April 19

All About Autoimmune Disorders

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The ‘immune system’ is one of the most complex mechanisms in our bodies. 

It is designed to serve as a protection system to defend us from the millions of bacteria, microbes, viruses, toxins and parasites that we are in contact with daily.

It is therefore important that this system is functioning correctly and is in a healthy state. If it’s not, the body can be left open to attack, and a number of negative symptoms or disorders can occur.

These disorders can vary from simple allergies to full autoimmune disorders where the body attacks and destroys healthy body tissue by mistake.

This article will help you understand the immune system, how it works and how to keep it healthy. We will also look at the common immune system disorders, not so that we can treat or diagnose these, but to fully understand the potential nutritional needs or requirements of those suffering from such disorders.

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The Immune System

The immune system is constantly working behind the scenes, usually going unnoticed until something goes wrong.

If we catch a cold or flu virus, this means some germs have got past our immune system, so we get ill. This activates the immune system, which then gets to work on eliminating the invader, so that we can get over the cold or flu.

The same happens with the germs we eat daily - the immune system protects us from these too. Occasionally we will still get ill from these germs e.g. food poisoning, and the immune system fights back through vomiting and diarrhoea.

The immune system can also let us down, as it can inappropriately attack healthy cells within the body, leading to a number of disorders.

The main role of the immune system is to serve as protection against bacteria and viruses that want to enter the body. If these do get into our bodies, the immune system tries to detect and eliminate them as quickly as possible.

If these germs are not then eliminated, they can reproduce and make us sick. It is still the immune system’s role to handle and eliminate these germs. 

Components of The Immune System

The immune system comprises of a number of major components, each of which we will look at separately.

It’s important to note that the skin is a significant part of the immune system and is also the only visible part of it.

Our skin is usually the first protective barrier between us and the germs and bacteria. The epidermis contains special cells called ‘Langerhans cells’ that are an important early-warning component in the immune system.

The skin also releases antibacterial substances which can instantly kill most germs and the bacteria that land on the skin.

The nose, mouth and eyes are also components of the immune system. Lysozyme is an enzyme found in tears and mucus that breaks down the cell wall of many bacteria.

If the enzyme isn’t effective at eliminating the germs, saliva and mucus can act as transporters to capture and remove the germs from our body. Saliva is also anti-bacterial.

Cells also line the nasal passages, throat, lungs and skin. These play an important protective role too, and are involved in wound healing and defence against pathogens.

The majority of bacteria and viruses can be dealt with by the defences outside the body, but if they do make it inside, a germ is dealt with by the immune system on a very different level.

LYMPH SYSTEM

The lymph nodes are part of a large system that extends throughout the body, just like blood vessels.

This is a passive system, meaning any fluids in the lymph system are pushed around by normal body and muscle motion, eventually ending up in the lymph nodes.

This fluid is known as ‘lymph’, which is a form of blood but without the red and white cells.

The blood carries nutrients in it, and transfers these to the lymph system throughout the capillary walls. The lymph fluid then passively delivers these materials to the cells within the body. The lymph is also responsible for the excretion of proteins and waste products produced by the cells.

The same process will occur when germs enter the body. They will be passed into the lymph system and transported to the lymph nodes for processing. When this occurs, the lymph nodes swell to accommodate the unwanted bacteria, along with other bacteria fighting cells.

This acts as a filtering process and once complete, the lymph will re enter the bloodstream.

THYMUS 

The thymus is located between the breast bone and the heart.

Its main role is to produce T-cells, which are a collection of white blood cells that work togetherto destroy bacteria and viruses.

The thymus is of particular importance for the maturation of these T-cells and therefore becomes less of importance as we age. In adulthood, it is possible to remove the thymus because other parts of the immune system can handle the load. 

SPLEEN

The spleen has the role of filtering the blood to remove any foreign cells, including old red blood cells. It is possible to remove the spleen, and where this has happened, people can get sick more often as a result.

BONE MARROW

Bone marrow is responsible for producing new red and white blood cells. Stem cells are located in bone marrow, and these are the foundation to making all types of red and white cell types. Stem cells change into actual, specific types of white blood cells. 

WHITE BLOOD CELLS

White blood cells are a collection of cells that work together to destroy bacteria and viruses. They are therefore regarded as the most important part of our immune system.

Below is a list of the different types, names and classification of white blood cells: 

  • Leukocytes
  • Lymphocyte
  • Monocytes
  • Granulocytes
  • B-cells
  • Plasma cells
  • T-cells
  • Helper T-cells
  • Killer T-cells
  • Suppressor T-cells
  • Natural killer cells
  • Neutrophils
  • Eosinophil’s
  • Basophils
  • Phagocytes
  • Macrophages

Every single white blood cell in the body works independently as a living single cell organism. They have an ability to move around and can engulf other cells and bacteria.

Each of the different types of blood cells have a unique role to play in the immune system, and they can also transform themselves to meet the demand.

To measure immune system health, a count of total white blood cells can be used. A blood sample can be taken to determine the level of each type of white blood cell in someone’s body.

A normal white blood cell count is in the range of 4,000 to 11,000 cells per microlitre of blood.

As we already know, white blood cells main role in the body is to deal with foreign cells or bacteria. The ‘Major Histocompatibility Complex’ (MHC) or Human Leukocyte Antigen (HLA) is an inbuilt system that marks the cells in the body as ‘safe’.

Those cells without this marking are therefore classified as foreign antigens (substances on the surface of cells, viruses, fungi or bacteria), and an immune response occurs. 

IMMUNE RESPONSES

1. Innate Immunity

Innate, or nonspecific immunity is the defence system that we are born with. This is considered the front line of defence in the immune response against any foreign antigens.

Examples of innate immunity include: 

  • cough reflex
  • skin
  • enzymes
  • muscus/tears
  • stomach acid

2. Acquired Immunity

This type of immunity develops with exposure to various germs and bacteria. With time, the immune system builds a natural defence against that specific antigen.

3. Passive Immunity

Passive immunity provides antibodies that give immediate protection against antigens, but does not provide long lasting protection.

This can be naturally occurring such as with a mother to a newborn child via the placenta, or artificially such as an injection of antiserum e.g. tetanus antitoxin. 

Autoimmunity

The immune system can sometimes get it wrong, and we can see negative side effects as a result.

This type of mistake is called autoimmunity, or autoimmune disorder, and occurs when the body’s immune system attacks and destroys healthy body tissue.

There are more that 80 types of autoimmune disorders, and the exact cause of them is still unknown. It is believed that some micro-organisms (e.g., bacteria or viruses), medication, foods and environment factors may trigger changes that confuse the immune system.

It is also believed that some people are more genetically prone to autoimmune disorders.

An autoimmune disorder can result in:

  • the destruction of body tissue
  • abnormal growth of an organ
  • changes in the organ function

Areas typically affected by autoimmune disorders are:

  • skin
  • red blood cells
  • muscles
  • joints
  • endocrine glands (thyroid/pancreas)
  • connective tissues
  • blood vessels

Allergies

An allergy is classified as an immune response or reaction to substances that are not usually harmful.

Aside from protecting against bacteria and viruses, the immune system can react to allergies as it sees these as foreign antigens too.

Someone with these type of allergies are considered to have an over sensitive immune response that releases chemicals known as histamine in response to exposure. The histamine response can produce sneezing, itching, hives and watering eyes.

SYMPTOMS

Different allergies will produce different symptoms, and they are usually seen in the same part of the body that the allergen touches:

  • Allergies in the airways may cause stuffy nose, itchy throat, excess mucus, coughing or wheezing
  • Allergies to the skin may cause rashes, hives, itching, blisters or skin peeling
  • Allergies to food may cause vomiting, stomach discomfort, bloating, gas, cramping or diarrhoea

ALLERGY TESTING 

If an allergy is suspected then it’s important to refer the client to a medical professional. They will undertake a number of tests to confirm if an actual allergy exists.

The most common form of allergy testing is skin testing, such as the prick test, patch test and intradermal test. 

TREATMENT

The best way to reduce symptoms is to avoid what causes the allergies.
If this isn’t possible then there are a number of medications to prevent and treat allergies.

These include:  

  1. Antihistamines
  2. Corticosteriods
  3. Decongestants
  4. Injections

Once allergies have developed, treating them and carefully avoiding allergy triggers can prevent reactions in the future. 

Addison's Disease

Addison’s Disease is a disorder that occurs when the adrenal glands do not produce enough hormones. 

The adrenal glands are located on top of each kidney and consist of an outer portion known as the cortex and an inner portion known as the medulla. 

The cortex is responsible for the release of these key hormones, namely glucocorticoid, mineralocorticoid and sex hormones. 

Addison’s Disease results in damage to the hormone producing cortex, thus subsequently lowering output.
It is possible that the immune system can mistakenly attack the adrenal glands, which can result in this disease. 

SYMPTOMS

  • chronic diarrhoea, nausea and vomiting
  • chronic diarrhoea, nausea and vomiting
  • dehydration
  • dizziness when standing up
  • paleness
  • extreme weakness, fatigue and slow movement
  • salt craving
  • weight loss and reduced appetite

TREATMENT

Treatment with replacement corticosteroids will control the symptoms of this disease. This may need to be taken for life. 

Coeliac Disease - Sprue

Coeliac disease, also known as coeliac sprue, is an inflammatory condition caused by intolerance to gluten.

This condition creates inflammation in the small intestine while causing damage to the lining. This can also lead to vitamin deficits due to lack of absorption of nutrients and bowel abnormalities.

Gluten can be found in many of our typical foods such as oats, bread, wheat, rye, cakes, desserts, cereals and most processed foods.

The exact cause of coeliac disease is unknown but it can develop at any time in life, and can be hereditary.

Coeliac disease causes ‘leaky gut’, which is the result of damaged ‘villi’ in the stomach. These are responsible for absorbing nutrients, so those with leaky gut are unable to absorb nutrients properly.

Eating gluten for certain people will cause their immune system to react, which in the process damages the villi. Those with coeliac disease are more likely to suffer from other autoimmune diseases. 

SYMPTOMS

Symptoms can differ from person to person, but this is a list of the most common:

  • bloating,
  • fatigue,
  • abdominal pain,
  • diarrhoea,
  • lactose intolerance,
  • nausea or vomiting,
  • poor stools,
  • unexplained weight loss.

TREATMENT

Coeliac disease cannot be cured and the person should be tested to confirm this disease.

Blood tests are the most common and a medical professional can conduct these to test for specific antibodies in the blood if coeliac disease is suspected.

If confirmed, the person should follow a life-long gluten free diet.

Their goal should be to heal and improve their digestive system, and ensure it is strong and healthy to reduce any negative symptoms.

Grave's Disease

Grave’s Disease is an autoimmune disorder that leads to over activity of the thyroid gland, also known as hyperthyroidism.

The immune system can mistakenly cause the thyroid to produce too much thyroid hormones, resulting in Grave’s Disease.

SYMPTOMS

There are a large number of symptoms associated with this disease:

  • anxiety,
  • difficulty concentrating,
  • eyeballs that stick out (exophthalmos),
  • fatigue,
  •  increased sweating,
  • muscle weakness,
  • memory loss,
  • frequent bowel movements,
  • insomnia,
  • irregular heart rate,
  • shortness of breath,
  • double vision,
  • eye irritation or watering,
  • increased appetite,
  • irregular menstrual periods,
  • weight loss.

TREATMENT

A medical professional will test for Grave’s Disease. This involves a physical examination to look for increased heart rate and enlargement of the thyroid glands. It may also include a blood test to measure levels of TSH, T3 and free T4.

Hyperthyroidism can then be treated with one or more of the following: 

  • any-thyroid medications
  • radioactive iodine
  • surgery

Hashimoto's Disease

Hashimoto’s Disease, or chronic thyroiditis is swelling of thyroid gland that can lead to a reduced thyroid function (hypothyroidism). It is also caused by a reaction of the immune system against the thyroid gland. 

This disease is most common in females and takes months or even years to fully develop and be detected. 

SYMPTOMS

A number of different symptoms can occur: 

  • constipation,
  • difficulty concentrating,
  • dry skin,
  • hair loss,
  • fatigue,
  • irregular or heavy periods,
  • intolerance to cold,
  • mild weight gain,
  • enlarged neck,
  • joint stiffness,
  • swelling of the face.

TREATMENT

A medical professional will test for the disease. This involves a physical examination to look for increased heart rate and enlargement of the thyroid glands. It may also include a blood test to measure levels of TSH, T3 and free T4.

Hypothyroidism can then be treated via hormone replacement therapy (levothyroxine) to provide sufficient thyroid hormones. 

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a long-term disease that is caused by inflammation of the joints and surrounding tissues.

This is caused by the body’s immune system mistakenly attacking healthy tissue, and can occur at any age.

SYMPTOMS

This disease can start slowly and tends to affect the most common joints such as fingers, wrists, elbow, shoulders, knees and toes. It is also known to affect joints on both sides of the body equally.

TREATMENT

There is no exact test for diagnosing RA, but two lab tests commonly used are:

  • Rheumatoid factor
  • Anti-CCP antibody

Type 1 Diabetes

Type 1 diabetes is considered to be most likely an autoimmune disorder in which there is a high level of sugar (glucose) in the blood.

In Type 1 diabetes, beta cells that are located in the pancreas produce little to no insulin because they have been mistakenly attacked by the immune system. It can occur at any age, and can be passed down through families. 

SYMPTOMS

There are a large range of symptoms associated with Type 1 diabetes, with a few of them being: 

  • Increased thirst,
  • Increased hunger,
  • Fatigue,
  • Blurred visions,
  • Heavy urinations,
  • Deep or heavy breathing,
  • Flushed face,
  • Dry skin or mouth.

TREATMENT

Diagnosis and treatment for Type 1 diabetes is extensive.
Typically, tests include fasting blood glucose levels, oral glucose tolerance test and the haemoglobin A1C test.

If diagnosed, intensive medical treatment and help may be needed so the person can get into full control of their diabetes.

Summary

An autoimmune disorder occurs when the body’s immune system attacks and destroys healthy body tissue by mistake.

Symptoms will vary based on the type and location of the faulty immune response. A medical professional will help diagnose and treat an autoimmune disorder.

There is no known prevention for most autoimmune disorders, but we do know that a healthy diet and lifestyle can reduce the likelihood of developing these or symptoms of them. 

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