Auto Immune

These are a large number of diseases caused by the body mistakenly mounting an immune response against one or more of the bodies own tissues. The best known auto immune disease is rheumatoid arthritis, in which the immune system wrong headedly attacks the joints causing pain , swelling and ultimately crippling of severely affected joints.

A list of some of the more common autoimmune diseases appears below. There is also an unusual condition called autoimmune cluster where many of the different body systems are attacked serially or simultaneously. Many of the diseases are characterised by exacerbations and remissions

These illnesses are treated in a variety of ways. If the illness is specific to one organ only like thyroiditis, simply replacing the hormone is an effective treatment.

If the autoimmune disease attacks are insidious and attack organs such as the joints in rheumatoid arthritis, conventional medicine tries to suppress the whole immune system using powerful drugs often with many potential side effects such as NSAIDs, prednisone, methotrexate, plaquenil, arava or a combination of these. Unfortunately all too often these approaches while helpful fail to fully control the disease and may lead to serious long term side effects such as osteoporosis and Cushings syndrome in the case of steroids.

Using an integrative & holistic medical approach, our aim is to use traditional medicines and other treatments as well to minimise the necessity for using powerful and potentially harmful drugs such as the ones in the paragraph above. We can do this in several ways:

1) Firstly natural medicines can be used to help suppress or balance T cell function and reduce the intermediary substances which the immune system creates to attack bodily structures. Immune Diseases can be divided into those characterised by T Helper Cell 1 (TH1) or T Helper Cell 2 (TH2) dominance. Natural medicines may affect the TH1/TH2 balance with the aim of modifying the auto-immune disease in question. ( see Table 2)

2) Secondly they can also help reduce the bodies stress, which is often an important factor in triggering exacerbations of these auto immune conditions. This includes stress of oxidation and exposure to toxic substances and foods to which an individual may be intolerant.

Table 1.
Condition	Antibody Attacks
Addison's disease	Adrenal cells
Autoimmune hemolytic anemia	Erythrocytes
Chronic active hepatitis	hepatocytes
Graves's disease	Thyroid-stimulating hormone receptor
Idiopathic hypoparathyroidism	Parathyroid cells
Idiopathic thrombocytopenic purpura	Platelets
Iritis	Iris of the eye
Myasthenia gravis	Acetylcholine receptors
Pemphigus	Intercellular substance of skin
Pernicious anemia	Gastric parietal cells
Polymyalgia rheumatica	Muscle cells esp. in proximal muscle groups.
Primary biliary cirrhosis	Mitochondria within liver
Rheumatoid arthritis	Proteins within joints
Scleroderma	Nuclei and centromeres of some organs
Sjogren's syndrome	Nuclei and centromeres
Systemic lupus erythematosus	Nuclei, DNA, RNA, erythrocytes, etc.
Thyroiditis	Thyroid
Ulcerative Colitis	Large bowel endo thelium
Vitiligo	Melanocytes (of skin)

Table 2
TH1 dominant conditions include :	TH2 dominant conditions include:
Crohn’s disease	Allergies
Diabetes type I	Asthma
Hashimoto’s disease & Grave's Disease (thyroiditis)	Chronic Sinusitis Many Cancers
Psoriasis	Hepatitis C
Rheumatoid arthritis	Ulcerative colitis
Sarcoidosis (may be Th2 also)	Viral infections
Recent research indicates not all autoimmune disease follows this pattern for example multiple sclerosis may be mixed or variable TH1/TH2 dominance, however this classification still provides a potentially useful therapeutic tool for at least some of the auto immune illnesses

3) Thirdly they can sometimes be used to help protect specific organ groups in danger of attack.

4) Fourthly Reducing foods high in arachidonic acids ( especially saturated fat products such as fatty meats, beef, pork, lamb & dairy) may be of benefit. Arachidonic acid is metabolised into ecosinoids such as prostaglandins and leukotrienes which are the mediators of inflammation. (aspirin helps arthritis because it is a prostaglandin inhibitor - so we don't want to eat foods which may increase ecosinoids such as prostaglandins). The right balance of Omega 6 to Omega 3 fatty acids (4-10:1) limits the effects of the ecosinoids, Aussie diets have plenty of Omega 6 fatty acids but are usually short of Omega 3, explaining why Omega 3 containing salmon oil, linseed oil and flaxseed oil may benefit arthritis and inflammation. Refined flour and sugar products may do the reverse and increase inflammation.

5) Fifthly we can use the psychological technique of cognitive behavioural therapy, meditation, relaxation, massage etc, plus natural and sometimes conventional antidepressant medicines to help individuals cope with their auto immune disease and the disability and chronic pain it may cause.

6) Sixthly, many of the autoimmune disease are more common in women and may relate to oestrogen dominance and some women report an improvement in their symptoms when their testosterone and or natural progesterone levels are supplemented.

7) Lastly real attention to a healthy diet and both aerobic and resistance exercises can only improve your bodies resistance to autoimmune diseases.

More on Th1 & Th2 Regulation.

Often, up regulators of TH1 are down regulators of Th2 and vice versa, so we can look to help from substances to down regulate TH1 for the illnesses in column 1, and which down regulate TH2 for the illnesses in column 2. (see Table 3 which is an attempt to categorise cytokine mediated regulators of Th1 & Th2)

Down Regulators of Th1	Down regulators of Th2	Downregulators of Th1 & Th2	Balancers of Th1/Th2
Arginine 4Nitric oxide	Perilla seed	glucocorticoids e.g prednisone	Soy Isoflavones
Curcumin	Quercetin		Plant sterols and sterolins
Polypodium Leucotomas	Luteolin		Probiotics
	and some other isoflavones		Pregnenalone
			DHEA

So for example in rheumatoid arthritis, the Down regulators of TH1 may help, especially when combined with the balancers ( sometimes known as adaptogens) of Th1/Th2.

For Allergies or chronic sinusitis the Down Regulators of Th2 may help, especially when combined with the adaptogens.

Combine these with a low stress diet and lifestyle, a positive attitude and appropriate exercise and if necessary prescription mainstream treatment as well, and we may achieve a real improvement in lifestyle and quality of life for sufferers of allergies and autoimmune conditions.