Autoimmune conditions are becoming increasingly common. Estimates vary, but it appears that at least 8-9% of the population in North America and Western Europe have one of these conditions, with The American Autoimmune Related Diseases Association estimating a higher value of 14%. They are conditions that involve an abnormal immune response directed against one or more organs of the body. If the misguided attack is against the thyroid gland, it can result in Hashimoto’s thyroiditis. If it is directed against pancreatic beta cells that produce insulin, it can result in type 1 diabetes or latent autoimmune diabetes of adults (LADA). If it involves tissue encasing joints (synovium), it can result in rheumatoid arthritis. It if involves the liver, it can result in autoimmune hepatitis, and so on.
While it requires a genetic predisposition towards autoimmunity that we have no control over (e.g., the HLA-B27 gene for ankylosing spondylitis), there are numerous environmental triggers of these diseases that we can do something about. Identifying and correcting these factors stacks the odds in your favor of reducing the autoimmune inflammation, pain, organ dysfunction, even reversing the condition altogether.
Among the most important factors to correct in order to minimize or reverse autoimmunity are:
Wheat and grain elimination–If you are reading this, you likely already know that the gliadin protein of wheat and related proteins in other grains (especially the secalin of rye, the hordein of barley, zein of corn, perhaps the avenin of oats) initiate the intestinal “leakiness” that begins the autoimmune process, an effect that occurs in over 90% of people who consume wheat and grains. The flood of foreign peptides/proteins, bacterial lipopolysaccharide, and grain proteins themselves cause immune responses to be launched against these foreign factors. If, for instance, an autoimmune response is triggered against wheat gliadin, the same antibodies can be aimed at the syapsin protein of the central nervous system/brain, resulting in dementia or cerebellar ataxia (destruction of the cerebellum resulting in incoordination and loss of bladder and bowel control). Wheat and grain elimination is by far the most important item on this list to reverse autoimmunity.
Correct vitamin D deficiency–It is clear that, across a spectrum of autoimmune diseases, vitamin D deficiency serves a permissive, not necessarily causative, role in allowing an autoimmune process to proceed. It is clear, for instance, that autoimmune conditions such as type 1 diabetes in children, rheumatoid arthritis, and Hashimoto’s thyroiditis are more common in those with low vitamin D status, much less common in those with higher vitamin D levels. For this and other reasons, I aim to achieve a blood level of 25-hydroxy vitamin D level of 60-70 ng/ml, a level that usually requires around 4000-8000 units per day of D3 (cholecalciferol) in gelcap or liquid form (never tablet due to poor or erratic absorption). In view of the serious nature of autoimmune diseases, it is well worth tracking occasional blood levels.
Supplement omega-3 fatty acids–While omega-3 fatty acids, EPA and DHA, from fish oil have proven only modestly helpful by themselves, when cast onto the background of wheat/grain elimination and vitamin D, omega-3 fatty acids compound anti-inflammatory benefits, such as those exerted via cyclooxygenase-2. This requires a daily EPA + DHA dose of around 3600 mg per day, divided in two. Don’t confuse EPA and DHA omega-3s with linolenic acid, another form of omega-3 obtained from meats, flaxseed, chia, and walnuts that does not not yield the same benefits. Nor can you use krill oil with its relatively trivial content of omega-3s.
Eliminate dairy–This is true in North America and most of Western Europe, less true in New Zealand and Australia. Autoimmunity can be triggered by the casein beta A1 form of casein widely expressed in dairy products, but not by casein beta A2 and other forms. Because it is so prevalent in North America and Western Europe, the most confident way to avoid this immunogenic form of casein is to avoid dairy altogether. You might be able to consume cheese, given the fermentation process that alters proteins and sugar, but that has not been fully explored.
Cultivate healthy bowel flora–People with autoimmune conditions have massively screwed up bowel flora with reduced species diversity and dominance of unhealthy species. We restore a healthier anti-inflammatory panel of bacterial species by “seeding” the colon with high-potency probiotics, then nourishing them with prebiotic fibers/resistant starches, a collection of strategies summarized in this Wheat Belly Blog post and in greater detail in Wheat Belly Total Health. People sometimes view bowel flora management as optional, just “fluff”–it is anything but. Properly managing bowel flora can be a make-it-or-break-it advantage; don’t neglect it.
There you go: a basic list to get started on if your interest is to begin a process of unraveling the processes of autoimmunity. In some conditions, such as rheumatoid arthritis and polymyalgia rheumatic, full recovery is possible. In other conditions, such as Hashimoto’s thyroiditis and the pancreatic beta cell destruction leading to type 1 diabetes, reversing the autoimmune inflammation does not restore organ function: hypothyroidism results after thyroiditis quiets down and type 1 diabetes and need for insulin persists after pancreatic beta cell damage. But note that the most powerful risk factor for an autoimmune disease is another autoimmune disease–this is why so many people have more than one autoimmune condition. People with Hashimoto’s, for instance, can develop rheumatoid arthritis or psoriasis. So the above menu is still worth following even if you cannot hope for full organ recovery.
More discussions like this, i.e., how to stack the odds in favor of reversing or NOT having numerous health conditions, can be found in Wheat Belly Total Health.
I’ve had thyroid issues for over twelve years … an unusual case where I had Graves’ Disease and Hashimoto’s Disease at the same time! Yes, I was a mess! My thyroid finally “burned out” and I have just had Hashimoto’s hypothyroidism for 11 of those 12 years.
What can I expect a wheat free/dairy free + right supplementation of D3/fatty acids/probiotics do for me? Will my thyroid correct itself, or will this just prevent more autoimmune disorders from taking over?
Thanks in advance!
Re: My thyroid finally “burned out” and I have just had Hashimoto’s hypothyroidism for 11 of those 12 years.
I’m no expert on Hashis (although there’s no shortage of self-proclaimed experts on the web), but there may be some basic information to discuss while we await any input that Dr. Davis might have. Presumably you have seen the wiki page on it:
http://en.wikipedia.org/wiki/Hashimoto%27s_thyroiditis
which might actually be more advanced than what a typical endocrinologist might offer.
Hashis is generally considered to be irreversible, and your characterization as “burned out” would be consistent with that. There are reports that thyrocyte regeneration might be possible, but I didn’t quickly find any reports demonstrating that in humans. It’s much like T1D in that regard, so managing it is largely a matter of hormone replacement.
And that gets into depressing territory pretty quickly, because clueless consensus medicine tries to do so solely with T4, relying on the largely uninformative TSH as the metric. A question you can use to screen doctors on this is: “None of this may be indicated in my case, but do you routinely test free T3, free T4 and reverse T3, and do you ever prescribe T3 or desiccated thyroid?” If the answers are no and no, find a more informed and competent doctor.
re: What can I expect a wheat free/dairy free + right supplementation of D3/fatty acids/probiotics do for me?
You can probably slow or arrest further thyroid damage, as well as avoid other auto-immune ailments.
The Wheat Belly Total Health book, by the way, has quite a bit of content on thyroid health.
Thank you! Aside from my hair and nails (but not my skin) being brittle, I am not too bad on Synthroid. I have always eaten pretty “clean” with very little processed food but that “clean” diet did include wheat, dairy and sugar. Weight isn’t as easy coming off, but I can also blame the creeping 40s for that :D … with exercise I am about 5-8lbs off my ideal weight.
After doing a cleanse, I noticed positive changes with no dairy (no sniffles!) but have not really gone totally wheat free (oats, quinoa, beans etc.) and it will be much harder. Will read up and give it a try. Thank you very much for the comment and links!
re: … with exercise I am about 5-8lbs off my ideal weight.
Exercise is great, but has no predictable effect on weight. I remarked on that myth earlier today at:
https://drdavisinfinitehealth.com/2015/01/high-triglycerides/comment-page-1/#comment-58385
re: … positive changes with no dairy (no sniffles!) …
You may find that the reaction to bovine dairy vanishes some months after being completely free of gluten-bearing grains and other adverse proteins. You can always try caprine (goat) dairy at any time and see what happens.
> … but have not really gone totally wheat free (oats, quinoa, beans etc.) …
Wheat, barley & rye need to be dialed to zero, forever. Oats are commonly cross-contaminated with gluten, but their real problem is being sky hi gly, plus having a suspect protein of their own (avenin). Quinoa is just a glycemic risk, and needs to be limited. Beans vary, and their glycemic load is often offset a bit by their prebiotic value – just mind the net carbs unless the picture is clear on that.
Dr. Davis,
Have you found any correlation between wheat and ALS?
My 58 year old brother was diagnosed with diverticulitis in July of 2013 and was given intense antibiotics and sent home. Shortly thereafter he developed systemic fasciculations from the neck down. At about the same time he went on a wheat free diet. He lost 50# in a short period of time and we all thought it was from eliminating the wheat. Unfortunately, several months later he was diagnosed with ALS.
Any thoughts on this?
Thanks, Meg
re: … wheat and ALS
While we await any update Dr. Davis might have on that, it has come up before. See:
https://drdavisinfinitehealth.com/2011/07/wheat-belly-frequently-asked-questions/comment-page-3/#comment-37720
And are you confident about the diagnosis. I also found one other comment that someone had been misdiagnosed with ALS merely because they had a very high CRP due to some other problem.
Thanks, Bob, and yes, the diagnosis has been confirmed more than once.
While I suspect that there is indeed a cause-effect relationship with wheat/grains and ALS, there are no data connecting them formally, aside from Dr. Fasano’s data that show that the gliadin protein of wheat initiates multiple forms of autoimmunity. But ALS has not specifically been examined for this effect.
It is odd that the ALS appeared after wheat elimination. This obviously suggests that another cause was at work. At the very least, vitamin D restoration and bowel flora manipulation help, but I suspect that another entirely unrelated cause is at work.
Thank you, Dr. Davis
A study found a strong association between ALS and reverse folded superoxide dismutase 1 (SOD1). SOD is an antioxidant made by the Krebs energy cycle. I don’t know how SOD gets combined and folded into SOD1. There could be several pathways to this defect.
ALS represents demyelation and subsequent damage of lateral nerve takeoffs from the spinal column. One of SOD1’s duties is to prevent and heal oxidation damage to the myelin in these junctions.
http://www.alsa.org/research/about-als-research/genetics-of-als.html
Thank you.
Hi Dr Davis….
Id love to know your thoughts on diverticulitis… My partner is currently suffering from this and id like to know what protocol you would recommend to reduce or eliminate completely this symptom.
Cheers☺
Dr. Davis has said here about that:
“Uncertain about the relationship of wheat and diverticular disease, Heather Ann. I suspect there is indeed a relationship, but we have insufficient data.”
and
“Beyond the diet, which has incredible transforming effects on gastrointestinal health, I know of no other specific manipulations.”
You can see all the traffic about it on this blog with this search URL:
https://www.google.com/search?as_q=diverticulitis&as_sitesearch=wheatbellyblog.com
Many users report relief from symptoms, but this disease likely takes decades to get established, and if it can remiss, it’s not likely to be rapidly.
Rob – diverticulitis?
I can only share that when I first met my husband he was tossing back a half dozen anti- acids every time he ate. He’d have to pull over on the side of freeways and throw up in Los Angeles. The doctor had never once asked him what he was eating. When I finally realized that at some point he was going to be in serious trouble because by then they were giving him meds for duodenal ulcers I made my first convert to WB. After the first week or so he has never needed another half dozen anti-acids, much less a single one. I am convinced diverticulitis does have something to do with it. Good luck. I hope your problem is as simple as diet.
Rob, failed to add – for years my husband had not been able to eat nuts, of any kind. He didn’t know that peanuts/legumes were not a tree nut. I’d also been in those shoes. After my tummy had healed from wheat I did a trial run and didn’t double over in cramps he tried them too. Nothing. I bought a slew of bagged nuts. Can’t keep them in the house now.
Can you recommend brands for both the probiotics and the omega 3 supplements? Thank you
re: Can you recommend brands for both the probiotics …
A recommendation that has appeared in the blog previously is:
“Take a high-potency probiotic for at least several weeks, longer if an autoimmune condition is present. 30-50 billion CFUs per day has been working very well for us, especially brands with a wide variety of Lactobacillus and Bidifobacteria species, such as VSL3, Renew Life, and Garden of Life brands.”
I put a link to the source of that quote in my user ID here. Note that 2 of those 3 PBs are sold and must be kept refrigerated. I know the Sigma-Tau VSL is, but don’t recall which of the other 2 is.
re: … and the omega 3 supplements?
See:
https://drdavisinfinitehealth.com/2013/01/nutritional-supplements-in-the-wake-of-wheat-elimination/
Yes! It is this autoimmune version of the wheat-belly nutritional approach in which I am finally seeing some results. I also want to add that there needs to be an emphasis placed on prebiotic foods that help feed the probiotics and aid in repairing the autoimmune system. Also, for some people, they may need to eliminate eggs as well. For myself, what seems to work best is the autoimmune paleo protocol with some nuts, seeds, nightshade veggies and tubers (potatoes), and properly prepared legumes on the ‘not allowed’ list. On the ‘allowed list’, I don’t do well with coconut oil, but am ok with grass-fed butter. I also have to avoid soy as best as possible. I add ground up beef liver and bone marrow to chili, soups, stews and pot roast. I also eat oysters twice a week (minus any oil). It is of utmost importance to maximize vitamin/mineral intake, and eat foods that feed the probiotics (legumes) and help rebalance the gut micro biome such as mushrooms, ginger, and asparagus.
http://aiplifestyle.com/what-is-autoimmune-protocol-diet/
http://www.thepaleomom.com/2012/05/modifying-paleo-for-autoimmune.html
And contrary to popular belief, legumes are Paleo.
http://www.theguardian.com/science/2010/dec/27/neanderthals-cooked-diet-us-research
The plaque problem comes from the barley (grain); not the legumes. I know this because my dental checkups always turn out well when I don’t eat any grains.
Hello! my life is changing for the better because of going wheat free. 35 pounds lighter since September is just the start! I have psoriasis and was hoping giving up the wheat would cure my autoimmune issues. Do you or anyone out there know how to make it better? Does anyone else have it? Any advise would be great!
re: … since September is just the start! I have psoriasis and was hoping giving up the wheat would cure my autoimmune issues.
Dr. Davis responded to a similar question here some time ago with “My experience is that psoriasis improves in the majority, though it takes many months to respond.”
The topic has arisen a couple of dozen times. You can find all the traffic by plugging
psoriasis site:wheatbellyblog.com
into Google Search.
Sufferers have suggested that in addition to doing all of the things mentioned in the article above, that you also try going dairy-free for a while, and possibly consider progesterone therapy.
There is an excellent book called “Healing Psoriasis: A Drug Free Program That Really Works” written by Dr. John Pagano, DC. He discusses diet and nutritional balance. His suggestions about the type of foods you should eat and those to avoid are easy to follow and do bring relief. This book can be purchased on Amazon or in bookstores. It has had many reprints.
His recommendations are not grain free, but easily adapted to our way of eating.
My wife and I love what you do Dr. Davis. I began my wheat free journey last year and haven’t looked back. i refuse to touch wheat products, as well as most grains. My father died of colon cancer at 69 (he was diagnosed at the age of 60). He was a fit as a fiddle, up to that point in time. I think it had a lot to do with his lifestyle and what he ate. We appreciate all the work that you do an I look forward to many more wheat free years. For those for a good AIP meal plan can check out this website. I’m pretty sure there aren’t many AIP food delivery companies and these guys are the real deal. http://www.paleoonthego.com/Auto-Immune-Protocol-AIP-Friendly-Menu