The Root Cause Of Autoimmune Disease & The 10 Steps To Help Reverse It | Dr. Mark Hyman

What we see now is a total epidemic about immune disease that is being completely misunderstood. 80 million Americans, some estimate 100 million Americans, who have an autoimmune disease. If you collectively take all the autoimmune diseases together, combined, it's more people that have cancer, heart disease, or diabetes combined. Wow, okay. So how come we don't hear about it? Why? Because every specialty has their autoimmune disease. You've got the neurologists, you've got MS, you've got the GI my doctors have got colitis, you've got the rheumatologist, we have rheumatoid arthritis, you have the dermatologist, we have psoriasis, and I could go on and on. You've got the thyroid doctors who've got Grave's disease or Hashimoto's. So essentially everybody's siloed. The problem is that autoimmune disease is not a bunch of really different diseases. It affects different people differently, but there are common principles that we can use to address the causes and get people healthy. So this is really an epidemic and it's getting worse and worse. And by the way, this is not something you see in countries that really living in ways that are traditional. For example, I just got back from Mongolia on a horseback trip. There was nothing there. I mean, they were living in Eden in the way that they had done for thousands of years. There was no cell service, there was no Wi-Fi, they were living in Earth, they were having yak milk, and they're living close to the Earth, they're living on the ground, they're living in dirt, basically. And these people don't get autoimmune disease. If you look at traditional hunter-gatherer tribes, they don't get autoimmune disease. They don't get allergies, they don't get asthma, they don't get autoimmune disease, and yet in our Western society we get a lot of these problems, allergies, asthma, autoimmune diseases, skin disorders. I mean, we just see it left and right. So the question is why? Well, it's because something has dramatically changed in our modern world. We're going to get into what those things are, but we're just seeing so many people with autoimmune diseases and the rate of these diseases is going up. as infectious disease went down. And there's some connections there we're going to talk about. So we're going to talk about the main causes of autoimmune diseases. And yet we know a lot of what the causes are, even though most traditional doctors don't treat the cause. They simply use medication to suppress inflammation and suppress the symptoms, which can make people feel better in the short run, but don't actually deal with the problem. It's like taking morphine and having a broken ankle and being able to walk on it. It still kind of works, but not the best idea. And yes, sometimes it can prevent more complications, more serious consequences of autoimmune disease such as joint destruction or kidney failure or other things. So it's not that medications are all bad. It's just that if there's a better way, let's talk about it. So we're going to talk about the conventional versus a functional medicine approach. I'm going to tell you a story about a patient who I had. It's just remarkable and if I'm not making this up, which I'm not, and if this is true, which it is, Then what are the implications of this story of this young girl who suffered from one of the worst autoimmune conditions I've ever seen and her recovery? If even one case could get better using a different approach than we currently use, shouldn't we be spending billions of dollars studying it? No, we're not doing that because it's not a drug. And yes, the biggest Profit Center for many of the pharmaceutical companies are these autoimmune drugs. It costs about 50 grand per person per year, sometimes more for these medications. So let's kind of take a step back and let's talk about what is autoimmunity, what causes it, and why should we be so concerned? Well, autoimmune disease, like I mentioned, things like rheumatoid arthritis, psoriatic arthritis, lupus, type 1 diabetes, Graves' disease, Hashimoto's disease, multiple sclerosis, Crohn's disease, colitis, I mean, the list goes on. are all diseases where the body is attacking itself. The immune system is out of control. It creates systemic inflammation and depending on your genetics and the various issues you have, it attacks different parts of the body. But essentially the process is the same where we create autoantibodies. We create antibodies which are normally designed to fight infection or even to kill cancer, We create antibodies to then attack our own tissues, and that's when we get into trouble. So basically, we have this run of inflammation. We have an immune system that's confused, and our immune system is supposed to empty up when we have foreign invaders like an infection, or when we have cancer to kill the cancer, and that's good. Or when we're maybe trying to deal with our gut and creating antibodies to different food things that are in there, although that usually is because of a leaky gut. And so basically your immune system is your first line of defense, but when it goes awry, it causes widespread destruction in the body and your own cells and tissues and organs get caught in the crossfire. And it's not a good thing. It's just not a good thing. It's good when it comes to dealing with cancer, when it comes to infections, we want that. What we see now is a total epidemic about immune disease that is being completely misunderstood. In fact, now there's even a conversation about pre-autoimmune disease that a lot of people are seeing positive levels of ANA antibodies, which we test for at functionhealth.com, which is a testing platform where you can order your own test essentially and get the results and have an interpretation and figure out what's going on. So we're picking up a lot of people, probably 30% of the people that we see just young, various healthy people, not really sick people generally, are showing up with an elevated level of an antibody called anti-nuclear antibody, which is an early sign of autoimmune disease. So this is really scary to me as a doctor. So the question is, you know, why is the body doing this? What is the root cause? You know, most doctors, when they think of a patient, they essentially go, well, here's the symptoms, here's the lab test. Okay, you have these tests, you have these symptoms that are off. It means you have this or that disease. We name the disease, and then we blame the name for disease with a problem. Now, this young girl, Isabel, I was talking about before, she came to see me when she was 10 years old, and she had a severe autoimmune disease called dermatomyositis. Dermatomyositis is nobody's best friend. Essentially, it's one of the worst autoimmune disease you can have. Everything, your joints, your skin, your liver, your blood vessels, your muscles. I mean, pretty much everything gets affected. And so you have widespread destruction throughout your body. Now, the doctors didn't say, gee, why is her immune so pissed off. Instead, they gave her a pile of drugs, steroids, cancer drugs to suppress her immune system. They're about to put her on an immune blocker called TNF-alpha, which is an antagonist, which is basically blocking the inflammation marker in the blood that's responsible for a lot of autoimmune disease, which can be helpful. But again, nobody was asking a very simple question is why is she so inflamed in the first place? Why is her immune system so pissed off? Now, as I mentioned, Isabel had one of the most severe cases of autisms I'd ever seen at 10 years old. She had severe skin rashes, that's the dermatitis. It's pretty much itis means inflammation. She had every kind of itis. She had vasculitis, which is inflammation of your blood vessels causing Raynaud's. She had gastritis causing inflammation of her esophageal tract and causing trouble reflux. She had hepatitis affecting her liver. She had inflammation of her blood cells. I don't even know what to call that, but she had low white count and low red cells. she had severe muscle damage, so she had myositis and very severely elevated muscle enzymes. She had also severe arthritis and joint swelling. So basically everything was under attack. Now this cute little girl, Isabel, was 10 years old. She was from Texas. She loved riding horses. She couldn't do the most basic things anymore. She couldn't squeeze her hand or make a fist. Her tips of her fingers and her toes were totally numb all the time from Raynaud's disease, which is the damage of the blood vessels. autoimmune condition. She had rashes all over her body that were irritated. She was exhausted. She felt miserable. Her hair was falling out. And, she was being treated by doctors who were doing the best they could, but were using the old paradigm. They were saying, okay, well, she's got inflammation. Let's get that under control. So, they gave her a huge dose of steroids, something called Solu-Medrol, which essentially a horse dose of 1200 milligrams intravenously. She has to go to the hospital and get intravenous steroids. every three weeks just to sort of be able to function. She was on Methotrexate, which is a chemo drug, because that suppresses inflammation. She was on also aspirin to thin her blood because the inflammation caused her blood to clot. She was on acid blockers because of the reflux from her stomach. She was on calcium channel blockers to help open up her blood vessels because of her Raynaud's. I mean, let's know she was on more drugs than I've seen even 80-year-olds beyond. and despite these mega doses of medication, she wasn't better. I mean, she was managed. You call it managing her disease. Her labs were all abnormal. Her skin was still inflamed. Her joints are tumbling. She just wasn't in the hospital, basically. And. And her doctors wanted to add another drug called the TNF alpha blocker, something like remicade or Humira. You might have heard about it. You probably saw the ads on TV because there's tons of ads for these drugs on TV. which is a whole other topic that farmers should not be advertising on TV. But anyway, basically this drug can be helpful but if you don't have anything else to do to fix the problem, but it increases the risk of cancer and also infections because it suppresses the immune system, right? So it turns off the inflammation and we need inflammation for cancer and infection but not for autoimmune disease or allergy, right? So that's the problem. Now, her mom was not happy with this plan, so she brought her to see me and we did a pretty A simple program. It wasn't that hard, but I asked a very different set of questions. I asked not, you know, what's the inflammation, but what's the cause? Not what's the name of her disease, but what's the cause of her problem? What's pissing off her immune system? And so that's the job of a functional medicine doctor, to be a detective, to look deeply into the root causes, and to try to understand why. And I always say functional medicine is the medicine of why. Conventional medicine, medicine of what? What disease do you have and what drug do I give? Not why. In fact, I always say just because you know the name of your disease, it doesn't mean you know what's wrong with you. Say it again. Just because you know the name of your disease, let's say dermatomyositis, it doesn't mean you know what's wrong or what's causing it. Dermatomyositis just means skin and muscle inflammation. because those are the two most prominent symptoms. It doesn't mean anything. It's just a fancy medical word describing the symptoms, nothing to do with the cause. So functional medicine gives us a map to help understand why, to understand inflammation. I often call myself an inflamologist, and that's what we should be, inflamologists. And in fact, inflammation, autoimmune diseases is a real issue and obviously an allergy and asthma, but also in heart disease and cancer and diabetes and obesity and dementia, pretty much all the age related diseases are all disease of inflammation. In my book, Young Forever, I did talk a lot about how one of the hallmarks of aging is inflammation or what we call inflammation. So when we look at the causes, how do we start to think about causes systematically? How do we have a organized approach to diagnosis about what is causing the body to react to something? Now, what we really know is that the body is not really attacking itself. on purpose. It's trying to do the job that it's supposed to do, which is fight bad things, right? Bad things. What are the bad things? Allergens, bugs, microbes, and mostly imbalances in your gut or your microbiome. We'll talk about that. Toxins and, you know, also stress and poor diet also drive inflammation and psychological stress, physical stresses. But, but basically, there's really five causes of almost all disease, allergens. and that can be a food sensitivity, it can be a true allergen, like a peanut allergy, it can be microbes, it can be something like, you know, Lyme disease or hepatitis or anything like that. Plus it can be just dysbiosis, imbalances in the floor and the gut. It can be toxins, petrochemical toxins, environmental toxins from pesticides, herbicides, plastics, as well as heavy metal toxins, flame retardants. I mean, the list goes on and on. So in fact, there's a whole school of research now on what we call auto-gens, autogens are environmental toxins that trigger an autoimmune response. So all these factors need to be investigated. We need to look at each person, say, hey, do they have any allergy stuff? Is there gluten sensitivity? Are they harboring latent infections that might be confusing their immune system? Or do they have a toxin like heavy metals or pesticides? What's their diet like? Are they eating an inflammatory diet? How much stress do they have? All these things need to be considered and need to be investigated. And that's really what functional medicine does. It helps you investigate. the root cause. It's really a diagnostic model to think about an operating system to think about the body as a system, to think about root causes, and to help the body restore balance. That's the goal. So basically, you got to figure out the cause. If you want to fix autoimmune disease, you got to get to the cause. And, you know, unfortunately medicine, we don't do a good job at that. We get a little bit of that, but not much, right? If you have pneumonia, it's caused by streptococcal infection. okay, you give penicillin, that's fine. But most diseases, chronic diseases, which, by the way, six out of 10 Americans have, which are accountable for over 85% of our health care costs, which are now 4.3 trillion dollars, yikes, caused by an infection like streptococcal pneumonia or, you know, hepatitis C. I mean, those are real. They need to be treated. But that's not really the majority of problems people are seeing. So functional medicine docs really understand the body of the system. It's an ecosystem and we seek the cause, we understand the basic interactions between them, we know when things go wrong, how to fix it, and understanding the interconnections between symptoms and organs and systems rather than all these specialties. You know, I always say, I don't really need to know anything about the fine points of a particular autoimmune disease or be a specialist in that. area, but I need to understand inflammation and I need to see the root causes. And I can treat, I've never seen a case of dermatomyositis in my life other than, you know, with traditional medicine care when I was in residency and early practice. But as a functional medicine doctor, I never treated one before, but I knew exactly what to do because I followed the methodology of functional medicine. It provides a fundamentally different way of solving medical problems, gets to the root of the illness, and understand the disturbances that really are going on. So let's talk about Isabella a little bit more. So she, you know, I've seen good doctors and their response was to let's shut down this kid's immune system. Let's let this kid suffering. Let's just throw the whole kitchen sink, the whole barn, everything. And that would have been okay. She might have done improvements in her symptoms, but she would have had a high risk for cancer, infection, osteoporosis, muscle weight things, psychiatric illnesses. And by the way, would have cost a huge amount of money forever, right? This is a 10-year-old girl. She's going to be on a drug that costs 50 grand a year for the next 60 years. You do the math. That's one person. So we're talking about it. It was an untenable thing. So I asked really a simple question with Isabel, which is why I didn't focus on what the name of the disease was. I want to know why she's inflamed. Inflammation started. How we can really find the root causes and how we get to restore balance in her immune system. So it's not just not finding the cause. It's also understanding how to get the immune system working better, taking out the bad stuff. putting in the good stuff. So some insults usually are triggering some confusion. We call it molecular mimicry. There's a theory about molecular mimicry that, for example, some food you're eating or gluten somehow confuses your immune system and it thinks your thyroid is some foreign object, but it's just cross-reacting with the gluten antibodies and that's why you end up with autoimmune disease. So we were looking for toxins, we're looking for allergens, we're looking for bugs. her dysbiosis. And by the way, a lot of autoimmune disease starts in the gut and a lot of it starts what we call leaky gut, which clearly she had. So, when I kind of did her history, I very detailed history is really important. She had to find out what the story is, you know, not just oh, here's your disease, but like what is your background, right? She had exposure to severe toxic mold and that can be a trigger, that's a toxin. Stachybotrys is black mold and that was in her house and her mother also worked in Limestone pits when she was pregnant and she's supposed to a lot of toxins and fluoride, even heavy metals. And she also also had her immunizations before 1999. And before 1999, the American Academy of Pediatrics and the CDC had not removed primers from the vaccines for childhood vaccines. So they're getting a lot of, like, 167 times the amount of mercury in the vaccines. They tell me, oh, wait a minute, we haven't added it all up and it's a lot of mercury. We've never gotten out. So they did movement except for flu shots. And so, if you're getting a multi-dose file flu shot, which is what most people get, single dose doesn't have climaerosol, but it's a preservative. So, when you stick the needle in over and over, you got a multi-dose file, you use it. But, it's in the flu shots. So, she was getting flu shots every year. And, she also loved to eat sushi. So, she had large amount of tuna, sushi which she ate regularly, adding more mercury. She also had a diet that was very high in sugar. lots of dairy. She also had many infections over her life, ear infections, sore throats, because she was on a lot of immunosuppressive drugs too. And steroids also caused problems. She had lots of antibiotics. So, lots of antibiotics, lots of steroids, which causes real damage to the gut. So, mold, mercury, antibiotics, sugar, dairy, gluten, junk food, all were potential irritants. So, when I dug in, I looked at her lab tests pretty carefully. and, you know, the conventional labs, they were a mess, right? So they were, you know, high levels of muscle enzymes called CPK or liver function tests were off the chart. She had many autoimmune antibodies that were not just slightly high, they were off the chart high, like highest I've ever seen, anti-nuclear antibodies, rheumatoid factor, anti-SSA or Sjogren's antibodies, anti-double stranded DNA, anti-RNP, lupus anticoagulant, a lot of big mumbo jumbo medical terms, but basically the whole soup of autoimmune antibodies were just off the chart with her. And by the way, most autoimmune specialists do not check antibodies after the initial check. They go, oh, they don't ever go back to normal. Well, no, they don't if you don't get rid of the cause. But they do if you get rid of the cause. And we saw that with Isabel. So she had also a lot of problems. She had lots of elevations and other markers of inflammation like c-reactive protein. Her white count was really low, her red cells were low, her vitamin D was severely low. She had really high antibodies to gluten, which by the way is a common cause of autoimmune disease, probably the most common and can trigger significant inflammation and leaky gut. Her mercury level, we did a challenge test, was off the chart. And the only way to really check is to actually give people a drug that pulls out the metals like the MSA. And she had a level 33, normal is less than three. So it was very high. And at the first visit, I simply didn't do too much. I just put her on an anti-inflammatory elimination diet with no gluten, no dairy, no sugar. processed foods, got rid of the most common allergens. I gave her multivitamin, I got her vitamin D, I gave her some B12 and folate because of the acid blockers blocking that I get fish oil, which is anti-inflammatory evening primrose oil, which is anti-inflammatory so I kind of gave her some basic nutritional support and also gave her an antifungal, a nice stat. It's not absorbed, but it's used to treat yeast overgrowth. And I suspect that she had that due to the multiple course of antibiotics. do the serach she's been taking, also give her liver support, something called enacyste, supported liver and boost glutathione. And I told her parents, she should probably over time she's fine, she should taper off her acid blocker, the calcium channel blocker, her Raynos, and the steroids if she could. Two months later, she comes back and, you know, I didn't know what to expect. Two months later, she came back and she said her symptoms were completely gone. Her rash was gone, her joint pain was gone, her hair was growing back, her muscles weren't hurting. There was an offer medication. her autoimmune markers were much, much better. Her muscle enzymes, her liver function, her C-reactive protein, all normal. Now, this is just two months. Then I added probiotics to help her digestive system heal a little bit and reduce the inflammation. I got her an achEating drug called DMFA to bind the metals from her tissues and help her to read it and help get off the prednisone. I gave her some herbs to help her adrenal glands because she was in a lot of steroids. and she tapered those down. Several months later, everything was normal. All of her lab tests were normal, including her white count, her liver function, her muscle enzymes, the autoimmune antibodies, except for one called RNP, but every other autoimmune antibody that we mentioned that were off the chart, ANA, rheumatoid factor, all that stuff, completely normal. Never see that, right? Her mercury came down from 33 to 16. After 11 months, her mercury came down to 11. Her gut inflammation was gone. Oh yeah, she had a lot of gut inflammation. Even though she didn't have digestive symptoms, she had a test that we look at stool testing. And, why would I look at stool testing for an autoimmune patient? But basically, every autoimmune patient should have a stool test, right? We use GI effects by Genova. Essentially, look at Calprotectin, which is a marker you can actually get at a regular lab quest or lab core. And, Calprotectin is a marker of gut inflammation. that is super important because it's used for colitis or Crohn's disease. But if you have just slight elevations, it all indicates a low level of inflammation. So really, really important. Now, after a year, she was off all her medications. Her labs were normal. She felt great. She was able to ride her horse again to show, and she was just so excited. And, you know, I checked in with her, like, many years later, and she was great, and she was still fine. And we fixed the problem. So you get rid of the cause. It's not like stuff keeps coming back. Now, I've treated autoimmune disease for decades this way, and I've seen patient after patient we've got resolved, not everybody 100%, but the majority get better if not cured. Now, her case really isn't rare, and I take a similar approach pretty much with all autoimmune disease. You have to be detective and be an immunologist and what's going on. Now, if what I'm saying is true, like I said before, this should be a major effort from the NIH and the US government and private donations to actually fund research to look at this in a different way. But, everybody's in their silos, everybody's got their specialty, nobody's thinking of the body as a whole system. Even at Cleveland Clinic, when we did research looking at psoriatic arthritis, rheumatoid arthritis, comparing top rheumatologists there to our clinic, the functional medicine doctors, our patients did better in terms of all the objective metrics and the scoring systems for rheumatoid arthritis and psoriatic arthritis. So, I think this is really possible. So, what are the 10 steps to think about to reverse autoimmune diseases? Well, It's really, really easy. First, take out the bad stuff and you have to find it all. And so for Isabel, it was a lot. It was mold, it was mercury, it was yeast in her gut, it was gluten, it was heavy metals, all the stuff. And they have to add back the good stuff. We add back the good stuff, all the ingredients for good health, right? Whole foods, right? Levels of nutrients, the balance of hormones, light, air, water, movement, connection, meaning, love, purpose. all these things are really essential ingredients for health. So if you have an autoimmune disease, I really encourage you to find a functional medicine doctor and work with them. We see patients at the Ultra Wellness Center. Check your labs out, try functionhealth.com, get your panel done. You can see if you have pre-autoimmune disease or other markers. And I think you'll be able to really move forward. So what do you need to do? First, get tested for hidden infections. Now, there are a lot of things that can go wrong. When I say infections, it can also be dysbiosis, which is imbalances in the gut flora. that cause gut and cause damage where, by the way, 70% of your immune system is in your gut. So if there's a damaged gut lining, you're getting food and bugs leaking in, your immune system's getting seeing that, it's like, ah, that's bad. Let's create an immune response. And that's essentially what happens. But that's probably the most common cause. Gluten is a big factor in causing leaky gut. It's probably one of the biggest factor because it increases something called zonulin, which disturbs the tight junctions in the cells that hold them together and allows the and bacterial proteins and things that leak in. But other things, any factors too. You can have a parasite. For example, parasites are associated with rheumatoid arthritis. It can be Lyme disease, which has been linked to autoimmune disease, other tick infections. You need to be a detective and be able to figure that out. Check for heavy metals, check for environmental chemicals, really important, like mercury. Fix your leaky gut, really important. That's so important. I think we just talked about leaky gut, but get rid of the bad bugs, the cheese, parasites, bad bacteria. provide that this program that you need to actually heal your gut. We call it a 5R Program in Functional Medicine, which is removing the bad stuff like bad foods and inflammatory foods and allergens, bad bugs, and then replacing things that are missing like digestive enzymes or prebiotics, reinoculate with healthy bacteria, probiotics, repair, which is provide the nutrients for gut lining healing, for example, glutamine, zinc, and fish oil, and evening primrose oil, many other compounds are really important, vitamin A for healing gut. And then the fifth R is restore, which is to reset your nervous system and that means dealing with stress differently. So super important. So make sure you check that. Also, if you think you have an autoimmune disease or you think you might, you 100% wanna get checked for celiac and you wanna look at gluten antibodies, anti-gliadin antibodies, as well as tissue transglutaminase antibodies, IgA and IgG for both. And we'll put this all in the show notes, but it's super important as a screening test. And even if you don't have full-blown celiac, there's non-celiac gluten sensitivity, so you may have even with levels that don't approximate a level that would be considered celiac, actually you might still have a lot of reaction. So that can be important. Also, I encourage people to try elimination diet as a first step. And I wrote something called the 10-Day Detox Diet, really important. And I wrote this because I saw so many patients in my practice who are struggling with various autoimmune diseases, gut issues, metabolic issues, pre-diabetes, weight issues. And by far, this is the most powerful therapeutic tool that I have in my arsenal, which is basically an elimination diet getting rid of processed food, sugar, dairy, gluten, grains, beans, nuts, and seeds and things you can have, but the other things you can't. So, it's basically lots of veggies, protein, not sugary veggies. And, and it's quite healing and powerful. I encourage people to try that. It's super low cost, super easy to do. We're going to put a link in the show notes to my book, the 10-Day Detox Side, which you can follow as a cookbook as well. Also, you can take things that help calm your immune system down, making sure you're on the right nutrients. Vitamin D is essential for autoimmune disease prevention. If you have MS, for example, we know you'll have low levels of vitamin D and link to MS and other conditions. vitamin D, fish oil, vitamin C, probiotics, a lot of things are available and you can find them all on our online store at store.drhyman.com and complementary herbs can work great. So curcumin, Boswellia, ginger, you often use a product called Zyflamend, Z-Y-F-L-A-M-E-N-D, which is a combination of different herbs, also known as inflammasome, can be very helpful. Regular exercise, very anti-inflammatory, dealing with stress, very anti-inflammatory, so meditation, yoga, deep breathing, sleep is super anti-inflammatory, you get eight hours every night, super important. So, these are just sort of high level thinking, but this is not hard for most people. Most of the time you don't need a doctor, although sometimes you need to do some investigations like a stool test, heavy metal test and so forth, food sensitivity testing. But I encourage you to really not accept the traditional view of autoimmune disease and to actually start to take ownership by digging into the root causes. So no matter what autoimmune disease you struggle with, get deeper into it, figure out the cause, work with a functional medicine doctor. You can go to ifm.org and look in your area with a good functional medicine doctor. You can get my ebook. It's called the 10-day detox autoimmune solution. Give you a basic free framework of how to think about it. If you love that last video, you're gonna love the check it out here. We see as we age is a diminishment and a decline in the number and the function of our mitochondria and the health of mitochondria. That's why one of the hallmarks of aging that I talked about in Young Forever is dysfunctional mitochondria. And so, key to understanding longevity.