AutoImmune & Rheumatological Triggers and Areas of Treatment

In the treatment and management of autoimmune and rheumatological conditions from a Naturopathic perspective, there are five key underlying imbalances that must be examined and addressed. Naturopathic Doctors refer to these imbalances as potential "obstacles to healing." When these are corrected or minimized, the frequency and severity of disease flares can be reduced. Addressing these underlying factors early on may prevent the need for medications and halt disease progression.

In some cases, preventing severe damage to tissues, organs, or joints necessitates the use of immunosuppressant or DMARD medications. While this approach is more intensive, it still aims to prevent permanent tissue or organ damage, which could otherwise lead to the need for surgery and lifelong medication management.

If you're worried about a family history of autoimmune or rheumatological conditions and wish to take preventive measures against developing them yourself, it's important to pay attention to these five factors, below.

1. Elevated Inflammation/Inflammatory Markers: (Having a thorough medical intake would inform myself on which inflammatory markers would be most appropriate to investigate, saving the patient time and money. I didn't go to medical school to let labs do all the work; I never take a shotgun approach.)

   1. ESR >4 mm/hr

   2. hs-CRP >3mg/L

   3. IL-6 >10pg/mL

   4. TNF-a >2.2pg/mL

   5. Fecal Calprotectin: >173µg/g

   6. HDL >75mg/dL for women/>90mg/dL for men

   7. Low 25-OH Vitamin D <30ng/mL

   8. Secondary Thrombocytosis/Thrombocythemia (elevated RBC's, Hematocrit, Platelets)

   9. Fibrinogen Activity

   10. Uric Acid

       1. Test:

          1. Blood Markers + Stool Marker (GI-MAP) above.

          2. Insurance will cover: ESR, hs-CRP, Lipid Panel, CBC w Diff, maybe Uric Acid.

          3. Out of Pocket: IL-6, TNF-a, Fibrinogen Activity, GI-MAP stool test.

2. Hormonal Imbalances: (HPG-HPA-axis Dysfunction)

   1. HPG-Axis: Hypothalamic/Pituitary/Gonadal-Axis > Low or Excess Estrogens, Progesterone, Testosterone

   2. HPA-Axis: Hypothalamic/Pituitary/Adrenal-Axis > Low or Excess Estrogens, Progesterone, Testosterone

   3. Thyroid Function: TSH/T3/T4, TBG, rT3

      1. Test:

         1. DUTCH Complete(urine) - Out of Pocket.

         2. Blood Hormone Markers - Insurance.

3. Chronic Infections:

   1. Bacterial (Bowel Dysbiosis,SIBO/IBS/IBD)

   2. Viral (EBV, CMV, HHV-6)

   3. Fungal (Black molds/Candida/SIFO)

      1. Tests: (depending on symptoms present in visit)

         1. Out of Pocket:

            1. SIBO 3hr Breath Test

            2. GI-MAP Stool Test - IBS, IBD, Candida, Parasitic infections.

            3. Blood: EBV VCA, Early Ag, Nuclear Ag IgG's(testing for CAEBV), CMV IgG, HHV-6 IgG,

            4. MycoTox Urine and Antibody Tests- Black mold. HERTSMI Home Testing

4. Stressors/Trauma: (Dysautonomia)

   1. Physical: Any blunt-force trauma, laceration, or injury that jolts the autonomic nervous system.

      1. Extreme stimulation of the Sympathetic (Fight or Flight Nervous system).

   2. Emotional: Destructive relationships, A breakup/Divorce, Isolation/Loneliness, a Legal Battle, etc.. Again Autonomic Nervous system dysregulation.

   3. Physiological: Blood sugar dysregulation, Hormone Imbalances(Sex and Stress hormones), dehydration, Toxin overload (alcohol, smoke), Inflammation, Chronic  infections, Malnutrition/Poor Nutrition, Eating food allergies/sensitivities without healing Intestinal Permeability(Leaky Gut) - treating intestinal dysbiosis and providing nutrients L-Glutamine, SCFA's(Butyrate), Fiber, Probiotics.

5. Environmental Toxins: (Hard to avoid some of these, but they can add up quickly)

   1. Some Common Food Triggers: Gluten, Dairy, Eggs, Nightshades

   2. Heavy metal exposures(Mercury Amalgam fillings/Large fish)

   3. Correlation w/ Vaccines (Molecular Mimicry)

   4. Herbicides/pesticides (Round-Up)

   5. Mold Toxin Exposure (Ochratoxin-A, Citrinin, Gliotoxin, etc..)

   6. Synthetic Fragrances

   7. Petroleum-chemical exposures

   8. Excessive EMF's close to vital organs (phones, laptops, bluetooth headphones, 5G-towers, wifi)

   9. Synthetic Food preservatives/coloring/flavor enhancers (

   10. Combusted plant material (smoke/smoking)

   11. Unfiltered Municipal Tap Water (See what's in your city's Tap Water)

Areas of Treatment:

1. Anti-Inflammatory/Immune-Modulating Support:

   1. Anti-Inflammatory/Mediterranean Diet:

      1. Increasing Omega-3 Fatty acids: Small, Wild-Caught, Cold-Water Fish (Sardines, Herring, Anchovies, Salmon, Cod, Trout)

      2. Increasing Dietary Bioflavonoids:

         1. Carotenoids: (ß-carotene, Lycopene, Lutein, Zeaxanthin, Quercetin)

            1. Reds, Oranges, Yellows

         2. Flavonoids: (Anthocyanins)

            1. Blues, Purples

         3. Indoles, Glucosinolates, Isothiocyanates: (Sulfurophane)

            1. Greens(Cruciferous Veggies)

         4. Inositol & Isoflavones:

            1. Whites

         5. Polyphenols:

            1. ECGC(Green Tea), Resveratrol (Red Grapes), Flavonols (Dark Chocolate), Oleocanthal (Olive Oil)

         6. Terpenes: (Limonene, Carnosol)

            1. Citrus peel, cherries, rosemary.

      3. Avoidance/Minimization of (Top-3):

         1. Oxidized Seed oils: Vegetable/Canola/Rapeseed Oil, Soybean, Cottonseed, Peanut, Sunflower, Sesame. - Look for Avocado oil or Olive oil.

         2. High Fructose Corn Syrup(HFCS) & Added Simple Sugars.

         3. Highly Processed Carbohydrates(HPCS) - Breads, pastries, crackers, cookies, etc..

   2. Omega-3's

   3. Vitamin D3

   4. Boron (Calcium Fructoborate)

   5. Probiotics

   6. Serrapeptase

   7. Bromelain

   8. Herbal Medicine Anti-Inflammatories:

      1. Curcumin

      2. Thunder God Vine

      3. Boswellia

   9. Medicinal Mushrooms Immunomodulators:

      1. Reishi

      2. Turkey Tail

      3. Cordyceps

      4. Shiitake

2. Hormone Balancing Support:

   1. High Estrogens:

      1. DIM

      2. Ca-D-Glucurate

      3. Alpha-Lipoic Acid

      4. Milk Thistle Seed

      5. Avoidance of Xenoestrogens

      6. Implementation of Phytoestrogens

   2. Low Estrogens:

      1. Estrogenic Herbs:

         1. Black Cohosh

         2. Alfalfa

         3. Chaste Tree Berry

         4. Licorice Root

         5. Lavender

         6. Red Clover 

         7. Fennel

         8. Pumpkin seeds

      2. Implementation of Phytoestrogens

         1. Organic Soy, Beans, Nuts(Walnuts), Seeds(Pumpkin, Sunflower, Chia, Ground Flax, Sesame).

      3. Bioidentical Hormone Replacement Therapy(BHRT):

         1. Oral, Topicals, Pellets, Patches.

   3. Low Progesterone:

      1. Progesterogenic Herbs:

         1. Chaste Tree Berry

         2. Shatavari

         3. Black Cohosh

         4. Lady's Mantle

         5. Maca

         6. Siberian Ginseng

      2. Implementation of Progesterogenic Foods:

         1. Nuts, Dark Chocolate, Poultry(Chicken/Turkey), Citrus fruits, Leafy Greens, Peppers, Avocados, Salmon, Shrimp, Oats, Cruciferous Veggies (Above)

   4. Low Testosterone:

      1. DHEA - dose varies.

      2. Testosterone Replacement Therapy (TRT)

      3. Herbs that Directly and Indirectly Increase tT & fT

         1. Tribulus terrestris

         2. TongKat Ali

         3. Saw Palmetto - helpful in combination with TRT or alone

         4. Pygeum - helpful in combination with TRT or alone

         5. Nettle Root - helpful in combination with TRT or alone

         6. American Ginseng

         7. Ashwagandha

References:

1. Brice-Ytsma, Hananja, and Nathalie Chidley. Herbal Medicine in Treating Gynaecological Conditions 1, Herbs, Hormones, Pre-Menstrual Syndrome and Menopause. Aeon, 2020.

2. The rest are linked to the words above.

3. If you want more research please reachout - I ran out of time attaching the data above.