Autoimmunity with Dr. Ben Weitz: Rational Wellness Podcast 242
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Dr. Ben Weitz discusses a Functional Medicine approach to Autoimmunity.
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0:45 Autoimmune Diseases are very common and are increasing in the United States. Autoimmune diseases are where our immune system, instead of fighting off foreign invaders, like viruses and bacteria, attacks our own cells, tissues, and organs. Common autoimmune diseases include Hashimoto’s thyroiditis, Grave’s hyper thyroid, rheumatoid arthritis, vitiligo, Alzheimer’s disease, Parkinson’s, psoriasis, hair loss known as alopecia, inflammatory bowel diseases like Crohn’s disease and Ulcerative colitis, IBS, multiple sclerosis, and type I diabetes.
4:31 How should autoimmune diseases be treated? Conventional medicine is focused on treating the symptoms, such as by giving thyroid hormone to patients with Hashimoto’s thyroiditis, but often ignores the autoimmune condition. And when medicine treats the autoimmune condition, such as in Inflammatory Bowel Disease, like Crohn’s disease and ulcerative colitis, drugs are often prescribed that suppress part of the immune system to decrease this attack by the immune system on the body. These drugs can be chemotherapeutic agents like methotrexate or Cyclophosphamide and there are various types of newer drugs that target specific parts of the immune system, like the TNF alpha blocking drugs Remicade, Enbrel, and Humira. The downside of such drugs is that by suppressing the immune system, they increase our risk of infections and of cancer.
10:18 In Functional Medicine we try to find the root cause of their autoimmune disease, so we look at a number of possible triggers, including gut health and infections. We might do a good stool test or we might screen for systemic infections through blood work. If the protein structure/amino acid sequence of the bacteria or virus is similar to structural proteins in the body, you might have cross reactivity and the immune system attacks that organ or tissue in the body. We may treat with herbal antimicrobials, other diet and lifestyle factors, as well as other gut healing formulas.
13:39 Food sensitivities. You can have cross reactivity between the proteins in certain foods like gluten or dairy and proteins in the body and antibodies that attack foods can attack our organs, like our thyroid gland, leading to Hashimoto’s. Food sensitivities can be addressed by either following an elimination diet in which you avoid some of the most common foods that cause sensitivities or to do food sensitivity testing and then avoid foods that show reactivity to.
Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.
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Hey, this is Dr. Ben Weitz host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest in cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. And to learn more, check out my site, dr.weitz.com. Thanks for joining me. And let’s jump into the podcast. Hello, Rational Wellness podcasters. Today, I will be doing a solo podcast. Typically, I interview another doctor or practitioner or researcher, but today I wanted to discuss a functional medicine approach to autoimmune diseases.
So what are autoimmune diseases? Well, autoimmune diseases are an increasingly common cause of sickness and death in the United States. And these diseases have been on a rise for at least the last 30 or 40 years. So what happens in an autoimmune disease is your immune system attacks yourself. So our immune system, this is a system of cells and communication systems in the body that is designed to protect us from bacteria, viruses, parasites, our immune system’s involved in tissue repair and what our immune system does is it creates an inflammatory process, that’s how it keeps us safe. And because our digestive system is one of the ways in which we’re open to the world, food and liquid particles come into our mouth, go down through our digestive tract, come out the other end. And therefore a huge portion of our immune system is centered around our digestive track, our intestines, et cetera. And that’s because that’s one of the ways that we most commonly interface with bacteria, and viruses, and fungi, and parasites, and also toxins that come into our bodies. It’s not the only way, but it’s one of the most common ways.
And so what happens in autoimmune diseases, our immune system instead of fighting off these external threats, turns inwards and ends up attacking our own tissues, our own cells, our own organs. And in one way or another, our immune system is out of balance. Now, let’s talk about a few of the most common autoimmune diseases. And we know now that there are over 100 different autoimmune diseases that have been identified. And there’s a number of other common diseases that have autoimmune components. For example, heart disease has an autoimmune component. There’s an inflammatory condition inside the walls of the arteries that plays a role in why cholesterol plaques start to build up in those arteries and eventually block off the blood flow. So some of the most common autoimmune diseases, probably the most common is Hashimoto’s hypothyroid. And this is a form of decreased thyroid function and probably the second most common one is Grave’s hyperthyroid. After these two, the more common autoimmune diseases include rheumatoid arthritis, vitiligo, Alzheimer’s disease, Parkinson’s, psoriasis, hair loss known as alopecia, inflammatory bowel diseases like Crohn’s and ulcerative colitis. And now Dr. Pimentel has identified that the most common gastrointestinal condition IBS, often has an autoimmune origin, multiple sclerosis, Type 1 diabetes, on and on and on. There’s a huge number of these autoimmune diseases.
Now, how should patients with autoimmune diseases be treated? Now, our medical system is essentially our conventional medical system is focused on finding out what symptoms patients have and then providing the treatments that are going to help modulate those symptoms. So, for example, if a patient comes into the office with hypothyroidism, well, that patient will typically be given thyroid medication. In other words, their thyroid is not working the way it’s supposed to, so we will give thyroid medication. And then that’s the end of the story. But we know from lots of research that in the United States, the majority of cases of hypothyroidism are caused by an autoimmune process. We refer to this as Hashimoto’s. So what that means is your immune system is attacking your thyroid and over time, there’ll be more and more damage to your thyroid gland. And essentially your thyroid will stop working, will the function of the thyroid will decrease. You may need more and more thyroid medication.
And the same thing occurs in autoimmune conditions that attack other systems of the body, whether it be other organs like your digestive tract, take somebody with Crohn’s or ulcerative colitis. These patients have an inflammatory condition in their intestinal tract. Their immune system is attacking the lining of their small intestine, large intestine, et cetera. And so over time you’ll have damage, ulcerations, and all sorts of inflammatory situations going on in that epithelial layer of their intestinal tract. That damage will lead to leaky gut. Over time, these patients tend to get worse. And when they do get worse, they sometimes require having part of their intestinal tract resected. Just cut out because it’s so inflamed and damaged, it may not be able to come back or it could kill them.
Now, these autoimmune conditions are treated by the medical profession in general with drugs that suppress the immune system. So we have an immune system that’s attacking our own tissues, and you can see how it could make sense to suppress the immune system. The problem is that the immune system is needed to fight off infections and cancer. And so when you suppress part of the immune system, you decrease its… But you potentially decrease its effectiveness for fighting off infections, and cancer, and for the other functions of immune system. So what’s typically done for treating these autoimmune diseases is in a crisis situation or at the beginning, typically corticosteroids are used. These may also be used when there is flareups. Sometimes chemotherapy agents are used, sometimes older chemotherapy agents like methotrexate or other newer chemotherapy agents. And now we have a series of injectable drugs like the TNF alpha blocking agents like Humira, Remicade, and a bunch of newer medications and these all block some part of the immune system to dampen down the damage that’s liable to continue.
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But what do we do in Functional Medicine? Well, in functional medicine, we’re trying to find… We’re not just trying to treat the symptoms, not that patients don’t need their symptoms taken care of, not that patients with Hashimoto’s hypothyroid don’t need thyroid medication, they certainly do. But we also need to focus on the autoimmune condition, this situation where the immune system’s attacking your own organs and cells. And we want to decrease that from happening because we don’t want the patient to have more and more damage over time. So a functional medicine approach we’ll look at a number of different factors that affect the proper functioning of our immune system. For one thing, we have issues like gut health and infections. We can have gut infections like certain bacteria that can lead to autoimmunity. We can have various types of chronic infections, some in the gut, sometimes systemic chronic infections. We can have viral infections. And what happens with infections and a similar process happens with food sensitivities and toxins. And we’ll go into those in a few minutes, is that your immune system attacks say the virus or the bacteria, and then the protein structure of that virus or bacteria or the amino acid structure is similar to tissues in your body. And we get cross reactivity. So we get cross reactivity from the antibodies that are attacking the bacteria or virus, et cetera. And then those antibodies start attacking part of our body. And so if we can determine what some of these underlying infections are, and then we can take appropriate steps. In Functional Medicine, we tend to use specific types of herbs and other factors that we know can improve the health and help our body to fight off these infections. We’ll often use, say herbal products. And then we dampen that autoimmune process because we dampen that chronic infection. And that’s one way in which we can help get this autoimmune process under control.
If there’s a big imbalance in the gut, we’ll often have leaky gut. Leaky gut is another process that can lead to increased auto immunity. And so healing up the lining of that gut, there’s specific protocols we can use with diet, lifestyle and targeted nutritional supplements.
We can also look at things like food sensitivities. So what happens with food sensitivities is let’s say you have a food sensitivity to gluten, what happens in that case is your immune system attacks the gluten, and then it cross reacts because that gluten tissue has an amino acid structure that’s a similar to thyroid tissue and those antibodies that are attacking the gluten are now attacking your thyroid tissue. And so this can be one of the triggers for a series of autoimmune conditions such as Hashimoto’s thyroiditis.
So I like to use with my patients either an elimination diet, where we take out some of the most common food sensitivities, and then after a period of time, we slowly test them back in to see if they have any reactions. The other thing we’ll do is at times is do food sensitivity testing with one of the more sophisticated panels and then take some of those foods out. And then in some cases, if they’re very strong food sensitivities, we will recommend that the patient’s simply not eat for example, gluten or dairy anymore, or we’ll have take them out for a period of time and then test them back and see if there’s any symptoms.
Now, in some cases, there are no symptoms. And yet we know that some of these factors can reduce that inflammatory process. And so if we see, for example, antibodies, autoantibodies say, we are tracking a patient with Hashimoto’s and let’s say they have thyroid peroxidase antibodies, and we see those go down significantly. That’s an indicator that we’re getting to somebody’s underlying causes for this autoimmunity. And so while measuring thyroid antibodies is typically not done by the average conventional medical clinician, and I’m not criticizing them for not doing this because it’s not really part of the protocol and using a conventional medical approach, they don’t really have tools. There’s no commonly used drugs that can really help to affect this unless they go to this, some of these more severe, pretty harsh injectable immune blocking drugs. So there’s reasons why it doesn’t make sense for conventional medical doctors to do this, but we want to track these auto antibodies because this is a measure of this underlying autoimmune process. And sometimes we’ll have patients who don’t have any symptoms.
So take myself, I discovered that I had a TSH that was elevated. Didn’t have any symptoms of hypothyroid, didn’t have fatigue, or hair loss, or dry skin, or any of the other symptoms of hypothyroid and was tracking my other thyroid factors, my T3, my T4, which were normal. And then at some point in time my thyroid, my TSH went up more, I had mildly elevated thyroid peroxidase antibodies. So I took a Functional Medicine approach. I looked at some food sensitivities eliminated certain foods. I did some stool testing that showed certain bacteria that were overgrown, that could be autoimmune triggers. I used certain herbs and other nutritional protocols to get my gut imbalance. And I saw my thyroid antibodies decrease.
And then I experimented with certain nutritional supplements because certain nutritional deficiencies can affect any autoimmune condition. In fact, nutritional deficiencies are actually not just frank deficiencies, but having less than optimal levels of nutrients. And this is something that we in the functional medicine world commonly see is there’s normal labs, and then there’s optimal labs. And when you look at a typical lab in the United States, there’s a reference range. And that reference range, unfortunately is based on where the average American is and anything above that’s considered abnormal. Anything within that range, conventional approaches say, don’t worry about it. Unfortunately who wants to be like the average American. So when we look at something like vitamin D we’ll see that there’s a reference range that says under 30 is low, over 30 is fine. Don’t worry about it. However, there’s a ton of research showing that there is an optimal range that’s higher than 30. Now, there’s still debates exactly what it is. Is it 40 to 60? Is it 50 to 70? Is it higher than that? So depending upon what you’re looking at, which studies, and your approach, but certainly the optimal range is different than the reference range. So when we’re going to look at nutritional deficiencies, we’re going to try to figure out what the optimal range is. So I had done some food sensitivity panels. I had done a nutritional panel on myself.
One of the nutrients that was especially was the most low was zinc. My vitamin D I struggled to get it up to… I try to target my vitamin D level in around 60. I try to get in that 50 to 70 range. For autoimmune disease. Sometimes it’s better to get it a little higher, and mine tends to go between 40 and 50. So I also did a genetic test and found out I don’t absorb zinc very well, or I have certain genetic factors that make it less likely that I’ll properly absorb zinc.
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So I started looking at some of these nutritional factors. I decided first to try adding a high dose iodine because some patients have reported doing better with high dose iodine. Iodine’s a crucial factor in thyroid. So when we talk about thyroid hormones, we have T4 and T3. The most commonly prescribed hormone is T4. T4 has four iodine molecules, T3 has three, T4 gets converted to T3. So iodine is crucial for formation of thyroid hormone. So I decided to take a high dose iodine in my case, and in quite a number of cases of patients with Hashimoto’s. In fact, I would say most patients with Hashimoto’s don’t do well with iodine. So I took 12.5 milligrams of iodine and nature to eat some seaweed regularly. And my TSH went from nine to 25 and that’s certainly the wrong direction. So I cut the high dose iodine. I had then done that nutrition test. I decided to significantly increase my intake of zinc supplements, increase my vitamin D. I went to 10,000 a day for a period of time while tracking it with lab testing. I also added 200 micrograms of selenium. I got stricter with eliminating certain foods that I sometimes tend to react to, that I enjoy eating and worked a little bit more on gut health. And I got my TSH down to four and a half and saw a decrease, an additional decrease in my thyroid antibodies.
So we know that nutritional deficiencies can be super important if you have nutritional deficiencies or levels of nutrient are less than optimal. Those are another thing we can look at. We know that various toxins, heavy metals can play a role. And we also know that for depending upon which autoimmune disease, there’s certain infections, there’s certain heavy metals that tend to play a role. So one of the most important things, when I see a patient in a functional medicine consultation is looking at the whole picture, looking at their history from starting all the way from when they were born. Were they born by vaginal delivery or C-section? Were they breastfed? Did they have a lot of ear infections? Did they have a lot of other infections? And I have to do multiple antibodies. Let’s look at where they live. Let’s look at their history, let’s look at all their symptoms. And then we get a picture of where the most likely potential underlying triggers might be for their potential autoimmune condition or their autoimmune condition that they may come in with that we know about. And then we will try to target the things that look like the most likely possibilities. And we’ll do some very careful efficient lab testing that helps us to identify specific triggers, potential triggers for their autoimmune disease. And then step by step peeling back the layers of an onion, will try to eliminate some of those sensitivities, either food sensitivities or toxins and help maybe do a detox program, maybe do a gut health program, figure out what sort of environmental exposures they may be having, sure up nutritional deficiencies will hit the most likely factors first.
And then we’ll peel back that first layer of the onion. And then as they start feeling better, we may dive into the next layer. And as we do this, hopefully over time, and this is what I’ve seen in most of my patient population, we get people feeling better. We see their autoimmune markers improving and this is a way to treat the root causes of their chronic diseases and not simply treat their symptoms. And that’s something that functional medicine is really uniquely designed to do.
Now I did mention a number of things that can affect our autoimmune diseases. There are many, many other things. We know that stress, lack of sleep. We know that the way they other factors in their lifestyle, their amount of exercise or lack of exercise, and there’s quite a number of other things that affect our lifestyle factors that can affect their potential for autoimmune diseases. And these are things that we look at by taking a careful history by doing screening exams. And then we want to do some careful testing. We want to be judicious about that. Over testing. We want to do the most efficient test. First, we want to get them done in the most economic manner for patients because some of these tests are expensive, but if we don’t test, then we’re just guessing. And I think from a functional medicine perspective, we want to get our patients feeling better. And we also want to put out the smoldering fire of autoimmunity that may be affecting this patient’s long term health and leading to more and more chronic diseases.
We know that patients who have an autoimmune disease are more likely to have another autoimmune disease. And are more likely to have damage to those targeted organs over time. So I hope I’ve given everybody some things to think about. Autoimmune diseases, how we can approach them from a functional medicine approach. The bottom line is by improving your diet and lifestyle, getting rid of toxins, shoring up nutritional deficiencies, improving our gut health. There’s a lot we can do to reducing the chronic disease burden in this country and around the world. Thank you. And I look forward to speaking you with you next week.
Thank you for making it all the way through this episode of the Rational Wellness Podcast. And if you enjoyed this podcast, please go to Apple Podcast and give us a five star ratings and review that way more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts. And I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica, Weitz Sports Chiropractic and Nutrition Clinic. So if you’re interested, please call my office (310) 395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben weitz. Thank you and see you next week.
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