Autoimmunity: It's All ONE Disease...
[This post was originally published on Feb 25, 2016, then received some minor updates on October 2, 2017 and July 12, 2018.]
I was diagnosed with Hashimoto’s thyroiditis (the most common autoimmune condition) in early 2008 and have since built my practice on helping others manage their autoimmune hypothyroidism (and adrenal dysfunction, which I also suffered from). As they say, “We teach what we most need to learn.”
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And something interesting happened along the way. I’ve become just as (if not more) passionate about autoimmunity as I am about hormones. (With most of my clients, we’re addressing both—their dysregulated immune system as well as their hormonal imbalances.)
What also happened is that about three years ago, my alopecia (autoimmune hair loss), worsened, to the point that I ended up becoming 50 percent bald. Prior to this deluge of hair loss (and fear), I’d only had intermittent (and relatively small) bald spots. Thankfully, I was able to turn this bad episode around.
Many people diagnosed with Hashimoto’s (or any other form of autoimmunity) have more than one autoimmune condition, whether they know it or not.
There can be a co-occurrence or “kaleidoscope of autoimmunity,” which was certainly my situation, including some female members of my family (Hashimoto’s, alopecia (two types: universalis and areata), and Celiac—and these are just the ones we know of).
Multiple Autoimmune Syndrome (MAS) is “the combination of at least three autoimmune diseases in the same patient.”
In fact, some people can have Graves’ disease (autoimmune hyperthyroidism) and Hashimoto’s (autoimmune hypothyroidism) at the same time. Weird, right? Another common scenario is Graves’ that morphs into Hashimoto’s.
(We’ve received a great deal of inquiries about whether our #1 best selling Essential Thyroid Cookbook will be helpful for people with Graves’ disease. Given that, at its core, it’s a whole foods cookbook, yes, it can be helpful, but more importantly, we sleuthed out the most immune-supportive nutrition to highlight in our recipes, so from that standpoint, yes, it can be helpful. Our recipes certainly wouldn’t cause a hyper flare!)
Once the immune system has gone rogue and crossed the line from focusing its attention on non-self (pathogens, viruses, bacteria) to self (normal tissue), all tissues are up for grabs. And once you develop one manifestation of autoimmunity, if it goes unaddressed, the chances of developing another autoimmune condition are greater than 50 percent. (Yes, I know that some say that autoimmunity is simply viral and there is no “tissue attack,” but I feel this is short-sighted and only tells part of the story, at least for most of us.)
According to Dr. Datis Kharrazian, “Eighty percent of those with a diagnosed autoimmune condition have antibodies to other tissues.”
As of this July 11, 2018 update, I’m in the midst of running an online masterclass series for those with alopecia called Reversing Alopecia. In doing additional research for the course, I found that:
- Dr. Gerald Mullin from Johns Hopkins says that statistically, someone with an autoimmune disease is at risk of a total of seven autoimmune diseases in his or her lifetime. (The critical point I would add is…IF the known or existing autoimmunity goes unmanaged.)
- “In addition to autoimmune thyroid disease, it has been long suspected that there is an association between [alopecia areata] and other autoimmune disorders such as vitiligo, systemic lupus erythematosus, psoriasis, inflammatory bowel disease, and rheumatoid arthritis.” [Source]
It doesn’t mean that everyone with alopecia will acquire these diseases, certainly. There’s an association with these other conditions.
This post isn’t meant to be alarmist or to use scare tactics. In fact, it’s meant to provide comfort and assurance.
This isn’t about fear mongering, it’s about making value judgments, defined as “… a judgment… of the usefulness of something or someone, based on a comparison or other relativity.” [Wiki]
Autoimmunity is one disease, not 90-some separate diseases treatable with symptom management alone. (The functional medicine community is now saying it’s more like 100+ diseases.)
I need to repeat this—autoimmunity is one disease.
When you turn your attention to the root of the imbalance—a hypervigilant, confused immune system—any and all manifestations of autoimmunity can be addressed.
Notice that I don’t say “cure” or “treat” or “heal.” I’m not a doctor, so I don’t claim to cure, treat, or heal anyone, but I’m confident saying that autoimmunity can be “managed” and “addressed.” You can live symptom-free.
(To be clear, with Type 1 diabetes, it’s understood that people with this condition need to be insulin-dependent for life.)
Even though most of my autoimmunity clients come to me with Hashimoto’s (I recently discovered that I’m referred to as “The Hashimoto’s Lady” by a local holistic nutrition study group), many of my clients have another known autoimmune condition, such as alopecia, psoriasis, scleroderma, Sjogren’s syndrome, rosacea, or Raynaud’s and are thrilled to hear that what we do to simply focus on the Hashimoto’s can largely, if not completely, address their other autoimmune condition(s).
While autoimmunity is one disease (there, I said it again), I don’t claim to be an expert in each and every type of autoimmune condition, given that there’s a spectrum of autoimmunity—a more advanced type is multiple sclerosis (MS), for instance. Each type needs immune modulation, most importantly, but also symptom management, depending on how the autoimmunity is expressed.
In addition to their Hashimoto’s, nearly half of my clients also have an autoimmune skin condition such as psoriasis, rosacea, or eczema (eczema is now thought to be autoimmune in nature). Like alopecia, these are all visible expressions of autoimmunity, so any improvement in immune function (or lack thereof) is easily seen.
I’m not a dermatological expert, but the majority of the time, these skin conditions are gone by the time our work together is done. Gone, as in…completely cleared. And if they’re not cleared, they’re greatly reduced in appearance.
I’ve had clients get very emotional and say things like, “I’ve had psoriasis for years—I never thought it would go away. I’ve tried everything and nothing has worked. Now, you can’t even see where it was—I don’t even have any scarring.” (Note: These results may not be typical. Psoriasis can be one of the more challenging types of autoimmunity to address.)
Given that autoimmunity is skyrocketing and it’s not uncommon to have more than one autoimmune condition, it’s easy to get overwhelmed with it all and think of these different manifestations of autoimmunity as silos, as in, “I have multiple illnesses that I need to manage.”
Again, there are always considerations for how different types of autoimmunity present themselves, but underneath it all, it’s one disease. And one that can be managed.
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Unfortunately, conventional medicine isn’t adept at helping people with autoimmunity of which the measures can also be considered preventative if you happen to have autoimmunity in your family and haven’t yet been diagnosed with an autoimmune condition.
With Hashimoto’s, for instance, the go-to “treatment” is thyroid hormone replacement. I’m not completely against thyroid drugs, especially when symptoms are so unmanageable that they’re greatly affecting someone’s quality of life.
But man, this approach is really barking up the wrong tree—it allows the autoimmune antibodies to smolder on, advancing the Hashimoto’s and making people sitting ducks for other tissue attacks.
With alopecia, the approach often involves corticosteroid shots, Minoxidil (Rogaine), or immunosuppressants. Don’t get me started on any of these. (If you want to know more about what I think about them (along with other helpful information), you can download my free ebook, Hair Loss: It’s Reversible without Drugs, Creams, Injections, and Steroids.)
I recently returned from vacation and on my way home, sat next to a lovely woman on the plane who struck up a conversation. She asked what I did for a living and when I told her, she said, “Yeah, I’m just waiting for the hammer to fall. Autoimmunity is rampant in my family—I guess I’ll just wait and see how it shows up for me.”
Meanwhile, she drank three Diet Cokes, ate a bunch of gluten-filled pretzels, ate a small Snickers bar, and slathered her hands not only antibacterial gel, but also toxin-filled lotion.
No judgment here—she’s likely ignorant of how these things are affecting her immune system and drawing that hammer closer and closer to her.
She was largely the inspiration for this post.