The Daily 5 with Dr. Sara Szal Gottfried

5 Tips for Autoimmune Health

Autoimmune disease has skyrocketed in prevalence. In the US alone, 25 million people are diagnosed with autoimmune illness, and up to 50 million Americans have a disease characterized by immune dysregulation. Yet conventional medicine offers no answers or cures, only brush-offs, band-aids, and hefty bills.

Here are 5 tips to lower your risk of autoimmune disease.

Increased intestinal permeability, also known as leaky gut, is one of the triad of factors that we believe lay at the root of autoimmune disease. The other two factors are genetic susceptibility and triggers such as trauma or infection. When you have leaky gut, you may have symptoms of constipation, gas, or bloating, even brain fog, or you may have no symptoms. What happens in leaky gut is there is a loss of the integrity of the intestinal lining that allows things to pass through to the person’s bloodstream that don’t belong, like bacteria and other inflammatory pathogens. This can cause chronic inflammation, which in turn causes the immune system to be reactive all or most of the time, setting the stage for the onset of autoimmunity. The goal is to target the leaky gut and reset the immune system to health.

One of the main ways to improve leaky gut is through diet. To help repair your gut barrier, make sure you are getting nutrients like vitamins A, B, D, zinc, and healthy fats; additional supplements may be called for too. For many of my patients, I recommend consuming bone broth–based soups and powders containing L-glutamine, which may help seal leaky gut.

Giving up alcohol is another important step. Alcohol is one of the surest ways to damage the delicate cells of your gut and cause leaky gut.

Do people in your family have autoimmune disease or mysterious symptoms no doctor seems to be able to diagnose? Consider testing your genetics. However, your genetic code does not tell you if you will develop autoimmune disease; rather, it can inform us about your potential assets and vulnerabilities so that we might be able to work around them with lifestyle management, such as how you eat, move, think, sleep, and navigate toxic stress.

Trauma can be a trigger for autoimmunity. In my precision medicine practice, I noticed a seemingly unusual pattern: many of my patients who suffer from autoimmune disease and symptoms have a history of trauma. People need to learn how the body processes trauma and learn new ways to cope with stress and resolve their symptoms. If you have experienced trauma in your childhood or later as your adult life, you may have tried talk therapy to help resolve it. But surprisingly, talk therapy is not an effective tool, especially for PTSD. As I tried to unwind the trauma from my body, I tried to connect the dots between my psychology and my physiology by trying mind-body therapies like Hakomi; trauma-informed care; as well as practices such as Holotropic Breathwork® that help you enter a healing state of consciousness.

Toxic stress or trauma can be the trigger that sets off autoimmune disease in people with a genetic predisposition and intestinal permeability and chronic inflammation. Many people often don’t notice how high their stress levels are particularly when they live with toxic stress long term. I find that to manage my stress and cortisol levels, I need to track and measure them which then allows me to take steps to improve them.

● Measure your stress baseline. Either check your stress level on the Perceived Stress Scale, or invest in a wearable that checks your heart rate variability or similar metric. If using a wearable, get a solid baseline over several days of measurement and record the average value of the HRV or composite metric, for example, Oura’s “Readiness” score or Garmin’s “Body Battery.”
● Measure your sleep quality. Toxic stress and traumatic life events can disturb your sleep-wake cycle. Consumer sleep trackers are reasonably accurate at measuring total sleep time and at tracking both light sleep and rapid eye movement (REM) sleep. You can use this information to improve your sleep and start a conversation with your doctor. I like to use them for directionality, such as if your REM sleep is low, that usually means you need to go to bed earlier. If you don’t have enough deep sleep, you may need to work on gut health.

All disease begins in the gut, and autoimmune disease is no exception. Whether you have gut symptoms or not, if you have autoimmunity, research shows that an anti-inflammatory diet is a critical contributor to overall health. To reduce the inflammation caused by diet, many functional medicine clinicians recommend a strict elimination diet. The basic principle of diets like these is: when you remove the foodbased triggers that may be contributing to your autoimmune condition, you will likely experience major improvements in your symptoms. The most common trigger foods are dairy, gluten, alcohol, grains, and eggs. But there are many more. While the list of foods can feel exhaustive, I find that some people can begin with cutting out a few of the worst offending foods, like dairy and gluten, and feel improvements in symptoms.

Find more details on the Elimination Diet in my new book THE AUTOIMMUNE CURE on sale March 12, 2024.