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How a confused immune system can do harm.
The immune system is brilliantly designed to protect us from the complications of infection, injury, and disease – but it isn’t perfect. In a condition known as autoimmunity, the immune system can cause harm by attacking the body’s own cells, tissues, and organs.
Let’s take a closer look at how autoimmune diseases work.
“Hello! Are you me? Are you dangerous?”
These words are declared countless times each day by the immune system – T cells and antibodies, in particular. As immune cells float around the body, they encounter all kinds of molecules from outside of the body (antigens), and must quickly determine whether these foreign particles are friend or foe.
Immune cells are somewhat like night guards or bodyguards, walking around and surveying anyone or anything that seems suspicious. The ability of these cells to quickly and properly identify self from non-self and dangerous from safe is the cornerstone of proper immune function.
T-cell: Oh, hello there. I didn’t hear you come in.
T-cell: Say, are you me? Are you of this human body?
Spinach: Uh, nope. I’m a plant. I came from the outside.
T-cell: Oh, okay, so you’re foreign. But are you dangerous?
Spinach: Au contraire! I’m very healthy for you. I contain folate and a number of other nutrients!
T-cell: Let me confirm that for myself… Do you have your passport? Ah, I see, yes, you are safe indeed! Very well, then! Carry on, carry on.
After the above exchange, the immune cell floats on, looking out for other antigens.
In the event of something harmful to the body – say, a virus – the exchange would look more like this:
Antibody: Hey there, are you me?
Antibody: Hang on, I can tell you’re not from around here. Actually, wait a minute, I’ve met you before – you’re dangerous! Prepare to die!
The body’s immune system would then mount a strong response to defend the body and attack the virus. Being able to discern self from non-self and safe from dangerous is a large part of how the immune system keeps us healthy.
Autoimmunity: confusing self with non-self
A host of diseases can ensue when the cells of the immune system lose the ability to differentiate self from non-self and safe from harmful – namely, allergies, autoimmunity, and chronic illness.
In the case of somebody allergic to cat dander, for example, that person’s immune system properly identifies cat dander as foreign, but incorrectly categorizes it as dangerous. A person with this allergy will thus experience the immune activation symptoms of runny nose, itchy eyes, and wheezing that occur as the immune system attacks the cat danger antigen.
When it comes to autoimmunity, the immune system gets confused over the answer to the question, “Are you me?” The immune system starts mistaking some of the body’s own cells as foreigners – dangerous foreigners, at that.
For example, in the case of Hashimoto’s thyroiditis, the conversation between cells might look like this:
Immune cell: Oh, hello. Are you me?
Thyroid cell: Yes, I’m your thyroid!
Immune cell: I don’t know… I think you’re not from around here.
Thyroid cell: No seriously though, I am. I’m part of the same body as you. We belong to the same human.
Immune cell: I don’t think so. And I think you’re dangerous too.
Thyroid cell: Whaaat!!? Are you serious?
Immune cell: Prepare to die!
In the bodies of individuals with Hashimoto’s thyroiditis, the immune system mistakenly produces antibodies against the cells of the thyroid, in turn damaging the thyroid gland and undermining its functioning. This eventually causes the signs and symptoms of hypothyroidism – symptoms like fatigue, hair loss, weight gain, constipation, high cholesterol, menstrual irregularities, carpal tunnel syndrome, and brain fog.
Autoimmune conditions affect roughly 8% of the population, and 78% of those with an autoimmune condition are women.
There are over 80 different kinds of autoimmune diseases. Some common autoimmune conditions include:
- Hashimoto’s thyroiditis – the most common cause of hypothyroidism in the developed world
- Grave’s disease – a type of autoimmune hyperthyroidism
- Rheumatoid arthritis – in which the immune system attacks the joints, causing inflammation, pain, and deformity
- Multiple sclerosis – in which the immune system attacks the myelin sheath surrounding the nerves
- Inflammatory bowel disease (IBD) – which includes the digestive ailments of Crohn’s disease and ulcerative colitis
- Psoriasis – an autoimmune disease that can cause plaques on the skin and arthritis
- Celiac disease – in which the consumption of gluten-containing grains like wheat, rye, barley, and spelt can cause a host of health problems
- Systemic lupus erythematosus – known as “lupus,” for short, a condition that can affect the skin, joints, brain, kidneys, blood cells, heart, and lungs
- Type I diabetes mellitus – a disease in which antibodies harm the cells of the pancreas that make insulin, thus disrupting blood sugar regulation in the body. This condition has been on the rise in younger and younger children in developed countries. (Type I DM is not to be confused with the more common type II DM, which is a subsect of metabolic syndrome.)
- Myasthenia gravis – in which the cells that produce acetylcholine are attacked, thus affecting the muscles’ ability to properly function
- Scleroderma – a disease that results in tightening and hardening of the skin and joints
How common are autoimmune diseases?
Chances are that you know somebody – or several people – with an autoimmune disease: autoimmune conditions affect roughly eight percent of the population. Seventy eight percent (78%) of those with an autoimmune condition are women.
Autoimmune conditions are now the third most common disease category in the USA.
Unfortunately, autoimmune conditions have become more common in recent decades – and no, it isn’t because we’re getting better at diagnosing them. Research has shown that the prevalence of anti-nuclear antibodies (ANA), a blood marker indicative of autoimmunity, has recently increased significantly in the United States. In fact, autoimmune conditions are now the third most common disease category in the USA, right after cancer and cardiovascular disease.
What causes autoimmune diseases?
Research has shown that autoimmune conditions are influenced by genetics, but ultimately triggered by environmental factors like stress, nutrition, heavy metal toxicity, chemicals, hormones, and even infections. (As the old saying goes, “Genetics loads the gun; environment pulls the trigger.”)
“Genetics loads the gun; environment pulls the trigger.”
For example, inflammatory bowel disease, lupus, rheumatoid arthritis, and multiple sclerosis have all been linked to mercury exposure – even at levels of mercury typically considered safe. Living in poverty during childhood is a risk factor for developing rheumatoid arthritis in adulthood. The risk of rheumatoid arthritis is also higher among farm workers exposed to chemicals, as well as those who smoke or are exposed to cigarette smoke.
Gender plays a role in autoimmunity as well. Due to influence of estrogen and other female hormones on the immune system, women are more likely to have increased antibody production not only after infections and vaccinations, but also in response to trauma.,,,,
How are autoimmune diseases treated?
The treatment of autoimmune diseases varies from person to person, and condition to condition. Thankfully, a number of natural remedies, nutritional strategies, and pharmaceutical options exist. Proper nutrition, appropriate exercise, and stress management are all key to managing (and preventing) just about any autoimmune disease, as is avoiding environmental toxins.
In my own practice, I have found that many patients with autoimmune conditions also have intestinal permeability (AKA “leaky gut”). Strategies to heal the gut, restore the proper balance of digestive microbes, and support gentle detoxification are often the cornerstones of healing and preventing autoimmunity.
Working with a naturopathic physician or other functional medicine provider can make all the difference.
ReferencesClick here to see References
 National Institute of Allergic and Infectious Disease. Autoimmune Diseases [Internet]. Accessed May 16, 2022. Available at: https://www.niaid.nih.gov/diseases-conditions/autoimmune-diseases
 Fairweather D, et al. Sex differences in autoimmune disease from a pathological perspective. Am J Pathol. 2008 Sep; 173(3):600-9. doi: 10.2353/ajpath.2008.071008.
 Dinse GE, et al. Increasing prevalence of antinuclear antibodies in the United States. Arthritis Rheumatol. 2020 Jun;72(6):1026-35. doi: 10.1002/art.41214.
 National Institutes of Health, The Autoimmune Diseases Coordinating Committee. Progress in Autoimmune Diseases Research, Report to Congress, March 2005. Accessed May 16, 2022. Available from: https://www.niaid.nih.gov/sites/default/files/adccfinal.pdf
 Dooley MA, Hogan SL. Environmental epidemiology and risk factors for autoimmune disease. Curr Opin Rheumatol. 2003 Mar;15(2):99-103. doi: 10.1097/00002281-200303000-00002.
 National Institute of Environmental Health Sciences. Autoimmune Disease [Internet]. Accessed May 16, 2022. Available at: https://www.niehs.nih.gov/health/topics/conditions/autoimmune/index.cfm
 Walsh SJ, Rau LM. Autoimmune diseases: a leading cause of death among young and middle-aged women in the United States. Am J Pub Health. 2000 September; 90(9):1463–6. doi: 10.2105/ajph.90.9.1463.
 Styrt B, Sugarman B. Estrogens and infection. Rev Infect Dis. Nov-Dec 1991;13(6):1139-50. doi: 10.1093/clinids/13.6.1139.
 Girón-González JA, et al. Consistent production of a higher TH1:TH2 cytokine ratio by stimulated T cells in men compared with women. Eur J Endocrinol. 2000 Jul;143(1):31-6. doi: 10.1530/eje.0.1430031.
 Klein SL. The effects of hormones on sex differences in infection: from genes to behavior. Neurosci Biobehav Rev. 2000 Aug;24(6):627-38. doi: 10.1016/s0149-7634(00)00027-0.
 Lang TJ. Estrogen as an immunomodulator. Clin Immunol. 2004 Dec;113(3):224-30. doi: 10.1016/j.clim.2004.05.011.
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Dr. Erica Zelfand
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