How to Stop Attacking Yourself: 9 Steps to Heal Autoimmune Disease.

Via on Aug 5, 2014

Mark Hyman

Inflammation is a “hot” topic in medicine.

It appears connected to almost every known chronic disease—from heart disease to cancer, diabetes to obesity, autism to dementia, and even depression.

Other inflammatory diseases such as allergies, asthma, arthritis, and autoimmune disease are increasing at dramatic rates. As physicians we are trained to shut off inflammation with aspirin, anti-inflammatory medication such as Advil or Motrin, steroids, and increasingly more powerful immune suppressing medication with serious side effects.

But we are not trained to find and treat the underlying causes of inflammation in chronic disease. Hidden allergens, infections, environmental toxins, an inflammatory diet, and stress are the real causes of these inflammatory conditions.

Autoimmune diseases, specifically, now affect 24 million people and include rheumatoid arthritis, lupus, multiple sclerosis, thyroid disease, inflammatory bowel disease, and more.

These are often addressed by powerful immune suppressing medication and not by addressing the cause. That’s like taking a lot of aspirin while you are standing on a tack. The treatment is not more aspirin or a strong immune suppressant, but removing the tack.

If you want to cool off inflammation in the body, you must find the source. Treat the fire, not the smoke. In medicine we are mostly taught to diagnose disease by symptoms, not by their underlying cause.

Functional medicine, the emerging 21st century paradigm of systems medicine, teaches us to treat the cause, not only the symptoms, to ask the question why are you sick, not only what disease do you have.

I recently participated in a group discussion with a conventional doctor, a rheumatologist, and patient with an autoimmune disease, and one of my patients who was cured of a complex autoimmune disease by addressing the causes.

The focus of the other doctors, however, was on how to suppress the inflammation with medication, not finding and treating the cause. Functional medicine is a different way of thinking about disease that helps us understand and treat the real causes of inflammation instead of finding clever ways to shut it down. Medicine as it is practiced today is like taking the battery out of a smoke detector while a fire burns down your house!

Autoimmune conditions are connected by one central biochemical process: A runaway immune response also known as systemic inflammation that results in your body attacking its own tissues.

When my patient described how he cured his autoimmune disease by finding and eliminating the causes of inflammation in his diet and environment, it was dismissed as a “spontaneous remission.” In the face of a paradigm-shattering medical case, these doctors were hardly curious and quickly dismissive, describing what was shared as anecdotal.

My patient on that panel, a hard-working 46-year old father of three, was once so inflamed he could barely function. By treating the underlying causes of his inflammation he is now in vibrant good health, enjoying his life with his kids and fully capable of caring for them.

Stories like these (and the many others I have shared in my blogs, books, and on television) are not anecdotes but a giant compass pointing us in the direction we should be looking to find answers to our health problems.

In today’s blog, I will explain what autoimmunity is, how inflammation spirals out of control, describe some of the underlying causes for these fires in the body, and provide you with nine steps to cool the fires of inflammation and overcome conditions that range from allergies to arthritis and more.

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Autoimmunity: What it is and How it Occurs

We are facing an epidemic of allergic (60 million people), asthmatic (30 million people), and autoimmune disorders (24 million people). Autoimmune diseases include rheumatoid arthritis, lupus, multiple sclerosis, psoriasis, celiac disease, thyroid disease, and the many other hard-to-classify syndromes in the 21st century.

These are all autoimmune conditions, and at their root they are connected by one central biochemical process: A runaway immune response also known as systemic inflammation that results in your body attacking its own tissues.

Your immune system is your defense against invaders. It is your internal army and has to clearly distinguish friend from foe—to know you from others. Autoimmunity occurs when your immune system gets confused and your own tissues get caught in friendly cross-fire.

Your body is fighting something—an infection, a toxin, an allergen, a food or the stress response—and somehow it redirects its hostile attack on your joints, your brain, your thyroid, your gut, your skin, or sometimes your whole body.

This immune confusion results from what is referred to as molecular mimicry. Conventional approaches don’t have a method for finding the insult causing the problem. Functional medicine provides a map to find out which molecule the cells are mimicking.

Interestingly, autoimmune disorders occur almost exclusively in developed countries. People in poor nations without modern amenities like running water, flush toilets, washing machines, and sterile backyards don’t get these diseases.

If you grew up on a farm with lots of animals, you are also less likely to have any of these inflammatory disorders. Playing in the dirt, being dirty, and being exposed to bugs and infections trains your immune system to recognize what is foreign and what is “you.”

In this country, autoimmune diseases, when taken all together, are a huge health burden. They are the eighth leading cause of death among women, shortening the average patient’s lifespan by eight years. The annual health care cost for autoimmune diseases is $120 billion a year representing nearly twice the economic health care burden of cancer (about $ 70 billion a year). (i)

Unfortunately, many of the conventional treatments available can make you feel worse. Anti-inflammatory drugs like Advil, steroids, immune suppressants like methotrexate, and the new TNF-alpha blockers like Enbrel or Remicade can lead to intestinal bleeding, kidney failure, depression, psychosis, osteoporosis, muscle loss, and diabetes, not to mention overwhelming infection and cancer.(ii)

When used selectively these drugs can help people get their lives back. But they are not a long-term solution. They shouldn’t be the end of treatment, but a bridge to cool off inflammation while we treat the root cause of the disease.

There is another way to deal with autoimmune conditions. Let me share the same story I told the doctors on that panel.

Recovering from Autoimmunity: Addressing the Root Causes of Inflammation

My patient Sam ended up on a long misadventure through the medical system before he came to see me. For years he went from doctor to doctor getting all kinds of labels for his problems but no real help in treating them.

This hard-working, once healthy trade professional had suddenly developed a series of inflammatory conditions including chronic sinus and prostate infections. Many doctors gave him many antibiotics for these infections.

Shortly thereafter, he developed severe chest pains and went to the emergency room. While he was there, doctors found swollen lymph nodes and told him he had lymphoma, a form of cancer. For three weeks he lived in despair until the biopsy results came back. It turned out he didn’t have cancer but an autoimmune disease. Which autoimmune disease? The doctors weren’t quite sure…

He had many abnormal blood test results—like low white blood cell and platelet counts, high levels of auto-antibodies of all types (antibodies that attack our own tissues), high immunoglobulins (the foot soldiers of the immune system), and autoimmune thyroid disease. But doctors had a hard time putting their finger on what was wrong. They couldn’t label him.

Meanwhile, Sam developed metabolic syndrome and weight gain (pre-diabetes) as a result of the runaway inflammation in his body.

Here is a quote from one his specialist’s notes:

“Whether he has lupus or Sjogren’s syndrome is a bit unclear. Regardless, he merely needs observation and no therapeutic intervention at this time.”

This unfortunately is all too common. What exactly did they plan to observe, how bad he felt? Or would they just wait for him to get worse before intervening?

That’s when he came to me. Using a functional medicine approach, a new way of thinking about the underlying causes and imbalances in chronic disease, I began by asking Sam some simple questions. Then I went hunting for toxins, allergens, and infections—all common causes of inflammation—and found the real causes of his symptoms.

He had taken so many antibiotics that altered his gut flora or bacteria and promoted yeast overgrowth. Fungus and yeast flourished in his body, growing between his toes, on his toenails, in his crotch, and scalp. He had Helicobacter pylori bacteria in his gut. He had a leaky gut and reacted to many foods, including dairy and gluten. He was exposed to toxins at his job and had high levels of mercury. And he had chronic sinus infections.

So we went to work cleaning house. I treated his yeast with anti-fungals and the H. pylori with antibiotics, got rid of his food allergies, fixed his gut, detoxified him from metals and cleaned up his sinuses.

Then I helped heal his immune system by supporting it with nutrients. I gave him zinc, fish oil, vitamin D, herbs, and probiotics, and put him on a clean, whole-foods, allergen-free, anti-inflammatory diet.

At his next follow-up visit, I asked Sam how he was doing, expecting him to say that he felt a little better. However, his response surprised even me. He said he felt fine.

“What about the fatigue?” I asked.

“I have great energy.”

“What about the bloating and gas?”

“Nope.”

“What about the reflux?”

“Gone.”

“What about your sinuses and chronic phlegm?”

“All clear.”

“What about your memory and concentration problems?”

“All better.”

And he lost 15 pounds.

When his labs came in, they confirmed what he told me—they were all back to normal. His white cells increased and his immune markers calmed way down.

Sam’s results simply reflect the application of a new model of thinking about problems called functional medicine—it’s a way to get to the root of health problems and treat the underlying causes of what ails you instead of suppressing symptoms with medications.

If you have an autoimmune disease, here is what you need to think about and do.

Nine Steps to Treating Autoimmune Disease

1. Check for hidden infections—yeast, viruses, bacteria, Lyme, etc.—with the help of a doctor, and treat them.

2. Check for hidden food allergens with IgG food testing or just try The UltraSimple Diet, which is designed to eliminate most food allergens.

3. Get tested for celiac disease, which is a blood test that any doctor can do.

4. Get checked for heavy metal toxicity. Mercury and other metals can cause autoimmunity.

5. Fix your gut. For details, see my blog on irritable bowel syndrome.

6. Use nutrients such as fish oil, vitamin C, vitamin D, and probiotics to help calm your immune response naturally.

7. Exercise regularly—it’s a natural anti-inflammatory.

8. Practice deep relaxation like yoga, deep breathing, biofeedback, or massage, because stress worsens the immune response.

9. Tell your doctor about Functional Medicine and encourage him or her to get trained—go to functionalmedicine.org for more information and to get a copy of the Textbook for Functional Medicine.

Give these steps a try—and see if you don’t start feeling less inflamed. As I said earlier, the answers are right in front of you. Treat the underlying causes of your illness and you will begin to experience vibrant health once more.

Now I’d like to hear from you…

Have you been diagnosed with an autoimmune disease?

How is your doctor treating you?

Have you been frustrated by the medical advice that you’ve been given?

What steps have you taken to get to the root of the problem, and what have your results been?

Please leave your thoughts by adding a comment below—but remember, we can’t offer personal medical advice online, so be sure to limit your comments to those about taking back our health!

 

References

(i) Nakazawa, D. (2008). The Autoimmune Epidemic. Simon & Schuster. New York.

(ii) Siegel, C.A., Marden, S.M., Persing, S.M., et al. (2009). Risk of lymphoma associated with combination anti-tumor necrosis factor and immunomodulator therapy for the treatment of Crohn’s disease: a meta-analysis. Clin Gastroenterol Hepatol. 7(8): 874-81.

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Editor: Cat Beekmans

Photo: Author’s Own, Pixoto

About Mark Hyman

Mark Hyman, M.D. believes that every individual deserves a life of vitality—and that they have the potential to create it for themselves. That’s why he is dedicated to tackling the root causes of chronic disease by harnessing the power of Functional Medicine to transform healthcare. Dr. Mark and his team work every day to empower people, organizations and communities to heal their bodies and minds, and improve our social and economic resilience.

Dr. Mark is a practicing family physician, a six-time #1 New York Times bestselling author and an internationally recognized leader, speaker, educator and advocate in his field. He is also the founder and medical director of The UltraWellness Center, chairman of the board of the Institute for Functional Medicine, a medical editor of The Huffington Post and a regular medical contributor on Katie Couric’s TV show, Katie.

To achieve his mission of transforming healthcare, Dr. Mark works with individuals and organizations, as well as policy makers and influencers. He has testified before both the White House Commission on Complementary and Alternative Medicine and before the Senate Working Group on Health Care Reform on Functional Medicine. He has consulted with the Surgeon General on diabetes prevention, and participated in the 2009 White House Forum on Prevention and Wellness. Senator Tom Harkin of Iowa also nominated Dr. Mark for the President’s Advisory Group on Prevention, Health Promotion and Integrative and Public Health. In addition, he has worked with President Clinton, presenting at the Clinton Foundation’s Health Matters, Achieving Wellness in Every Generation conference, as well as the Clinton Global Initiative.

Dr. Mark also works with fellow leaders in his field to help people and communities thrive—he co-created The Daniel Plan with Rick Warren, Dr. Mehmet Oz and Dr. Daniel Amen, a faith-based initiative that helped The Saddleback Church collectively lose 250,000 pounds. He has appeared as an advisor on The Dr. Oz Show, and is also on the Board of Dr. Oz’s HealthCorps, which tackles the obesity epidemic by educating the American student body about nutrition. With Drs. Dean Ornish and Michael Roizen, Dr. Mark crafted and helped introduce the Take Back Your Health Act of 2009 to the United States Senate to provide for reimbursement of lifestyle treatment of chronic disease.

Join Dr. Mark on his path to revolutionize the way we think about and take care of our health and our societies by following along and chiming in online through his website, on Twitter, Facebook and Instagram @markhymanmd.

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60 Responses to “How to Stop Attacking Yourself: 9 Steps to Heal Autoimmune Disease.”

  1. J. Haden says:

    I had a long slow decline for 15 years. Finally removed amalgam fllings, analyzed hormone levels, did I.V. chelation sessions, balanced thyroid hypothyroidism, removed wheat , etc. Went to The Tree of Life and cleansed which helped hugely… Still had low energy, and had developed Hasimotos.The biggest and most import discovery I made on my own after seeing 8 doctors throughout this process ,who never had the answer — I read Dr. Bronstein's book on IODINE. I had stopped iodized salt when sea salt became the rage, I never eat fish, I am exposed to lots of bromine, chlorine and fluoride. I took the iodine uptake test. In three months on 12 mg. of iodine I lost 22 points and have the energy of a 40 year old. People think I'm in my mid50's, I will be 70 next year! My thyroid numbers, even TSH, ARE ALL NORMAL. Sugar is the only real trigger for me now…my naturopath now feels like 12 mg is the standard dosage for us all. I use Iodizyme-HP BY Biotics as I don't tolerate nascent iodine. I lost 15 years but feel terrific and know I have another 20 great years ahead of me!

    • marlene walker says:

      I have Hashimotos and it is an awful state of being ……im soooo tired all the time no interest in anything i flucuate between 0.001 >29……….i should be overweight but i am quite opposite ……48 kgs……my quality of life is zilch ……sleep all the time…..and i take between 100-200 mg Eutroxsig meds per day …..sometimes it makes my heart beat so fast…..i am only 53 but feel 83…..so much depression goes with this disease also …i hate it …..

  2. Tracey says:

    I have been battling an autoimmune issue for about 10 years. It has been diagnosed as Rheumatoid Arthritis but I still have my doubts. What I know for sure is my body is on fire with inflammation!! And my hands are starting to cripple. I was briefly on Methotrexate and Prednisone but got off because the side effects listed scared me! I now only take 800 mg prescription Ibuprofen daily to function. I have always believed my symptoms are the result of food allergies. I would love to feel normal again as I am only 54 and hopefully have a long life ahead of me. I haven't even been able to work because I am so fatigued and experience so much discomfort. I will take your advice and try to find some relief. Thank you for this article!

    • Dorothy says:

      Tracey, Don't give up! I was where you are about 9 years ago. My day would start at 5am with 800 mg of ibuprofen in order for my hands to relax enough to be used (usually by 11am) – and I was only 33 at the time. I've seen more doctors than I can count. Ultimately, this article is right. Adjusting my diet to fit my needs (everyone is different – you need to listen to your body and learn what's right for you), was assisted with injections of B-12 and Vit D, along with Iron supplements. But nothing took the fatigue away until I began to eliminate processed, high fructose foods and began to exercise regularly. I am still on my own journey, but feel so much better than I have in the past. Herbal teas (dandilion and camomile) also help with stomach discomfort. Wishing you all my best! Dorothy

      • Tracey says:

        Thank you Dorothy!! I need to find a functional medical Dr like Dr Hyman as well to help me with this process. It seems so overwhelming and I am not sure how to begin. Do you have a medical professional helping you? Were you dealing with R A? Are you completely cured or in remission?

  3. Kate says:

    One thing about Western medicine, or non-functional medicine, Dr. Hyman, is the belief system that you've got something, and you basically always have it and are never cured, unless it's cut or radiated out of you. Thus, you must be on medications the rest of your life for whatever you've got, and the side effects are slightly less noxious than the original symptoms. Over the past seven years of a massage therapist, I've become more observant of clients and myself, and know that functional medicine, including functional nutrition, are the way to go. About 8 years ago, a naturopathic dentist diagnosed me with a "wicked wheat allergy" while muscle testing for substances that would help to heal my gums after dental surgery. Since then, I have been up and down with inflammation, going off and on wheat at various times. Now I am 100% off wheat (the proliferation of gluten free products really helps), and never felt better. I had some setbacks–I picked up a severe intestinal parasite eating shrimp at a local restaurant, that ruined my intestines. Over time, I realized I would have symptoms of rheumatoid arthritis, and the next I would be fine. My teeth got bad, painful and sensitive. With sunshine and supplements, I no longer have any problems with my teeth.(Magical Vitramin D). It's this ebb and flow of symptoms and problems that must be acknowledged, as the body does its best to heal itself. We want to be in balance, our bodies want the same, and I suspect functional medicine is looking to help that along.

  4. Maggie says:

    I am a Chiropractic student and fully understand the power of the body as a self-healing organism. When we provide the body the proper nutrition, exercise, and create a positive environment for ourselves, we can live life at an elevated level beyond just the absence of disease. While functional medicine is a beautiful approach to restoring the body's innate ability to heal itself- this idea of "medicine and treating the cause" is by no means a new concept. In fact- aruvedic and traditional practices all over the world have been doing this for years. There exist many natural ways to restore health to the body- have have been throughout history. Functional medicine is ONE of these.

  5. Patty says:

    Thanks for a great article! I had a plethora of issues and was finally helped by a functional MD. She refused to give up when no one else was able to figure out what was going on in my body. With her guidance, I healed. I am so, so grateful for the burgeoning science of treating the patient, not the symptom. We have a long way to go, unfortunately, before this is considered mainstream in our society, but it's available for those of us willing to seek it out and be made whole again.

  6. Chrystabel says:

    I was 13 when I was exposed to high levels of environmental mold and fumes from a kerosene heater. Within a few months, my hair started falling out, I had chronically swollen lymph glands, was in and out of doctors' offices with antibiotic prescriptions to treat chronic sinus infections. And I started having epileptic seizures so was put on medication for that. (Epilepsy is an inherited condition in this case, my father also has idiopathic epilepsy). I found and followed a similar cleanse program to Dr. Hyman's when I was in my late teens, that focused on systemic candida control. This would have been in the mid 1990's. With supplementation and guidance from an alternative health practitioner, I gained back a measure of health in my life. Now in my 30's, I recognize that I have allowed my health to deteriorate, while not as severe as my initial situation, we go back to our "old" patterns of eating and behaving, we lose the health and vitality we thought we had recovered. There comes a point in life where extreme cleansing becomes tougher on the body. I have been instructed by both a conventional medical professional and an alternative health practitioner to be gentle with my body. This is my advice to anyone looking to make big changes. Be gentle with your body, and be gentle with your mind & emotions.

  7. sesailespropres says:

    I was diagnosed with Hashimoto's 23 years ago; in the last 6 years they have added "mixed autoimmune disease" to the mix, which means that my blood tests show lupus, sjogren's, reynauds, RA. I was doing pretty well, keeping myself healthy, eating well, until husband and I split. I needed income, so I took the only job a person with very little work experience can get – a grocery store. I continue to look for a lower stress job, but my RA is consistently flared, I have gained 40 pounds, and I find myself uncomfortable. I have recently started walking and biking and taking yoga, but thus far have seen little change. My rh doctor has me on gabapentin, cymbalta, plaquenil and synthroid. I look ten years older than I did 2 years ago, and am always tired.

  8. Jim Linck says:

    I totally agree with all that you are saying and I have done 8 of your nine steps, however reducing stress seems to have me stumped. I am a 61 year old male who has been a stutterer all my life and the stress of speaking has become a habit for me and it always around and I am at a loss as to how to reduce the self imposed stress that I have?????

    • Leah says:

      Have you tried any therapies such as Hypnotherapy, Thought Field Therapy, Reflective Repaterning or Energetic NLP.? Plus Yoga , Tai Chi, Qi Gong or meditation? All of those have really helped me with anxiety, stress and depression. As well as avoiding gluten and alcohol (as they really affect my moods) I feel good.

    • Truthfully says:

      Jim, try talking to your subconscious. 3 times a day and especially before going to sleep, say out loud something like this: "My speech flows easily and clearly. I am relaxed when I speak. Speaking is enjoyable for me and those who hear me. I am at ease." It might surprise you how quickly results come. All the best.

  9. theheathenvegan says:

    About 10 years ago, I developed what I thought to be a one-time episode of uveitis (inflamed eye, basically). Over the next few years, it returned with increased regularity, to the point where it would return every four to six months. For those who don't know, it's extremely painful and is treated with steroid drops. My eye doc became concerned that I must have some underlying autoimmune disease, so sent me in for blood tests. Nothing came back as conclusive (though I found out recently that I did, in fact, have elevated levels of CRP, an indicator of inflammation…no one discussed that with me). Soon after the blood work, I began experiencing all-over joint pain. More doctor visits and a recommendation that I see a rheumatologist for more tests. He was booked six months out, but I made an appointment anyway. In the mean time, I decided for completely unrelated reasons to go vegan. After just a couple of months, the joint pain was gone, and I hadn't had a flare-up of the uveitis. Months later, still symptom-free, I went through the rigorous testing with the rheumatologist. Nothing showed up. I explained to the doc that I hadn't had any symptoms at all since cutting all animal products out of my diet. He shrugged. I've now been vegan for over five years, and I haven't had a single occurrence of joint aching or the uveitis. I try to eat as clean as possible, but the only real thing I focus on is having no animal products. I've never felt better in my life.

  10. jackie says:

    I was diagnosed with Crohns' disease some 12 years ago or so, after a debilitating flame up put me in the hospital. I have an interest in health and fitness and started reading about gluten free diets, cutting out all processed foods, etc. Not to mention, my husband is from a small wonderful town in Romania, where they ate only natural, whole foods, most of which they grew themselves. He was always telling me how horrible the American diet is, and would give me so much grief when I would go for fast food or anything in a box. So, over a year ago I cut out gluten, most sugar, etc. My last colonoscopy, my Doctor was amazed. I was healing, plus, my bloodwork was 'fantastic' as he said. This was the first time in the 12 years that he has said anything so positive to me about my test results.

  11. Monica says:

    Ten years ago, after a sudden flare up of itinerant joint pain along with lower back pain, fatigue, alopecia, and labored breathing, the doctor ordered numerous tests and a week later the diagnosis of lupus was suggested as the reason for these symptoms. I was stunned since the most severe disease I experienced was pneumonia in one lung two decades prior. The rheumatologist prescribed plaquenil for the pain but I decided to go the holistic route. A good friend who is also a nurse practitioner suggested I find a functional doctor in my area to treat the disease. After following the functional doctor's recommendations to change my diet as well as see an acupuncturist to assist with the pain, in 6 months I was pain free and many of the other symptoms abated after a few years. The last time I saw the rheumatologist, she stated if I were to present to her on that day, she would not diagnose me as having lupus. Patience for me was key to feeling better. I have been practicing yoga and meditation consistently the past 5 years which, in my opinion, has helped me deal with everyday life stress. I have not had another flare up since the first one ten years ago. I am grateful to all my alternative/complementary doctors, friends, and teachers.

  12. multipleauto says:

    I have multiple autoimmune diseases, including systemic lupus, myasthenia gravis, autoimmune hepatitis, as well as fibro and several secondary illnesses from the primaries listed. I have done everything listed, been tested for all of these things and I find no relief. If for not the medications of western medicine, I would not be here today. I was that kid growing up on the farm exposed to animals, bugs and germs. I have been tested for everything under the sun and have lived a healthy life following the rules of a healthy lifestyle as best as I can.

    I hope this article helps some people, but it does have the potential hurt many. This article gives the impression to the public that autoimmune disease can be prevented and cured by following these nine steps, and that if you are not doing these things it could be your fault.Taking healthy steps is always good, but if a person is still ill and needs medication, they should not be made to feel guilty or inadaquate in their struggle.I have not felt relief with any of this.

    This upsets me! It's no wonder healthy people come up to me and recommend this or that new multilevel marketing product with claims of a cure when they can't even pronounce the names of my diseases. But they know how to cure them! Or other healthy well intentioned people who just don't get it because they read an article like this and they wonder if you are doing everything you can to make yourself healthy? Gosh, you must be doing something wrong? Have you tried…??? No one wants to live like this! No one! It's right in the title of this article that this is the answer. How to stop attacking yourself: 9 steps to heal autoimmune disease. That's quite a claim. Try telling this to the people who have died from it!

    • Andrea says:

      I whole-heartedly agree with multipleauto. I have grown very wary of "helpful advice" that well-meaning people like to give after reading an article or two. I am also very skeptical of anyone claiming to "cure" an auto immune disease. More than anything, I am tired of the blame being put on the patient.
      I do believe that changes in lifestyle and diet can help many people, but I know that it can't help everyone. I also know that the traditional medicines really do work for many people and for others they do not. Auto-immune diseases are not one-size-fits-all.

  13. Kristy says:

    This article is right on. I have had so many issues with my "gut" and have had to change my diet, my mindset, the people I surround myself with and even the work that I am doing for my livelihood. All of these changes have impacted me positively and in a healthy manner. I am now in a good place. Mind, body and spirit work together – and when one is off, they are all off. Our bodies have the ability to heal on their own. People have been around much longer than modern medicine. Remember that the next time you are offered a medication that you may not really need. Our bodies have the abilty and they WANT TO heal. Get yourself into a space where you can heal, if that means changing jobs or diet or the people you surround yourself with daily, do what you need to do to be healthy! Your health and well being are worth it. There is hope!!!

  14. Michael says:

    Been dealing with this for a long time. My case presented itself as psoriasis and has moved on to psoriatic arthritis and IBS, along with chronic tendinitis in my Achilles. My case is mild compared to a lot of others but, after seeing a number of MDs and dermatologists and being fed up with their lack of help, I only now see an acupuncturist and practice Yoga and meditation on a daily basis. I've modified my diet and try to be as vegetarian as possible but, as others can attest to, when your body reacts unfavorably to innocuous foods like olive oil (among others), sometimes you have to pick your poison and choose the item that will least affect your system. Just another form of ahimsa in my opinion.

  15. Collette says:

    So Mark, along this same thinking and using these same guidelines, can we create such strong immune systems thereby establishing natural IMMUNity and rendering vaccines/IMMUNizations unnecessary (for our children)?? I wholeheartedly believe that we can, but would very much appreciate your thoughts on this matter. Thank you.

  16. Skye says:

    Thank you for this article – It really resonated with me. I was diagnosed with Celiac 3 years ago by a doctor who simply "checked all the boxes" on a blood test form after I had explained that for 10 years my health was getting worse and nobody was able to figure out why. I live and travel abroad, so doctors often blamed my "Illness" on my lifestyle.
    I adopted more of a paleo lifestyle and I instantly felt better. The headaches I was having every other day disappeared, I had more energy, my mental clarity returned, and so much more! I have not depended on medicines, and the doctors in the country I live in still believe in mostly natural remedy, which is good. There is still a lot of work to be done on my part – and I still have some struggles, but I definitely appreciate the attitude about treating the root cause as naturally as possible as opposed to the symptoms with pharms.

  17. Guest says:

    I'm just starting down this road I'm 72 and have been getting bronchitis and asthma attacks for almost 9 months now. They come and they. I am given prednisone and antibiotics. They go away for a short time, but always come back. We never treat the cause, whatever that is, just up the steroid and pills. I've changed my diet, cook organically, and think I eat healthy. Your article tells me, perhaps, that I should look for a doctor interested in finding the root cause. That I will try to do, although I don't know where to start.

  18. JenBe says:

    Thank you for this article. I was sick, with flue like symptoms (nausea, bone ache and extreme fatigue) all of last winter and it took a lot of prodding on my side (half a year of it) until my doctor sent me in for tests. Eventually I was diagnosed with low levels of anti bodies, however not low enough to give me any treatment. Now in the summer my symptoms are better, but because we live in a State with harsh winters I am concerned about this coming season. I am suffering under more frequent ocular migraines than ever in my life and though I try to exercise I tire very quickly, so much that by 5 p.m. I am feeling fatigued most of the days. We eat very healthy, as much organic as possible, I am a vegetarian and on a gluten free diet. All I know is that once I started eating hot peppers on a regular basis it seemed to help a bit (at least concerning the bone aches). I would love to to the elimination diet, but if all my food allergies and the vegetarian and gluten free diet I am concerned that I may not get enough nutrients. I would be very happy about advice, thank you again.

  19. Renee says:

    I love the method of thinking that you use! As a beauty therapist, people come to me with all sorts of ailments and the doctors they have seen are no help to them. I wish there were more doctors that follow functioning medicine! I am trained in manual lymphatic drainage massage and my first response is often to start with some LDM as it reduces inflammation, however, if you’re immune system is attacking your body, would this aggravate the problem?

  20. Steph says:

    Thanks for this article I will be bringing this up to my doctor as I'm labeled the "mystery patient". My blood results all come back perfect but the fatigue and issues keep coming I'm hoping to research more and adopt a few of the ideas in this article in order to get back to feeling like my normal bubbly self again.

    • Deb says:

      I think this is where I fall as well. My blood work indicated Lupus, but the numbers keep going down, but the joint pain is there in spades and tired + early mornings where I cannot fall back to sleep. Major reaction to the Hydroxychloroquin, so have to look for other ways. Good luck to you!

  21. Tacey says:

    The thinking here dangerous! Antidotal at best.

  22. Mel J says:

    Flax seed oil capsules have been a miracle worker for me. They have relieved my psoriasis and inflammation like nothing else has. If you Google flax seed oil, you'll see all of the great qualities — works better for me than fish oil.

  23. Amy E says:

    Lyme Disease, known as the Hidden Plague, can be responsible for many auto-immune disorders. It's difficult to diagnose. Cut out sugar, stress, processed foods, dairy and gluten. This tremendously helped me with my inflammation problems. Lyme patients should not take steroids or ibuprofen. Good health to all.

  24. Rebecca says:

    I have been saying this for years "Your body is fighting something—an infection, a toxin, an allergen, a food or the stress response—and somehow it redirects its hostile attack on your joints, your brain, your thyroid, your gut, your skin, or sometimes your whole body." and people just look at me like I am crazy.

    I have never believed that the immune system just gets stupid one day. It is just far to amazing.

    I was diagnosed with Fibromyalgia 20 years ago, I quickly came to see it merely as a symptom. I needed to find the cause and 10 years ago I was diagnosed with Lyme Disease as well as several co-infections. I began treatment and now use primarily alternative, natural means to manage the Lyme and am nearly symptom free and I was a mess prior.

    Because of this I have become a holistic health counselor, so much of the healing starts right at home.

    Thank you! I hope it doesn't take to much longer for mainstream medicine to catch on. There are far to many people suffering needlessly,

  25. Mandy says:

    My daughter was diagnosed with rheumatoid arthritis at the age of 22. Did not want to be on lifelong medication so went to a Naturopath who sent her for full blood allergy testing. Extremely allergic to dairy (the proteins) and eggs. Arthritis has settled really well, no need for medication although still having some tummy troubles that we can't quite put our finger on the cause. Caffeine seems to be one trigger though

  26. l huntsinger says:

    You are a true pioneer for millions of us that the "modern" form of medicine does not help AT ALL!! After 20 years of Graves, my auto immune disease into Hashi's. I finally found a doctor last year that is doing exactly what your article is about. I am slowly beginning to heal. The best information I have found has come from support groups, not from the current medical community. They are closed minded and dismissive of the millions that have auto immune disease. Fortunately, we do have pioneers that are stepping out and truly finding answers. Every idea in your article works. Hope the leaders in medicine wake up and see the antiquated treatments they now do, is killing people not healing people.

  27. Constance says:

    I was told I have wegners disease ten years ago and almost died from it I had a cleaning of my blood and was put on high doses of prednisone along with cytoxin for one year I've been off of everything since then but now because of the effects it had on my kidneys I have to take blood pressure meds and I'm depleted of vitamin d and have a large gut I can't get rid of any ideas that could help would be appreciated

  28. Lisainparis says:

    I have suffered with hypothyroidism for over 8 years and have always taken Levothyroxine. Since diagnosed I gained 50 pounds, had a mental breakdown causing me to need anti-depressants, have become so fatigued I can barely function. Finally, 6 months ago my family was so concerned over my weight, depression, and fatigue my mom went with me to doctor to convince them there was something wrong. My labs were always "normal" and the docs just would never believe me. It was then we discovered my thyroid antibodies were over 5000 and I was referred to an endocrinologist. I went to a specialty clinic 3 hours away to be told I have an auto-immune disease, Hashimoto's Thyroiditis. At first she was concerned I had developed encephelopathy due to my sudden problem remembering things (I had been having problems communicating at work, not able to remember words, and having horrible headaches). She ran the labs and referred me to neurologist. I was put on 80mcg levothyroxine and told to come back in 3 months after seeing the neuro. Since then, I've had MRI of brain, overnight sleep studies and the daytime nap study. They ruled out narcolepsy but said I "do have unexplained excessive daytime sleepiness". My labs are "normal" so no change in thyroid medicine. Endo says thyroid is almost dead but levo is the only treatment. When I ask about WHY my body is attacking itself, she has no answer and just says I'm reading too much and to be patient with the levo. She won't test for food allergies or any other deficiencies. I have been reading all about this disease and have been gluten free on my own for less than a week and have already lost weight with reduction in the swelling and stomach issues. I also tend to have a UTI or blood in my urine at every regular doctor visit this past year and wonder if that has something to do with it. They ignore the blood and usually put me on an antibiotic for the uti. But it does make me concerned that there is more to it than just a gluten sensitivity. Thanks for your story and allowing me to share a synopsis of mine.

    • ARCK says:

      Hi – I was on synthroid and then eltroxin for Hashimoto's and tolerated it poorly. My skin was incredibly itchy at one point the skin on my face was peeling off – long story short, I cut back my eltroxin (now on 1/4 – 1.2 of .05 per day) and I take a selenium 200 mcg per day. AND most importantly, I started treating my uncorrected adrenal insufficiency with Adrena Plus herbal combo. All these meds are contraindicated for adrenal insufficiency. I was having a horrible time handling stress and I'm a pretty solid person. For a month I stopped all meds, got my adrenals on track (added B complex at the beginning and I take it now and again if I'm feeling jumpy). I sometimes wonder if I have a mix of Hashimoto's and Graves because I feel hyper thyroid too. It is frustrating that it takes so long to find solutions.

  29. Valerie Kwietniak says:

    I was diagnosed with Wegeners's Granulomatosis in 2002. I was treated with Cytoxan and Prednisone, I relapsed in 2003 and in 2004 put on Methotrexate, in the fall of 2004 I got on an elliptical for two minutes, a year later 45 minutes, a year after that 1 hour. From the beginning I looked at this terrible disease as my teacher; I learned extreme self-care and never looked back. I've been in remission for six years. Today I'm healthier than I was before the illness!

    • Constance says:

      Can you please tell me what an elliptical is as I too have Wegeners and have never heard of that . Thank you

  30. sarsm says:

    I found your article really interesting. I would love to find a doctor who would look at these issues for me.

    I have asthma (since my childhood), Crohn’s disease, IBS and now apparently the start of arthritis.

    I have had three burnouts, shingles twice and various other problems.

    I take immune suppressants.

    I have a known peanut allergy but I know I also react to many other foods. I can’t seem to cope with a lot of vegetables and all of the healthy wholemeal stuff gives me such bad stomach cramps I am doubled up.

    I’ve tried completely removing dairy etc from my diet, but it didn’t change anything. I’ve tried vitamins/supplements and probiotics and they do help but only for a limited time.

    I have a very stressful life my son is autistic and has many health problems and I also have three other children two of whom also have conditions.

    I have no family support (apart from that from my very lovely husband) which means it’s very exhausting.

    I keep trying things to try and help myself, but I feel lost. On top of that it’s hard to find time to look after myself because the children have such enormous needs, and there are regularly situations which just cannot be left.

    I’ve also tried therapy, physiotherapy, massage.

    • Leah says:

      Another suggestion is NAET. It has worked for me and my daughter. I had CFS and she had multiple allergies. It turned out I actually had lots too but didn't realise. It is a process but we are both 80% better than we were. The practitioner has also ben a huge support to us both.

    • Deb says:

      I've been doing the IsaGenics program. I have lupus, but no swelling issues, mostly pain in my joints. A friend also with Lupus introduced me to this product – for some reason it really works for people with autoimmune. It provides you with a complete meal with a whey protein. My husband is really skeptical about these kinds of programs and researched it. My friends Dr said this was a really good product. Could be worth checking in to. Have read successful feedback that includes Chrone's, IBS, and arthritis. If my statement gets approved and you see this, I wish you luck!!!

  31. Connie Matthews says:

    Dr., how or what kind of questions do you ask to find the type of Dr. that does this kind of treatment? Is the Dr. a Natural pathic or D.O.?

  32. Janet says:

    I have just recently achieved a state of being fibromyalgia pain free after a long journey of 17 years. The success came about when I finally approached fibromyalgia as a food allergy issue *and* that my diet (SAD at the time) was causing inflammation. By eliminating wheat and dairy, then following a paleo *and* low FODMAP diet with the goal of managing my blood sugar and IBS symptoms. The final touch was adding bone broth, and digestive enzymes to my diet. I am not pain free, as now the only remaining pain, is due to degenerative arthritis in my spine, but I was actually unable to realize this because I had so much pain all over from fibromyalgia that I could not tell the difference! I now have a lot more energy, no more brain fog, and just over all feel so much better.

  33. Nicky says:

    WOW! Finally someone that gets it. I was bed ridden and frustrated, doctors got mad at me when i finally said no to all teh drugs that numbed the pain. Finally was diagnosed with R.A and auto immune disease. I did a bit pr reading and talking to others and noticed that food played a big part, So I made a drastic change. I quit eating processed foods. I grow, can freeze and dehydrate my own food. I have figured out what restaurants have what I call safe foods, that will not upset my stomach ans send me into a flare up. When i cheat I pay for it. I garden, take care of my chickens have a few cats and a dog. Live in country and am moving to a cabin in the Ozarks. Staying hydrated is a big help. No soda unless you can find ones that have real sugar and not the other stuff. Only home made wheat bread. little to no carbs. It is not an easy diet, but beats being bed ridden and in pain all the time. My flare ups are only once or twice a month and not as bad. I do still take one of the meds from the doc. but only 1/2 and 1 time every 2 weeks. The other meds I dot like how they make me feel. make me worse cause i cannot eat at all on them. I am determined to live the best life i can for as long as i can and live my dream as long as i can.

  34. Mojo says:

    Been through the gamut with my sister. This info and responses are all too familiar. Making most sense now – HISTAMINE INTOLERANCE. Google it.

  35. viviana rodriguez says:

    I was sick a lot as a child. I remember always seeing mold n our apt when i was little. I was always feeling drained, even in my teens. I was diagnosed w lupus, sjogrens syndrome and fibromyalgia. I hurt everyday, especially my lower back along w my sciatica. My mother is staying w me to help. She is 63, I’m 31 and she has way more energy than I do!!

  36. Stu Heck says:

    I'm somewhat surprised that this article didn't address the role of nutrition in inflammatory issues and autoimmune problems. The average American diet – full of "factory food" – disrupts organ function and affects mental performance from many perspectives, which creates a vicious cycle from which many do not recover. There's a wonderful book – "The Schwarzbein Principle" – that lays out the problem and solution pretty clearly (in a nugget – EAT REAL FOOD). It was ahead of its time when first published about 15 years ago. It would be good to hear from Dr. Hyman on this topic.

  37. acha2010 says:

    I was diagnosed with hypothyroidism in the mid-1990's and was instantly put on levothroid and later synthroid. In 2008 after still feeling like crap with my fatigue, my hair still thinning and still not being able to get to a weight that I thought was healthy for me I got off of the thyroid medication all together. Every time I went to the doctor to tell them an update on how I felt and to get my blood work done they just said well stay on the medication. I couldn't do it anymore and I told them that. If they weren't going to see that I still felt awful and the only thing being on synthroid did was give a regular period, but all other symptoms stayed the same I was done with them. I felt like I was being fed the attitude you have this and you'll take this little pill for the rest of your life. I'm not to be told things like that. I said thank you and no I won't. I have since been an awesome journey of healing. At that time I was already practicing meditation, yoga, and I am a massage practitioner. I started to educate myself on the mind/body connection and today I am not only healing myself but I can now give my clients a better understanding of the importance of mind-body connection. Thank you for sharing this wisdom. ~Jennifer

  38. Merryl says:

    My experience is that most mainstream medicine seems to complicate autoimmune problems rather than solve them but can be a necessary adjunct to the complete healing process. I was first diagnosed with an autoimmune illness 38 years ago and have gone through a series of different kinds of autoimmune illnesses since then. The only treatments that work are those that deal with the underlying causes of STRESS, which can either be caused by the inflammatory responses taking place or the cause of the the inflammatory responses. Either way, food, exercise and rest coupled with getting into one's own rhythm seem to be the only clear answer to what comes up. Each person's path will be different and each of us must find what works for our particular body but as the saying goes, All Roads Lead to ROME.

  39. Meighan hanson says:

    I have had RA SINCE 2009. I went through the alternative treatment for 3 years and detox, vegan, green smoothies, Lyme titters, antibiotic treatments and never got relief. Now I’m on humira, methotrexate and prednisone. It’s not perfect and I get sick a lot, but I’m not in excruciating pain anymore. I’d love to have my health back. Suggestions?

  40. Jane Webster says:

    I found your article so interesting and inspiring….. is there someone in the UK who has similar methods to you? I would be so grateful to know…

    I am in London.

    Jane.

  41. Rachel says:

    How do I find a doctor who will know about these therapies and treatments and not just throw antibiotics at my 9-year-old daughter?

  42. JimJDukes says:

    My first indication of an autoimmune disorder was in 2002 when my eyes were attacked & my epithelial layer began tearing. I was diagnosed with Corneal Dystrophy by me eye dr. Who advised me that he thought my immune system was attacking my eyes. Then in 2008 I began vomiting & diarrhea with a great loss of blood. Put into hospital & diagnosed with severe pan ulcerative colitis. Went on Remicade infusions every six weeks after all oral meds failed. Diagnosed with Vasculitis in 2011 taking Prednisone for outbreaks, Dapsone 100 mg daily, & Clobetasol Propionate 0.05 % as needed. I have sleep apnea since 1998 & on CPAP. Type II Diabetes in 2003 on Metformin 1000 & insulins. COPD diagnosis in 2006. In July 2014 went on oxygen due to advancing COPD. Take probiotics, Gas-X, Fish Oil, & other supplements for Ulcerative Colitis. Doctors just keep giving me more med. I am a 66 year old white male who is obese & sedentary. That's a capsule of my health.

  43. liz bielich says:

    I was diagnosed with an autoimmune disease not specified and I was treated with Plasmoquin a malaria prophylactic. It helped for a while but not long term. Found your article very interesting. Thank you

  44. Diabeat says:

    Doctor Hyman, I read your article with interest but noticed that you did not mention type 1 insulin dependent diabetes. It seems to me to be one of the more common autoimmune disorders. I have had it for over 20 years; I have a strong family history, and I had dysentery as a child a few years before becoming diabetic. I know we are a cash cow to the pharmaceutical industry and the only way a cure would be released is if it's a medicine you have to take every day of your life, so they can keep making money. I am in good diabetic control and have a very good diet (almost all local organic produce, mostly vegetarian, nothing from a box, etc.) and exercise regularly, but of course I am still diabetic. Have you ever treated any type 1 diabetics?

  45. Bridgette says:

    I am a 33 year old mother of 2 school aged boys. My problem is that I have yet to be diagnosed with anything. I have been stuck in an endless cycle of lab work, thyroid ultrasounds and role out tests. Seven months ago I had to practically beg my primary care doctor to help me, and order some tests because of the weight gain, fatigue and body aches. All my thyroid function tests came back in range, but after more begging, she sent me for ultrasound of my thyroid where it came back as enlarged with some small nodules. Off to an endocrinologist specialist who ordered more tests, all back normal with an exception of my vitamin D, which was low. No RA, no Lupus. The plan was to just monitor the thyroid every 6 weeks with ultrasound and blood work and take a mega doses of Vd3. In the meantime, I started experiencing more symptoms – pain, swollen joints, numbness, brain fog and poor focus, disorientation at times, mucus cough/wheezing in the mornings, calf cramps, teeth are chipping, ear pain and ringing… and back to my check up of 7 weeks on 50,000iu of Vd3…more blood work that continued to show normal thyroid but now in addition to the vitamin d deficiency, my b12 and magnesium were low. She sent me to get a colonoscopy and upper scope, all normal – no colitis, crohns, celiac… My fatigue has gotten so bad, some days I cant get out of bed. I am at jeopardy of losing my full time job. I decided to get a second opinion and seen another endocrinologist. She's also following the same treatment plan as the first – only monitoring the thyroid function, on a ton of supplements (Vd3, magnesium, b12, calcium) and actually said all of my symptoms could be from me being overweight or sleep deprived. I laughed, as the weight gain isn't stopping, and impossible to lose, and I wish I can actually stay awake for more than 2 hours at a time without needing a nap. For the heck of it she ordered some A1C panels as I've developed some brown patchy skin changes to which she thinks is diabetes, some cortisol and parathyroid tests. All normal. She did want to look into the cortisol more and ordered the ACTH Stim test…Its just more and more tests with nothing to help me. The pain and fatigue are unbearable at times, and I've attempted to remain in good mental health, but as of lately I have started to feel a loss of hope to ever feeling better and finding an answer. On top of it all, I carry an individual health insurance policy for my sons and I, and the medical bills that have been piling up are becoming overwhelming. I feel I have lost faith in Mainstream Medicine practices and the US healthcare system in general. What I am going through, if its an autoimmune disease, I wish it on no one.

  46. Doris Forbes says:

    Wow! Never realized that being hypothyroid was classed as an autoimmune disease!
    Being hypo started in my late 30's the 1st symptons being kidney problems which went on for about three years , the doctor just gave ural powders and sent me on my way. After 3 years like this I then found suddenly all my energy was gone and took forever to do anything. I thought that maybe this was normal as you got older and put up with it. Many visits to doctor over this time. Then had all the classic symptons of a heart attack so scuttled off to the doctor and was laughed at and told it was probably a blood clot not a heart attack but nothing was done to check it out. Said that everyone was telling me my skin looked yellow but when I looked in the mirror it just looked brown to me. The doctor peered a bit closer & said it did look a bit yellow so sent me off for blood test for thyroid. I nearly died while she dithered around taking more blood tests to send to a specialist. He apparently had a fit and told her to get me on medication straight away. My metabolic rate was 0.01 normal was 22 to 26. Medication got me back to normal after a few months and was good for years until our thyroxine was tampered with. Govt got rid our medication and brought in the horrid eltroxine, known here in NZ as helltroxine. This was brought in July 2007 and so many of us throughout the country got extremely sick on this as the fillers used were the problem. Our immune systems were severely compromised. Glandular fever, always getting sick, swelling of feet and legs, fibromyalga were just a few of the problems we ended up with. Still got the swelling and fibromyalga getting worse and the hair loss, well am now on sythroid and have never gained back all my hair as apparently a side effect of synthroid is hair loss. just great! About 9 years ago I picked up a bug from a dirty guest house I stayed for one night and it got into my stomach and got very sick with that and then found it had given me IBS. I take probiotics for that off my own bat and helps with bloating and flatulence. IBS can swing both ways either constipated or diahria . cant remember how to spell that sorry. Still can be embarrassing though. Also I take iodine pills which help a bit with tiredness from thyroid and managed to get Vit D from doctor as cant go in sun as my feet swell up even more. Some things I would like to try I cant get as here doctors have a very narrow view and to find one who is knowledgeable about thyroid is like looking for a needle in a haystack.

  47. kaeli says:

    Hi. My 2 autoimmune diseases both kicked off after childbirth: thyroid from my first daughter and RA from my second. After taking NSAIDs, steroids and methotrexate for 2 yrs, gaining weight and still having flare ups I decided to do my own research into how I could improve things outside of the drugs the doctors insisted were the only cure.

    Research found online explained how foods could trigger autoimmune diseases so I decided to eliminate all key trigger food groups for 6 weeks……after 2 I was off all meds apart from methotrexate. The doctors response? Spontaneous remission. Coincidence.

    4 yrs later and I suffered from a flare up….why? Because I let the diet slip…happy to say it is back under control again! I have however developed an even stronger and dare I say violent reaction to wheat/gluten so wonder if I now have celiac disease too? I have eliminated it all from my diet now anyway so probs not worth being tested.

    Keep spreading the word. ..people need to know they can fix stuff themselves and don’t need to rely purely on medication.

  48. Fedup says:

    I agree with everything you have said but in the real world, I can't eliminate stress as I have to work. I am an anxious person who also suffers depression because go the stress. I believe my auto immune conditions were "triggered" by an extreme case of stress in my life. My conditions seems to worsen with age. How do you explain advanced arthritis type conditions??? I'm 45 and MRI shows my back is like 80 year old. I'm such a fussy eater to eliminate foods is even more "stressful"….what do I do? I wish someone could tell me how to fix myself rather than swallow all these pills…

  49. Richa says:

    Hi, I have Juvenile Rheumatoid Arthritis. I was diagnosed when I was 17 and I’ve been on immuno suppressants since then. This was almost a decade ago.

    My doctors have never bothered to figure out the underlying cause of the disease and mostly just kept me on a daily dose of steroids and Methotrexate.

    I am fairly active and I live in Delhi which means that I am in a developing country with all sorts of allergens and pollutants.

    I’m quite helpless when I have a flare and I would be more than grateful if someone could help me out with managing JRA.

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