Natural Health Medicine

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AUTOIMMUNITY – Stop the body’s attack on itself!

Autoimmunity or autoimmune conditions, relate to diseases (of which there are more than 80), where the immune system is attacking the body’s own healthy tissues and cells. This insult on the body by the immune system could be localized, to a specific organ or it could be systemic, effecting various parts of the body. This can change the way an organ or body systems functions and can cause damage and inflammation, resulting in many different symptoms.

CAUSES of AUTOIMMUNITY

• Digestive issues are one of the most important areas to zone in on with autoimmunity, you may or may not know you have issues in this area, and thats ok because there are fantastic tests that can reveal this information for us (see below).
• Infection can also trigger autoimmunity and this ties in with some of the digestive investigations but also may not be isolated to this area.
• Hormones imbalances are often missed in autoimmune investigations, particularly estrogen and prolactin issues.
• Allergies and food intolerances can play a role in autoimmune conditions beyond just a gluten problem.
• Many people with autoimmunity can have a problem with gluten (the protein found in many grains), and while it can be tricky to establish celiac disease from non celiac gluten sensitivity, we do our best to establish this from the start as management is different. Its worth noting that the gold standard diagnosis of celiac disease can only be done via a biopsy (endoscopy) through a gastroenterologist, whilst there are many people who have gluten issues who are not celiacs its good to know where you fit.
• There is research which shows an association between heavy metal exposure, which can also be tested.

Understanding Your Immune System

Our immune system produces antibodies (also known as immunoglobulins) in response to antigens (foreign substance such as bacteria and viruses), this allows our immune system to easily identify and destroy a particular antigen. In autoimmunity the immune system produces antibodies against the nucleus of the body’s own cells, these antibodies are known as autoantibodies or antinuclear antibodies (ANA’s). It’s important to note that not all autoimmune conditions cause ANA levels to rise.

Understanding ANA’s

A blood test can determine the presence of ANA’s, if positive it will be commonly reported as a titre, starting weak, moving to higher titres, examples include 1:80, 1:160, 1: 320, 1: 640, 1: 1280, etc etc, the value along with clinical signs and symptoms provides significance to a positive result and progression of disease. ANA test results can be positive in people without any sign and symptoms of autoimmune disease and you may find that medically this not considered relevant. Considering that ANA’s can be present years before signs or symptoms appear, we consider that any ANA should not be dismissed and all the appropriate investigation begin, rather than a “wait and see” approach! A positive ANA will prompt further testing which may be able to narrow down autoimmunity in specific tissues such as thyroid antibodies etc.

What To Test?

IIt is really important to test certain areas which may be causing the problem or may help treat your autoimmune condition, we have a list of our non-negotiable tests and then others that we may add later if needed. Many times it can be really useful to improve certain nutritional markers, provide certain support and improve digestion and then move on to the next test if and when needed. Examples of some tests: ANA, vitamin D, thyroid antibodies, estrogen, prolactin, anion gap, white cells, inflammatory markers, zinc, selenium, mercury, lead, cadmium, stool tests (parasites, bacterial overgrowth, yeast, microbiome, short chain fatty acids), immunoglobulins, breath tests (Helicobacter pylori, small intestinal bacterial overgrowth SIBO), viruses just to name a few! With heavy metal testing we need to decide if we want to check current exposure or past exposure. With all the testing, we like to start with easily accessible and inexpensive testing first, work in with GP’s when needed and then move on from there. Autoimmune diseases will involve lifestyle changes and depending on the severity of the situation will depend on the extent of changes needed, it is certainly an area that is dependant on lifestyle medicine. With the correct testing treatment can be directed on the areas that will have the best impact.

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Examples of AUTOIMMUNE DISEASES

Thanks to the Australian Society of Clinical Immunology and Allergy, the below is a very good list of autoimmune diseases: Addison’s disease (adrenal), Autoimmune hepatitis (liver), Coeliac disease (gastrointestinal tract), Crohn’s disease (gastrointestinal tract), Diabetes Mellitis Type 1a (pancreas), Grave’s disease (thyroid), Guillain-Barre syndrome (nervous system), Hashimoto’s thyroiditis (thyroid), Multiple sclerosis (nervous system), Pernicious anaemia (stomach), Primary biliary cirrhosis (liver), Sclerosing cholangitis (liver), Myasthenia gravis (nerves, muscles), Ulcerative colitis (gastrointestinal tract), Antiphospholipid antibody syndromes (blood cells), Mixed connective tissue disease Dermatomyositis (skin, muscles), Polymyalgia rheumatica (large muscle groups), Polymyositis (skin, muscles), Primary Raynaud’s disease (blood vessels), Psoriasis (skin), Rheumatic fever Rheumatoid arthritis (joints, less commonly lungs, skin, eyes), Rheumatoid arthritis (joints), Scleroderma (skin, intestine, less commonly lungs, kidneys), Sjögren’s syndrome (salivary glands, tear glands, joints), Systemic Lupus Erythematosus (skin, joints, kidneys, heart, brain, red blood cells, other), Vasculitis disorders (are relatively rare and result from inflammation of blood vessels), Churg-Strauss syndrome (lungs, skin, nerves), Cryoglobulinaemia (skin, kidneys, nerves), Goodpasture’s syndrome (lungs, kidneys), Henoch-Schonlein purpura (skin, joints, kidneys, gut), Microscopic polyangitis (skin, kidneys, nerves), Wegener’s granulomatosis (sinuses, lungs, kidneys, skin), Behcet’s disease (mucous membranes, skin, eyes), Central nervous system vasculitis (brain) Kawasaki syndrome (skin, mucous membranes, lymph nodes, blood vessels), Polyarteritis nodosa (kidneys, gut, nerves, skin), Giant cell (temporal), arteritis (arteries of the head and neck), Takayasu arteritis (arteries of the head and neck), Vitiliago.

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Pathology Testing

In House Testing

Interpretation of results is conducted by giving careful consideration to the relationship between the various results, as well as understanding their strengths and limitations. We take into account certain factors, such as; diet, stress levels, gender, age and if relevant, pregnancy and lactation. Our ability to contextualize your results allows us to formulate a highly individualised assessment with a more targeted treatment.

Most interpretation is facilitated using laboratory tests, however we also use in-house testing, as this can be a useful and is easily completed as part of your appointment. These tests are also used as a convenient way of assessing progress in following consultations.

Below is a list of our current in house testing. NOTE: There is no extra charge for in house testing.

Blood Glucose
This test provides information on the concentration of glucose in the blood. Diabetics and pre-diabetics will show an elevated reading. Glucose is elevated after eating and lowest in the fasting state, therefore results are evaluated accordingly.

REQUIREMENTS PRIOR TO TESTING
minimum 2 hours of fasting (water is permitted)

PROCEDURE
finger prick blood test

Cholesterol
Cholesterol is required for the production of steroids, sex hormones, bile acids and cellular membranes. Whilst testing for cholesterol is commonly used to identify cardiovascular risk, readings can provide an insight (along with other tests) about other illnesses, as the liver metabolizes cholesterol. This test provides a total cholesterol reading (elevated levels will be referred for a lipid profile)

REQUIREMENTS PRIOR TO TESTING
no fats to be ingested 6 hours prior to testing

PROCEDURE
finger prick blood test

Triglycerides
Triglycerides are a form of fat in the bloodstream. Produced in the liver, it acts as a storage source for energy. High levels in the blood are deposited in the fatty tissues. High levels may be due to poorly controlled diabetes, nephrotic syndrome, familial hypertriglyceridemia, glycogen storage disease, hypothyroidism or chronic renal failure. Low levels may suggest malabsorption syndrome, malnutrition, hyperthyroidism or abetalipoproteinemia.

REQUIREMENTS PRIOR TO TESTING
overnight fast (12 – 14 hours, water is permitted)

PROCEDURE
finger prick blood test

Heamoglobin
Hemoglobin serves as a vehicle for oxygen and carbon dioxide transport. The oxygen carrying capacity of the blood is determined by the hemoglobin concentration and it also acts as an important acid-base buffer system. Women tend to have lower values than men, and values tend to decrease with age. Decreased levels indicate anemia. Due to the many factors affecting this test, careful consideration is given around the circumstances at the time of testing.

REQUIREMENTS PRIOR TO TESTING
overnight fast (12 – 14 hours, water is permitted)

PROCEDURE
finger prick blood test

Urinanalysis
Urinalysis can reveal a significant amount of preliminary information about the kidneys and other metabolic processes. pH provides the acid-base balance and reflects the work of the kidney to maintain normal pH homeostasis in the body. Protein is not usually present in urine, and therefore its presence may indicate glomerular membrane injury. Specific gravity is a measure of concentration of particles in the urine, including waste and electrolytes. High specific gravity results may indicate dehydration, and low indicates hydration status. Interpretation is made based on the presence or absence of glycosuria and proteinuria. Leukocytes (white blood cells) are suggestive of a UTI (urinary tract infection). Nitrites also may indicate a UTI. Ketones may be present in the urine in poorly controlled diabetes, hyperglycaemia. Ketones may also be associated with alcoholism, fasting, starvation, high protein diets and isopropanol ingestion. Blood is not supposed to be present and may indicate injury.

REQUIREMENTS PRIOR TO TESTING
specimen must be tested within 1 hour

PROCEDURE
urine

Blood Pressure
Blood pressure is considered a principle vital sign, assessing the pressure exerted by circulation of blood upon the walls of the blood vessels. Both low blood pressure (hypotension) and high blood pressure (hypertension) have many causes, controlled by the nervous and endocrine systems.

REQUIREMENTS PRIOR TO TESTING
none

PROCEDURE
non invasive (sphygomanometer)

Anthropometric Measures
Anthropometric measurements are comparative measures of the body and include weight, height, body mass index (BMI) and waist circumference. Findings are compared to reference standards to assess weight status and the risk for various diseases.

REQUIREMENTS PRIOR TO TESTING
none

PROCEDURE
non invasive (scales, tape measure)

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