Chronic Pain and “Autoimmunities”

“I don’t really do well with most medications/herbs/botanicals.  I eat better than most.  I’ve been to every medical/alternative specialist there is.  All my testing is normal/severe.  Nothing works, in fact, I’ve been getting worse.”  In our chronic pain condition practice, whether it be diabetic or peripheral neuropathies, chronic fatigue, migraine, dizziness, vertigo, Fibromyalgia, thyroid issues, tremors, Restless Leg Syndrome and more, autoimmunities are one of the most over-looked and under-appreciated triggers and perpetuators of these debilitating conditions.  It is often the biggest reason the case has failed and many patients seeking care in the health care system are suffering from undiagnosed autoimmunity.

Autoimmunity has become a vastly under-appreciated, growing epidemic.  Autoimmunity is basically the loss of self-tolerance – or the ability of the immune system to recognize self-tissue (thyroid, pancreas, cartilages etc) from foreign or pathogenic organisms (bacteria, virus, parasite, etc.) thus leading to immune attacks upon oneself.  The loss of self-tolerance and the development of autoimmunity is a major reason why many individuals notice a rapid decline in their health and seek care with a health care professional.  Unfortunately, autoimmunity leads to a destructive process to various tissues over several years, and an early autoimmunity may be easily over-looked in chronic pain patients in the current health care model.  In the current system, autoimmune disease is not diagnosed until the tissue has already been destroyed.  In other words, an individual may have cartilage antibodies for several years and suffer significant pain but they will probably not be diagnosed with rheumatoid arthritis until they have severe joint deformity.  Another person may have subtle autoimmunity to myelin and present with diverse neurological symptoms (peripheral neuropathy, brain fog, anxiety, depression, etc.) but he/she will not be diagnosed because his/her MRI is “normal” because it does not show “enough” destruction to be sensitive to MRI findings.  It is not clear that the antibodies that attack self-tissue appear years before total tissue destruction is obvious, and during these years, clients suffer symptoms associated with this destruction process.

In today’s health care arena, it is not uncommon for a person suffering from the early stages of autoimmunity to seek consultation, and since they have “normal” blood labs and do not have total tissue destruction, are not diagnosed with any conditions.  Often times these individuals end up seeking alternative medicine, as conventional medicine models offer them little support in the early stages.  It is very important for chronic pain patients to seek health care professionals who are able to detect that patients are in early stages of undetected autoimmune expressions and who are able to provide nutritional, dietary, neurological, and lifestyle modifications, protocols and strategies to support their overall health and to co-manage their cases.

Functional medicine doctors are among the most well-versed alternative practitioners addressing this vastly under-diagnosed and under-appreciated patient population.  The battle for the autoimmune patient is the immune system – not the targeted tissue.  In other words, if you have an autoimmune attack on your thyroid, you may express hypothyroid symptoms (tired/sluggish, cold hands and feet, gains weight easily and can’t lose it, depression, constipation) or hyperthyroid symptoms (heart palpitations, inward trembling, increased pulse even at rest, nervous and emotional) or in most cases, an alternation of both.  The battle is not the end organ, the thyroid, in this case.  The battle is to calm down or modulate the immune system and to address everything that is causing it to attack the thyroid and produce the seemingly inconsistent symptoms above.  You could be looking at stress, blood sugar issues, chronic viral infections, yeast, mold, parasites, food allergies, the now, ever-popular “inflammation” of the body and more.  The patient needs a thorough workup of their nervous system and entire biochemical system to determine which stressors are present, so that a strategy can be developed to support the patient’s overall health and effect non-drug management of their chronic conditions.  This is functional medicine at its best and is probably the reason so many functional medicine practices have such a large percentage of chronic pain patients comprising the bulk of their practices.  Utilizing a comprehensive history and examination, along with specialized autoimmune testing, the functional medicine doctor generally will have a strong probability of ferreting out the diagnosis and appropriate non-drug treatment protocol for that patient and his/her condition.

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