'Autoimmune' conditions and the gut health
Autoimmune conditions are fairly common and can involve many different organs and tissues of the body. The better known ones are hashimoto's, type one diabetes, lupus, rheumatoid arthritis, multiple sclerosis and coeliac disease, but there are many more. They often have a genetic component, but the onset of the disease might be triggered by an acute stress, an injury or infection, or maybe courses of antibiotics that have killed off beneficial gut bacteria.
There is a huge amount of research currently investigating the protective role of gut bacteria in our health, and it would appear that an acute episode of stress, or indeed chronic stress can affect this microflora in much the way a course of antibiotics can decimate their numbers. But what does our gut and its teeming population of friendly microbial residents have to do with autoimmunity? Well, it's all about the ability of the gut’s surface tissue - where they live - to absorb the nutrients from our diet, whilst also providing a barrier to everything that's waste. And it turns out the protective presence of our bacterial friends contributes enormously to that barrier function, which if not working well, can be a factor in developing autoimmune conditions.
When the gut's barrier function is not performing well, sometimes termed 'leaky', it can mean all sorts of things - in effect 'antigens' (bacteria or their by-products, undigested proteins, or viruses), can pass through and cause an immune reaction. This passage of antigens crossing an overly leaky gut lining is thought to be a factor underlying autoimmune conditions. In coeliac disease it's undigested gluten proteins causing the reaction, in other diseases it may be particular (pathogenic) bacteria.
What causes the gut to become leaky?
There are several factors; an acute episode of stress, or chronic stress can disrupt the gut's protective microbial community; a diet high in gluten for some people can make the intestinal surface very leaky. Regular use of painkillers do the same and alcohol binges are not great for our protective bacteria, and of course antibiotics can do collateral damage killing off a lot of this microflora. These are all factors that can produce an overly leaky gut. If this then allows a flood of things other than dietary nutrients to cross the gut's surface, our adaptive immune system gets activated and registers the invading molecules, tagging them for destruction as well as future recognition.
What then causes the immune systems of some people to develop an autoimmune reaction, where their immune systems in effect attack 'self' tissue, is currently being researched. But one theory is that if their immune system identifies a particular invading protein for destruction and thinks it has seen a similar protein structure elsewhere in the body, it decides to be extra vigilant and destroy that tissue too.
Of course we do have a few less friendly bacteria, of the pathogenic variety lurking in a few outposts of our guts too, but these are generally kept at bay by giving the good bacteria lots of veg - that they thrive on. Various viruses and gut pathogens have been implicated as triggers for autoimmune conditions, for example both ankylosing spondylitis and crohn's disease are associated with the gut pathogen, klebsiella pneumoniae, which is thought to be a triggering factor involved in the initiation and development of these diseases.
The autoimmune condition
Few of us know if we carry the genetic predisposition for any of the autoimmune diseases, and having relatives with crohn's or coeliac disease or MS is no guarantee of developing them anyway. What we as individuals can control however, is the lifestyle choices that may raise the risk of developing them.
Imagine a genetically predisposed individual with a few of those offending, pathogenic microbes lurking in their gut, maybe they had a course of antibiotics for a tooth abscess last year. Maybe they eat a diet with very few vegetables, that's rather high in starch, (which has been shown to enhance the growth of klebsiella microbes), and that starch also happens to contain a lot of gluten. Imagine they suffer regular headaches for which they take painkillers and on most Friday nights they indulge in alcoholic binge-drinking to wind down with friends.
Not too uncommon a scenario, but one that unfortunately paves the way - over time - for increasing the risk of a leaky gut, and therefore an autoimmune condition, if and when, an episode of stress should suddenly pop up into their life.
Some of these risk factors are unavoidable - the tooth abscess needed the antibiotics for example, but the dietary choices are within our control and certainly an awareness of our gut's microflora and the essential role they play in protecting gut health, is a factor we need to consider. Look after your friendly microbes, and they will look after you!
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About Eleanor Strang
Eleanor Strang BSc NT Dip ION mBANT CNHC
Eleanor Strang qualified at The Institute for Optimum Nutrition and completed a BSc in Nutritional Therapy at the University of West London. Her interests include gut health, gluten sensitivities, autoimmunity and fertility. She practices in London and Surrey and writes for Dr Morton’s medical helpline.