I have a special interest in working with people who experience chronic pain. As happens with many people, it took my own experience to propel me to study and learn more about how to best help this patient population. In 2007, I became very ill with what was later diagnosed as Hashimoto's Thyroiditis. This is an autoimmune illness (AI) caused by the body mounting an attack on the thyroid gland in an attempt to destroy it. For those who have not heard of this illness, the thyroid is a major part of the endocrine system. It is a gland that makes and stores hormones that help regulate the heart rate, blood pressure, body temperature, and the rate at which food is converted into energy. Thyroid hormones are essential for the function of every cell in the body. They help regulate growth and the rate of chemical reactions (metabolism) in the body.
It took me 5 years of researching, asking questions, and trial and error to begin to regain my health. At the urging of a colleague, I went gluten free in the fall of 2010. After 2 weeks, I felt so much better that I decided to continue avoiding gluten. As I continued to research, I found information about what was referred to as the "Paleo" lifestyle. I decided to try it in the Spring of 2011. After several months, the majority of my inflammation was reduced, my blood work showed changes in a positive direction, I began going days at a time without taking anti-inflammatory medication, and I was able to slowly begin bodyweight exercises and walking.
After eating this way for a year now, I can say that I am never going back to eating as I did before, and I don't have "cheat" days because my body cannot handle the effects of foods that lead to inflammation. I am passionate about sharing this knowledge with as many people as possible. The media has picked up on the term "Paleo Diet" and "Caveman Diet," portraying it as a fad diet used to lose weight and re-enact history. My mission is to sift through the emerging research to find studies to show that there is a scientific basis behind eating this way, and to educate people that this lifestyle may be useful as an adjunct to treating AI. For me and the other 23.5 million Americans living with AI, there is hope for living a better life, based on the way we nourish and move our bodies.
Research has shown a connection between inflammation and AI, as well as a link between modern foods and their far-reaching effects on health. In their 2004 paper titled "Origins and evolution of the Western diet: health implications for the 21st century," Cordain et al presented data to show that diseases which are epidemic in contemporary Western countries are rare or non-existent in hunter-gatherer and less Westernized societies. They discussed data showing that Industrial era foods (dairy, refined cereals, refined vegetable oils, and fatty meats from animals prevented from grazing) underlie or exacerbate virtually all chronic diseases of civilization: 1) glycemic load, 2) fatty acid composition, 3) macronutrient composition, 4) micronutrient density, 5) acid-base balance, 6) sodium-potassium ratio, and 7) fiber content.
Other recent research from Ganesh et al (2011) shows that the changes associated with the disease process of autoimmune thyroid disorders (AITD) are brought about by inflammatory cytokines. Cytokines serve as the software that run the immune system. A number of studies have now established that dysregulation of immune cell function causes AI such as lupus, arthritis, thyroiditis, carditits, and diabetes. It is highly likely that cytokine dysfunctions are the first step in the onset of these self-reactive immune responses. (Kalvakolanu, 2011) Additionally, Singh et al (2011) discussed the role of cytokines in the development of autoimmune diabetes (Type 1 Diabetes), Rose et al (2011) studied the sequence of events triggered by infection that lead to autoimmune myocarditis and subsequent cardiomyopathy, and Volin and Koch (2011) provided an in-depth view into the role of pro-inflammatory cytokines in the development of autoimmune arthritis.
The most interesting studies that may eventually provide evidence for correlation of diet as a factor in the development of AI come from the University of Maryland's Center for Celiac Research headed by Dr. Alessio Fasano: http://www.celiaccenter.org/
Dr. Fasano's research investigates the increased intestinal permeability which often precedes disease, causing an abnormality in the antigen delivery that triggers the multi-organ process leading to an autoimmune response. Dr. Fasano's research has shown that once gluten is eliminated from the diet, the intestine resumes its baseline barrier function, autoantibody titers are normalized, the autoimmune process shuts off, and intestinal damage heals itself. He continues to research the possibility that changes in intestinal permeability due to gluten may underlie not just Celiac Disease; but also other AI processes.
These are exciting times for those who struggle with AI, as current research attempts to explain what thousands of people have found to be anecdotally true. As Chris Kresser, L.Ac discussed in a recent podcast the issue of intestinal permeability or 'leaky gut' has been made fun of for years as pseudoscience. Not to worry, the research surrounding this issue is about to explode due to the fact that the first drug to treat intestinal permeability is being developed. Once "Big Pharma" gets involved, and there is suddenly money to be made from treating this issue, the research to justify it won't be far behind!
References:
Cordain L, Eaton SB, Sebastian A, et al. Origins and evolution of the Western diet: health implications for the 21st century. American Journal of Clinical Nutrition. 2005: 81(2): 341-354.
Fasano A. Systemic autoimmune disorders in celiac disease. Curr Opin Gastroenterol. 2006; 22: 674-679.
Ganesh B, Bhattacharya P, Gopisetty A, and Prabhakar B. Role of cytokines in the pathogenesis and suppression of thyroid autoimmunity. Journal of Interferon and Cytokine Research. 2011; 31(10):721-731.
Kalvakolanu D. An introduction to the special issue on "Cytokines and Autoimmune Diseases." Journal of Interferon and Cytokine Research. 2011; 31(10): 693-694.
Moudgil K and Choubey D. Cytokines in autoimmunity: Role in induction, regulation, and treatment. Journal of Interferon and Cytokine Research. 2011; 31(10): 695-703.
Rose NR. Critical cytokine pathways to cardiac inflammation. Journal of Interferon and Cytokine Research. 2011; 31(10): 705-710.
Singh B, Nikoopour E, Huszarik K, Elliot J, and Jevnikar A. Immunomodulation and regeneration of Islet Beta Cells by cytokines in autoimmune Type 1 Diabetes. Journal of Interferon and Cytokine Research. 2011; 31(10): 711-719.
Volin MV and Koch AE. Interleukin-18: a mediator of inflammation and angiogenesis in rheumatoid arthritis. Journal of Interferon and Cytokine Research. 2011; 31(10): 745-751.
Interesting statistics from the website of the American Autoimmune Related Diseases Association, Inc.
- The National Institutes of Health (NIH estimates up to 23.5 million Americans suffer from autoimmune disease and that the prevalence is rising.
- Researchers have identified 80-100 different autoimmune diseases and suspect at least 40 additional diseases of having an autoimmune basis. These diseases are chronic and can be life-threatening.
- NIH estimates up to 23.5 million Americans have an AD. In comparison, cancer affects up to 9 million and heart disease up to 22 million.
- NIH estimates annual direct health care costs for AD to be in the range of $100 billion (source: NIH presentation by Dr. Fauci, NIAID). In comparison, cancers costs are $57 billion (source: NIH,ACS), and heart and stroke costs are $200 billion (source: NIH, AHA).
- NIH research funding for AD in 2003 came to $591 million. In comparison, cancer funding came to $6.1 billion; and heart and stroke, to $2.4 billion (source: NIH).
- NIH research funding for AD in 2003 came to $591 million. In comparison, cancer funding came to $6.1 billion; and heart and stroke, to $2.4 billion (source: NIH).
- The NIH Autoimmune Diseases Research Plan states; "Research discoveries of the last decade have made autoimmune research one of the most promising areas of new discovery."
- According to the Department of Health and Human Services' Office of Women's Health, autoimmune disease and disorders ranked #1 in a top ten list of most popular health topics requested by callers to the National Women's Health Information Center.
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http://www.aarda.org/research_display.php?ID=102
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