Is Autoimmune Disease Curable?

Most doctors say not. It can only be ‘managed’, they say. With a lifetime of drugs and, if you’re lucky, some invasive surgery. I disagree. Autoimmune disease can be reversed with some simple (and safe!) diet and lifestyle modifications. I’ve done it. And so have countless other people. The anecdotal evidence is strong. And, make no mistake, anecdotal evidence is meaningful. Not persuaded? A recent study now provides scientific backing.

Autoimmune disease comes in many shapes and sizes. Some are mild. Some are very severe. Many are life-threatening. All our life-altering. Psoriasis, type-1 diabetes, Crohn’s disease, rheumatoid arthritis, Hashimoto’s thyroiditis, multiple sclerosis. These are some of the well-known varieties. And they are all becoming more prevalent. New forms are also being added to the list. Regularly. Chronic fatigue syndrome, Alzheimer’s disease, chronic obstructive pulmonary disease (COPD), Parkinson’s disease, and even Schizophrenia are now all suspected to have autoimmune origins. The different types affect different tissues and produce different symptoms. But they all have the same underlying cause. Immune dysregulation. The immune system attacks the body’s own tissues.

Antibodies are responsible. These little front-line soldiers recognise foreign proteins (from microorganisms, toxins or food, for example) and mark them for destruction by the heavy artillery. Some of these foreign proteins have sections which look similar to sections of our own proteins. As a result, some antibodies, in a sinister act of betrayal, end up turning on us. These autoantibodies are a sort of evolutionary accident. Fortunately, we have also evolved systems for detecting and destroying autoantibodies. Unfortunately, people with autoimmune disease are genetically predisposed to produce more autoantibodies. And predisposed to a breakdown in the clean-up system. But an environmental trigger is still required. The foreign proteins which stimulate the production of autoantibodies still need to get inside the body for autoimmunity to persist. Genetics loads the gun. But environment pulls the trigger. Around one-third of autoimmune disease risk can be explained by genetics. The other two-thirds is environment.

There are many environmental triggers, from microbial infection to toxic chemical exposure to food intolerances. But the combination of poor diet, stress, and lack of sleep and exercise creates the terrain in which the disease is able to propagate. Luckily for us, we can control these factors. Optimise them. And ultimately prevent, or reverse, autoimmunity. I addressed stress in a previous post. Sleep and exercise I’ll discuss another time (spoiler alert: get eight hours; move more). For now, I’ll get into the diet piece in a bit more detail.

Certain food proteins are able to stimulate the autoimmune response. But only if they get inside the body. And this is only possible if the integrity of the gut barrier is compromised. Indeed, intestinal permeability is now thought to be the precursor in every autoimmune disease. Certain food proteins and chemicals are very effective at breaking down the gut barrier. As is an imbalance of gut bacteria (dysbiosis), which is, in turn, largely driven by diet. The immune system is further dysregulated, and the autoimmune process further propagated, by general inflammation and nutrient deficiencies. Again, diet-related. Our typical Western diet of processed food and refined carbohydrates is potently autoimmune-promoting. But so are many ‘healthy’ diets. At one point, I thought veganism was the answer. It wasn’t. Turns out the vegan diet is nutrient-deficient and full of autoimmune-provoking foods. Moving to a more ancestrally-appropriate diet helped a lot, but it wasn’t enough to reverse an existing autoimmune disease.

Pain is a great motivator. And it seems to be a requirement for me to do anything. A Christmas booze binge two years ago was the tip of the iceberg. I felt awful. The Crohn’s was creeping back. I had to find a solution. Thankfully, I came across the Autoimmune Protocol (AIP) at the right time. Exercise, stress management and sleep are all part of it. Diet is the cornerstone. I was doing a lot right already. I was exercising and eating well. But I needed to reduce stress, prioritise sleep, and further refine my diet.

The underlying principles of the AIP diet are to maximise nutrient-density, and to eliminate inflammatory, gut-damaging and immunogenic foods. It can be summarised as follows:

  • Consume grass-fed/pastured meat, wild-caught fish, fresh fruits and vegetables in abundance
  • Include the most nutrient-dense foods, such as organ meat, seafood and non-starchy vegetables
  • Introduce gut healing foods such as bone broth and other sources of collagen (think bones, skin and connective tissue)
  • Remove all processed foods, including refined sugars and vegetable oils
  • Remove grains, legumes, dairy, eggs, nightshade vegetables (potatoes, tomatoes, peppers, chilies, aubergine), nuts and seeds, coffee, alcohol and food additives
  • Moderate carbohydrate intake
  • Prioritise healthy fats, such as fat from grass-fed/pastured animals, extra-virgin olive oil and coconut oil

I approached AIP like I do all my experiments in diet and lifestyle. If the potential upside is big, the downside limited, and the rationale sensible, I’ll give it a go. 100%. All in. The potential upside was not only reversing Crohn’s disease, but optimising my health in general. That’s pretty big. The only downside was making some additional lifestyle changes. That’s not a risk. It’s just time and effort. And there was a sound biochemical and physiological rationale. That’s enough for me. We don’t need scientific evidence to experiment with something that ticks these boxes. It’s not a drug or surgery with dangerous side-effects. Just try it and see what happens. Generate your own evidence. As it happened, there was some evidence that AIP was effective at reversing autoimmunity. The internet and social media were awash with testimonials and case studies. Tragically, this sort of anecdotal evidence is often dismissed by the scientific and medical communities. Just stories they say. Not science. Not evidence. Which is odd, because it’s patient ‘stories’ that form one of the foundations of clinical medicine. Double standards?

After a couple of months on the AIP, my Crohn’s symptoms had gone. And they’ve remained so, other than a brief wobble or two. The blood markers associated with the Crohn’s inflammatory process are all at normal levels. In short, it worked. Really well. That’s my evidence.

If you want more than anecdotal evidence (a reasonable ask, by the way), you’re in luck. Researchers at the Scripps Clinic in California have recently published a study, which investigated the effectiveness of the AIP in 15 people with active inflammatory bowel disease (Crohn’s disease or ulcerative colitis). The results are impressive. 11 of the 15 participants experienced clinical remission after just 6 weeks. That’s 73%. In 6 weeks. And these are people who had lived with the disease for an average of 19 years. On top of that, four patients were able to discontinue or reduce their medication. Now, a word of caution. This was only an uncontrolled pilot study. It wasn’t a randomised controlled trial. But it was well-conducted research, and provides the necessary rationale for future trails.

Is it a cure? In my last post I said not. But I’m starting to rethink it. This is a strategy which reverses the symptoms of autoimmune disease by addressing the underlying cause. If that was a drug or surgery, would we call it a cure? I think we would. While this initial study looked specifically at inflammatory bowel disease, the anecdotal evidence speaks to a broad range of autoimmune conditions.

So, what are you waiting for? If you have an autoimmune disease, or believe you are predisposed, give AIP some serious consideration. Try it and see what happens. Produce your own data. It’s not easy to transform your diet and lifestyle. But it’s not as hard as you think. And it’s certainly not as hard as living with an autoimmune disease. I’ve been at it for the best part of two years now. It was habit after a month. Just part of my life. I’m layering on some additional restrictions at the moment, to address some other issues. They’re not habit yet. And it’s a challenge. But the upside is huge. So, I figure it’s worth giving it a shot.

I wouldn’t, however, be much good at any of this were it not for my family and friends. Sustained lifestyle change requires a support network. Katie, my wife, is incredible. She gives me the time and space and love I need to prioritise my health. She literally lives the diet with me. And she’s the best mum. None of this would work without her. I’d be knee-deep in beer and pizza by day three. My parents are a brilliant all-round help too. Eating away from home is challenging, of course. But my mum, brother, in-laws and close friends make it easy for me. Even though it’s difficult for them. And there is more than enough banter to stop me taking myself too seriously. I can’t thank any of them enough. Owning your health, it turns out, is a team sport.

For full details of the AIP, and a thorough review of the biology, check out The Paleo Approach by Dr. Sarah Ballantyne. This was my starting point. I read the book and dived straight in. If it all seems a bit daunting, take a look at the 6-week implementation strategy designed by the team at Autoimmune Wellness. This was used in the Scripps Clinic study, and I hear it works well. AIP is not the only solution. There are several similar approaches out there. All with strong anecdotal evidence. A good friend of mine is tackling MS with the Wahls Protocol. She was brave enough to try it. And it’s working.

Whatever strategy you chose, don’t wait. Start generating your own evidence. But don’t do it alone.

Own your health,

– James

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