Chris: Yes. Autoimmunity requires a really comprehensive approach because there are so many different potential underlying causes that can contribute to it. If you think of the functional model that I’m teaching you in this course is the thing that characterizes Functional Medicine and distinguishes it from the conventional approaches, we’re not just trying to use supplements and herbs, even, to suppress symptoms. We’re trying to address the root causes of the condition.
In the case of autoimmunity, the root cause is immune dysregulation. If you remember way back to the introduction of the course, we talked about the Functional Medicine pyramid, which was like a way of prioritizing the underlying causes that you’re most likely to see in your practice and where you can make the biggest bang for your buck. On the bottom of the pyramid was the gut, the HPA axis, the stress response, stress, which is not just psychological or emotional stress, but can be driven by poor blood sugar regulation, inflammation, and also circadian disruption.
And then you have a lot of the issues that can show up on a blood panel that we’re going to be covering. Blood sugar dysregulation can drive immune dysfunction, you’ve got hormone imbalances, so, thyroid being the main one, but cortisol, of course, but also endocrine hormone issues. You’ve got nutrient deficiencies or nutrient excesses that can do that. Of course, insulin resistance is another hormone imbalance, but it’s more to the blood sugar issues.
You’ve got all of those things that you’re going to be learning about in the course, and then you’ve got additional considerations like chronic infections, so this could be like tick-borne diseases, could be reactivated viral infections like Epstein-Barr has been correlated with autoimmunity. You’ve got intracellular infections like mycoplasma, so chronic infections overall. You’ve got heavy metal toxicity like mercury, lead, cadmium, arsenic can drive in the immune dysregulation. You’ve got mold and other biotoxins can do that. In some cases, you’ve got toxins like pesticides, herbicides, glyphosate, and other industrial chemicals that people are exposed to and not detoxifying very well, and just impaired detoxification in general can be a driver of autoimmunity.
We have to cast a pretty wide net when you’re dealing with autoimmune disease and you’re trying to identify and address any potential triggers. We can start with the bottom of the pyramid, the gut, the HPA axis, and some of the things that can be identified with a comprehensive blood panel, which is why I structured the pyramid that way in the first place as the most common contributors and the things that are most important to identify. Of course, diet, I almost don’t even mention that because it’s so obvious to me and I think to many of you, but I should mention that because in a way, in a Functional Medicine model, in the ADAPT model, diet is even before the bottom of the pyramid. It’s the background environment that all of this is happening in. Obviously nutrient-dense anti-inflammatory diet, but in some cases AIP and removing foods that can be problematic for people with immune dysregulation that are otherwise healthy like nightshades, eggs, nuts, and seeds.
And then you have to look at the lifestyle as a whole, which we’re doing in this course, you have to look at sleep, you have to look at stress management which is a crucial part of HPA axis regulation overall. You have to look at pleasure, fun, and social connection, which I think are really critical for our immune health. It’s been part of our evolutionary history. And of course, physical activity, the appropriate amount, not too little, not too much. You’re really kind of assessing the entire exposome when you’re looking at autoimmune disease. To an extent, that’s true for any condition, but it’s especially true for autoimmune disease because of how sensitive the immune system is to all of those different influences.