SARS-CoV-2, the virus causing COVID-19, has infected millions and has caused hundreds of thousands of fatalities. Risk factors for critical illness from SARS-CoV-2 infection include male gender, obesity, diabetes, and being over age 65. However, researchers are also now discovering that autoimmunity may be at play.
COVID-19: New Insights
There’s no doubt that COVID-19 is a rapidly evolving situation and disease we are still learning more and more about every single day, including COVID-19’s links to autoimmunity.
Back in January 2020, we didn’t know much. COVID-19 was a distant news headline from way across the pond in China, similar to the SARS outbreak of the 1990’s. We knew a virus was spreading, people were wearing masks, and we were going about business as usual.
Fast forward to March 2020, COVID-19 came from out of nowhere along with what we thought was…an apocalypse? Toilet paper was flying off the shelves; Food chain supplies were in short demands; and Vitamin C was nowhere to be found. It’s as if what was supposed to happen back in 2000 (Y2K) finally unfolded 20 years later.
Fast forward once more to today, as we now learn to live our lives again with the virus in the world instead of in fear of the virus), two recently released reports are helping doctors explain why COVID-19 may be more virulent in some people, but not others: An autoimmune disease-like over activation of the immune system.
The Autoimmune-COVID Connection
Orlov et al (2020) have found that increased Th17 cell activation may lead to increased likelihood for lung injury and respiratory failure.
Th17 (T helper 17) cells are pro-inflammatory immune cells that produce the inflammatory compound Interleukin-17 (IL-17) that helps protect the body from microbes and pathogens too powerful or not well suited for our general immune cells (Th1 and Th2 cells), including extracellular bacteria, some fungi and viruses.
Basically, Th17 cells play a big role in our immune system defense, almost like the emergency break or back-up reinforcements for our other immune cells.
The article published in the Journal of Immunology found that that patients with acute respiratory distress syndrome (ARDS) have increased levels of IL-17 in their lungs as if the body is attacking itself, unable to differentiate between the pathogen (SARS-CoV-2) and the host’s lungs.
A follow up article (Bastard et al, 2020) published in Science Magazine found those with “life threatening” COVID-19 symptoms also had increased auto-antibodies (self-attacking immunoglobulin proteins), pointing once more to the fact that what separates “critical COVID-19” from “mild or asymptomatic COVID-19” may be more autoimmune in nature.
Both of these findings lead us to ask: Which came first, the chicken or the egg?
Do critically ill COVID-19 patients actually have an underlying autoimmune condition or does COVID-19 spark a new onset autoimmunity?
Although these are two questions still to be answered, the more you understand how autoimmune disease itself works, it’s not a far stretch to believe that an underlying autoimmune susceptibility may be the “perfect” storm for “mystery” health conditions— not just virulent COVID-19, but a myriad of other symptoms and conditions as well—from vertigo to hormone imbalances, IBS, chronic migraines, allergies, food intolerances, chronic fatigue and more.
In fact, I often find that when a patient tell me: “nothing has helped me feel better” or “doctors can’t figure out what is wrong” that an underlying autoimmunity may be at play.
How Autoimmune Disease Works
Autoimmune disease is one of the fastest spreading chronic illnesses of modern day, annual diagnoses now surpassing both heart disease and cancer deaths combined with over 100 different presentations and still growing.
Autoimmune disease is exactly what it sounds like: “auto” (self) immune disease or “attack.” It’s what happens when your body’s own immune cells get super confused, overwhelmed and over activated, and in turn start “firing” signals at your body’s tissues—unable to distinguish between pathogens or its own healthy self.
This self tissue attack can actually happen without having a full blown autoimmune disease itself, and autoimmunity actually occurs in 3 different stages:
Stage 1: Silent autoimmunity
Stage 2: Autoimmune “flares”
Stage 3: Autoimmune disease
Basically, your body can send inflammatory signals to your body tissues without having a full blown disease for years—if not your whole life—causing a myriad of symptoms, unbeknownst to you that it’s actually your immune system at play.
Symptoms of autoimmunity or “autoimmune flares” depend on the specific tissues or regions of your body that your immune system is attacking, but may include:
- Brain fog, poor memory, vertigo, headaches, anxiety, depression (brain attack)
- Constipation, weight gain, hair loss, fatigue (thyroid)
- Joint pain, swelling, water retention (arthritic)
- Shortness of breath, asthma, allergies, chest pains (lung)
- IBS, constipation, loose stools, nausea, GERD, stomach pain (colon, stomach or intestinal tissue attack)
Typically these autoimmune flares will “come and go”, most often dependent on the triggers or stressors at play in your life—physically and mentally.
There are 3 primary triggers that “set off” autoimmunity (aside from being genetically susceptible to experience your condition). These include:
1.) Food triggers
2.) Chemical & Environmental triggers
3.) Lifestyle triggers
Food triggers happen when you eat foods that you are naturally intolerant to, your gut bacteria are out of whack or you have reduced oral tolerance due to poor digestion (such as low stomach acid, low digestive enzymes, sluggish gallbladder).
Chemical and environmental triggers may include overexposure to chemicals in the foods you eat, water you drink or air you inhale—such as working in a beauty salon or around paint fumes. There are over 80,000 chemicals we are exposed to daily—many of them unregulated—and many researchers actually also believe that chemical exposures, not just diet and exercise, may be a bigger driving factor in the reason why chronic disease continues to rise. Chronic mold exposure, present in at least 50% of buildings in the U.S. is also an often overlooked factor. Loss of chemical and environmental tolerance is often the “straw that breaks the camels back” for an autoimmune cascade (kind of like what happened with my own chronic mold story).
Lastly, lifestyle triggers include anything where in the demands in your mental or physical life exceed your body’s ability to recover—sleep deprivation, high caffeine consumption, overtraining or a sedentary lifestyle, overwork—no play, lack of social connections. All of these add up.
Although our bodies are hardwired to adapt and fight stress (and stress is inevitable), the greater or more prevalent our “trigger” list grows, the more our immune system fires and loses its tolerance.
Reading that list, you’re probably thinking: “Well, I guess everyone has autoimmunity then!” It IS very common.
Some key factors that can make you MORE resilient against autoimmune disease include:
- Younger age (autoimmunity typically does not onset in a more progressed stage until the 30’s and 40’s)
- A healthy gut microbiome and digestion (70-80% of your immune system is in your gut)
- A nutrient dense anti-inflammatory diet
- Numbness (you’re numb to the fact that you actually feel “off” because you think just because it’s common—like IBS or headaches—it’s your normal; Fact: no “symptom” is normal. Your body, when in balance, can feel symptom free)
Post COVID-19 Syndrome: An Emerging New Autoimmune Disease?
While research is continually evolving, clinically, I am seeing more and more patients who have been “touched” by COVID-19, survived it just fine, but in the aftermath, have developed several “mystery” symptoms they didn’t have before such as:
- Constipation
- IBS
- Severe anxiety or depression
- Fatigue
- Brain fog
- “Not feeling like themselves”
All this months after the 7 to 15 day stint with the illness.
And as I have learned more about how the immune system is over activated, I have begun advising them in targeted nutritional and lifestyle strategies aimed at improving autoimmunity with fantastic results.
If you are struggling with post COVID-19 symptoms that seem odd or unexplained, an autoimmune approach to your nutrition and lifestyle may help too.
This may include:
- Adopting an anti-inflammatory autoimmune-paleo diet for at least 30 to 60 days
- Optimizing sleep like it’s your job (7 to 9 hours of quality uninterrupted sleep)
- A mind-body stress management practice daily (like yoga, meditation, etc.)
- Daily sweat without over-exertion (infrared sauna, fresh air and sunshine walks, short HIIT type workouts and strength training)
- Immune stabilizing supports, like liposomal glutathione, liposomal cucrumin, resveratrol, short chain fatty acids and Vitamin D
Easier said than done? Yes. Just like if drinking green juice every day and working out every day was easier, many people would naturally be 10 pounds lighter without constantly saying they want to lose 10 pounds, managing autoimmunity and sending symptoms or flares into remission is also a matter of time and consistency. And you do not have to go it alone.
If you are struggling with “mystery” symptoms or “nothing helps” you feel better despite doing “all the things”, autoimmunity may be at play. Reach out to our clinic today to learn more about how we can help.