10 Causes of Autoimmunity

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Once I was officially diagnosed with autoimmune disease I dove into how to heal like it was my job. I refused to accept that my condition would gradually worsen and that prescription drugs were the only option. Healing from the inside out is no easy feat, though, and it started with getting down and real with myself on what really led to this condition. I knew genetics played a role, but only a third or so, which meant two-thirds were things that have happened in my life--whether in my direct control, in my environment, or something that happened to me by chance.

If you really start digging into it, you will find that there seem to be a million and a half reasons why one gets an autoimmune disease and it can be overwhelming. Autoimmune conditions are fairly common. I've read stats such as autoimmune conditions affecting 80 million Americans and 5% of the population in Western countries--and those are the diagnosed cases. Many conditions go undiagnosed. So how do you figure out your unique situation? How do you figure out how to get your body to stop attacking itself? Hack away at it one variable at a time. I sought help from experts, played investigator, did some heavy self-introspection. I feel like I have boiled down my main reasons, which I'll list below.

But first, I also have a theory on what ultimately caused the autoimmunity (AI) to trigger when it did despite living relatively healthy as can be these days. I heard some stories from others on there being one "traumatic" event in which their body was never really the same and AI set in. For me, I am fairly convinced the final trigger that caused everything to blow up happened in December '15. I got a really bad case of the flu where I was sick for 14 days at a level that was worse than I had ever experienced in my life. It simply wrecked me, and ever since that I never really felt the same to be honest. For example, I was weak working out into January--I figured I'd just have to patient yet tough to build back--and I also had a gut setback in which I was sensitive to everything yet again (ugh) among other noticeable symptoms. Now I'm thinking that flu and its bugs threw things off just enough in an already-vulnerable environment. Combine that with go-getter me who was trying to workout thinking about marathons and ultras, and it was a perfect storm that blew up on me.

I did a stool test in January (the GI MAP) to assess the current state of my gut and it came back showing elevated levels of salmonella, staph, enterococcus, and pseudomonas. Say what?! I was shocked. I also tested positive for moderate candida and some small intestinal bacterial overgrowth (SIBO), both of which were nothing new and had been taking a toll for a long time. Interestingly fungal infections (eg candida) are present in most autoimmune cases.

So there's that, but I would never blame just the flu. I know it's more.

My Top-10 Reasons For Developing Autoimmunity

1. Gut dysbiosis -- chronic infections, overgrowths and an imbalance between beneficial and harmful gut bacteria.
2. Leaky gut -- little particles of food getting into the bloodstream and triggering an immune response, this one is all too common and dangerous. Read more here.
3. Other hidden infections -- in my case, those two root canals one of which I got when I was 16 years old.
4. Nutritional deficiencies -- not because of a poor diet, but rather malabsorption due to gut issues.
5. Stress(!) -- This is where I get real and admit I have a deep history of chronic stress, high-stress living, and spending too much of my life in a sympathetic state. 
6. Impaired detox and poor methylation -- all my resources were tapped and body not able to do its job to be resilient and full-functioning. The deficiencies can be detected in blood testing and even some hormone tests. Methylation what? For more on what it is and its role especially with inflammation and immunity read here.
7. History of adrenal insufficiency and mild hypothyroidism -- mostly in my 20s. Thyroid interestingly tanked even more right before AI triggered.
8. History of HPA Axis dysfunction and other hormonal imbalances -- I've made this no secret.
9. Environmental toxins, mold exposure -- living in small beach apartments for the past 5 years.
10. Genetic susceptibility -- up to one-third of one's risk factors for developing an AI disease.

Other factors branch off from these 10, like why the gnarly gut dysbiosis? It's not because I've had a diet rich in refined carbs and sugars, that's for sure. So this is where you have to play investigator and often it's not that hard to nail down the reasons. 1) I was a C-section baby which put me at a gut deficit on Day 1 due to not being exposed to all the beneficial bacteria in the vaginal canal. I am not crazy here; there is plenty of evidence to support this link. 2) Having an eating disorder (ED) and the stress/diet issues related to that were a huge factor in worsening my poor gut, there's literature supporting this connection as well. 3) Replace ED stress with endurance training/ triathlon stress and this is when my gut issues got really bad. Oh I could tell stories but I don't want to lose my readers ;) 4) And then other things like being a wine drinker.... and heck, let's be honest: I've enjoyed drinking alcohol for many years of my life... a little in high school, a lot in college, and on and off in my adult life since. I think alcohol can be fine (in moderation), until it's not. I reached the point of even moderation being too much for my body and I'm sure it ties into the aforementioned reasons.

All those 10 things, and some, and at the end of the day it was a big body burden... 

And What Else in the Present?

I also pondered deeply and honestly, what else besides the flu was I doing in the present time and mostly in my control that could have also triggered this thing? I wanted to uncover anything that I could change....

1. Stress -- while I love my life, love the present, and the direction it's going, I was still addicted to that stressed out way of living--letting little dumb things set me off or becoming overwhelmed when it's easily preventable. It was time to change once and for all. Adopt new habits and no bullshitting it. Even though I've eased up on training/racing in recent years, I think I was still stressed about my role as an athlete and races like Boston, so on.
2. Diet -- yes, of course I eat healthy and avoid junk, but there are certain healthy foods that can still be gut irritants to the sensitive person such as nuts, eggs, chocolate, nightshades, dairy, gluten and alcohol, as well as foods implicated in SIBO and candida such as FODMAPs. I was having all these except gluten. None of these things had to be eliminated forever; rather, just long enough to heal the gut, make progress, then reintroduce slowly.
3. Alcohol -- I already described a bit of my history with alcohol. Last year I really cut back. But then over the holidays it crept back in and I was back to regular wine consumption. Not a ton, but it was too much for my current state. In March I went cold turkey and it helped a ton. In a future post I'll discuss my reintroduction and how I've found what I believe to be my ideal balance.
4. Mold/toxin exposure -- I didn't pay thousands of dollars to test this so it is more speculation on my part, but I trust my senses. I'm fairly convinced the beach apartment we lived in from early 2012 until February 2016 had mold/mildew in the bathrooms--I could smell that smell, you know what it is. Plus I often woke up felt groggy, congested and shitty no matter what I ate, drank or did the day(s) before. I think our old bed/sheets/comforter played into that as well--it was like 10 years old--and the more of a deficit I got into, the more sensitive to everything I became. We moved in February and most of my morning issues of feeling crappy disappeared instantly!
5. Exercise -- Without a doubt my exercise habits have changed in the recent few years trying to promote health above all, but I still had an exercise addiction, and with a race on the calendar (Boston) plus toying around with more race ideas (ultra) I am just used to doing a lot and pushing my body--but that doesn't mean it's right in this context. It's so funny talking to my functional doctors who think the amount of running/training I do is absurd, yet to me it's just normal lol! Looking back at 2015 into this year I have to admit i was still going relatively full-speed (marathoning, backpacking trips, hours-long trail hike/runs, a 30k race in November, this year back to weekly running in the 20-40mpw range for Boston, strength training, etc). And that's just exercise; doesn't even touch on my workload and all the other stuff we do.

'But You're So Healthy!'

Everyone always tells me, "You're so healthy, you are the healthiest person I know! How could YOU be dealing with this?!" I agree, I do pride myself on a healthy lifestyle and I feel like I have all the tools to do it right. So this was a wakeup call for sure, and quite humbling, but at the end of the day it does make sense and I've totally made peace with it. I'm actually finding an immense amount of personal growth and deeper happiness because of it! Go figure.

Hopefully this post explains that even "healthy people" may be at risk. A lot of the normal things we do and are exposed to can build up over time and create an unhealthy body burden. You can see in my case that there were just many variables in and out of my control that added up over time and were too much on a sensitive body. Sometimes our healthy habits aren't even enough to offset the negatives, and things happen. Not to mention those of us who are Type A'ers and who don't easily slow down. I'm a go-getter by nature and not one to take a back seat and observe, but this wake-up call has forced me reevaluate a lot. I realized I can still be a go-getter but take a different approach, slow down a bit, find better balance and foster a better environment for my body.

As I have opened up more about my AI condition, I've received an outpouring from others who tell me about their condition--varying levels of some kind of autoimmunity--and the tools they use to work through it. I'm coming to find it's really common, and I know i'm not the only one. Folks like Dr. Mark Hyman and others mentioned on my last post are doing a great job to create awareness on appropriate healing methods.

In my next post I'll go more into my healing protocol that allowed me to achieve a ton of progress in a relatively short amount of time.