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Conventional Medicine Gets the Autoimmune Wrong

Here’s a common scenario in my practice:  A patient comes in with a prior diagnosis of autoimmune disease. Sometimes it is a new diagnosis, and the patient is worried about how to proceed. Sometimes it is a longstanding illness they have lived with for much of their life. In most cases, they are looking for help where the conventional approach to autoimmunity has failed them.

There are many different types of autoimmune disease. All have in common the curious fact that the person’s immune system has become misdirected. The immune system is meant to provide protection against infection and foreign invaders to the body – like bacteria, viruses and other pathogens. When one has autoimmune activity, it means that the person’s own body is under attack.  

Falling under the umbrella of autoimmune disease is a variety of ailments, which vary widely in prevalence, symptomatology and severity. Some autoimmune diseases are very common, like Hashimoto’s thyroid disease. Others are rare, like Scleroderma. Some attack a single part of the body, like Hashimoto’s, while others, like lupus, can be more systemic, attacking multiple organ systems. Other examples of autoimmune disease are rheumatoid arthritis, multiple sclerosis, Grave’s disease, Type I diabetes, inflammatory bowel disease, psoriasis, and alopecia.

The Typical Conventional Response to Autoimmune Disease

Patients routinely describe that their physician — be it primary care or specialist — has diagnosed a condition or worse, a disease. Sometimes the patient is already on prescribed medications as treatment, but other times they are not.

Invariably, what they have been told is that there is nothing to be done:

  • “We will wait and see.”  
  • “You will probably need to be on medication at some point.”
  • “Let’s continue to watch your blood testing yearly and wait and see when symptoms develop.”  

Few, if any of these doctors, offer advice on how to potentially keep the disease from progressing. Or, if already in the throes of symptomatic disease, offer suggestions how to lessen the symptoms with anything but anti-inflammatory medications, replacement hormones or immune-modulating drugs.

This is a very serious problem, and a failing of conventional medicine. It’s exactly why I chose to continue my training with the Institute for Functional Medicine.

A Functional vs Conventional Approach to Autoimmune Disease

Let’s take the case of early autoimmune thyroid disease:

With Hashimoto’s, for instance, the patient will often be told that they have autoantibodies – which means there are immune markers in the bloodstream directed not against invaders, like bacteria or viruses, but actively attacking the body’s own tissues of the thyroid or its receptors. This is the basis of autoimmune thyroiditis, or Hashimoto’s thyroid disease, which often leads to low functioning thyroid and the need to take thyroid hormone medication.  

The conventional doctor will let the patient know that these antibodies are there, and that most likely the thyroid will begin to malfunction, causing too little hormone to be released into the blood and causing the symptoms of hypothyroidism – low energy, weight gain, constipation, dry skin …  When that occurs, treatment with thyroid hormone replacement will begin.  

This leaves many people wondering – what can I do now?  Is there anything I can do to stop this from happening?  Am I going down a road I can’t switch out of?  

How can one reverse the damage – or halt the progression of the autoimmune disease ravaging the body?

The Functional Medicine Approach

I like to think of a Functional Medicine approach to treatment as two-fold:

  • Doing everything we can to improve the immune system’s ability to rebalance while …
  • Lessening the odds of the immune system continuing to rebel — and, quite possibly, beginning another attack on another system in the body — which could then lead to another autoimmune disease.

How do we do this? First, we work to support whatever system or systems in the body are under attack – replacing nutrients or hormones that are lacking due to the autoimmunity. We frequently use B-complex, D3 and multivitamin supplementation; and, of course, hormone replacement, as needed in hypothyroidism.

Then, we work to build resilience and decrease inflammation in the body by using good old detective work to find the root cause, or triggers, of the immune dysfunction, and treat that. We look at food, stress, gut health, toxin exposure and infections.

5 Steps to Decrease Inflammation & Rebalance Your Immune System

  • Practice improving your emotional and physical response to stress. Getting good sleep and exercising is imperative. Mindfulness meditation and other mind/body techniques are helpful for reducing stress hormones.
  • Experiment with your food – discover sensitivities, triggers, and intolerances. We usually recommend an allergy elimination diet – taking out gluten, dairy, soy, corn, and eggs, along with other common allergens depending on your specific medical condition- for a short time and reintroducing to see if symptoms are affected by food.
  • Support your microbiome and heal your leaky gut.  Eat healthy whole foods and lots of vegetables and fiber. Start taking a probiotic. Our go-to is Dr. Blum’s formula, created for our patients. Learn More
  • Decrease your exposure to toxins and improve your body’s ability to manage exposures. Watch out for common toxins in food (herbicides and pesticides), cleaning supplies, and even in personal care products.  We recommend looking at the Environmental Working Group and following their suggestions for cleaning up toxins in the home.

    If you are concerned about the toxin build-up in your body, you might want to consider our 21-Day Simply Detox. It’s the exact program we use with our patients at the Blum Center for Health. Learn More
  • Be assessed with functional testing for nutritional needs and to rule out any chronic or acute infectious disease processes.  We will often request stool testing for microbial balance, in depth blood testing for nutritional needs, and more extensive saliva and urine testing for hormone balance.

If you live near the New York City metro area, come see me, or one of my colleagues. We would be happy to help. People travel from all over the world to work with us. Come join our family!

If traveling to us is not possible, you can work with our Director of Nutrition or Health Coach by phone or Skype. Call 914-652-7800 for more information.

Or, you can also find a functional medicine practitioner through the search feature on the Institute of Functional Medicine’s website

Meet Darcy McConnell, M.D.:  Dr. McConnell brings her broad expertise in prevention, mind-body medicine, and women’s health to Blum Center for Health, in Rye Brook, NY. She is board certified in Family Medicine and Integrative Medicine, with postgraduate training from the Institute for Functional Medicine. Darcy lives with her husband and three sons and enjoys the outdoors, cooking healthy meals for her family and friends and is an enthusiastic yogi.

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Leaky Gut and Food Sensitivities

Did you know that your biggest exposure to the outside world every day is through your mouth?  That’s why 70% of your immune system lives in your gut, lying in wait to protect you from anything that seems foreign to the body (called antigens because they stimulate the immune system), which believe it or not includes food and the toxins and microbes that ride along with the food that you ingest while eating.

Your gut, which starts in your mouth, travels through your stomach, small intestine, colon or large intestine, and ends in your rectum, is supposed to be a closed tube – with the intestinal lining creating a barrier that separates the inside of your body and immune system from these outside exposures.  When you digest your food, the intestinal lining can then selectively choose what can enter your body by opening and closing special gates called tight junctions.

In functional medicine, an intestinal barrier with damaged tight junctions that isn’t keeping antigens out of the body is known as a leaky gut.  Studies have increasingly found that a leaky gut is associated with arthritis, autoimmune disease, allergies, and food sensitivities.

Causes of leaky gut vary, but the most important is dysbiosis, which is an imbalance in the bacteria in the gut, also called the gut microbiome.  Dysbiosis can be an overgrowth of harmful bacteria, yeast or parasites, or not enough good bacteria, and is commonly caused by a poor diet, a course of antibiotics, frequent use of antacids, and stress. These gut bacteria are important because not only do they interact with your immune system to keep it healthy, they also turn the food we eat into healthy compounds, especially something called short chain fatty acids which heal the tight junctions between your cells and protect the integrity of the gut barrier.  This is why food is so important, too, because the food you eat determines which bacteria will thrive and what kinds of compounds they will make when they digest your food.  

But why is leaky gut associated with inflammatory disease like arthritis? When the contents of your gut, which includes pieces of food and gut bacteria, “leak” into your body, your immune system is activated creating inflammatory chemicals that travel throughout your body and cause system-wide inflammation, especially in the joints. And this happens non-stop until your gut microbiome and lining are repaired.  

The good news is that you can rebuild your microbiome and repair your gut. Food has the most influence on the diversity of the microbiome, and that’s why you should always start with changing your diet by increasing fruits and veggies, especially those rich in polyphenols, bioflavonoids, and fiber because these tend to increase the good bacteria that make short-chain fatty acids and heal the gut. Also, you need to remove foods from your diet that feed the bad bacteria like sugar, processed flour products, alcohol, and too many animal products.  You also need to test yourself for food sensitivities and remove sensitive foods such as gluten, dairy, soy, corn, eggs and the nightshade vegetables. Our elimination diet explainer shows how to do this.

The next step is to treat your dysbiosis. At Blum Center for Health we start with cleansing herbs like berberine, grape seed extract, black walnut, and oregano that can clear out bad bacteria and yeast. In fact, we created our own custom herbal antibiotic mix called Gut Cleanse. Once you have eliminated the bad bacteria and yeast, probiotics and the right food can help you rebuild the good stuff, repair the gut lining, reduce inflammation, and eliminate food sensitivities.

For more, please review the video above.

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How to Effectively Navigate an Elimination Diet

Perform an Elimination Diet

Elimination diets are the cheapest, most effective way of identifying the foods that trigger inflammation and disease in your body. For many, elimination diets hold the key to conquering chronic pain and I use one with arthritis patients as outlined in my book Healing Arthritis.

The great news, is that elimination diets are generally short and easy to follow. My elimination diet requires just two main steps.

Step 1:  Remove Gluten, Dairy, Corn, Soy, Eggs and Sugar From Your Diet For 3 Weeks

Gluten, dairy, corn, soy, and eggs represent the most common culprits for food sensitivities. Eliminating them makes it likely you’ll be cutting your problem foods from your diet. Sugar is also removed because it is a trigger for inflammation and removing it will help you learn to avoid processed foods, which usually include the common culprits, too.

A lot of times my patients ask me why we are removing all five foods at once, and whether it would be better or just as good to remove one at a time.  However, first you have to remove the foods and feel better, and then you can reintroduce each food one at a time to see if you feel worse.  If you only removed one food, you might not feel better because you are still eating another problem food.  It would be hard to complete the experiment because you might not notice you feel worse when you reintroduce the food, because you never felt better in the first place!

Continuing the diet for three weeks will give your immune system a chance to quiet down without the food triggers around.  More importantly,  it should reduce your symptoms and help you feel better.

Step 2:  Reintroduce Each Food One at a Time

Good job on making it three weeks without eating gluten, dairy, corn, soy, eggs and sugar! Now, you begin the second, and final, step, which is the reintroduction of each food, one at a time.

This is when you will gather all the information about whether the food is good for you or not and you’ll uncover some food sensitivities.  Use this symptom chart to help you keep track.

Symptom Chart - Blum

For each food that you reintroduce, think about the symptoms on your list and use none, mild, moderate, or severe to describe your reaction to it in the boxes provided. This will help you remember later when you look back.

After the three weeks on the elimination program, do the following. Introduce one food at a time:  It doesn’t matter which order you choose to reintroduce the foods.  I usually tell my patients to choose the food you miss most to go first. Eat that food at least twice each day, for two days, noticing how you feel.  On day three, don’t eat the food, but continue to observe how you feel. If you have no reaction to the food, you are ready to move on to the next food on day four.

If you do have a reaction – such as headache, rash, brain fog, fatigue, digestive reaction, or other symptoms – stop eating it, and write it down in the above table so you don’t forget later.  [Once you know a particular food isn’t good for you, remove it again.]  The food reaction should go away within a day or two, but for some people it can take longer.  Try the next food: Once that reaction goes away, it is time to try the next food.

Finding out if you are having a noticeable reaction to gluten is important. If you don’t have a reaction and don’t have an autoimmune disease, you can add it back into your diet.  However, keep in mind that gluten is known to damage the gut, and so we still recommend eating it in limited amounts.

Be patient, because it will take you another two weeks or so to reintroduce all the foods you have eliminated. At the end of those weeks, you should now know whether gluten, dairy, corn, soy, or eggs are creating an immune reaction in your body.

Once you’ve identified your triggers you can successfully avoid them. But the better news is that it may not be permanent. Some people, after an additional period of healing, can reintroduce the foods and be symptom-free. In my own experience, I have been eating a diet 95% free of these foods for more than ten years, my reactions when I do eat them are minor compared to what they once were. They are still there, but it’s much more pleasant than it used to be!

Looking to make your elimination diet successful? Sign up for the email list (on the bottom right of this page) to stay up to date on our next article “5 Things To Know Before Starting an Elimination Diet”!

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What’s the Difference between a Food Allergy and a Food Sensitivity? An Interview with Sezelle Gereau, MD

There’s a lot of buzz these days about food allergies and sensitivities. There’s a lot of confusion too. We spoke with our resident expert, Sezelle Gereau, MD, to learn the difference between the two and why it matters.

What is the difference between a food allergy and a food sensitivity?
When one is allergic to a food the body recognizes it as a pathogen, and goes through a set of immunologic responses to attack and contain it.  They can be life threatening, as we recognize with children and peanut allergy.  While sensitivities can be uncomfortable, they do not trigger the immune system in the same way.  So, one can be either allergic or sensitive to a food, although the two are often confused.  For example, one can have a true allergy to milk, or a lactose intolerance, which is more of a sensitivity and not a true allergy.

If a food sensitivity does not trigger the immune system in the same way as a food allergy then why are they so uncomfortable?
Sensitivities are different, both in their symptoms and their underlying mechanisms. Most commonly one will present with gastrointestinal symptoms such as gas, cramps, bloating, heartburn, headaches, or irritability. Some will complain of brain fog and fatigue. The most common food sensitivity is lactose.  Sulfites and alcohol are other frequent offenders.

What about gluten?
Common, but not as much as generally thought by the public, is gluten sensitivity – you can be allergic to wheat, or have a sensitivity to gluten. A gluten sensitivity is not a true allergy, but can trigger a set of responses that feel like an allergy.  Celiac disease is an autoimmune disease also related to sensitivity to gluten, but again, not an allergy. It is important to know if one has gluten sensitivity, as it can lead to issues in other parts of the body, such as your thyroid gland.

Do we outgrow allergies and sensitivities?
One can outgrow food allergies. Many children have food allergies early in life, and they commonly outgrow them by about age 8.  Food sensitivities are idiosyncratic, and there is no specific pattern.  The best way to train your body to outgrow both allergies and sensitivities is to eliminate the food completely.  Sometimes foods can be re-introduced on occasion without adverse effect, but if one has a severe reaction it is recommended that you completely eliminate these foods from your diet for good.

How do I know if I have an allergy or a sensitivity?
There are a number of ways to test for food allergies, including blood tests such as IgE or IgG.  You may have heard of the ALCAT or MRT testing.  Your doctor may choose to do any one of a number of these, and each has its pros and cons – but the best way to understand if one is allergic or sensitive is to eliminate the food strictly for 3-6 weeks and then reintroduce it in small amounts, one by one over a series of days and observe for reactivity.

When should I call a doctor?
Many times a functional medicine doctor, such as one of our doctors at Blum Digital, LLC, can help you sort out these issues.  They can help you start to grapple with your reactions and relationship to foods.  A comprehensive history with some additional testing can help one to understand if this is truly reactivity to foods, or if something else is out of balance in the body.

What’s new and exciting?
An exciting new treatment available for food allergy is allergy drops – which offers a way to eliminate the allergy entirely, not just control symptoms.  It is safe and effective for both adults and children. Come in for a visit if you’d like to learn more.

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Autumn’s Must-Have Immune-Boosting Foods

Autumn is here in full glory … the beautiful display of jewel-colored leaves, the waning light and the crisp, cool air all signal the arrival of the Fall harvest, a cornucopia of gut-healthy foods perfectly suited to cooler days.

It’s the perfect time of year to visit your local Farmers Market. Right now farm stands are hitting their peak with produce that has taken all summer to mature. Better yet, visit a farm and pick your own! From crisp apples to hearty greens and deliciously sweet root vegetables, Fall foods are nutritional powerhouses –they are packed with antioxidants that help your immune system fend off viruses and bacterial infections as we head into winter.

7 Immune-Boosting Foods to Add to Your Plate Right Now

1. Figs — High fiber and loaded with potassium, fresh figs are a rich source of phytosterols — plant nutrients that help reduce cholesterol. They are also high in beta-carotene, a carotenoid known to protect against cancer. Try them cut in half with just a drizzle of raw local honey. Divine!

2. Pomegranates — Pomegranate seeds owe their superfood status to polyphenols, powerful antioxidants thought to offer heart health and anti-cancer benefits. They are also a good source of fiber, B vitamins, vitamin C, vitamin K and potassium. Add pomegranate seeds to salads, sprinkle over oatmeal, toss in green salads, or blend them in smoothies.

3. Sturdy Greens — Leafy greens are full of vitamins, minerals, and disease-fighting phytochemicals. They are rich in fiber, vitamin C, vitamin E. Boost your consumption of greens by adding them to salads, smoothies, soups and stir fry recipes.

4. Pumpkin Seeds — Rich in magnesium, immune-boosting zinc, fiber and plant-based Omega-3 Fatty Acids, pumpkin seeds are power-packed little kernels of nutrition. Either eat them raw (after they’re cleaned and dried, of course) or roast them at 170 degrees for about 20 minutes. Either way, toss them in salads or pack them to put in your bag for a midday snack.

5. Sweet potatoes — Chock-full of beta-carotene, vitamin C and magnesium, sweet potatoes are anti-inflammatory powerhouses. Try oven-baked sweet potato wedges, add sweet potato cubes to chili, or simply bake it as you would a white potato and add a little ghee, cinnamon and black pepper.

6. Winter squash — Packed with vitamins A and C, beta-carotene, potassium and fiber, the winter squashes soothe our bellies, boost our immune system and support vision and skin health. Cut one in half, brush a little coconut oil on the flesh and roast it flesh-side down in a 450 degree oven for about 20 minutes. Yum! Or, add it to stews, curries and stir-fry recipes.

7. Parsnips — Though these veggies may resemble carrots, they have a lighter color and sweeter, almost nutty flavor. Loaded with potassium and high in fiber, parsnips have an impressive array of vitamins, including vitamins B, C, E and K. Use them in stews and soups or roast them for a delicious alternative to french fries.

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Summer Sun and Vitamin D

Everyday, I am asked by someone, whether or not they need to take Vitamin D in the summer. Now that we are in the midst of lots of sunshine and summer is here, I thought this would be a good topic for our August newsletter. Vitamin D is much more than a vitamin. In fact, every cell in your body has a receptor on it for D, which makes it more like a hormone, than a vitamin. It supports your immune health, and is critical for people with autoimmune diseases. It is also necessary for your body to absorb calcium, and women with low vitamin D levels are at a higher risk of osteoporosis. And let’s not forget about mood … many of you might notice you feel bluer in the winter when there is less sunshine.

Yes, Vitamin D is made by sunshine. However, in the northern latitudes where we live (New York), the sun is only strong enough to stimulate Vitamin D production in your skin 3-4 months/year, May-August. During these months, your skin will make enough Vitamin D to support good blood levels, IF you are outside for at least 20 minutes/day, without sunscreen, between 10am – 2pm, in shorts and a tank top. Meaning your arms and legs need to be fully exposed without sunscreen during peak hours of maximum sun. Do most people get this? No. So if you walk or exercise outside, spend time in the garden or other outdoor activities regularly, and don’t use sunscreen every minute, you are probably okay taking the summer months off. But honestly, most of the people I see in my medical practice don’t have an appreciable bump in their Vitamin D levels in the summer. They simply don’t get as much exposure as they think so they need to stay on their normal regimen. And that could be you.

While I am certainly not advocating NO sunscreen, I do think it would be okay, to spend 20 minutes a day without it, if you are trying to get your D. But then be sure to slather up with a broad spectrum SPF!

Here are my suggestions:

  1. If your Vitamin D levels were in a good range before the summer (above 40) and you are outside most days during peak hours, you can probably take the summer off.
  2. If your Vitamin D levels were low before the summer, or if you aren’t outside much without sunscreen during the middle of the day, you should continue your supplement.
  3. In my experience, 2000 iu/day of Vitamin D3 (cholecalciferol) is the minimum amount to maintain your levels. If you are trying to raise them, double the dose to 4000 for 3 months or until you are tested again.
  4. Always adjust your dose by following blood levels. Your primary care doctor can do this for you.