“Autoimmune diseases are genetic. Autoimmune diseases have no known cause. Autoimmune diseases have no cure. The best you can do is manage symptoms.” Have you been diagnosed with an autoimmune disease and been told any of these things? If so, then you’ve been misinformed!
Yes, some autoimmune diseases indeed have a genetic link, meaning an individual can be predisposed, but there is a lot more to the story when it comes to whether or not someone will actually develop the condition. While medical professionals are generally knowledgeable and well-meaning, they often simply do not keep up with the research on a particular topic – find out why many doctors are 17 years behind the current research. Sometimes the science is there in plain sight, but seems to be brushed over or forgotten before it becomes common knowledge or integrated into practice.
By no means do we have all the answers to autoimmune diseases yet, but science has certainly made advancements in pinpointing some of the major triggers. For example, underlying infections have appeared in the literature many times over the course of the last few decades in relation to various autoimmune diseases, including multiple Sclerosis (MS) and celiac sprue.
Possibly the most well-known infection-autoimmune connection is multiple sclerosis and viruses. Anti-viral medications have been shown to be very effective in the management of MS, which is a neurodegenerative autoimmune disease affecting the central nervous system. MS has been linked to the presence of several viruses that affect the central nervous system – particularly human herpesvirus 6 (HHV6). Several studies have shown a direct association between the two, including one which found the virus in the nervous system tissue of 73% of MS patients and in 54% of blood samples, as opposed to 0% in the nervous system and blood of healthy controls. Additionally, Borrelia burgdorferi (the bacteria that causes Lyme disease) has also been found in a high percentage of MS patients. One study showed 38% infection rate and another 20% although due to limitations of testing, this number is likely even higher. Other viral and bacterial infections, such as Epstein barr virus (EBV), mycoplasma, and Chlamydia pneumonia have also been associated with MS.
Enteropathogens (gut infections) are another area of interest in autoimmune disease and other chronic digestive disorders. Interestingly, the parasite Giardia lamblia has been shown to be related to the development of celiac disease (autoimmune response to the ingestion of the dietary proteins, gluten and gliadin) since as early as the 1940s. And yet curiously, this rarely gets attention in the media or amongst gastroenterologists who are treating celiac patients. A private medical practice in Los Angeles, California conducted a study between the years 2000 and 2013 to investigate this link further. The researchers took stool and saliva samples from 1336 patients complaining of nonspecific gastrointestinal symptoms and tested them for various types of gut pathogens as well as blood markers for celiac disease. Almost half of the subjects tested positive for at least one infection, while 13% tested positive for four or more! The most common infections were T. gondii and E. histolytica/dispar (parasites) and also H. pylori (gram negative bacteria). A high percentage of subjects who tested positive to gliadin (one of the diagnostic markers for celiac disease) also tested positive for enteropathogens.
In a separate study, patients with both Cryptosporidium parvum (parasitic infection) and elevated gliadin antibodies actually saw resolution of digestive problems and normalization of celiac markers after 2 weeks of antiparasitic treatment. In the LA study, function of the hypothalamus pituitary adrenal (HPA) axis was also measured using 24-hour cortisol, DHEA, and melatonin levels. Patients with gut pathogens inevitably demonstrated dysfunction of the HPA axis in addition to digestive distress. This makes sense since HPA axis dysfunction, which results in disturbances of sex and stress hormones, has been linked to autoimmune disease as well. Perhaps this aspect of autoimmune disease would resolve if gut infections were properly diagnosed and treated as part of standard of care?
Although we still may be pretty far off from a more integrated and whole-body approach being the standard of care for autoimmune diseases, there are practitioners who are already addressing chronic disease from this perspective. If you have been diagnosed with an autoimmune disease, you will want to find a healthcare practitioner who is willing to address all the underlying factors, including infections and HPA axis dysfunction. You can also help to educate others, including your current health care providers, regarding research on infections and their role in the various autoimmune diseases. While the process of eliminating the infections may not be straightforward, it is certainly a step in the right direction – knowing what you are dealing with is half the battle.
1. Stuppy, W. The Role of Infections in Celiac Disease. Townsend Letter: The Examiner of Alternative Medicine. Aug/Sept. 2014.
2. Holtorf Medical Group. Innovative Treatments of Multiple Sclerosis and other Neurodegenerative Diseases.