Are you ready to overhaul your COVID symptoms? Finding relief at the end of a very long, arduous fight can be resolved with proper diagnostics and support. Getting to the root cause of your aches and pains is just what Dr. Autoimmune ordered. 

What is long COVID?  

Current research is conflicting, but it appears continuing symptoms could persist 1-3 months after infection, or even longer. The virus can trigger inflammation in various systems in your body, creating one or more symptoms.

If you have tested positive, or know you were exposed and have new or persisting symptoms from the the list below, your inflammation could be getting the better of you. Unfortunately these symptoms are so common that one research article indicated 52% of 16-30 year olds had symptoms at 6 months post-infection. These are some of the symptoms associated with long COVID:

Neurological:

  • Insomnia
  • Headaches
  • Fatigue
  • ‘Brain fog’
  • Anxiety/depression
  • Memory impairments
  • Pain syndromes

Lung / Pulmonary:

  • Reduced lung capacity
  • Wheezing / gasping / unable to get full breath
  • Chest pain / tightness

Cardiac:

  • Palpitations
  • Abnormal heart rhythm
  • Clotting abnormalities

Gastrointestinal:

  • Abdominal pain
  • Nausea
  • Weight loss
  • Constipation
  • IBS

Endocrine:

  • Elevated insulin
  • Fatigue after meals
  • Shaky, lightheaded or ‘hangry’

Why me?

Long COVID thrives on immune system weaknesses! There are multiple reasons why some experience long symptoms, while others are unscathed. Contributing factors may include age, obesity, inflammatory markers, and insulin resistance (IR). IR is when your cells resist insulin and can no longer use glucose for energy. This can cause sugar cravings after meals, weight loss resistance, and fatigue. 

One of the common symptoms of long COVID, loss of smell and taste, may indicate that the brain is resistant to insulin and therefore not getting enough fuel. Insulin resistance can lead to neurodegeneration (conditions like Parkinson’s and Alzheimers). Correcting insulin imbalances often lessen or eradicate symptoms.

How do we control insulin resistance?  

Functional medicine might be the answer to your blood sugar handling issues. Assessing inflammation in the body is the first step for determining if your problem is systemic and what the root cause may be. Commonly, the culprit is in your gut. Imbalances in your microbiome have a profound effect on all of your bodily systems. Hormone imbalances can have a similar impact. Could cortisol and stress dysregulation be causing sleep disturbances, leading to insulin resistance? A resounding yes!  

Dr. Autoimmune can help!

We have seen a dramatic increase of long COVID cases hauling their way through our practice. For many, autoimmunity was triggered or exasperated by the virus. Our proprietary process of diet, supplementation, lifestyle strategies and therapies can change your life. We have even seen cases that are now two years old improve or remiss!  

Call us today and find out how our New Patient Exam process can help your health soar.

Autoimmunity Is Rising- Have You Been Tested?

What are Antinuclear Antibodies?

Antinuclear antibodies (ANAs) are antibodies (proteins that our body creates to fight infections) that are made to attack our own body, or “autoantibodies”. The prefix ‘auto-’ means ‘self’. So, autoantibodies are antibodies against the self, and an autoimmune disease occurs when someone’s immune system is attacking their body using autoantibodies. Examples of autoimmune diseases include multiple sclerosis, Hashimoto’s thyroiditis, rheumatoid arthritis, scleroderma, lupus, and many more. Antinuclear antibodies attack the nucleus of our cells, hence their name.

A positive ANA usually suggests a vascular condition, or a condition that affects blood flow. Some autoimmune vasculitis conditions include systemic lupus erythematosus (SLE), Sjogren’s syndrome, scleroderma, mixed connective tissue disease, and Wegener’s granulomatosis.

Implications

The presence of ANAs in your blood could mean that you might develop an autoimmune disease in the future, if you don’t already have one. Note that typical autoimmune disorders take 5-9 years to develop and symptoms may or may not be present.

In other words, testing for ANAs may provide a chance to stop a disease before it really starts. This is why it is included in our initial and every follow-up blood panel!

The prevalence of autoimmune disease and ANAs has been rising over the last few decades. While the western medical model deems the presence of ANAs a nonconcern without the presence of symptoms, we are now seeing that it can progress into an autoimmune condition over the course of a few years if left unchecked.

Researchers from the National Institute of Environmental Health Sciences (NIEHS) studied the prevalence of positive ANA markers over a 25 year period. Here is what they found:

  • From 1988–1991, 11% (~22 million people) had a positive ANA
  • From 1999–2004, 11.5% (~27 million people) had a positive ANA
  • Here’s the kicker: From 2011–2012, 15.9% (~41 million people) had a positive ANA

From 22 to 41 million people in 25 years is a huge jump! Among the age subgroups, adolescents (ages 12-19) had the highest rate of change, with their prevalence nearly tripling over the time period from 5% to 13%.  Another way to grasp this is that from 88’-04’ ANA Abs jumped 23% and from 04’-12 ANA Abs exploded another 52%!!!

Understanding Test Results

So, you got a positive ANA result on your blood test. There are a couple of other pieces of information next to that result that may seem a bit confusing. Let us break it down for you.

Titer

Your titer is the measure of how many antibodies were found in your blood. You may have a titer of <1:40, 1:40, 1:80, 1:160, or 1:320. The ‘1’ before the colon represents a certain volume of blood, and the number after the colon represents the amount of ANA’s found in that amount of blood. 

A negative test would be a level, or ‘titer’, of less than (<) 1:40 (a.k.a. 40 antibodies per measure). A low titer is between 1:40 and 1:80 (40-80 antibodies per measure), while a high result would be 1:80 or above. It can be confusing because the number presents as a ratio, so one might think that 1:160 is smaller than 1:80, but the reality is a 1:160 titer is double that of a 1:80. 

Pattern

If you have a positive ANA result on your labs, next to your titer there will be a pattern. This just describes how the ANAs look under a microscope. Here are the types of ANA patterns and their associated conditions:

  • Speckled (most common in females)
    • Systemic lupus erythematosus (SLE)
    • Sjogren’s syndrome
    • Systemic sclerosis (scleroderma)
    • Polymyositis
    • Rheumatoid arthritis
  • Homogenous (most common in males)
    • Can be seen in any autoimmune disease, higher levels associated with Lupus
  • Nucleolar
  • Mitochondrial
    • Primary biliary cholangitis (PBC)
    • Systemic sclerosis (scleroderma)
  • Cytoplasmic
    • Primary biliary cholangitis (PBC)
    • Systemic sclerosis (scleroderma)
    • Autoimmune hepatitis (AIH)
  • Speckled + Cytoplasmic
    • Antisynthetase syndrome
  • Centromere
    • Systemic sclerosis (scleroderma)
    • Raynaud’s phenomenon
  • Homogenous + Nucleolar
    • Systemic lupus erythematosus (SLE)
    • Chronic autoimmune hepatitis
    • Juvenile idiopathic arthritis

What Can We Do?

All autoimmune conditions, including rheumatoid arthritis, celiac disease, lupus, and Sjogren’s syndrome, require three things to develop:

  1. Genetic predisposition
  2. Intestinal permeability (a.k.a “leaky gut”)
  3. An environmental trigger (can be inflammation, toxin exposure, food sensitivities, infections, or even stress)

Two of these things can be controlled. With proper nutrition and supplementation, we can heal leaky gut, reduce inflammation, and remove food triggers. Interventions can be taken to remove other triggers also, such as testing your house for mold and treating infected sinuses.

When we see a positive ANA marker, we want to get those antibody levels down to slow down or stop disease progress. One of the first things to do is remove gluten from the diet because gluten is a common food trigger that causes inflammation and worsens leaky gut.

What may be most important to realize is that this one marker is a wake up call.  You need to become very serious about your health if this is positive, and your level of dedication to daily habits and lifestyles that promote inflammation need to change!  That may be hard to swallow, but your body is infinitely wise and it is trying to tell you that what you are doing is not working and we need to change direction to get back into harmony!  Our program has shown an 85% success rate with autoimmune disorders, but it requires your participation – the pill to fix the ill is not our approach!

If you’re interested in getting a comprehensive blood test that includes the ANA marker, and then developing a plan for reaching optimal wellness, contact us below!

Ian Hollaman, DC, MSc, IFMCP

Women in Medicine

For centuries, women have been making groundbreaking contributions to the field of medicine. Unfortunately for much of history, female scientists have been overlooked or had the credit for their contributions stolen. Since March is National Women’s History Month, we here at Dr. Autoimmune wanted to take a moment to highlight some of these scientists. From creating life-saving treatments to discovering new elements, here are some extraordinary women who made waves in medicine:

Marie Curie (1867 – 1934)

  • First woman to win a Nobel Prize
  • First and only woman to win a Nobel Prize twice
  • Only person to win two Nobel Prizes in two different disciplines (chemistry and physics)
  • First woman to become a professor at the University of Paris (1906)
  • Discovered radioactivity- she even coined the term!
  • Discovered the two elements of polonium (named after Poland, her native country) and radium
  • Founded the still-major medical research centers, the Curie Institute in Paris and the Curie Institute in Warsaw
  • Pioneered research in using radioactive isotopes to minimize tumours, a.k.a chemotherapy
  • Invented mobile X-ray machines for field medicine during World War I

Alice Ball (1892 – 1916)

  • First woman and first African-American to graduate from the University of Hawaii with a master’s
  • Developed the “Ball Method”, which was groundbreaking in the treatment of leprosy

Gerty Cori (1896 – 1957)

  • First woman to receive a Nobel Prize in medicine
  • Discovered how our bodies store and use glycogen for energy
  • Identified and named the “Cori Cycle” after the process of glycogen being broken down into lactic acid and converted to usable energy
  • Also identified the catalyst in this process as the “Cori ester”
  • Discovered the root cause of glycogen storage disease as being an enzyme defect

Helen Taussig (1898 – 1986)

  • Founded the field of pediatric cardiology
  • Discovered the cause of “blue baby syndrome” and developed a procedure that saved countless childrens’ lives
  • First woman and first pediatrician to be elected head of the American Heart Association
  • Was awarded a Presidential Medal of Freedom in 1964

Gertrude B. Elion (1918 – 1999)

  • Invented first immunosuppressive drug, which was used to reduce rejection rates among organ transplants
  • Invented first treatment for leukemia
  • Oversaw the development of AZT, the first treatment for AIDS

Rosalind Franklin (1920 – 1958)

  • Took the first image, an X-ray crystallography photo, of DNA
  • Her discovery of DNA’s double helix structure was stolen by James Watson and Francis Crick, who published the discovery, only mentioning her in a footnote, and won the Nobel Prize for themselves

All of these women had to deal with sexism and exclusion in their respective fields throughout their career, yet they persevered. Thanks to their perseverance, we have X-rays, numerous successful treatments, and an overall better understanding of the human body and its processes. We are honored to be able to use our platform to keep their names alive in our collective memory.


We know that making changes in your daily habits can be difficult, but when something is as important as your health, or a potentially groundbreaking scientific discovery, you have to persevere. Anything worth anything takes courage, determination, and patience. Hopefully we can all learn a little something about courage from these brilliant women who never gave up, despite the challenges they faced every step of the way.

Feel inspired to take your life by the reins? Send us a message below. We are eager to help you reach your wellness goals.






    The COVID-Immune Connection

    Numerous credible sources have been discussing the link between current events and the increase in autoimmunity. They claim we are facing a ‘super-epidemic’ of autoimmune disease as a result of both the COVID-19 infections and vaccines. This may sound alarming if you didn’t happen to know that we are already in an autoimmune epidemic in the western world. Over the last 30 years, the instance of autoimmunity has tripled! The number of Americans with autoimmune disease now surpasses the number with heart disease.  In fact, the most common autoimmune disease, Hashimoto’s thyroiditis, accounts for 90% of hypothyroidism cases.

    Although there is a genetic component to autoimmune disease, this rapid increase can not be explained by an increase in the frequency of the causal genes. These autoimmune conditions are forming in people who have already been born (and unfortunately research by the Environmental working group shows that mom’s pass on hundreds of toxin residues prior to a child’s birth) and may not have developed the condition until later in life. This means that these genes were always here, but something new is triggering their expression. The study of how environmental factors such as pathogens, chemicals and nutrients affect gene expression is called epigenetics. This category of factors is the culprit for our autoimmune epidemic.

    So what has really changed in our environment over the last few decades? More than ever, our society consumes toxins on a regular basis. Pesticides, antibiotics, preservatives and thousands of other chemicals called “persistent organic pollutants” are present in our food, water, medicine and air. In addition to physical toxins, our bodies are also constantly being bombarded with harmful EMF radiation.

    Another major factor that has changed in our society is our newfound obsession with sterility and hygiene since the discovery of viruses and other harmful microbes (hand sanitizer anyone?). The hygiene hypothesis refers to the idea that consistently introducing the body to different microbes results in a stronger immune system, whereas keeping the body in a sterile environment weakens the immune system, leading to a higher instance of allergies and autoimmune conditions. Your immune system needs to have the chance to meet different microbes so that it can learn how to launch a defense. If you never give it that chance because you sanitize everything you touch, how will it ever be able to protect you?

    While introducing pathogens to your immune system is important for building it, the onset of infection can be a double-edged sword. Professor Yehuda Shoenfield, who is fondly referred to as the ‘father of autoimmunity,’ has identified that the cytokine storm caused by an infection is the first in a pattern of events that consistently lead to autoimmune conditions. Therefore, pathogens can actually provoke autoimmunity in some people while strengthening the immune systems of others. The main determining factor is whether the individual is predisposed for autoimmunity (ie, is the gun loaded and primed?). Other important factors are their gut microbiome health, nutrient status, exposure to environmental pollutants and toxins, stress, hormones and low vitamin D levels.

    COVID-19 is not the first time that we as a society have dealt with a coronavirus. This is actually the third of its kind to emerge in the past two decades. In 2003, we saw the SARS epidemic and in 2012, the MERS-CoV epidemic in the Middle East. A correlation between autoimmune diseases and coronaviruses has already been established following these previous outbreaks. Not surprisingly, there is already emerging evidence of autoimmune reactions in the body following a COVID-19 infection and correlations have already been found between severe Covid cases and certain autoimmune diseases including immune thrombocytopenic purpura (ITP), Guillain-Barrė syndrome (GBS), Miller Fisher syndrome (MFS), and, in children, Kawasaki-like disease.

    It is common knowledge at this point that COVID-19 cases don’t always end once the initial virus has run its course. The term “Covid long-haulers” refers to those suffering from the first post-viral syndrome to ever be recognized in the medical community. Many COVID-19 patients have found that they are left with such symptoms as these for months following their initial infection: breathing difficulties, chest pain, chills, disorientation, hallucinations, muscle/body aches, insomnia, exhaustion, vomiting, diarrhea, high temperature, hair loss, and even cognitive issues such as memory loss, brain fog and confusion. It seems the most common symptoms are extreme fatigue, lingering cough, shortness of breath and body aches.

    So, why do some COVID-19 sufferers end up with this so-called “long COVID” for months, while other people get to kiss their infection goodbye after only a few weeks? A body’s ability to destroy the virus and then repair the bodily damage that it caused is determined by a number of factors. The state of our health prior to the infection, our levels of important immune-supporting vitamins, our genetics and our levels of stress are the most impactful. The problem with these factors is that they can be sneaky. Many people may not be aware that they have one. People don’t know if they have a nutritional deficiency or genetic predisposition. While many so-called ‘long-haulers’ were dealing with another autoimmune condition prior to contracting Covid, sufferers from long-hauler syndrome have also been people who seemed healthy pre-infection.

    The solution for long-haulers may be found in functional medicine and natural solutions. The reasons one’s body may not be recovering properly are entirely individual. The functional medicine model focuses on an individualized approach to care, taking into account the patient’s diet and lifestyle. Often, complex health issues such as this can be addressed by resetting the immune system.  In fact, Dr. Autoimmune has now seen over a dozen post-covid infection cases with every single patient responding favorably to addressing deeper health issues like insulin resistance, obesity, elevated blood pressure, nutrient deficiencies and hidden infections that continued to sap the body’s ability to heal itself.

    The way that functional medicine approaches complex immune issues is to:

    •  First, look at the gut health of the individual. The immune system is affected by the gut microbiome and the integrity of the intestinal lining. This gut-immune connection is often at the heart of chronic inflammation. The protocol here is to remove, replace, repair, reinoculate and rebalance. Remove pro-inflammatory foods from the diet, replace them with clean foods, repair the gut using supplementation/lifestyle change, and finally reinoculate the gut with healthy bacteria.
    • Second is understanding if there are signs of blood sugar handling stress; ie, do you have any fatigue after meals or carb cravings following a meal?  Or, do you get shaky, lightheaded or irritable in between meals?  If either of these are present you will see significant swings in blood sugar and this is highly stressful to your immune system!
    • Third on the list is detoxification, starting with identifying areas in the patient’s life where they could be exposed to toxins, and ending with a full detox using supplementation and diet to support the kidneys and liver.
    • Fourth, inflammation is addressed through nutrition.
    • Fifth is the official ‘immune system reset’. Our bodies evolved to naturally clean out dead cells to stimulate the production of new ones through intermittent fasting. It is important to support the process of cleansing with certain nutrients such as vitamin D and zinc.
    • Lastly, we address mitochondrial fatigue and start resuscitation. Mitochondria are the organelles within our cells that produce usable energy for our bodies. If they aren’t working optimally prior to infection, we likely will have a harder time mounting a defense and then be left severely depleted. Through nutrition and lifestyle change, functional medicine can support mitochondrial resuscitation.

    Long-hauler syndrome is an immune system condition at its heart, with likely an autoimmune component to it. The fact that COVID-19 can trigger certain autoimmune diseases is part of why many leading immunologists are warning us of an approaching autoimmune super-epidemic. The main concern for other immunology experts is not the infection itself, but the vaccine designed to protect against it.

    The concern regarding vaccines and autoimmunity is not a new one. In fact, the link is known. There is even a term for this class of conditions!  Autoimmune syndrome induced by adjuvants (ASIA) is the term coined for autoimmune conditions that are triggered by an ingredient in vaccines called an adjuvant. Vaccines have traditionally included a live virus and required an adjuvant to work effectively. Aluminum is the most common adjuvant. This toxin also happens to be a huge risk factor for developing autoimmune disease (you ask your providers for “metal/preservative free” versions of vaccines).

    The new COVID-19 vaccine is the first vaccine to use mRNA technology instead of the live virus itself. Therefore, adjuvants are not needed in Pfizer, Moderna or AstraZeneca’s vaccine. However, even a leading vaccine manufacturer, Novavax, has admitted that, “…it has been hypothesized that immunizations with or without adjuvant may be associated with autoimmunity.”

    The reason for this lies in the concept of molecular mimicry, which is exactly what it sounds like. When two molecules look identical or very similar, they can be mistaken for each other. Basically, after the COVID-19 infection, your body is hyped up and ready to destroy all of the proteins associated with COVID using pre-made antibodies. It is in a state of hypervigilance for these specific proteins. It is awfully concerning, then, to know that COVID-19 shares 26 identical proteins with humans (further confirmed through multiple peer reviewed journal articles recently published). That means that your body is now likely to attack those proteins indiscriminately, even if they are part of your body and not part of a virus. So whether or not the virus itself or the mRNA for fighting the virus is used in a vaccine, the concern of molecular mimicry is still there.

    One particularly concerning group of proteins that are susceptible to this mimicry are the proteins in our lungs creating a surfactant to cover our alveoli. The alveoli are tiny air sacs in our lungs that allow for gas exchange (A.K.A. breathing). Surface tension on the alveoli has to be kept at an ideal level in order to keep them from collapsing. Alveolar surfactant proteins are responsible for this job. They also share an identical peptide sequence with the glycoprotein on the virus, meaning that they could be collateral victims in your body’s attack on covid.  This is why it is so crucial we have a regulated immune system.  Basically, the question you should be asking yourself is, “Is my immune system self-regulating or do I have predispositions I’m not aware of increasing my risk of complications?”  Although there are many factors that push our immune system one way or another, your provider should be able to sit down with you and come up with a game plan on how to optimize your health!

    There are multiple mechanisms by which our super-epidemic may be achieved. It is not possible as of now to predict the exact numbers, but one thing is for sure: in the years to come following this pandemic, we will see an unprecedented spike in autoimmune disease.

    Yours truly in optimizing the immune system,

    Ian Hollaman, DC, MSc, IFMCP

    For more up to date information and tips on autoimmunity please visit our blog

    10 Ways to Use Coconut on the Autoimmune Protocol

    Coconuts are not nuts to many people’s surprise, which is an amazing gift to those embarking on an autoimmune nutrition protocol. During the autoimmune nutrition protocol, nuts and seeds are avoided temporarily to aid digestion and gut healing. The low glycemic coconut meat and water inside contain many healthful macro and micronutrients to support gut healing, fight inflammation and boost immunity.

    Coconuts contain 65% fat in the form of medium chain triglycerides (MCT) which are shown to contribute to increased metabolism of fat for fuel, help satiate appetite and cravings, and improve brain function in epilepsy, Alzeihmer’s, and other neurodegenerative diseases. The fatty acids in coconut oil are much more easily converted into one of the mitochondria’s prefered fuels: beta-hydroxy-buterate (BHB). BHB is a ketone molecule that can be made in the body by restricting carbohydrates, exercising, and increasing coconut oil intake. The benefits of feeding your cells BHB over glucose is that beta-hydroxy-buterate protects your neurons and reduces the burden of insulin demand on the pancreas. One study showed successful reduction of neurodegenerative symptoms in Alzheimer’s disease. BHB is a clean burning fuel for your mitochondria, which are the power plants of your cells, and can reduce the production of potentially harmful reactive oxygen species (ROS) inside the cell and even clean up the damage of oxidative damage done by ROS. 

    The meat and water of the coconut contain a considerable amount of minerals and phytonutrients such as B vitamins, vitamin C, vitamin E, potassium, magnesium, manganese, copper, and iron. Phytonutrients such as shikimic acid aid in coconut’s antimicrobial, antiviral, and antifungal properties. Coconut also contains galactomannan and pectin which improve blood sugar regulation and support healthy cholesterol levels. These are the many reasons to include coconut in your daily diet while healing from Hashimotos, neurological degenerative disease, heart disease, and diabetes. Enjoy some of Dr. Autoimmune’s TOP 10 ways to use coconut!

    Shaved coconut and coconut millk

    Homemade Coconut Milk

    • 2 cup warm water
    • 1 cup dried coconut shavings

    Add dried coconut shavings and warm water to blender. Blend ingredients in a high speed Blender. Place your nut milk bag in a large wide mouth jar. Pour the blended nut mixture into the nut milk bag jar. Squeeze out the nut milk using your hands and milk bag.

    Coconut Water Kefir

    • Glass mason jar with lid
    • Piece of cheesecloth
    • Plastic strainer
    • Plastic measuring spoons
    • 1 quart organic coconut water
    • 3 tablespoons water kefir grains https://shop.culturesforhealth.com/collections/kefir/products/water-kefir-grains
    • 1 cup fresh berries

    Place the water kefir grains in the coconut water.

    Cover the jar with cheesecloth so that grains can breathe – allow the kefir grains to culture the coconut water for 24 to 48 hours, out of direct sunlight.

    Once the culturing process is complete, remove the kefir grains using a strainer.

    Puree the fresh fruit and coconut water to add fabulous flavor.

    To refresh kefir grains, add them to a quart of water with a ¼ cup of coconut sugar. Let this sit for about 48 hours so that the sugar water has time to feed the grains.

    Note: Never use metal utensils when dealing with live cultures.

    Coconut Curry

    • 2 cans coconut milk
    • 1 oz fresh ginger, sliced
    • 1 oz fresh turmeric, sliced
    • 3 bay leaves
    • 1/4 cup curry powder (homemade: omit cayenne powder for nightshade free curry powder. Include  2 tsp turmeric, 1 tsp cumin, 1 tsp coriander, ½ tsp fenugreek, 1 tsp ginge, ¼ tsp black pepper)
    • 1 jalapeño (optional)
    • 3 garlic cloves, minced
    • 2 lbs stew meat
    • 1 tbsp Coconut oil
    • Salt to taste at the end

    Heat 1 tbsp of coconut oil in a large sauce pan at medium-high heat. Add the stew meat and let brown for 5 minutes. Add garlic, ginger, turmeric, and jalapeño and stir until garlic becomes aromatic. Add coconut milk, bay leaves, and curry powder. Bring to boil then simmer for 20-30 minutes. Add salt to taste at the end.

    Serve with vegetable stir-fry or oven roasted vegetables.

    Blueberry Cobbler

    • 2 pints organic bluberries
    • 1 juice from one lemon
    • 1/4 cup coconut flour
    • 1/3 cup coconut butter
    • 1/3 cup coconut shavings
    • 1-3 Tbps of raw honey or sweetener of choice
    • 1 tsp cinnamon (optional)

    Preheat oven to 375 degrees. Mix half the lemon juice and blueberries in a 9 x 9 inch baking dish, drizzle with a little Honey. In a mixing bowl, mix remaining ingredients plus remaining honey. Crumble the coconut dough on top of Blueberries. Bake for 30 to 35 minutes.

    Ranch Dressing

    • 3/4 cup water
    • 3/4 cup coconut milk 
    • 5 tablespoons of fresh dill, chopped finely (2-3 tbsp dried)
    • 2-4 tablespoons olive oil (can adjust for desired consistency)
    • 2-4 tablespoons apple cider vinegar
    • 1 teaspoon sea salt
    • 1/2-1 tsp fresh ground pepper
    • 1/2 teaspoon garlic powder
    • 1 garlic clove, peeled

    Place everything except the dill in a blender and blend until smooth. Pour into a larger bowl and stir in dill. Reserve in a glass jar and store in the refrigerator. Keeps about one week.

    Vibrant Coconut Panna Cotta

    • 1 cup thick coconut cream
    • 1- 1 1/4 tsp organic gelatin
    • 2 tbsp water
    • 1-2 tbsp Raw Honey
    • 1- 1 1/2 tsp organic Raw Beet powder
    • 1/2 -1 tsp vanilla
    • Optional add in or replacement: Food grade peppermint, rosemary, or basil essential oil; or replace beet powder with cacao, matcha or spirulina powder

    Add gelatin, water and beet powder together in a small saucepan using a spoon to create a paste. Set this aside for a minute or two as it will allow the gelatin to bloom and thicken. Add remaining ingredients to saucepan and heat on medium-low heat until the gelatin has dissolved (1 – 2 minutes). Make sure all the ingredients are evenly combined. Taste the mixture and adjust any of the flavor or sweetness to your liking.

    Pour mixture into a glass jar or mug and place it in the fridge to set. Let chill for 2.5-3.5 hours

    Coconut Sour Cream

     Makes 1 to 2 cups (varies depending on how much cream is in each can)

    • 2 (13.5oz) cans full fat coconut milk, chilled
    • 1 tsp probiotic powder (bodyecology.com)
    • Pinch sea salt

    Place the cans of coconut milk in the refrigerator for about 24 hours. Then open the cans and scoop the thick white cream at the top into a small saucepan. Pour off the coconut water into a jar and reserve it for another use (such as a smoothie). Heat the coconut cream over the lowest heat to about 98°F. Remove the pan from the heat and whisk in the probiotic powder. Pour the mixture into a clean quart jar and cover with a clean dish towel secured with a rubber band.

    Let the jar sit out on your counter for 24 to 48 hours to culture.

    Then stir in a pinch or two of sea salt, cover the jar with a lid and refrigerate to solidify. Use as desired.

    Coconut Cinnamon Roasted Sweet Potato

    • 2 medium sweet potatoes, peeled and cubed
    • 2 tbsp melted coconut oil
    • 1 to 2 tsp ground cinnamon
    • 1/2 tsp sea salt

    Preheat the oven to 425°F. Put the sweet potatoes, oil, cinnamon, and salt in a large baking dish or rimmed baking sheet and mix well to coat with the oil using your hands or a large spoon. Bake, uncovered for 30 to 35 minutes or until the yams are very tender.

    Homemade Dark Chocolate

    • 1/4 cup melted coconut butter  (measure after melting)
    • 1/4 cup carob powder, cocoa powder or cacao powder  *NOTE: if using carob powder, add 2 Tbsp of coconut oil
    • 2 Tbs date paste or raw honey, OR stevia sweetener to taste

    In a small bowl, blend all ingredients well. Make sure there are no lumps. It should only take a minute. Pour the mixture into molds. If you use chocolate bar molds , it should take about an hour for everything to firm up. If you use something larger, it may take a bit longer.

    Vanilla Coconut Snowballs 

     Makes about 12 snowballs:

    • 1 cup coconut butter
    • 3 tbsp virgin coconut oil
    • 1 tbsp stevia, Lakanto or coconut sugar (optional)
    • 1 cup unsweetened shredded coconut, plus extra for rolling
    • 1/2 tsp raw vanilla powder
    • Pinch of sea salt

    Place the coconut butter and coconut oil in a small saucepan and warm over the lowest heat until softened but not completely melted. Pour the mixture in the food processor fitted with the “S” blade. Add the honey and process for a few seconds. Then add the shredded coconut, vanilla powder and salt. Process until combined. Scoop the mixture into a bowl and form into balls. If the mixture is too soft to form, place the bowl in the refrigerator for about 30 minutes, then try again. Roll each ball in shredded coconut and serve. Store extra snowballs in an airtight container in the refrigerator for up to a month.

    A Case Study in Autoimmune Disease – Part 3 – Implementing Support

    (Before reading this post, be sure to check out A Case Study in Autoimmune Disease – Part 2 – Evaluation, where Dr. Ian gives an overview of Molly’s initial test results.)

    Neuro Rehab

    We began a course of brain-based therapy in the office called “neurologic rehabilitation.” Basically, we took the findings from her exam and began to customize brain-based exercises she could repeat at home after being taught in office which targeted the weaknesses that were creating symptoms and vicious cycles. In particular, we targeted her parietal lobe and vagus nerve/brain stem. She noted that within weeks of starting the therapy, she was digesting better and seemed less preoccupied with her body image. This was critical because when doing deep dietary intervention, there is always the possibility of doing more harm than good. Even though she was not perfect on keeping up with the home-based exercises, it appears what we did in office significantly helped her.

    Shockwave/Chiropractic

    Molly was an avid runner and because of a chronic knee and hip issue, she was prevented from her favorite pastime, jogging. This was her outlet for stress. We began breaking up scar tissue with our shockwave device, doing gentle chiropractic adjustments, and using muscle activation techniques to get her flexibility up and pain relieved. We got her back on the trail after about 6 weeks and slowly increased her miles so she could get the benefits of exercise. I think Molly may have been most excited about this, but the reality was as her fatigue went away, she immediately wanted to become more active. Cortisol management through exercise may be one of the most effective ways of helping my clients so this was very satisfying to watch her improve and get back on the trail.

    Repeat BW

     Previous8 Week Follow Up16 Week Follow Up
    Homocysteine12.5 >9.79.6
    TSH1.2 (normal!)Not repeatedNot tested
    Vitamin D3195 (Too high, dose adjusted down)Not tested
    Ferritin1516 (Started iron supplementation and gave dietary recommendations)47
    WBC4.44.74.8
    Eosinophils57 (Determined she was reacting to a few specific foods in her diet)3
    EBV15.415.619.1 (Not unusual to see a mild increase before it drops)
    Candida Abs IgA +Normal  

    Repeat DUTCH

    As you can see, her hormone reserve (DHEA-S) has come up (from 37 to 81) and she is showing a strong ovulation response! Her husband is happy the testosterone came up from 3.8 to 6.3 (she is too!) and her estrogens have started to recover. Overall, she noted an improved menstrual cycle with fewer cramps and less irritability.

    Lessons and Takeaways

    Molly was a complicated case, but she is a quintessential example of how the functional medicine model works. She was suffering from a disorganized immune system brought on by stress from hormones, gut, dietary imbalances and an inability to manage her stress load. Even though it sounds complicated, the reality is, we changed her diet with guidance from our nutritionist, customized supplementation based on her labs, used some basic in-office therapies like PeMF, worked through her structural problems and gave her the confidence through repeat labs and the resolution of her symptoms that she was back on track in life!   She came to us frustrated, upset and let down by her western medical providers. I knew because of her motivation and initial blood work and exam findings we could change her life. But don’t take it from me; below is her testimonial on her results to date.

    Molly’s Review

    “I can’t recommend Dr. Ian and the rest of the staff at [Dr. Autoimmune] enough–they have truly changed my life. I came in earlier this year for help with Hashimoto’s thyroiditis. I had recently discovered the autoimmune origins of my hypothyroidism and decided to see whether there was any truth to the idea that nutrition and lifestyle changes could actually have a noticeable effect on how I felt. After following through on an elimination diet (and eliminating gluten for good), taking the supplements Dr. Ian and Natalie suggested, and doing neurofeedback, I can honestly say I’ve never felt this good–ever. I thought feeling low energy and motivation was just a part of my personality, but after almost five months of working with the team here, I can see that’s not the case. I have a level of energy that amazes me most days, which has affected my work life and relationships for the better, plus my generalized anxiety has quieted down. I can’t shut up to my friends and family about how much better feel, and the team at Dr. Autoimmune is to thank for that. From Joy and Danielle at the front desk, to Natalie the nutritionist, to Dr. Ian, I felt seen, cared for, and consistently prioritized during my  whole treatment. The best investment I’ve ever made!”

    A Case Study in Autoimmune Disease – Part 2 – Testing

    (Before reading this post, be sure to check out A Case Study in Autoimmune Disease – Part 1 – Evaluation, where Dr. Ian gives an overview of Molly’s case and what she presented with initially.)

    Molly’s blood work findings:

    Homocysteine 12.5 TSH 1.2 (normal!) Vitamin D 31 Ferritin 15 WBC 4.4 Eosinophils 5 EBV positive for reactivation Candida Abs IgA +  

    Interpretation:

    Having an elevated homocysteine level above a 7.0 increased the chance that Molly was suffering from an inability to methylate, which is one of the most important detoxification reactions the body undergoes. It also may indicate a B vitamin deficiency that must be corrected because methylation requires specific forms of B vitamins.

    Molly was struggling with hormonal symptoms including low libido, severe cramping during menstruation and mood fluctuations. In addition to these challenges, her Epstein-Barr virus that most likely triggered her thyroid condition had become reactivated and was most likely wreaking havoc on her hormonal system. Throw in the inability to detoxify and you can begin to understand why she was having such a hard time.

    Her ferritin (stored iron) was borderline low and certainly was part of her chronic fatigue. Most likely this was from the state of her gut, not from a lack of iron in her diet as she ate red meat. Keep in mind her TSH was spot on perfect and she still suffered from classic thyroid symptoms like fatigue, brain fog, constipation, cold intolerance and anxiety. Even though her TSH was normal, her vitamin D was not optimal. Vitamin D hormone regulates the immune system and is one of the primary protectors against viral infections.

    It was obvious that Molly had been fighting infections for quite some time (candida + Epstein-Barr at the minimum) because her white blood cell (WBC) count was borderline low at 4.4. On top of this, her eosinophils were elevated which indicated either an environmental or food trigger (it can take up to 72 hours for symptoms to surface from food sensitivities).

    Lastly, Molly’s Candida antibody was high. This indicated a severe immune reaction more than likely from overgrown fungus. Candida is found in every one of us but when Candida is overgrown from overconsumption of refined, processed sugars, it creates inflammatory havoc with the endocrine and immune system. Molly had symptoms of hypoglycemia and fatigue after meals, but after we lowered the candida in her body, her blood sugar swings were a thing of the past.

    We also ordered specialty lab tests including:
    1. Urinary hormone test
    2. DNA based stool test
    3. Wheat sensitivity test

    1. The “DUTCH” test -Dried, Urinary Test Comprehensive Hormones:

    Molly’s hormone levels were not in a great place. Her progesterone was fine, so she was ovulating, but her estrogen was in the tank. Estrogen is a critical component of a normal cycle and her levels were basically menopausal, yet she was only 35 years old. Molly’s DHEA-s level was also low. DHEA-s is a precursor hormone critical to estrogen production.

    When someone experiences high levels of inflammation like leaky gut, infections, or food sensitivities, their hormonal balance is disrupted. This illustrates perfectly how the body is interconnected. If Molly had gone to a primary care or endocrinologist, they more than likely would never have connected her gut problems to a hormonal imbalance. Molly’s cortisol level was normal. In her condition, I would have expected an abnormal cortisol level, but except for her waking cortisol, her pattern was relatively fine. What is important was that her cortisone was low. Physiologically, this is important because it is an indication of chronic inflammation. So, her adrenal function was becoming taxed by inflammation and this was causing adrenal symptoms of fatigue, low motivation and chronic hip and knee problems.

    2. The GI Map test:

    This test is an amazing way to see what is replicating in the gut (good guys and bad guys), inflammation markers and digestive enzyme activity. Molly was in trouble because she was dealing with an overgrowth of virus and her firmicutes level was high, indicating bacterial overgrowth in her small intestine, A.K.A, SIBO (small intestine bacteria overgrowth). These infections were driving inflammation, hormonal disruption and the poor overall health her thyroid and body was in.

    We immediately customized her supplementation to address both infections and to give her gut the support it needed to “weed & feed.” Molly began anti-microbials, gut healing compounds and prebiotics that were gentle yet effective in healing her gut. We also tailored her diet so she had everything she needed to keep her momentum once the supplements stopped. This was the most important aspect of her case and spending the three months of strict adherence to the diet changed her life!

    3. Wheat Sensitivity Test

    What you see above is Molly’s positive antibodies to wheat and markers indicating leaky gut. She also had active antibodies to LPS (lipopolysaccharides), which are basically bacterial poo. So, she had leaky gut (intestinal permeability), was highly reactive to wheat (and one exposure could be causing months of inflammation) and was mounting an immune reaction against gram negative bacteria (indicating small intestinal bacterial overgrowth). That was all from just one test!

    This confirmed her gut was in big trouble and we needed to start her on a 5R program: Remove, Repair, Replace, Re-inoculate and Rebalance. Molly required a customized 3 month plan using dietary interventions (think a step above Paleo) and customized supplementation (led by our fabulous staff nutritionist). The amazing part is, within 30 days she was already feeling so much better!

    The news about Molly’s condition only gets better, as you’ll read about in part 3 when we detail the in-office therapies she took advantage of.

    A Case Study in Autoimmune Disease – Part 1 – Evaluation

    In June 2020, Molly, a pleasant 35-year-old woman, presented to me for an evaluation of a hypothyroid condition. Molly’s symptoms included fatigue, lack of focus, unstable mood, digestion issues, and skin and hair problems. On top of these symptoms, she had a nagging hip injury that prevented her from exercising, her main form of stress relief. She loved life and spending time with her family and husband but had pulled back from social activities and confided in me that her libido had also significantly suffered as a result of her health challenges. She wanted to get healthy enough to have a baby and be the best wife she could be for her loving husband.

    When Molly was 20 years old and in her second year of college, her life started to spin out of control. She had great difficulty managing the stress of her heavy workload and as a result, turned to binge eating and excessive exercise. She began to develop social anxiety and felt depleted and exhausted all the time. Molly also noticed significant short- term memory issues and would walk into rooms and forget why she was there. Molly admitted that she just didn’t feel as mentally sharp as she used to.

    Her primary care physician ordered blood work and found an elevated thyroid stimulating hormone and prescribed Armour Thyroid. She responded decently at first, but her symptoms continued to fluctuate especially around menstruation. During her case review with me, her husband indicated he thought she might be suffering from seasonal affective disorder, or SAD, because her symptoms would worsen during the shortest days of the year. She admitted to needing naps to function and that she had terrible bloating after meals. After further questioning around her bowel movements, she admitted to chronic constipation and that it could fluctuate “all over the place and it’s really confusing what’s causing what!”    

    Exam findings:

    I performed a comprehensive neurologic and metabolic exam and observed some important findings:   1. Fungal nail growth 2. Decreased vibration sensation from her shoulder to large thumbs 3. Poor capillary refill in thumbs 4. Poor parietal pointing 5. Down going optokinetic testing poor 6. L side soft palate failed to raise normally 7. Chronic trigger points in her glut max, glut medius and overtightened psoas 8. Restricted L hip mobility in flexion  

    Interpretation:

    Fungal nail growths indicate a few things metabolically. One is that she was clearly not getting enough blood flow into her feet and that the origin of the fungal growth was most likely the gut. The poor capillary refill and abnormal vibration sensation further confirmed that inflammation was decreasing her body’s natural ability to send blood flow. Low iron levels were discovered later which can contribute to poor circulation as well.    

    Parietal pointing is a test to determine how well the body knows where it is in space. She had a poor ability to place her index finger over a dot of ink I had placed on her arm while her eyes were closed. Your parietal lobe is highly correlated to body image disorders and one of our treatment goals was to avoid a flare up of her previous food deprivation condition. I’ll explain how we supported this when we cover her treatment plan.

    Her optokinetic ability was a test of her tracking a tape with different colored squares. As her eyes vertically tracked the tape downward, it was difficult for her to keep her eyes moving in a fluid manner. This, plus a drop in her L side soft palate was an indication her vagus nerve was not firing optimally. The vagus nerve is critical to your parasympathetic nervous system, aka “rest and digest” (versus the sympathetic “fight or flight”).    

    Remember, one of the tenets of functional medicine is – fix the gut first – but in reality, it’s fix the gut & brain first! More on rehabilitation to this system later. Lastly, Molly had chronic musculoskeletal concerns which were creating big problems in her ability to cope with stress – since she could not run, she could not keep her inflammation in check!

    Check out A Case Study in Autoimmune Disease – Part 2 – Testing to learn about the diagnostic testing that is conducted to further evaluate autoimmune disease.

    Should you get the vaccine?

    Routine vaccinations have been a part of preventative medicine since the first smallpox vaccine was officially created in 1796 based on African discoveries brought to the west by a slave named Onesimus. Vaccinations used en masse can halt an infectious disease’s spread through herd immunity. This has been shown historically in regards to smallpox, tuberculosis, polio, and typhoid fever, just to name a few (8).
    Vaccines are generally made of 3 main components: antigens, adjuvants, and preservatives. The antigen is used to introduce your body to the infectious agent so that your cells know how to respond if they encounter that antigen again. Adjuvants are used to stimulate the immune system and make the vaccine more effective. These ingredients can be cause for concern. A common type of adjuvant used in vaccines is aluminum, and a common preservative is thimerosal, which contains mercury (1). According to the CDC, other ingredients that live in vaccines include stabilizers like sugar or gelatin, and residual materials from production such as eggs or formaldehyde (9).  Some may also wish to consider the ethical concern of using aborted fetal tissue (cell lines obtained from an aborted fetus) in vaccines, as this is another contentious aspect of vaccine use.
    Just like all drugs, vaccines can have negative effects. The reason why this is cause for so much concern is that unlike medications, which are given to people who are not well and are willing to take such risks to get better, vaccines are given to generally healthy people in preparation for a possible exposure in the future. This nature of vaccines has led to understandable widespread mistrust and hesitancy.  Also, considering the massive nationwide campaigns and propaganda used to sell pharmaceutical companies’ products, many people are hesitant to inject themselves or their children with these medical interventions.

    Vaccines and Autoimmunity

    The most major concern regarding negative effects of vaccines is the well-documented correlation between vaccine administration and the onset of autoimmune disease. Autoimmune disease requires a perfect storm of 3 factors in order to develop: genetic predisposition, leaky gut syndrome, and environment. Vaccines affect the body’s environment. Because the individual would have to have the other two factors in order for the vaccinated environment to trigger an autoimmune response, this ‘side effect’ of vaccination is relatively rare (but also very hard to track since according to VAERS, the vaccine tracking system, only about 10% of vaccine reactions are actually reported or connected to the time of administration).

    Rarity does not mitigate the cause for concern, though. Someone presenting as generally healthy could have a genetic predisposition for autoimmunity that they are unaware of. Besides, the scale by which vaccinations are administered means this ‘rare’ bad outcome actually happens to large amounts of people. There are many studies that have shown the presence of auto-antibodies (antibodies that attack self-tissue) following vaccine administration, though sometimes the autoimmune response may not happen until years after the vaccination (2). This makes it difficult to prove a connection. A vaccine can be proven to work effectively relatively easily, but proving it’s safety, especially long-term, is a much more difficult endeavor.

    Depending on the disease being vaccinated against, the safer method for acquiring immunity might actually be to contract the disease (please don’t go to a Covid party until you talk to your doctor first!). This is a natural way of acquiring immunity. One great example of this is the immunity one has to shingles if they got chicken pox as a child. These two diseases are caused by the same virus, so the immunity that was acquired in childhood can protect the person for their whole life. This is the concept behind “chicken pox parties”, where parents purposely infect their children with the virus in order to strengthen their immune systems (note that I’m not endorsing this but it is commonplace).

    The COVID-19 Vaccine

    Vaccines are a hot topic right now because the new COVID-19 vaccine is just now reaching the public, and many people have many questions about it. Without stating a recommendation regarding getting this vaccine, our office would like to help educate the public about the pros and cons so that everyone can make an informed decision.

    This particular vaccine is unique in that it is the first mRNA vaccine to be licensed for human use, and on a huge scale nonetheless. For most of us, this is where the questions start.

    When a cell is going to make a protein, the instructions for doing so are copied from DNA in the nucleus to messenger RNA (mRNA) molecules. The mRNA is used to build these proteins in the fluid space of the cell, the cytoplasm. It is important to note that the mRNA molecules are never at any point inside the nucleus and do not have the ability to alter DNA. They are simply blueprints for building a protein.

    Our bodies have built-in mechanisms for controlling the production of proteins: how many, how often, and what to do when one is malfunctioning. The new COVID vaccine injects our cells with synthetic genetic material that our bodies do not have built-in regulations for. This is an area of concern for many immunologists (and yes, me!).  I think extra caution is warranted in those who have family with autoimmunity or currently suffer from some form of autoimmune disorder. The long term safety and efficacy of this vaccine has not been studied due to the emergent need for it’s release (it is incredibly hard and rare to obtain an Emergency Authorization which was granted for both vaccines on the market).

    COVID-19 is a flu-like virus that has been shown to inflict long term organ damage in some individuals. Damage to the heart, lungs, and brain has been documented in recovering COVID patients (5). The possible long-term effects of contracting the virus must be weighed against the possible long-term effects of getting the vaccine when making this decision. This vaccine, unlike others, does not contain toxins like mercury. It doesn’t contain the live virus so adjuvants aren’t needed. Pfizer published the ingredients in this vaccine at the end of December: mRNA, a mixture of lipids (nanoparticles), sodium phosphate, sodium chloride, and sucrose (7). Besides the long-term autoimmune concerns regarding mRNA, the lipids in this cocktail pose another (especially relating to allergic reactions).
    The mRNA molecules are quite fragile, so they are coated in a fatty layer of PEGylated lipid nanoparticles. This coating both protects the mRNA and hides it from our bodies so that it isn’t destroyed by our immune systems. PEGylated lipid nanoparticles have been used in other drugs before and have been documented to instigate allergies and autoimmune diseases (6).

    Another question you might ask is “what exactly does the vaccine prevent”?  If you read through this study you will find that surprisingly, preventing contraction of the disease is not what it will do.  The vaccine’s main objective is to prevent the serious complications from COVID-19 and it does so at a 90% effectiveness – how long this lasts is not known.  If it will be effective on mutated strains is not known just as influenza vaccines are constantly changing due to the shifty nature of the virus.  What are other measures that could provide similar protection yet not have the side effects?  Does that even exist?

    There are measures besides vaccination that one can take to protect themself from complications resulting from COVID-19. For example, there is strong evidence that vitamin D supplementation can significantly reduce the risk of contracting the disease as well as reduce the risk of experiencing severe symptoms or complications if the disease is contracted (3).  In one study, researchers used statistical models the researchers claimed they could prevent 89% of COVID-19 related deaths just by getting the most severely deficient vitamin D levels elevated into normal levels (4)!  Keep in mind there has not been a randomized trial with a placebo and treatment group using vitamin D.  Please also remember that dosing should be done with lab testing prior and maintained at a 45-60ng/dl level.  Excess vitamin D supplementation can suppress the immune system as well. This is why we call it a “Goldilocks Hormone”; too little or too much could harm you, so you have to get it just right.

    Vaccines are all very different in their necessity, risks, and efficacy. Herd immunity is extremely important in a population in order to protect the vulnerable, but the way to achieve it does not only involve vaccination. Our immune systems need to meet a variety of microbes in order to be able to tell the difference between self-tissue and harmful antigens (for more on this read about the hygiene hypothesis). Acquiring immunity naturally through the contraction of the disease is the way humans have maintained a varied and robust response to most infections we have and will be exposed to.  Vaccines, like any medical intervention, need to be examined under the light of informed consent – will this harm or will this help and what information is there on both sides to help make this decision?  Blindly accepting dogma and those already indoctrinated into the standard medical model does not necessarily lead to optimal health.  Each individual needs to have information about whether they should accept the recommendations given and if the benefits outweigh the risks. Clearly time will tell as to which measures being implemented by our government actually helped with this pandemic, and which wounded the citizens of our incredible Nation.

    Yours in optimal health,
    Ian Hollaman, DC, MSc, IFMCP
     
    Sources:

    (1) Adjuvants and Vaccines. (2020, August 14). Retrieved January 14, 2021, from https://www.cdc.gov/vaccinesafety/concerns/adjuvants.html
    (2) Agmon-Levin, N., Paz, Z., Israeli, E., & Shoenfeld, Y. (2009). Vaccines and autoimmunity. Nature Reviews Rheumatology, 5(11), 648-652. doi:10.1038/nrrheum.2009.196
    (3) Ali, N. (2020). Role of vitamin D in preventing of COVID-19 infection, progression and severity. Journal of Infection and Public Health, 13(10), 1373-1380. doi:10.1016/j.jiph.2020.06.021
    (4) Brenner, H., & Schöttker, B. (2020). Vitamin D Insufficiency May Account for Almost Nine of Ten COVID-19 Deaths: Time to Act. Comment on: “Vitamin D Deficiency and Outcome of COVID-19 Patients”. Nutrients 2020, 12, 2757. Nutrients, 12(12), 3642. doi:10.3390/nu12123642
    (5) COVID-19 (coronavirus): Long-term effects. (2020, November 17). Retrieved January 14, 2021, from https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351
    (6) Ickenstein, L. M., & Garidel, P. (2019). Lipid-based nanoparticle formulations for small molecules and RNA drugs. Expert Opinion on Drug Delivery, 16(11), 1205-1226. doi:10.1080/17425247.2019.1669558
    (7) Korin Miller December 14, & Miller, K. (2020, December 14). Pfizer’s COVID-19 Vaccine Arrived Today-Here’s Exactly What’s In It. Retrieved January 14, 2021, from https://www.health.com/condition/infectious-diseases/coronavirus/pfizer-covid-19-vaccine-ingredient-list
    (8) Timeline of human vaccines. (2021, January 11). Retrieved January 14, 2021, from https://en.wikipedia.org/wiki/Timeline_of_human_vaccines
    (9) What’s in Vaccines? Ingredients and Vaccine Safety. (2019, August 05). Retrieved January 14, 2021, from https://www.cdc.gov/vaccines/vac-gen/additives.htm

    How Does Autoimmunity Start?

    There is a phrase in functional medicine by Mehmet Oz: “Your genetics load the gut; your lifestyle pulls the trigger.” Specifically, genetic risk for autoimmunity sets the stage, but our environment (lifestyle, diet, and mindset) can trigger a happy or tragic ending.

    There is much we can do to influence our genetics and health through our actions and behaviors. Many individuals not only improve their quality of life but sometimes even reduce their autoimmune lab markers and go into remission! So how does autoimmunity start in the first place? It takes a triad of factors: genetic predisposition, intestinal permeability (leaky gut), and environmental triggers.

    Genetic Predisposition

    Most people think of their genetics as a life sentence or a predetermined future. However, the emerging field of epigenetics has shown that environmental factors have a huge influence on which genes are actually expressed. In other words, just because you may have genes related to autoimmunity does not automatically mean that those genes will do anything harmful to you (you are NOT chained to your family’s destiny). Genetic predisposition is only one of the factors contributing to disease. Research shows there are common genetic factors that set the stage for autoimmunity, yet findings show that glutathione production and redox capabilities (the body’s ability to get rid of free radicals by reducing oxidative stress) dramatically influence autoimmune gene expression.

    Single nucleotide polymorphisms, frequently called SNPs (pronounced “snips”), are the most common type of genetic variation among people. Each SNP represents a difference in a single DNA building block, called a nucleotide. Types of SNPs such as MTHFR, GST, and COMT can affect glutathione production and oxidative stress management systems. Individuals with these types of genetic variations require more support through epigenetics (modifying diet, preterm environment, chemical/drug exposure, stress, long term supplementation, etc.).

    An SNP within a gene can lead to further genetic variations because genes are in charge of coding DNA. But some SNPs can occur in non-coding sections of DNA. So, even though genetic variances are correlated with diseases like Celiac, they may not have been the cause of the disease. In fact, the bulk of genetic research shows that DNA methylation (the process of changing the activity of a DNA segment) has been found to contribute most to immune tolerance breakdown and autoreactivity (the loss of self V. non-self and therefore autoimmune disease).

    Fortunately, many nutrition and lifestyle strategies can limit the impact of these genetic variations and SNP’s!

    Intestinal Permeability AKA “Leaky Gut”

    The intestines span a single-cell wall that protects your body from the external world. This wall is protected by a mucous membrane called secretory IgA, which is influenced by the environment of bacteria in the intestinal tract known as the microbiome. The cell wall has many functions, mainly providing a barrier between the intestinal tract and the body cavity. Between each cell in the intestinal wall are tight junctions which are meant to be just that: TIGHT! Research is now finding that tight junction failures are associated with a host of conditions, from chronic inflammation, cancer, and autoimmune diseases to allergies and heart disease.

    Tight junctions fail due to:

    • Toxins
    • Infection
    • Free radicals (ROS)
    • Inflammation Stress (blood sugar issues)
    • Hormone Imbalances (pregnancy, menopause)
    • Microbial imbalance (Dysbiosis)
    • Diet (food allergies, poor digestion)
    • Drugs (NSAID’s etc.)
    • Early exposure to gluten and casein
    • Chronic cortisol
    • Autoimmunity
    • Zonulin
    • Not breastfed or breastfed from a mother with intestinal permeability

    After the tight junctions fail, something called molecular mimicry occurs. This is where food, viruses, and bacteria enter the bloodstream through the intestinal cell wall. Essentially, your gut leaks. Your body then starts making antibodies to these foreign invaders. Antibodies are usually antigen-specific, but they can easily bind to something that they perceive as dangerous even if it isn’t because of similar molecular structures. To put it simply, your antibodies can get confused and start to see your own tissue as foreign bacteria, viruses, or food. Molecular mimicry is found in research between the foods gluten & casein and the thyroid; or also between bacteria, viruses, and self tissue. This is how autoimmunity begins. The self (auto-) is attacked by the immune system (-immunity).

    Environment

    The most influential environment for autoimmunity is preterm and during pregnancy. However, you can still do a lot to reduce environmental triggers of autoimmune disease for the rest of your life. Many of the triggers for autoimmune diseases have been studied and infections, vaccines, and other toxins are considered important implications in autoimmune disease. For example, the infection Epstein–Barr virus (EBV) is associated with Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis, Graves (hyperthyroid), and Hashimotos (90% of the issue behind hypothyroidism).

    Nutrient depletion and dietary environmental triggers also trigger autoimmunity. For example, Vitamin D deficiency affects the genetic production of vitamin B’s and T-regulatory cells, which are both associated with autoimmunity prevention. Zinc deficiency contributes to a leaky gut and alters the microbiome. Research shows taking zinc can tighten the junctions between cells in the gut. In addition to nutritional factors, other environmental triggers of autoimmunity can include sleep disturbances and stress. Melatonin production from adequate sleep can improve inflammatory diseases like Multiple Sclerosis.

    Toxin and chemical exposure in our air, clothing, furniture, water, food, and other products contributes to autoimmunity. The verdict is out on many major toxins already in use in our society: such as flame retardants, pesticides/herbicides, air fresheners, hair dyes, cleaning supplies, wood stains and oils, laundry detergents, home insulation, art supplies, carpet, smoking, air pollution, mercury fillings, and most plastics. Thankfully, we can vote with our dollars and choose to change the environment we live in by purchasing EWG.org-approved low-toxin products and reducing our exposure.

    Key Learnings

    1. Autoimmunity starts with the trifecta overlap of leaky gut, genetic predisposition, and environmental triggers.
    2. Despite the genetic influences in your body, your environment is what contributes most to the expression of autoimmune diseases.
    3. You can change your diet, improve your sleep, reduce your stress, and toxin load. Each behavior change improves leaky-gut and reduces your environmental triggers.
    4. Oftentimes making epigenetic changes can influence the genetic expression of the autoimmune disease and can halt or even reverse the autoimmune diagnosis.

    Trust us, this is overwhelming at first but when you start to break down your unique contribution towards disease or optimal health it becomes incredibly empowering!  Chronic disease is a lifestyle, not destiny.  You have the choice in this journey to accept your fate or take charge and find a functional medicine practitioner who can guide you through this individualized process.  Trust your gut, find that person who can lead you to a new level of health, and let your health soar!

    Yours in Health,
    Dr. Ian Hollaman, DC, MSc, IFMCP