Managing Autoimmunity is an informative slide show of key points to healthy immune regulatory factors. These basic items: toxic load, diet, nutritional stores, immune triggers, glutathione stores and genetics converge to create or deny a certain immune level of activity. Delivered to the Functional Medicine Club at SCUHS

1. Managing Autoimmunity Dr. Nancy Doreo, DC Applied Kinesiologist, Science Based Nutrition, Health Coach, FirstLine Therapy PCCW 1986

2. Autoimmunity Origins Horror autotoxicus: Literally, the horror of self-toxicity. A term coined by the German immunologist Paul Ehrlich (1854-1915) to describe the body's innate aversion to immunological self-destruction.

3. History Continued This concept of autoimmunity as the cause of human illness is relatively new, and it was not accepted into the mainstream of medical thinking until the 1950s and 1960s.

4. Prevalence Autoimmune diseases are a major threat to the health of all Americans. 14 to 27 million Americans suffer from the more than eighty illnesses caused by autoimmunity. The incidence is on the rise.

6. Causes of Autoimmunity

7. Environment Pathogens, drugs, hormones, and toxins are just a few ways that the environment can trigger autoimmunity

8. Inflammatory Cytokines Inhibit red blood cell growth Activate Microglia Cause pain Cause stiffness Impair intestinal barrier Impair blood brain barrier Wreak chemical havoc with neurotransmitters, hormones, nitric oxide, glutathione

10. MS

11. Osteoporosis

12. Chronic infections (e.g., recurrent sinusitis, Lyme or tick-borne diseases, periodontal disease, infected root canals, bacterial overgrowth of the small intestine, GI infections, candidiasis…)Metabolic syndrome, diabetes Heart disease Inflammatory bowel disease Coeliac Autoimmune diseases Cancer “itises” (arthritis, etc.)

13. Chiropractic Oath I will keep the physical, mental and spiritual needs of the sick as my foremost duty, ever searching for and correcting the cause of their disease to the best of my ability, insofar as my science is in the highest precepts of my Alma Mater and harmonious with the Vis MedicatrixNaturae.

14. Critical Management Points History Exam Labs: in office challenges, blood/saliva/urine Working Diagnosis versus Existing Diagnosis Plan of Action Phases of Plan Follow Up Re-evaluate

15. TH1 / TH2 Challenge X-Viromin / XFLM Apex Energetics 2 caps, three times a day for three days Record symptoms for worsening/improvement When not to challenge When to stop the challenge What to do with the results…

16. Dr. Mark Percival, DC, ND: “Meet them where they are, lead them where they need to be.” Health Coach ®

17. AutoImmunity Reality: Celiac Hashimoto’s Fix? Manages Fluctuates MS Psoriasis Rheumatoid

18. Get the BIG Idea Management Teach Management Strategies

19. 2 Most Common Symptoms PAIN FATIGUE

20. Environmental Triggers LOCATION STRESSES DIET (gmo, processed) PAST HISTORY NEURO-ENDOCRINE MEDICAL THERAPIES

21. Systemic Structural Factors Chiropractic Spinal Cranial TMJ Pain Referral Patterns Hemisphericity Left Brain / Right Brain Dominance

22. Left Brain/Right Brain Immune The left brain activates the immune system in such a way that it produces a barrage of protection against outside threats and if uninhibited by the right brain, against our own tissues. The right hemisphere gives us empathy toward others. It is the hemisphere that feels our organs and tissues and regulates their drive – keeping digestion under control, keeping the immune system regulated so it doesn’t attack our own tissues and keeping our heart beat regular

23. Dr. Walter Schmitt, DC, DIBAK, DABCNQuintessential Applications www.theuplink.com

24. Integrity of Barriers Lungs Skin Gut

25. Detoxification Pathways Liver Phase 1 the cytochrome P450s require several nutrients to function, such as copper, magnesium, zinc and vitamin C Liver Phase 2 · Glutathione conjugation: Methionine/Cysteine/Glutamate · Amino acid conjugation: cysteine/taurine/glycine/glutamine · Methylation: Folate, B12, Choline, Methionine · Sulfation: sulfur foods, glutathione, taurine · Acetylation: thiamine, pantothenic acid, and vitamin C · Glucuronidation: Magnesium

26. Systems Permit Viscous Cycles Mercury Poisons Methionine Synthase Default in GSH and GSSG permit poor detoxification of haptens Inflammation is BiDirectional Brain BBB Periphery Cytokines reduce memory and increase anxiety

27. Modulation of autoimmune diseases by nitric oxide.Singh VK, Mehrotra S, Narayan P, Pandey CM, Agarwal SS.Immunol Res. 2000;22(1):1-19. Nitric oxide (NO) is an intercellular messenger that performs a number of functions, including neurotransmission, vasodilatation, inhibition of platelet aggregation, and modulation of leukocyte adhesion. NO has recently been shown to act as a potent cytotoxic effector molecule as well as to play an important role in the pathogenesis of organ-specific autoimmunity. NO may also modulate the immune response by interfering with Th1/Th2 balance in autoimmune diseases. This review will discuss the role of NO and nitric oxide synthase (NOS) in pathophysiologic and therapeutic implications in various autoimmune diseases with particular reference to T helper-1 (Th1) and T helper-2 (Th2) cytokines.

28. Genomics Glutathione Peroxidase 1 SNP Metalloproteinase SNPs 5 MTHFR Others… Genova

29. Genetic Predisposition

30. Summary of therapies for the immune system Folic Acid Vitamin B12 Support IL 10 Pycnogenol Green Tea Resveratrol Hespiridin Vitamin A Probiotics Support T Reg Vitamin D Glutathione SOD Cordyceps PG E1 BCSO, EPO, Borage PG E2 Avoid NSAIDs Dr. Walter Schmitt, DC DIBAK DABCN , The Immune System, What to Do First, Next and Last

31. Sydney MacDonald Baker, MD 2006 “He who ignores individuality fails the patient.”

32. Know Your Effects TH1 Stimulators Astragalus Echinacea Mushrooms Goldenseal TH2 Stimulators Green tea Grape seed Pine bark Lycopene Regulatory T Cells Vitamin D EPA DHA Glutathione SOD Anti-inflammatory Boswellia Curcumin Quercitin Dr. DatisKharrazian, DC, DIBAK, DABCN, etc… Mastering the Thyroid

34. treat

35. protectBy permission of Dr. Aristo Vojdani, Ph. D., M. Sc., C. L. S.

36. Dr. Chris Astill-Smith, DO, DIBAK Top 3 Magnesium B6, Pyridoxal 5 Phosphate Zinc

37. Dr. Mark Hyman, MDAuthor http://www.youtube.com/watch?v=iebbvViAmqQ

38. SMBTCWOLGS01(013111)DATIS.PPT Copyright © 2011, Datis Kharrazian. All Rights Reserved 33 By permission of Dr. Aristo Vojdani, Ph. D., M. Sc., C. L. S.

39. SMBTCWOLGS01(013111)DATIS.PPT Copyright © 2011, Datis Kharrazian. All Rights Reserved 34 Gluten-Associated Sensitivity and Cross-Reactive Foods Panel 4, serum IgG and IgA a-Casein Sorghum b-Casein Millet Casomorphin Tapioca Milk Butyrophilin Amaranth Cow’s Milk Quinoa American Cheese Yeast Chocolate Spelt Coffee Polish Wheat Rye Sesame Barley Corn Oats Rice Buckwheat Potato

40. Modifiying Processes Rather than Curing Diseases environmental factors + susceptibility 4R Program + Anti-Inflammatory Lifestyle Chapter 23, Textbook of Functional Medicine, page 319

41. Some Examples of Imbalances RA Inflammatory prostaglandins lead to upregulated Th1 SLE Disease of upregulated Th2 Variable in response to pregnancy High Estrogen increases Th2 activity- worsens condition Low Estrogen at menopause usually symptoms improve Thyroid Interactions Thyroid gland reactively attempts to balance the effects of elevated adrenalin, feedback attempts to lower T4 to counteract cardiac irritability, leads to elevations of TSH with symptoms of hypothyroidism.

43. Gut Barrier

44. Glutathione Stores

45. Anti-Inflammatory Lifestyle

46. Exercise and Rest Habits