Autoimmunity
Autoimmune diseases are the result of your immune system (auto antibodies) accidentally attacking the healthy cells inside your body (muscle tissues, bones, organs). There are more than 100 autoimmune diseases in existence. The medical community is still searching for answers to learn why the human body sometimes attacks itself. (Source: Cleveland Clinic)
DISCLAIMER
The following information is not an attempt to provide medical advice. I am not a licensed medical professional or nutritionist. This is just a general overview of some of the autoimmune disorders and medical conditions that are linked to intestinal permeability. There are many reasons why someone may have an adverse reaction to certain foods but you should always check with a licensed medical professional if you think you're developing a food allergy or having gastrointestinal issues. I don't receive any form of compensation if you click on any of the links included below.
Addison's Disease (autoimmune adrenalitis / adrenal insufficiency)
Addison's disease is a life-threatening autoimmune disease caused by damage to the adrenal glands. The adrenal glands are responsible for making hormones, specifically (cortisol and aldosterone.) Getting diagnosed is rare, as it only affects on average people aged 30 - 50, from 4 to 11 per 100,000 of the population (U.S.) The disease is more commonly seen in women.
Risk factors include: type I diabetes, hypoparathyroidism, myasthenia gravis, vitiligo, Grave's disease, pernicious anemia, chronic thyroiditis, dermatis herpetiformis, and hypopituitarism. Treatment requires lifelong prescription medicine to replace hormones the adrenal glands stopped making.
Studies show that people with Addison's disease can benefit from a diet high in sodium, calcium and Vitamin D. (Sources: Mayo Clinic & NIH).
Resources:
National Adrenal Diseases Foundation (NADF)
Celiac Disease
Celiac Disease is an autoimmune disease that affects the lining of the small intestine, triggered by eating gluten, a protein found in the grains wheat, barley, rye, spelt, durum, semolina, kamut, malt, triticale, einkorn, and oats not labeled gluten free. Gluten is a common ingredient used to make bread, cookies, pastries, pasta, cereal, soy sauce, salad dressings, marinades, jerk sauce, mustard, chicken bouillon cubes, broth, gin, vodka and whiskey to name a few. Repeat exposure to gluten damages the lining of the small intestine, leading to malabsorption, weight loss, fatigue and anemia.
While Celiac Disease can affect people of all ages only 1.4% of the global population has a diagnosis. Risk factors include people who have a group of normal gene variants DQ2 or DQ8 (only 3% of people with these genes develop Celiac disease), lyme disease, people who contract a high number of infections at a young age and changes in the bacteria in the digestive tract that help with digestion. Research also points to an increase in people being diagnosed with Celiac Disease after a Covid-19 infection.
Treatment requires a lifelong avoidance of any food, drinks, medicines, and personal hygiene products (shampoo, toothpaste, lotion, makeup) that contain gluten. No amount of gluten is safe for people with Celiac disease. (Sources: Mayo Clinic & NIH).
Resources:
Chronic Lyme Disease
Lyme Disease is caused by a tick bite that infects the body with a bacteria (borrelia burgdorferi). If caught early, Lyme disease can be cured with antibiotics. However, some people develop symptoms of ongoing fatigue, cognitive impairment and pain for six months or longer, even after being treated with antibiotics. This is referred to as: Post Treatment Lyme Disease Syndrome (PTLDS). The term "Chronic Lyme Disease" is not fully accepted or acknowledged within the medical community. However, the NIH uses it to describe people with persistent illnesses after an infection from a tick bite that have also experienced a significant impairment to their quality of life. Lyme disease is most commonly reported in the northeastern and upper midwestern United States, but some cases have also been reported in Washington state, California and Oregon. (Lyme disease is also found in Canada, Western Europe and Asia.) For the states with reported cases of Lyme disease, 40 out of 100,000 people infected develop Lyme Disease. 5% of the people treated for Lyme Disease in the U.S. develop Chronic Lyme Disease. Illnesses that are often diagnosed in people with Chronic Lyme Disease include heart disease, arthritis, neurological disorders, visual impairments and skin rashes. Lyme disease is often a delayed diagnosis for a number of reasons, one being because most people don't realize that they've been bitten by a tick.
Risk factors for developing Lyme Disease include environment: living near wooded areas with a large population of rodents, vegetation: high grass, human risk behaviors: sitting in grass, hiking, camping. (Source: NIH).
Resources:
John Hopkins Lyme and Tickborne Disease Tracker
The Quiet Epidemic (documentary film on Lyme Disease available on Amazon, Apple TV and Vimeo)
Under Our Skin (documentary film on Lyme Disease available on their website and YouTube)
Crohn's Disease
Crohn's disease is an autoimmune disorder and inflammatory bowel disease that can affect a person's entire gastrointestinal tract. More commonly, inflammation occurs in the small and large intestine. This is a chronic disease with symptoms that can develop gradually and become worse over time. In some cases people can experience a remission in symptoms for a few years before another flare up occurs. In the U.S., more than half a million people have been diagnosed with Crohn's disease.
Risk factors include people who smoke cigarettes, people with a family member with IBD and people aged 20 - 29 years old. Crohn's disease can be life threatening for people who develop colon cancer.
Research shows people with Crohn's disease benefit from eating a low fiber, lactose free, low salt, low fat, high calorie diet and should avoid carbonated drinks, popcorn, and nuts. (Source: NIH).
Resources:
American Gastroenterological Association
Fibromyalgia
Fibromyalgia is a chronic condition but is not considered an autoimmune disorder by the medical community. (Why these asinine decisions continue to be made in healthcare will forever irk my soul.) A rheumatologist or internal medicine specialist is more likely to diagnose and treat patients with fibromyalgia. Fibromyalgia is considered a diagnosis of exclusion because people often receive a diagnosis after having positive antinuclear antibody tests that don't have enough biomarkers for other rheumatic diseases such as lupus and rheumatoid arthritis. While no longer required for diagnosis, doctors may check 18 pain points all over the body to determine whether or not someone has fibromyalgia. There are no current lab tests approved to diagnose fibromyalgia. People of all ages and races can develop fibromyalgia. The main symptoms for the disease include pain all over the body, fatigue and sleep disorders.
Risk factors for fibromyalgia include family history, non-genetic environmental triggers, an alteration of neural pathways that send pain signals from the brain to the body, and people with other pre-existing conditions or autoimmune diseases such as lupus, osteoarthritis, rheumatoid arthritis, chronic back pain, ankylosing spondylitis, IBS, depression and anxiety. (Source: NIH).
Resources:
Invisible (documentary available on Tubi app and YouTube)
Gluten Sensitivity
When your lab results come back negative for Celiac Disease, you might have Gluten Sensitivity, which is difficult to diagnose. Doctors and nutritionists may recommend an elimination diet that requires the removal of all foods containing gluten (wheat, barley, rye and oats not labeled gluten free) and slowly re-introducing foods that contain gluten to see if you have any gastrointestinal (GI) symptoms. Gluten Sensitivity, (Non-Celiac Gluten Sensitivity / (NCGS), gluten intolerance) is a medical condition that causes digestive issues in your intestines as well as other symptoms in the joints, eyes, skin, and in some cases the liver, kidneys and pancreas. The medical community has yet to reach a consensus on the best way to diagnose patients with Gluten Sensitivity. However, research suggests there are more people with Gluten Sensitivity than Celiac Disease in the U.S.
Risk factors for developing Gluten Sensitivity include having a direct relative with Celiac Disease, having adverse reactions to certain foods or other food allergies, exposure to tick bites, having other autoimmune disorders, having GI disorders or neurological disorders. Women are also more likely to have Gluten Sensitivity than men.
A strict gluten free diet is the only way to avoid triggering Gluten Sensitivity symptoms. This means avoiding all foods, drinks, medicines and personal hygiene products that contain gluten unless labeled gluten free or certified gluten free ( Ex. soy sauce, mustard, worcestershire sauce, salad dressing, cereals, pasta, bread, cookies, cake, pie, chicken bouillon cubes, etc.) Source: (NIH).
Resources:
***As someone with Gluten Sensitivity, I strongly disagree with much of the messaging these organizations (not GIG) use to describe and compare Gluten Sensitivity to Celiac Disease. I went to the doctor to get diagnosed but my symptoms were dismissed. While I strongly believe racial bias in medicine played a role in my experience, research has shown that most people with NCGS are self-diagnosed. In order to get tested for Celiac Disease, you do need to have consumed gluten before testing, so I don't recommend going gluten free before seeing an internal medicine or gastrointestinal physician.***
Graves' Disease
Graves' Disease is an autoimmune disorder that causes an overactive thyroid (a small, butterfly shaped organ on the front of your neck.) An overactive thyroid can lead to hyperthyroidism. Graves' disease can affect every organ in the body, due to the immune system attacking the thyroid, which controls how much energy the body produces.
This disease affects nearly 1 in 100 Americans. Other risk factors include being a woman, a family history of Graves' disease or Hashimoto's disease, Type I diabetes, vitiligo, rheumatoid arthritis, people over the age of 30 and smoking cigarettes.
People with Graves' disease should avoid food with large amounts of iodine because it can worsen the symptoms of hyperthyroidism. (Source: NIH)
Resources:
Graves' Disease and Thyroid Foundation
Hashimoto's Disease
Hashimoto's Disease (Hashimoto's thyroiditis, chronic lymphocytic thyroiditis) is an autoimmune disorder that attacks the thyroid and can lead to hypothyroidism or underactive thyroid. In Hashimoto's disease, the immune system attacks the thyroid (butterfly shaped organ at the front of the neck), producing a large number of white blood cells that build up in the thyroid, damaging the thyroid gland and preventing it from making enough thyroid hormones. The thyroid affects the body's energy levels which can affect every organ in the body, similar to Graves' disease.
Risk factors for Hashimoto's include family history, Type I diabetes, Celiac disease, rheumatoid arthritis, Sjögren’s syndrome and lupus. Men and woman can develop Hashimoto's disease, but it's more commonly diagnosed in women between the ages of 30 - 50.
There has not been enough research to prove that a gluten free diet is the best course of action for non-celiac people with Hashimoto's, though in some cases it can help reduce inflammation. Eating foods with a high amount of iodized salt such as seaweed can make symptoms worse. (Source: NIH).
Resources:
Irritable Bowel Disease (IBD)
Irritable Bowel Disease is a group of diseases (ulcerative colitis and Crohn's disease) that cause chronic inflammation in the lining of your digestive tract. IBD can be mild to severe and life threatening. Most people are diagnosed before they turn 30 but it is also possible to develop IBD later in life between 50 - 60 years old. People with IBD can experience periods of remission and flare ups.
Risk factors include family history, smoking cigarettes, NSAID medications (Examples: Ibuprofen, Aleve, Advil).
There is no specific diet for people with IBD but research has shown potential benefits to eating smaller meals and snacks throughout the day, an anti-inflammatory diet (AID), a balanced gluten free diet full of nutrients and avoiding trigger foods high in fat and carbohydrates. Source: (Mayo Clinic & NIH).
Resources:
American Gastroenterological Association
Crohn's and Colitis Foundation
Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder (disorders of gut-brain interactions) that is a group of symptoms (repeated pain in abdomen, a change in bowel movements) but does not show any visible signs of damage or disease to your digestive tract. Roughly 12% of people in the U.S. have IBS.
Risk factors include family history, other digestive diseases (GERD), chronic pain (fibromyalgia, myalgic encephalomyelitis/chronic fatigue syndrome), a history of stress and getting a severe infection in your digestive tract. Women are twice as likely than men to develop IBS.
People diagnosed with IBS have to go on a gluten free, high soluble fiber (beans, fruits, gluten free oats), low FODMAP diet. (Source: NIH).
Resources:
American Gastroenterological Association
Long Covid
Long Covid (postacute sequelae of SARS-CoV-2 - PASC, Long Hauler, Chronic Covid) is an illness that anyone infected with Covid-19 can get, regardless of whether they were hospitalized, unvaccinated or vaccinated. It is described as a group of symptoms that continue two to three months after the initial infection and with new symptoms developing over time.
To date, research shows that people with Long Covid have reported 200 symptoms, some of which include: fatigue, dizziness, sleep disturbances, joint and muscle pain, chest pain, digestive issues, loss of taste and smell, trouble breathing, heart palpitations, fever, memory lapses, tinnitus, uncontrollable body movements (tremors), difficulty concentrating (brain fog), depression and anxiety. The U.S. Department of Health considers Long Covid a disability if it "substantially limits one or more major life activities or includes a physical impairment, including any physiological disorder or condition affecting one or more body systems."
Some people report being healed after 1 year, some go on to develop worsening symptoms and others experience a relapse or an onset of new, debilitating symptoms with new Covid-19 infections. Globally, governments have committed to spending billions of dollars, so that scientists and doctors can continue to conduct studies and publish research papers on Covid-19 / Long Covid. There is still no cure for this illness. Sources: (WHO, SSA, NIH).
Resources:
JAMA Network Investigation - Autoimmune and Autoinflammatory Connective Tissue Disorders Following Covid-19
Scientific American / The Conversation - What We Know About Long Covid Right Now
Survivor Diaries - YouTube docuseries that follow different groups of people who developed Long Covid (POTS, ME/CFS, Dysautonomia, etc.)
Yale Medicine - Long Covid Blog
Lupus
Lupus (systemic lupus erythematosus) is an autoimmune disease that causes inflammation and permanent tissue damage to several parts of the body, which include: lungs, kidneys, joints, skin, the brain and heart. Lupus is different for each person diagnosed with the disease. It can affect multiple organs or just one part of the body, be mild or severe, go into remission and changes over time.
Risk factors for developing lupus include family history of lupus or other autoimmune diseases, people aged 15 - 45, being African-American, Asian, Hispanic or Indigenous American, and environmental factors such as sun exposure, viral infections, Epstein-Barr virus and a history of smoking. Both men and women can be diagnosed with lupus but women are ten times more at risk to develop the disease.
It's recommended that people with lupus eat a diet full of fruits, vegetables and whole grains. Source: (NIH).
Resources:
Life With Lupus Patient Support Community
Myalgic Encephalomyelitis / Chronic Fatigue Syndrome
Myalgic Encephalomyelitis / Chronic Fatigue Syndrome (ME/CFS) is a chronic, multi-systemic disease that causes neurological, autonomic, immunological and energy metabolism dysfunction. The main symptom is a condition called "post-exertional malaise / PEM" where small activities or simple tasks such as running an errand or washing your hair can cause extreme fatigue and an inability to function. Other characteristics of the disease include flu-like symptoms, gastrointestinal issues (IBD, IBS), sensitivity to light and sound, sleep disturbances, chronic pain, exercise intolerance, cognitive issues, dizziness or fainting upon standing, urinary and reproductive issues.
There are no known risk factors and anyone can get ME/CFS. This disease presents differently in each person. About 1/4 of the people in the U.S. diagnosed with the disease become bedbound or housebound and never regain their pre-disease level of functioning. There are no FDA approved treatments and no diagnostic testing for the disease. Source: (NIH).
Resources:
Help Rising - news, blog and support group for ME/CFS, Fibromyalgia and Long Covid
The Forgotten Plague - documentary on YouTube about the lives of people before and after being diagnosed with ME/CFS.
Unrest - popular documentary about living with ME/CFS available on YouTube and other streaming services.
Mixed Connective Tissue Disease
Mixed Connective Tissue Disease (MCTD) is a rare autoimmune disease that is hard to diagnose. An MCTD diagnosis requires people to meet these four criteria:
- an overlap of at least two connective tissue diseases (lupus, rheumatoid arthritis, systemic sclerosis, dermatomyositis, or polymyositi);
- Raynaud phenomenon (affects blood flow to the fingers and toes when exposed to cold or stressful conditions, causing numbness);
- a negative impact on organs caused by a special type of high blood pressure known as pulmonary hypertension, trigeminal neuropathy (nerve pain that affects the body's sensory or motor functions) or aseptic meningitis (inflammation of the brain and spinal cord);
- along with the presence of the antibody anti-U1-ribonucleoprotein
The cause and risk factors for MCTD is unknown. This disease can affect every organ in the body and may cause life-threatening conditions depending on the progression of the disease, the organ affected and the level of inflammation. People with MCTD may also have gastroesophageal reflux disease (GERD).
Anti-inflammatory diets are often recommended for connective tissue disorders but there's not enough scientific evidence to show that this helps to reduce symptoms. (Source: NIH).
Resources:
Genetic and Rare Diseases (GARD) Information Center
Mixed Connective Tissue Disease Foundation
Rheumatoid Arthritis
Rheumatoid Arthritis (RA) is a chronic autoimmune disease that causes fatigue, joint pain, stiffness, damage to the muscle tissues that cover the bones where joints connect, and can affect other parts of the body including the skin, lungs, eyes, nerves, blood and the heart. RA can be difficult to diagnose because many of the symptoms develop over time and there's no single test to diagnose this disease. RA looks different in everyone.
Risk factors include genetics and family history, smoking, lung disease, gum disease, obesity. Women are two to three times as likely to develop rheumatoid arthritis.
It's recommended to maintain a healthy diet full of protein and calcium. Source: (NIH).
Resources:
Rheumatoid Arthritis Support Network
Rheum TV - John Hopkins collection of videos, articles and resources for rheumatic diseases (RA, lupus, lyme disease, Sjogren's Syndrome)
Sjogren's (SHOW-gren) Syndrome
Sjögren’s Syndrome (SS) is a systemic autoimmune disorder whose hallmark symptom causes dryness of the eyes and mouth. Half of the people diagnosed with SS also develop glandular (moisture) issues in other organs such as the gastrointestinal tract, kidneys, lungs, skin, joints and nervous system. People of every age and race can develop SS. The disease presents differently for each person diagnosed and symptoms can range from mild to severe.
Risk factors include other rheumatic disorders such as rheumatoid arthritis and lupus, being middle aged and women are nine times more likely to receive a diagnosis than men. SS can be diagnosed via an antinuclear antibody lab test or through a minor salivary gland biopsy, however, many people are under diagnosed because there's no set criteria to refer people who suffer from dry eyes to a rheumatologist for testing. While there is no cure, there are several treatments available to manage the symptoms of SS.
There's no specific diet for people with Sjogren's Syndrome but staying hydrated and drinking moisture rich foods such as soups and porridge is recommended. Source: (NIH).
Resources:
Whipple's Disease
Whipple's Disease is a rare, systemic, infectious bacterial disorder that is mainly known for causing malabsorption, sores, lesions and destroying the villi inside the intestines. The bacteria, tropheryma whipplei, blocks the body's ability to process fats into energy. The disorder can affect every system in the body. The main symptoms are abdominal pain, weight loss, diarrhea, fever and joint pain. This illness is treatable with antibiotics but can be fatal if not treated soon enough to prevent serious damage. Getting a bowel biopsy from a gastrointestinal physician that is then tested for the bacteria is how the disease is diagnosed.
White people living in North America and Europe and middle aged men between the ages of 40 - 60 are more likely to develop Whipple's Disease. Other risk factors anemia, iron, vitamin B12 and folate deficiencies, working in agriculture or landscaping, and frequent contact with sewage and wastewater. This disorder can be misdiagnosed with rheumatic and other gastrointestinal disorders. Source: (NIH).
Resources:
National Organization For Rare Disorders (NORD)
New York Times Magazine "Diagnosis" Her Seering Gut Pain Suggested Celiac. Why Didn't Cutting Out Gluten Help?