What’s Wrong with How Autoimmune Disease is Treated

As I write this, in my office at Root Cause Medical Clinic, we are just concluding the week-long Gluten eSummit, a first of its kind free event that involves researchers from all over the world, all experts in the field of gluten. The Summit’s creator and the host is a dear friend, Dr. Tom O’Bryan. If you’ve ever attended one of my Gluten Sensitivity & Celiac Forums, or watched a DVD from one, you’ve had the pleasure of watching Dr. O’Bryan lecture.

In this post, I wanted to share with you my ‘take’ on one of the interviews at the Summit because it addresses a set of diseases that I feel very, very strongly about – Autoimmune Diseases. I blog about autoimmune often and have several YouTube videos on the topic as well. Yet, we need to continue to discuss this condition that manifests itself in over 100 different diseases, including celiac disease, because it is on the rise.

Currently, after heart disease and cancer, autoimmune diseases are the 3rd leading cause of death in this country. Autoimmune incidence is not only increasing rapidly, but the rationale and protocols utilized in our medical community really miss the mark in my opinion – and my opinion, I am happy to share, is echoed not only by Dr. O’Bryan but his guest Dr. Aristo Vodjani, a world-renown immunologist.

Obviously, if anyone should understand the inner workings of the immune system and why it would attack the human body (the definition of autoimmune disease), it would be Dr. Vodjani.

If You Want the Right Answer, You Have to Ask the Right Question

It’s important to understand that there are several aspects to the immune system. Dr. O’Bryan likens them to the various arms of our military – the Army, Navy, Air Force, and Marines. In his analogy, he points out that if the country needs to handle a problem in the sea, calling the Army is likely not the best strategy. Similarly, when looking for why the immune system is out of control, one needs to understand that there is more than one ‘branch’, just like in our military.

In other words, a practical example here, if you feel that you are having a reaction to gluten and you visit your doctor and he performs an ‘allergy’ test, when the result is negative for ‘wheat’ does that tell you anything? Well, if it was a Scratch Test it tells you absolutely nothing (more on that in a moment), and if it’s a blood test all it means is that you don’t have an allergy to wheat. It doesn't tell you if you have celiac disease and it doesn’t tell you if you are gluten sensitive, which is what you wanted to know.

Sadly this happens every day, to who knows how many suffering individuals. A patient is told that they don’t have an allergy when they wanted to know if they were reacting negatively to something they ate. It is two different questions!

You contacted the Army when it was an Air Force problem – see how that analogy works?

To be precise, immunologically speaking, an allergy creates an IgE response (an immediate, fast, and sometimes life-threatening response – think peanut allergies), while a sensitivity creates an IgA, IgG, or IgM response (a delayed response that can take anywhere from days to weeks to develop).

You need to ask the body the right question to get the right answer. And sometimes you may need to ask that question in a few different ways to truly get the correct answer.

Scratch Tests are NOT Accurate for Food Reactions

Let’s get back to the scratch test (skin test) remark I made earlier: The scratch test has been around for 120 years. It is mostly accurate, but not for food reactions. Use it only for inhalant type allergies – mold, plants, etc. For true allergy food results, use blood.

Please spread the word on this one; too many allergists, who are set in their ways, convince their patients that these tests are accurate for food reactions when they are not. It’s not normal to react negatively to food. But when it does happen, the immune response occurs in the gut, and the specific piece of the immune system reacting is called IgA (think Army). What should occur is that IgA destroys the offending food and ensures that it is excreted without ever entering the bloodstream from the gut.

Unfortunately, when an offending food(s) continues to be ingested, the site of the battle with IgA is on the lining of the small intestine. The inflammation that occurs as a result of that battle causes the tight junctions between the cells to open up, creating a leaky gut.

Now we have trouble because the offending food is no longer contained within the confines of the gut. The leaky gut allows it to escape out into the bloodstream where it can come in contact with other parts of the immune system – think Navy and Marines. More correctly named IgG and IgM.

When the immune system of the bloodstream gets involved we now can enter the arena of autoimmune disease. Why?

How Autoimmune Disease Develops

The ‘bad guy’ (let’s say gluten) gets out into the blood and the immune system reacts. The combination of the ‘bad guy’ and IgG or IgM in the bloodstream initiates something called the ‘complement cascade’ which binds itself to the aforementioned duo.

This complex that is now formed is, according to Dr. Vodjani, the MOST pathogenic (meaning disease-causing) and inflammatory (also leading to disease) molecule in the human body. This is profound. Just read that prior sentence again – “the MOST pathogenic and inflammatory molecule in the human body”.

[And by the way, an ‘Aha!’ moment for me came when Dr. Vodjani said that the ‘lag time’ between eating a food and having a reaction in the bloodstream could be as long as 1 to 2 weeks! I had always thought more in the range of 4 days. So that was a learning pearl for myself and the other doctors here at Root Cause Medical Clinic.]

This complement is the trigger for autoimmune disease. The immune system ‘sees’ the bad guy (e.g. gluten, dairy, etc) but sadly the bad guy ‘looks’ a lot like cells the thyroid, or joints, or brain.

This result is confusion, and the immune system begins to attack the cells of the body because they ‘looked like’ the bad guy.

We Have More Control Over Autoimmune Than You’d Think

Fortunately, the autoimmune disease takes many years to develop. I say fortunately because the best time to stop it is before it has developed into a full-blown autoimmune disease. Dr. Vodjani calls it autoimmune ‘reactivity’, this early stage. How do we stop it?

We simply remove the initiator or trigger from the environment – which in many cases is gluten. But regardless of what the trigger is, you must remove it and you must remove it permanently. Does this work? I say ‘yes’, but so does Dr. Vodjani and Dr. O’Bryan.

Dr. O’Bryan mentioned that not only does removing the trigger reverse autoimmune disease in its early ‘reactive’ stage, but it also has been seen to reverse it in its active full-blown stage. We too have seen that here in our medical and clinical nutrition departments at Root Cause.

The 64 million dollar question is: How do we identify the trigger? It’s not hard actually. We have great tests at our disposal.

Follow These Steps

Here’s all we need to do to prevent and detect many autoimmune diseases:

1. Isolate triggers the immune system. This involves testing. Remember ALL the armed forces… When we test here at Root Cause, we use comprehensive blood tests that look at immune system reactions across the board, not just IgE or IgA.
2. Realize that gluten isn’t the only potential food trigger, so look for others. There is excellent cross-reactive foods blood test that looks at many food triggers.
3. Find out if you are already in the autoimmune reactivity zone – meaning early changes have already occurred that will lead to autoimmune disease. How? We have a blood test for this too. I’ll warn you that this is a newer test on the market and ‘new’ often means pricey and this one is, but that’s its only downside. Otherwise, it’s brilliant – how wonderful to see early autoimmune tendencies before they become a full-blown disease.
4. Prevent further triggers from assaulting the immune system by healing the leaky gut. Wondering if you have a leaky gut? Yes, we have a test for that. But we often ‘save’ that test for later on in care to determine if we have successfully healed the gut. Often times doing it early on in care can be a waste of funds when it’s pretty obvious someone is suffering from a leaky gut.
5. Get ready to be disciplined! One thing Dr. Vodjani made perfectly clear that I completely agree with, and you’ve heard me say it before – Cheating is a no-no. Eliminating these triggers must be a zero-tolerance policy.

A Little Message to Dietary Cheaters…

By the way, have you ever cheated and not ‘felt’ it and then thought maybe a little cheating was okay? Dr. Vodjani explained why that occurs.

If you used to get headaches let’s say when you ate gluten and these headaches went away when you embarked on a gluten-free diet, cheating, either intentionally or inadvertently, doesn’t necessarily mean that you’ll gain experience headaches. Better for you if it did, or at least if some symptom occurred that caused you some pain and discomfort because then you’d be less inclined to cheat.

Sadly, for many people, their ‘reaction’ is a silent one. Gluten can destroy your brain cells, as an example, and you can’t feel that happening. Gluten can cause a lot of destruction inside your better that you are unable to feel until it’s too late and you have a serious disease.

As Dr. O’Bryan put it, Alzheimer’s isn’t a disease of 50 and 60-year-olds. It begins in the 20s and 30s; it just takes 30 years or so of brain cells being destroyed before you manifest overt symptoms of the disease and finally receive a diagnosis. The key is that we don’t want to wait for the diagnosis, we want to be pro-active.

As we talked about earlier, autoimmune disease is the 3rd leading cause of death and its incidence is increasing dramatically every year. We know that the trigger is environmental and we now understand how to isolate these triggers.

Finding the Triggers Is the Real Key to Prevention and Treatment

That’s pretty exciting actually. It would be a truly wonderful thing to reverse this disease incidence. Are you thinking that it’s all genetic? Remember, having the genes for a disease doesn’t mean that you’ll manifest it… thankfully.

Having the genes doesn’t require you to develop a specific disease, it simply means that you are predisposed. Forty percent of the population has the genes for celiac disease. While the incidence of the disease is on the rise, it’s not forty percent. So don’t ‘fall for’ the idea that it’s all genetics, it isn’t. And that isn’t solely my opinion, again I have a very good company amongst world-renowned researchers, such as Dr. Vodjani and Dr. Fasano.

The takeaway from the interview and the one I’d like to impart is that we have at our disposal the ability to make great inroads in detecting, preventing, and treating autoimmune disease, something our planet is in great need of – certainly something our country is in great need of. I hope you found this informative. The human immune system is an amazing but complex system. I endeavored to simplify its a better understanding of how autoimmune disease develops.