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Nutrition and Autoimmunity

Fight MS with Food: How hidden food and chemical sensitivities lead to autoimmunity and Multiple Sclerosis

>p>©Elizabeth Yarnell January 23, 2011 All rights reserved.

It was a true Eureka! moment. I literally felt a light bulb in my head blink on as I re-played the animation on the web. “Did he just say T-cells? I think he just said T-cells!”

T-cells are a subset of white blood cells that are known to be the instigators of exacerbations in multiple sclerosis. Research for a cure for MS focuses on how to suppress the T-cells, or stop them from setting off an immunologic response once they have been mysteriously triggered. As the neurologist explained after my own diagnosis with MS eleven years earlier, no one knows why the T-cells in MS patients decide to attack the person’s own body when their job –as part of the immune system– is to protect the body.

I was watching animations created for medical students that explained how hypersensitivity reactions affect the body as I prepared to take the examination to become a Certified Leap Therapist (CLT) through Signet Diagnostic Corporation. The objective was to understand the immunologic effects on the body when it encountered allergens, or what the body might perceive as an allergen as tolerance levels decrease.

Signet offers a patented test that uses a blood sample to determine if common foods or chemicals incite a non-allergic (non-IgE) inflammatory response. This can include immune reactions by T-cells. A CLT is trained to interpret the results and design a safe diet and menus for the client to help avoid triggering these debilitating hypersensitivity reactions. This Mediator Release Test (MRT) and the complementary LEAP dietary management program are most often used to help cure chronic migraines, fibromyalgia, irritable bowel syndrome (IBS), and inflammatory conditions.

“No one knows what triggers the T-cells to act irrationally,” the neurologist told me. Theories include viral infections, overheating the body core (as in a hot tub), and vitamin D and/or omega-3 fatty acid deficiencies.

My own diagnosis had inspired me to be proactive about my future and research nutrition and how it links to health. I went on to invent and patent a quick, easy and healthy cooking method, become an award-winning author of a popular cookbook, Glorious One-Pot Meals, and speak around the country about healthy eating and how it helps those with and without MS alike have a better chance at a healthy life.

But what if… The light bulb in my brain was beaming insistently. What if MS was caused by sensitivities to common foods and chemicals? What if these kinds of reactions were causing the T-cells to behave irrationally?

I replayed the animation.

Type I Hypersensitivity

An allergy is an overreaction of the immune system to a normally harmless substance called an allergen.

The allergen enters the mucous membrane where it is taken up by the antigen presenting cell, which presents it to the T-cells. The T-cells activate other white blood cells to release IgE antibodies against the allergen.

The IgE antibodies bind with the allergen and release inflammatory chemical mediators like histamine, prostaglandins, and cytokines, etc.

These mediators cause inflammation. Antihistamines work by blocking the histamine receptors to prevent the symptoms of an allergic reaction.

 

He did say “T-cells!” He’s saying the T-cells make the determination that foreign substances are allergens. These allergic reactions cause inflammation.

So, in MS patients, maybe the T-cells aren’t actually acting “irrationally”; they could be reacting to something in that person’s environment. According to the animation, an allergen had a number of routes available for entry into the body, including the nose, by inhaling aroma molecules, and the mouth/stomach, by eating or drinking something. Of course, as our largest organ, our skin can be an entry point, too– just remember the last time you encountered poison ivy? That one contact with an allergen is enough to set off an immunologic response which manifests on the skin but also systemically makes you feel lousy as well as itchy.

Typically, an allergic reaction occurs shortly after exposure, as in cases of anaphylaxis after eating peanuts or shellfish, or contact dermatitis after touching poison ivy. Anaphylaxis happens when inflammation closes airways, while dermatitis shows up as hives, rashes, or general edema.

But, of course, we’ve known about IgE food-specific antibodies for a long time. Current allergy testing is focused on either how much IgE antibody is produced or on the size of the wheals created by food-specific skin testing. However, MS, though it is an inflammatory disease, has never been thought of as an allergic disease; MS patients don’t typically exhibit signs of anaphylaxis. But is anyone testing MS patients for food allergies?

Connections were jangling around in my brain, bouncing off of the more than one dozen lesions multiple sclerosis had already placed there. I couldn’t see the whole picture yet.

Perhaps IgE antibodies don’t tell the whole story. I continued with the next animation.

Immune Complex Type III Hypersensitivity

When antigens and antibodies bind together they form chains called Immune Complexes. While large immune complexes are easily eaten up by janitorial white blood cells, smaller immune complexes can escape.

These smaller complexes react with and activate complement, which causes inflammation. If the smaller immune complexes become trapped, the special forces clean-up crew arrives to release tissue-damaging enzymes.

 

Now it seemed more pieces of the MS puzzle were falling into place. An antigen enters the body and gets handcuffed together in a chain with antibodies to form an immune complex. Smaller immune complexes become trapped in tissues. The immune complexes attract neutrophils, which release other white blood cells and inflammatory enzymes that eat away at the surrounding tissues.

MS begins with an area of inflammation indicating where something is eating away at the myelin sheath surrounding a nerve. Myelin insulates a nerve the same way a plastic sheath insulates the fibers inside a power cord. When demyelinization happens, or the cord fibers are exposed and frayed, the flow of information (synapses) can be interrupted, causing an array of symptoms we associate with MS like loss of motor control, disturbed vision, and coordination issues. The body heals the wound on the nerve by immobilizing it with calcium, leaving the telltale plaque or lesion we see in the brain MRIs of people with MS.

Is it possible that smaller immune complexes land on a myelin sheath, causing what appears to be an autoimmune reaction but in fact is food-specific immune-complex-mediated hypersensitivity?

I remembered in that instant an August, 2009, Scientific American article my mother had passed along to me some months earlier about celiac disease. Written by Alessio Fasano, professor of pediatrics, medicine and physiology and director of the Mucosal Biology Research Center and the Center for Celiac Research at the University of Maryland School of Medicine, it explains the workings of celiac disease on the bowels.

Fasano writes that the smooth muscles of the bowels were always believed to be impermeable, paved as they are so tightly with cells that the scientific name is “tight junctions.” Like the tiles in a closely-grouted tile floor.

But, he continues, this is not true with celiac sufferers. The hundreds of biopsies of the bowel that he and his team have performed over the last two decades have shown him that the cells that line the bowel walls of celiac patients are swollen to the extent that the joints in between become loosened and permeable. Large particles pass through the bowel wall that shouldn’t, leading to a cascade of other physical issues. In other words, the inflammation in these cells cause a formerly smooth surface to become craggy and full of holes. Things can go through it or even get stuck on the crags, which further worsens the problem.

What if this happens to the myelin sheaths, too? What if the hypersensitivity allergic reaction caused the smooth cells forming the myelin sheaths to become swollen, and the surface to become craggy? The allergen-antibody pairs of smaller immune complexes could get stuck in the crags and attract neutrophils, since they have escaped the patrolling phagocytes whose job it is to sweep these immune complexes out of the body. As the neutrophils degranulate, they shoot enzymes at the immune complex in hopes of destroying it, but since it is stuck in or near the myelin sheath, the enzymes eats away at the sheath as well.

Hmmm… things were clicking quickly through my brain. There have been many studies of MS sufferers that look for correlations to predict probability of contracting the disease, but the most they’ve been able to determine is that there are higher rates of MS for people who spent their childhood above the Mason-Dixon line than below. In other words, they don’t know much about who gets MS, why, or what triggers it.

Scenes from a 1995 Julianne Moore movie called “Safe” flashed through my mind. In this film she portrays a homemaker who develops multiple chemical sensitivity (MCS), a controversial diagnosis for when a person becomes so highly sensitized to chemicals in the air, water, food, etc. , that they cannot live in our modern world.

In the movie, Julianne slowly begins to develop unpredictable and strange bodily reactions, such as persistent fatigue, uncontrollable coughing (when surrounded by truck exhaust while driving), asthma-like symptoms (at a baby shower), nose bleeds (when getting a perm at a hair salon), vomiting, and eventually convulsions (at the dry cleaners).

In 2001, when trying to get rid of the persistent, daily hives (urticaria) that plagued me for three years, I visited an allergy specialist at National Jewish Hospital. While he couldn’t help me through his IgE tests (which revealed that I was reacting to all but 19 of 250 substances tested), he did teach me about tolerance thresholds.

We each have a tolerance threshold, he explained, and for some reason I had crossed mine and now my body was reacting to everything. His suggestion was to take a daily antihistamine to keep the hives at bay.

That sounded like a Band-aid, to me; not a solution for reclaiming my health.

Our overall tolerance threshold can be filled by the toxins we eat and drink, the pollution in the air we breathe, the chemicals we put on our skin and hair which absorb into our body, the synthetic additives we eat in our food… In short, everything we do in modern life contributes to our toxic load.

Everyone’s tolerance threshold for his or her toxic load is different, and the ways that crossing the toxic threshold manifest are different, too. Perhaps the reason why more people have chronic issues now than ever before is because the deck is loaded against us from birth. The Environmental Working Group has found that the average newborn shows traces of 250 toxic contaminants in their cord blood; we are doomed in the womb, to some extent.

But, as far as I knew, none of this MS research had shown any allergy-related correlations between the thousands of patients surveyed, and no one was reporting immediate MS exacerbations after eating a peanut, for example. There was still something missing. I watched the final animation.

Delayed Type IV Hypersensitivity

A subset of T-cells react with a small molecule from the antigen, called a hapten, that binds to a carrier protein. They activate and release mediators such as cytokines, resulting in inflammation. Symptoms may appear after 24 hours and reach their peak at 48-72 hours after exposure.

 

This presented an exciting development. Type IV hypersensitivity reactions that cause an inflammatory response can be delayed by three days or so after the exposure? That would make it extremely difficult to pinpoint what it was that caused the problem. Since these reactions are also dose-dependent and patient-specific it’s even more likely that the original irritant could remain a mystery to most people.

It is called “oral tolerance”: how much of a substance your body can safely eat before triggering an immunologic reaction. Oral tolerance, like the toxic threshold, is an individual matter. What is fine for one person could cause problems for the next, but maybe only if they eat it twice in a row or a lot at one time, or maybe just a minuscule amount is enough to set things off.

I was studying these materials from Signet because we had finally discovered their Mediator Response Test (MRT) when my 6-year old’s abdominal x-rays showed fecal matter backed up throughout his colon. His history of spontaneous vomiting and chronic constipation was well known to us, but all the useless therapies from the medical community had failed to solve or even mitigate the severe constipation problem. He was suffering.

The MRT showed my son was sensitive to 41 foods and common food additives and chemicals. Eliminating these substances from his diet had profound effects not only on his toileting efforts but also in almost every aspect of his life. Within 2 months he had grown more than 2 inches and gained 15 lbs. His tantrums dwindled and he became a significantly happier person. It was life changing for the entire family. I wanted to be able to offer the same relief to help others, so I was earning my certification through Signet.

The other parts of Fasano’s article that I found eye opening were his interpretations of how autoimmune diseases, like MS, related to his research on celiac patients:

“Indeed, a growing body of evidence suggests that virtually the same trio of factors underpins most, and perhaps all, autoimmune diseases: an environmental substance that is presented to the body, a genetically based tendency of the immune system to overreact to the substance, and an unusually permeable gut.”

 

I realized that my doctors had been asking me the wrong questions about my family history. While no one in my family had ever had MS, if you included autoimmune diseases and other forms of chronic inflammatory conditions the list exploded. Migraines, fibromyalgia, Crohn’s disease, topical dermatitis, and IBS on one side, and Scleroderma and Gilliam Barré syndrome on the other.

It seemed to me that MS could be a result of one or more simultaneous or consecutive hypersensitivity reactions due to the introduction of one or more environmental stimuli. If this is true, then like Fasano said, you can eliminate the symptoms by removing the environmental stimuli.

Could it be that easy to solve MS, a disease that afflicts 250,000 Americans and confounds the many researchers holding millions of dollars of funding who are actively searching for a cure? Could you simply eliminate the offending stimuli and avoid the whole immunologic reaction cycle to begin with?

How was it possible that no one had made this connection before? Yet, so far as I could tell, it wasn’t being seriously considered, or no one had looked at it enough to make an inroad into the desperate MS community, anyway.

Most MS research focuses on drugs that will stop the immune reaction by suppressing the immune system (so that the T-cells don’t react) or affecting the T-cells in other ways. These drugs are patented and marketed, and reap billions for drug companies. Medical doctors often dismiss nutrition and may never have taken a single course on nutrition in medical school, and they are the ones who propose research projects for funding. When Fasano and his team announced that a leaky gut contributes to celiac disease and autoimmunity in general, they were met with “great skepticism” in the medical community. A decade later, there has been grudging acceptance that food does play a role in health for people with celiac disease and there has been more interest than ever in nutrition, yet it is still considered fringe thinking.

But I was interested in food and how it linked to health, and had been studying nutrition for a decade at this point. I decided to start my own research study. The Fight MS with Food project exists to explore the link between undiagnosed food sensitivities and multiple sclerosis. A social entrepreneurial endeavor, its goal is to empower MS sufferers to help themselves avoid MS attacks, and hopefully even heal the underlying digestive disorders leading to a loss of tolerance in the first place. Clients enroll with a financial commitment to reinforce the value of the effort, but fees will lower to help defray the costs when donations and/or grants arrive. A database tracks many aspects of client progress to assess the validity of the approach. So far, though early, results are promising as every MS patient has shown improvement or cessation of MS symptoms.

When I awoke blind in my right eye that morning in 1999, two scant weeks before my thirtieth birthday, I never imagined that the devastating diagnosis of multiple sclerosis would lead me along a path toward helping myself and so many others. Multiple sclerosis forced me to take a close look at how I was living my life and make some fundamental changes that have led me back toward robust health. Sharing this information and watching other people reclaim their health simply by changing their diet has turned my own diagnosis into a gift for myself, my family, the tens of thousands who use and love my cooking method and are healthier for it, and hopefully, the MS community as well.