Guest Post by Dr. Kellie Ferguson: Naturopathic Medicine for Autoimmune Disease

July 14, 2012 in Categories: by

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Allow me to introduce Dr. Kellie Ferguson, N.D., a Naturopathic Physician in British Columbia, Canada.  Kellie is actually a very old friend of mine–we went to high school together!  But don’t worry; neither one of us remembers high school so no embarrassing stories can be told.  I asked Kellie to give a quick overview of Naturopathic Medicine and how it relates to autoimmune conditions and how she’d approach their treatment.  Also, you can read more about Kellie’s practice at her website www.koruhealth.com and her blog www.koruhealth.blogspot.ca

 For those that may not know Naturopathic Medical trainingis very comprehensive and similar to conventional Medical training.  Licensed Naturopathic physicians must complete a 4 yr undergraduate degree as well as a 4 year Naturopathic Medical postgraduate degree from a regulated and fully accredited school.  That degree includes classroom and clinical rotations and is followed by North American licensing exams.  There are two big differences between conventional and Naturopathic medicine:  our primary treatment therapies use botanical medicine, diet and nutrient therapies, counselling and homeopathy and using pharmaceutical medicine only if absolutely necessary.   Conventional medicine also focuses is on the diagnosis of disease then using the pharmaceutical or surgical treatments indicated for that disease.  In Naturopathic Medicine, the goal is to treat the underlying cause and triggering factors affecting that disease process and optimizing overall health and normal body functioning.   It is very important to note that Naturopathic Physicians are not licensed in all Provinces and States, therefore in many places there is no regulation on who can call themselves a Naturopathic Doctor.  To make sure you find a practitioner with the appropriate training and who has passed all the regulatory exams have a look at these two websites: CAND for Canada and AANPfor Naturopathic Physicians in the US.

So let’s start with the basics of how an autoimmune process does its thing.  Basically, the immune system is triggered (sometimes by a virus, sometimes by bacteria or foods in the gut) and that starts things going.  This pathway triggers inflammation and causes the immune system to be on high alert to the original trigger.  Unfortunately, in an autoimmune process the immune system confuses (cross-reacts) our own body tissues with the original trigger.  So when these immune cells come in contact with those normal tissues it attacks and reinitiates the inflammation turning it into a bit of a runaway train.  Conventional treatment is to suppress the immune system trying to tamp down the reaction.  This is usually effective but just manages the symptoms.  The Naturopathic approach is to find and eliminate the original trigger and help the body to restore appropriate control of the immune system.  Sometimes both approaches are needed, especially initially if the system is pretty aggravated, but in the long run people tend to get much better success with addressing the underlying issue rather than just suppressing  symptoms.

In Sarah’s post about the Autoimmune Protocol she talks about the importance of addressing the gut.  While it may sound so strange to address the belly when we’re talking about eczema or rheumatoid arthritis, the gut plays an enormous role in managing the immune system.  There are huge patches of immune cells lining the gut protecting us from bacteria or parasites in our foods.  The healthy bacteria (or probiotics) living within the gut act as schooling grounds, training our body to be less allergic by triggering for different chemicals to be released.  You can imagine that if there are any food sensitivities or unhealthy bacteria or fungi present, then all that immune tissue is going to react and cause inflammation and lots of potential for cross reactions.   If you don’t have enough good healthy bacteria (normal flora), then they won’t be able to help the immune system to regulate itself.  If the gut becomes damaged enough (because of ongoing food sensitivities or some medications) then it allows undigested proteins to get into the body whole, which increases the potential for food sensitivities and cross reactions to occur. 

As I mentioned above, the first step to modulating the immune system is to find and address the gut immune triggers, whether they are food sensitivities or abnormal flora.  Sarah’s asked me to do another post later to discuss food sensitivity testing so check back later for that.  Once they are identified, we can limit or avoid those foods to allow the immune system to settle down.  Occasionally, we need to look at testing to identify if there are any harmful bacteria or fungi present and we can address those with diet (Paleo and SCD are ideal) and often with herbal or prescription antibacterials/antifungals.  Probiotics serve double duty by preventing harmful bacteria and fungi from taking up residence in the gut and also by stimulating normal immune regulation by releasing regulatory chemicals called cytokines.   It’s always wise to research probiotics or consult a Naturopath first as there are lots available over the counter but purity, potency and freshness are significant issues.

Even once the triggers have been identified and eliminated, many people need to heal their gut in order to prevent new food sensitivities from developing.  There are lots of protocols for doing this and the SCD or Specific Carbohydrate Diet was specifically designed to do this.  I often do a multi-step process with probiotics, digestive enzymes, fiber, omega 3 fatty acids and a product for intestinal healing.  This can be accomplished with diet rather than supplementation by increasing bone broths, coconut oils, cabbage and fiber, lots of fish and nuts and seeds.  But I have occasionally found that the gut is too compromised at the outset to be able to properly digest these foods without supplemental support.

The last step is to directly affect the immune system.  A word of caution:  This is too tricky to do without discussing with a qualified practitioner (I’d recommend a licensed Naturopathic physician) that is knowledgeable about herbal medicine and their interactions with medications.  There are many herbs that modulate the immune system, that is to say help boost it when it’s underfunctional and help to control it if it’s too active, but obviously there is lots to consider before starting any of these.  Some include: Echinacea species, Rehmannia, Albezia, Nettles and Quercitin.  Do not add any of these herbs (no not even Echinacea!) if you have an active autoimmune process without first discussing it with a licensed Naturopathic Physician.

I hope this has been a helpful primer on autoimmune support and keep an eye out here for more information on food sensitivity testing. If you have any questions or comments please feel free to email or post via my blog, where you can also find more tips about current news topics, allergies, Autism and other Naturopathic topics.

Comments

My son is on SCD. His gut problem is severe ulcerative colitis. Thank you so much for this article. I’m looking forward to reading more on your website and blog.

Actually, recent studies show that higher insoluble fiber intake speeds healing in models of colitis and diverticulitis. Also, the higher the intake of insoluble fiber, the lower the chances someone will have high c-reactive protein (implying that it reduces or prevents inflammation). It reduces risk of cancer and cardiovascular disease. I can’t find a single scientific journal article that actually shows that insoluble fiber irritates the gut and I have a feeling this is myth. Instead, I can find evidence that it reduces bile acid loss (which ultimately improves digestion), is an essential signal for ghrelin suppression after meals (which has a ton of different important effects in the body), that it improves insulin sensitivity, and helps to remove toxins from the body. I can’t find a single reason why insoluble fiber should be limited.

Studies show the more insoluble fiber from fruits and veggies you eat, the lower the CRP. But this is a little different than upping your veggie intake to lower a high CRP, but given how healthy high veggie diets are, I think it’s still worth a try. Basically all non-starchy veggies are higher in insoluble fiber, especially leafy greens (like lettuce, kale, collards), cabbage, artichoke, asparagus, etc.

Everybody with autoimmune disease has infections. These need to be found and addressed first or you will never make traction on inflammation and food sensitivities. Test for herpes viruses, coxsackie, strep, mycoplasma, lyme, candida, and if positive for lyme then test for other tick borne infections. I deal with autoimmune disease in myself and my whole family. once you get the infections under control, you can modulate the immune system better. Low dose naltrexone works great. This is what my doctor does, and it works!

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