One of my favorite sessions I attended at #medx was an autoimmune presentation by Dr. Bonnie Feldman (@DrBonnie360). I’m pretty sure my neck hurt from shaking my head in agreement the entire time she was talking.
In her presentation, @DrBonnie360 talked about how we need to add an integrative layer in our healthcare system and we need to mix functional medicine with clinical care. In doing so, our health system would be able to offer the best of eastern and western traditions. This integrative layer would include health care providers such as health coaches, dietitians, chiropractors, acupuncturists, physical therapists, support systems etc. Without this layer of wellness, it will be almost impossible for an individual to achieve complete health.
Because our health care is so silo’d it has made it extremely difficult to get a diagnosis. Patients start off at one doctor, then bounce to another, then to another, then another, then, if you’re lucky, you find a doctor who understands what you’re going through and is able to get you the treatment you need. There are so many autoimmune patients who have comorbidities because it takes so long for us to receive a diagnosis. In order to create a foundation for healing, you, the patient, must establish trusting partnerships with your healthcare providers. If you’re all working in tandem, you’ll have the tools you need at your disposal.
In order to not only treat our diagnosis, but create a state of total health, doctors and patients must expand their toolkit. The photo to the right is a slide that Dr. Feldman presented. I love the way that she’s included so many practitioners which are considered “alternative treatments” in her wellness layer. I strongly dislike how the western culture looks at treatments which have been around for thousands and thousands of years as ‘alternative’ and not first line treatments. Everything can’t be fixed with a pill – and that’s just the honest truth.
I loved when @DrBonnie360 talked about how we need a targeted approach to health and gave the example of treating a patient not only with antibiotics, but with pre and probiotics as well. That way the antibiotics can help fight the infection and the supplements can help the gut replenish the flora that is killed from the antibiotics.
“Cherish the things you can do today because you might not be able to do them tomorrow.”
Due to the complexity of autoimmune disease, there are so many more questions than answers. In talking with my Chiropractor, and from the research I’ve done, I truly believe that people are starting to realize that our health care system is flawed and these ‘alternative’ or ‘complementary’ treatments aren’t a bad way to go. Biologics work in some, don’t in others and lose their effectiveness over time in most. I’m not suggesting that we stop taking our medications and go get “cured” by a massage. I’m purely suggesting that in order to have complete health we need to compliment our medication with diet and lifestyle changes as well.
Dr. Bonnie Feldman opened my eyes to the future of autoimmunity. She explained that the best science we have to be hopeful about is in the micro biome community. This research may be very early, but if scientists can identify what exactly in our micro biome is causing these diseases, we can then find a cure. There are a few start ups that are researching the leaky gut syndrome and are trying to develop therapies to address it. There are also companies within the food industry which are trying to expand into medicinal food. My functional medicine doctor actually told me about a diet which a company has developed and is now conducting clinical trials. This medicinal food therapy was created to help reset the immune system. I’m contemplating participating in the experiment.
“Diet and lifestyle can affect the feedback loops between the gut immune system and the brain.”
I believe this is a really important quote, stated by Dr. Feldman during her session. There are numerous research studies out there that show the connection between the two. The following is a great explanation of this connection:
“The gastrointestinal tract is a long tube from mouth to anus that in effect exists within our bodies and yet it’s contents are excluded in a time and content sensitive manner from our inner being by a single columnar epithelial cells thickness. It’s principle roles are the digestion and absorption of our foods, the management of an ecologically co‐dependant community of bacteria and the development and maintenance of the mucosal lymphoid immune system – purportedly the largest collection of immune tissues in the body. These mucosal tissues, by virtue of their location are directly exposed to the external environment and challenged with antigenic loads consisting of commensal bacteria, dietary antigens, and viruses at far greater quantities on a daily basis than the systemic immune system faces in a lifetime. These mucosal barriers are not simply the first line of defense; they are also the site of greatest clinical opportunity to influence physical and mental health through the ingestion of foods and microbes. Over thousands of years the bacteria that coexist with our body have developed highly specialized skills to survive and modify our health through altering gene expression and overall function.44 This mutual relationship is the most dynamic and least understood aspect of integrated nutritional health care. Problems with the gastrointestinal immune system normally result in a change or loss of mucosal tolerance and a subsequent up or down regulation of key immune responses.45 The overall effect is to induce altered pro inflammatory chemical output. This can result in chronic inflammatory conditions including autoimmune diseases, allergy, cancer and depression.
Michael Ash BSc (Hons) DO, ND, Dip ION, The Stressed Gut: The Depressed Brain: The Immune Link and the Gut Brain Axis”
The following is a fun, cartoon video that can help you get more familiar with the micro biome if you’re unfamiliar.
One take away that @DrBonnie360 gave me was the development of autoimmunity clinics in Israel. I was fascinated with this model. If an individual has an autoimmune disease they are treated within these autoimmunity clinics. They also identify at risk children and work with them to make diet and lifestyle changes to help prevent the development of an autoimmune disease. I found this paper by Dr. Shonfeld (one of the leaders within this space) which talks about whether it’s possible to predict if one will have an autoimmune disease or not. From their research, it appears that there are indicators that do make it possible to start to identify these patients.
There are about 50 million people in the US who have an Autoimmune Disease. That breaks down to 1 in 6.
While we’re still in the beginning stages of beginning to understand autoimmune diseases, there is already research that supports diet and lifestyle changes making a positive impact. I hope if you take 1 thing away from this post it’s this:
Explore your options. Don’t allow our current healthcare model to box you in to thinking you only have your rheumatologist to rely on. There are so many resources out there that can help you create your own integrative level. Even if there isn’t an official integrative layer in our system, talk to your providers, talk to your practitioners, your health coaches, acupuncturists, chiropractors – see if you can get communication going between them.
If we can begin to break down the silos, the barriers, the walls that have been put up between medical disciplines, we can start to create a wellness system instead of a disease system.
Wishing You A Pain Free Day!