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Autoimmune Disease and Adrenal Fatigue Syndrome

An autoimmune disease can raise many questionsMillions of people are diagnosed with some form of autoimmune disease, and the number is rapidly growing. Prevalence of the disease is 75% more prevalent in women than men. Autoimmune disease occurs when the immune system thinks healthy tissues of your body are invading bacteria or viruses and begins to attack them. Women are thought to have a stronger, more reactive immune system than men, which is why they may be more susceptible to autoimmune conditions. Autoimmune diseases are classified by the main tissue the immune system attacks. While the conditions often cause systemic issues, there is usually one main organ system that the autoimmune system responds to.

There are many types of autoimmune diseases with differences in their development or progression, which results in widespread symptoms. It’s important to note that an autoimmune disease diagnosis does not mean there is no hope. Autoimmune diseases vary from symptom to symptom and person to person, so depending on how you manage your diagnosis, you may have the opportunity to reclaim your health and your life. However, it’s important to understand that antibodies are usually always present and may flare up on occasion.

The goal is to stay in remission as long as possible by identifying the cause, staying away from triggers, and optimizing your immune system. Because many different organs throughout the body may be affected, symptoms of each autoimmune disease can vary greatly. Moreover, symptoms often mimic those of Adrenal Fatigue. Although the two conditions are related, it’s important to recognize the differences between them, as well as similarities, and how both can exist in a susceptible body.

Types of Autoimmune Disease

Some common autoimmune conditions include:
Hashimoto’s Thyroiditis – the immune system attacks the thyroid, thereby decreasing its effectiveness, resulting in hypothyroid symptoms;

Inflammatory Bowel Disease (IBD) – ulcerative colitis or Crohn’s disease, whereby the immune system attacks the lining of the colon causing diarrhea, nausea, and abdominal pain;

Systemic Lupus Erythematosus (SLE) - characterized by joint pain and swelling, a butterfly rash across the face, inflammation of mucous membranes, and other symptoms;

Rheumatoid Arthritis – the immune system attacks the joint space, specifically in the fingers and hands causing swelling, joint pain, and even changes to bone structure;

Celiac Disease – the immune system is triggered and reacts to gliadin, a component of gluten, causing damage to the intestinal lining;

Sjogren Disease – a condition characterized by dry eyes and dry mouth, wherein the immune system attacks the salivary glands and tear ducts, and can also be associated with other autoimmune conditions;

Raynaud’s Phenomenon – often a symptom in many other autoimmune conditions, Raynaud’s is characterized by vasoconstriction of blood vessels that supply the fingers resulting is white waxy fingers at the onset of cold temperatures or stress.

Stages of Autoimmune Disease

Autoimmune disease stagesThere are three stages in the progression of an autoimmune disease. Stage one is the silent autoimmune disease, during which time antibodies may become elevated, however, the target organ shows no symptoms or loss of function. Stage two is known as Autoimmune Reactivity, characterized by elevated antibody levels and the some symptoms present as well as mild loss of function. However, in stage two, no severe impairment of tissue associated with the disease occurs. Stage three is what most doctors would identify as an autoimmune disease, at which point labs, imaging, and special studies are able to identify significant loss of function along with elevated antibodies and significant signs and symptoms of the disease.

Conventional medicine usually catches immune dysfunction in the advanced stage when it’s already too late. For example, Addison’s disease is only diagnosed when 90% of adrenal function has been affected. At this point, it’s very difficult to regain function. However, it’s encouraging to know that you can identify your problem well in advance of stage three of an autoimmune disease if you’re alert and listen carefully to your body’s signals. If the signs are caught early, your body will have the opportunity to rebuild itself under the right guidance.

What Causes Autoimmune Disease?

The exact cause of autoimmune diseases is unknown, however, environmental and genetic factors are known to play a large role in the onset and progression of the disease. Environmental factors such as chronic stress due to external factors or an underlying condition, toxin/pollutant exposure, immune-reactive dietary proteins, and underlying infections have all been examined as potential triggers of immune dysregulation. Once the immune system starts to identify the body’s own cells as enemies, this may lead to loss of self-tolerance, and therefore, production of tissue-attacking antibodies.

Infections, particularly those involving the Epstein Barr virus (EBV), Herpes Simplex 1, and Herpes Simplex 2, have been associated with the onset of autoimmune disease. The bacteria Escherichia coli (E. coli) is also thought to contribute to autoimmune conditions. The reason these infections may trigger an autoimmune condition is unknown but there are two working theories.

The first theory involves molecular mimicry, the method a virus or bacteria may use to evade detection by the immune system. In a properly functioning immune system, if a virus is presented, your immune cells recognize it as foreign material and attack it. In molecular mimicry, a virus is able to disguise itself as healthy tissue (by attaching to proteins and sugar complexes that healthy cells in our body have on their surfaces). At first, the immune system doesn’t recognize the invading virus, allowing the infection to spread. Eventually, however, the immune system catches on but because the virus is mimicking healthy tissue, your body is now susceptible to your immune system attacking actual healthy tissue. Autoimmune condition, viruses and bacteriaAn important example of molecular mimicry is the cross reactivity of gluten with gut cells. Studies have shown that gluten, found in most wheat products, can be viewed as a foreign object by the body, inducing your immune system to create antibodies against it. Since gluten antibodies have been shown to cross react with gut cells and pancreatic islet cells, antibodies against gluten actually damage the body’s own cells leading to an increase in gut diseases and the possibility of developing diabetes.

The second theory involves gut health, which can be damaged by E. coli. Studies have shown that the gut bacteria and oral microbiota of people with both Type 1 Diabetes and Rheumatoid Arthritis are less healthy. Since many immune cells are located in the gastrointestinal tract, it seems logical that an unhealthy gut leads to immune deficiencies.

Therefore, maintaining healthy gut microbiota and a healthy intestinal lining are important to your overall health. Infections with E. coli throw our gut microbiota out of balance, which affects how you absorb and manage nutrients in your body. This type of dysregulation can sometimes damage the intestinal lining causing the immune system to attack healthy gut tissue, and can result in a number of issues including IBD. Although having an unhealthy gut may not cause an autoimmune condition in everyone, unless your body is genetically predisposed as we’ll discuss, it may be enough to cause a reaction.

But let’s not forget about our genetic makeup. Genetic factors affect how the immune cells are structured and immune cells can be formed and function in many different ways. Major histocompatibility complex (MHC) is involved in the cell recognition function. A slight genetic alteration leading to a problem with this complex combined with an environmental trigger can be enough to tip the body towards an autoimmune condition. The genetic link, however, is not as simple as one protein code and one gene since numerous factors can be linked. As an example of this complexity, just look at how autoimmune diseases play out in a family. When a disease is hereditary, it is passed down generations through genes, however, autoimmune diseases are unique. If one person in the family is diagnosed with Hashimoto’s thyroiditis, another member of the family may potentially be diagnosed with systemic lupus erythematosus (SLE). Genetics prime the body for an autoimmune disease, but environmental factors determine the particular type of disease.

An increased risk of an autoimmune disease does not necessarily imply your body will develop that disease unless it is triggered by a certain situation or condition in the body. If environmental factors and existing conditions in the body are favorable to a certain autoimmune disease, it’s much easier to trigger. In some situations, the body may be genetically predisposed to an autoimmune condition but environmental factors are never strong enough to allow the disease to progress.

Adrenal Fatigue

An autoimmune disease and adrenal fatigue/Adrenal Fatigue Syndrome (AFS) is a condition directly related to the hypothalamic pituitary adrenal (HPA) hormonal axis. This axis is the pathway that manages our response to stress and the release of cortisol. Stress can be an external event or a result of some underlying condition in the body. When the adrenals are overtaxed and become exhausted, AFS can surface and the clinical presentation can vary widely. Symptoms may include fatigue, exercise and stress intolerance, insomnia, metabolic disturbances, frequent infections, heart palpitations, and hypoglycemia. The effects of a weak adrenal system are therefore felt throughout the body.

Autoimmune Condition Progression as a Cause of Adrenal Fatigue

The progression of an autoimmune diseaseAlthough there is no clear cause of an autoimmune disease, upon examining the etiology of the disease, many factors clearly come into play. As mentioned earlier, factors include genetic predisposition and an array of environmental factors ranging from stress and infections to immune system issues. Often overlooked, and seldom considered, is the role of our adrenal glands.

The adrenal glands are located just above the kidneys and control the production and release of the hormone cortisol. During physical or emotional stress, the hypothalamus acts on the anterior lobe of the pituitary gland causing it to secrete certain hormones and trigger numerous hormone pathways, including the adrenocorticotropic hormone (ACTH) pathway, which signals to the adrenals to produce cortisol. After a sufficient amount of cortisol is produced, cortisol act on the hypothalamus to turn off the pathway. However, if the amount of cortisol produced is not sufficient, the pathway is not turned off and the upstream hormone ratios become out of balance. This puts pressure on the adrenal glands and upstream glands such as the anterior pituitary gland, which regulates many other hormone pathways including the thyroid hormone response, as well as the hormone responses controlling bone growth and sexual development. Hormonal imbalances and unusual cortisol to other hormone ratios have been associated with the incidence of autoimmune conditions including SLS and Hashimoto’s thyroiditis.

Cortisol, produced by the adrenal glands, is extremely important in supporting the body during times of stress, and cortisol plays a particularly important role in suppressing the immune system by downregulating the immune response. Autoimmune disease is the result of the immune system overreacting to a stimulus and attacking healthy tissue over time. Usually, the body puts checks and balances in place to ensure that when the immune system is on overdrive, cortisol is able to downregulate the immune system and bring back the balance. This is how the body normally works. However, excessive stress on your body puts strain on the adrenal glands, thus, altering the balance of hormones along the way.

Adrenal Fatigue and surrounding circumstances can be a perfect storm for triggering an autoimmune disease. In advanced Adrenal Fatigue, cortisol levels are diminished and not available to effectively downregulate an overactive immune system. Therefore, the immune response can progress unchecked from stage one to stage three, inflammation can occur, and it should come as no surprise that people who are predisposed to an autoimmune disease also have weak adrenal function.

Moreover, if your body is genetically predisposed to autoimmune reactivity due to constitutional factors and there is an environmental trigger affecting the autoimmunity of your body, cortisol can usually keep the response low and manageable. However, if you are also suffering from Adrenal Fatigue, your low cortisol levels will not be able to regulate the immune system and it’s much easier to lose self-tolerance. This scenario presents the perfect opportunity for an autoimmune disease to arise, trigger symptoms, and progress into a much worse condition. Whereas Adrenal Fatigue does not directly cause an autoimmune disease, however, it’s important to understand the relationship between cortisol and immune system management.

Adrenal Fatigue as a Result of an Underlying Autoimmune Disease

An autoimmune disease leading to adrenal fatigue/As mentioned above, AFS can be the result of chronic stress on the body due to either an external stressor, such as a stressful work environment, relationship stress, or family stress, or an underlying cause of stress on the body, such as a chronic infection or chronic disease like an autoimmune disease.

The HPA pathway is triggered when our body encounters a stressful stimulus. Usually, the stimulus is short lived. The hypothalamus signals to the pituitary to release hormones that affect the adrenal glands, which subsequently produce the hormone, cortisol. Finally, cortisol travels through the body in order to respond to the stimulus. This response may include activating sugar reserves to give your body energy or releasing neurotransmitters such as norepinephrine to keep your brain on high alert. Epinephrine is also released as a last resort to prepare your body for the “fight or flight” response. Cortisol and other glucocorticoids also manage the inflammatory response by upregulating anti-inflammatory signals and downregulating pro-inflammatory chemicals. The result is suppression of the immune system.

With autoimmune conditions, the immune system tends to work on overdrive, especially if your body is in a hyperactive immune state. Because the body has a network of chemical signals, an increase in immune response causes high cortisol and glucocorticoid demand. This activates the HPA axis and results in huge demands on the adrenal glands. If the situation becomes chronic, your adrenal glands will no longer be able to keep up with the high cortisol output needed to regulate the immune system. A heightened immune state may be due to a primary autoimmune condition but can also be the result of foreign objects being placed into the body, such as breast implants that remain for a long period of time. Your body may react negatively to these foreign objects and trigger an autoimmune response, characterized by all the classic symptoms of an autoimmune disease, such as fatigue, joint pain, anxiety, and brain fog, just to name a few. Removing foreign objects may give temporary relief and reduce symptoms. However, although welcome, the relief is often short lived and followed by a worsening of fatigue and adrenal crashes. Without properly fortifying the adrenal glands ahead of time, the immune heightened state the body has become accustomed to continues unabated. When pre-existing adrenal weakness is combined with low cortisol output, the heightened immune response can trigger an increase in reactive metabolites, which, in turn, may lead to adrenal crashes.

Eventually, Adrenal Fatigue sets in because the amount of cortisol produced by the adrenals is insufficient to meet the demands of a heightened immune system response.

Whether autoimmunity has caused AFS, or AFS has weakened your immune response, it is important to recognize that both of these conditions can affect each other, often creating a vicious cycle if left uncorrected. Unfortunately, conventional medicine often misses the adrenal connection.

Hyperactive Immune State

An autoimmune disease and your immune systemRegardless of whether autoimmunity is the cause or result of AFS, a healthy immune system is a crucial part your body’s defense.

Unfortunately, in a small cohort of people, the immune system is in a hyperactive state far beyond what it was designed to handle when faced with pathogens or insults. This can lead to serious consequences.

Sufferers in this category are uniquely faced with a clinical situation in which the symptoms of an autoimmune condition exist but laboratory tests do not support the symptoms. Nonetheless, these sufferers are diagnosed and treated as if they have autoimmune disease without focusing on the root cause, therefore, positive clinical outcomes are elusive. In the presence of AFS, the clinical picture can be very confusing.

Let’s take a step back. As mentioned earlier, our immune system is able to detect pathogens that may become active when the body is under stress. To protect us, an inflammatory response is initiated to neutralize any pathogens that have taken the opportunity to surface. The job of the immune system is to simultaneously attack and neutralize a myriad of active and potential pathogens. If your immune system is working properly, flare-ups of co-infectious states (such as Helicobacter pylori and Lyme disease) and chronic pathogens (such as Candida or EBV) are automatically squashed. Most people are aware that a weak immune system is the cause of recurrent infections or hard to cure infections. And this is certainly true. However, on the flip side, few people are aware that a hyperactive immune state can also be problematic. It is, in fact, a key factor in forming the perfect storm that leads to inflammation circuit dysregulation.

The body’s immune system tends to be very well designed and your immune cells are trained to recognize and target enemies while avoiding “friendly fire” and an autoimmune condition. In some people, however, a supercharged immune system may result in adverse effects. A hyperactive immune system, far beyond the state of overload, can generate an immune response that is more intense than what the body actually needs—too much. Certain antibodies, for example, experience cross reactivity between actual and perceived pathogens, external and internal, creating a rampage of “friendly fire,” whereby normal cells are attacked along with the pathogens. This can lead to a flare up of symptoms consistent with the symptoms of autoimmune-type conditions. In other words, a hyperactive immune system can trigger symptoms resembling an autoimmune condition.

It’s important to remember that this type of event is uncommon, however, the collateral damage caused by a hyperactive immune state can be significant. Sufferers may start to experience symptoms typical of an autoimmune condition such as joint pain and fatigue. Moreover, if your body is already inflamed due to an existing microbiome imbalance, GI tract irritation, or reactive metabolite overload, it’s difficult to know for sure whether a true autoimmune disease (such as primary Hashimoto’s’ thyroiditis or Lupus) exists or just symptoms resembling an autoimmune condition, which surface every time good cells are attacked in the crossfire.

When your immune system is in a hyperactive state, you can start to experience fatigue, one of the typical autoimmune disease symptomsLaboratory tests, such as RA, CRP, ANA titers and anti-TPO antibodies, often add to this confusion. In this type of situation, antibodies may be normal or borderline high rather than very high in a true primary autoimmune state. Other laboratory studies are generally unremarkable. Unfortunately, accurate diagnosis depends on a detailed history to properly differentiate and few clinicians are on the alert for minor differences that can differentiate a true autoimmune disorder from Adrenal Fatigue. When normal or borderline high laboratory tests are accompanied by fatigue, joint pain, psoriasis, gastric discomfort, weight gain, vasculitis, and muscle ache, the knee-jerk reaction of most physicians is to clinically diagnose an autoimmune disease. The body is not always viewed in the comprehensive or holistic way required to diagnose a hyperactive immune state or AFS.

Patients are often put on steroids and autoimmune medications and short-term benefits are common as the hyperactive immune state calms down due to the anti-inflammatory properties of corticosteroids. Long-term use of steroids can be problematic since it can reduce your overall immune response and mask the underlying excessive metabolite problem if a hyperactive immune system is the true cause. Slow and gradual deterioration of the body occurs, in particular, over time, the inflammation circuit of the NeuroEndoMetabolic (NEM) stress response becomes dysfunctional. The thyroid is the most easily affected.

Autoimmune Thyroiditis

The thyroid gland is one of the organs most vulnerable to attack by a hyperactive immune state, leading to low thyroid function. Unfortunately, symptoms of an underactive thyroid are also prevalent in advanced AFS. In addition, primary thyroid dysfunction must be considered as part of a differential diagnosis. Since recovery approaches are very different for autoimmune conditions and AFS, identifying the correct diagnosis is important.

The thyroid gland controls your overall metabolic rate and is responsible for regulating body temperature. Therefore, even slight changes in thyroid function can result in fatigue, weight gain, and feeling cold, in the underactive case, or anxiety and heart palpitations, in the overactive case. One of the most frequent complaints that brings a patient to their doctor is fatigue and a lack of energy. The standard medical workup usually includes a complete metabolic panel to evaluate thyroid function. In a hyperactive immune system, anti-thyroid autoantibodies (also called anti-thyroid antibodies) targeting one or more components of the thyroid gland may be activated. The most significant are the anti-TPO antibodies—present in roughly 90% of Hashimoto’s thyroiditis, 10-20% of nodular goiter or thyroid carcinoma, and 75% of Grave’s disease. Clinicians often make a Hashimoto’s thyroiditis diagnosis based on laboratory tests showing upregulation of anti-TPO antibodies accompanied by fatigue and low energy.

It should also be noted that 10-15% of normal individuals have high levels of anti-TPO antibodies but do not have a primary autoimmune disease like those mentioned above. The high titer can be secondary to a hyperactive immune system when the inflammation circuit is working on overdrive. Often, patients are mistakenly diagnosed with clinical or subclinical primary Hashimoto’s thyroiditis and thyroid hormone replacement is started. An autoimmune disease and the thyroidLittle consideration is given to alternative causes such as inflammation circuit overload. When symptoms of fatigue improve with thyroid hormone replacement, physicians are misled into thinking they are on the right track, especially if laboratory test results begin to normalize. More often than not, although fatigue improves, high anti-TPO antibody count does not totally normalize. Doctors are at a loss, however, and since the patient feels better, no further investigations are performed. In other words, normalizing TSH, free T4, and free T3 gives the physician a false sense of compliance. Persistently high rT3 or anti-TPO titers are disregarded in such circumstances and little attention is paid to whether symptoms are caused by a hyperactive immune system-triggered adrenal burnout—inflammation circuit dysfunction accompanied by fatigue. Since thyroid hormone replacement tends to increase energy levels and normalize laboratory test results, until the approach stops working, there is little interest or need to further consider other differentials. The entire therapeutic focus is on primary thyroiditis alone as the presumed diagnosis.

Without resolving the underlying root causes of a possible hyperactive immune system and Adrenal Fatigue as a secondary causes of symptoms resembling an autoimmune disorder, many sufferers continue to require ever-increasing doses of thyroid hormone replacements over time to maintain normalized laboratory test results and sustain energy levels. This can play out over decades and to maintain the energy levels, many start on T4 replacement, eventually advancing to combination T4/T3 formulas, and ultimately, progressing to the most potent T3 replacement. Although sufferers may feel terrible inside and are often wired and tired, they are told all is well. In other words, based on lab tests and symptoms alone, thyroid slowdown symptoms are treated as an autoimmune issue when in reality may indicate issues with the inflammation circuit. Thyroid hormone replacement merely covers up the symptoms. Therefore, a holistic approach should be used to fully understand the root cause of symptoms and to develop a comprehensive long-term recovery plan.

Steroids - Friend or Foe

In addition to or in place of thyroid hormone replacement therapy, one of the first lines of treatment for autoimmune disease is the administration of oral glucocorticoids. Whereas this may present a valuable short-term solution, numerous problems are associated with taking steroids for long term immunosuppression. The first is decreased immune system function making your body more susceptible to common diseases such as yeast infections, colds, and flu. Other adverse effect of chronic glucocorticoid use can be triggering the onset of Cushing’s Syndrome, characterized by a rounded, reddened face, accumulation of fat, and a decrease in bone density. An autoimmune disease and steroidsTo avoid Cushing’s Syndrome, it’s important to only use glucocorticoids under the supervision of a qualified healthcare provider and to not become dependent on steroid treatments as a long-term solution. Therefore, it’s important to avoid chronic steroid use in managing an autoimmune disease, while effectively managing cortisol levels. With an autoimmune condition, it’s easy to overburden the adrenal glands. To properly manage autoimmune conditions, the adrenal glands must be functioning effectively. The adrenals should be supported to ensure sufficient cortisol levels and manage the immune response, and at the same time, any triggers that may lead to a hyperactive immune system should be removed while supporting good immune cells.

Autoimmune Disease and the NEM Stress Response

An autoimmune disease stress responseFrom a big picture perspective, an autoimmune disease and a disrupted stress response can affect almost every system of the body. The NeuroEndoMetabolic (NEM) Stress response regulates your body’s overall response to stress and thus, plays a unique role in both mediating immunity and maintaining the health of metabolic and inflammatory processes. Autoimmunity and Adrenal Fatigue are closely linked to both these processes. Disruption in the NEM stress response, especially the detoxification and inflammatory circuits, creates a suitable environment for the progression of an autoimmune condition, as well as amplifying any existing adrenal and endocrine stress response issues.

It is important to remember that your body reacts to stress in a holistic way via the NEM stress response. When discussing autoimmune conditions and Adrenal Fatigue, we tend to focus on the metabolic component, one of two major components of the NEM stress response. The metabolic component is made up of the inflammatory circuit, metabolic circuit, and detoxification circuit. Under stress, ideally all three processes function synergistically to get your body ready for action by producing stress hormones, cleansing your body of unnecessary toxins, boosting your metabolism, and reducing inflammation. However, if an imbalance or issue with one of these processes exists, chronic stress can have repercussions on your entire body.

The triad specifically involved with the inflammatory circuit is the GI tract, microbiome, and immune response. These three aspects play a role in how inflammation affects autoimmunity, GI distress, food allergies, and response to infection. Studies have shown that a high-fat diet can alter gut flora, leading to increased intestinal permeability and lipopolysaccharides (LPS). Absorbing large amounts of LPS—a negative byproduct of bacteria—can cause increased endotoxemia, which triggers inflammation in the gut and can lead to metabolic and autoimmune disorders. Certain food additives have also been found to alter the tight junction permeability of intestinal cells and are therefore associated with the rising incidence of autoimmune disease. Some examples of auto immunogenic additives include gluten, emulsifiers, organic acids, nanoparticles, and microtransglutaminase (MTG) found in meat glue.

When your gut microbiome is functioning correctly, nutrient absorption and your immune response work together to protect your body from invading bacteria and viruses and to digest food. In turn, the immune system is downregulated, metabolism functions normally, and excess reactive metabolites are cleansed from the body. However, dysfunction of the GI tract absorption process, imbalances in the microbiome, or an overactive or hyperactive immune response to digested food tend to cause issues and throw the NEM system out of balance.

Autoimmune Disease and Gut Health

An autoimmune disease and gut healthDiet and GI health are integral parts of both autoimmune remission and Adrenal Fatigue recovery. The GI tract, microbiome population, and immune system work together to maintain healthy nutrient absorption, stave off invading bacteria and viruses, and excrete toxins. Billions of bacteria live in the GI tract to aid digestion and also to fight foreign molecules that enter the body. When microbiota encounter something they cannot fight, inflammatory signals are sent to trigger increased production of NF-kB—a proinflammatory signal that communicates with other parts of the body to increase inflammation. If this situation becomes chronic or your intestines become damaged due to previous immune responses and the presence of unchecked NF-kB, your body may trigger an immune response when one is not necessary. NF-kB is also known to activate the breakdown of intestinal cell tight-junctions, leading to increased intestinal permeability, a syndrome also known as leaky gut. Leaky gut occurs when there is damage to the lining of the intestine that allows unintended proteins and particles through. The intestine lining normally acts the an initial barrier of the immune system, keeping toxins and bacteria out of the bloodstream. The lining also aids in the absorption of essential nutrients, vitamins, and minerals. When damage occurs or inflammation increases, the barrier becomes less selective about what can stay in the gut and enter the body. In response, your body may try to compensate by increasing the attack on what it perceives to be invading toxins regardless of how benign they may be. In addition, due to an increased immune response and leakiness, your immune system may begin to respond more and more frequently to anything that crosses over from the GI tract, which presents more opportunities to react to similar nutrients and healthy cells throughout the body. To halt these effects, it’s important to address your leaky gut and GI tract dysfunction. A number of strategies can be used to manage the immune system such as removing triggers, re-introducing beneficial bacteria, making nutritional changes, and managing your lifestyle. Natural compounds with GI supportive properties include DHEA, glutamine, and pantethine.

Once the GI tract, microbiome, and immune response are balanced again and functioning synergistically, the NEM Stress response may normalize. The process is long, and in many cases, requires ongoing management. However, once the system is addressed holistically, managing an autoimmune disease and Adrenal Fatigue are much easier and we can better understand why the body might be plagued by these conditions, moreover, why certain supportive methods may be incredibly helpful.

Autoimmune Disease and AFS Relief

Meditating for calming an autoimmune diseaseAutoimmune diseases and AFS are interrelated and in many cases, may even overlap. Although it’s difficult to pinpoint the exact cause of either, managing symptom can be similar. Lifestyle modifications are important and since increasing cortisol levels helps with autoimmune issues, exercise is often recommended to manage an autoimmune condition. If you’re also suffering from Adrenal Fatigue, make sure to start exercising gradually. For example, why not try making long walks and meditation a priority in your life to relax the body and also manage cortisol levels.

Diet plays a big role in managing an autoimmune condition. A number have studies have investigated low-inflammatory diets and autoimmune protocol diets, which aim to eliminate common trigger foods such as dairy, gluten, corn, and sugar. These diets can be difficult to follow but they are often a crucial part of your recovery. Lowering sugar and caffeine intake can also help Adrenal Fatigue recovery since they affect cortisol levels, so avoiding excess amounts is often a helpful step towards recovery.

Supplements can be helpful both in Adrenal Fatigue recovery and managing autoimmune symptoms. The available selection of supplements is as vast as the symptoms, therefore, it’s important to target the underlying cause. So, as you progressively manage the underlying cause of stress and your immune system response, supplements may help by supporting your body throughout the recovery process.

Chronic inflammation has been associated with heart disease, metabolic disease, and autoimmune disease. Omega-3 fatty acids found in fish oil are extremely beneficial in managing chronic inflammation. Fish oil helps to down-regulate chronic inflammatory processes by blocking NF-kB. Other supplements can also block NF-kB such as turmeric and resveratrol. However, it is important to consult an experienced physician before starting any supplement program, particularly those suffering from the advanced stage of Adrenal Fatigue, since you may be more sensitive to higher doses of supplements.

Vitamin D, vitamin A, and glutathione have also been shown to increase T cells, important immune cells that can increase or suppress the activity of T Helper cells, the fighter cells of your immune system. Getting a sufficient amount of quality sleep and controlling blood sugar levels can also minimize the stress on the body and improve immunity by decreasing the number of TH17 cells, inflammatory T cells that amplifies NF-kB.

The body has two ways of fighting infection: via TH1-mediated T cell activation or through TH2-mediated B cell activation. TH1 works via natural killer cells and cytotoxic T cells, which directly destroying antigens when they encounter them. Many supplements are known to increase TH1 function including echinacea, astragalus, maitake mushrooms, glycyrrhiza, pomegranate, and Melissa officinalis (lemon balm). TH2 works directly through B cells, which produce antibodies that tag antigens so natural killer cells can find them more efficiently and store them in memory. Autoimmune disease and natural solutionsSome foods can increase TH2 function including green tea, grape seed, antioxidant extracts of goji/acai berries, resveratrol, and flavonoids. People are genetically predisposed to being either more TH1 or TH2 dominant. Therefore, someone who is TH2 dominant may not feel good due to taking TH1 supplements like echinacea, whereas someone who is TH1 dominant may feel worse from drinking green tea. So, it’s important to evaluate your own body’s disposition and to determine your symptoms before taking large amounts of a particular supplement.

Another important way to prevent further triggers is by improving gut health. Glutamine has been specifically shown to help with leaky gut, a condition that occurs when intestinal permeability is compromised. Glutamine may help rebuild the intestinal barrier and prevent bacteria, toxins, or foreign materials from leaking through the intestinal wall into other parts of your body where they may trigger an immune response. This can provide relief for the immune system and improve gut function. Those suffering from AFS may not tolerate glutamine supplements, which can also have stimulatory effects on your metabolism.

Pantethine, also known as vitamin B5, can also help with leaky gut by improving both gut motility and intestinal repair. Pantethine causes contraction of the gut wall and stimulates movement of blood—and therefore, nutrient transfer—around the intestine. In addition, pantethine is a precursor to coenzyme A, which supports adrenal function. Coenzyme A provides the building blocks of the adrenal glands allowing them to produce the glucocorticoids demanded by your body in Adrenal Fatigue. Pantethine works best when taken alongside vitamin C.

Many other supplements like plant sterol, DHEA, pregnenolone can be helpful and in addition to lifestyle modifications can be used to support adrenal function and help manage an autoimmune diagnosis. It’s best to seek support from your healthcare provider before embarking on a recovery plan by yourself. Understanding the fine balance between an autoimmune disease and Adrenal Fatigue, as well as the importance of cortisol, the microbiome, and gut health, is essential. All of these components must be examined and holistically explored to effectively reach a state of balance. These conditions are not static, so managing these conditions cannot be static either. Each management process must be dynamic and fluid in order to effectively address the dynamic processes involved, moreover, a multisystem support plan must be put into place. Under the clinical setting of Adrenal Fatigue, nutritional supplements may exhibit paradoxical reactions, presenting the opposite clinical outcome to what is expected or normally experienced. The weaker your adrenals, the higher the risk of paradoxical reactions, therefore, self-navigating the recovery process is not recommended.


Autoimmune disease contributing factorsAutoimmune diseases are on the rise in the United States. While there is no understood single well-understood cause of autoimmune disease, there are a number of contributing factors, such as environmental impact, genetic predisposition, and any underlying conditions already present in your body. One of the conditions gaining a lot of attention lately is leaky gut syndrome. This occurs when permeability of the intestine wall is compromised and foreign materials are able to pass into other parts of the body where they can trigger an immune response. This, in turn, may be the tipping point that leads to an autoimmune reaction.

Autoimmune disease can be the result of AFS, however, Adrenal Fatigue may also be caused by an autoimmune condition. On the surface, this may seem confusing and frustrating, but it does makes sense when you consider on the cortisol connection. Cortisol downregulates the immune system and if your immune system is dysfunctional, as in the case of low cortisol levels associated with advanced Adrenal Fatigue, autoimmunity is more likely to occur. Genetic factors also play an important role, especially in those who have a hyperactive immune system. An autoimmune condition is inflammatory by nature and generates unwanted reactive metabolites that can overtax the HPA hormonal axis resulting in Adrenal Fatigue and chronically low cortisol levels. From the NeuroEndoMetabolic (NEM) stress response system point of view, treatment of autoimmune conditions should clearly be focused on removing the root cause while supporting the adrenals by tackling gut triggers, reducing inflammation, and helping the immune cells work alongside balanced cortisol levels.

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