Managing Autoimmune Disease
Feb 6, 2022
Managing Autoimmune Disease
Our immune system is designed to protect us against foreign entities like bacteria and viruses that could have the potential to make us sick. When our body detects a potential invader entering our body, it will prompt our white blood cells and immune system to go fight it off! This is an incredibly important and intricate system for the benefit of our overall health and ability to survive in the outside world.
Unfortunately, for those with an autoimmune disease, the body struggles to decipher what is supposed to be there (because it’s a part of our body) and what isn’t. As a result, our immune system’s antibodies will attack our own body’s healthy cells by mistake. The incidence of autoimmune disease has increased dramatically over the past couple decades with nearly 24 million Americans affected (as of 2017). The rise could be due to a number of factors including lack of quality nutrients in the diet, increased internal and external stress, poor sleep, and/or exposure to environmental toxins or other chemicals in our everyday life.
There are over 80 (inching closer to 100 in recent years) known autoimmune diseases that we are currently aware of. Some autoimmune diseases affect only one part of the body (organ, tissue or gland); others attack several parts of the body. Genetics sometimes play a role in a person’s chances of contracting an autoimmune disease (as we sometimes see with multiple sclerosis and lupus, for instance); but many times, genetics or familial history actually have nothing to do with it.
Gender plays a role. Women are three-quarters more susceptible than men to autoimmune conditions. Rheumatoid Arthritis, Multiple Sclerosis and Systemic Lupus Erythematosus disproportionately affect women. Age is a factor too. Autoimmunity most commonly affects people between the ages 15 to 44 (although it’s not limited to this age range either). Race may be a predeterminate as well. For instance, Lupus is nearly three times more likely to occur in African Americans and Hispanics than in whites.
The symptoms and expression of autoimmunity can vary depending on the exact type. One of the challenges of diagnosing autoimmunity is that the early symptoms tend to be very generic such as fatigue, joint or muscle pain, digestive issues, or even weight changes. It’s common that specific, decipherable symptomology won’t occur until the disease has advanced, which makes an actual diagnosis potentially difficult to determine. In fact, many people do go misdiagnosed as a result. Oftentimes a blood test for specific antibodies is required for an official diagnosis, as well as collaboration with a specialist, depending on the type.
Since beginning my Master’s Program in Nutrition, Healthspan and Longevity, I have been drawn to the study of autoimmune diseases most especially because they seem to be accelerating at an unprecedented rate. My interest further accelerated when my sister was diagnosed with Eosinophil Esophagitis, an autoimmune condition that attacks the esophagus. We overhauled her diet and lifestyle, and while there have been a few slips in the road, her condition is being very well managed primarily through controlling toxic inflammation through diet and other lifestyle modifications.
Autoimmune diseases are considered a chronic health condition, and they cannot be cured. But trust me when I say that it doesn’t mean that you have succumb to just dealing with it day in and day out in misery. If controlled methodically and carefully, many people enjoy normal, active and fun lives without too much struggle. But the key to managing autoimmune conditions begins by controlling inflammation and healing the gut. And (no surprise) the major key players in achieving both of those are diet and lifestyle.
Nearly half of the patients I treat have an autoimmune condition. Alongside a variety of other wholistic remedies and specific laboratory testing (which I highly recommend for all patients), I often use the Autoimmune Protocol (AIP) Diet as an initial dietary springboard to get us on the right track. The purpose of the AIP diet is to reduce inflammation immediately by eliminating inflammation-inducing foods, with the intention of then reintroducing foods incrementally in order to uncover any potential dietary triggers adding to that specific patient’s toxic load. It will be imperative that the patient avoid any known triggers moving forward. Personalized nutrition is one of the most powerful tools in managing autoimmune symptoms, which is why this particular elimination diet is a great place to start.
So let’s take a moment and discuss what the AIP diet is. The AIP diet was developed by Dr. Loren Cordain who discovered that certain foods actually trigger people with autoimmune disease. The AIP was developed as a form of elimination diet specifically aimed at reducing inflammation and healing leaky gut, which has been thought to contribute to the development of - or further escalation of - autoimmune diseases. It lays its foundations in the Paleo Diet (see my blog post on Keto vs Paleo for more information), and focuses on highly nutrient dense foods as well as high levels of omega-3 fatty acids.
Under RD supervision, a patient will follow a strict AIP diet for several weeks to eliminate as much inflammatory load as possible. Among the foods restricted during this time include:
· Grains
· Legumes (beans, soy, peanuts, hummus)
· Dairy and all dairy derivatives (including ghee)
· Refined sugars including alternative sweeteners (ex. Stevia, xylitol)
· Industrial seed oils (vegetable and canola are the more popular)
· Nightshade vegetables (tomatoes, potatoes, eggplant, peppers, among others)
· Eggs
· Nuts and seeds
· Coffee
· Chocolate
· Alcohol
· Some spices including coriander and cumin
· Gum
· Emulsifiers and food thickeners
· NSAID pain killers including ibuprofen, aspirin, and naproxen sodium (Aleve)
· Blue-green algae
This might seem like a lot. And it is. You might be asking yourself why so many foods and food categories. Some of these foods are known to cause inflammation such as lectins, saponin and capsaicin in nightshade vegetables; and others like blue-green algae, stimulate the immune system, which we want to avoid since autoimmune patients already have an overactive immune response. For people with an autoimmune condition, their immune system is already fired up, so we need to avoid any foods that could stimulate it even more.
While a patient is following the AIP elimination portion of the diet, their diet will consist of the following foods:
· Organic, grass fed, lean meats
· Sustainably grown fish (low in heavy metals)
· Most vegetables (outside of the nightshade category)
· Some fruits (within moderation, although *some patients may need to eliminate fruit entirely*)
· Coconut products and coconut oil
· Olive oil
· Sweet potatoes only (NOT yellow or russet potatoes)
· Avocado
· Fermented foods (excluding any with dairy)
· Vinegars (balsamic, red wine, apple cider)
· Gelatin from grass-fed beef
· Small amounts of honey and maple syrup
· Most non-seed herbs (ex. Basil, mint, oregano)
· Green tea and non-seed herbal teas
· Arrowroot starch
· Bone broth
After strict 4-6 week elimination of all of the AIP “trigger” foods which will be at least 4-6 weeks, the reintroduction phase will begin. Under RD guidance, you will then systematically and strategically reintroduce these foods back in, ensuring that you’ve built in a few days of buffer in between each introduction to measure any negative symptoms you might have. This time is critical in evaluating your body’s feedback to these foods. If you react negatively to a food (each person’s symptoms will vary and should be carefully monitored), you may have to indefinitely remove that food from your diet. This could be a sign of excessive toxic burden to your body which could contribute to your overall inflammatory load.
As mentioned before, it’s important to pursue this diet under medical supervision either with your RD or another qualified healthcare practitioner. The elimination portion of the diet will require careful planning to make sure that you are receiving adequate calories and nutrients since this portion is fairly limited and strict in available foods. And during the reintroduction phase, it’s imperative to monitor symptomology carefully to manage inflammatory response and to strategically plan which foods come when during this phase.
It’s important to remember that while diet is a huge component to our overall inflammatory load, incorporating a stress management routine to reduce stress will be an integral part of the regulation of autoimmune symptoms also. I often work with my patients on identifying unnecessary externals stress either in their environment, in their relationships, or in their everyday life. We not only practice stress reduction techniques like meditation, exercise, dance or incorporating herbal teas, for example, but we also strategize ways to cope with stress as it arises. Autoimmune patients have a much lower tolerance for stress, so this is an important part of the practice.
Incorporating a gut protocol is a very likely requirement for autoimmune patients; however, this component will likely come later down the line, and will look different for each patient. I never recommend jumping immediately into a gut protocol, and there is no one-size fits all plan that works for everyone. As mentioned above (and in several other articles, too), the gut is a big player in the overall functioning and efficiency of our immune system. The health of our gut could be a determining factor for the potential development of autoimmune disease, and it can also play an important role in managing the symptoms associated with it too. The gut cannot be overlooked when dealing with autoimmunity, and the AIP diet is a great starting point during which the gut will begin to heal.
If you, or anyone you know, has an autoimmune disease and you’re interested in working with me, please reach out! Having an autoimmunity does not need to define the rest of your life, and I can help you find your balance to live a long, happy, healthy and vibrant life.
REFERENCES:
https://www.gene.com/stories/autoimmune-disease-101
https://www.aarda.org/a-different-autoimmune-diet-food-therapy-for-optimal-health/