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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.

Can You Brush and Floss Your Way to Relieved RA?

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:

  1. 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!
  2. 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.
  3. 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 and rheumatoid 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!

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!

Rheumatoid Arthritis: The Interplay Between Food, the Gut, and the Immune System

Over 1.5 million adults in the US have rheumatoid arthritis (RA), and that number is growing.

RA is an autoimmune condition in which the immune system mistakenly attacks healthy cells. In the case of RA, the immune system targets the joints leading to inflammation and damage. As a result, it is common for people with RA to experience pain, tenderness, and stiffness in their joints. The hand, wrist, and knee joints are especially vulnerable.

While the cause of RA can vary, what we eat plays a critical role in how RA is either allowed to progress or stopped in its tracks.

The Role of the Gut in Immune Response

Our diets impact how our gut functions. In addition, our gut has a unique role in the immune system. Therefore, the interplay between what we eat, our gut function, and our immune system is a key component of RA treatment.

Everyone’s digestive tract contains a variety of bacteria. This is normal, and it’s a good thing when properly balanced.

Some of the bacteria work with the body to promote optimal health, while others do not. For example, healthy gut bacteria are a vital player in the body’s immune response. They act as “gatekeepers” in the intestines and also prevent the growth of less healthy bacterial strains.

One common pathway by which RA is triggered is called dysbiosis. Dysbiosis is a disturbance in the normal balance of beneficial bacteria, predominantly in the gut. This imbalance creates a foothold for unhealthy bacteria to move in.

People with RA often have an overgrowth of bacteria in their digestive tract. Unfortunately, this overgrowth of bacteria crowds out beneficial bacteria that would typically perform protective functions in the intestines. When this protection is lost, the immune system no longer functions optimally.

A poorly functioning immune system can result in an autoimmune reaction, causing the inflammation and pain of RA.

The Diet Connection

The bacterial balance in the digestive tract is highly sensitive to what you eat. A diet high in sugar, processed food, unhealthy fats, and simple carbohydrates contributes to dysbiosis.

The standard American diet is the perfect example of the type of eating pattern likely to disrupt the bacteria in the gut and cause inflammation.

Almost 60% of the standard American diet is made up of ultra-processed food. These kinds of foods contain additives and other components that encourage the overgrowth of bacteria. They are also low in the fiber and nutrients required for a healthy gut.

When your diet negatively affects gut bacteria, this can trigger autoimmune conditions such as RA.

Healthy Food, Healthy Gut, Healthy Joints

Your gut bacteria and, by extension, your immune system depend on a healthy balance of nutrients for optimal health.

This is good news because how you eat can be changed for the better. Diets high in anti-inflammatory foods and low in sugar and ultra-processed foods have been shown to reduce the activity of RA in the body. The right balance of nutrients in the diet will decrease inflammation and allow healthy bacteria to thrive.

The goal of RA treatment is not just to manage pain and stiffness in the joints. Instead, the goal is to return the immune response to normal and halt damage to the joints.

Because of the critical role diet plays in bacterial balance, it is a key area of focus in the holistic treatment of RA.

If you are interested in tackling your RA with proven natural methods, contact us using the form below!

Yours in Health,

Ian Hollaman DC, MSc, IFMCP