Autoimmune disorders make up a very large disease category in which many common conditions fall, such as rheumatoid arthritis, lupus, Crohn’s disease, ulcerative colitis, multiple sclerosis, type 1 diabetes, psoriasis, autoimmune thyroid disease and many more. In autoimmune disease, the immune cells synthesise so-called autoantibodies against the body’s own tissue. The antibodies signal to other immune cells to destroy proteins or lipids in the tissue, as the body mistakenly sees these as invaders. Which tissue is affected determines which disease you are diagnosed with.
Many factors have been shown to cause or increase the risk of autoimmune diseases. The risk of developing autoimmunity is particularly high when you have the following three risk factors: 1) genetic sensitivity 2) elevated intestinal permeability (also called “leaky gut”) and 3) an external trigger; i.e. an environmental factor. This triad of factors ‒ or one of them in isolation ‒ causes most autoimmune diseases. Consequently, co-morbidity is also high; if you suffer from one autoimmune disease, you’re at major risk of developing a second, a third, etc. However, research has shown that the importance of your genetic makeup is very limited. Individual genetic variations can increase vulnerability to certain diseases. However, diet, lifestyle and other environmental factors determine how genes are expressed, i.e. whether they are turned on or off. Sometimes, a genetic variant causing an impairment of some biological function is only an issue in the presence of a specific kind of burden. The importance of genes has been downplayed in favour of intestinal health and trigger factors when it comes to the development of autoimmune disease.
Intestinal permeability or leaky gut is a phenomenon that has been found to be present in all autoimmune conditions where it has been scientifically investigated. Leaky gut means that the intestinal mucosa becomes fragile and permeable. Consequences are numerous. Toxins from intestinal bacteria (“endotoxemia”) and larger particles from the diet are allowed to pass through the barrier, a barrier that normally should only let fully digested nutrients through. This leads to activation of the immune system located just inside the intestinal wall. Immune cells start to communicate to activate each other and begin releasing large amounts of proinflammatory molecules. Entire microorganisms can also pass the barrier, which has been observed in conditions such as lupus, type 1 diabetes and myalgic encephalomyelitis (sometimes called chronic fatigue syndrome, or ME/CFS for short). The phenomenon is called microbial translocation and can cause inflammation and autoimmunity in tissues located far from the gut. In microbial translocation, the body’s immune system reacts similarly to an infection. Damaged intestinal mucosa is also less able to absorb nutrients, which in itself can reduce the body’s ability to heal as well as impair the ability of the immune system to function optimally.
There are many potential causes of leaky gut, such as gut flora composition, presence of SIBO, nutritional deficiencies, and dietary components such as gluten, casein (milk protein) and other peptides (small proteins) that may be difficult to break down. Lifestyle factors such as stress, lack of sleep, certain pharmaceutical drugs and a sedentary lifestyle can also contribute to leaky gut.
Often, there’s an additional trigger that along with leaky gut increases the risk of autoimmunity. One example is infections. Epstein-Barr is a virus that is particularly associated with autoimmunity. However, many other infections – both viral and bacterial – have been shown to cause an autoimmune reaction. In fact, infections might be the most widely known trigger of autoimmune disease across the medical and scientific professions. Toxic metals such as mercury, cadmium and aluminum make up another category that can play some role in autoimmunity, especially when it comes to neurological diseases.
Formation of autoantibodies can sometimes be secondary to a tissue or cell injury caused by surgery for example. Proteins from the internal environment of a tissue or a cell are exposed, whereupon the immune system forms autoantibodies against these proteins that should not normally circulate freely.
Medical research has revealed that vitamin D deficiency is a very important factor in the development of all types of lifestyle diseases, including autoimmune diseases.
Each patient with autoimmune disease has a unique combination of underlying factors that triggered their condition. At Nordic Clinic, we carefully review each patient’s history and recommend tests and interventions based on their unique symptom picture, lifestyle and contributing environmental factors.