Hi, Dr. Connie here.
When given medications to take, how many times have you questioned exactly what that specific medication is doing in your body?
Have you ever wondered why some Lupus or other chronic disease patients do better than others?
Or have you noticed that while some people may be sensitive to certain foods, others can eat anything and still have great energy and are as healthy as ever?
I used to wonder too. As a twin, my twin sister was blessed with all the good, healthy genes and I, not so much.
I am a Type A person who needs to constantly feel like I’m busy moving forward, while my sister can be just as content having a night out with friends, with no real plans for the day, week, or even the month.
She can sleep all day while I would be up at the crack of dawn out for a jog.
Growing up, I leaned toward healthy habits, at times having OCD tendencies that alienated my friends and family.
But I got Lupus, and no one in my family has Lupus. When I was diagnosed, I was truly puzzled and deflated.
I see the same scenario play out in my clinical practice. While some patients can regenerate and restore their functional status, some just struggle to heal.
Some are constantly struggling to feel better, while for others, it comes easy.
What’s more puzzling is that many times, this is not correlated with lifestyle habits. I’ve treated patients who are clinically obese and eat a poor diet, yet come in with perfect labs (cholesterol, glucose, liver, and kidney markers).
On the other hand, an elite Ironman athlete who is as fit as they come can have out of control cholesterol.
There’s no rhyme or reason.
So today I’d like to talk about medications typically prescribed for autoimmune conditions, how they work, their herbal counterparts, and their effectiveness in modulating our immune response.
Typical Classes of Medications
- DMARDS (Disease Modifying Anti-Rheumatic Drugs)
- Biological Response Modifiers
- Biopharmaceuticals (Biologics): Benlysta and other newer drugs
- Immunosuppressants: Chemotherapeutic agents and Corticosteroids
What’s important to remember is that the goals for any immune medications are to down regulate the inflammation, increase resistance against infection, and prevent autoimmune disease and cancer.
Our innate immune system and acquired immune system are typically the targets for these drugs.
For the context of our talk today, the innate immune system is our initial immune reaction to an infection to kill off the offender, such as a flu or bacterial infection. When this occurs, we experience redness, high temperature, increased WBC, pain, swelling etc.
Acquired immune system is when the initial acute response becomes prolonged and fails to shut off. This is typically what’s correlated with the autoimmune response.
Our cells signal each other to enable such “systemic response” to protect and fight.
- Corticosteroids, like Prednisone
- NSAIDS, like Celebrex, Naproxen, Ibuprofen, etc.
- Statins (used to lower cholesterol)
- Chloroquine, like Plaquenil
- Opioids (immunosuppressants)
Typical Biologic Immunomodulators
- Stem Cell Therapies
- Monoclonal Antibodies (Humira, Benlysta, etc)
These are powerful drugs that target our T lymphocytes that affect our DNA. They are non-reversible and have powerful side effects
- Methotrexate: folate analog interferes with DNA
- Azathioprine (Imuran): purine analog that interferes with DNA
- Leflunomide: arava pyrimidine synthesis inhibitor
- Mycophenolate Acid (Cellcept): inhibits guanosine synthesis, also altering our DNA
TNF Alpha Inhibitors
These drugs inhibit TNF Alpha, an inflammatory marker in our bodies.
- Infliximab (Ramacade)
- Etanercept (Enbrel)
- Adalimumab (Humira Pen)
Here’s a little trivia about Humira.
As mentioned above, Humira is a human monoclonal antibody used mainly to treat Rheumatoid Arthritis.
It’s the best selling pharmaceutical to date. In 2013 retail sales were 5.4 billion dollars and average costs for a US patient per month is $3100.
The number one autoimmune disease in the U.S. is RA and it’s on the rise, so this particular drug company is doing really well, but I digress.
The Problem With Medications
All such drugs are aimed at disease progression and the goal is to start care early to prevent progression and damage.
Problem is that this is all downstream medicine. Meaning, we are treating the effects of our disease rather than looking to the root cause.
A good example is a running faucet. Instead of looking to turn the faucet off, you keep mopping up the water on the floor.
Over time, you’ll get tired, just like your cells get tired of cleaning up the mess caused by the toxicity of the medications.
Just like how the floor will be damaged, this will cause some structural damage to our cells and eventually our bodies because of this incessant offense.
A Gentler Solution
Another reason why I am so passionate about this topic is that there are various herbals and nutraceuticals that affect the same pathways as the medications, without the side effects.
They are much more gentle on the body as well.
Not only that, they also help our bodies reestablish homeostasis to allow for healing, so that we can reverse this and turn the faucet off once and for all.
Another element not discussed by your doctor is lifestyle, which includes eating, exercising, and stress relief, as we are particularly vulnerable to any compromise.
Not once has my Rheumatologist spoken to me about diet. But this is not their fault because they had much bigger problems to deal with.
But the problem is that there’s growing body of research to indicate the link between diet and disease, particularly autoimmune disease.
Remember that all such meds in each class aim to shut off or alter one specific metabolic pathway that is affecting our immune system.
But once you mess with mother nature and turn that pathway off, other problems arise, including all the side effects and even death.
Such class medications, such as “immunomodulators” are not new. Natural immunomodulators were used in every indigenous population since the beginning of time.
However, they are dismissed because back in those days, they didn’t have the ability to validate such effectiveness by conducting “double blind” studies.
There’s something to be said about the timeless wisdom. Our ancestors’ inherent understanding of our health and disease cannot be refuted, especially looking at the history of oriental medicine.
Herbs and mushrooms in particular have been used for millennia for various medical purposes. Their primary use was for wound healing and infections.
So How Do We Affect Our Immunity With Nutrients?
- By enhancing our gut barrier integrity, limiting gut permeability
- Up-regulating our antimicrobial potential
- Priming our immune system to improve pattern recognition in our cells
- Restoring detox balance
- Activating our innate cellular defense mechanisms
- Supplying our body with essential nutrients, such as vitamin A, D, B12, C, E, and folic acid
- Getting complete amino acids in our diet, especially glutamine, glycine, taurine and arginine to help our body detox
As an example, vitamin D is considered a potent immunomodulatory hormone.
Yet we Lupus or autoimmune patients experience a deficiency and are at risk because we are told to avoid the sun because we have sun sensitivity.
So with all this said, we know that nutrient status can play a huge role in our disease progression.
Yet, most Lupus and autoimmune patients rely solely on meds to control disease progression and often overlook the potential for food as medicine.
I’m not advocating managing your disease without medications.
All I’m saying is that while we use medications, it is important to replenish your body with necessary nutrients to support it and ultimately help it reestablish its balance.
So here’s what I recommend:
- Help to decrease gut permeability and enhance our natural killer cell activity
- Help to decrease cancer risk up to 62% (1)
- Prevent upper respiratory tract infections (2)
- Improve gut permeability, are immunoprotective, inhibit toxins, and have anti-inflammatory effects (3)
- Green Leafy Veggies
- Normalize functioning of T helper cells, which results in improved T lymphocyte and natural killer cell activity
- Decrease antibody response
- Powerful anti-inflammatory
- Fish Oil
- Decreases inflammatory pathways in the body and repairs cellular receptor
- Works as a powerful antioxidant
- Detox Formula
- Provides all bioavailable nutrients your body needs to self modulate inflammation, improve immune function, heal leaky gut, restore mitochondria for improved energy, and eliminate toxins from your body
- Vitamin D
- Stimulates immature/naive immune cells, which help our bodies defend against infection
- Down regulates our mature immune cells by dampening our immune response
- Powerful inflammatory protectant by protecting against inflammatory damage in our body
Vitamin D insufficiency is emerging as a clinical problem of global proportions. Autoimmune disease susceptibility and severity links to Vitamin D deficiency.
As you can see, there’s so much more that can be done. As for the nutrients, you don’t have to buy from me, but it’s wise to be careful with what you put into your body.
Most supplements do not contain what they say they contain, they often contain many fillers and such.
I’ll leave that up to you to decide.
I hope you enjoyed this blog.
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That’s it for today, see you next week!
J Clin Immunol, 2001, Vol21(4):264-271
Expert OPin Biol There:2015 Jan;15(1) 9-20
J Pediatr Gastroenterol Nutr.2010 Aug 10