Estrogen Metabolism

An interesting aspect of the observations concerning estrogens and autoimmunity relates to estrone metabolism and to the 16α-hydroxylated metabolite—a mitogenic estrogen that appears to increase estrogen-induced autoimmunity—in relation to levels of the 2-hydroxylated metabolite, which is not mitogenic or immunogenic. A number of studies on patients with RA and SLE have demonstrated elevated levels of the mitogenic 16α- hydroxyestrone ( 16α-OHE), likely contributing to the cellular proliferative state observed in these autoimmune diseases. Gastrointestinal Research suggests there is a correlation between mucosal barrier function and autoimmune disease. The GI tract is responsible for regulating the traffic of molecules between the environment and the body through a barrier mechanism. Together, the GI barrier with its selectively permeable intracellular tight junctions, lymphoid tissue, and neuroendocrine network control the balance between tolerance and immunity to potential antigens. When the precise trafficking of molecules becomes dysregulated, autoimmune disease can occur.

Intestinal Permeability The permeability of the intestinal barrier depends on the regulation of intercellular tight junctions, which are responsible for selectively trafficking beneficial and potentially harmful molecules—such as nutrients and antigens, respectively — between the environment and host. It is now widely accepted that tight junction dysfunction, commonly referred to as “leaky gut”, plays a role in the pathogenesis of several diseases, particularly autoimmune diseases. Emerging scientific findings from mucosal biopsies of IBD patients have shown altered expression of critical tight junction proteins, possibly due to the effects of pro-inflammatory cytokines on barrier integrity. This suggests a vicious cycle is created , in which increased intestinal permeability allows further leakage of intestinal contents, contributing to a pro-inflammatory immune response on intestinal tissue that in turn promotes further gut leakiness.

Microflora Balance A healthy intestinal tract harbors a large variety of beneficial microflora, or “friendly” bacteria, residing in close proximity to rapidly renewing intestinal epithethial cells and other components of the mucosal immune system. Components of beneficial microflora are essential to maintain a balanced immune and inflammatory response; when this balance is disrupted, excessive immune activation could pose a risk to the development of intestinal or systemic inflammation.

Naturopathic Approach

A naturopathic approach to treating someone with an autoimmune disease, certainly depends on the autoimmune disease and mostly on the person who has it. Regardless, since it is an immune disorder, a good place to start is with the immune system – 60%-70% of which is in the gut. Often a modified elimination diet along with a gut restoration program is recommended along with clinical nutrition to help rebalance the immune system and put health back in the body to support the resolution of symptoms or minimize progression. Autoimmune disease is considered to be an inflammatory disease, so strict focus through food, movement, stress and trigger elimination, herbals and nutrients that support an anti-inflammatory environment are often prescribed.