Ms. M is an attractive 40 year old Market Research Analyst. She lives in a beautiful upscale South Florida Community. She has a loving mom and a steady caring gentleman friend. In February, she came to see me and have me her history. She was always cold, her hearing would fade in and out, and her ears hurt daily. She’d have sudden attacks of vertigo that would last for 6-8 hours and leave her on the bathroom floor vomiting, followed by almost a week of feeling ‘Foggy’. It would take another week to feel normal. This was going on several times a year for a couple of years, and the episodes were getting progressively worse. She’d frequently get headaches. In addition, she could not remember ever not having diarrhea. She’d feel gassy and bloated and get congested right away almost every time she ate. She’d seen doctors in the past and was treated with antidepressants. She was on those for 2 years, which caused weight gain as well as a constant ‘weird’ feeling. And even though her food was running right through she couldn’t lose the weight. In fact, she was the heaviest she’d ever been at 190 pounds and only 5’3”. Her hands and feet were constantly tingling with an annoying sensation as if they’d fallen asleep. She’d had a cold earlier in December and been put on antibiotics. And after the antibiotics treatments she’d typically get a yeast infection.
In general, Ms. M felt miserable, scared and desperate. Nothing she’d tried had helped. Her new physician diagnosed her with Meniere’s disease, Hashimoto’s Thyroiditis, and Irritable Bowel Disease, along with a very complex list of food allergies. He then sent her to a nutrionist (smart doctor). Does this sound like you or a friend, or your mom, or your sister? Are you at loss for what to do about your ‘weird’ symptoms and you feeling your doctors don’t believe you are no longer listening to you?
Interestingly enough, all of these conditions are examples of what are called ‘Auto Immune’ disorders, a group of related syndromes having in common the underlying inflammation that results when the body no longer recognizes itself and has the immune system attack and destroy its own tissues. Auto Immune diseases are a result of the interaction between an individual’s unique genes and their environment. The theory says for an autoimmune disorder to start, there must be some kind of triggering event, such as a bacterial or viral infection (and potentially a change in the defense system of the body by further interaction with antibiotics), a genetic ‘weakness’ or susceptibility related to immune system individuality, or an imbalance or weakness in the person’s hormonal system (adrenal, pituitary, thyroid, hypothalamus). Our immune system is designed to protect us- from pretty much everything including infection, injury, toxins, etc.- by a complicated system of “communication” between our cells and the components they make: our chemical ‘signals’. In a healthy immune system, this communication is clear and specific. The body can tell the difference between a “foreigner” and “self” (our own tissues or cells) very effectively. The chemical signals says this is “me” and the other is “not me” are working. The idea that the body can become “allergic to itself” (autoimmune) means the recognition progress has broken down and the immune system and the immune system can attack the host’s tissues (self) resulting in an autoimmune disease. The term ‘autoimmune disease’ refers to a varied group of more than 80 serious chronic illnesses, which can involve almost very human organ system. Approximately 5% of the population or 15 million people in the U.S have been diagnosed with and are seeing a doctor for some type of autoimmune disorder. Another 10-20 % of people have early stage autoimmune symptoms and imbalances. This makes autoimmune issues nearly as prevalent as high cholesterol, high blood pressure and diabetes. The idea that all autoimmune disorders may be related and connected, in terms of cause and progression, is a new one. This was discussed in an editorial article called “Autoimmunity” in the 2005 edition of Nature, and presented at a seminar I attended a few weeks ago in Orlando given by a brilliant biochemist and my mentor, Jeffrey Bland, Ph. D. Also, very interesting, auto-immune conditions occur much more frequently in women than in men. In fact, the family disorders that includes Lupus (SLE), Rheumatoid Arthritis (RA), Multiple Sclerosis (MS), Sjogren’s Grave’s Disease, Raynaud’s Disease, Myasthenia Gravis, Crohn’s Disease and the above conditions Ms. M was found to have, occur 5-10 times more often in women. Approximately 75% of autoimmune diseases occur in women, during the childbearing years. Sex hormones are thought to play a role, because the incidence of some autoimmune diseases increases after menopause; some may suddenly during pregnancy, with flare-ups at delivery, while others get worse during pregnancy. This may not be an entirely bad thing. Women are uniquely designed to be more tolerant of foreign proteins. We have to be. When we carry a baby in pregnancy, half of the baby’s proteins- the half that came from the DNA of the sperm- is “foreign” not of our making. Yet our bodies tolerate it, even nurture it and protect it. This is wonderful and assures the continuation of our species. But what if we are not pregnant? What if we just hurt, and no one seems to be able to help?
What kind of support can we offer Ms. M? Constant diarrhea “for as long as she could remember” told me her digestive system was creating a mal absorption issues as well as discomfort and inconvenience. Two of the most common causes of diarrhea for long periods of time are either intolerance to milk sugar (lactose) or sensitivity to wheat protein (gluten). Just as to be on the safe side, we eliminated both. Because she had a strong history of recurrent infections and antibiotics, I knew this was also affecting her digestion. In a healthy intestine, “there are more bacteria than there are stars in the known universe,” says Dr. Bland. These gut bacteria help us digest our food, make Vitamin K and biotin (a B vitamin), and protect our immune systems. Our intestines are where the majority of our immune systems cells lie. Anytime an antibiotic is used, the healthy gut bacteria have to be replenished. They are the guardians to our intestinal lining, which proteins stay in and get properly digested and which proteins accidentally slide through into the blood stream undigested. Whole intact proteins in the blood are reacted as if they were allergens, creating an antibody-inflammatory response. In the case of gluten, the protein found in wheat, rye, oat and barely foods, the inflammatory response they might be triggering could be related to the discomfort in her ears. So in addition to eliminating all wheat products, we also started a good quality probiotic. This is the name given to the supplements that replace the numerous strains of healthy gut bacteria.
The treatment plan for Ms. M included the following recommendations:
Total elimination of any source of gluten from her diet and any other identifiable allergic triggers. Daily supplementation with a probiotic. High doses of Vitamin D. Daily consumption of whey protein, which is particularly high in an amino acid called glutamine. Glutamine specifically aids in intestinal healing. A multivitamin-mineral supplement providing higher amounts of the B vitamins and folic acid which would result in reducing her inflammation.
Co-enzyme Q10 to improve energy levels, as she was very fatigued from constant diarrhea. Reduced intake of salt and salty foods. Increased intake of water as diarrhea is a dehydrator and replacing lost fluid would also support her energy.
Within 10 days of implementing the treatment plan, the majority of Ms. M’s symptoms had resolved or minimized to the point where she felt they were no longer an issue. She felt it was a miracle! Within 3 weeks, Ms. M had a really good idea of which foods might retrigger symptoms (very mildly and temporarily) and what to do to replace them. Bodies really are pretty miraculous. When we pay attention to them, and give them what they need, their design tends to recreate healthy fairly readily. The good news is that women can do things now to help prevent initiation or flare ups of autoimmune diseases later. Ms. M’s treatment recommendations are also good preventive measures. Additionally, all of these choices help to protect the organs that are targeted by autoimmune issues (heart, brain, breasts, joints) and even help reduce risk of cancer.
By: Paula H. Mendelsohn (A registered Dietitian and Certified Clinical Nutritionist in private practice in Boca Raton.)
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