The triad of autoimmune disease—all meet together
Autoimmune diseases have reached epidemic proportions over the last number of years. We are all aware of the well-established “triad” of contributing factors – genetic susceptibility, impaired intestinal permeability, and environmental triggers – but gender has not gotten much attention. The American Autoimmune Related Diseases Association (AARDA) states on their website that of the 50 million Americans living and coping with more than 100 serious, chronic illnesses that have autoimmunity as their underlying cause, more than 75 percent of them are women. In some disease states, it is a 10:1 ratio of women to men. Autoimmune diseases have been cited in the top ten leading causes of death among women younger than 65 years. Moreover, these diseases represent the fourth largest cause of disability among women in the United States.
Component #1: Genetics. With regards to the three components of the triad of autoimmunity, genetics of course is the one component that can’t be modified. This is the reason why it cannot use the word “cure” when talking about treating these conditions naturally. So when talking about restoring one’s health back to normal, or reversing the autoimmune component, the goal is to get the person into a state of remission, and after this has been accomplished the next goal is to help them maintain a state of wellness.
But since the genetic component can’t be modified, you might wonder how it’s possible to get someone into a state of remission AND to help them maintain their health. Perhaps this can best be explained by looking at a different autoimmune condition such as Celiac disease. With Celiac disease, the autoimmune trigger is gluten. If someone with Celiac disease completely avoids gluten, then they may will remain in remission from this autoimmune condition on a permanent basis. This is true even though nothing can be done to change the genetics associated with Celiac disease.
Sticking with the example of Celiac disease, another thing to keep in mind is that just because someone has a genetic predisposition for Celiac disease doesn’t mean they will develop this condition. In fact, even if someone with the genetic markers for Celiac disease eats gluten, this doesn’t guarantee that they will develop Celiac disease. It’s a similar situation with those people who have Graves’ Disease and Hashimoto’s Thyroiditis. Those with a genetic marker for these conditions, as well as other autoimmune conditions, won’t necessarily develop the specific condition unless they are exposed to an environmental trigger and they also have a leaky gut.
Component #2: Environmental trigger. While having a genetic predisposition seems to be necessary for the development of thyroid autoimmunity, other factors are also necessary, which of course is the basis behind the “triad of autoimmunity”. So in addition to having a genetic predisposition, an environmental trigger is also necessary to cause the development of Graves’ Disease or Hashimoto’s Thyroiditis. Unlike most other autoimmune conditions, with Celiac disease we know that the environmental trigger is gluten. And while it’s not easy for many people to completely avoid gluten, it still is a huge advantage knowing what the specific autoimmune trigger is.
This is what makes it challenging to help people with other types of autoimmune conditions, including Graves’ Disease and Hashimoto’s Thyroiditis. With these conditions the environmental trigger can differ from person to person. The following are just a few examples of environmental triggers of thyroid autoimmunity:
- Foods (i.e. gluten)
- Bacterial Infections (i.e. H. Pylori)
- Viral infections (i.e. Epstein Barr)
- Parasites (i.e. Blastocystic Hominis)
- Environmental toxins (i.e. mercury)
So how do you find the environmental trigger? This can be challenging, but it’s usually accomplished through a combination of a good health history and the appropriate testing. Stress was a big factor in the development of autoimmune disease. And this can be verified through an adrenal saliva test. And while stress is a big factor with many others with autoimmune thyroid conditions, some people have other triggers.
Sometimes the person will test positive for multiple triggers. For example, someone might choose to get an adrenal saliva test along with a comprehensive stool panel, and the results of the two tests reveal compromised adrenals and multiple infections. Of course it is possible that only one of these factors was the “true” environmental trigger, but it’s challenging to know which is the primary trigger, and of course either way the goal should be to address all of these imbalances. In other words, if someone has both adrenal problems and an infection, while it’s possible that dealing with a lot of stress weakened the person’s immune system and led to an infection, which in turn was the autoimmune trigger, the goal should be not only to eradicate the infection, but to help the person improve the health of their adrenals.
Component #3: Leaky gut. Pioneering researcher and medical doctor Dr. Alessio Fasano published a landmark paper in 2012 detailing the integral link between leaky gut and autoimmune disease. The paper boldly suggests that autoimmune disease cannot exist without leaky gut. Normally, a primary job of the intestines is to block the absorption of larger material. It becomes “leaky” by absorbing bigger proteins than it should allow in the blood. Once in the bloodstream, these materials invite immune reactions. Along the way, the body starts mistaking healthy tissues as enemies too.
This autoimmunity can target any tissue in the body.
- The thyroid? Hashimoto’s or Graves’ thyroiditis.
- The joints? Rheumatoid arthritis.
- The gut? Celiac disease or Ulcerative colitis.
- The pancreas? Type I Diabetes
- Connective tissue? Scleroderma
- Red blood cells? Hemolytic anemia
So while autoimmune diseases are characterized by the types of tissues the body is attacking – these attacks start by leaky gut.
Autoimmunity is an immune problem mediated by gut health. To manage autoimmune disease successfully – fix leaky gut.
In summary, the triad of autoimmunity theorizes that three factors are necessary to develop any autoimmune condition. These include a genetic predisposition, an environmental trigger, and a leaky gut. Although not being able to modify the genetic component is the reason why we can’t cure conditions such as Graves’ Disease and Hashimoto’s Thyroiditis, the expression of our genes can change, and we of course can address the other two components, which can put the person into a state of remission. And it is also is very possible to maintain a state of wellness by having a healthy gut and minimizing your exposure to environmental triggers.