• Glenn S. Rothfeld, MD

"Cross-Your-Fingers Medicine": The Trouble With How We Treat Autoimmune Diseases

Cancer, heart disease, and illnesses like Alzheimer’s and Parkinson’s are all hugely prevalent in the population, and widely studied, even if the direction of the studies leans heavily toward the pharmaceutical model. But another enormous group of diseases affecting nearly 24 million Americans is not as widely publicized and studied, even as it ravages the population with progressive pain and disability. This group is collectively known as the autoimmune diseases.

According to a National Institutes of Health (NIH) report, more than 80 conditions can be listed as autoimmune diseases. The risk to women of getting an autoimmune disease is particularly great, as around 1 in 9 women will get an autoimmune condition sometime in their lives. These diseases range from very prevalent like Hashimoto’s Thyroiditis, Rheumatoid Arthritis and Ulcerative Colitis, to well-known illnesses like Diabetes Type 1, Multiple Sclerosis and Celiac Disease, to relatively unknown but lethal diseases like Scleroderma, Myasthenia Gravis and Autoimmune Hepatitis.

The thing that distinguishes autoimmune illnesses from other disease processes is that they are actually caused by the body attacking itself. Normally our immune cells are programmed to recognize the “self” from the foreign invaders and to act accordingly. But in autoimmune illness, that recognition is lost, and our immune cells begin to form antibodies to attack our own tissues. This leads to damage to that tissue, generalized inflammation, stiffness and fibrous tissue created to “heal” the inflammation, and resulting pain, stiffness and disability.

One problem in the conventional treatment of autoimmune diseases is that each disease is treated as a separate problem, even though once you have an autoimmune disease, the risk of getting another one in your life is around 25%! (Source). Ulcerative colitis is treated by a gastroenterologist, psoriasis by a dermatologist, rheumatoid arthritis by a rheumatologist etc. And these diseases are frequently treated by what I call cross-your-fingers medicine. That is, the patient is given heavy duty medications that suppress the illness and the inflammation. These medications include potent corticosteroids such as prednisone, strong anti-inflammatories such as Indomethecin and diclofenac, potent metabolic poisons such as Methotrexate, and newer “biological response modifiers,” also called TNF blockers, like Enbrel, Remicade and Humira. Each of these medications can have dangerous, sometimes deadly, side effects. But in the end, they are not addressing the cause of the illness— they are merely suppressing the symptoms and hoping that the inflammatory disease burns itself out. They cross their fingers and hope for the best!

Here’s a place where I think conventional medicine loses its way. Because there are not really more than 80 diseases; there is one immune system problem with 80+ manifestations. The problem is that the immune system has been irritated so much that it is attacking itself. If it attacks the thyroid, it causes Hashimoto’s or Graves’ Disease. If it attacks the lining of the bowel, it’s ulcerative colitis, or Crohn’s Disease. If it attacks the synovial membrane of the joints, it’s rheumatoid arthritis. And so on.

Fortunately, there’s a natural strategy that can be brought into play with any of these diseases. As with anything in Integrative Medicine, we take a broad, “systems” approach to the illness, and address both the causes and the effects of the disease.

We can summarize the approach to:

  1. Control the symptoms

  2. Look for and eliminate irritants and triggers to the imbalanced immune system

  3. Use natural medicines to bring the immune system back into balance

The first challenge is to control the symptoms, and those symptoms vary widely depending upon which organ(s) are attacked. Controlling symptoms may involve short-term medication, including anti-inflammatories, thyroid medications, or even brief treatment with antimetabolites and prednisone. It does no good to try and correct an immune system imbalance while someone’s joints are deteriorating, for instance.

But natural medicines can still be utilized even to address symptoms. Thyroid supplementation can be given in the dessicated form (usually pig thyroid) called Armour Thyroid and NatureThroid. Synthetic steroid hormones like prednisone can be mimicked by bio-identical hormones like DHEA and pregnenolone. And there are many studies proving the efficacy of curcumin (or its cooking herb equivalent, turmeric) for inflammatory diseases. One pilot study published in Phytotherapy Research 2012 by Chandran et al. compared curcumin to the anti-inflammatory drug diclofenac in patients with rheumatoid arthritis, and the curcumin had the best results, with no significant side effects! Fish oil, white willow bark, proteolytic enzymes like bromelain and serrapeptase, and the herb boswellia are all effective in anti-inflammatory conditions as well.

The second goal is to remove and/or treat any factors that are irritating the immune system. Our environment has created so many immune toxins that our immune cell switches are permanently stuck in the “on” position. There are 80,000 chemicals approved for use in our environment, and thousands more added every year. And yet there are credible animal studies that show increase in autoimmune illnesses at levels of exposure to toxins (including chemicals contained in Teflon) well below levels considered acceptable by the EPA.

Allergy is another risk factor in the development of autoimmune disease. I always tell patients that allergy is an inflamed immune system turned outward, and autoimmunity is an inflamed immune system turned inward. Many times, we can turn down the inflammatory response of an autoimmune situation by careful attention to allergies.

Finally, we can readjust the immune system back into balance by utilizing a natural medicine approach. One way to do this is to balance so-called Th1 and Th2 lymphocytes. Th1 lymphocytes are those that protect the cell against invasion by organisms. Th2 lymphocytes prowl our bloodstream, creating antibodies to protect organisms they come in contact with. In autoimmunity (and allergy) the Th2 lymphocytes are overactive, and frequently the Th1 lymphocytes are suppressed. This is the case with newborns, and so nature gives the mother’s milk a powerful substance called colostrum, present even before the milk itself comes in. This magic substance contains molecules called transfer factors, which boost the infant’s Th1 / cell-based immunity at the same time as it quiets down the blood-based antibody response involving Th2. The result is less vulnerability to cellular viruses, and less danger of the infant having an antibody response to any of the mother’s blood that the child is exposed to. Transfer factors derived from animal sources are very useful in correcting the Th1/Th2 imbalance of autoimmune illness.

Another incredible therapy I’ve found is the use of the herb white peony and in particular its extracts called peony glucosides. The herb itself (which is not white, but comes in many colors) is grown in China and Japan and has many uses. But it turns out that the glucoside extracts from white peony, and particularly the one called paeoniflorin, balances the Th1 / Th2 lymphocytes in much the same manner as transfer factors from colostrum (Source). This balancing actually turns off inflammatory messengers in the immune system (called cytokines). And amazingly, this remarkable herb also shows significant pain relieving properties. So it actually lessens the symptoms while it cures the disease.

Other remedies to correct a dysfunctional immune system that is forming autoantibodies include Vitamin D3, fish oil, and isoflavones, one of the bioactive compounds found in soy products. Other steps to consider include:

  1. Detoxify your home and your environment

  2. Pay attention to your gut health, since a large proportion of your immune cells reside there

  3. Eat an anti-inflammatory diet. We suggest moving in the direction of a “paleo” diet.

  4. Work on your stress levels. Nothing gets an immune system riled up as much as a high stress internal environment.

  5. Connect with your spiritual self. Autoimmunity is, at its basic level, your body attacking itself, and a greater understanding of this and connection to spirit outside of yourself can contribute to healing.

With all of these tools, no longer will those of you with autoimmune diseases have to “take drugs and cross your fingers.”