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5 Minute Primer on the 5 As

5 Minute Primer on the 5 As: Autoimmunity, Autoimmune Disease, our Approach, Allopathic Medicine, and the AIP

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Autoimmunity and autoimmune disease are two different states

We use “autoimmunity” and “autoimmune disease” interchangeably for the sake of discussion and because the acronym “AI” is marginally better than “AD” or “AID” relative to other uses of those terms. In reality, however, autoimmunity and autoimmune disease are two different states.

First, let’s remember that our immune system is a good thing. It’s vital to health. A normal immune response means that, when a foreign invader enters your system, your immune system perceives the threat, kicks on, and uses antibodies to attack that invader. Inflammation means this attack is in progress. Then immune regulatory cells come in and tell the immune system when the point of interest is resolved and to stop the attack. The corresponding inflammation recedes. The immune system stores the identifying information to be ready for any future attack by the same invader. This is how we stave off infection and disease. So far so good.

1.  Autoimmunity

Autoimmunity occurs when antibodies misdirect that attack not on a foreign invader, but on the body’s own tissue, just as if it were a foreign invader. These cells are called “autoantibodies,” meaning they attack back onto the self. The presence of these autoantibodies is, in effect, an early warning sign that things have gone awry. Yet their presence is not the only factor in autoimmune disease.

2.  Autoimmune disease

In autoimmune disease, some point of interest triggers autoantibodies to attack; the autoantibodies’ pre-program then directs them to attack the body’s own tissue where that point of interest presents; and the immune regulatory cells don’t tell them to stop. Inflammation now presents significant symptoms in whatever organ is affected, which is typically indicated by your genetic predisposition. It’s this level of drama that often enables a diagnosis in the conventional medical system.

Another factor of autoimmune disease is the presence of gut permeability or “leaky gut.” When you think about it, the digestive system is not actually internal to your body – it’s an open tract from your mouth to your anus through which foods travel, nutrients are absorbed into your system, and waste is expelled. When your gut has been permeated by antagonists such as foods, toxins, or other points of interest that that the immune system’s autoantibodies attack, junctions in the gut are opened through which things get into the body that aren’t meant to be there. More inflammation.

3.  Our Approach

While it’s true that it’s not entirely clear why autoantibodies form and immune regulatory cells fail in autoimmune disease, it has been found that removing the points of interest – the triggers – can go a long way toward calming the immune system’s attack. It can be, in fact, more effective than leaving the triggers in place, and trying to block or suppress the immune system’s response to them.

For example, a functional medicine approach to autoimmune disease seeks to identify and treat the triggers. These can be any of a variety of antagonists, such as a reactive food (gluten), a cross-reactive food (corn), a stealth infection (bacterial, parasitic, virul, or fungal), a hormone imbalance (i.e. thyroid or adrenal), an extreme stressor (physical or emotional), or an environmental toxin (pesticide, herbicide, mercury, or any number of chemicals or heavy metals in air, water, soil, or food).

Because the human immune system is complex and autoimmune disease is multi-factorial, we typically try to identify any and all potential antagonists in an effort to gain a greater impact on the whole. If you’re eating gluten, for example, and are not getting enough sleep, and you have a stealth infection on board, the goal would be to remove all three of these antagonists and see how much reduction in inflammation you can achieve. When your symptoms resolve and your inflammatory markers decrease, you and your doctor may be in a position to discuss a reduction in pharmaceutical interventions, if any have been brought into your treatment protocol.

4.  Allopathic medicine

Note that, in the discussion of our approach, we say “you and your doctor may be in a position to discuss” options about the need for any other interventions. Our approach includes a collaborative relationship with other practitioners in your team. Autoimmune disease, once activated, is for life (remember how those immune cells store information?).

Specifically, we recognize that there is a role for allopathic (pharmaceutical or surgical) intervention in a person’s journey with autoimmune disease, whether that may be before or during your time of pursuing a healing-based approach. This is because:

  • Functional medicine is not an entirely “nature-based” approach itself, in that medications are deployed when, and if, necessary. For example, if an infection is found, a pharmaceutical drug may be needed to resolve it. Certainly, herbal, supplemental, and nutritive interventions are considered, but functional medicine seeks to combine the best of all available medicines for each individual situation.
  • It’s important to work collaboratively with your specialist. While a conventional physician may focus on a particular system of the body – say, the GI tract, as a gastroenterologist, while a functional medicine practitioner seeks to focus on the interconnected whole of the system – your specialist has a deep knowledge of the affected system, as well as an array of pharmaceutical interventions that may still be necessary to manage your condition, or to manage an acute flare, or to manage the systematic reduction of what pharmaceutical interventions you’ve already got in use. You’ll want your specialist as a partner in your healing-based approach: hopefully you’ve got, or soon will find, one who’s supportive of your taking additional steps to help heal your condition using a functional medicine approach. It’s important that they support your goals even if they themselves don’t have the time to learn the specifics that your other team members specialize in.

5.  The Autoimmune Protocol (AIP)

And then there’s the Autoimmune Protocol (AIP). The AIP is a diet-based protocol rooted in the Paleo diet that takes additional, specific steps toward healing autoimmune disorder through:

  1. A short-term elimination diet that excludes foods known to be inflammatory and includes foods known to be highly nutritive and healing;
  2. A reintroduction protocol that enables individuals to achieve the widest diversity of safe foods without reigniting symptoms;
  3. An increasing focus on lifestyle factors that can also upset the immune system and cause the misdirection and overreaction that we’re trying to avoid.

Why all the focus on diet? Because so much of what triggers our immune system gets into our bodies through our gut. Remember the leaky gut discussion? Heard of the microbiome? Does the gut-brain connection sound familiar? All of these and more are discussed in depth in our member content.

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