Autoimmune Disorders

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

Autoimmune disorders are both a growing problem worldwide and also a very underdiagnosed problem due to the complexity of the disorders and the wide variety of symptom presentations. Why are these health problems called disorders, rather than diseases or syndromes? This is because the diagnosis refers not to a specific disease but to a much broader problem of systemic general health.

Autoimmune disorders are defined as disturbances of physiological function and/or tissue structures resulting from a combination of genetic propensity and exogenous factors such as the stress from disease, trauma, drugs and environmental toxins. Often these autoimmune disorders are linked to hormonal imbalances and chronic inflammation that stress the immune system and cause improper immune responses, or immune mis-sense. These improper immune responses denote the term autoimmune, meaning that the body is applying immune responses and inflammatory mechanisms not to exogenous invaders of the body, but to the endogenous normal cells and tissues. The various mechanisms by which the immune system could mistake a normal cell for a cell invaded by a pathogen, such as a virus, or for a mutated, or cancerous cell, are still poorly understood due to the complexity of the system.

As could be expected, a person afflicted with an autoimmune disorder often is found to be affected by more than one, and with such a dysfunction in the highly regulated immune responses, other health problems related to immune function and tissue maintenance may also become a problem, such as cancer, cardiovascular disease, and neurodegeneration. Restoring homeostatic immune function is the primary goal when afflicted with autoimmune mis-sense, not just managing symptoms, which is the focus of standard therapy. While the causes of autoimmune disorder are still unclear, research continues to uncover an ever more complex array of factors and pathogens that have evolved ways to evade the complex human immune response and create both immune hypofunction and dysfunction. A more complex, holistic and restorative approach is obviously necessary to treat autoimmune disorder, and allopathic approaches alone have been found to be sorely inadequate. Complementary and Integrative Medicine (CIM) provides the patient with an array of therapies to address a broad array of health concerns in autoimmune disease, integrating with standard pharmaceutical medicines to provide a better quality of life, reducing adverse effects of medication and supporting the underlying health to perhaps achieve a remission of the disorder.

The complex problem of autoimmune disorder requires a more complex solution than taking a single pill. Recent research is finding that while immune suppression may temporarily alleviate symptoms, that long-term outcomes are poor, as the human organism needs to enhance the function of the immune system to correct this disorder, and immune suppressing and steroid medications do not achieve this basic goal. Modern medicine has done little more than try to manage symptoms in these autoimmune disorders to date, but the thoughtful patient understands that something must be done to correct the underlying health, as well as the disorder of the immune system, and take stress off the system by correcting a broad array of health factors, including restoring the Biome to manage the many microbial factors that stress an array of aspects of the complex human immune cascade. In 2015, experts at the U.S. National Cancer Institute Laboratory of Molecular Immunoregulation and the Society for Women's Health Research published a report that stated: "There is emerging literature on the role of the microbiota in the pathogenesis of autoimmune disease, with clear and increasing evidence that changes in the microbiota are associated with some of these diseases" (PMID: 25416067). This, and many other basic health concerns obviously need to be addressed to correct various autoimmune disorders, not just to manage symptoms. As in cancer treatment, even modern medical specialists are finally turning to Complementary and Integrative Medicine (CIM) to help in the total package of effective care.

The NIH (National Institutes of Health) ranks autoimmune disorders as the third largest category of disease in the United States, behind cardiovascular disease and cancer. Worldwide, autoimmune disorder is now ranked as the most common cause of disease. Many believe that this is only the tip of the iceberg, as most autoimmune disorders are subclinical or undiagnosed. This should tell us something important. Namely, that the modern world is putting an incredible amount of stress upon our complex immune responses and that we should all do something to improve our health holistically to prevent this common dysfunction before it manifests as a serious problem.

The most well-known autoimmune disorders are Multiple Sclerosis, Rheumatoid arthritis, Hashimoto's Thyroiditis, Type One Diabetes and Psoriasis. Other disorders are becoming increasingly well-known, unfortunately. These include Angioedema, Vitiligo, Lupus, Scleroderma, Sjogrens, Polymyositis, Dermatomyositis, Graves, Addison's and Cogan's diseases. The list of autoimmune disorders is large, though, and surprisingly includes forms of endometriosus, Coeliac disease, COPD, Guillame-Barre, Myasthenia Gravis, schizophrenia, pernicious anemia, narcolepsy, and idiopathic thrombocytopenic purpura. In fact, many of the growing sets of allergic reactions are classified as autoimmune disorder, and the growing incidence of hypersensitivity disorders is clearly linked, as well as autoinflammatory disorders. Most autoimmune disorders actually begin unseen and asymptomatic, sometimes years before a clinical pattern of symptoms emerges. Allergies, hypersensitivity, and chronic inflammatory states, such as irritable bowel syndrome, often precede the diagnosis of autoimmune disorder. Many autoimmune disorders are secondary to other health problems and diseases. Understanding and prevention of immune missense could be the most important health focus of this century, and new Complementary treatment strategies are vitally important in this overall treatment protocol, and should be integrated into your standard care.

An October 6, 2008 article in the New York Times stated that experts now believe that Sjogren's syndrome is one of the three most common autoimmune disorders in the United States. This vastly underdiagnosed disorder affecting the secretory glands and other tissues, causes dry mouth, eyes, throat, and other membranes, as well as dry skin, tooth decay, trouble swallowing, depression, memory problems, neuropathy, thyroid disorder, and leads to increased incidence of bronchitis, sinusitis, skin rash etc. Patients with Sjogren's face a 44-fold increase in risk of developing lymphoma, a cancer of the lymphatic cells of the immune system. The 3 million patients diagnosed with Sjogren's syndrome in the United States today, 90% women, are believed to be a fraction of the total population afflicted with earlier stages of this disorder. Greater than 50 percent of patients diagnosed with Sjogren's syndrome have acquired this autoimmune disorder secondary to another autoimmune disorder or disorders, often undiagnosed. Modern medicine still takes an average of 6 years to confirm the diagnosis after patients complain of symptoms to their doctor, underscoring the difficulty in properly assessing and treating autoimmune disorders. Modern medicine needs help. This help will come from Integrative and Complementary Medicine, such as Traditional Chinese Medicine (TCM), a medical specialty designed to treat both the symptoms and the underlying homeostatic dysfunction. TCM assesses each patient individually and makes a holistic diagnosis based on its specialized system, as well as a diagnosis based on modern tests and disease paradigms. This thorough and holistic system of diagnosis and assessment allows the physician to create treatment protocols that prevent the progression of autoimmune diseases from their early subclinical stages.

Diagnosis of autoimmune disorder is very problematic. Various tests for antibodies and markers may detect a problem, but in many cases more than half of these tests are negative when the diagnosis is positive, while many subjects in clinical study, with positive tests, still do not present with a clear diagnosis. Sometimes a more invasive test, like a tissue biopsy, must be performed, and often, the doctors must depend completely on signs and symptoms and a diagnosis of exclusion. These tests are rarely ordered, and if the symptoms are unclear, the patient often refuses such invasive tests. As in many systemic disorders, under-diagnosis is often linked to the lack of an effective treatment, as well. If the big pharmaceuticals have not produced a pill for the problem, diagnosis is discouraged, and the insurance companies are reluctant to approve the necessary tests and specialist consults. If the most effective treatment studied lies outside the realm of standard medicine, medical doctors often do not pursue the diagnosis. A wait and see attitude prevails, until the stage of the autoimmune disorder reaches a level where harsh drug therapies are warranted. The drugs used to treat autoimmune disorders are for the most part immune suppressant drugs, which themselves cause many serious health problems. Today, finally, we see a number of rheumatologists incorporating Complementary Medicine into their practice. Patient demand with understanding of their disease will drive even more integration of Complementary Medicine in the years to come.

Autoimmune disorders, and the treatment of autoimmune disorders, presents the patient population with considerable risk of comorbid conditions, sometimes life threatening. A November 26, 2011 online early publication of a large Swedish study of autoimmune disorders and the incidence of pulmonary embolism, or a life-threatening blood clot in the lungs that may lead to stroke or heart attack, as well as lung disease, showed that during the first year following hospitalization for an autoimmune disease, the relative risk of a pulmonary embolism was over 6 times that of the normal population, with increased risk extending for 10 years. This study reviewed over 500,000 patients admitted to hospitals for an autoimmune disorder without a prior history of venous thromboembolism. The findings suggested that the autoimmune disorders most asociated with this high risk of a life-threatening pulmonary embolism were thrombocytopenic purpura, polyarteritis nodosa, polymyositis or dermatomyositis, and systemic lupus erythematosus (Lancet, Nov 26, 2011 doi:10:1016/S0140-6736(11)61306-8; Bengt Zoller MD et al). The exact reasons for increased risk of pulmonary embolism in autoimmune disorders was not made clear, but the fact that the common medications used to treat these disorders, namely synthetic corticosteroids (Prednisone et al), increase the risk of pulmonary embolism dramatically, is the most likely reason for this high risk with hospitalization for these autoimmune disorders, which typically are first treated with a high dosage of prednisone or other synthetic corticosteroid medication. The logical answer to this increased risk of comorbid life-threatening health problems would be to try to reduce the dosage as far as possible of prednisone or other synthetic corticosteroids. This could be achieved easily with integration of Complementary Medicine. The answer to the problem in standard medicine in the United States, though, is to continue with the high dosage of prednisone or other synthetic corticosteroid, and to have the patient take a thoracic CT scan, a high dosage of radiation that comes with considerable long-term risk of cancer, and then to add more problematic pharmaceuticals when signs of lung fibrosis occurs, as well as to prescribe a number of medications to inhibit clotting, a natural mechanism of the body to help repair vascular damage from inflammation. This adherence to a protocol of increased medication risks rather than decreased prescription and integration with Complementary Medicine in the treatment of autoimmune disorders is creating much anxiety in the patient population today, as well as a growing number of medical doctors that specialize in autoimmune or rheumatic diseases.

The integration of Complementary Medicine to achieve better outcomes and quality of life for the patients with autoimmune disorders is a sensible approach. This Integrative Medicine could decrease medication side effects, comorbid risks, and increase quality of life for the patients. Even better, Integrative Medicine can be used to prevent autoimmune disorders, especially when these patients are identified for increased potential risk. As more and more research identifies biochemical and genetic markers for potential risk, and the patterns of ill health associated with increased risk of autoimmune disorder is elucidated, the potential to prevent these disorders, which are increasing in frequency in the population at an alarming rate, is great. For the patient, preventive medicine of a holistic nature is the sensible course of action to address the issues of autoimmune disorders, and if an autoimmune disorder is suspected, prompt care from a Complementary physician may be the key to avoiding a disabling health problem in the future, and progression of the disease mechanisms. The therapies in Traditional Chinese Medicine are for the most part supportive of healthy immune function, modulatory, and safe, not suppressive of normal immune function. This comprehensive treatment stategy has minimal chance of adverse side effects, and is restorative. The possibility that acupuncture, herbal and nutrient medicine will interfere with standard therapy when a knowledgeable Licensed Acupuncturist and herbalist is integrating this protocol is extremely minimal, almost unheard of.

Herbal research is producing promising and safe treatment for autoimmune pathologies. Dr. Frederick Vivino, a rheumatologist at the University of Pennsylvania Medical Center, stated in the aforementioned N.Y. Times article, that "there is a growing interest among pharmaceutical companies in biologic (i.e. herbal-like) remedies that could cause a remission of symptoms." Growing interest in immunomodulation rather than immunosuppression, and research from such prominent institutions as the Harvard Medical School that confirms the effectiveness of herbal chemicals to achieve this immunomodulation, is bringing confidence to patients that integration of Complementary Medicine into their treatment protocol for autoimmune disorders will pay dividends.