An Autoimmune Condition and Adrenal Fatigue Syndrome – Part 1

By: Dr. Michael Lam, MD, MPH; Justin Lam, ABAAHP, FMNM

an autoimmune condition can raise many questionsMillions of people are diagnosed with some form of autoimmune condition, and this number is rapidly growing. Prevalence of the disease is 75% more common in women than in men. Autoimmune disease occurs when the immune system begins to attack healthy tissue in the body, thinking it is an invading bacteria or virus. It is thought that because women have a stronger, more reactive immune system then men, they are more susceptible to an autoimmune condition. Autoimmune diseases are classified by the main tissue the immune system attacks. While the conditions often cause systemic issues, there is often a main organ system the autoimmune system responds to.

There are many types and progressions of autoimmune diseases, and many have widespread symptoms. It is important to note that a diagnosis of an autoimmune disease does not mean that there is no hope. Autoimmune diseases vary symptom to symptom and person to person, so depending on how you manage your diagnosis, it provides an opportunity to reclaim your health and your life. However it is important to understand that the antibodies will usually be present and can always flare up from time to time.

The goal is to stay in remission as long as you can by identifying the cause, staying away from triggers, and optimizing your immune system.

Because many different organs can be affected throughout the body, symptoms of each autoimmune disease can vary greatly. The symptoms of an autoimmune disease can often mimic the symptoms of adrenal fatigue. The two conditions are related and it is important to note the differences between the two, the similarities, and how both can exist in a susceptible body.

Some common autoimmune conditions include:
Hashimoto’s Thyroiditis – the immune system attacks the thyroid, which decreases the thyroid effectiveness and results in hypothyroid symptoms

Inflammatory Bowel Disease (IBD) – Ulcerative colitis or Crohn’s disease, which includes diarrhea, nausea, and abdominal pain; the immune system attacks the lining of the colon

Systemic Lupus Erythematosus (SLE) – characterized by joint pain and swelling, a butterfly rash across the face, inflammation of mucous membranes, and other symptoms

Rheumatoid Arthritis – the immune system attacks the joint space, specifically in the fingers and hands which causes joint swelling, joint pain, and even changes to the bone structure

Celiac Disease – the immune system is triggered and reacts to gliadin, a component of gluten, which then causes immune damage to the intestinal lining

Sjogren Disease – a condition characterized by dry eyes and dry mouth; the immune system attacks the salivary glands and tear ducts, this syndrome can also be seen with other autoimmune conditions

Raynaud’s Phenomenon – often a symptom in many other autoimmune conditions, it is characterized by vasoconstriction of the blood vessels supplying the fingers, the result is white waxy fingers as a result of cold or stress

Stages of Autoimmunity

Autoimmune condition stagesThere are 3 stages to the progression of an autoimmune condition. Stage 1 is a silent autoimmune condition , where antibodies can become elevated, but the target organ has no symptoms or loss of function. Stage 2 is Autoimmune Reactivity, where antibodies are elevated and the person presents with some symptoms and mild loss of function. However, in stage 2 there is no severe impairment of the tissue associated with the disease. Stage 3 is what most doctors would identify as Autoimmune disease, where labs, imaging, and special studies can identify significant loss of function along with the elevated antibodies and significant signs and symptoms.

Conventional medicine usually catches such dysfunction when it’s already too late and in full blown late stages. For example, Addison’s disease is only diagnosed when 90% of adrenal function is affected. By this time, it is very difficult to regain adrenal function. However, it’s encouraging to know that you can identify your problems well before it reaches to stage 3 of autoimmune disease if you are on the alert and is a careful listener of your body’s signals. When caught early, your body has plenty of chances to rebuild itself with the right guidance.

What Causes Autoimmune Disease?

The exact cause of autoimmune diseases is unknown, but environmental and genetic factors play a large role in the onset and progression of the disease. Environmental factors such as chronic stress, either externally or an underlying condition of the body, toxin/pollutant exposure, immune-reactive dietary proteins, and underlying infections have all been examined as potential causes for the trigger of immune dysregulation. Once the immune system starts to identify its own cells as enemies, that could lead to loss of self-tolerance, and therefore production of self-tissue antibodies.

Infections especially with the viruses Epstein Barr Virus, Herpes Simplex 1 and Herpes Simplex 2 have been associated with autoimmune disease onset. The bacteria E.coli has also been thought to contribute to autoimmune conditions. The reasons for these infections triggering an autoimmune condition is unknown, but there are two working theories.

The first theory includes a term called molecular mimicry. Molecular mimicry is a way the virus or bacteria might try to escape the immune system. In a normal immune system, the virus presents itself, the immune cells recognize it as foreign material, and attacks it. In molecular mimicry, the virus is able to disguise itself to look like healthy tissue (by attaching proteins and sugar complexes that healthy cells in our body have on their surface.) The immune system doesn’t recognize the invading virus at first, so the infection can spread. Eventually, the immune system catches on, but because the virus mimicked healthy tissue, the body is now susceptible to an immune attack on the actual healthy tissue. autoimmune condition , viruses and bacteria. A very important example of molecular mimicry is the cross reactivity of gluten with gut cells. Studies have shown that gluten, found in most wheat products, can be viewed as a foreign object by the body, inducing it to create antibodies against it. Since gluten has been shown to cross react with the gut and pancreatic islet cells, the antibodies against gluten actually damage the body’s own cells, leading to increased gut diseases and possible diabetes.

The second theory involves gut health, which E.coli damages. Studies have shown that people with Type 1 Diabetes as well as Rheumatoid Arthritis have less healthy gut bacteria and oral microbiota. Since many immune cells are located in the gastrointestinal tract, it is logical to see that an unhealthy gut can lead to abnormal immunity.
Maintaining healthy gut microbiota and healthy intestinal lining is important in our overall health. When infected with E.coli, our gut microbiota is thrown out of balance, which affects how we are able to absorb and manage nutrients from our body. This dysregulation can at times damage the intestinal lining, which causes the immune system to attack the healthy tissue of the gut, which results in issues such as IBD, inflammatory bowel disease. While having an unhealthy gut might not cause an autoimmune condition in everyone, if our body is genetically predisposed, as we will discuss further, it might be enough to cause a reaction.

Not to be forgotten is our genetic makeup. Genetic factors affact how the immune cells are structured. There are many ways immune cells are formed and able to function, one of these is the MHC, major histocompatibility complex, which are involved in cell recognition. A slight genetic problem with this complex combined with an environmental trigger can be enough to tip the body to an autoimmune condition. The genetic link, however, is not as simple as one protein code and one gene. There are many factors and issues that can be linked and studied. An example of the complexity is to look at how autoimmune diseases play out in a family. Often, when a disease is thought to be genetic, it is able to be passed down to children. However, autoimmune diseases are unique because if one person in the family is diagnosed with, Hashimoto’s thyroiditis, another member of the family might be diagnosed with SLE (lupus). While the genetics primed the body for an autoimmune disease, environmental factors determined the course of the disease.

When the body has an increased risk of an autoimmune disease, it does not necessarily mean that the body will progress to that disease unless triggered by a situation or condition on the body. If environmental factors and existing conditions on the body are favorable towards an autoimmune disease, it will be easier to trigger. There are situations though where the body is genetically predisposed to an autoimmune condition, but the environmental factors are never strong enough to have the body progress to a disease.

An Autoimmune Condition and Adrenal Fatigue

an autoimmune condition and adrenal fatigueAdrenal Fatigue Syndrome (AFS) is a condition directly related to the hypothalamic pituitary adrenal (HPA) hormonal axis. This axis is the pathway that manages our response to stress and the release of cortisol. Stress can be an external event, or underlying condition in the body. AFS is a condition that can surface when the adrenals are overtaxed and become exhausted. The clinical presentation is wide and varied. Symptoms can include fatigue, exercise and stress intolerance, insomnia, metabolic disturbances, frequent infection, heart palpitation, hypoglycemia etc. The effect of a weak adrenal system therefore can be felt throughout the body.

Read Part 2 | Part 3

© Copyright 2017 Michael Lam, M.D. All Rights Reserved.

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