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Lupus and DHEA: A New Approach

Lupus is an autoimmune condition that can cause inflammation and pain in any part of the body. As with all autoimmune conditions, there is no “cure” necessarily, but it stems from imbalances in the body that can be adjusted, so remission from this condition is possible.

Autoimmunity is when the body attacks its own tissue and organs. In lupus, any bodily system can be attacked, so there are a wide range of possible symptoms. Some of the most common symptoms include:

  • Muscle and joint pain
  • Fever
  • Rashes (malar “butterfly” type)
  • Chest pain  
  • Hair loss (alopecia)
  • Sun or light sensitivity
  • Kidney problems
  • Mouth sores 
  • Prolonged or extreme fatigue
  • Anemia
  • Brain fog
  • Memory problems
  • Blood clotting
  • Eye disease
  • Anxiety

One natural method for relieving lupus symptoms that has been showing a lot of positive results is DHEA. DHEA (dehydroepiandrosterone) is a mild male hormone. It can be helpful for reducing lupus symptoms such as hair loss, joint pain, fatigue, and brain fog.

In blood tests, DHEA levels tend to be lower in people who have inflammatory diseases such as lupus, rheumatoid arthritis (RA), and inflammatory bowel disease. The more severe a person’s symptoms are, the lower their DHEA levels are. So, the hypothesis is that the higher we can get the DHEA levels, the less symptoms that person will experience! Experiments with mice and clinical trials with humans have both shown that DHEA supplementation can, in fact, reduce symptoms of lupus.

How Does it Work?

While it theoretically makes sense that if low DHEA = more symptoms, then high DHEA = less symptoms, we need to know how this works in order to be sure that it isn’t just a random connection. 

You may have heard of a “cytokine storm” in relation to the recent pandemic. It is basically a state of systemic inflammation. Cytokines are proteins that are important for communication between cells. Some cytokines are actually anti-inflammatory, but many are pro-inflammatory, meaning that they cause inflammation, as they do in a cytokine storm.

Studies have shown that DHEA may help regulate cytokine production and reduce the amount of pro-inflammatory cytokines that are created, therefore reducing overall inflammation. The relationship between cytokines and DHEA may also explain why DHEA levels are lower in people that have chronic inflammatory conditions, such as lupus and RA. Pro-inflammatory cytokines actually suppress the enzymes that are needed to make DHEA. So there is a bit of a “chicken and the egg” situation here, since it is not exactly clear which comes first. But we know that there is a vicious cycle:

DHEA can reduce autoimmunity, but it also increases resistance to infection. How can it both amp up and calm down your immune system? The answer is in its ability to regulate. The key to resolving autoimmunity is not to suppress the entire immune system, which leaves your body vulnerable to infection, but to regulate the immune system so that it works properly. DHEA seems to be an important factor for immune system regulation. The biggest factor though, of course, is T-regulatory cell function- literally named for their job of ‘policing’ the immune system.

Side effects of DHEA can include acne, facial hair growth, oily skin, and excessive sweating. In one study, even though every patient who continued to take the DHEA for 12 months showed significant improvement, 16% of the participants dropped out of the study early due to side effects. This goes to show that this medication may not be the best option for everyone (doses tended to be high so this may have led to side effects).

DHEA can also lower good cholesterol (HDL cholesterol) in women and raise estrogen levels in postmenopausal women. (Learn more about the importance of healthy cholesterol levels here and the issues with estrogen dominance here.) There have been concerns raised about the long-term effects due to lowered HDL cholesterol, so it is important to talk with a doctor about DHEA rather than attempting to use it by yourself.

At Dr. Autoimmune, we use a functional medicine approach to identify the root cause of your condition and develop a custom plan using diet, supplementation, and lifestyle change to help you reach your health goals. We are unique because we also address the brain through functional neurology, which is especially helpful for lupus patients struggling with brain fog and memory loss. With an 85% success rate, we are confident that we can get you the results you are looking for. If you’re ready to be brave to change, click the “Start Your Journey” button at the bottom of this page.

What is Sjögren’s Syndrome?

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)
  • Mouth sores and dental problems
  • Swollen or painful salivary glands
  • Difficulty swallowing
  • Acid reflux
  • Raynaud’s phenomenon
  • IBS

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.

Sjögren’s can occur on its own, but it often shows up alongside other autoimmune conditions like lupus, rheumatoid arthritis, inflammatory bowel disease, Raynaud’s phenomenon, fibromyalgia, pernicious anemia, and thyroid conditions such as Hashimoto’s and Graves’. This useful graphic below (by the Sjögren’s Foundation) uses percentages to show the overlap of each of these conditions with Sjögren’s.

How Does Sjögren’s Start?

Like all autoimmune conditions, Sjögren’s requires 3 things to develop:

  1. A genetic predisposition
  2. Leaky gut (intestinal permeability)
  3. Environmental trigger

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!

Irritable Bowel Syndrome vs. Irritable Bowel Disease

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.

IBSIBD
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!)

  1. 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.

  1. 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. 

  1. 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.

  1. 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.

Sources:

ccfa.org/resources/diagnosing-and-managing-ibd.html

cedars-sinai.edu/Patients/Programs-and-Services/Inflammatory-Bowel-Disease-Center/Inflammatory-Bowel-Disease-FAQ.aspx

https://aboutibs.org/facts-about-ibs.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996528/

https://www.biorxiv.org/content/10.1101/2020.09.30.321448v1

The Functional Medicine solution to a Pain in the Gut


If you’re interested in learning more about how our Functional Medicine approach can help ease Digestive System conditions:
Join us on August 24, 2017, at 600pm for a FREE lecture, hosted by Dr. Ian Hollaman.

Attendees will be invited to enjoy exclusive, new patient pricing.

Call us, OR register with the form at the bottom of this article today. Space is limited! (p) 303.882.8447


Your gut is struggling when you have IBS/IBD. Did you know that the number of bacteria that live in the gastrointestinal tract outnumber your body’s cells by a factor of 10! These microbes make up the gut microbiome and are incredibly important to your health and wellness. They are involved in your metabolism, weight, nutrition and absorption, physiology, and immune function. Without these bacteria, you cannot digest properly, keep invasive bacteria at bay, lose weight, balance blood sugar, or live! In utero, your microbiome is nonexistent. It begins as you pass through the birth canal and the vaginal mucosa microbiome is exposed to your body. It is further developed through nursing, formula, and food. Perhaps not surprisingly, a child’s microbiome is very much like the mother’s microbiome. As a result, children can face similar health problems as their mother. For example, if your mother had IBS, it is probable that you will also because your immune systems are similar due to similar microbiomes. Very commonly, patient report that they were not breast fed, had a short duration of breast feeding or were not exposed to the outdoor environment heavily in early years.

I love dirt! My kids love dirt! In fact, they play in it nearly every day. It is their happy place. One of the many great benefits of playing in the dirt is that it supports your microbiome. There are so many beneficial bacteria in the dirt that when they get in and on your body, your body actually becomes healthier! The more nutrient rich the soil is, the more nutrients your body is exposed to. But also, the more nutrient dense the soil when growing plants, the stronger and healthier the plants grow. If these are plants that you eat, there are more nutrients available to you for your body to grow from. Symbolically, if you think of your gut microbiome like the dirt, the more complex the gut microbiome the better your GI tract can work and process food, metabolize, digest, excrete properly, and fight off invaders.

Recent research backs this theory up and a study published in 2010 by Thom Mcdade (http://snip.ly/8vn8s#https://news.northwestern.edu/stories/2017/july/germs-at-four-less-inflammation-at-forty/) enhanced the theory that early and continuous exposure to bacteria regulates our immune system later in life. “The developing immune system is similar to the brain,” McDade says. “No one questions that a baby needs exposure to language to drive the neurological processes that underlie the development of speech. The immune system is similar; its development is driven by exposures from the environment. In this case, the key exposures are microbial. Without those exposures, it doesn’t work quite right.”


Your GI tract is home to between 70-90% of your immune system and the microbiome is what develops and maintains your immune system. The tiny bacteria adhere to the mucosal lining of your digestive tract, eating nutrients around them. They eat the same nutrients as some “invaders” and keep them in check by eating their food source. Without the microbiome, “invaders” would be able to take over and your health would fail. In fact, this is how some illnesses develop.

Since there is not a single cause for IBS or IBD, and western medicine goes so far as to say there is no known cause for IBS or IBD. As a result, traditional treatment revolves around the symptoms. Western doctors typically recommend removing the foods that seem to trigger your symptoms; increase fiber and water, and limit FODMAPs food which are specific sugars found in some fruit, vegetables, grains, and dairy products. And when these changes don’t solve the problem, medications are recommended to suppress symptoms as they occur.   Antidiarrheals such as Imodium, Laxatives for constipation; Anticholinergics and antidepressants are used for the pain (and now anticholine drugs like allergy medications are strongly correlated to dementia). Since it is emotionally taxing and anxiety ridden to have these conditions, anti depressants and anti anxiety medications are recommended to help the emotional swings.   Standard treatment for IBS and IBD generally do not support your microbiome. In fact, one of the most common therapies for IBD, corticosteroids, destroys the diversity of the microbiome and leaves people more susceptible to pathologic infections and small intestinal bacterial overgrowth! Corticosteroids are also known to decrease bone density, making bones weaker. Without any other options, patients are told to take these medications without fully understanding that later in life your immune system may become significantly weaker and trivial falls could create fractures to your bones!

We work with clients every day who desire a better life and are willing to make the appropriate health modifications to regain their health and leave IBS/IBD in the past. I have dedicated my practice to working with patients who truly want to create change in their life and be healthy. For nearly a decade, functional medicine has been the corner stone of our care; every day with every client, to help them reach their goals and let their health soar. And the results are incredible!

Functional medicine is key for me being able to offer insights into your health. I can’t say that IBS and IBD are caused by any one thing. But I can say that I can help you address the weaker links that lead to IBS and IBD. Through functional medicine, I am able to look beyond your individual symptoms to the web that they create and the underlying causes for them. Your body is communicating what it needs through its symptoms, from pain and uncomfortable bowel movements to depression and bloating. Stool, saliva, and blood testing give further insight into where your body needs support. Understanding how to interpret the messages from symptoms and testing allows me to guide you back to health. I work extensively with you to develop a diverse, complex microbiome as well.

Creating a diet that is specific to your body’s needs and supplements that target your needs accomplishes this. Specific therapies like Chiropractic, visceral manipulation and Pulsed Electromagnetic therapy can also change how the immune system signals. Since you are a dynamic person, your needs are unique to you. We create individualized care plans to get you the results you want quickly and comfortably.

We work with clients every day who desire a better life and are willing to make the appropriate health modifications to regain their health and leave IBS/IBD in the past. I have dedicated my practice to working with patients who truly want to create change in their life and be healthy. For nearly a decade, functional medicine has been the corner stone of our care; every day with every client, to help them reach their goals and let their health soar. And the results are incredible!

If you are sick and tired of being sick and tired look to the bugs as the source of true health! Contact us and we will determine if we can help you at a deeper level and give you back the life you deserve!


If you’re interested in learning more about how our Functional Medicine approach can help ease your Thyroid condition symptoms:

Join us on August 24, 2017 at 600pm for a FREE lecture, hosted by Dr. Ian Hollaman.

Attendees will be invited to enjoy exclusive, new patient pricing.

Call us, OR register with the form below. Space is limited! (p) 303.882.8447