Functional Medicine for Autoimmune Conditions

What are autoimmune conditions?

Your immune system protects you from disease and infection by attacking germs, such as viruses and bacteria. If you have an autoimmune disease, your immune system attacks the healthy cells of your organs and tissues by mistake. This can damage or destroy normal tissue, or change how an organ works.^{1, 2}

In an autoimmune disease, the body makes autoantibodies, proteins that target its own healthy tissues by mistake. At the same time, special cells called regulatory T cells fail to do their job of keeping the immune system in line.^{3, 4}

There are more than 80 known types of autoimmune disease, and researchers believe there are between 80 and 150 in all. They can affect almost any part of the body.^{1, 2, 3, 5}

An estimated 8% of people in the United States have an autoimmune disease. Anyone can get one, but women get many types much more often than men. In women, they often start during the childbearing years.^{1, 3, 5}

Some people are at greater risk. Some autoimmune diseases run in families, and if you have one autoimmune disease, you are more likely to get another. Some are more common in certain racial or ethnic groups, or affect them more severely.^{1, 3}

No one is sure why autoimmune diseases happen, but you can't catch them from other people. Certain genes may make some people more likely to get one. In people who have these genes, viruses, certain chemicals or other things in the environment may trigger the disease. Sunlight, chemicals called solvents, and viral and bacterial infections are linked to many autoimmune diseases.^{1, 3}

Here are five autoimmune conditions and the parts of the body they affect:^{2, 4, 6}

• Lupus (systemic lupus erythematosus): can affect many parts of the body, including the skin, joints, heart, lungs, kidneys, blood cells and brain^{4, 3}
• Hashimoto's thyroiditis: the immune system makes antibodies that attack the thyroid, a small gland in the front of the neck. The thyroid can become damaged and unable to make enough thyroid hormones⁶
• Rheumatoid arthritis: the immune system attacks the lining of the joints. It can also attack other parts of the body, such as the lungs and eyes^{3, 1}
• Psoriasis: skin cells multiply too quickly and pile up on the surface, causing scaly, inflamed skin^{4, 3}
• Sjögren's disease: the immune system attacks the glands that make moisture, such as tears and saliva^{4, 3}

Common symptoms of autoimmune conditions

Each autoimmune disease is different, and symptoms depend on the part of the body that is affected.^{1, 2, 3}

Many autoimmune diseases cause redness, swelling, heat and pain, which are signs of inflammation. For many autoimmune diseases, symptoms come and go, or are mild at some times and severe at others. During a flare, symptoms may get severe for a while. Later, you may have a remission, when symptoms get better or go away for a time.^{1, 3}

Other symptoms depend on the disease. For example, Sjögren's can cause dry eyes and a dry mouth. Hashimoto's can cause weight gain and sensitivity to cold. Rheumatoid arthritis causes painful, stiff, swollen joints. Psoriasis can cause thick red patches covered with scales, and lupus can cause a "butterfly" rash across the nose and cheeks.^{3, 6}

Many symptoms of autoimmune diseases can also be caused by other health problems. Common symptoms include:^{1, 2, 3}

• Fatigue (feeling very tired)^{2, 3}
• Fever, which may be low-grade (mild)^{2, 3}
• A general ill feeling (malaise)²
• Joint pain, stiffness or swelling^{2, 7}
• Muscle aches or pain^{1, 7}
• Rash, blisters or changes in skin color^{2, 7}
• Dizziness³
• Swollen glands⁷
• Belly pain⁷

How autoimmune conditions are diagnosed and treated

Autoimmune diseases can be hard to diagnose. There's usually no single test that shows whether you have a certain autoimmune disease. Many of these diseases have similar symptoms. So it can take a long time, and visits to different types of doctors, to get a diagnosis.^{1, 3}

Your health care provider will do a physical exam. Tests that may be done include an antinuclear antibody (ANA) test, other autoantibody tests, a complete blood count and a urine test.²

An ANA test is a blood test that looks for antinuclear antibodies, which attack your own healthy cells. A large number may be a sign of an autoimmune disorder, but an ANA test alone cannot diagnose a specific disease. Many healthy adults may have a positive result, especially women over the age of 65. A negative result makes an autoimmune disorder less likely, but it doesn't completely rule one out.⁷

You can help your doctor by learning about the health conditions in your family and keeping track of your symptoms, including how long they last and what makes them better or worse.^{1, 3}

It can also help to see a specialist who deals with the symptoms that bother you most. For example, a dermatologist (skin doctor) can help with a rash, and a rheumatologist treats arthritis and diseases such as lupus.^{1, 3}

The treatment depends on the disease, how severe it is and your symptoms. Treatment may relieve symptoms, or replace something the body can no longer make on its own, such as thyroid hormone for an underactive thyroid. In most cases, the goal is to suppress (slow down) the immune system and ease swelling, redness and pain from inflammation. Your doctor may prescribe corticosteroids or other medicines. For some diseases, you may need treatment for the rest of your life.^{1, 2, 3}

Most autoimmune diseases are chronic (long-lasting), and many have no known cure. Many can be controlled with treatment. But treatments exist for only some of these diseases, and they don't work for everyone. There is no known way to prevent most autoimmune disorders, and new treatments are being studied all the time.^{2, 3, 5}

Knowing your triggers, following your treatment plan and seeing your doctor regularly can help you prevent flares or keep them from becoming severe.³

How our care fits alongside your rheumatologist or other specialist

Avicenna Functional Medicine does not replace your rheumatologist or other specialist, or the treatment they prescribe. Our role is to add to your care, not to take its place.

In a functional medicine visit, we look at factors that may contribute, such as gut health, environmental exposures and immune regulation, alongside the care you already receive. We also look at stress and sleep.^{3, 5}

Research ties these factors to autoimmune disease. Sunlight, solvents and infections are linked to many autoimmune diseases, and regulatory T cells normally help keep the immune system in line. Stress can trigger flares in some autoimmune diseases, and not getting enough sleep could make stress and symptoms worse. Research also suggests that immune responses to a newly found type of gut bacteria may cause some cases of rheumatoid arthritis.^{3, 5}

Research on these links is still developing. Scientists are still working to understand how the immune system leads to autoimmune disease, and studies of complementary and alternative therapies are limited. There is usually no single test for an autoimmune disease, so any testing we suggest looks for possible contributors. It does not diagnose an autoimmune disease or replace the tests your specialist uses.^{1, 3, 5}

Please do not stop or change any prescribed medication without talking to the doctor who prescribed it. Some complementary products can cause health problems or interfere with how your medicines work, so talk with your doctor before trying one.³

What to expect at Avicenna

All visits are by telehealth, for patients located in Florida and Texas. We are a cash-pay practice, and we accept HSA and FSA. Care usually follows these steps:

• A free, 30-minute discovery call to talk about your health and whether our approach is a good fit for you
• A full intake visit with our health coach, under clinician supervision, covering your history, symptoms, current treatment and goals
• Testing chosen for you, where it is likely to be useful
• A personalized plan, with follow-up visits to review how you are doing and adjust the plan as needed

When to get urgent care

Contact your doctor if you develop symptoms of an autoimmune disease. If you already have one, call your doctor if you think a flare is coming.^{2, 3}

Medicines that suppress the immune system can cause serious side effects, such as a higher risk of infections. If you take one, ask your doctor which signs of infection they want to hear about right away.²

Telehealth visits with our team are not for emergencies. Call 911 right away if you have warning signs of a medical emergency, such as:⁸

• Chest pain or pressure that lasts two minutes or more⁸
• Trouble breathing or shortness of breath⁸
• Sudden confusion, unusual behavior or trouble waking up⁸
• Fainting or passing out⁸
• Sudden dizziness, weakness or changes in vision⁸
• Being unable to speak⁸
• Severe belly pain, or sudden severe pain anywhere in the body⁸
• Coughing up or vomiting blood⁸
• Thoughts of suicide or of harming someone else (you can also call or text 988)⁸