It may be hard to believe, but brushing your teeth can help your joints. All dentists will tell you that your dental health is tied to your physical health, but how seriously do we really take that? Your mouth has its own microbiome, which is the mini ecosystem made up of bacteria and other small life forms, just like your gut and your skin. When any of your microbiomes are out of balance, there will be consequences.
Rheumatoid arthritis (RA) is an autoimmune disease, which is a type of disease where someone’s body attacks itself. In the case of RA, the body is attacking the joints, causing painful inflammation that limits range of motion and affects daily activities. Many people with RA find themselves unable to run, walk, lift things, or even use their hands without severe pain.
How Does RA Start?
In functional medicine, our goal is to discover the root cause of disease. What we’ve learned is that all autoimmune diseases require three things in order to develop:
Genes: Without the genes for an autoimmune condition, the disease cannot manifest. Genes are not a life sentence, though. We have some control over whether our genes are actually expressed or “stay asleep”. Just because you have the genes, doesn’t mean you’ll have the condition!
Leaky gut: The cells that make up our intestine lining are held together by tight junctions, which are important for keeping our partially-digested food from seeping out. Many factors, including gluten and NSAIDs such as Ibuprofen, cause these tight junctions to loosen and allow material to leak out, which causes inflammation in the body. Read more about the gut’s connection to RA here.
Last but not least, a trigger: Many things can trigger an autoimmune response, including viral or bacterial infections.
One specific type of bacterial infection has been tied to RA as a trigger. The bacteria is called Porphyromonas gingivalis and is also a common culprit behind periodontal disease, a common gum disease. In periodontal disease, an infection causes inflammation in the gums and can lead to symptoms such as:
Swollen, red, and tender gums
Bleeding gums
In more serious cases, tooth loss (periodontitis)
Gum Disease and RA
Have you ever wondered what plaque on your teeth actually is? Bacteria such as P. gingivalis produce a sticky film that can build up- and that becomes plaque! The bacteria in plaque create acids, which slowly break down tooth enamel. Not only does the yellowish film not look pretty, but it can lead to gum disease andrheumatoid arthritis. P. gingivalis causes nasty inflammation in the gums, as you can see in the picture above, so just imagine the inflammation it can cause in your joints!
It has become clear that periodontal disease and periodontitis are linked to RA, but recent research has been able to narrow down the link to P. gingivalis bacteria specifically.
In this study, mice that were infected with P. gingivalis bacteria either developed arthritis, or their already existing arthritis got worse. Another study found that the correlation between the antibody to P. gingivalis and RA was even stronger- in fact, two times stronger- than the correlation between smoking and RA. Smoking has been a known major risk factor for RA for many years, but now we know that periodontal disease caused by P. gingivalis bacteria is more than twice as likely to lead to RA. Do you believe the dentists now?
Your RA Might Have a “Friend”
For the most part, good dental hygiene can keep bad bacteria from running rampant. Brushing and flossing twice a day as well as regular visits to a dentist are important steps to take. One way that P. gingivalis can grow is if your mouth is too dry. Unfortunately, another autoimmune condition, Sjögren’s syndrome, specifically attacks the salivary glands and leaves the mouth very dry. Sjögren’s is therefore a risk factor for plaque buildup and periodontal disease. Given what we just learned about the connection between periodontal disease and RA, it should be no surprise that 21% of Sjögren’s patients have also been diagnosed with rheumatoid arthritis.
This is a common theme in our office: Many people who have been diagnosed with one autoimmune disease also develop another one or more. In fact, at the time someone is diagnosed with an autoimmune disease, there is a 50% chance that another one already exists. If the genes are there and the environment allows one disease to develop, then it is very likely that other autoimmune genes will be triggered.
At Dr. Autoimmune, we use a functional medicine approach to get to the root cause of complex conditions. Our structured program removes the guesswork and uses science-backed lab testing, diet change, and supplementation to get your body back on track. Using this method, we have an 85% success rate. If you’re interested in finding real solutions for your conditions, fill out the form below to get started!
April is Sjögren’s awareness month, so we thought it would be a great time to shed some light on it. Sjögren’s (pronounced show-grens) syndrome is a common autoimmune condition where moisture-secreting glands are attacked. This usually happens first in the eyes and mouth, so dry eyes and mouth are the most common symptoms.
Other symptoms can include:
Dry eyes
Dry mouth
Vaginal dryness
Dry nose, recurrent sinusitis, nosebleeds
Dry or peeling lips
Dry skin
Fatigue
Joint or muscle pain
Inability to focus or ‘brain fog’
Respiratory issues like shortness of breath, dry cough, or recurrent bronchitis
Anxiety and depression
Memory loss
Dysautonomia
Headaches (most commonly tension-type or migraines)
Sjögren’s syndrome can develop at any age and in any sex, but it is most common in women (9 out of 10 patients are women) and people over 40. It is considered a widely underdiagnosed condition, with the Sjögren’s Foundation estimating that over 2.5 million patients are currently undiagnosed.
The genes associated with Sjögren’s aren’t known yet, but we can’t control those anyway. What we can have some control over, though, is whether those genes are expressed. Our genes basically can be turned on and off with the right environmental factors. This is why gut health and removing triggers are more important than our genes.
In functional medicine, we use diet change and supplementation to heal the gut while working with you to find out possible triggers in your life. Common triggers include stress, viral or bacterial infections, and mold or toxin exposure.
Dry Eyes
One of the first things to occur in Sjögren’s is the glands that produce tears, the lacrimal glands, are attacked by the immune system. You might think that we only produce tears when we cry, but our lacrimal glands are actually always working to keep our eyes moistened.
Have you ever wondered why we blink? Our eyelids keep moisture trapped beneath, so when the part of our eye that is exposed to air starts to dry out, blinking spreads a new film of moisture over them. This method only works, however, when our lacrimal glands are producing moisture.
Dry eyes can lead to burning, itching, a feeling like sand is in the eyes, blurred vision, and difficulty tolerating bright lights. Think back to the last time you were challenged to a “blinking contest”. After some time of forcing your eyes to remain open, your vision starts to become affected and you start to feel a burning sensation. This is what chronic dry eyes associated with Sjögren’s syndrome can feel like.
Dry Mouth
One of the 2 most prominent symptoms, dry mouth is uncomfortable and can lead to dental problems. Along with the lacrimal glands, the salivary glands are the first to be affected. Salivary glands produce saliva, which keeps our mouths and gums moist and also helps with digesting food.
People with Sjögren’s are more likely to develop cavities and gum disease due to lack of moisture, so recommendations include stimulating saliva production with sugar-free (xylitol or maltitol if sugar alcohols are tolerated) lozenges and brushing teeth after every meal. These types of recommendations are only good for managing symptoms without actually addressing the root cause.
What Can You Do?
At Dr. Autoimmune, we are experts at getting to the root cause of your condition and working with you to develop a personalized plan to reach your health goals. Most of our clients notice huge changes within only 30 days. Fill out the form below to get started on your health journey!
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:
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
As a child, were you covered in pink calamine lotion after proclaiming “it itches?” Did your mom soak you in a bath with oatmeal to soften and dissolve those scabs that came after a bout of chickenpox? Mine did.
Professor Ronald Goldsteinm, a member of the BIU’s Mina and Everand Goodman Faculty of Life Sciences calls this a ‘souvenir’ from childhood. What does this mean for you as an adult? Goldstein states that in one-third of people over 50, or in those with weakened immune systems (our clients), chickenpox reactivates in the form of shingles. That is a lot of people!
In one-third of those cases, shingle symptoms are far more serious than the itching you experienced as a child. The pain can be debilitating and last for months or years. Should you or should you not get the anti-shingle vaccine? That is a hot topic for many! He explains that it provides effective protection in only 50% of cases and can not be given to immune- compromised patients.
Chickenpox/shingles is only 1 of the 8 different Herpes viruses that affect humans.
Herpes 1 is generally transmitted orally or to the genitals through oral transmission. Think cold sores in the corner or inside of your mouth.
Herpes 2 causes genital infection and is usually passed through sexual transmission and can not live very long outside of the body. There’s not much to think about except ‘no thank you’.
Herpes 3 is our itchy enemy which causes chickenpox or shingles. Like its friend, HHV1, herpes zoster likes to infect skin cells and nerve cells and often forms in a band or belt-like pattern. Most everyone knows someone who has had chicken pox or shingles.
Herpes 4 is also called Epstein-Barr virus (EBV) also known as the kissing disease, mononucleosis. A very popular virus that has made it through the majority of the population.
Herpes 5 is the official name of cytomegalovirus (CMV). It can also be a cause of mononucleosis. In people with healthy immune systems, the virus may not even cause any symptoms. If you do not have a healthy immune system, it can cause problems passed onto newborns, and can cause hepatitis. CMV can be transmitted through sexual contact, breast-feeding, blood transfusions, and organ transplants. CMV infection is one of the most difficult complications of acquired immune deficiency syndrome (AIDS).
Herpes 6 gives rise to roseola (a viral disease causing high fever and a skin rash in small children) and a variety of other illnesses associated with fever in that age group. This infection accounts for many of the cases of seizures associated with fever in infancy.
Herpes 7 is even more recently observed and is closely related to 6. Like other human herpes viruses, 6 and 7 are so common that most of humankind has been infected at some point, usually early in life. HHV7 can also cause roseola, but it is not clear what other clinical effects this virus causes.
Herpes 8 was recently discovered in tumors called Kaposi’s Sarcoma (KS). These tumors are found in people with AIDS and are otherwise very rare. KS forms purplish tumors in the skin and other tissues of some people with AIDS. It is very difficult to treat with medication. HHV8 may also cause other cancers, including certain lymphomas (lymph node cancers) associated with AIDS. The fact that these cancers are caused by a virus may explain why they tend to occur in people with AIDS when their immune systems begin to fail.
Dormant vs Active Viral Infections
What wakes herpetic infections from their cozy little rest? Many factors that include stress, sex, temperature fluctuations, weakened immune systems and even certain foods (lysine/arginine ratio) can trigger an outbreak. There is no formula to determine when you can experience an outbreak once contracting HSV. It can show its ugly head of symptoms as early as a week, up to years after infection. Each person’s immune response to environmental and emotional stress is different, so your biggest defense for any viral overload is to nurture your superhero–the immune system! You can experience an outbreak at first contact or during a stressful time, and it could be a one-time event for you. A revisit from any strain of a herpetic virus can overload your immune system and create the cytokine storm we have all heard so much about in the past year. No thank you!
Like many viruses, Herpes (HSV) is a sneaky devil and can lay dormant and hide out in the ganglia nerve. Keep HSV dormant by actively lowering your stress levels, because stress can raise your cortisol levels and hormones play a huge role in one’s stress response. Try adding exercise, switch to eating clean and unprocessed foods, and consciously participate in suppressing any immune overload. You can also try meditating, practicing yoga, mindfulness, or other ways to cope and manage stress. Some sources tout that a lysine-rich diet may suppress the herpes virus. All these factors can contribute to less frequent flare-ups.
Herpetic Infections Relationship with Autoimmunity
More and more evidence is linking herpes viruses to the development of multiple autoimmune disorders including lupus, rheumatoid arthritis, Sjögren’s syndrome, and central nervous system neurological illness. Studies have suggested that vulnerability to multiple sclerosis is gained in early childhood, with viral infections acting as a trigger. If a herpes infection is activated, it can contribute to the development of autoimmune diseases.
“’It’s important to note that EBV is triggering exhaustion and flu-like symptoms for millions of women. EBV is super common: 95 percent of people have it. It will lie dormant in the body as long as the immune system is strong. But stress — like that caused by COVID- 19 (from any source) — can weaken immunity, allowing EBV to reactivate. In a study conducted by Ohio State University, subjects under increased stress were twice as likely to have EBV reactivation.“
Let’s just say, herpes sucks! It’s surprising how many people do not know that their herpetic infection can awaken under a stressful circumstance. To confirm whether or not yours may have resurfaced and may be a trigger for your health challenges, a test of EBV virus nuclear antigen, capsid, IGM and early antigen markers can be performed through a blood draw to confirm this suspicion. Ask your doctor.
To summarize, there are multiple ways herpes viruses trigger autoimmunity. Both molecular mimicry and bystander activation were reported in EBV- and HSV- induced autoimmunity. In addition, as ‘neurotropic’ viruses, herpes viruses can infect and kill central nervous system cells directly, leading to several autoimmune diseases.
The cause of any virus story? Who really knows. Today we are facing new viruses and strains that are running through the population at rapid rates. Viruses and bacteria will always be on this planet, and will always challenge our immune health. It’s their job. We can defend ourselves from these pesky little buggers by ramping up our immunity with proper diet, stress management, and supplementation.
Want my quick and basic protocol for anti-viral support? Here it is:
1) Vitamin D – 10,000 IU daily (monitor with labs to 60 ng/dl)
2) Selenium – 200mcg twice daily (no more than 3 months!)
3) Zinc – 100mg, divided doses and mind you it may cause nausea (copper required if long term)
Come see us and Dr. Autoimmune and get a baseline of your health, so you can win the war on virus overload and create a flexible, super-human immune system!
Every human body is different in so many ways, but one thing we all have in common is poop! Pooping is something every living creature on this planet must do in order to stay alive and healthy. The process of defecation means the discharge of feces from the body. Poop is the left-over waste in our system after all of the nutrients of our food have been absorbed (or so we hope). It’s vital for our health that we are properly eliminating these toxins, otherwise they get reabsorbed into our system. There’s a delicate balance that happens in our body based on fiber consumption, hydration, and muscle motility (determined by healthy brain function) that deter-mines how our bowel movements might appear and how often you’ll pass them.
What is a normal poo?
There are many sizes, shapes, and colors your stool can be and all of them tell us different things about our health. Consistency is key: whether you’re having one or two bowel movements every day, you still want to make sure they are healthy! The Bristol Stool Chart is a helpful reference point to guarantee your bowel movements are where they should be.
According to The Bristol Stool Chart, the seven types of stool are:
•Type 1: Separate hard lumps, like nuts (hard to pass
•Type 2: Sausage-shaped, but lumpy
•Type 3: Like a sausage but with cracks on its surface
•Type 4: Like a sausage or snake, smooth and soft
•Type 5: Soft blobs with clear cut edges (passed easily)
•Type 6: Fluffy pieces with ragged edges, a mushy stool
•Type 7: Watery, no solid pieces, entirely liquid
Types 1–2 indicate constipation, types 3–5 are considered to be ideal, normal poops (especially 4), and types 6–7 are considered abnormal and indicate diarrhea.
The color (and even smell!) of your stool can tell you things about it as well. Colors can range from a medium brown, black, green, red, or even yellow/gray. Here’s a list of what some of these might say about what’s going on inside your body:
Medium to dark brown: Normal!
Black: Can mean there is upper GI bleeding going on. If this continues for 2-3 poops, consult with your doctor.
Green: Can be a sign that your stool is moving too quickly through your digestive tract. Vegetables like spinach, kale, blueberries, or green supplement powders can show up in your stool without enough fiber to slow down the digestive process.
Red/Purple: Can be a result of eating deeply colored vegetables like beets, but if you haven’t eaten anything of this color, you should reach out to your doctor (could be as simple as a hemorrhoid or something else).
Yellow/Gray: Typically a sign of mucous, or bile, in the stool which can mean an issue with the liver or gallbladder.
What might be causing problems?
There are many reasons why you might not be eliminating properly! Constipation and diarrhea can result from stress, dehydration, lack of fiber, too much alcohol or caffeine, inflammation, or autoimmune disease. Dysbiosis is an “imbalance” in the gut microbial community and can mean that the bad bacteria in your digestive system has overgrown the good. This can cause bacterial over-growth, like SIBO, resulting in constipation, gas, bloating, food intolerances, and nutritional deficiencies.
Food sensitivities may be one of the most common, yet overlooked reasons for change in bowel movements. If you find your pattern flip flopping this could be IBS, but in reality there may be a chronic food sensitivity that you are unaware of! Foods like gluten and dairy are potentially inflammatory to your body and this may be causing either constipation (from bacterial overgrowth) or diarrhea (body needs to get it out fast!). At Dr. Autoimmune, we will help you determine any food sensitivities you may have so you can drop that inflammation and get this common leaky gut trigger removed. Without fully getting your diet dialed in to what you need, it may be impossible to have normal gut function.
Consistent bowel movements are a way to avoid dysbiosis and potential disease. Keep a look out for changes in your stool to help you stay aware of what’s going on inside your body. Fiber (vegetables, people!) and hydration might be two easy additions to your routine that could help you stay regular AND stay healthy! If you have tried all of the tricks and are still suffering, this is where functional medicine shines! Dr. Ian and our nutritionist are trained to pick up on these abnormal patterns and help you find the root cause of abnormal poo!
If you’d like to get started, fill out the form below and we’ll reach out shortly. We look forward to working with you to help you reach your health goals. We have a very comprehensive stool analysis that all of our clients complete because of just how important gut health is.
May the (good) poo be with you,
Ian Hollaman DC, MSc, IFMCP
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Masks have become so politicized that even physical altercations have broken out regarding their usage. While many see mask-wearing as a decision that affects other people and is therefore not entirely personal, others maintain that everyone should take their health into their own hands.
Most schools around America that have been operating physically have implemented some sort of mask requirement. Even though children represent the demographic that is of the lowest risk and lowest spreading rate, they’ve still been forced to participate in the mask-wearing that has been the theme of this past year. Given the known negative effects of wearing masks along with the knowledge that children are of the lowest risk of mortality or getting severely ill from a COVID-19 infection, why are they still being forced to wear them?
Concerns have been raised over a false sense of security that may come from wearing a mask. If an individual is under the impression that a mask will protect them and others, they may become lax with other strategies that are equally, if not more effective at limiting the virus’s spread. Another concern is masks that are not properly kept clean may become spreading agents themselves. When considering children, can we really expect them to keep their masks properly sanitized? Sure, parents are responsible for this, but this brings us to our next issue. Think for a moment about how many people reuse their (often homemade) cloth masks every day.
The type of mask definitively alters its effectiveness. In this Vietnamese study, there was a significant difference in viruses spread among cloth mask wearers versus medical mask wearers. Hospital workers wearing cloth masks were 13 times more likely to contract an influenza-like virus. According to the study, “Penetration of cloth masks by particles was almost 97% and medical masks 44%.” Even more shockingly, cloth mask wearers were 3 times MORE likely to contract a virus than those who didn’t wear any mask at all. This means that the cloth masks actually increased the risk. Now ask yourself, is this good science or virtue signaling?
The Norwegian Institute of Public Health (NIPH) recommended against mask wearing for individuals without respiratory symptoms, citing concerns over proper usage. The researchers maintained that in order for an official recommendation to be effective, customized mask training needed to be provided directly to communities. They also stated that there is no reliable evidence that non-medical masks provide any protective effect. Let’s take a second to reflect on what this means, taking into account the supplies shortage we’ve seen regarding proper masks for medical workers. If we can’t even supply our front-line workers with proper equipment, the majority of the public is not going to be able to find the proper equipment. We’ve already seen that this leads to an increase in homemade cloth masks.
Children’s immune systems are young and flexible, making it the perfect time to introduce them to potentially harmful pathogens in the world so that they can learn how to protect themselves. It also makes them extremely resilient and quick to launch an attack on the virus (and we don’t have time to discuss how amazing breast feeding works for a baby’s immune system). Researchers have discovered that the SARS-CoV-2 virus is not able to replicate rapidly in childrens’ bodies due to a combination of factors. For one, because children’s immune systems are young, they contain many naive T cells just waiting to be deployed. Naive T cells are immune cells that have not yet been assigned to a specific virus or other pathogen, so they are readily available to study and launch an attack against a new pathogen. As a person grows up and is exposed to new environments, their bodies make less naive T cells because they’ve already learned the majority of antigens they encounter regularly.
Further evidence of a rapid immune response amongst children is found in the types of antibodies present in children versus adults following a COVID infection. Adults developed both antibodies against the SARS-CoV-2 spike protein (which allows the virus to enter a cell), and against its nucleocapsid protein (which is essential for the virus to replicate). Children, on the other hand, did not develop antibodies against the nucleocapsid protein because this protein is typically only present once the virus is widespread in the body.
All of these factors help to explain why some children develop Covid symptoms but repeatedly test negative for the virus on a PCR test. The virus simply is not able to replicate enough to show up on the test before the child’s body squashes it.
Another interesting possible reason for the low risk amongst children revolves around a specific enzyme found inside the nose called angiotensin-converting enzyme 2 (ACE2). This enzyme binds to spike proteins on the surface of the SARS-CoV-2 virus and allows it to enter the human cells. This study found that the amount of ACE2 in the nose increased with age, starting a very low amount for the youngest age group.
Age has been determined to be a large risk factor regarding Covid-19. One reason for this is the increased instance of comorbidities (other life-threatening conditions) amongst older populations. For example, Covid-19 patients who also have heart conditions are more likely to pass away from the infection. However in this study, age was independently a significant risk factor even after adjusting for such comorbidities. It is undeniable that children are at much lower risk than older adults, and not just for their lack of other health issues.
A child’s immune system is malleable and needs to be regularly challenged and stimulated in order to continue growing and strengthening. This study demonstrated the connection between growing up in a sterile environment and having a suppressed immune system. This concept is known as the ‘hygiene hypothesis’, which claims that early exposure to pathogens (amongst other things such as dander, mold and allergens) is integral to immune system development. If the child’s naive T cells never have the chance to meet any pathogens, how can they protect the child from disease later in life?
In addition to learning about the external environment, the immune system must also learn to tell the difference between a real pathogen and a human cell look-alike. When foreign material resembles a bodily cell, such as gluten proteins with thyroid tissue, an inexperienced immune system may accidentally end up attacking the host’s own body. This is how autoimmunity begins. But, gluten is not enough! We must remember that the immune system is complex and it involves genetics, environment and triggers (all three are required for autoimmunity). Merely having a family member with a chronic illness does not warrant the need to isolate our children – in fact, it harms their ability to respond when we don’t give them the opportunity to be outside, live life and just be kids!
There are also other factors to consider when discussing mask-wearing for children, notably the psychological effects it may have on them. Social distancing and school closures pose a new kind of challenge to a child’s interpersonal development. Hearing-impaired children lose the important tool of lip-reading as well as the practice necessary to hone that skill. Similarly, children within the autism spectrum lose the opportunity to practice reading facial expressions, which is something that they are predisposed to struggling with.
The question of whether we should force children to wear masks is a question of risk-benefit analysis. Simply, do the possible benefits outweigh the possible harms? If this isn’t the case, we cannot in good conscience advocate for society-wide mask requirements.
Yours in health,
– Dr. Ian Hollaman DC, MSc, IFMCP
What is Irritable Bowel Syndrome (IBS)?
Irritable bowel syndrome is a functional diagnosis that is given to individuals who have chronic gastrointestinal symptoms such as diarrhea and constipation, but no inflammatory diseases are found to be the cause. IBS is a frustrating diagnosis because it is often given by gastroenterologists when there is no known cause of the symptoms. Individuals are often left feeling hopeless because there are no medications for IBS.
IBS is classified as a “functional disorder”, similar to tension headaches and chronic fatigue syndrome (CFS). Another common term is “wastebasket diagnosis”, which means that by exclusion of other problems, this is the default diagnosis. In functional medicine we know that there are physiological causes for these disorders, but this type of classification often leads people to believe that IBS is more psychological which isn’t true.
IBS is very common. In fact, it is the most common reason for individuals to miss work. People with IBS often have normal test results on standard blood panels, which makes it difficult to diagnose. IBS commonly runs in families and it can develop at any age. The Rome criteria for diagnosing IBS is the standard. The criteria include abdominal discomfort and pain lasting at least one day per week for the past three months connected to at least two of the following factors: Defecation causing pain and discomfort, changes in defecation, and stool consistency alterations.
In functional medicine, IBS is known to be caused by intestinal dysbiosis, likely small intestinal bacterial overgrowth (SIBO) or other pathogenic bacterial infections in the gastrointestinal tract. Intestinal dysbiosis may also manifest as a deficiency of healthy bacteria and, not surprisingly, people with IBS list histories of frequent antibiotic consumption.
What is Irritable Bowel Disease (IBD)?
Irritable bowel disease is an umbrella term for many inflammatory gastrointestinal diseases, such as Ulcerative Colitis (UC), Crohn’s, and Microscopic Colitis. A simple trick for identifying inflammatory diseases is to remember that the suffix ‘-itis’ means ‘inflammation’. The most common forms of IBD are Crohn’s and UC, which are also autoimmune diseases. Autoimmunity occurs when the body creates antibodies that attack healthy tissue because it mistakenly identifies its own cells as being foreign pathogens. Not all irritable bowel diseases are autoimmune.
Irritable bowel disease has been on the rise since the turn of the 20th century, especially in developed urban countries. Like other autoimmune and inflammatory conditions, it is believed that increased antibiotics usage and sterilization of our environments have both contributed to this rise. IBD includes chronic inflammatory diseases that occur in different parts of the digestive tract.
Key Distinctions Between IBS & IBD
Though IBS and IBD often have similar gastrointestinal symptoms, they are different. You can actually have both IBS and IBD at the same time. Here are some major differences between IBS and IBD.
IBS
IBD
Inflammatory Disease
✓
Gastrointestinal symptoms
✓
✓
Other symptoms
✓
Exacerbated by stress
✓
✓
Medications Available
✓
Elevated calprotectin/lactoferrin
✓
Though IBS is not technically an inflammatory condition, you can have another type of autoimmune disease at the same time as having IBS (remember, leaky gut must be present for autoimmunity to start and quite frequently leaky gut exists with IBS). Also, many of the symptoms of IBS are similar to IBD but IBD symptoms also affect other areas of the body, such as the joints (example: Ulcerative Colitis).
Stress can aggravate both IBS and IBD. Anxiety around not being able to have accessibility to a bathroom is commonly associated with IBS. IBD can flare in low-stress or high-stress environments. IBS diarrhea differs from that of IBD in the volume of loose stool; there is often a greater amount of stool for those with IBD.
Symptoms
IBS Symptoms:
frequent diarrhea
loose stools
abdominal pain
cramps
chronic constipation
IBD symptoms can include the above as well as:
occasional constipation
fever
blood in the stool
skin conditions
joint pain
malnutrition
weight loss
fistulas
urgency of bowel movement
extreme fatigue
loss of appetite
eye inflammation
intestinal scarring
If left untreated IBD can lead to:
perforations (holes) in the colon
colon cancer
liver disease
osteoporosis
anemia
Support Options
Gastroenterologists often depend on prescription medications aimed to help reduce inflammation, but these medications treat symptoms and don’t address the root cause of the inflammation that causes these symptoms in the first place. A more effective method is to get rid of the source of inflammation by thorough functional testing to discover the root cause.
IBS medications are often not effective because they are merely intestinal antispasmodic medications, which are drugs used to reduce muscle spasms. Again, these aren’t getting rid of what is causing your IBS symptoms. Most conventional doctors don’t know that dysbiosis and diet are contributing to IBS.
In functional medicine, we understand that diet and lifestyle can actually ‘turn’ autoimmune-related genes on and off.You may not know that just because someone has a certain gene, doesn’t mean it will actually be expressed. Epigenetics is the study of how the environment affects gene expression. We can alter genetic expression by altering our environment. This is especially true for IBD, but epigenetics also impacts the microbiome in cases of IBS.Dietary and lifestyle changes are the tools we use to optimize our body’s environment. In a functional medicine treatment plan for IBS, diet change and improved digestion can almost completely resolve symptoms because of how we can impact the diversity of the gut microbiome.
IBS Diet
If you think you suffer from IBS or have been diagnosed with IBS, you may find relief from implementing a combination of these dietary changes. To help with your decisions, find out if you classify as constipation-predominant, diarrhea-predominant, or pain-predominant. Testing with a functional medicine practitioner can help you discern this classification. (Contact us using the form below!)
Gluten-free
Going gluten-free is a great option for many individuals with IBS. Gluten has been shown in research to aggravate the intestinal lining and cause holes in the walls of the intestines.
Gluten is a protein found in wheat and other grains like barley, rye, and spelt. Many people with IBS have a gluten sensitivity or intolerance which leads to the symptoms of IBS. Avoiding gluten in the diet can reduce symptoms.
Low-Fiber
Fiber is often recommended for individuals with gastrointestinal issues. Sometimes adding fiber only exacerbates abdominal bloating and pain when trying to eliminate. This is because fiber is bulking. Constipation isn’t a problem of not enough stool, it is a problem with the intestinal cells not having enough energy to contract. So bulking up stool just makes for more painful constipation.
Going on a low-fiber diet or emphasizing mostly soluble fiber from vegetables and fruit is more supportive for most individuals with IBS. To do this, simply go on a paleo-style protocol and avoid grains to reduce insoluble fiber in the diet.
Low-FODMAP
IBS is often a symptom of small intestinal bacterial overgrowth (SIBO), where there is too much bacteria in the small intestines. When this happens, some of the carbohydrates we eat become over fermented in our gut and release gas. Sometimes this gas causes constipation, sometimes it is a different gas that causes diarrhea.
FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are short-chain carbohydrates found in certain foods that will aggravate SIBO and IBS. Avoiding these foods temporarily can help create balance in the microbiome as well as relieve symptoms:
dairy products
beans/legumes
grains
sweeteners
alcohol
certain fruits (peaches, watermelon, pears, mangoes, apples, plums, nectarine)
certain vegetables (potatoes, mushrooms, artichoke, onion, garlic)
cashews, pistachios
Keep in mind long term FODMAP has not been studied and currently Dr. Autoimmune does not recommend this as a management strategy over 3 months.
Elimination Diet
Each person’s microbiome is like a fingerprint. To discover what your individual triggers are for IBS symptoms you can do an elimination diet. The best elimination diets are the GAPS, Wahl’s or AIP protocols. These are superior because you are eliminating all common food triggers at one time while supporting the reshaping of the microbiome. This allows you to get to a baseline of health before adding in foods. If you take out only one food at a time, you might not be able to see a difference in symptoms.
Here are some common food triggers that you can test:
coffee
chocolate
insoluble fiber
nuts
dairy
gluten
eggs
nightshades
IBD Diet
Because inflammation is the driving force behind IBD, we have to eat an anti-inflammatory diet. But we also need to do thorough testing to find out what is at the root of the inflammation, often dysbiosis. In autoimmune IBD diseases, a protocol such as the Autoimmune Paleo Protocol or GAPS diet protocol is indicated. However, modifications based on bio-individuality and testing would be necessary. Again, severely restricted diets are not recommended long term. Your microbiome thrives on diversity and fiber so without these elements an elimination diet may cause more harm than good! We strongly encourage you to work with an experienced practitioner to guide you through a customized diet.
‘Gluten’ is a word that most of us in this day and age are familiar with. Comedians love the subject, bakeries proudly offer gluten free options, and the label ‘gluten-free’ is greatly sought after. Gluten is a protein found in wheat, barley, and rye. We all knew whole wheat products as being a part of the food pyramid and a staple of our diets, yet now we are being told to be wary of it- why is this?
Celiac disease (CD) is an autoimmune condition in which the body attacks its own small intestine in the presence of gluten. Gluten’s protein structure (gliadin) is very similar to that of our small intestine’s enzymes (transglutaminase), so the immune system gets confused. The problem with this is that the small intestine is where our bodies absorb the majority of nutrients from food. The other problem is that the small intestine is where 70-80% of our immune system resides. With the small intestine damaged, the body begins to become nutrient deficient and inflamed. This results in a wide range of symptoms and long-term complications.
Symptoms of celiac disease can involve gastrointestinal symptoms associated with malabsorption, including:
Diarrhea
Steatorrhea (oily stool)
Weight loss
Failure to thrive
It can also involve non-gastrointestinal symptoms such as:
Iron deficiency
Aphthous stomatitis (canker sores)
Chronic fatigue
Short stature
Reduced bone density
Tingling/Numbness
Headaches
Brain fog / Mental clarity problems
Anxiety / Depression
Sensitivities to gluten used to be considered relatively rare and were not a major concern until recent decades. Rates of these sensitivities have been steadily increasing during this time period. Celiac disease has increased in frequency by 7.5% per year over the last 30 or so years according to this 2020 meta-analysis. The regions studied were in Europe, North America, and Oceania. From this data, we know that the average annual rates of diagnosis are as follows: 7.8 per 100,000 men, 17.4 per 100,000 women, and 21.3 per 100,000 children. The majority of those affected by celiac disease are clearly women and children.
Nailing down gluten as the culprit for these symptoms can be difficult. The symptoms can occur up to days after ingesting gluten, making it hard to make the connection between them. These symptoms may also be related to other gastrointestinal conditions. Do you experience any number of the symptoms discussed in this article? You may be sensitive to gluten or a related ingredient. Fill out the form at the bottom of this page so we can begin tackling your health goals together.
The Celiac Disease Foundation estimates that 2.5 million Americans are living with undiagnosed celiac disease, leaving them vulnerable to developing long-term complications. Due to the genetic nature of the disease, those with a first-degree relative (parent or sibling) living with celiac have a 1 in 10 risk of also developing it.
So, why are the rates of gluten sensitivity rising so rapidly? There are a number of theories, and they are all regarding environmental factors. Given the rate of increase, this dramatic change in CD could not be caused by genetics, though it does require a genetic predisposition (HLA DQ 2/8). Environmental factors affect how our genes are expressed through a process called ‘epigenetics’. All autoimmune disorders have a genetic component, yet they are ultimately triggered through an environmental exposure of some sort. The rates of all autoimmune disorders have been increasing along with celiac.
What is fascinating is that 60% of those who went on a GF diet for an entire year did not recover their gut health! This should not come as a surprise because removing the trigger does not stop the inflammatory and autoimmune process. This is why functional medicine shines! Working with someone who can determine your other triggers and use diet and supplements to wind down the immune system is a step above just going gluten free. If you have gone gluten free but you are still struggling there is hope! Don’t give up. We have seen great transformations by taking your efforts one step further.
Do you want to assess your risk of developing Celiac and determine if you have a gluten sensitivity/wheat allergy? Contact our office by filling out the form at the bottom of this page.
Many people just like you are feeling the aches and pains of old age. But are these aches and pains normal? Just because it is common doesn’t mean you have to embrace inflammation and deterioration of your body. Just imagine growing old and still feeling your youthful, agile body move with ease. Doesn’t this sound like a dream? Well, it doesn’t have to be just a dream. You can live a life with less pain and more resilience. With a functional approach to your health your body doesn’t have to be subject to arthritis.
What is arthritis?
There are 2 major categories of arthritis. One category is understood as Osteoarthritis and the other is considered Autoimmune arthritis such as Rheumatoid arthritis. These two different diagnoses are typically thought to be inevitable diseases that develop as we age. This is a huge misconception and often we accept these diagnoses without any thought to fully heal. Research is telling us that these two different types of arthritis are actually being diagnosed in younger and younger individuals, including osteoarthritis. This tells us something about the nature of these diseases, that they might be a result of diet, lifestyle and our environment.
Osteoarthritis:
This type of arthritis was previously understood as pain and inflammation in the joints caused by inflammation primarily due to obesity. The theory was that the meer excess weight contributed to the deterioration of joints and cartilage. Research has revealed that this isn’t the full story. We now know that the pain and deterioration of joints and cartilage are due to inflammation coming from different parts of the body due to visceral fat storage (fat stored around organs,muscles, and inside joints that burden the body). Osteoarthritis is now considered part of metabolic syndrome in which the hyperinsulinemia (high insulin) contributes to insulin resistance and excess fat which leads to inflammation in the body. This metabolic disorder is a digestive issue and can be reversed with food and lifestyle changes! This process closely mimics osteoporosis which is another manifestation of chronic low grade inflammation.
Rheumatoid arthritis:
Rheumatoid Arthritis(RA) is an Autoimmune disease that afflicts 1.5 million people in the United States. Many are being diagnosed younger and younger. Autoimmune diseases are all similar in their origin, in that the body’s immune system has run off the railroad tracks due to leaky gut. A leaky gut allows undigested foods and bacteria/yeast/viruses to enter the bloodstream and the immune system goes on alert to create antibodies. If this goes unnoticed, the immune system can become hyperactive and confused. It eventually can no longer differentiate between itself and foreign substances. The immune system, which is normally on alert at all times to protect the body from invaders like bacteria and viruses, turns on overdrive and cannot be shut off. In the case of Rheumatoid Arthritis, the body begins to attack tissues, joints and cartilage, which causes inflammation and chronic pain. Most frequently a doctor will check two markers, Rheumatoid factor and Cyclic Citrullinated Peptide (CCP-Ab) antibody to determine this. What is confusing is that you may not have these positive but all the symptoms of osteo or rheumatoid arthritis. There are other markers like CRP-HS, a combination of inflammatory chemicals made in the liver positive. If this is significantly elevated you may have something called polymyalgia rheumatica, and it is then treated with the same drugs as rheumatoid arthritis.
When the tissues around the joint are inflamed, either due to metabolic syndrome or autoimmune origin, the synovial fluid inside the joint becomes thick and swells. This is painful because the synovial fluid is what normally provides a slick and smooth movement when you move your joints. After inflammation continues without any resolve, the cartilage begins to deteriorate. Cartilage is the elastic tissue that covers the ends of bones. Overtime, loss of cartilage and the space between joints results in loose, unstable joints, and permanent damage. For this reason, early detection and prevention of arthritis is a high priority in the medical field. But, the frustrating aspect is most providers are not looking at the infections, foods and environmental factors which are driving the condition!
What is functional medicine?
Functional medicine’s approach is always to get to the root cause of disease in a holistic and systemic approach. By looking at the body’s systems as a whole we can observe indications of illness present before severe imbalances in your blood levels are noticeable. This approach to disease is perfect for chronic diseases such as arthritis in which early detection is paramount to prevention and recovery.
Functional medicine incorporates gastrointestinal, musculoskeletal, endocrine, neurological, and psychological treatments to support the entire body’s healing capacity. The functional medicine approach for arthritis recognizes that our gut comprises 70-80% of our immune system. Correcting leaky gut and improving digestion are high priorities for a functional medicine approach to both types of arthritis. This is because all arthritis is caused by chronic inflammation throughout the body. Though each category is slightly different, they both have the same functional medicine treatments focused on the gut and diet. Increasing antioxidants, gut healing and anti-inflammatory foods are ways to get ahead of the inflammation and balance the immune system. Most importantly we must ask the question “why”? Why might I have these issues rather than accepting the common assumption “its genetic” and something I have no choice in.
How does arthritis get worse?
There are many barriers for patients using conventional treatments that inhibit a full remission of arthritis. Typically NSAIDS and other anti-inflammatory drugs are used to turn off the body’s immune system. This might temporarily resolve the inflammation and pain symptoms but these drugs contribute to leaky gut and allow for foreign invaders to freely enter the body without any deterrent (for example prednisone over long periods of time increases your susceptibility to chronic infections). There are also many environmental and genetic factors that trigger RA. One study shows that prevalence of RA increased in urban cities opposed to rural cities 1. These factors must be addressed in the health of an RA patient and taking conventional drugs will not do this.
In osteoarthritis patients the importance of reducing insulin in the body is the key. This is very much a dietary and lifestyle component. Many people continue to eat a diet that is high in processed simple and complex carbohydrates in the forms of grains and packaged foods that contribute to high insulin in the body. Insulin is a fat storing hormone. Its job is to take glucose to the cells or to the liver to be stored as fat. A lifestyle that contributes to storage of fat can perpetuate hyperinsulinemia and inflammation that burdens the joints.
How does functional medicine help arthritis?
“Approximately a year ago I developed joint pain without a known cause. After some research, I visited Dr. Autoimmune. Dr. Hollaman provided me with a foundation on which I could build on to decrease my joint pain and improve my health. He truly has a gift to help people and I’m very thankful I decided to visit Dr. Autoimmune” -Jan
A functional medicine treatment plan for arthritis will include nutrition therapy, supplementation, functional neurology to improve brain function, and other alternative therapies to improve cell function, especially immune system function. A functional approach recognizes that the immune system is in charge of both inflammation and anti-inflammation. Inflammation is needed in the body to allow the immune system to do its job and clean up the ‘bad guys’. The problem of auto-immunity and metabolic syndrome is not that there is inflammation, it is that there is something confusing the body to attack itself and cause chronic inflammation. Functional medicine exposes the root cause of the confused immune system and when we treat this, the body can realign the natural immune response.
Your body has the ability to heal itself and it all starts with an initial examination. During this we will cover a comprehensive neurologic and metabolic exam plus a case review. Then we will want to identify any key areas that need support and give necessary labs to show what needs to be done uniquely for your case. At the report of findings Dr. Ian Hollaman, DC, MSc, IFMCP will give you his best care recommendations and a treatment plan if he is able to help. Rest assured no stone will be left unturned as we look for the root cause!
Contact Dr Autoimmune Today. +1 (303) 882-8447 1 Chou CT, Pei L, Chang DM, Lee CF, Schumacher HR, Liang MH. Prevalence of rheumatic diseases in Taiwan: a population study of urban, suburban, rural differences. J Rheumatol. 1994;21(2):302-306.
Is this part of why you are not healing?
A breakthrough research article was just published in Gastroenterology Research and Practice linking a four fold increased Mercury level in patients with Celiac Disease following a Gluten-Free Diet. Mercury is ubiquitous in our environment and we actually breathe it in whether we are aware or not. Mercury is increasingly used in industries like pharmaceuticals, medical devices, fire retardants, batteries and switches plus lighting. It is considered extremely neurotoxic at small quantities and our main exposures come from vaccines, fish consumption and dental amalgums.
When it enters the body, Mercury binds onto tissues throughout the body (affinity to neurologic tissue – think brain fog, insomnia, anxiety, depression & memory loss) and does not let go easily. Recent research points to mercury exposure as a very common factor in many cardiovascular, neurodegenerative and autoimmune diseases because of its up-regulation of our inflammatory systems and suppression of the immune system. It has truly become impossible to avoid this exposure as more and more research is indicating an increasing trend of chemical and heavy metal levels in human milk, fetal tissue and other body tissues.
So what is the connection to mercury and celiac disease?
If you are familiar with the pathogenesis of Celiac disease then you understand it requires hyperpermeability of the small intestine, colloquially called “leaky gut”. If you have followed my blog over the years you also know that Celiacs on a gluten free diet still have a high proportion reporting symptoms and their small intestine microvilli rarely fully heals!
So if medical research indicates, “Complete normalization of duodenal lesions is exceptionally rare in adult coeliac patients despite adherence to GFD, symptoms disappearance and negative CD related serology”, could one of the reasons be we are more susceptible to toxic exposures like heavy metals?
I think this new research article clearly indicates that a four-fold increase in mercury, a known neurotoxin is seeping into our bodies because Celiacs and many with gluten sensitivity never heal their gut which is the #2 most important detoxification system in our body. It is the primary interface between the external and internal world and we carry 70-80% of our immune system in it!
So whether you suffer from Celiac, one kind of autoimmune disease or any other it may be appropriate to look at this aspect in your approach towards wellness!
It may be hard to believe, but brushing your teeth can help your joints. All dentists will tell you that your dental health is tied to your physical health, but how seriously do we really take that? Your mouth has its own microbiome, which is the mini ecosystem made up of bacteria and other small life forms, just like your gut and your skin. When any of your microbiomes are out of balance, there will be consequences.
Rheumatoid arthritis (RA) is an autoimmune disease, which is a type of disease where someone’s body attacks itself. In the case of RA, the body is attacking the joints, causing painful inflammation that limits range of motion and affects daily activities. Many people with RA find themselves unable to run, walk, lift things, or even use their hands without severe pain.
How Does RA Start?
In functional medicine, our goal is to discover the root cause of disease. What we’ve learned is that all autoimmune diseases require three things in order to develop:
Genes: Without the genes for an autoimmune condition, the disease cannot manifest. Genes are not a life sentence, though. We have some control over whether our genes are actually expressed or “stay asleep”. Just because you have the genes, doesn’t mean you’ll have the condition!
Leaky gut: The cells that make up our intestine lining are held together by tight junctions, which are important for keeping our partially-digested food from seeping out. Many factors, including gluten and NSAIDs such as Ibuprofen, cause these tight junctions to loosen and allow material to leak out, which causes inflammation in the body. Read more about the gut’s connection to RA here.
Last but not least, a trigger: Many things can trigger an autoimmune response, including viral or bacterial infections.
One specific type of bacterial infection has been tied to RA as a trigger. The bacteria is called Porphyromonas gingivalis and is also a common culprit behind periodontal disease, a common gum disease. In periodontal disease, an infection causes inflammation in the gums and can lead to symptoms such as:
Swollen, red, and tender gums
Bleeding gums
In more serious cases, tooth loss (periodontitis)
Gum Disease and RA
Have you ever wondered what plaque on your teeth actually is? Bacteria such as P. gingivalis produce a sticky film that can build up- and that becomes plaque! The bacteria in plaque create acids, which slowly break down tooth enamel. Not only does the yellowish film not look pretty, but it can lead to gum disease andrheumatoid arthritis. P. gingivalis causes nasty inflammation in the gums, as you can see in the picture above, so just imagine the inflammation it can cause in your joints!
It has become clear that periodontal disease and periodontitis are linked to RA, but recent research has been able to narrow down the link to P. gingivalis bacteria specifically.
In this study, mice that were infected with P. gingivalis bacteria either developed arthritis, or their already existing arthritis got worse. Another study found that the correlation between the antibody to P. gingivalis and RA was even stronger- in fact, two times stronger- than the correlation between smoking and RA. Smoking has been a known major risk factor for RA for many years, but now we know that periodontal disease caused by P. gingivalis bacteria is more than twice as likely to lead to RA. Do you believe the dentists now?
Your RA Might Have a “Friend”
For the most part, good dental hygiene can keep bad bacteria from running rampant. Brushing and flossing twice a day as well as regular visits to a dentist are important steps to take. One way that P. gingivalis can grow is if your mouth is too dry. Unfortunately, another autoimmune condition, Sjögren’s syndrome, specifically attacks the salivary glands and leaves the mouth very dry. Sjögren’s is therefore a risk factor for plaque buildup and periodontal disease. Given what we just learned about the connection between periodontal disease and RA, it should be no surprise that 21% of Sjögren’s patients have also been diagnosed with rheumatoid arthritis.
This is a common theme in our office: Many people who have been diagnosed with one autoimmune disease also develop another one or more. In fact, at the time someone is diagnosed with an autoimmune disease, there is a 50% chance that another one already exists. If the genes are there and the environment allows one disease to develop, then it is very likely that other autoimmune genes will be triggered.
At Dr. Autoimmune, we use a functional medicine approach to get to the root cause of complex conditions. Our structured program removes the guesswork and uses science-backed lab testing, diet change, and supplementation to get your body back on track. Using this method, we have an 85% success rate. If you’re interested in finding real solutions for your conditions, fill out the form below to get started!
April is Sjögren’s awareness month, so we thought it would be a great time to shed some light on it. Sjögren’s (pronounced show-grens) syndrome is a common autoimmune condition where moisture-secreting glands are attacked. This usually happens first in the eyes and mouth, so dry eyes and mouth are the most common symptoms.
Other symptoms can include:
Dry eyes
Dry mouth
Vaginal dryness
Dry nose, recurrent sinusitis, nosebleeds
Dry or peeling lips
Dry skin
Fatigue
Joint or muscle pain
Inability to focus or ‘brain fog’
Respiratory issues like shortness of breath, dry cough, or recurrent bronchitis
Anxiety and depression
Memory loss
Dysautonomia
Headaches (most commonly tension-type or migraines)
Sjögren’s syndrome can develop at any age and in any sex, but it is most common in women (9 out of 10 patients are women) and people over 40. It is considered a widely underdiagnosed condition, with the Sjögren’s Foundation estimating that over 2.5 million patients are currently undiagnosed.
The genes associated with Sjögren’s aren’t known yet, but we can’t control those anyway. What we can have some control over, though, is whether those genes are expressed. Our genes basically can be turned on and off with the right environmental factors. This is why gut health and removing triggers are more important than our genes.
In functional medicine, we use diet change and supplementation to heal the gut while working with you to find out possible triggers in your life. Common triggers include stress, viral or bacterial infections, and mold or toxin exposure.
Dry Eyes
One of the first things to occur in Sjögren’s is the glands that produce tears, the lacrimal glands, are attacked by the immune system. You might think that we only produce tears when we cry, but our lacrimal glands are actually always working to keep our eyes moistened.
Have you ever wondered why we blink? Our eyelids keep moisture trapped beneath, so when the part of our eye that is exposed to air starts to dry out, blinking spreads a new film of moisture over them. This method only works, however, when our lacrimal glands are producing moisture.
Dry eyes can lead to burning, itching, a feeling like sand is in the eyes, blurred vision, and difficulty tolerating bright lights. Think back to the last time you were challenged to a “blinking contest”. After some time of forcing your eyes to remain open, your vision starts to become affected and you start to feel a burning sensation. This is what chronic dry eyes associated with Sjögren’s syndrome can feel like.
Dry Mouth
One of the 2 most prominent symptoms, dry mouth is uncomfortable and can lead to dental problems. Along with the lacrimal glands, the salivary glands are the first to be affected. Salivary glands produce saliva, which keeps our mouths and gums moist and also helps with digesting food.
People with Sjögren’s are more likely to develop cavities and gum disease due to lack of moisture, so recommendations include stimulating saliva production with sugar-free (xylitol or maltitol if sugar alcohols are tolerated) lozenges and brushing teeth after every meal. These types of recommendations are only good for managing symptoms without actually addressing the root cause.
What Can You Do?
At Dr. Autoimmune, we are experts at getting to the root cause of your condition and working with you to develop a personalized plan to reach your health goals. Most of our clients notice huge changes within only 30 days. Fill out the form below to get started on your health journey!
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:
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!
As a child, were you covered in pink calamine lotion after proclaiming “it itches?” Did your mom soak you in a bath with oatmeal to soften and dissolve those scabs that came after a bout of chickenpox? Mine did.
Professor Ronald Goldsteinm, a member of the BIU’s Mina and Everand Goodman Faculty of Life Sciences calls this a ‘souvenir’ from childhood. What does this mean for you as an adult? Goldstein states that in one-third of people over 50, or in those with weakened immune systems (our clients), chickenpox reactivates in the form of shingles. That is a lot of people!
In one-third of those cases, shingle symptoms are far more serious than the itching you experienced as a child. The pain can be debilitating and last for months or years. Should you or should you not get the anti-shingle vaccine? That is a hot topic for many! He explains that it provides effective protection in only 50% of cases and can not be given to immune- compromised patients.
Chickenpox/shingles is only 1 of the 8 different Herpes viruses that affect humans.
Herpes 1 is generally transmitted orally or to the genitals through oral transmission. Think cold sores in the corner or inside of your mouth.
Herpes 2 causes genital infection and is usually passed through sexual transmission and can not live very long outside of the body. There’s not much to think about except ‘no thank you’.
Herpes 3 is our itchy enemy which causes chickenpox or shingles. Like its friend, HHV1, herpes zoster likes to infect skin cells and nerve cells and often forms in a band or belt-like pattern. Most everyone knows someone who has had chicken pox or shingles.
Herpes 4 is also called Epstein-Barr virus (EBV) also known as the kissing disease, mononucleosis. A very popular virus that has made it through the majority of the population.
Herpes 5 is the official name of cytomegalovirus (CMV). It can also be a cause of mononucleosis. In people with healthy immune systems, the virus may not even cause any symptoms. If you do not have a healthy immune system, it can cause problems passed onto newborns, and can cause hepatitis. CMV can be transmitted through sexual contact, breast-feeding, blood transfusions, and organ transplants. CMV infection is one of the most difficult complications of acquired immune deficiency syndrome (AIDS).
Herpes 6 gives rise to roseola (a viral disease causing high fever and a skin rash in small children) and a variety of other illnesses associated with fever in that age group. This infection accounts for many of the cases of seizures associated with fever in infancy.
Herpes 7 is even more recently observed and is closely related to 6. Like other human herpes viruses, 6 and 7 are so common that most of humankind has been infected at some point, usually early in life. HHV7 can also cause roseola, but it is not clear what other clinical effects this virus causes.
Herpes 8 was recently discovered in tumors called Kaposi’s Sarcoma (KS). These tumors are found in people with AIDS and are otherwise very rare. KS forms purplish tumors in the skin and other tissues of some people with AIDS. It is very difficult to treat with medication. HHV8 may also cause other cancers, including certain lymphomas (lymph node cancers) associated with AIDS. The fact that these cancers are caused by a virus may explain why they tend to occur in people with AIDS when their immune systems begin to fail.
Dormant vs Active Viral Infections
What wakes herpetic infections from their cozy little rest? Many factors that include stress, sex, temperature fluctuations, weakened immune systems and even certain foods (lysine/arginine ratio) can trigger an outbreak. There is no formula to determine when you can experience an outbreak once contracting HSV. It can show its ugly head of symptoms as early as a week, up to years after infection. Each person’s immune response to environmental and emotional stress is different, so your biggest defense for any viral overload is to nurture your superhero–the immune system! You can experience an outbreak at first contact or during a stressful time, and it could be a one-time event for you. A revisit from any strain of a herpetic virus can overload your immune system and create the cytokine storm we have all heard so much about in the past year. No thank you!
Like many viruses, Herpes (HSV) is a sneaky devil and can lay dormant and hide out in the ganglia nerve. Keep HSV dormant by actively lowering your stress levels, because stress can raise your cortisol levels and hormones play a huge role in one’s stress response. Try adding exercise, switch to eating clean and unprocessed foods, and consciously participate in suppressing any immune overload. You can also try meditating, practicing yoga, mindfulness, or other ways to cope and manage stress. Some sources tout that a lysine-rich diet may suppress the herpes virus. All these factors can contribute to less frequent flare-ups.
Herpetic Infections Relationship with Autoimmunity
More and more evidence is linking herpes viruses to the development of multiple autoimmune disorders including lupus, rheumatoid arthritis, Sjögren’s syndrome, and central nervous system neurological illness. Studies have suggested that vulnerability to multiple sclerosis is gained in early childhood, with viral infections acting as a trigger. If a herpes infection is activated, it can contribute to the development of autoimmune diseases.
“’It’s important to note that EBV is triggering exhaustion and flu-like symptoms for millions of women. EBV is super common: 95 percent of people have it. It will lie dormant in the body as long as the immune system is strong. But stress — like that caused by COVID- 19 (from any source) — can weaken immunity, allowing EBV to reactivate. In a study conducted by Ohio State University, subjects under increased stress were twice as likely to have EBV reactivation.“
Let’s just say, herpes sucks! It’s surprising how many people do not know that their herpetic infection can awaken under a stressful circumstance. To confirm whether or not yours may have resurfaced and may be a trigger for your health challenges, a test of EBV virus nuclear antigen, capsid, IGM and early antigen markers can be performed through a blood draw to confirm this suspicion. Ask your doctor.
To summarize, there are multiple ways herpes viruses trigger autoimmunity. Both molecular mimicry and bystander activation were reported in EBV- and HSV- induced autoimmunity. In addition, as ‘neurotropic’ viruses, herpes viruses can infect and kill central nervous system cells directly, leading to several autoimmune diseases.
The cause of any virus story? Who really knows. Today we are facing new viruses and strains that are running through the population at rapid rates. Viruses and bacteria will always be on this planet, and will always challenge our immune health. It’s their job. We can defend ourselves from these pesky little buggers by ramping up our immunity with proper diet, stress management, and supplementation.
Want my quick and basic protocol for anti-viral support? Here it is:
1) Vitamin D – 10,000 IU daily (monitor with labs to 60 ng/dl)
2) Selenium – 200mcg twice daily (no more than 3 months!)
3) Zinc – 100mg, divided doses and mind you it may cause nausea (copper required if long term)
Come see us and Dr. Autoimmune and get a baseline of your health, so you can win the war on virus overload and create a flexible, super-human immune system!
Every human body is different in so many ways, but one thing we all have in common is poop! Pooping is something every living creature on this planet must do in order to stay alive and healthy. The process of defecation means the discharge of feces from the body. Poop is the left-over waste in our system after all of the nutrients of our food have been absorbed (or so we hope). It’s vital for our health that we are properly eliminating these toxins, otherwise they get reabsorbed into our system. There’s a delicate balance that happens in our body based on fiber consumption, hydration, and muscle motility (determined by healthy brain function) that deter-mines how our bowel movements might appear and how often you’ll pass them.
What is a normal poo?
There are many sizes, shapes, and colors your stool can be and all of them tell us different things about our health. Consistency is key: whether you’re having one or two bowel movements every day, you still want to make sure they are healthy! The Bristol Stool Chart is a helpful reference point to guarantee your bowel movements are where they should be.
According to The Bristol Stool Chart, the seven types of stool are:
•Type 1: Separate hard lumps, like nuts (hard to pass
•Type 2: Sausage-shaped, but lumpy
•Type 3: Like a sausage but with cracks on its surface
•Type 4: Like a sausage or snake, smooth and soft
•Type 5: Soft blobs with clear cut edges (passed easily)
•Type 6: Fluffy pieces with ragged edges, a mushy stool
•Type 7: Watery, no solid pieces, entirely liquid
Types 1–2 indicate constipation, types 3–5 are considered to be ideal, normal poops (especially 4), and types 6–7 are considered abnormal and indicate diarrhea.
The color (and even smell!) of your stool can tell you things about it as well. Colors can range from a medium brown, black, green, red, or even yellow/gray. Here’s a list of what some of these might say about what’s going on inside your body:
Medium to dark brown: Normal!
Black: Can mean there is upper GI bleeding going on. If this continues for 2-3 poops, consult with your doctor.
Green: Can be a sign that your stool is moving too quickly through your digestive tract. Vegetables like spinach, kale, blueberries, or green supplement powders can show up in your stool without enough fiber to slow down the digestive process.
Red/Purple: Can be a result of eating deeply colored vegetables like beets, but if you haven’t eaten anything of this color, you should reach out to your doctor (could be as simple as a hemorrhoid or something else).
Yellow/Gray: Typically a sign of mucous, or bile, in the stool which can mean an issue with the liver or gallbladder.
What might be causing problems?
There are many reasons why you might not be eliminating properly! Constipation and diarrhea can result from stress, dehydration, lack of fiber, too much alcohol or caffeine, inflammation, or autoimmune disease. Dysbiosis is an “imbalance” in the gut microbial community and can mean that the bad bacteria in your digestive system has overgrown the good. This can cause bacterial over-growth, like SIBO, resulting in constipation, gas, bloating, food intolerances, and nutritional deficiencies.
Food sensitivities may be one of the most common, yet overlooked reasons for change in bowel movements. If you find your pattern flip flopping this could be IBS, but in reality there may be a chronic food sensitivity that you are unaware of! Foods like gluten and dairy are potentially inflammatory to your body and this may be causing either constipation (from bacterial overgrowth) or diarrhea (body needs to get it out fast!). At Dr. Autoimmune, we will help you determine any food sensitivities you may have so you can drop that inflammation and get this common leaky gut trigger removed. Without fully getting your diet dialed in to what you need, it may be impossible to have normal gut function.
Consistent bowel movements are a way to avoid dysbiosis and potential disease. Keep a look out for changes in your stool to help you stay aware of what’s going on inside your body. Fiber (vegetables, people!) and hydration might be two easy additions to your routine that could help you stay regular AND stay healthy! If you have tried all of the tricks and are still suffering, this is where functional medicine shines! Dr. Ian and our nutritionist are trained to pick up on these abnormal patterns and help you find the root cause of abnormal poo!
If you’d like to get started, fill out the form below and we’ll reach out shortly. We look forward to working with you to help you reach your health goals. We have a very comprehensive stool analysis that all of our clients complete because of just how important gut health is.
Masks have become so politicized that even physical altercations have broken out regarding their usage. While many see mask-wearing as a decision that affects other people and is therefore not entirely personal, others maintain that everyone should take their health into their own hands.
Most schools around America that have been operating physically have implemented some sort of mask requirement. Even though children represent the demographic that is of the lowest risk and lowest spreading rate, they’ve still been forced to participate in the mask-wearing that has been the theme of this past year. Given the known negative effects of wearing masks along with the knowledge that children are of the lowest risk of mortality or getting severely ill from a COVID-19 infection, why are they still being forced to wear them?
Concerns have been raised over a false sense of security that may come from wearing a mask. If an individual is under the impression that a mask will protect them and others, they may become lax with other strategies that are equally, if not more effective at limiting the virus’s spread. Another concern is masks that are not properly kept clean may become spreading agents themselves. When considering children, can we really expect them to keep their masks properly sanitized? Sure, parents are responsible for this, but this brings us to our next issue. Think for a moment about how many people reuse their (often homemade) cloth masks every day.
The type of mask definitively alters its effectiveness. In this Vietnamese study, there was a significant difference in viruses spread among cloth mask wearers versus medical mask wearers. Hospital workers wearing cloth masks were 13 times more likely to contract an influenza-like virus. According to the study, “Penetration of cloth masks by particles was almost 97% and medical masks 44%.” Even more shockingly, cloth mask wearers were 3 times MORE likely to contract a virus than those who didn’t wear any mask at all. This means that the cloth masks actually increased the risk. Now ask yourself, is this good science or virtue signaling?
The Norwegian Institute of Public Health (NIPH) recommended against mask wearing for individuals without respiratory symptoms, citing concerns over proper usage. The researchers maintained that in order for an official recommendation to be effective, customized mask training needed to be provided directly to communities. They also stated that there is no reliable evidence that non-medical masks provide any protective effect. Let’s take a second to reflect on what this means, taking into account the supplies shortage we’ve seen regarding proper masks for medical workers. If we can’t even supply our front-line workers with proper equipment, the majority of the public is not going to be able to find the proper equipment. We’ve already seen that this leads to an increase in homemade cloth masks.
Children’s immune systems are young and flexible, making it the perfect time to introduce them to potentially harmful pathogens in the world so that they can learn how to protect themselves. It also makes them extremely resilient and quick to launch an attack on the virus (and we don’t have time to discuss how amazing breast feeding works for a baby’s immune system). Researchers have discovered that the SARS-CoV-2 virus is not able to replicate rapidly in childrens’ bodies due to a combination of factors. For one, because children’s immune systems are young, they contain many naive T cells just waiting to be deployed. Naive T cells are immune cells that have not yet been assigned to a specific virus or other pathogen, so they are readily available to study and launch an attack against a new pathogen. As a person grows up and is exposed to new environments, their bodies make less naive T cells because they’ve already learned the majority of antigens they encounter regularly.
Further evidence of a rapid immune response amongst children is found in the types of antibodies present in children versus adults following a COVID infection. Adults developed both antibodies against the SARS-CoV-2 spike protein (which allows the virus to enter a cell), and against its nucleocapsid protein (which is essential for the virus to replicate). Children, on the other hand, did not develop antibodies against the nucleocapsid protein because this protein is typically only present once the virus is widespread in the body.
All of these factors help to explain why some children develop Covid symptoms but repeatedly test negative for the virus on a PCR test. The virus simply is not able to replicate enough to show up on the test before the child’s body squashes it.
Another interesting possible reason for the low risk amongst children revolves around a specific enzyme found inside the nose called angiotensin-converting enzyme 2 (ACE2). This enzyme binds to spike proteins on the surface of the SARS-CoV-2 virus and allows it to enter the human cells. This study found that the amount of ACE2 in the nose increased with age, starting a very low amount for the youngest age group.
Age has been determined to be a large risk factor regarding Covid-19. One reason for this is the increased instance of comorbidities (other life-threatening conditions) amongst older populations. For example, Covid-19 patients who also have heart conditions are more likely to pass away from the infection. However in this study, age was independently a significant risk factor even after adjusting for such comorbidities. It is undeniable that children are at much lower risk than older adults, and not just for their lack of other health issues.
A child’s immune system is malleable and needs to be regularly challenged and stimulated in order to continue growing and strengthening. This study demonstrated the connection between growing up in a sterile environment and having a suppressed immune system. This concept is known as the ‘hygiene hypothesis’, which claims that early exposure to pathogens (amongst other things such as dander, mold and allergens) is integral to immune system development. If the child’s naive T cells never have the chance to meet any pathogens, how can they protect the child from disease later in life?
In addition to learning about the external environment, the immune system must also learn to tell the difference between a real pathogen and a human cell look-alike. When foreign material resembles a bodily cell, such as gluten proteins with thyroid tissue, an inexperienced immune system may accidentally end up attacking the host’s own body. This is how autoimmunity begins. But, gluten is not enough! We must remember that the immune system is complex and it involves genetics, environment and triggers (all three are required for autoimmunity). Merely having a family member with a chronic illness does not warrant the need to isolate our children – in fact, it harms their ability to respond when we don’t give them the opportunity to be outside, live life and just be kids!
There are also other factors to consider when discussing mask-wearing for children, notably the psychological effects it may have on them. Social distancing and school closures pose a new kind of challenge to a child’s interpersonal development. Hearing-impaired children lose the important tool of lip-reading as well as the practice necessary to hone that skill. Similarly, children within the autism spectrum lose the opportunity to practice reading facial expressions, which is something that they are predisposed to struggling with.
The question of whether we should force children to wear masks is a question of risk-benefit analysis. Simply, do the possible benefits outweigh the possible harms? If this isn’t the case, we cannot in good conscience advocate for society-wide mask requirements.
Irritable bowel syndrome is a functional diagnosis that is given to individuals who have chronic gastrointestinal symptoms such as diarrhea and constipation, but no inflammatory diseases are found to be the cause. IBS is a frustrating diagnosis because it is often given by gastroenterologists when there is no known cause of the symptoms. Individuals are often left feeling hopeless because there are no medications for IBS.
IBS is classified as a “functional disorder”, similar to tension headaches and chronic fatigue syndrome (CFS). Another common term is “wastebasket diagnosis”, which means that by exclusion of other problems, this is the default diagnosis. In functional medicine we know that there are physiological causes for these disorders, but this type of classification often leads people to believe that IBS is more psychological which isn’t true.
IBS is very common. In fact, it is the most common reason for individuals to miss work. People with IBS often have normal test results on standard blood panels, which makes it difficult to diagnose. IBS commonly runs in families and it can develop at any age. The Rome criteria for diagnosing IBS is the standard. The criteria include abdominal discomfort and pain lasting at least one day per week for the past three months connected to at least two of the following factors: Defecation causing pain and discomfort, changes in defecation, and stool consistency alterations.
In functional medicine, IBS is known to be caused by intestinal dysbiosis, likely small intestinal bacterial overgrowth (SIBO) or other pathogenic bacterial infections in the gastrointestinal tract. Intestinal dysbiosis may also manifest as a deficiency of healthy bacteria and, not surprisingly, people with IBS list histories of frequent antibiotic consumption.
What is Irritable Bowel Disease (IBD)?
Irritable bowel disease is an umbrella term for many inflammatory gastrointestinal diseases, such as Ulcerative Colitis (UC), Crohn’s, and Microscopic Colitis. A simple trick for identifying inflammatory diseases is to remember that the suffix ‘-itis’ means ‘inflammation’. The most common forms of IBD are Crohn’s and UC, which are also autoimmune diseases. Autoimmunity occurs when the body creates antibodies that attack healthy tissue because it mistakenly identifies its own cells as being foreign pathogens. Not all irritable bowel diseases are autoimmune.
Irritable bowel disease has been on the rise since the turn of the 20th century, especially in developed urban countries. Like other autoimmune and inflammatory conditions, it is believed that increased antibiotics usage and sterilization of our environments have both contributed to this rise. IBD includes chronic inflammatory diseases that occur in different parts of the digestive tract.
Key Distinctions Between IBS & IBD
Though IBS and IBD often have similar gastrointestinal symptoms, they are different. You can actually have both IBS and IBD at the same time. Here are some major differences between IBS and IBD.
IBS
IBD
Inflammatory Disease
✓
Gastrointestinal symptoms
✓
✓
Other symptoms
✓
Exacerbated by stress
✓
✓
Medications Available
✓
Elevated calprotectin/lactoferrin
✓
Though IBS is not technically an inflammatory condition, you can have another type of autoimmune disease at the same time as having IBS (remember, leaky gut must be present for autoimmunity to start and quite frequently leaky gut exists with IBS). Also, many of the symptoms of IBS are similar to IBD but IBD symptoms also affect other areas of the body, such as the joints (example: Ulcerative Colitis).
Stress can aggravate both IBS and IBD. Anxiety around not being able to have accessibility to a bathroom is commonly associated with IBS. IBD can flare in low-stress or high-stress environments. IBS diarrhea differs from that of IBD in the volume of loose stool; there is often a greater amount of stool for those with IBD.
Symptoms
IBS Symptoms:
frequent diarrhea
loose stools
abdominal pain
cramps
chronic constipation
IBD symptoms can include the above as well as:
occasional constipation
fever
blood in the stool
skin conditions
joint pain
malnutrition
weight loss
fistulas
urgency of bowel movement
extreme fatigue
loss of appetite
eye inflammation
intestinal scarring
If left untreated IBD can lead to:
perforations (holes) in the colon
colon cancer
liver disease
osteoporosis
anemia
Support Options
Gastroenterologists often depend on prescription medications aimed to help reduce inflammation, but these medications treat symptoms and don’t address the root cause of the inflammation that causes these symptoms in the first place. A more effective method is to get rid of the source of inflammation by thorough functional testing to discover the root cause.
IBS medications are often not effective because they are merely intestinal antispasmodic medications, which are drugs used to reduce muscle spasms. Again, these aren’t getting rid of what is causing your IBS symptoms. Most conventional doctors don’t know that dysbiosis and diet are contributing to IBS.
In functional medicine, we understand that diet and lifestyle can actually ‘turn’ autoimmune-related genes on and off.You may not know that just because someone has a certain gene, doesn’t mean it will actually be expressed. Epigenetics is the study of how the environment affects gene expression. We can alter genetic expression by altering our environment. This is especially true for IBD, but epigenetics also impacts the microbiome in cases of IBS.Dietary and lifestyle changes are the tools we use to optimize our body’s environment. In a functional medicine treatment plan for IBS, diet change and improved digestion can almost completely resolve symptoms because of how we can impact the diversity of the gut microbiome.
IBS Diet
If you think you suffer from IBS or have been diagnosed with IBS, you may find relief from implementing a combination of these dietary changes. To help with your decisions, find out if you classify as constipation-predominant, diarrhea-predominant, or pain-predominant. Testing with a functional medicine practitioner can help you discern this classification. (Contact us using the form below!)
Gluten-free
Going gluten-free is a great option for many individuals with IBS. Gluten has been shown in research to aggravate the intestinal lining and cause holes in the walls of the intestines.
Gluten is a protein found in wheat and other grains like barley, rye, and spelt. Many people with IBS have a gluten sensitivity or intolerance which leads to the symptoms of IBS. Avoiding gluten in the diet can reduce symptoms.
Low-Fiber
Fiber is often recommended for individuals with gastrointestinal issues. Sometimes adding fiber only exacerbates abdominal bloating and pain when trying to eliminate. This is because fiber is bulking. Constipation isn’t a problem of not enough stool, it is a problem with the intestinal cells not having enough energy to contract. So bulking up stool just makes for more painful constipation.
Going on a low-fiber diet or emphasizing mostly soluble fiber from vegetables and fruit is more supportive for most individuals with IBS. To do this, simply go on a paleo-style protocol and avoid grains to reduce insoluble fiber in the diet.
Low-FODMAP
IBS is often a symptom of small intestinal bacterial overgrowth (SIBO), where there is too much bacteria in the small intestines. When this happens, some of the carbohydrates we eat become over fermented in our gut and release gas. Sometimes this gas causes constipation, sometimes it is a different gas that causes diarrhea.
FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) are short-chain carbohydrates found in certain foods that will aggravate SIBO and IBS. Avoiding these foods temporarily can help create balance in the microbiome as well as relieve symptoms:
dairy products
beans/legumes
grains
sweeteners
alcohol
certain fruits (peaches, watermelon, pears, mangoes, apples, plums, nectarine)
certain vegetables (potatoes, mushrooms, artichoke, onion, garlic)
cashews, pistachios
Keep in mind long term FODMAP has not been studied and currently Dr. Autoimmune does not recommend this as a management strategy over 3 months.
Elimination Diet
Each person’s microbiome is like a fingerprint. To discover what your individual triggers are for IBS symptoms you can do an elimination diet. The best elimination diets are the GAPS, Wahl’s or AIP protocols. These are superior because you are eliminating all common food triggers at one time while supporting the reshaping of the microbiome. This allows you to get to a baseline of health before adding in foods. If you take out only one food at a time, you might not be able to see a difference in symptoms.
Here are some common food triggers that you can test:
coffee
chocolate
insoluble fiber
nuts
dairy
gluten
eggs
nightshades
IBD Diet
Because inflammation is the driving force behind IBD, we have to eat an anti-inflammatory diet. But we also need to do thorough testing to find out what is at the root of the inflammation, often dysbiosis. In autoimmune IBD diseases, a protocol such as the Autoimmune Paleo Protocol or GAPS diet protocol is indicated. However, modifications based on bio-individuality and testing would be necessary. Again, severely restricted diets are not recommended long term. Your microbiome thrives on diversity and fiber so without these elements an elimination diet may cause more harm than good! We strongly encourage you to work with an experienced practitioner to guide you through a customized diet.
‘Gluten’ is a word that most of us in this day and age are familiar with. Comedians love the subject, bakeries proudly offer gluten free options, and the label ‘gluten-free’ is greatly sought after. Gluten is a protein found in wheat, barley, and rye. We all knew whole wheat products as being a part of the food pyramid and a staple of our diets, yet now we are being told to be wary of it- why is this?
Celiac disease (CD) is an autoimmune condition in which the body attacks its own small intestine in the presence of gluten. Gluten’s protein structure (gliadin) is very similar to that of our small intestine’s enzymes (transglutaminase), so the immune system gets confused. The problem with this is that the small intestine is where our bodies absorb the majority of nutrients from food. The other problem is that the small intestine is where 70-80% of our immune system resides. With the small intestine damaged, the body begins to become nutrient deficient and inflamed. This results in a wide range of symptoms and long-term complications.
Symptoms of celiac disease can involve gastrointestinal symptoms associated with malabsorption, including:
Diarrhea
Steatorrhea (oily stool)
Weight loss
Failure to thrive
It can also involve non-gastrointestinal symptoms such as:
Iron deficiency
Aphthous stomatitis (canker sores)
Chronic fatigue
Short stature
Reduced bone density
Tingling/Numbness
Headaches
Brain fog / Mental clarity problems
Anxiety / Depression
Sensitivities to gluten used to be considered relatively rare and were not a major concern until recent decades. Rates of these sensitivities have been steadily increasing during this time period. Celiac disease has increased in frequency by 7.5% per year over the last 30 or so years according to this 2020 meta-analysis. The regions studied were in Europe, North America, and Oceania. From this data, we know that the average annual rates of diagnosis are as follows: 7.8 per 100,000 men, 17.4 per 100,000 women, and 21.3 per 100,000 children. The majority of those affected by celiac disease are clearly women and children.
Nailing down gluten as the culprit for these symptoms can be difficult. The symptoms can occur up to days after ingesting gluten, making it hard to make the connection between them. These symptoms may also be related to other gastrointestinal conditions. Do you experience any number of the symptoms discussed in this article? You may be sensitive to gluten or a related ingredient. Fill out the form at the bottom of this page so we can begin tackling your health goals together.
The Celiac Disease Foundation estimates that 2.5 million Americans are living with undiagnosed celiac disease, leaving them vulnerable to developing long-term complications. Due to the genetic nature of the disease, those with a first-degree relative (parent or sibling) living with celiac have a 1 in 10 risk of also developing it.
So, why are the rates of gluten sensitivity rising so rapidly? There are a number of theories, and they are all regarding environmental factors. Given the rate of increase, this dramatic change in CD could not be caused by genetics, though it does require a genetic predisposition (HLA DQ 2/8). Environmental factors affect how our genes are expressed through a process called ‘epigenetics’. All autoimmune disorders have a genetic component, yet they are ultimately triggered through an environmental exposure of some sort. The rates of all autoimmune disorders have been increasing along with celiac.
What is fascinating is that 60% of those who went on a GF diet for an entire year did not recover their gut health! This should not come as a surprise because removing the trigger does not stop the inflammatory and autoimmune process. This is why functional medicine shines! Working with someone who can determine your other triggers and use diet and supplements to wind down the immune system is a step above just going gluten free. If you have gone gluten free but you are still struggling there is hope! Don’t give up. We have seen great transformations by taking your efforts one step further.
Do you want to assess your risk of developing Celiac and determine if you have a gluten sensitivity/wheat allergy? Contact our office by filling out the form at the bottom of this page.
Many people just like you are feeling the aches and pains of old age. But are these aches and pains normal? Just because it is common doesn’t mean you have to embrace inflammation and deterioration of your body. Just imagine growing old and still feeling your youthful, agile body move with ease. Doesn’t this sound like a dream? Well, it doesn’t have to be just a dream. You can live a life with less pain and more resilience. With a functional approach to your health your body doesn’t have to be subject to arthritis.
What is arthritis?
There are 2 major categories of arthritis. One category is understood as Osteoarthritis and the other is considered Autoimmune arthritis such as Rheumatoid arthritis. These two different diagnoses are typically thought to be inevitable diseases that develop as we age. This is a huge misconception and often we accept these diagnoses without any thought to fully heal. Research is telling us that these two different types of arthritis are actually being diagnosed in younger and younger individuals, including osteoarthritis. This tells us something about the nature of these diseases, that they might be a result of diet, lifestyle and our environment.
Osteoarthritis:
This type of arthritis was previously understood as pain and inflammation in the joints caused by inflammation primarily due to obesity. The theory was that the meer excess weight contributed to the deterioration of joints and cartilage. Research has revealed that this isn’t the full story. We now know that the pain and deterioration of joints and cartilage are due to inflammation coming from different parts of the body due to visceral fat storage (fat stored around organs,muscles, and inside joints that burden the body). Osteoarthritis is now considered part of metabolic syndrome in which the hyperinsulinemia (high insulin) contributes to insulin resistance and excess fat which leads to inflammation in the body. This metabolic disorder is a digestive issue and can be reversed with food and lifestyle changes! This process closely mimics osteoporosis which is another manifestation of chronic low grade inflammation.
Rheumatoid arthritis:
Rheumatoid Arthritis(RA) is an Autoimmune disease that afflicts 1.5 million people in the United States. Many are being diagnosed younger and younger. Autoimmune diseases are all similar in their origin, in that the body’s immune system has run off the railroad tracks due to leaky gut. A leaky gut allows undigested foods and bacteria/yeast/viruses to enter the bloodstream and the immune system goes on alert to create antibodies. If this goes unnoticed, the immune system can become hyperactive and confused. It eventually can no longer differentiate between itself and foreign substances. The immune system, which is normally on alert at all times to protect the body from invaders like bacteria and viruses, turns on overdrive and cannot be shut off. In the case of Rheumatoid Arthritis, the body begins to attack tissues, joints and cartilage, which causes inflammation and chronic pain. Most frequently a doctor will check two markers, Rheumatoid factor and Cyclic Citrullinated Peptide (CCP-Ab) antibody to determine this. What is confusing is that you may not have these positive but all the symptoms of osteo or rheumatoid arthritis. There are other markers like CRP-HS, a combination of inflammatory chemicals made in the liver positive. If this is significantly elevated you may have something called polymyalgia rheumatica, and it is then treated with the same drugs as rheumatoid arthritis.
When the tissues around the joint are inflamed, either due to metabolic syndrome or autoimmune origin, the synovial fluid inside the joint becomes thick and swells. This is painful because the synovial fluid is what normally provides a slick and smooth movement when you move your joints. After inflammation continues without any resolve, the cartilage begins to deteriorate. Cartilage is the elastic tissue that covers the ends of bones. Overtime, loss of cartilage and the space between joints results in loose, unstable joints, and permanent damage. For this reason, early detection and prevention of arthritis is a high priority in the medical field. But, the frustrating aspect is most providers are not looking at the infections, foods and environmental factors which are driving the condition!
What is functional medicine?
Functional medicine’s approach is always to get to the root cause of disease in a holistic and systemic approach. By looking at the body’s systems as a whole we can observe indications of illness present before severe imbalances in your blood levels are noticeable. This approach to disease is perfect for chronic diseases such as arthritis in which early detection is paramount to prevention and recovery.
Functional medicine incorporates gastrointestinal, musculoskeletal, endocrine, neurological, and psychological treatments to support the entire body’s healing capacity. The functional medicine approach for arthritis recognizes that our gut comprises 70-80% of our immune system. Correcting leaky gut and improving digestion are high priorities for a functional medicine approach to both types of arthritis. This is because all arthritis is caused by chronic inflammation throughout the body. Though each category is slightly different, they both have the same functional medicine treatments focused on the gut and diet. Increasing antioxidants, gut healing and anti-inflammatory foods are ways to get ahead of the inflammation and balance the immune system. Most importantly we must ask the question “why”? Why might I have these issues rather than accepting the common assumption “its genetic” and something I have no choice in.
How does arthritis get worse?
There are many barriers for patients using conventional treatments that inhibit a full remission of arthritis. Typically NSAIDS and other anti-inflammatory drugs are used to turn off the body’s immune system. This might temporarily resolve the inflammation and pain symptoms but these drugs contribute to leaky gut and allow for foreign invaders to freely enter the body without any deterrent (for example prednisone over long periods of time increases your susceptibility to chronic infections). There are also many environmental and genetic factors that trigger RA. One study shows that prevalence of RA increased in urban cities opposed to rural cities 1. These factors must be addressed in the health of an RA patient and taking conventional drugs will not do this.
In osteoarthritis patients the importance of reducing insulin in the body is the key. This is very much a dietary and lifestyle component. Many people continue to eat a diet that is high in processed simple and complex carbohydrates in the forms of grains and packaged foods that contribute to high insulin in the body. Insulin is a fat storing hormone. Its job is to take glucose to the cells or to the liver to be stored as fat. A lifestyle that contributes to storage of fat can perpetuate hyperinsulinemia and inflammation that burdens the joints.
How does functional medicine help arthritis?
“Approximately a year ago I developed joint pain without a known cause. After some research, I visited Dr. Autoimmune. Dr. Hollaman provided me with a foundation on which I could build on to decrease my joint pain and improve my health. He truly has a gift to help people and I’m very thankful I decided to visit Dr. Autoimmune” -Jan
A functional medicine treatment plan for arthritis will include nutrition therapy, supplementation, functional neurology to improve brain function, and other alternative therapies to improve cell function, especially immune system function. A functional approach recognizes that the immune system is in charge of both inflammation and anti-inflammation. Inflammation is needed in the body to allow the immune system to do its job and clean up the ‘bad guys’. The problem of auto-immunity and metabolic syndrome is not that there is inflammation, it is that there is something confusing the body to attack itself and cause chronic inflammation. Functional medicine exposes the root cause of the confused immune system and when we treat this, the body can realign the natural immune response.
Your body has the ability to heal itself and it all starts with an initial examination. During this we will cover a comprehensive neurologic and metabolic exam plus a case review. Then we will want to identify any key areas that need support and give necessary labs to show what needs to be done uniquely for your case. At the report of findings Dr. Ian Hollaman, DC, MSc, IFMCP will give you his best care recommendations and a treatment plan if he is able to help. Rest assured no stone will be left unturned as we look for the root cause!
Contact Dr Autoimmune Today. +1 (303) 882-8447 1 Chou CT, Pei L, Chang DM, Lee CF, Schumacher HR, Liang MH. Prevalence of rheumatic diseases in Taiwan: a population study of urban, suburban, rural differences. J Rheumatol. 1994;21(2):302-306.
A breakthrough research article was just published in Gastroenterology Research and Practice linking a four fold increased Mercury level in patients with Celiac Disease following a Gluten-Free Diet. Mercury is ubiquitous in our environment and we actually breathe it in whether we are aware or not. Mercury is increasingly used in industries like pharmaceuticals, medical devices, fire retardants, batteries and switches plus lighting. It is considered extremely neurotoxic at small quantities and our main exposures come from vaccines, fish consumption and dental amalgums.
When it enters the body, Mercury binds onto tissues throughout the body (affinity to neurologic tissue – think brain fog, insomnia, anxiety, depression & memory loss) and does not let go easily. Recent research points to mercury exposure as a very common factor in many cardiovascular, neurodegenerative and autoimmune diseases because of its up-regulation of our inflammatory systems and suppression of the immune system. It has truly become impossible to avoid this exposure as more and more research is indicating an increasing trend of chemical and heavy metal levels in human milk, fetal tissue and other body tissues.
So what is the connection to mercury and celiac disease?
If you are familiar with the pathogenesis of Celiac disease then you understand it requires hyperpermeability of the small intestine, colloquially called “leaky gut”. If you have followed my blog over the years you also know that Celiacs on a gluten free diet still have a high proportion reporting symptoms and their small intestine microvilli rarely fully heals!
So if medical research indicates, “Complete normalization of duodenal lesions is exceptionally rare in adult coeliac patients despite adherence to GFD, symptoms disappearance and negative CD related serology”, could one of the reasons be we are more susceptible to toxic exposures like heavy metals?
I think this new research article clearly indicates that a four-fold increase in mercury, a known neurotoxin is seeping into our bodies because Celiacs and many with gluten sensitivity never heal their gut which is the #2 most important detoxification system in our body. It is the primary interface between the external and internal world and we carry 70-80% of our immune system in it!
So whether you suffer from Celiac, one kind of autoimmune disease or any other it may be appropriate to look at this aspect in your approach towards wellness!
Is this part of why you are not healing?
