Autoimmune disease is stranger danger that has gotten out of hand. One of my children is at an age where I am thinking he might be old enough to stay home alone. Of course, we are having the conversation of not opening the door for strangers and taking care of himself and the house, and what to do in the event of an emergency. Autoimmune disease I liken to not only him screaming and throwing items out the window indiscriminately at anyone who knocks at the door but also calling 911 and setting the house on fire. With autoimmune diseases, the immune system is over-responsive. Some common autoimmune diseases include rheumatoid arthritis, lupus, type 1 diabetes, psoriasis, and Hashimoto’s Disease. Symptoms of autoimmune diseases include fatigue, joint pain and swelling, skin conditions, abdominal pain, digestive issues, recurring fever, and swollen glands. Why does the immune system become over sensitized and how can we calm it down to respond appropriately? This is my goal as a functional medicine doctor treating autoimmune disease- finding that balance.

How do autoimmune diseases occur?

To understand why or how this happens, we need to think about how the immune system works. Our immune system is a sophisticated system of defense. I think of the immune system in layers. The first “defense” against pathogens is barrier function. Any interface where the outside world meets our inner physiology is a barrier (skin, the lining of the digestive tract). It is here that lies the first line of defense against pathogens or “strangers” to our system. The other layers of the immune system are our heavy artillery at the border- the innate immune system which basically throws out bombs indiscriminately when activated. Think of this is as the redness and swelling after a bug bite- that is your innate immune system- the first responders at work. Behind that we have our slower moving sharp shooters- the adaptive immune system that responds specifically to pathogens. Imagine a highly specialized team that swoops in and takes out specific pathogens. An example of this is the immunity you might appreciate after a vaccine or a previous infection. Your immune system was taught to “attack” when it sees a specific “stranger” to prevent you from getting sick.

Barrier function – where the outside world meets the inside world. I recently attended a biodynamic osteopathic conference where one of the exercises was to feel the patients skin barrier- where the air interacts with the body.  It was extremely interesting to me that if you sit quiet long enough with your patient, you can actually get a sense of this! When the integrity of our “barriers” – most specifically the gastrointestinal lining and our skin become compromised, you can imagine that the first responders (innate immune system) have to work much harder.  You can also imagine that the adaptive immune system (think antibodies here) over time will work harder as well. This creates a situation where oversensitization can occur.  Stranger danger gone wild to the point where damage to surrounding tissue as well as the strangers themselves cause the immune system to be in state of constant vigilance and attack.

How do you treat autoimmune disorders?

It is not unusual for me to see my autoimmune patient’s go into remission by calming down the immune system.  To do this, we work on restoring barrier function.  We sometimes must take additional steps in identifying strangers that triggered the issue in the first place.  We sometimes need to work to calm and support the immune system. Strangers can take the shape of foods, infections, toxins but it can also take the shape of physical, emotional or spiritual trauma.  In functional medicine we explore this in each individual patient because the stranger danger is different for each person.  One of my favorite moments from the recent annual Institute of Functional Medicine conference was at a lecture by Dr Jeff Bland. He said something so profound.  He said “Does your patient feel worthy of health?” If you think about it, our body is attacking “self” in the case of autoimmunity.   I certainly do not think that all autoimmune patients have a spiritual or emotional wound of self-hatred but sometimes our self-talk- “I am so stupid for doing that”, “what is wrong with me”……..seemingly benign does not help in our healing.  Our self-talk matters at the epigenetic (over the genome) level where most predisposition to autoimmunity lies.

If you have the diagnosis of an autoimmune disease consider exploring your stranger danger and barrier function, whether or not you are on biologics or other immune suppressing treatment.  At my functional medicine practice, I bring what my patient needs at that given moment using an eclectic mix of conventional medicine, functional medicine, integrative and osteopathic principles.