Updated: Apr 6
Treatment Options: Conventional vs Naturopathic Medicine
As discussed in my previous post, autoimmune diseases (AD) arise from a combination of genetic and environmental factors; genetics being the loaded gun or fuel and the environmental factors being the trigger or lighter. Certain genetic variations (“polymorphisms”) alter the regulation of immune cells to set the stage for autoimmunity, and particular environmental factors interact with these genes to activate autoimmunity.
It is important to remember that although having certain genes does increase your risk of autoimmunity, it does not guarantee that autoimmunity will occur as environmental triggers are required to instigate the autoimmune cascade. While it is not possible to change your genetic make-up, it is certainly possible to minimise your exposure to these known environmental factors and therefore reduce your risk of AD development.
However if the development of an AD has been allowed to occur there are still steps you can take to reduce your symptoms and hopefully even reverse the disease processes. Contrary to common belief (and the advice of most conventional doctors), an AD diagnosis does not mean resigning yourself to a lifetime of harmful drugs and increasingly debilitating symptoms. Recent studies on epigenetics have revealed the science behind recovery, demonstrating that it is indeed possible to recover from autoimmunity, and complete recovery has been proven in numerous cases.
Once the underlying causes of autoimmunity have been identified, the offending triggers can be removed and the necessary therapies used to reverse the progression of the disease and hopefully eliminate it altogether. The body is primed for health and with the right support is very capable of healing itself.
Under the Western medical model, an AD diagnosis from your doctor typically takes years as these complex and diverse diseases are difficult to diagnose with standard medical tests and unfortunately conventional medicine does not recognise that autoimmunity (along with most other health conditions) operate on a disease spectrum so they are often not identified until the advanced stages have been reached. The body doesn’t become sick overnight, it is a gradual process that if identified early enough can be halted in its tracks, however when diseases are allowed to progress, it becomes more challenging to identify the triggers that lead to the disease state in the first place.
A further issue is that AD, under the current medical system, are not recognised as diseases of the immune system but instead are treated as diseases of the particular organs being attacked. Firstly, this means that the underlying health issue is ignored and secondly, unlike other chronic diseases such as cancer, there isn’t one unified branch of medicine to treat autoimmunity so instead treatment is segregated and limited to the organs being affected.
Conventional doctors often have a limited understanding of all the different diseases that comprise AD (there are now considered to be over 100) so they often dismiss an individual’s symptoms as psychogenic, choosing instead to refer them to a psychiatrist or, worse still, prescribe them anti-depressants!
Western medicine typically works by addressing the disease rather than the individual. General standards of care are applied to each individual case based on what has been found to work most often in controlled scientific studies regardless of the individual’s unique set of circumstances. Due to the multifaceted nature of autoimmunity, there really is no one-size-fits-all approach and therefore no known “cure” exists, as defined by conventional medical standards, since each case will have a unique combination of triggers, requiring a unique approach to healing.
By also focussing on managing the disease symptoms rather than trying to reverse the autoimmunity, the underlying causes of chronic inflammation are not identified or treated. Instead the inflammation is merely suppressed with anti-inflammatory and potent immuno-suppressive drugs, which cause a host of unwanted side effects including fatigue, weight gain, depression, infections, intestinal bleeding, osteoporosis, kidney failure and even cancer.
Commonly used drugs for AD management include:
- Corticosteroids e.g. prednisone, methylprednisolone and dexamethasone. These reduce inflammation however long-term use comes with several risks such as high blood pressure, type 2 diabetes, weight gain, increased infections and osteoporosis.
- Immunosuppressants e.g. methotrexate and cyclophosphamide. These reduce the body’s immune response and are associated with liver toxicity, kidney disease, increased infections, cardiovascular disease and cancer.
- Biologic response modifiers e.g. etanercept and infliximab. These modify the immune response, however they come with dangerous side effects including lymphoma, leukaemia, skin cancer, other AD, depression, hallucinations, hypotension and lupus-like syndrome.
The Naturopathic view and treatment approach for AD is quite different. Natural medicine views autoimmunity as the body’s response to an imbalance so it focusses on identifying and removing the driver of disease such as a hidden chronic infection rather than simply suppressing the body’s response. By also recognising that AD are diseases of the immune system rather than a particular body part, treatment is centred around supporting and strengthening the immune system so that it can regain proper function.
One of the key principles of naturopathic medicine is viewing the body as a whole rather than as separate and distinct body parts, recognising that the health of individual body systems directly affect the health and functioning of the others. This holistic approach is essential for AD recovery. Natural treatment targets the root cause of disease and restores proper immune system functioning so that AD can hopefully become a distant memory and an important lesson to be learned from.
Increasingly more research is pointing to intestinal permeability (or ‘leaky gut’) as an important prerequisite for the development of AD. An essential aspect of treatment is therefore to identify and subsequently remove the issue responsible for causing the increased intestinal permeability, be it a food intolerance, an infection or exposure to a certain chemical. The final step is then to repair the gut to prevent the translocation of unwanted substances from the gut lumen into the bloodstream.
Recovering from autoimmunity is absolutely possible but it won’t be achieved with a one-stop miracle cure, instead it requires taking the specific actions that are required for you as an individual to rebalance and heal your body. ADs are among the most complex and difficult diseases to treat, but they are also one of the diseases for which naturopaths can make a significant difference to an individual’s quality of life.
I've set out below some important factors to consider with each case of autoimmunity.
10 Important Treatment Considerations for AD
Address intestinal permeability (‘leaky gut’) and gut dysbiosis
Identify any food allergens or intolerances with support from a natural health practitioner by undertaking a well-controlled elimination diet
Completely eliminate both gluten and dairy since these are highly inflammatory, and gluten is directly implicated in the development of AD
Focus on eating an anti-inflammatory diet and supplementing with anti-inflammatory nutrients such as turmeric, boswellia, omega 3 fatty acids and strain-specific probiotics
Identify and treat any underlying infections including yeast, bacteria, virus and parasites
Reduce toxin and chemical exposure such as from food additives, pesticides, contaminated water, tobacco smoke and toxic beauty & cleaning products
Check for heavy metal toxicity (particularly mercury) using a comprehensive hair mineral test
Limit pharmaceutical drug usage to those that are essential as medications such as non-steroidal anti-inflammatories and antibiotics contribute to intestinal inflammation, dysbiosis and food sensitivities
Ensure daily movement and regular light/moderate exercise (intense exercise can increase stress and inhibit recovery)
Practice regular relaxation to help manage stress; such as yoga, breathing techniques, journaling and massage therapy
(I’ll provide more detail for each of these treatment considerations in follow-up blog posts as there is a lot of information to cover!)
The use of natural products for treating all types of disease, including AD has seen a marked global increase in recent years. Certain natural products such as green tea polyphenols, curcumin, boswellic acids, resveratrol, pomegranate and quercetin have all been well researched for their potent antioxidant and anti-inflammatory properties that are able to suppress inflammation and AD processes, without the safety issues and adverse side effects. Natural treatments can also be used quite safely alongside conventional medicines (under the guidance of a well-qualified natural health practitioner) so that required dosages of pharmaceutical drugs can be reduced.
The bioavailability of natural products does vary significantly however so it is essential that high quality and well-proven products are used. The recent development of nanoparticle delivery offers a promising method of ensuring that the pharmacological and therapeutic properties are maximised, helping to mitigate the issue of bioavailability for these products and improve their efficacy.
While still being dictated by the pharmaceutical industry, further scientific research is emerging for the use of natural products with AD, including controlled clinical testing, so they will hopefully become even more widely accepted and used as therapeutics, either alone or as adjunctive therapy to mainstream Western drugs for the treatment of AD.
Campbell A. W. (2014). Autoimmunity and the gut. Autoimmune diseases, 2014, 152428. https://doi.org/10.1155/2014/152428
de Punder, K., & Pruimboom, L. (2013). The dietary intake of wheat and other cereal grains and their role in inflammation. Nutrients, 5(3), 771–787. https://doi.org/10.3390/nu5030771
De Santis, S., Cavalcanti, E., Mastronardi, M., Jirillo, E., & Chieppa, M. (2015). Nutritional Keys for Intestinal Barrier Modulation. Frontiers in immunology, 6, 612. https://doi.org/10.3389/fimmu.2015.00612
Duan, L., Rao, X., & Sigdel, K. R. (2019). Regulation of Inflammation in Autoimmune Disease. Journal of immunology research, 2019, 7403796. https://doi.org/10.1155/2019/7403796
Dudics, S., Langan, D., Meka, R. R., Venkatesha, S. H., Berman, B. M., Che, C. T., & Moudgil, K. D. (2018). Natural Products for the Treatment of Autoimmune Arthritis: Their Mechanisms of Action, Targeted Delivery, and Interplay with the Host Microbiome. International journal of molecular sciences, 19(9), 2508. https://doi.org/10.3390/ijms19092508
Fasano A. (2012). Zonulin, regulation of tight junctions, and autoimmune diseases. Annals of the New York Academy of Sciences, 1258(1), 25–33. https://doi.org/10.1111/j.1749-6632.2012.06538.x
Gregoric E, Gregoric JA, Guarneri F, Benvenga S. (2011) Injections of Clostridium botulinum neurotoxin A may cause thyroid complications in predisposed persons based on molecular mimicry with thyroid autoantigens. Endocrine. 2011 Feb;39(1):41-7. doi: 10.1007/s12020-010-9410-9.
Hechtman, L. (2012) Clinical Naturopathic Medicine. Second Edition. Elsevier
Konijeti, G. G., Kim, N., Lewis, J. D., Groven, S., Chandrasekaran, A., Grandhe, S., Diamant, C., Singh, E., Oliveira, G., Wang, X., Molparia, B., & Torkamani, A. (2017). Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease. Inflammatory bowel diseases, 23(11), 2054–2060. https://doi.org/10.1097/MIB.0000000000001221
Lerner, A. Jeremias, P. Matthias, T. (2015) The World Incidence and Prevalence of Autoimmune Diseases is Increasing. International Journal of Celiac Disease. Vol. 3, No. 4, 2015, pp 151-155. doi: 10.12691/ijcd-3-4-8 | Research Article
Mu, Q., Kirby, J., Reilly, C. M., & Luo, X. M. (2017). Leaky Gut As a Danger Signal for Autoimmune Diseases. Frontiers in immunology, 8, 598. https://doi.org/10.3389/fimmu.2017.00598
Myers, A. (2019) What to Eat (and Not Eat) to Reverse Autoimmune Disease. July 2019. https://www.amymyersmd.com/2018/04/eat-not-eat-reverse-autoimmune-disease/
Nakazawa, D. (2008). The Autoimmune Epidemic. Simon & Schuster. New York.
Sanctuary, M. R., Kain, J. N., Angkustsiri, K., & German, J. B. (2018). Dietary Considerations in Autism Spectrum Disorders: The Potential Role of Protein Digestion and Microbial Putrefaction in the Gut-Brain Axis. Frontiers in nutrition, 5, 40. https://doi.org/10.3389/fnut.2018.00040
Siegel, C.A., Marden, S.M., Persing, S.M., et al. (2009). Risk of lymphoma associated with combination anti-tumor necrosis factor and immunomodulator therapy for the treatment of Crohn’s disease: a meta-analysis. Clin Gastroenterol Hepatol. 7(8): 874-81.
Vojdani A. (2015) Lectins, agglutinins, and their roles in autoimmune reactivities. Altern Ther Health Med. 2015;21 Suppl 1:46-51.
Wang, L, Wang, F‐S, Gershwin, ME (Research Center for Biological Therapy, the Institute of Translational Hepatology, Beijing 302 Hospital, Beijing, China; and Division of Rheumatology, Allergy and Clinical Immunology, University of California at Davis School of Medicine, Davis, CA, USA). Human autoimmune diseases: a comprehensive update. (Review). J Intern Med 2015; 278: 369– 395.