Environmental Management

http://www.drmyhill.co.uk/wiki/Autoimmune_diseases_-_the_environmental_approach_to_treating

autoimmune diseases - the environmental approach to treating

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1 How auto-immunity may be switched on2 Immune adjuvants.3 Treatment of Auto-immunity3.1 Reduce the infectious load through diet and probiotics3.2 Get rid of adjuvants by doing detox regimes3.3 Vitamin D3.4 Diet3.5 Essential fatty acids3.6 Anti-oxidants3.7 Low dose naltrexone3.8 Thyroid and adrenal function4 Related Tests5 Related Articles

Autoimmunity occurs when the immune system has made a mistake. The immune system has a difficult job to do, because it has to distinguish between molecules which are dangerous to the body and molecules which are safe. Sometimes it gets its wires crossed and starts making antibodies against molecules which are "safe". For some people this results in allergies, which is a useless inflammation against "safe" foreign molecules. For others this results in autoimmunity which is a useless inflammation against the body's own molecules. These are acquired problems - we know that because they become much more common with age.

It is likely we are seeing more autoimmunity because of Western lifestyles, diets and pollution. Chemicals, especially heavy metals, get stuck onto cells and change their "appearance" to the immune system. In this respect they act as haptens [1] to switch on inappropriate reactions.

How auto-immunity may be switched on

Viruses and chemicals: autoimmunity may be switched on by viruses or exposure to chemicals, in particular the pesticides and heavy metals. The result is a useless inflammation which causes symptoms wherever the inflammation arises. This inflammation will be made much worse by poor antioxidant status. See Antioxidants. Having poor antioxidant status is a disease amplifying process.

Molecular mimicry - the idea here is that the body makes antibodies against food or bacteria in the gut which then, through sheer chance, cross reacts with the body's own molecules. So for example ankylosing spondylitis is thought to be caused by molecular mimicry against klebsiella bacteria in the gut and those antibodies then cross react with spinal ligaments - one has to be a particular tissue type for this to happen namely HLA B27 positive. There is some evidence to suggest that rheumatoid arthritis may be partly due to molecular mimicry with bacteria proteus mirabilis and tissue types HLA DR1 and 4. Clinically one sometimes sees arthritis following viral infections (pallindromic rheumatism) and this too may be molecular mimicry.

Have a look at [[2]] where it is suggested that gluten sensitivty results in autoimmune thyroid disease.

The following combinations have been shown:

Epstein Barr Virus with genotype HLA DR-15 puts one at risk of multiple sclerosisEBV and HLA DR3 puts one at risk of autoimmune thyroiditisEBV and HLA DR4 puts one at risk of autoimmune cardiomyopathyEBV and HLA DR7 - puts one at risk of primary biliary cirrhosisEBV and HLA DR7 plus smokiong puts one at risk of rheumatoid arthritis and multiple sclerosisEBV has been associated with 33 autoimmune diseases, including systemic lupus erythematosis and Sjogren's syndromeCMV (cytomegalovirus) has also been associated with autoimmune reactions

Helicobacter pylori infection is associated with idiopathic thrombocytopeonic purpura (ITP), systemic sclerosis, Crohn's disease and Guillam Barre syndrome and other vasculitic conditionsEradication of H pylori has resulted in resolution of ITP and also anti-phospholipid syndromeBUT H. pylori infection is protective for childhood asthmaWegener's granulomatosis may be switched on by staphlococci in the nose

Antibodies against yeast (saccharomyces cerevisiae) ie ASCA are predictive of developing Crohn's diseaseASCA is associated with arteriosclerosis- this too may be an autoimmune diseaseParasitic worms are protective agaisnt many forms of autoimmunity. They have a proven track record in Inflammatory Bowel Disease. For further infomration see [[3]]Malaria is protective against SLEvaccination may well increase risk of autoimmunityswine flu vaccination has been followed by epidemics of Guillam Barre syndrome and narcolepsy.

Immune adjuvants.

Many chemicals are immune adjuvants and "turn on" the immune system. One example is hay fever rates in Japan which are much higher in the cities than the countryside although pollen counts are much higher in the countryside! It is diesel particulates that make the difference - they act as adjuvants to switch on an immune response against grass pollen.

Vaccinations all contain immune adjuvants (without which they do not work!) such as mercury (thiomersal,) aluminium, squalene (a toxic lipid) or whatever. These have the potential to switch on the immune system to trigger allergies and/or autoimmunity. My personal view is that the evidence for benefit of the annual flu vaccination is probably out-weighted by potential damage so I no longer recommend this for my patients. Instead I direct them toViral infections - good nutrition is highly protective against viral infection.

Pesticides are very good at switching on allergy and probably autoimmunity as well. They too are immune adjuvants.

Heavy metals such as nickel and mercury also seem to activate the immune system.

Silicone. Silicones and other synthetic materials are widely used in surgery and cosmetic surgery. Many are strong adjuvants - ie they switch on the immune system. Silicones will migrate out of implants and distribute widely throughout the body to switch on allergies and/or auto-immunity. Devices may be contained in silicone such as pacemakers. Also think of breast implants, repair mesh for hernias, micro-chips, contraceptive devices, injected silicones for body contouring etc. See Silicone Breast Implants and Injections. Some people react to surgical suture material!

Prescription drugs which are of course chemicals! Practolol, a beta blocker, was taken off the market because it could trigger retroperitoneal fibrosis - now thought to be an autoimmune disorder. Hydralazine, another drug for blood presssure, may induce systemic lupus erythematosis.

Hormones Dydrogestone, a synthetic progesterone, can trigger autoimmune hepatitis. Indeed female sex hormones have profound effects on the immune systme and explain why autoimmuity is much more common in women than men.

Treatment of Auto-immunity

Conventional medicine uses steroids and immuno-suppressives to suppress this useless inflammation. But suppressing the immune system is a risky business, making patients more susceptible in the long term to infections and possibly cancer.

The environmental approach can be used to treat autoimmunity in the following ways:

Reduce the infectious load through diet and probiotics

By treating the upper fermenting gut. See [[4]]

Get rid of adjuvants by doing detox regimes

Do a good chemical clean up and detox regime. To read about detoxing follow links, or look for articles under 'Toxic Problems: Pollution and Poisoning'.Multiple Chemical Sensitivity - Detoxification - how to reduce your chemical load using physical methods and micronutrientsDetoxing and Treatment of Multiple Chemical Sensitivity (MCS): - see Chemical Poisoning and Multiple Chemical Sensitivity (MCS) - how to reduce the body loadDetoxing - Far Infrared Sauna (FIRS)Silicones cannot be got rid of in this way - they are large tough molecules which cannot be broken down by enzyme systems nor can they be excreted.

Vitamin D

Vitamin D has profound immune modulating properties. Vitamin D is made in the skin through the action of sunlight on cholesterol. Sunshine has marked pro-inflammatory properties so when it lands on the skin vitamin D is made from cholesterol - which counteracts this tendency to pro-inflammation. Thus vitamin D has profound anti-inflammatory effects locally in the skin - it then diffuses into the rest of the body where it modulates inflammation there. Vitamin D is probably the most powerful nutritional tool we have in the fight against auto-immunity.

Although vitamin D is present in some foods, it is there in such tiny amounts that changing one's diet hardly makes any difference in vitamin D levels. It is all about getting enough sunshine and failing that one simply has to take supplements. I like everybody to take at least 2000i.u. daily and for people with autoimmunity give them up to 50 000i.u. weekly. This is roughly equivalent to an hour of good sunshine daily landing directly on the skin of someone in shorts and T-shirt. The incidence of autoimmunity increases in people who live away from the equator with the best example of this being multiple sclerosis.

Diet

The strongest antigens appear to be gluten, milk protein and probably yeast. Sugar and refined carbohydrate are similarly pro-inflammatory. Everybody with autoimmunity should aim to do aStone Age Diet.

Essential fatty acids

Broadly speaking, the omega 3 and 6 fats feed into hormone and prostaglandin pathways, which tend to suppress inflammation so:

take evening primrose oil (4 capsules daily).take cod liver oil (4 capsules daily). Must be filtered oil: cod liver oil needs filtering to remove pesticides, check with your supplier. Eat oily fish.

Anti-oxidants

Good anti-oxidant status protects against many of the malign effects of inflammation. SeeAntioxidants

Low dose naltrexone

The idea here is to boost one's own production of opiates (endophines). This is achieved by giving a tiny dose of a morphine blocker naltrexone (4mgs, compared to a therapeutic dose of 50mgs) in the evening which partly inhibits endogenous morphine production but that is followed by a rebound increase in endogenous production. See LOW DOSE NALTREXONE

Thyroid and adrenal function

Both thyroid and adrenal hormones have immune modulating effects. Well worth getting both checked! See Thyroidand Adrenal Gland - the gear box of the car (DHEA and cortisol) – underactive