Autoimmunity is the process where the immune system mistakes healthy tissue and cells as harmful and proceeds to attack them. There are ways to identify what is causing the autoimmunity through different types of tests.
Can you please begin by explaining what autoimmunity is?
Dr. Greg Olsen: Absolutely. When we start looking at autoimmunity and finding the cause, the first part is understanding what it is. Autoimmunity, breaking it down, involves your immune system. The auto part means that your body’s immune system is attacking your body tissue. That can result in different areas. Sometimes it can be in one area, such as the thyroid and the Hashimoto’s or the pancreas and a type one diabetes. The basic mechanism is, the immune system is malfunctioning. It’s overactive. It’s identified an area in your body to attack and begins attacking it.
What are some examples of common autoimmune diseases?
Dr. Greg Olsen: When we look at autoimmune diseases, it can attack many different tissues in the body. Some of the most common ones, as I mentioned before, Hashimoto’s. Hashimoto’s is the name given to an autoimmune disorder where the body attacks the thyroid. There’s type one diabetes. Type one diabetes is where the body is attacking the pancreatic tissue, effecting insulin production. We can have another common one, rheumatoid arthritis is an autoimmune condition where the body is attacking the joint tissue in the body. There is also autoimmunity where the body can begin attacking brain tissue, cerebellum. It can also attack myelin tissue, which can create other neurological dysfunction. It can attack platelet cells. There are quite a few areas where the body can attack itself, and those are some of the most common ones that I see clinically.
Are some people genetically more prone to autoimmune diseases or disorders, or are there any risk factors?
Dr. Greg Olsen: That’s a very important part to look at, related to autoimmune disorders. The genetic predisposition, I think we’ve all seen or known people who have that autoimmunity connection, and it’s been passed on. There are many areas, health-wise, where genetics can predispose or get passed on to, so you may be at issue for that. When we look at that, a high percentage of the time, we’re really looking at the environmental triggers associated with that, meaning you may have a genetic predisposition to that autoimmune disorder, and if the right things happen, environmentally, it’ll trigger it and allow that to express itself. Very commonly, I will see people who have experienced an autoimmune disorder and they’ll relate that it happened after some big stress or some big event in their life where that immune system triggered, over-activated, and allowed that genetic predisposition or that genetic factor to express itself where that came into being.
Genetic predisposition is a risk factor. Stress is definitely a risk factor. When we look to identify other risk factors, when we look at the mechanism of the autoimmune disorder, the autoimmunity, when we break it down to where it’s coming from, it is typically the body’s immune system is responding to a particular type of tissue, and that tissue has protein or amino acid sequences associated with it. The body doesn’t identify a tissue like we would, saying, hey, there’s thyroid tissue, hey, there’s cerebella tissue, hey, there’s myelin tissue, hey, there’s some pancreatic beta cells. It says, hey, is there something similar? I’m supposed to be the guardian of this body. Is there something similar to this substance that came in that I have targeted to attack because it’s foreign? I target it by saying, hey, there’s some proteins that I recognize with it. That’s how I identify it. If these proteins, or a protein or amino acid sequence is similar, then I’m going to go attack it. The risk factors associated with that come into play.
Very commonly, outside of the genetic and stress factors is when we look at intestinal or gastrointestinal function being compromised. That’s where we look at environmental components that can be gluten or gliadin exposure, other cross-reactive foods, other irritants to that intestinal lining. Foods can be a big part to that. In particular when we look at the protein component of gluten, gliadin, there are over 50 different gliadin. Gliadin is a protein sequence, and so typically, that will get passed to the intestines. If the gut is compromised and that can get into the system and the body starts attacking that protein sequence, then it says, okay, well, here’s these other tissues that look like that, and it can begin attacking them. Those are some of the key risk factors associated with autoimmune diseases and disorders.
What are some of the potential causes of autoimmunity that researchers have debated?
Dr. Greg Olsen: We look at the history of autoimmunity. That’s been looked at a number of factors over time, everything from strictly genetic predisposition, there’s nothing you can do about it, to bacterial infections, to most recently looking at the underlying mechanism of why is the immune system targeting or triggering the way that it is? When we can look at a particular person or situation and identify that the environmental component is a part that’s more identified with it as the cause, then we can associate or look at that component as that’s really where the triggering is. We have some autoimmune disorders that truly do have more of a genetic component to it. When we look at, what is the potential cause, it really has to be looked at, individually, which autoimmune disorder. There are some basic underlying mechanisms that understanding how the immune system works, but you can’t just take one area out and say this is the sole cause, and this is the sole cause, in the entire spectrum of autoimmune disorders.
What type of testing can be done to try to determine the cause of someone’s autoimmunity?
Dr. Greg Olsen: Well, it is very important to do the right type of testing. Most often, when we’re looking at identifying a cause of somebody’s autoimmunity, we want to look at how that immune system is working. We want to look at how that GI tract is working or intestinal tract is working.
A couple of key tests that I look at and determine that, one is, we call mucosal integrity test. That’s a test where we can identify is that area in the intestine, that junction is called a tight junction, is it compromised? Do we see antibodies related to that being attacked? Are we getting substances through there? Number one is looking at the mucosal integrity or if there’s a leaky gut situation allowing this environmental triggering of substances passing through the intestines to go in and trigger the immune system.
Secondly is looking at testing to identify environmentally, are we looking at these different types of foods? We have detailed gluten or gliadin testing. My preferred one is through a lab called Cyrex Labs. It really is a, clinically, for me, it’s the gold standard as far as identifying the relationship to gluten or gliadin in that, and then also looking at the next step with that is looking at the cross-reactive food patterns. Some people will go to get the identification of an autoimmunity and start to avoid gluten and shift over to these certain other foods that are very common, but it’s also been found that many of those foods that people would shift over to once they’ve avoided gluten are common cross-reactors for people who have gluten or gliadin immune problems.
So, first step, mucosal integrity, second step, looking and identifying food triggers. Third step in the process, many times, is identifying, is this autoimmunity limited to one area, such as the thyroid or the pancreas? Or is it a multi-system involvement? That is also a test I do with Cyrex Labs where they can test and identify for multi-organ involvements, multi-tissue involvement with regard to the autoimmunity.
Next step beyond that, because almost every time I identify with that we see that there is a stress involvement with it, is evaluating a person’s stress, stress response. That can be identified, testing-wise, through testing stress response evaluation or another test, we call an adrenal stress index. Those are to identify those areas.
Also, testing that is just a general blood test to see how the different systems in the body are working, including what’s called C-reactive protein, which measures inflammation in the body. It is not diagnostic for autoimmunity, but if there is inflammation, it’s a way of giving a bit of a measure with it, meaning if the body is being attacked and there’s an inflammatory response, we can use that to monitor one of the factors through monitoring how we’re doing in the recovery process.
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