Adair Small, RN May 2012
My April column was about easily preventible diseases, the communicable ones for which we have developed vaccines. Unfortunately we have no idea how to prevent many conditions and the list of autoimmune disorders is one that just seems to keep growing. There are currently more than 80 widely accepted conditions in this category. Autoimmune literally means an immune response to the self. In other words the immune cells in the body begin to attack and destroy healthy body cells. This is similar to an allergic reaction, but there the stimulus comes from outside the body and not from the body itself. One of the confusing aspects is that an outside stimulus may be the initiator. For example in Celiac Disease or sprue, the intestinal lining reacts to gluten (found in most grains) by destroying the villi necessary to absorb nutrients. Eating a gluten-free diet relieves this, but it can take some time for the intestines to “calm down” and sometimes the inflammation never entirely resolves.
Among Americans, 23.5 million people have an autoimmune disease. Women seem to be more likely to develop one than men. Some disorders seem to have a familial tendency. Environmental exposure to certain things, sunlight, chemical solvents, and even certain viral and bacterial infections can increase the risk. Your ethnicity or race can make you more or less susceptible to various autoimmune conditions and can affect the severity of the disease.
Any organ in the body can be involved. The thyroid gland is a commonly affected gland and is a good example of the ways autoimmune conditions can behave. An affected thyroid can underproduce thyroid hormone (Hashimoto’s Disease) or overproduce it (Grave’s Disease). Thyroxine affects the function of multiple organ systems so its levels are vitally important to normal function. Too much is as bad as too little. Grave’s disease also illustrates how peculiar the malfunction of our immune system can be. In this case, the body makes antibodies that mimic a hormone the pituitary gland makes to regulate the thyroid gland. TSH, thyroid stimulating hormone, is at normal levels, but the thyroid gland responds to the abnormal antibodies and goes into overdrive. This can damage the heart and eyes and cause many distressing symptoms such as anxiety and insomnia. There are several treatments depending on the severity of the condition. Sometimes it completely resolves with minimal treatment.
Many autoimmune disorders profoundly affect a person’s life even though they are quite common such as Type I diabetes. We are all familiar with the fact that just replacing insulin does not solve all the health problems diabetics face. Diet and exercise are of vital importance to maximize control of blood sugar levels and minimize organ damage.
Each autoimmune disorder is unique, but they all share some common characteristics. Most can cause fatigue, dizziness, and low-grade fever. Most are characterized by remissions when symptoms abate and exacerbations or flares when symptoms suddenly increase. Stress, both environmental (such as heat or cold) and emotional, generally cause exacerbations.
Other disorders such as Addison’s Disease, pernicious anemia, rheumatoid arthritis, Crohn’s Disease, lupus, multiple sclerosis, psoriasis, and ulcerative colitis, have been recognized for a long time, but are still hard to control. There are fairly effective medications, but balancing drugs and dosages to minimize side effects is difficult. Most drug regimens involve suppressing the immune system generally to some degree. You can imagine that this has major drawbacks. Making various life style changes and modifying the environment in some way are almost always a part of learning to live successfully with an autoimmune disorder.
Whenever there is no cure for a condition, alternative medicine practitioners become very active. This can be a good thing; the problem is that it is very hard to sort out the valid recommendations from those which have little or no good research behind them. A number of traditional institutions (like UCLA) have Complementary Medicine departments which can be an ideal source for consultation.
Having a chronic condition is never easy, but joining a support group can be very helpful. Thanks to internet technology, even those with a rare disorder can find a community of others to offer practical suggestions and a listening ear.
Adair Small, Congregation Nurse, nurseocuucorg
Just type in the disorder you are searching for and you will find information and further resources.
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