In our last blog post, we talked about how if you have tried everything, then you are probably an autoimmune patient. We also talked about how many (but not all) autoimmune patients have a time in their life they can point back to as the beginning trigger to their autoimmune disease. This typically shows up as a patient saying, “Ever since my 3rd pregnancy”, or “since that car accident 8 years ago”, or “ever since I got really sick on that vacation”, or “ever since my divorce,” or “ever since menopause I feel like my health has not been the same.” If this is you then you are probably autoimmune! It is estimated that 1 in 4 people have dysfunction in their immune system, including autoimmunity!
The hard part about being autoimmune is how do you test for it and especially how do you test for it early? There are currently over 80 classified autoimmune diseases and they all share extremely similar symptoms in early stages. Traditionally medicine waits for the autoimmune disease to cause enough destruction it becomes obvious. This means (in our current medical model) we must wait years for the autoimmune disease to destroy your joints, thyroid, brain, adrenal glands, liver, etc. to the point where these tissues fail. For example, it takes 8 years right now for the average diagnosis of hypothyroidism (which is an autoimmune condition). If you are already feeling sick and chronically fatigued, isn’t there a way to find out the problem earlier? The answer is YES! For this, we turn to a test from Cyrex labs called Array 5.
Array 5 is called the “Multiple Autoimmune Reactivity Screen”. This panel puts together 24 different possible autoimmune markers in the most complete auto-immune screening panel doctors have available to them today. If you want research specifics you can take any marker on the test and go to PubMed or google scholar and look up research articles. In this blog article, I am going to try and translate some of the academic research talk to a more relatable level.
Emerging research is showing us that we can use antibodies as early markers for autoimmune disease. How quickly these antibodies will progress into an autoimmune disease is dependent upon many factors such as negative and positive immune cell selection in the thymus, autoimmune regulatory genes (AIRE), FoxP3, Intestinal permeability, and others. This area of research is very exciting as it gives us a great opportunity to intervene and return a sick person to health!
Let’s take a look at some of the markers I have found to be very interesting.
- TPO and TGB antibodies against thyroid tissue. These antibodies indicate an autoimmune reaction against the thyroid. I often get patients in my office who have “normal” thyroid tests, but these antibodies can show up years before we see overt thyroid failure and you develop hypothyroidism.
- Antibodies to the ovaries or testis is something we’ve found with patients struggling with fertility and hormone problems. If you have chronic problems surrounding fertility, progesterone, estrogen, and/or testosterone it is possible you have an autoimmune condition affecting these vital organs. Another common antibody for miscarriages is the anti-phospholipid which is a disorder of blood clotting that can lead to multiple miscarriages and increase your risk for stroke. These two sets of antibodies have helped immensely with some of our infertility cases.
- Antibodies to 21-hydroxylase in the adrenal cortex has been a marker that has helped us in many chronic fatigue patients and “adrenal fatigue” patients (see our blog article on adrenal fatigue). Certain patients came in our office and no one has been able to restore their adrenal function. If this antibody is positive, it means your immune system is destroying your adrenal gland and diminishing its production.
- Cytochrome P450 test has been a very interesting test. While it is classic for autoimmune hepatitis, it can also give us great insight into why someone is “always toxic”. Cytochrome P450 is an enzyme in the liver that helps us process different chemicals. Often the patients who are chronically fatigued and have multiple sensitivities to various chemicals (perfumes, soaps, allergies, food additives, etc) show up positive for this antibody.
- GAD65 antibodies are implicated in a variety of diseases including diabetes type 1, latent autoimmune diabetes, and cerebellar ataxia. The GAD65 enzyme also helps your body to make GABA, one of the calming neurotransmitters. People with this antibody often have problems with anxiety, restlessness, difficulty sleeping as well as possibly some of the prediabetic problems or cerebellar problems (dizziness, nausea).
- The myocardial peptides and alpha myosin markers are great indicators of autoimmune destruction of heart tissue and blood vessels. With heart disease being the number one killer in America for the past century it is always vitally important to consider this vital organ. Unlike the thyroid or other endocrine glands, you literally cannot live without the heart. If you are destroying it through an autoimmune process we want to know that and take action to prevent further destruction immediately! What a huge finding this can be for a patient!
There are other markers on the test also, but to prevent an overly lengthy post I will stop there. The big picture is that this test has helped us unravel some of those “mystery patients” that had been to multiple doctors, had tried multiple things, and either had no diagnosis or had gotten very poor results. If you are that mystery patient, then please consider the fact that you may be autoimmune! No one else is running this type of autoimmune screen. Some people have had one antibody for the thyroid run, or one for rheumatoid arthritis, but this more comprehensive panel, for the first time, gives us a cost efficient way of testing for multiple autoimmunities, and getting patients started on a clear path of why they are sick and how they can recover.