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What You Need to Know if You’re Diagnosed with an Autoimmune Disease

Donna is a 35-year old woman who had her second child a year ago, but she just hasn’t been able to recover her energy. She kept chalking it up to having a toddler and a newborn. But, when the baby turned one-year old and she was still exhausted, she decided to get a thorough check-up.

Her lab work showed she had the most common of autoimmune diseases: Hashimoto’s thyroiditis.  

On the one hand she was relieved to have an answer, but on the other she was saying a big, “Now What!?”

Autoimmune diseases are on the rise, and many people are asking the same question as Donna, “Now What?”

The approach to repairing the immune system involves a few essential lifestyle changes and evaluation of some basic body functions to begin the road to healing.  

Here are the 4 Pillars of a Healthy Immune System

  • Having healthy digestion with balanced gut microbiome
  • Practicing ways to prevent stress from entering the body and changing your body chemistry
  • Cleaning up and avoiding environmental toxicants in your home and workplace, and improving the body’s ability to detoxify
  • Enjoying an anti-inflammatory diet that is high in whole foods, vegetables, healthy fats, lean protein, fruits, nuts and seeds and low in processed foods, sugar and alcohol

By the way, these four pillars are the basis of Dr. Blum’s book, the The Immune System Recovery Plan. And right now she is diving deep to create a new LIVE course: The Immune Recovery Challenge, a group program specifically designed to help relieve the suffering of people with autoimmune diseases!  

Healing Your Gut

Everything begins with healing the gut. Nearly everyone who has an autoimmune disease has a gut microbiome that is out of balance. A leaky gut, also called increased intestinal permeability, is associated with autoimmunity, and research has made it clear that to repair the immune system and reduce inflammation, you must heal the leaky gut. We repair the gut through food, proven, scientifically-supported antimicrobial supplements and building resilience to life’s stressors.

Understanding Digestive Symptoms

If you have digestive symptoms such as gas, bloating, constipation, diarrhea, heartburn or reflux, it’s important to get to the bottom of why you are having these, and not just cover them over with a medication, such as an antacid or laxative. You can try food-based approaches first, such as eliminating dairy and alcohol triggers if you have heartburn or reflux, increasing vegetable intake for more fiber if you have constipation, and adding a probiotic to balance gut bacteria if you have diarrhea. If these steps don’t work, then consider getting a functional stool test to look more closely at gut imbalances that can then be specifically addressed.

How Stress Fuels Autoimmunity

Stress is almost always about how we perceive our world—what is very stressful for one person can be completely neutral for someone else because of how each person views that same situation.  

The key is to figure out what your personal stress response is—for example, trouble sleeping, anxiety, slow digestion—and then finding and using tools to turn it around. A recorded guided relaxation at bedtime can help with sleep, learning a measured breathing technique can help with anxiety, and just chewing your food 15-20 times per bite can change your digestion for the better.  Having a daily practice such as meditation, prayer, or a walk in Nature without your phone, can begin to remind your body about how to relax and let go of stress. There are some great free meditation apps with Learn to Meditate courses and guided meditations, and I encourage you to try them out, too. My favorite is Insight Timer; it has lots of free guided options that are wonderful.

How Toxicants are Related to Autoimmunity

We are all exposed to multiple toxicants in our environment every day, some of which we can control through our buying and eating habits and some, like air pollution, we can’t.

Take control of the ones you can control—substitute glass food storage containers for plastic ones, use wax paper instead of plastic, use refillable stainless steel or glass water bottles instead of disposable single-use plastic ones. Visit the Environmental Working Group’s website, www.ewg.org, for more ways to reduce your exposures.

To support your liver’s ability to detoxify what’s coming into your body, eat lots of leafy greens, onions, garlic, leeks, and as many different colors of vegetables as you can every day. These have antioxidants which put out the fire of inflammatory free radicals and help stop the damage of toxins in the body. If you had significant workplace or home exposures to chemicals or molds, then you may need additional professional help to support healthy detoxification.

Food is Medicine … Especially When You Have an Autoimmune Condition

As we say everyday at Blum Center for Health, food is medicine. It’s not the only medicine, but it is an important part of anyone’s medicine who is trying to get healthy or healthier. Dietary regimens need to be tailored to each individual’s unique needs, traditions, and preferences. But some basic principles for choosing food that applies to almost everybody who isn’t vegetarian:

  •     the more vegetables, the better—a minimum of 5 half cup servings a day
  •     the more colorful vegetables, the better
  •     healthy fats such as avocados, nuts and seeds, olive oil
  •     whole grains
  •     small amounts of animal proteins without hormones, antibiotics
  •     fish that are low in mercury
  •     no ingredients that you can’t pronounce
  •     the fewer foods out of a box, carton or plastic container, the better
  •     fruit for dessert

These are the basics of what is known as the Mediterranean diet which has been shown in scientific studies to reduce heart disease and inflammation in the body.

The Importance of Discovering Your Trigger Foods

If you have an autoimmune disease it is important to identify foods that trigger your symptoms. We typically suggest starting with  a short-term elimination diet, where we take out the most inflammatory foods, and then add back each food in a methodical way, to identify exactly which foods cause problems.  In essence, you walk away with a personalized nutrition plan!

How We Can Help You Reverse Your Autoimmune Disease

If you want personal one-to-one treatment, come to Blum Center for Health. People travel from around the world to meet with our practitioners. You’ll meet with your practitioner for an hour and a half, meet with our Functional Medicine Nutritionist, and receive your first treatment plan. Get More Info

If you want a do-it-yourself approach, follow the 4-step plan outlined in Dr. Blum’s bestselling book, The Immune System Recovery Plan. Written specifically for people with autoimmune conditions, this book will put you on the road to recovery.

And if you want to do-it-with us, keep your eyes peeled for Dr. Blum’s new LIVE course: The Immune Recovery Challenge!  We begin in October (it will be here before you know it!) The Immune Recovery Challenge is the step-by-step companion to The Immune System Recovery Plan. During the course, you will follow the 4-Step Immune System Recovery Plan protocol together with Dr. Blum, using video and live coaching. It’s devoted to your HEALTH TRANSFORMATION! I hope you’ll join us!

Meet Elizabeth Greig, FNP:  In her dual role as our Functional Medicine Nurse Practitioner and a teacher in our Mind.Body.Spirit programs at Blum Center for Health, Elizabeth Greig, MSN, FNP, helps treat and heal patients with complex chronic health conditions. Whether she’s treating a medical condition or leading a class in meditation, Elizabeth helps people understand that when it comes to healing, it’s more about nourishing life, than it is about battling illness. Learn more about Elizabeth’s practice.

 

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Hypothyroidism: A Silent Epidemic

Guest post written by Jill Grunewald

If you’re even loosely tuned into online health communities, it probably seems as though “thyroid” is all the rage. Everyone appears to be talking about it. But that doesn’t mean that addressing—or assessing—thyroid health is a fad or “the next big thing.”

In fact, although the thyroid is a tiny gland, it is a big thing.

Why? Because every cell has thyroid hormone receptors. This is why the symptoms of hypothyroidism can run the gamut from mild fatigue to pronounced depression, for example. Additionally, more and more women—and to a lesser but no less concerning degree, men—are being diagnosed with hypothyroidism or low thyroid function. The problem is even starting to affect young girls, for reasons discussed below.

Hypothyroidism as a condition isn’t new. Lab testing for thyroid function has been around since the 1950s. You may have had a grandma or great aunt who had a “glandular problem,” which often meant they were hypothyroid.

What is the Thyroid?

This little butterfly-shaped gland in our neck is the maestro of our endocrine (hormonal) system. I like to refer to it as the spoon that stirs our hormonal soup.

Thyroid hormones—primarily T3 and T4—play a significant role in energy and metabolism. This is why the thyroid is often called “the master gland of metabolism.” These hormones also influence the brain, gallbladder and liver function, body temperature regulation, the gastrointestinal tract, our reproductive and cardiovascular systems, red blood cell metabolism, steroid hormone production, and bone metabolism.

The thyroid takes a mineral and an amino acid, iodine and tyrosine respectively, and converts this combination into T3 and T4. T3 is the most biologically active thyroid hormone—it’s what helps keep us lean, sharp, and warm.

Familiar symptoms of hypothyroidism include:

  • Fatigue
  • Brain fog
  • Constipation
  • Depression
  • Weight gain/weight loss resistance
  • Hair loss, including outer third of eyebrows
  • Dry skin
  • “Thyroid hair” (dry, brittle hair)
  • Weak reflexes
  • Feeling cold when others are comfortable

Symptoms often not recognized as being associated with hypothyroidism include:

  • High cholesterol
  • Edema/fluid retention (often present around the eyes/face)
  • Recurring infections
  • Going prematurely grey
  • Low libido
  • Anxiety
  • Headaches
  • Infertility
  • Miscarrying
  • PMS
  • Pronounced morning fatigue
  • Being stiff and achy upon waking
  • Digestive issues
  • Irregular menstrual cycles
  • Parched mouth
  • Gravely voice

One of the reasons that hypothyroidism is a silent epidemic is that too many of the above symptoms are viewed in isolation—too often, an underactive thyroid isn’t suspect. If you’re depressed, you may get a prescription for an antidepressant. If you’re constipated, a laxative. If you’re gaining weight or weight loss resistant, a recommendation to eat less and exercise more. If you’re struggling to get pregnant, a suggestion to try IVF.

To complicate matters, even when thyroid function is tested, it’s often not evaluated thoroughly—doctors often run a simple TSH (thyroid stimulating hormone) test, which only tells a small part of the story. TSH should always be taken in the context of other thyroid hormones, especially considering that TSH can be within normal limits in the face of hypothyroidism. These additional labs include Free T3, Free T4, Reverse T3, and thyroid antibodies that could show the presence of Hashimoto’s (autoimmune hypothyroidism): thyroperoxidase antibody (TPOAb) and thyroglobulin antibody (TgAb).

Hypothyroidism: Root Cause?

Hashimoto’s is the most common form of thyroid dysfunction—it’s estimated that over 90% of people with low thyroid function have the autoimmune form of the condition. In fact, Hashimoto’s is the most universal autoimmune disease and it’s estimated that 30 million women alone have it, whether they know it or not.

Historically, iodine deficiency has been considered the culprit, but this too tells a small part of the story. Today, iodine-deficient low thyroid function, without the autoimmune component, is unusual, but that’s not to say that those with Hashimoto’s can’t be low in this important mineral.

Other, “modern” causes of hypothyroidism/Hashimoto’s include:

  • Exposure to environmental toxins (including heavy metals and pesticides) *
  • Unrelenting stress, which can result in adrenal dysfunction/HPA axis dysregulation
  • Systemic/cellular inflammation
  • Intestinal permeability
  • An infection
  • Nutrient deficiencies

* Environmental toxins in the form of chemicals added to skin care and cosmetics products is why we’re seeing Hashimoto’s—and other forms of autoimmunity—much more frequently in the female population, including younger and younger women. As Dr. Susan Blum states, “. . . every chemical you are exposed to adds to your toxic load. Having a high toxic load makes it harder for your liver to handle pesticides and environmental estrogens, toxins that we know will affect your immune system.”

Spotlight: Nutrition for the Thyroid

Perhaps you’ve already been diagnosed with hypothyroidism or Hashimoto’s. You may be on thyroid hormone replacement—or maybe not. Regardless, the thyroid is extremely nutrient dependent and being mindful of your diet is critical for managing Hashimoto’s and giving your thyroid the nutritional love it so depends on.

Eating minimally processed foods with naturally occurring vitamins, minerals, amino acids, and phytonutrients is one of the best ways to support the thyroid—and immune system.

Genetically modified foods (GMOs), artificial sweeteners and additives, toxic oils, and antibiotic- and hormone-laden foods—all part of the standard American diet (SAD, and yes, it really is sad), trigger oxidative stress, which in turn affects how our cells communicate. Knowing that every cell has receptors for thyroid hormone, it’s not difficult to recognize how a diet deficient in key nutrients can disrupt this cellular communication.

So, what are these key nutrients?

I spent many weeks digging deeply into thyroid- and immune-supportive nutrition and then identifying foods rich in those nutrients. This meticulous research and subsequent ranking system became the foundation, the “nutritional springboard” for my best selling cookbook, The Essential Thyroid Cookbook.

This first-of-its-kind cookbook will leave no trace of doubt that our recipes are uniquely beneficial to your thyroid and immune system. They’ll support you for a lifetime of peak thyroid function no matter where you are on your wellness journey.

And finally, as for the multi-faceted nature of hypothyroidism symptoms, often, they no longer need to be seen as silos warranting individual treatment. Support the thyroid and immune system, and likely, you’ll see far-reaching improvement with these previously maddening symptoms.

Jill Grunewald, HNC, is an integrative nutrition and hormone coach and best selling author of The Essential Thyroid Cookbook.

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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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3 Hidden Triggers that Create Chronic Stress

Chronic Stress Triggers And Sleep

We all know the stress of a busy, adult lifestyle – a delicate balancing act of work pressures, financial obligations, significant others, friends and family. Just the day-to-day running of your life can feel like a pressure cooker – managing a home, caring for kids or parents (or both), meeting obligations and running errands are all identifiable forms of stress.

You may have taken steps to mitigate these stressors through meditation, exercise, eating well, setting boundaries or scheduling self-care. Awesome!But, did you know that you might be undermining your efforts, and causing stress in your body, without realizing it?

Stress vs. Chronic Stress

Stress elevates cortisol and adrenaline, hormones responsible for “fight or flight” in what your body perceives as an emergency — something as serious as jumping out the way of a careening car, or something as nerve-wracking as public speaking. Once the event is over, our cortisol and adrenaline levels return to normal. This is a healthy stress response.

Chronic stress, however, creates havoc in the body. Cortisol levels, which spike during a stress-inducing event, remain elevated. As Susan Blum, MD, discusses in her book, The Immune System Recovery Plan, this increased baseline can damage the immune system and prevent it from healing. Ultimately, chronic stress can have a negative effect on the levels of good bacteria in the gut, reducing the ability of the immune system to fight infection and puts us at risk for autoimmune disease.

3 Hidden Triggers that Create Chronic Stress

  1. Over-exercising – While exercise, in general, is a great way to relieve stress, overdoing it can cause a host of problems that we don’t necessarily attribute to exercise. Intense exercise increases cortisol, the hormone that is released when your body is under stress. So if you participate in daily high-intensity workouts you may be getting too much of a good thing. Chronically elevated cortisol is related digestive issues, weight gain, and even depression. Further, over-exercising can have a detrimental effect on the immune system, making you more vulnerable to illness, and triggering flare-ups of underlying autoimmune disease.

What you can do:

  • ** Work with a trainer to create an exercise plan that includes a balance of interval training, strength training, core work and stretching.
  • **Add a “slower” more reflective activity to your weekly routine, such as restorative yoga, tai chi or Qi Gong.
  • **Find other ways to get your exercise high without stressing your body on a daily basis, such as a salsa dance class or learning a new sport.
  1. Skipping Meals – You consider yourself a healthy eater. You eat lots of seasonal, organic vegetables and fruits. You enjoy deliciously healthy fats, like avocado and nuts, and make a point of having some protein every time you eat. But, because of your busy lifestyle or, perhaps, because you’re trying to drop a few pounds, you skip meals, undermining your nutritious food choices. Skipping meals increases cortisol because your body thinks its starving. It also causes your blood-sugar levels to take a dive. You might have noticed that when you skip meals your thinking becomes foggy and suddenly you have a short fuse. Ultimately, skipping meals can slow your metabolism, putting you at risk for weight gain, and making weight more difficult to lose.

What you can do:

  • ** Plan meals ahead of time.
  • ** Set reminders on your phone to eat.
  • ** Carry nutrient-dense, whole-food snacks in the event you find yourself on-the-go.
  • ** Make eating a priority — it is your body’s fuel!
  1. Not Getting Enough Sleep – Research demonstrates that even slight sleep loss boosts cortisol levels and can accelerate the development of insulin resistance. In fact, one study found that getting just 30 fewer minutes sleep than you should per weekday can increase your risk of obesity and diabetes. Not getting enough sleep is related to a host of other issues including heart disease, high blood pressure, accidents, mood disorders, depression and decreased productivity.

What you can do:

  • ** Focus on what time you go to bed rather than focusing on what time you wake up.
    ** The earlier you eat dinner, the better — less digesting ensures a better night’s sleep.
    ** Ban screens from your bedroom – the light signals the body that it’s time to be awake.
    ** Create a sleep environment – make your bedroom cozy, clutter-free and a cool temperature to induce sleep.

Resources:

Blum, S. (2013). The Immune System Recovery Plan. New York, NY: Scribner

Endocrine Society. (2015, March 6). Losing 30 minutes of sleep per day may promote weight gain and adversely affect blood sugar control. ScienceDailyhttps://www.sciencedaily.com/releases/2015/03/150306082541.htm

Leproult R., Copinschi G., Buxton O., Van Cauter, E. (1997)  Sleep loss results in an elevation of cortisol levels the next evening. Sleep. 20(10), 865-70.

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Turn Off the Effects of Stress on Your Immune System

Stress is really about the degree of change you experience and how much it throws you out of balance.  Studies show that when stress pulls you too far off center, it affects your immune system in a negative way.  The body has a built in stress response for emergencies, which is often called “fight-or-flight.” In general, this is a good thing because it supports you when you need an adrenaline rush and cortisol boost from your adrenal glands to help you run, fight, or face an intense stressor, be it emotional or physical.

But when you think too much, you can get stuck in your thoughts, worrying about the future and replaying the past. At the same time, your adrenal stress hormones get stuck in the “on” position, producing those stress chemicals that have a negative impact on your immune system. It is this chronic stress that is the problem and the type of stress that makes you sick.

When you practice mind-body skills such as meditation, walking in nature, turning off the nightly news, knitting, or singing, to name just a few, you will learn to “turn the switch off” and your system will find balance again. Then you can easily move in and out of stress mode, benefiting from the adrenal boost when you need it and letting your system relax when you don’t.  But remember, learning to relax takes practice!