There is a phrase in functional medicine by Mehmet Oz: “Your genetics load the gut; your lifestyle pulls the trigger.” Specifically, genetic risk for autoimmunity sets the stage, but our environment (lifestyle, diet, and mindset) can trigger a happy or tragic ending.
There is much we can do to influence our genetics and health through our actions and behaviors. Many individuals not only improve their quality of life but sometimes even reduce their autoimmune lab markers and go into remission! So how does autoimmunity start in the first place? It takes a triad of factors: genetic predisposition, intestinal permeability (leaky gut), and environmental triggers.
Genetic Predisposition
Most people think of their genetics as a life sentence or a predetermined future. However, the emerging field of epigenetics has shown that environmental factors have a huge influence on which genes are actually expressed. In other words, just because you may have genes related to autoimmunity does not automatically mean that those genes will do anything harmful to you (you are NOT chained to your family’s destiny). Genetic predisposition is only one of the factors contributing to disease. Research shows there are common genetic factors that set the stage for autoimmunity, yet findings show that glutathione production and redox capabilities (the body’s ability to get rid of free radicals by reducing oxidative stress) dramatically influence autoimmune gene expression.
Single nucleotide polymorphisms, frequently called SNPs (pronounced “snips”), are the most common type of genetic variation among people. Each SNP represents a difference in a single DNA building block, called a nucleotide. Types of SNPs such as MTHFR, GST, and COMT can affect glutathione production and oxidative stress management systems. Individuals with these types of genetic variations require more support through epigenetics (modifying diet, preterm environment, chemical/drug exposure, stress, long term supplementation, etc.).
An SNP within a gene can lead to further genetic variations because genes are in charge of coding DNA. But some SNPs can occur in non-coding sections of DNA. So, even though genetic variances are correlated with diseases like Celiac, they may not have been the cause of the disease. In fact, the bulk of genetic research shows that DNA methylation (the process of changing the activity of a DNA segment) has been found to contribute most to immune tolerance breakdown and autoreactivity (the loss of self V. non-self and therefore autoimmune disease).
Fortunately, many nutrition and lifestyle strategies can limit the impact of these genetic variations and SNP’s!
Intestinal Permeability AKA “Leaky Gut”
The intestines span a single-cell wall that protects your body from the external world. This wall is protected by a mucous membrane called secretory IgA, which is influenced by the environment of bacteria in the intestinal tract known as the microbiome. The cell wall has many functions, mainly providing a barrier between the intestinal tract and the body cavity. Between each cell in the intestinal wall are tight junctions which are meant to be just that: TIGHT! Research is now finding that tight junction failures are associated with a host of conditions, from chronic inflammation, cancer, and autoimmune diseases to allergies and heart disease.
Tight junctions fail due to:
- Toxins
- Infection
- Free radicals (ROS)
- Inflammation Stress (blood sugar issues)
- Hormone Imbalances (pregnancy, menopause)
- Microbial imbalance (Dysbiosis)
- Diet (food allergies, poor digestion)
- Drugs (NSAID’s etc.)
- Early exposure to gluten and casein
- Chronic cortisol
- Autoimmunity
- Zonulin
- Not breastfed or breastfed from a mother with intestinal permeability
After the tight junctions fail, something called molecular mimicry occurs. This is where food, viruses, and bacteria enter the bloodstream through the intestinal cell wall. Essentially, your gut leaks. Your body then starts making antibodies to these foreign invaders. Antibodies are usually antigen-specific, but they can easily bind to something that they perceive as dangerous even if it isn’t because of similar molecular structures. To put it simply, your antibodies can get confused and start to see your own tissue as foreign bacteria, viruses, or food. Molecular mimicry is found in research between the foods gluten & casein and the thyroid; or also between bacteria, viruses, and self tissue. This is how autoimmunity begins. The self (auto-) is attacked by the immune system (-immunity).
Environment
The most influential environment for autoimmunity is preterm and during pregnancy. However, you can still do a lot to reduce environmental triggers of autoimmune disease for the rest of your life. Many of the triggers for autoimmune diseases have been studied and infections, vaccines, and other toxins are considered important implications in autoimmune disease. For example, the infection Epstein–Barr virus (EBV) is associated with Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis, Graves (hyperthyroid), and Hashimotos (90% of the issue behind hypothyroidism).
Nutrient depletion and dietary environmental triggers also trigger autoimmunity. For example, Vitamin D deficiency affects the genetic production of vitamin B’s and T-regulatory cells, which are both associated with autoimmunity prevention. Zinc deficiency contributes to a leaky gut and alters the microbiome. Research shows taking zinc can tighten the junctions between cells in the gut. In addition to nutritional factors, other environmental triggers of autoimmunity can include sleep disturbances and stress. Melatonin production from adequate sleep can improve inflammatory diseases like Multiple Sclerosis.
Toxin and chemical exposure in our air, clothing, furniture, water, food, and other products contributes to autoimmunity. The verdict is out on many major toxins already in use in our society: such as flame retardants, pesticides/herbicides, air fresheners, hair dyes, cleaning supplies, wood stains and oils, laundry detergents, home insulation, art supplies, carpet, smoking, air pollution, mercury fillings, and most plastics. Thankfully, we can vote with our dollars and choose to change the environment we live in by purchasing EWG.org-approved low-toxin products and reducing our exposure.
Key Learnings
- Autoimmunity starts with the trifecta overlap of leaky gut, genetic predisposition, and environmental triggers.
- Despite the genetic influences in your body, your environment is what contributes most to the expression of autoimmune diseases.
- You can change your diet, improve your sleep, reduce your stress, and toxin load. Each behavior change improves leaky-gut and reduces your environmental triggers.
- Oftentimes making epigenetic changes can influence the genetic expression of the autoimmune disease and can halt or even reverse the autoimmune diagnosis.
Trust us, this is overwhelming at first but when you start to break down your unique contribution towards disease or optimal health it becomes incredibly empowering! Chronic disease is a lifestyle, not destiny. You have the choice in this journey to accept your fate or take charge and find a functional medicine practitioner who can guide you through this individualized process. Trust your gut, find that person who can lead you to a new level of health, and let your health soar!
Yours in Health,
Dr. Ian Hollaman, DC, MSc, IFMCP
