Possible Causes of Autoimmune Diseases
Autoimmune diseases have been on the rise and it is more prevalent in modern industrialized nations than in developing countries. According to one article, 8% of the population is affected by autoimmune disease with 78% of them being women. The article has a graph of the gender different in prevalence for some of the various autoimmune diseases. With ulcerative colitis the incidence is the same for men and women. Type 1 diabetes and myocarditis are two of the autoimmune diseases that appear more often in men than women.
Autoimmune diseases include allergies, hay fever, asthma, Celiac disease, rheumatoid arthritis, lupus, Graves' disease, multiple sclerosis, and others. Then there are other diseases that have a suspected link to autoimmunity. These include irritable bowel syndrome (IBS), fibromyalgia, and others. You can see a longer list of autoimmune diseases on Wikipedia.
The root of the problem is a runaway inflammation initiated by your body's own immune system. Autoimmune disease is when the body's immune system makes mistakes and attack the body's healthy tissue instead of foreign invaders. Rheumatoid arthritis is when the immune system attacks the joints. Graves' disease is when the immune system attacks the thyroid. Crohn's disease is when the immune system attacks the gut. Celiac disease is when the immune system attacks the small intestine. Multiple sclerosis is when the immune system attacks the nervous system. Lupus is a systemic immune response resulting in chronic systemic inflammation.
The risk of autoimmune diseases is higher in modern societies and increases with age. If you are a middle-aged adult living in a modern country, it is likely that you know someone with an autoimmune disease. For example, in America, autoimmune disease as a group affects 5 to 8 percent of Americans. After cardiovascular disease and cancer, it (as a group) is the third most common category of disease in industrialized countries. In developing countries, allergies and autoimmunity are much less common.[6: page 188]
More woman suffers from autoimmune diseases than men. Three quarters of suffers are women. Some suspected reasons may be genetics, sex hormones, and that women have more sophisticated immune systems with elevated antibody responses.
Due to the vague and varied symptoms of autoimmune diseases, some patients may see on average six doctors before getting a correct diagnosis.
There are often three characteristic things that leads to autoimmune disease: genetic susceptibility environmental or food trigger, and excessive intestinal permeability.
Book: "The Autoimmune Epidemic"
Autoimmune Diseases on the Rise
In the last few decades, autoimmune disease have tripled in the United States, affecting as much as 24 million Americans.
Allergies of all types (including food allergies) are on the rise in developed countries including the United States. Asthma in the United States is up 7.7% from what it was in 2005. Lupus tripled over the past four decades.
In 1988 to 1994, about 54% of Americans are sensitive to one or more allergy-inducing substance. This is rate is 2 to 5 times higher than what it was back in the late 1970s.
Increases in autoimmune diseases are not just happening in the United States, but in other industrialized nations as well.
A paper from the Academy of Science, Paris France says ...
"Western countries are being confronted with a disturbing increase in the incidence of most immune disorders, including autoimmune and allergic diseases."
A website in the UK about type I diabetes states that its incidence is increasing about 4% each year.
What Causes Autoimmune Diseases?
The truth is that if a particular person is diagnosed with an autoimmune condition and asks the doctor as to what caused it, the doctor will probably say, "we do not know at this time". We can not know the cause for any particular case. We only have theories as to the various factors that increases risk. And likely a particular case is caused by a combination of factor plus a combination of triggers.
Autoimmune diseases are a dysregulation or imbalance in the body's immune system whereby the immune system attacks the body's own cells. It is as if the immune system is confused as to which agents are friend or foe.
The details of what exactly causes autoimmune disease is not fully known. The following are only hypothesis of possible causes. It may or may not be the actual cause for any particular autoimmune condition. Also keep in mind that not all studies indicate a conclusive result. There often may very well be conflicting studies that reach different conclusions.
With that said, autoimmune disease is believed to be caused by a combination of genetic predisposition and environmental factors.
Taking the autoimmune disease celiac disease as an example. People who do not have a certain set of gene type will never get celiac disease. However just because you have that certain set of genes, it only means that you have a predisposition to it. It does not necessarily mean that you will get celiac disease. [reference]
Taking autoimmune diseases as a group, genetics plays only 30% role. The rest is environmental factors. What environmental factors are involved?
Dr. Mark Hyman summarized it well on page 188 of his book The UltraMind Solution where he says ....
"We are becoming hypersensitive to our environments, perhaps because we live in an oversterilized environment and our immune systems don't mature properly. Or because we are eating hybridized and genetically modified (GMO) foods full of antibiotics, hormones, pesticides, and additives that were unknown to our immune systems just a generation or two ago."
Dr. Hyman also wrote the forward to the book The Immune System Recovery Plan which he says ...
"...the root causes of almost all autoimmune disease are the same: microbes, environmental toxins, allergens, stress, and poor diet."
By the way, anyone with any autoimmune condition should get the book The Immune System Recovery Plan: A Doctor's 4-Step Program to Treat Autoimmune Disease by Dr. Susan Blum. Her four steps are ...
- Using food as medicine
- Understanding the stress connection
- Healing your gut
- Supporting your liver
In the book, she writes ...
"The bottom line is that dysbiosis can trigger or promote an autoimmune disease because the lack of healthy flora and the influence of harmful flora cause the immune system to malfunction." [page 187]
In another book Why Do I Still Have Thyroid Symptoms? When My Lab Tests are Normal, Datis Kharrazian writes ...
"I suspect the weakening of the immune barriers, such as the lining of the digestive tract, respiratory tract, and the blood-brain barrier, is a big factor." [page 46]
Understanding Autoimmune Disease
Nikolas Hedberg presented a Hawthorn University webinair which you can watch in the video on the right. He also writes about the causes of autoimmune thyroid disease on his site.
Autoimmune disease can be triggered by different causes, some of which are mercury toxicity, gluten sensitivity, intestinal permeability ("leaky gut syndrome"), and infections. The same autoimmune disease could have been triggered differently for different individuals.
Mercury binds to proteins in the body and changes its shape. The immune system now sees these as foreign and launches an immune response. Leaky gut allows peptides, and partially digested foodstuff, and toxins through the intestinal membrane when it is not supposed to. This too initiates an immune response.
Book: "What Your Doctor May Not Tell You About Autoimmune Disorders"
Environmental Toxins and autoimmune diseases
Many animal studies have shown that pesticides can alter their immune system. In humans, epidemiological studies in Canada and Soviet Union find that children and adults exposed to pesticide exhibit immune system alterations.
Paper by DeLisa Fairweather of John Hopkins University writes ...
"Any number of environmental agents present in our diet, such as chemical food additives or pesticides, could interfere with regulation of the immune response contributing to the development of autoimmune disease in genetically susceptible individuals."
The average person eat take in about gallon of neurotoxic pesticides and herbicides each year.[The UltraMind Solution]
From the book "What Your Doctor May Not Tell You About Autoimmune Disorders" it says ...
"More and more researchers and physicians are recognizing that heavy metals and chemicals that are present in our everyday environment ... are at the core of the increase in the number of people who are affected by autoimmune disorders."
and the author believes that for chronic fatigue and immune dysfunction syndrome ...
"environmental factors such as heavy metals and chemicals can be at root of this disease process ... Toxins such as mercury, lead, formaldehyde, aluminum, and pesticides cause immune system dysregulation and excessive oxidative stress, or directly damage the cells themselves..."
Dr Mark Hyman writes on Huffingtonpost that environmental toxins may be a major factor in autoimmune diseases and provides some tips for addressing autoimmune disease.
One can reduce one's risk of autoimmune disease by reducing exposures to toxins like mercury, pesticides, and chemicals by buying organic. And also watch out for food sensitivities like gluten and casein.
Intolerances to Dairy and Gluten
Many people are intolerant to dairy and gluten and do not even know it. When you are intolerant to these foods and continue to eat them, it results in inflammation that is characteristic of autoimmune disease.
The autoimmune disease known as Celiac disease is when the person is intolerant to gluten. Gluten is a protein in foods processed from wheat, barley, and rye. Durum, semonlia, spelt, kamut, and faro are forms of wheat and need to be avoided. Typical bread and pasta contains gluten. The only way to stop the autoimmune condition for those with celiac disease is to stop eating gluten.
The Examiner cites from Cell. Mol. Life Sci that ...
"Autoimmune disorders occur 10 times more commonly in the gluten sensitive enteropathy celiac disease than in the general population."
Casein is a protein found in cow's milk. There are people who are allergic to casein. Some experts have hypothesis that a babies early exposure to formula cow's milk may be a contributing factor in the development of Type 1 diabetes -- an autoimmune disease where the immune system attacks the beta cells of the pancreas that produces insulin.
Dr. Loren Cordain's paper Cereal Grains: Humanity's Double-Edged Sword writes ...
"Dietary cereal grains are the known environmental causative agent for at least two autoimmune diseases: celiac disease and dermatitis herpetiformis"
The Science of Healing with Dr. Sternberg
Stress and Autoimmune Diseases
Could the increasing stress in our modern society be a contributing factor in autoimmune diseases? Possibility.
Dr. Esther Sternberg is a rheumatologist who specializes in brain-immune interactions and she tells of her story in her DVD about how she got rheumatoid arthritis (which is an autoimmune disease) after a period of immense stress in her life. And she tells how de-stressing in the relaxing Mediterranean helped her recover.
That is also why we hear anecdotal evidence that rheumatoid arthritis can exacerbate the symptoms.
The book The Autoimmune Epidemic tells how our stress hormone cortisol can affect our immune system ...
"Prolonged levels of heightened cortisol can not only lead to underfunctioning immune reaction, but can also indirectly stimulate an autoimmune response."
Learn more about how stress makes us sick.
Low Vitamin D Associated with Autoimmune Diseases
"There is now biologic evidence to back up the belief that vitamin D may protect against autoimmune diseases and certain cancers."
Vitamin D plays a role in the regulatory T-Cells of the immune system.
The study article Vitamin D supplementation and regulatory T cells in apparently healthy subjects: vitamin D treatment for autoimmune diseases? says that vitamin D supplementation results in significant increase and that ...
"Epidemiological data show significant associations of vitamin D deficiency and autoimmune diseases. Vitamin D may prevent autoimmunity by stimulating naturally occurring regulatory T cells."
Another publication writes ...
"The active form of vitamin D produces and maintains self immunologic tolerance, some studies show that 1,25(OH)2D inhibits induction of disease in autoimmune encephalomyelitis, thyroiditis, type-1 diabetes mellitus, inflammatory bowel disease (IBD), systemic lupus erythematosus, and collagen-induced arthritis and Lyme arthritis."
Another paper says that "Dysregulation of the vitamin D nuclear receptor may contribute to the higher prevalence of some autoimmune diseases in women".
The book Why Do I Still Have Thyroid Symptoms? When My Lab Tests are Normal writes ...
"Vitamin D appears to help again autoimmune-mediated thyroid dysfunction. Vitamin D appears to be helpful for autoimmune-induced diabetes. Numerous papers have been published linking autoimmune disease to vitamin D deficiency." [page 205]
Autoimmune caused by pathogens
Some believe that for certain autoimmune cases, micro-organisms such as bacteria or virus may have initiated a change in the body's immune system of those person who are genetically susceptible so that the immune system is no able to discern accurately healthy tissue from antigen.
There are animal models showing that infections can induce autoimmune disease. Here is chart of infections in humans that are associated with autoimmune diseases.
There is the article ...
Waterhouse, J. C., Perez, T. H. and Albert, P. J. (2009), Reversing Bacteria-induced Vitamin D Receptor Dysfunction Is Key to Autoimmune Disease. Annals of the New York Academy of Sciences, 1173: 757–765. doi: 10.1111/j.1749-6632.2009.04637.x
which says that low levels of vitamin D may be due to ...
"chronic infection with intracellular bacteria that dysregulate vitamin D metabolism by causing vitamin D receptor (VDR) dysfunction within phagocytes. The VDR dysfunction causes a decline in innate immune function that causes susceptibility to additional infections that contribute to disease progression. Evidence has been accumulating that indicates that a number of autoimmune diseases can be reversed by gradually restoring VDR function with the VDR agonist olmesartan and subinhibitory dosages of certain bacteriostatic antibiotics. ... Disease reversal using this approach requires limitation of vitamin D in order to avoid contributing to dysfunction of nuclear receptors and subsequent negative consequences for immune and endocrine function." [from abstract]
Infectious agent can activate autoreactive T cells that leads to autoimmune diseases. The Journal of Clinical Investigation has article explaining this mechanism.
Wikipedia has a list of diseases associated with infections. And one can see that many of the diseases listed are autoimmune in nature. For example, autoimmune thyroid disease is associated with Epstein-Barr virus and Helicobacter pylori.
And then there is the journal article titled Viruses can silently prime for and trigger central nervous system autoimmune disease.
Chris Kresser Revolution Health Radio podcast mentions ...
"... there’s really no consensus on what causes autoimmune disease, and identifying the underlying cause of a problem is always the most important step in figuring out how to treat it. My take on autoimmunity is that it’s multifactorial and there’s more than one cause, as is the case with most diseases. But I think infection is probably one of the main causes of autoimmunity, and it could be an infection that comes and goes and it’s sufficient to dysregulate the immune system and throw it out of balance and create an autoimmune condition..."
Page 329 of the book Digestive Wellness 4th Edition has a chart of various autoimmune diseases and the viruses associated with them. In the same book, it writes ...
"Selenium, magnesium, and zinc deficiencies have been associated with autoimmune diseases; low vitamin D levels are also seen in autoimmune conditions with frequency." [page 331]
GMO and Autoimmune Diseases
Most of America's corn, soy, and sugar beets are genetically modified (known as GMO). It has been suggested that GMO causes leaky gut which can then lead to food allergies and autoimmune diseases. There are anecdotal suggestions that these GMO's when consumed increases allergic reactions and inflammation which can lead to autoimmune diseases.
Some GMO crops can produce their own pesticides, which we can not wash off. And other crops are made more resistant to pesticides, which results in greater amount of pesticide spraying. As mentioned previous, there is link between pesticides and autoimmune diseases.
If you want to know the dangers of GMO, watch the documentary Genetic Roulette by Jeffrey Smith and Dr. Mercola's interview of Dr. Huber.
You can hear more on an podcast found on BlogTalkRadio.
One of the producers of GMO is Monsanto. Article on Friday Harbor Holistic Health writes ...
"The research team at the Walter and Eliza Hall Institute of Medical Research in Australia identified three proteins present in grains patented by Monsanto as disruptive to metabolic pathways, and as interfering with nearly all systems of the human body, generating inflammation and immune dysfunction."
Jeffrey Smith speaks out against GMO foods. In a full-length video, he talks about how consumption of genetically modified foods affect health.
Tips for a Robust Immune System
To get a better understanding of the link between infections and autoimmune diseases, watch Nikolas R. Hedberg's lecture in the video on the right. In on of his slides, he mentions that
"chronic autoimmune diseases should be screened for infections".
Although most people are carriers of some pathogens, the disease does not express itself unless the immune system is overtaxed or compromised. The latter part of the lectures, he gives some tips on how to support a robust immune system which includes ...
- Eat alkaline-forming diet.
- Adequate magnesium and potassium.
- Adequate proteins
- Reduce sugar and carbohydrates
- Consume probiotic foods
- Kefir, yogurt (if dairy tolerant)
- seaweed for iodine
Can Autism be possibly be an Autoimmune Disease?
Some people suggest that there might even be a link between autism spectrum disorders (ASD) and autoimmunity.
USAToday reports in 2010 that there is a higher risk of autism when there is a family history of autoimmune disease. Possibly the same genes that predisposes an individual to autoimmune disease is also involved in autism.
Paper by Kevin Becker notes some similarities between autism and asthma and suggests that there is a shared mechanism between the two ...
"shared observations between autism and inflammatory disorders are used in support of the development of a hypothesis for the apparent rise in the prevalence of autism using the framework of the immune hygiene hypotheses."
Like asthma, autism is higher in urban than in rural environments. But then that could be due to other factors such as higher mercury and chemicals in urban environments. There is a great deal of individuality based on genetic pre-disposition. One person may be able to tolerate a larger amount of mercury without getting sick. Another individual with certain genetic disposition may come down with an autoimmune disease like autism with just a tiny exposure -- perhaps as little as the amount of mercury in the thimerosal preservative in vaccines. Because it is such a controversial issue, we are not saying one way or the other that vaccines causes autism. And no one really knows. For more info on vaccines and autism.
Like other autoimmune disease, autism rate have increased across the United States. Part of this could be due to changes in the definition of autism as well as greater awareness for testing of it. However, this is not enough to explain the large increase.
Like other autoimmune diseases, many believed that autism is due to a combination of genetic and environmental factors. There are other that suggests it could be related to the age of the parents during the child's conception as well as the mother's gut flora health.
Autistics have poor gut flora, inflammed and leaky gut, and poor digestion (many of the same characteristics seen in other autoimmune diseases). Dr. Natasha Campbell-McBride says that autism is primarily a digestive disorder [reference]. She has an autistic child that she cured with the GAPS diet that she pioneered.
Homocysteine and Autoimmune Disease
The book The Heart Revolution writes ...
"Homocysteine may also play a role in autoimmune diseases" [page 185]
Some study have found that a lot of patients with autoimmune diseases have high homocysteine. That does not necessarily mean that high homocysteine causes autoimmune diseases, but there might be some link between the two.
The Hygiene Hypothesis
The hygiene hypothesis is that our childhood environment is "too clean". The theory is that an overly clean childhood environment does not allow the immune system to build up full strength is the idea of the hygiene hypothesis.
Dr. Peter Green writes that ...
"an exposure to infections and unhygienic conditions early in life somehow conveys protection against the development of allergies." [from book Celiac Disease: A Hidden Epidemic]
That would also explain why autoimmunity is rare in developing countries. You can see other examples of that support the hygiene hypothesis in article linked here.
Not everyone believes in the hygiene hypothesis. Personally, I do not think the hygiene hypothesis is a big factor in autoimmune disease. Paul Jaminet is also not a strong believer in the hygiene hypothesis as mentioned in a podcast.
And here is an interesting Op-Ed on the Hygiene Hypothesis and Farmer's Market on the New York Times.
Article updated February 2012 and is only opinion at the time of writing. Author is not a medical professional and this is not medical advice.
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