Your Complete Guide to Autoimmunity and Allergy Testing

This article originally appeared on Healevate.

Why do you get hay fever every spring, while others are totally unaffected? Why can one person cuddle up with their dog, while you break out in hives from merely petting the furry little guy? Allergies and autoimmunity are complicated conditions that exist on a spectrum, and have a few things in common.

  1. The underlying cause of both is inflammation.
  2. Having the right genetics predisposes you to developing them.
  3. The epigenetic factors responsible for manifesting the symptoms are probably more important than the genes themselves, since the environmental influences on the genes are what cause them to be turned on or off.

Epigenetics are all of the environmental factors that control your genes, so if you’re stressed out, not sleeping, eating an inflammatory diet, not exercising, and are surrounded by toxins in your home and on your body, there’s a good chance you’ll have some kind of inflammatory symptoms. These could be itchy, watery eyes from allergies or fatigue, brain fog, and constipation from an autoimmune condition.

These factors cause your immune system to kick up and start overreacting to normal stimuli, which ultimately produces systemic inflammation. Identifying the symptoms can help you get to the bottom of what’s causing your autoimmunity or allergies.

Symptoms of Autoimmunity and Allergies

Autoimmune and allergy symptoms are all on the inflammatory spectrum, so they can literally affect your entire body and cause many symptoms simultaneously.

Immune/inflammation: Asthma, wheezing, coughing, runny nose, post nasal drip, itchy or watery eyes, sneezing, unresolved infections, autoimmunity, swelling, anaphylaxis, and throat closing.

Skin/hair/nails: Dermatitis, eczema, acne, rashes, scaly skin patches, hives, photosensitivity, hair loss, nail pitting, dry eyes, skin, and mouth.

Gastrointestinal: Stomach pain, acid reflux, IBS, gas, bloating, nausea, diarrhea, constipation, gastroparesis (delayed stomach emptying), cankers, and food sensitivity.

Brain and mood: Headaches, brain fog, inability to focus or concentrate, double vision, blurred vision, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia, and insomnia.

Nerves: Tingling, pins and needles, numbness, and paresthesia.

Hormones: High or low blood sugar, weight gain or loss, excessive sweating, imbalance in thyroid, adrenal, and sex hormones.

Musculoskeletal: Joint and muscle pain, muscle weakness, and fibromyalgia.

Liver: Elevated liver enzymes, poor detoxification, and chemical sensitivity.

Cardiovascular: High or low blood pressure, rapid heart rate, and palpitations.

Which Test Should You Choose for Autoimmunity or Allergies?

Lab testing for allergies and autoimmunity can be exhausting, since the symptoms are vast and systemic.

Allergies are more easily tested, as you can do IgE antibody testing or skin prick testing to identify environmental allergens.

If your symptoms are outside the realm of typical allergies, then further investigation is warranted. Start with general testing to confirm that you have an inflammatory or autoimmune-based condition.

The serum labs for nonspecific markers of inflammation will let you know if you have an inflammatory or autoimmune process going on inside your body. If your symptoms coincide with a specific illness—for example, stomach pain, brain fog, and depression would possibly correlate to celiac disease—then specific testing should be initiated as well.

An important feature of reversing inflammatory, allergic, and autoimmune processes is finding the root causes. GI infections, food sensitivities/intolerances, toxicity, and hormone imbalances are all causes that could be contributing to your condition, and should be identified.

Autoimmunity and Allergy Testing

Allergy tests:

  • IgE antibody testing
  • Skin prick (scratch) testing

General inflammation and Autoimmunity tests:

  • CRP (C-reactive protein)
  • ESR (erythrocyte sedimentation rate)
  • ANA (anti-nuclear antibody)
  • APA (anti-phospholipid antibodies)
  • RF (rheumatoid factor)
  • Lactoferrin
  • Calprotectin

Testing for specific conditions is the next logical step if general testing suggests an autoimmune or inflammatory process, or if your symptoms correlate to a specific condition. For example, TPO (thyroperoxidase antibody) and TGA (thyroglobulin antibody) should be tested for autoimmune hypothyroidism (Hashimoto’s).

Allergy Tests

Environmental allergies to pollen, trees, weeds, dust, mold, and animals are fairly common, affecting over 40 million Americans annually.

Allergies are a hypersensitivity reaction to a substance that normally doesn’t cause a problem in most people. Once the substance is encountered and your immune system identifies it as foreign, it creates specific antibodies against the substance’s antigens (proteins).

IgE antibodies are one of several types of antibodies. They’re created when your body has a true allergic response to a substance and is considered a fixed allergy in that it will almost always provoke an immune response when the allergen is encountered. This type of testing analyzes your blood for the presence of IgE antibodies.

The skin prick or scratch test is often used as a quick screen, as it can be completed during an office visit. This test is administered on your back or arm, and anywhere between 20 to 40 substances can be tested, from dust, dander, and pollen to mold and foods.

A drop of the allergen is placed on your skin, and then a lancet is used to prick the skin, allowing the allergen to penetrate. Fifteen minutes later the results will be interpreted. A positive reaction will form a raised red bump that may itch (called a wheal). This type of test is usually performed in your doctor’s office.

General Inflammation and Autoimmunity Tests

CRP (C-reactive protein) is a protein made largely in the liver, immune, and fat cells in response to various inflammatory processes, such as tissue damage, infection, and disease states.

It’s released into the blood within a few hours of the inflammatory event; thus, it’s called an acute phase reactant. It’s a general marker of inflammation and isn’t specific to any particular condition. It can be used to track inflammatory and autoimmune conditions, as well as monitor flares. It’s often ordered with an ESR.

ESR (erythrocyte sedimentation rate) describes the inflammatory process in which red blood cells (erythrocytes) clump or aggregate together, causing sedimentation. The ESR measures the rate at which the erythrocytes settle in one hour in a vertical tube. It’s useful for assessing tissue destruction and levels of inflammation. Similar to CRP, the ESR is also a non-specific marker.

ANA (anti-nuclear antibody) is measured to assess levels of antibodies produced against the nucleus of a cell. It can be useful for identifying autoimmune conditions that affect multiple tissues throughout the body, such as lupus (SLE). ANA is a general indicator and isn’t specific to one particular condition.

APA (anti-phospholipid antibodies) reflect antibody production against phospholipids, which are required for blood clotting. APA is useful in blood clotting disorders, some of which are autoimmune, and for diagnosing lupus.

RF (rheumatoid factor) is an antibody that’s detectable in up to 80% of rheumatoid arthritis (RA) cases, but it can also be present in other autoimmune conditions such as lupus, scleroderma, and Sjogren’s. It can be helpful in distinguishing RA from other arthritic disorders.

Lactoferrin is a protein produced to combat inflammation. Lactoferrin can be measured in a stool sample and reflects inflammatory processes. It’s useful in diagnosing ulcerative colitis (UC) and Crohn’s versus non-inflammatory IBS. Since it isn’t specific, other causes of inflammation must be investigated such as dysbiosis, GI infection, and food intolerance.

Calprotectin is another protein measured in the stool that’s produced by a white blood cell called a neutrophil. Since neutrophils aggregate at the site of inflammation, calprotectin is more useful for diagnosing UC and Crohn’s against non-inflammatory IBS, as well as monitoring their progression. Other sources of inflammation should still be ruled out with other tests.

Testing for Specific Conditions

These are some of the common antibody (Ab) and gene tests associated with specific conditions. They may be helpful in diagnosis, along with other advanced tests and procedures such as biopsy or imaging.

Hashimoto’s: Thyroperoxidase Ab (TPO) and Thyroglobulin Ab (TGA)

Graves’: TPO, Thyroid Stimulating Hormone Receptor Ab (TSHR Ab), Thyroid Stimulating Immunoglobulin (TSI)

Diabetes (Type 1): Islet Cell Ab (ICA), Insulin Autoantibody (IAA), Glutamic Acid Decarboxylase Ab (GADA)

Autoimmune Hepatitis: Smooth Muscle Ab (SMA), Liver Kidney Microsomal Type 1 (Anti-LKM-1)

Ulcerative Colitis: Perinuclear Anti-Neutrophil Cytoplasmic Ab (pANCA)

Crohn’s: Anti-Saccharomyces Cerevisiae Ab (ASCA), Anti-CBir1, Anti-Omp C

Rheumatoid Arthritis: RF, Myeloperoxidase Ab (MPO), Cyclic Citrullinated Peptide Ab (CCP)

Lupus (SLE): MPO, APA, Anti Double Strand DNA (Anti dsDNA)

Myasthenia Gravis: Acetylcholine Receptor Ab (AChR)

Ankylosing Spondylitis, Juvenile Rheumatoid Arthritis (JRA), Reactive Arthritis (such as Reiter’s Syndrome): HLA-B27 gene test

Celiac: HLA-DQ2 and HLA-DQ8 gene tests, Anti-Tissue Transglutaminase Ab (tTG), Deamidated Gliadin Peptide (DGP), Endomysial Ab (EMA)

There are also specialty lab tests for celiac that involve testing IgG and IgA antibodies against gliadin, glutenins, gluteomorphins (made during the digestion of gliadin), and tissue transglutaminase. Cyrex Laboratories offers this panel, which is called the Array 3: Wheat/Gluten Proteome Reactivity & Autoimmunity.

Cyrex also offers the Array 5: Multiple Autoimmune Reactivity screen that measures IgG and IgA antibodies against 24 tissues and organs in the body. It includes many of the specific antibody tests, including ASCA, ANCA, TPO, TGA, GAD 65, and APA (discussed previously).

This test is very useful because it screens most of your body at once for AI, and when you have one known autoimmune condition, there’s an increased risk for autoimmune activity against other tissues. The tests in this panel can also be obtained in smaller panels according to condition or tissue type, including diabetes, neurological, and joint autoimmune reactivity screens.

Most of these tests can be obtained and completed by going through Direct Labs, which is a centralized location to buy and organize tests from labs such as LabCorp or Quest, as well as specialty lab companies who do mold and inhalant allergy testing.

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How to Test for Hidden Food Allergies or Sensitivities

This article originally appeared on Healevate.

If you’re experiencing a variety of health symptoms and have no known food allergies or sensitivities, you might wonder why you’d need to test yourself for them. You may believe that simply cleaning up your diet and eliminating soda, baked goods, sugar, and processed foods is enough. And while that’s certainly a good start, it’s not nearly enough to eliminate the immune and inflammatory processes that food reactions can cause.

Since eating is such an automatic process for most of us, we never stop to consider whether the symptoms we’re experiencing are related to food unless the reaction occurs while we’re actually eating or very soon thereafter.

If you have brain fog, fatigue, congestion, rashes, joint pain, or headaches, there’s a pretty good chance that your body is reacting to something you’re eating.

For many people, food is the most inflammatory substance they encounter on a daily basis. Because we eat multiple times a day, and because we’re creatures of habit, we tend to consume the same things, giving the immune system the opportunity to react.

Food sensitivities and allergies cause many symptoms, especially if you have a leaky gut. Any symptoms of inflammation or autoimmunity can point to food intolerances, so the list is vast.

Symptoms of Food Allergies and Sensitivities

The symptoms of food intolerance can manifest quickly, as with a swollen tongue or anaphylaxis, but quite often the symptoms are delayed. This makes them hard to pick up on, as well as attribute to a certain food.

Immune/inflammation: Allergies, asthma, runny nose, post nasal drip, unresolved infections, autoimmunity, swelling, wheezing, coughing, anaphylaxis, throat closing.

Skin/hair/nails: Dermatitis, eczema, acne, rashes, scaly skin patches, hives, photosensitivity (sun sensitivity), hair loss, nail pitting, dry eyes, skin, and mouth.

Gastrointestinal: Stomach pain, GERD (acid reflux), IBS, gas, bloating, nausea, diarrhea, constipation, gastroparesis (delayed stomach emptying), canker sores.

Brain and mood: Headaches, brain fog, inability to focus or concentrate, double vision, blurred vision, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia, insomnia.

Nerves: Tingling, pins and needles, numbness, paresthesia.

Hormones: High or low blood sugar, weight gain or loss, excessive sweating.

Musculoskeletal: Joint and muscle pain, muscle weakness, fibromyalgia.

Liver: Poor detoxification, chemical sensitivity.

Cardiovascular: Low blood pressure, rapid heart rate, palpitations.

The First Food Allergy or Sensitivity Test To Perform

The first method of screening isn’t a lab test at all. It’s an elimination diet. Eliminating the most common sources of food intolerances is a great way to find out if you have an issue.

Removing gluten, dairy, corn, soy, eggs, and nuts from your diet for 4 weeks, then adding them back one single food (not food group) at a time over a period of 3 days should tell you whether your body is reacting to something.

If you have a known autoimmune condition, you may also want to include the nightshade vegetables, such as tomatoes, potatoes, sweet and hot peppers, eggplant, and spices made from these, as well as gluten cross-reactive foods like coffee, chocolate, and the gluten-free grains.

If any of the previously mentioned symptoms appear during that 72-hour window, you should avoid that food for at least 6 months to give your immune system a break and let the inflammation go down.

This method can you help you to identify the source of your food troubles, but for some, reactions can occur to even the healthiest foods, such as blueberries or spinach, especially if they have a leaky gut. To further complicate matters, not only do the foods themselves cause a response, but the additives, colorings and gum resins (binders used in gluten-free foods) do as well. This is where testing can be valuable.

Food Allergies vs Food Sensitivities

Food allergies and sensitivities are very different issues. A food allergy occurs when the immune system identifies a food as a foreign substance and attacks it. This response occurs on a spectrum and can be anything from a swollen tongue to anaphylaxis, which is a potentially life-threatening reaction.

Food allergies are tested by measuring antibodies in the blood against particular foods. IgE and IgG are commonly measured. If you have an obvious response to a food, you can confirm it with this type of testing.

Food sensitivities are the more common and elusive form of food intolerance. They’re more vague than allergies and are considered to be any toxic or inflammatory response to food. Quite often they’re mediated by a lack of enzymes, stomach acid, and/or a leaky gut. Celiac disease is a perfect example, where a severe intolerance to gluten causes the destruction of the surface of the small intestine.

Testing for food sensitivities offers a variety of options; antibody and mediator release testing (MRT) are two of the better ones available. No matter what test you choose, be aware that if you have a leaky gut, there’s a good chance you’ll be reacting to many of the foods you eat.

Food Allergy and Sensitivity Tests

There are several types of testing available for identifying food allergies and sensitivities. IgE testing represents the true food allergy test. IgG testing can also identify allergies, but more commonly, it shows delayed sensitivity reactions. The rest of the testing options are for intolerances or sensitivities only.

  • IgE antibody test
  • IgG and IgA antibody test
  • Gluten and gluten cross-reactivity tests
  • MRT test

IgE Antibody Testing for Food Allergies

Antibodies are produced when your body mounts an immune attack on a substance it has identified as foreign, which in this case is food. It creates antibodies against specific proteins (antigens) in that food. Antibody tests measure your body’s immune response to a particular substance or organism.

There are several categories of antibodies. IgE antibodies are created when your body has a true allergic response to a substance, which is why traditional food allergy testing analyzes antibody levels in the blood. An IgE allergy is considered a fixed allergy in that it will almost always provoke an immune response when the food is consumed. This type of food allergy elicits an immediate response.

This test can be completed by traditional labs such as LabCorp or Quest, as well as the specialty lab companies Alletess Medical Laboratory and Great Plains Laboratory. IgE testing can easily be ordered online through Direct Labs.

IgG and IgA Antibody Testing for Food Allergies and Sensitivities

In spite of having an allergy, you can still yield a negative IgE test result. This is why it’s important to test IgG levels as well. IgG antibodies measure a delayed hypersensitivity reaction, which can take up to 72 hours to occur. These are the more difficult reactions to link to a particular food, so testing can be helpful here. IgG antibodies are the most prevalent antibodies in systemic circulation and are the most common form of immune-mediated food responses.

While some IgG responses represent true allergies, most are hypersensitivities or intolerances. Similarly, IgA antibodies also represent delayed hypersensitivities. They can take many hours or days to occur and operate in a low-and-slow manner.

Traditional labs such as LabCorp or Quest will offer this test. Genova Diagnostics offers an IgG test. Alletess Medical Laboratory offers stand-alone IgG testing, combined IgG and IgE testing, and IgA testing. Cyrex Laboratories offers the Array 10: Multiple Food Reactivity Screen that measures IgG and IgA levels. The Array 10 tests raw and cooked foods, additives, gum resins, and brewed beverages.

All of these IgG and IgA tests can be ordered online through Direct Labs.

Gluten and Gluten Cross-Reactivity Tests

If you suspect that you’re sensitive to gluten, or even have full-blown celiac disease, testing is an important piece of the puzzle. Gluten testing involves analyzing the IgG and IgA response to various components of the gluten molecule, including several gliadins, glutenins, gluteomorphins (made during the digestion of gliadin), and the intestinal enzyme transglutaminase. It’s important to note that you must consume gluten for this test to be as accurate as possible.

Once you confirm gluten intolerance or celiac disease, completing gluten cross-reactivity testing is helpful, since these foods elicit the same response from the immune system as gluten does. This means that they contain similar protein sequences as the gluten molecule (molecular mimicry). Milk, whey, chocolate, coffee, soy, potatoes, corn, eggs, and most gluten-free grains (including rice) are considered cross-reactive.

Conventional lab companies offer gluten testing and the Array 4: Gluten Associated Cross-Reactive Foods test. This test can be ordered online through Direct Labs.

Mediator Response Test (MRT)

The MRT utilizes different technology than antibody testing. It quantifies the inflammatory response to specific foods and additives. Mediator release refers to the inflammatory chemicals that are liberated from your cells in response to a sensitizing food.

Instead of measuring antibody production, this test measures your white blood cells’ chemical response to a food. It gauges the cells’ change in volume, which comes from the release of inflammatory chemicals such as histamine and cytokines. A non-reactive food will produce no change, while a reactive food will produce an increase or decrease in cell volume.

This is a blood test and is only offered by Oxford BioMedical Technologies.

The Bottom Line on Food Allergy and Sensitivity Tests

Start with the basics and conduct an elimination diet. That alone will give you new information to work with. From there, spend money only on the testing that could reveal new information that would alter your approach to food. If you’re already 100% gluten-free and are avoiding all cross-reactive foods as well, then gluten testing would be a waste of time and money.

So be smart and be proactive. Discovering hidden food allergies or sensitivities could make a huge difference in your day to day health.

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Why Autoimmunity Is Keeping You Sick And How To Reverse It

This article originally appeared on Healevate.

Do you feel fatigued even after you get a full night of sleep? Do you have achy muscles and joints, brain fog, an inability to concentrate, or insomnia? Do you get rashes, eczema, hives, or skin irritation? Do you have a hard time tolerating cold or heat? Do you get diarrhea, bloating, constipation, or stomach pain?

If you answered “yes” to several of these, there’s a good chance you have an autoimmune condition. Many people suffer for years with a vague set of symptoms that look like many other conditions but can’t be clearly defined or put in a box. Today we know this previous gray area actually defines the symptoms that precede or are involved in the process of autoimmunity.

This inflammation-based condition is a hot topic receiving lots of press right now in the health world, especially in holistic functional medicine and natural medicine spaces. This is partially because some AI conditions are now easier to diagnose, but much is due to the fact that we now understand the role of the gut and root causes as mediators of autoimmunity, not just a breakdown of immune function. This is a message practitioners, patients, and researchers want to get out, as autoimmune diseases are so prevalent—they affect at least 50 million Americans.1

Until recently, it was standard thinking that AI couldn’t be reversed, but now we know differently. Identifying the root causes and reversing intestinal hyperpermeability (leaky gut) are at the core of reversing the autoimmune process in the body. Doing this, combined with some diet and lifestyle changes, could have you healing and feeling like an elevated version of yourself.

What Exactly is Autoimmunity?

Autoimmunity, at its core, occurs when the immune system attacks healthy tissues that it’s mistaken as a foreign invader.

Previously, science believed that it was purely immune dysfunction or an overactive immune system that caused autoimmune conditions. Knowledge has advanced now, and we know that there are lifestyle triggers that lie at the heart of immune system dysfunction. These triggers, combined with genetics and epigenetics (the environmental influence turning genes on or off) are what regulate the AI process.

There are more than 90 diagnosable autoimmune conditions today.2,6 Some of the more common conditions are ankylosing spondylitis, Addison’s disease, Celiac disease, Crohn’s disease, Graves’ disease, Hashimoto’s thyroiditis, Lupus (systemic lupus erythematosus or SLE), myasthenia gravis, multiple sclerosis, psoriasis, rheumatoid arthritis, Sjogren’s disease, ulcerative colitis, and Type I diabetes, as well as allergies, asthma, dermatitis, and eczema.

This is only a short list of the conditions that have been described and categorized. In reality, you can have an autoimmune assault on any tissue in your body, and that process may not yet be defined, which can make diagnosis frustrating for you.

Even though there are many different types of AI conditions that are on a vast spectrum, they share one thing in common—that they’re all inflammatory in nature.

Chronic systemic inflammation sets the stage for an upregulated immune system that causes the body to attack itself.

The good news is that getting to the bottom of the root causes and making lifestyle changes can have a profound impact on the course of the autoimmune process, meaning that an AI disease doesn’t necessarily have to be defined to start reversing the process and healing.

How Does Autoimmunity Occur?

Dr. Amy Myers, MD, explains, “Autoimmune diseases are born when your body is working hard to defend itself against something potentially dangerous, such as an allergen, a toxin, an infection, or even a food, and it fails to differentiate between the intruder and parts of your own body. Mistaking certain types of tissues for harmful substances, your body turns these antibodies against itself, wreaking havoc on your organs.”1

The origin of autoimmune conditions is multifactorial and additive, in that it takes a genetically predisposed person in the right environmental circumstances with a leaky gut to develop an improper immune response. Family history accounts for one-third of the risk for developing an AI condition, as certain genes have been identified that directly affect the immune system and play a role in its hyperreactivity.14

Dr. Alessio Fasano, MD, the director of the Center for Celiac Research & Treatment at Massachusetts General Hospital for Children, has spent decades researching autoimmunity and how the immune system malfunctions, which led him to deduce that every autoimmune disease has three basic ingredients: a genetic predisposition, an environmental trigger, and a leaky gut.8,14

He explains that identifying the first two components was easy, since science has long known that AI conditions tend to run in families and that they can be triggered by infections, but the leaky gut component wasn’t identified until 2000, when he and his research team isolated the protein responsible for regulating gut barrier function, zonulin.14

Leaky gut, or increased intestinal permeability, arises when gut barrier function is compromised, allowing large particles that don’t normally enter the bloodstream to pass through. These particles are then triggers, causing the immune system to respond.

The environmental triggers are food sensitivities, allergens, toxins, and stress, which turn on the genes that initiate the AI process. This also generates chronic inflammation that perpetuates leaky gut and immune system activation.

Once the environmental triggers have entered the bloodstream, the immune system becomes primed and ready to defend, launching a biochemical war.

This war creates inflammation that activates certain genes, sustaining the immune response and allowing it to continue. As the war rages on and the immune system is on high alert, some confusion may arise, and the body may begin to attack itself.

One of the mechanisms believed to fool the immune system into thinking your body’s cells are pathogens is molecular mimicry. Molecular mimicry arises because there are specific protein sequences, or antigens, on the surface of certain microbial cells or foods that are similar to certain body cells such as the thyroid, intestinal cells, or nerves, essentially tricking the immune system. It loses its ability to clearly discern between self and non-self.

According to the ‘Thyroid Pharmacist’ Dr. Izabella Wentz, “This inadvertently causes a cross-reaction with our ‘self’ antigens, i.e., our own cells. This case of mistaken identity is thought to trigger the start of autoimmunity.”4

Similarly, another mechanism of autoimmunity occurs when toxins alter DNA and cause gene mutations. These mutations change the structure of tissues, causing the immune system to identify them as foreign and producing an assault on your body.

Triggers of Autoimmunity

The triggers that produce autoimmunity often occur together with the immune system responding to multiple ‘insults’ at the same time, since chronic inflammation mediates this process. Identifying the triggers and eliminating them is the key to reversing inflammation, calming the immune system, and shutting down the AI process. Common triggers of autoimmunity are:

  • Leaky gut
  • Dysbiosis and infection
  • Food sensitivity
  • Toxins
  • Stress

Trigger of Autoimmunity: Leaky Gut

Intestinal hyperpermeability, or leaky gut, starts when a trigger such as toxins, dysbiosis, stress, or food sensitivity creates inflammation, causing a dysfunction in zonulin, which regulates gut barrier function.

Fasano states, “Zonulin works like the traffic cop of our bodies’ tissues. It opens the spaces between cells, allowing some substances to pass through while keeping harmful substances out.” 6,8

Intestinal hyperpermeability occurs when there’s a breakdown in the function of zonulin, allowing larger particles such as bacteria, toxins, and partially-digested food particles through the intestinal walls to the bloodstream, where the immune system generates a reaction to clear them out. In genetically-susceptible individuals, these substances can eventually elicit an exaggerated or erroneous response, and the body can begin to assault its own tissue.

Leaky gut provides an easy access gateway to the immune system, when normally these particles would be kept out of the bloodstream. Under normal circumstances, when you encounter a typical foreign invader, such as a virus, bacteria, parasite, fungus (mold and yeast), or toxin, your immune system should answer by generating a response to anything it perceives to be a threat to your survival. In the case of autoimmunity, these large particles that have entered the bloodstream through a leaky gut cause an immune response that produces antibodies to the particles themselves and to the tissues of your body.

The causes of leaky gut must be eliminated and intestinal barrier function properly restored in order to reverse autoimmunity.

Trigger of Autoimmunity: Dysbiosis and Infection

Dysbiosis is the product of an imbalance between the beneficial and harmful organisms in your body, especially the gut. Healthy individuals have lots of the good guys within the GI tract that assist with digesting food, producing nutrients, and protecting from harmful organisms and inflammation.

When there’s a general imbalance between the good and bad flora, or when there’s an infection present, such as SIBO (small intestinal bacterial overgrowth), Candida (yeast), parasites, or mold, dysbiosis will arise. This imbalance allows for leaky gut to occur, since chronic inflammation develops as a byproduct, and it contributes to the deterioration of the intestinal barrier.

Native (commensal) and infectious organisms, like large particles leaked from the gut, can also trigger autoimmunity through molecular mimicry. Your body mounts an immune response, which is great when it zeroes in on a cold virus that shouldn’t be there, but it’s a problem when it mistakenly assaults your thyroid while it’s attacking H. pylori.4

There are many organisms implicated in the molecular mimicry process of autoimmunity, such as H. pylori (causes stomach ulcers and GI infections), Yersinia enterocolitica (causes GI infections), and Borrelia burgdorferi (causes Lyme disease), which may trigger Hashimoto’s thyroiditis.4

When the immune system sees Klebsiella pneumoniae, Shigella, Chlamydia trachomatis, and several other gram-negative bacteria, it ‘recognizes’ the self protein HLA B27 and attacks, inducing spondyloarthropathies, which are inflammatory conditions that include ankylosing spondylitis, psoriatic arthritis, and reactive arthritis (Reiter’s Syndrome).5 Viruses can also be triggers, as with multiple sclerosis and lupus, as well as the Epstein-Barr virus (EBV).5

Many other AI conditions can have a molecular mimicry component as well.

If you have an AI condition, it’s worth investigating to see if you have dysbiosis or an infection that may be perpetuating the process.

Trigger of Autoimmunity: Food Sensitivities

Food sensitivities are very common in those with autoimmunity. The usual suspects are gluten, dairy, eggs, nuts, soy, and corn, although you can have a reaction to any food you eat, especially those you consume frequently. Lectins, which are proteins found in legumes and grains, also activate the immune system and are implicated in autoimmunity.

These sensitivities generally arise when the partially-digested food particles enter the bloodstream through a leaky gut. Additionally, under the right circumstances, a cross-reactive process may ensue as well.

In another case of mistaken identity, foods produce a cross-reactive response through the same antigen-antibody-mediated process that the microorganisms produce.

According to PhD scientist Sarah Ballantyne, aka The Paleo Mom, “For those 20% of us with Celiac disease or gluten-intolerance/sensitivity (whether diagnosed or not), it’s critical to understand the concept of gluten cross-reactivity. Essentially, when your body creates antibodies against gluten, those same antibodies also recognize proteins in other foods. When you eat those foods, even though they don’t contain gluten, your body reacts as though they do. You can do a fantastic job of remaining completely gluten-free but still suffer all of the symptoms of gluten consumption—because your body still thinks you’re eating gluten.”7

Gluten is one of the most sensitizing substances we consume, and eating the cross-reactive foods can be just as bad, since they elicit the same response. Common cross-reactive foods are rye, barley, spelt, Polish wheat, oats, buckwheat, millet, sorghum, amaranth, quinoa, corn, rice, potato, hemp, soy, teff, milk, chocolate, yeast, coffee, sesame, tapioca, and eggs.7

When you have an autoimmune condition, you’re best served by eliminating gluten completely and any cross-reactives that are triggers for you. There’s no middle ground here—it’s all or nothing, because even one little bite will provoke a potentially hazardous flare-up.

Trigger of Autoimmunity: Toxins

When it comes to autoimmunity, you need to be concerned with the toxins inside and outside the body.

Toxins are all around us in the air, water, soil, and our food supply. We’re exposed to astounding amounts of pollution. Over 80,000 chemicals have been introduced into our society since 1900, and only 550 have been tested for safety.9

Dr. Donna Nakazawa, MD and author of The Autoimmune Epidemic, calls these environmental toxins “autogens,” since they create a reaction against the self.9

The toxins we take in can alter our DNA, producing gene mutations that change tissues. The immune system can attack these tissues since they’re not identical to your healthy tissues. Furthermore, the toxins can alter gene expression by turning on genes that promote inflammation, which can then produce autoimmunity and leaky gut. These are some of the more common toxins:

Heavy metals: Mercury, lead, cadmium, bismuth, arsenic, tin, and aluminum

Plastics: BPA, BPS, BPF, and phthalates

Food: Pesticides, herbicides, BT toxin (from GMOs), preservatives, additives, colorings, Teflon (non-stick cookware), and aflatoxins on peanuts and grains

Environmental chemicals: Chlorine, fluoride, bromine, xylene, dioxin, toluene, and PCBs

The organisms that normally reside within us, as well as the pathogenic invaders, can also produce toxins. Mold produces mycotoxins. Bacteria have two toxic mechanisms—the excretion of toxins called exotoxins and the endotoxins on the cell membrane of gram-negative bacteria. These toxins activate the immune system and produce inflammation.

Trigger of Autoimmunity: Stress

Chronic stress has many negative impacts on health, especially with regard to autoimmunity.

Chronic stress produces constant activation of the sympathetic nervous system (fight or flight) and increases levels of the stress hormone cortisol. Over time, constant cortisol elevation leads to cortisol resistance, where the body has to produce more and more to achieve the same response. When this happens for prolonged periods of time, cortisol levels become chronically low, and adrenal fatigue develops. Cortisol is the primary anti-inflammatory hormone in your body, and when levels are chronically low, low-grade inflammation rages, paving the way for autoimmunity.

Additionally, chronic stress alters immune function over time, causing some aspects to be amplified and others to be diminished, producing dysregulation.

A 2009 study on autoimmunity revealed that “most interestingly, the release of endogenous glucocorticoids [cortisol] is critical in regulating the severity of disease activity in patients with inflammatory conditions such as rheumatoid arthritis (RA). Blocking of cortisol production results in a flare-up in disease activity in RA patients, while surgical removal of the adrenals in patients with Cushing’s disease has been reported to exacerbate autoimmune disease.” This clearly illustrates cortisol’s critical role in immune function and inflammation.10

Chronic stress produces physiological changes such as decreased blood flow, oxygenation, motility, enzyme output, and nutrient absorption that directly impact the intestinal flora and gut function.11 Since 70-80% of the immune system is within the gut, this means decreased gut and immune function, which can impact autoimmunity. Further, stress diminishes immunity by depleting the antibody secretory IgA (sIgA) as well as essential hormones, and it promotes inflammation, which can all result in a leaky gut.12

Symptoms of Autoimmunity

Autoimmune conditions are characterized by a myriad of symptoms that can be vague and varied, waxing and waning, making diagnosis difficult. Inflammation, being central in the AI process, is the root of many of these symptoms.

Immune: Allergies, asthma, chronic or recurrent infections that won’t resolve, or yeast infections

Skin/hair/nails: Dermatitis, eczema, acne, rashes, scaly skin patches, hives, photosensitivity (sun sensitivity), hair loss, nail pitting, or dry eyes, skin, and mouth

Gastrointestinal: Food sensitivities, food allergies, stomach pain, GERD (acid reflux), IBS, gas, bloating, diarrhea, constipation, or gastroparesis (delayed stomach emptying)

Brain and mood: Headaches, brain fog, inability to focus or concentrate, double vision, blurred vision, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia, or insomnia

Nerves: Tingling, pins and needles, numbness, or paresthesia

Hormones: Poor blood sugar regulation (high or low blood sugar), weight gain or loss, cold intolerance, imbalanced female and male hormone systems, poor sleep quality, thyroid imbalances, adrenal imbalances, or multiple miscarriages

Cardiovascular: Palpitations, hypertension (high blood pressure), high cholesterol, anemia, or blood clots

Musculoskeletal: Joint and muscle pain, muscle weakness, or fibromyalgia

Liver: Poor detoxification, elevated liver enzymes, or chemical sensitivity

Lab Testing for Autoimmunity

Lab testing for autoimmunity can be exhausting and broad, since there are so many options. It’s best to start with the basics first and consider general blood tests.

General AI Tests:

ANA (anti-nuclear antibody)
ESR (erythrocyte sedimentation rate)
CBC (complete blood count)
CRP (C-reactive protein)
APA (antiphospholipid antibodies)
RF (rheumatoid factor)

GI Infections:

Stool analysis (general)
CDSA (comprehensive digestive stool analysis—looks at organisms, inflammation, and leaky gut)

Food Sensitivities/Allergies:

IgE test for allergies
IgG or IgA test for sensitivities/intolerance
Mediator release testing

Once you’ve pursued these avenues, testing for specific conditions may be in order, such as TPA (thyroperoxidase antibody) and TGA (thyroglobulin antibody) for Hashimoto’s. Cyrex labs has several tests specifically designed for autoimmunity, food intolerances, and intestinal permeability. The Array 5: Multiple Autoimmune Reactivity Screen tests twenty-four different tissues for AI activity.13

Treatment of Autoimmunity

Treating autoimmunity can be easier than you think. Many people get some level of resolution with lifestyle changes and even further resolution when specific lab testing uncovers hidden infections, toxicity, or low cortisol levels that can be treated.

The easiest way to work your way through treatment is to take a systematic approach so you can more easily see what’s working and what isn’t.

Diet: This is the best place to start, since you’ll need some time to identify which foods you should be avoiding; making permanent dietary changes can yield massive benefits when it comes to autoimmunity.

The first step is to begin a 30-day elimination diet. You can make this basic and eliminate the usual suspects that trigger reactions like gluten, dairy, corn, soy, and nuts, but you’d be better off eliminating known AI triggers as well. These include seeds, eggs, legumes and grains (because of the lectins), and nightshades (all varieties of peppers, potatoes, eggplants, etc). You may even choose to stop eating gluten cross-reactive foods as well if you know you have issues with gluten. After 30 days, you can begin the re-introduction phase to see if you have any reaction to each food.

If you want to jump right into a diet change, Paleo can be a good place to start, since it naturally eliminates many of the AI triggers. The first study ever completed on autoimmunity and the Paleo diet was published in 2014 by Dr. Terry Wahls, MD and author of The Wahls Protocol. Although it was a small study, it illustrated the beneficial effects of adopting a Paleo diet in relation to AI disease—especially a reduction in fatigue.3,15

The Autoimmune Paleo diet takes it one step further and eliminates all food triggers of AI. Dr. Ballantyne has the Paleo Approach, and Dr. Datis Kharrazian both have versions of this that are great resources. Dr. Kharrazian’s AI diet focuses on gut healing and is a simple version that includes many meats, vegetables, fermented foods, coconut, certain herbs and spices, low glycemic fruit, and some condiments.16

With all of the diet information out there, knowing what to eat can be very confusing, but with some work you can do it. As with any diet, you need to tailor it to your own specific biochemical needs. This means that some of the foods on the “avoid” list might be okay for you, and some acceptable foods may not be.

You need to figure this out to optimize your diet and health. Find your “you” diet.

Nutrients and Supplements: There are so many different nutrients necessary for treating autoimmunity and inflammation. The following are some examples of anti-inflammatory and gut-healing nutrients you can start with:

Magnesium, vitamin D, and EPA/DHA (omega-3 fatty acids) are recommended by Sarah Ballantyne for their important anti-inflammatory and immune-modulating effects.3,17

Vitamins C and E, zinc, and selenium function as antioxidants and protect against oxidative stress.17

Glutathione is a critical nutrient, as it’s the master antioxidant in the body, and there’s a significant breakdown with its function in AI. Taking supplemental glutathione (or its precursor, NAC (n-acetyl cysteine)) with alpha lipoic acid (ALA) and glutamine will help recycle glutathione efficiently. ALA also functions as an antioxidant and supports healthy mitochondrial function. Glutamine is an essential nutrient for intestinal cells and helps repair leaky gut (along with glutathione).18

Probiotics (“good bacteria”) increase the levels of healthy bacteria in your gut, which reduces inflammation and combats leaky gut.17

Digestive enzymes and betaine HCL are often necessary, since nutrient malabsorption plays a role in leaky gut and AI.17

Clean up your life: Eat organic foods, avoid GMOs, and choose more natural cleaning and personal care products to reduce the toxic burden on your body.

Reduce your stress levels: Stress is one of the main contributors to inflammation and poor immune function. Identify and manage your stressors. Reduce stress by creating boundaries, honoring your feelings, and organizing your life.

Relax: Take time-outs during the day to unplug and rest. Schedule downtime to give your body a rest by journaling, yoga, or meditation. Do what speaks to you.

Get into nature: Nature has significant healing benefits, so try to get out and enjoy it at least once per week.

Sleep: Getting adequate sleep is essential to healing. Avoid blue light stimulation from TVs, phones, and tablets for at least 2 hours before bed. Aim for a minimum of 8 to 9 hours per night, and try to get to bed by 10 PM. Sleep in a dark, cool, and quiet room for the most restful results.

Exercise: Moving your body is important to maintaining health and the healing process, but know your limits. Pushing too hard or too fast can delay your recovery. Give yourself adequate rest time, and only do what your body is telling you it can handle. In general, long-duration endurance exercises deplete cortisol and promote inflammation, so it may be best to avoid this and opt for walking, hiking, yoga, pilates, or weight lifting.

Empower yourself: Knowledge is power, so educating yourself on your condition makes you your best advocate. This knowledge will equip you with the best opportunity to manage your AI condition to give you the best quality of life.

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4 Simple Ways to Kickstart the Battle Against Inflammation

Inflammation may be the most common term used in all arenas of health now, and deservedly so since we know that it’s the underlying cause of almost every chronic disease on earth. Inflammation is your body’s response to danger signals, sounding the alarms to trigger biochemical processes to keep you alive in times of infection, injury, and trauma. This acute response is a healthy, normal process that is necessary for life. The key is that it begins and ends.

Chronic inflammation differs from the acute response in that it persists without end in response to foods, hidden infections, toxins, nutrient or hormone imbalances, or inefficient physiological mechanisms that would normally counteract inflammation. It’s the type of inflammation associated with disease. The most significant problem associated with chronic inflammation is that it’s largely silent, often causing destruction for many before it’s detected. During the time it is under the radar, the seeds of chronic disease have been planted and one day you wake up with achy joints and muscles, a headache, and digestive issues. You think to yourself, “Did I eat something bad or catch a bug?” All the while, this process has been building for years unbeknownst to you.

When these symptoms hang around for longer than a week or two, that’s the first clue this isn’t an acute infection or food poisoning. What do you do next?

The key to reversing chronic inflammation is identifying all possible causes and healing them, which often can be a long process. Working with an experienced practitioner can help you decide what treatments and lifestyle interventions are necessary after a thorough history and appropriate labs have been completed. In the meantime, there are several simple things you can do to begin tipping the inflammation scale in your favor.

Start on a basic anti-inflammatory diet. At a minimum, eliminate all gluten, dairy, soy, and sugar for at least 4 weeks. An organic, whole foods based diet consisting of healthy proteins, fats and high levels of plant foods is inherently anti-inflammatory. If you find that you still have some level of inflammation or other symptoms, you may need to eliminate some of the other common allergens such as corn, nuts, eggs, or fish. Also consider eliminating foods you eat frequently because even though they may not be common allergens or sensitizers, they could be causing an immune response in you.

Vitamin D3 is often deficient in people with autoimmune or chronic conditions. Vitamin D is a strong immune system modulator, especially with regard to its anti-inflammatory capacity. It also supports healthy gut flora, promotes gut barrier integrity, and activates adaptive immunity in the GI tract which all fortify a healthy inflammatory balance. Supplementing with high doses (10,000 IU per day) for a month to start. Be sure to monitor your 25(OH) Vitamin D serum levels aiming for a range of 50-80 ng/mL.

Essential fatty acids (EFAs) as fish oil, cod liver oil, or krill oil are important to the inflammatory response since humans don’t make them efficiently on their own. EFAs support the immune system by regulating the intensity and duration of the inflammatory response and decreasing the production of inflammation promoting compounds. Short term dosing at 3-6 g per day can help ramp up these effects, however caution should be taken when dosing above 3g daily if you take blood thinners or have a bleeding disorder.

Curcumin, green tea extract, and resveratrol all activate a potent anti-inflammatory pathway called Nrf2. They are far more effective at increasing antioxidant production than typical antioxidants, like Vitamin C or E, in their supplemental form. You can use these as individual supplements or in a combination product.

There are many other good supplements and foods that also decrease chronic inflammation, but the options listed above give you a relatively simple starting place. If you visit Dr. Google, the vast amount of information on treating chronic conditions and inflammation can be overwhelming, so spare yourself the confusion and stress.

Completing four weeks of an elimination/anti-inflammatory diet plus some support supplementation will give you a good idea of how advanced your situation is. If you are making good progress, keep doing what you’re doing, but drop the supplements down to maintenance doses. If you don’t feel better or only marginal improvement, then enlisting some help to dig into the causes may be necessary.