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Are These 3 Hidden Problems Causing Your Autoimmune Disease?

March 10, 2022 by Dr. Tiffany Caplan, DC, CFMP, IFMCP & Dr. Brent Caplan, DC, CFMP, IFMCP

What Causes Autoimmune Diseases Part 2

It’s a great mystery why some people develop autoimmune disease and others don’t, even when they share the same genes and the same home environment. But I am cracking the case today in this article and in part one. I have seen both external factors and internal factors set the stage for autoimmune issues in some people–but not in others. Understanding these risk factors for autoimmune disease helps us identify and address them in patients so that they can reverse their autoimmunity.

In this article, we’ll talk about the systems that can breakdown in your body and set you up for autoimmunity. I call them internal factors because these are problems that start inside your body, as opposed to external factors that come from outside your body such as chemicals, infections, or trauma. If you’ve ever wondered what causes autoimmunity, these factors may be the culprits.

The internal factors linked to autoimmune disease are:

  • Barrier permeability (skin, sinuses, lungs and leaky gut)
  • Abnormal cell production
  • Microbiome

External factors linked to autoimmune disease are discussed in part one, “What Causes Autoimmune Diseases and Why Are You Susceptible?”:

  • Chemicals
  • Pathogens
  • Trauma

So what do the internal factors mean and could they be the reason why you have autoimmunity? Let’s find out.

Barrier Permeability as an Autoimmune Trigger

Increased barrier permeability of the gut , sinuses, lungs, skin, and the blood brain barrier means that potentially harmful substances from the outside world can get into our bodies, where they don’t belong. Increased barrier permeability of the gut is more commonly called “leaky gut,” where undigested food particles and pathogens can escape from the intestines into the systemic circulation, causing problems throughout the body. Our gut is just one of our barriers. If any of our protective barriers break down, it can set off an angry immune response intended to protect us from these foreign substances. However, this overactive immune response can backfire, attacking harmless substances like pollen, food particles, or your own tissues.

Most people with autoimmunity focus on the gut barrier as a main contributing factor in autoimmunity. However, for some people the gut is only part of the picture or not a main area of concern. The problem could really be with any of our other multiple protective barriers that help keep things out of our bodies.

Our sinuses and lungs help protect us from things we breathe in and are exposed to in our environment. Our skin protects us from exposures to pathogens, chemicals, and UV light. Our blood brain barrier keeps harmful molecules from getting into our precious brains.

And of course, our gut barrier helps us absorb essential nutrients from our food but also protects us from pathogens, chemicals, and other foreign or potentially harmful substances we ingest.

Signs you may have increased barrier permeability are:

  • Reactions to foods
    • Reactions to inhaled substances (chemicals and environmental pollutants or even natural agents like pollen, dust, etc.)
    • Reactions to skin care products
    • Brain fog

Abnormal Cell Production as a Cause of Autoimmune Diseases

If you have low white blood cells, too many or not enough T cells, B cells, complement, or phagocytic cells, then you have abnormal cell production. There are many factors that play into cell production in the body, everything from nutrient deficiencies to excess stress.

If you make too many or too few of any of your immune cells, that can cause problems with your immune system being able to function properly. For instance, we know chronic stress and lack of sleep can impact how white blood cells are produced. Low white blood cell production leads to overall immune suppression and an immune system that doesn’t work very well.

One key component of immune system regulation is T-regulatory cell production (or Treg cells). Treg cells help keep different immune cells in check. That means they keep the immune system from going after a person’s own tissues or otherwise harmless substances like food particles. 

We know things like reduced vitamin D levels and low levels of the antioxidant glutathione directly impact Treg cell ability to regulate the immune system. Someone who has low vitamin D levels combined with factors that reduce their glutathione production – such as exposure to environmental toxins – may have more problems keeping high levels of healthy Treg cells. This can be a major factor in developing autoimmunity. Without enough Treg cells or Treg cells that just aren’t working their best, your body’s immune system might go into overdrive.

How to know if you have abnormal cell production:

  • Your immune cell production can be determined by laboratory testing. Your doctor can check for things like total white blood cells, white blood cell differentials, vitamin D levels, etc.
    • There is also a new test called a Lymphocyte MAP that can break down these different types of immune cells and show what imbalances exist.

The Microbiome’s Role in Autoimmunity

The microbiome is the collection of microorganisms–both good and bad–that live in your body. Many factors can impact these little guys in the gut including antibiotics, medications, stress, diet, exposure to toxins, nutrient deficiencies, etc.

Imbalances in the gut microbiome are often to blame for gastrointestinal symptoms such as inflammatory bowel disease, bloating, diarrhea, constipation, food reactions, or even neurological issues such as brain fog and depression or anxiety. Having your functional medicine provider order gut microbiome testing using stool and/or breath samples can determine whether the organisms in your gut are healthy or not.

Pretty much every surface of the body inside and out has its own microbiome, which can be disrupted and experience problems. For example, the skin, sinus, and oral cavity each have a unique microbiome.

In addition to testing, here are some ways to know if an imbalanced microbiome is to blame for your autoimmunity:

  • Chronic sinus issues
    • Digestive problems such as gas, bloating, diarrhea, or constipation
    • Poor dental health
    • Skin rashes

Genetics and Lifestyle Can Be an On/Off Switch for Autoimmunity

You might remember from “What Causes Autoimmune Diseases and Why Are You Susceptible?” that genetic susceptibility plays a big part in whether you will develop autoimmunity or not. Due to genetic differences, two people can have the same internal factors and yet one develops autoimmunity while the other does not.

Yet, lifestyle matters, too. External factors such as stress and poor food choices can overlap with internal factors to create a perfect storm. Reducing stress, avoiding foods like sugar that damage the microbiome, and eating meat that hasn’t been fed antibiotics can decrease your autoimmune triggers. Getting tested for food sensitivities and avoiding the foods to which you react can also play a part in healing the immune system.

Healing Your Barriers, Optimizing Cellular Health, and Rebuilding the Microbiome

The good news is that we have treatments to heal leaky gut, get normal cell production back on track, and restore a healthy microbiome. We often do a gut health protocol including stool testing to take a look at a person’s gut microbiome and gut barrier. We may use diet, probiotics, prebiotics, glutamine, aloe, and/or antimicrobial herbs to balance and strengthen the gut microbiome. At the same time, we heal the gut barrier, which immediately boosts normal immune function. If cell production is out of balance, we provide important nutrients such as vitamin D and glutathione. We look for other infections that might be throwing immune cells out of balance.

We’ll Find the Root Cause of Your Autoimmunity

Does it feel like your immune system has a mind of its own? Yes, it does, and you may be surprised that it actually has your best interests in mind. When you have an autoimmune disease, it means that your immune system is overwhelmed with triggers. It is turned on high alert and doing its best to keep you alive.

When we identify and remove as many stressors as we can, we are telling the body it is safe to calm down and turn off its overreactive surveillance. When the body can get into rest and repair mode, autoimmune issues will fade away. Each person’s autoimmune triggers are unique. Our goal is to bring the body back into a state of health by balancing the internal and external factors that led to immune dysfunction in the first place.

It’s difficult to figure out your own personal autoimmune triggers. It’s much easier to work with a functional medicine provider to pinpoint the exact cause or causes of your autoimmune issues and to order the right tests. That’s why I invite you to get in touch with the Caplan Health Institute so that we can identify and eliminate or reduce your own personal triggers. In doing so, we’ll put together all the pieces of the puzzle in order to solve the mystery of what’s causing your autoimmune disease and reverse the autoimmune process.


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