The Five Stages of Autoimmunity
In this series of articles, I am exploring the Autoimmune Spectrum.
If you have been diagnosed with an Autoimmune condition, I am sorry to hear that. I encourage my patients to think of a diagnosis as a description (or label) for a complex process.
It is a good start, but a diagnosis rarely describes the severity, momentum, and degree of immune system reactivity.
In the previous two articles I discussed Stage One – An Erratic and Reactive Immune System. If you have not read that yet, tap here.
And Stage Two – A Stubborn and Tired Immune system. If you have not read that yet, tap here.
The Five Stages
- Stage One – An Erratic and Reactive Immune System
- Stage Two – A Stubborn and Tired Immune System
- Stage Three – Active Autoimmunity and Tissue Damage
- Stage Four – Complex Chronic Autoimmune Disease
- Stage Five – Immune System Renewal or Breakdown
In this article I am going to introduce you to Stage Three.
If this experience sounds familiar, I encourage you to look into the Ancestral Autoimmune Protocol for Stage Three (See Below)
Stage Three – Active Autoimmunity and Chronic Damage
In Stage Three you will have been diagnosed with a fixed name, likely lifelong Autoimmune condition.
At this point, you will probably have taken antibiotics, painkillers and/or antidepressants, anti-inflammatories, and possibly even immune-suppressing steroid drugs. Your doctor will begin treating you as if you will be spending a lot more time together.
Autoimmunity is like a bad marriage.
Imagine being in a marriage that has become a long grind of just trying to control the damage. You have both become masters of the slow burn, pushing each other’s buttons but not pushing anyone out of the door. At least, not yet!
In Stage Three, you will need to find the balance of minimal stress and a lifestyle dedicated to healing your immune system.
In this stage of Autoimmune disease, your whole body is now in a pitched battle. Although it may only appear to be going after your hair or your elbow, the upregulation in immune system activity can change your entire metabolism.
This can change your mood, your sleep, your memory, or even your sex drive.
The most important change is almost unconscious. Your life’s big question may go from ‘How good can I make it?’ to, ‘How bad can I take it?’
The Autoimmune Spectrum is meant to help patients and clinicians find some sense of predictability in a highly chaotic situation.
I have met people in Stage Three who had no previous medical history and I have met people who had every symptom of Stage One and then Stage Two, starting the day they were born. I have worked with people in Stage Three who regress into Stage Two, then Stage One and then have normal health.
I have also worked with people whose condition progressed rapidly or moved on to include other Autoimmune Conditions. All any of us can do is be VERY thorough in our assessment of our health and then do EVERYTHING we can to get better.
In Stage Three, your primary concern needs to be – DO NOT enter Stage Four.
Your next job is to work your way back to Stage Two.
Autoimmunity is a life-long process. Some of us have decades of good health and some of us just want one good day. To turn this around, you will need to become one of those people who doesn’t eat everything you are offered. You may even become one of those people who starts sharing leading-edge medical research at a dinner party.
You will definitely want to become one of those people who takes a handful of supplements every day – at least, at first.
The hardest part for us all is having to change most of our habits.
Stage Three ~ 120 Days
If you have been diagnosed with an active Autoimmune Disease, your life has just changed -possibly forever.
That change might be very little in the long term, but in the short term, you will want to become focused on a specific four month protocol. There are a few options but they are all similar in the Dos and Don’ts.
Before I describe my approach to this stage of Autoimmunity, I want to bring you attention to how impatient, and hyperfocused this can make people feel.
I often relate this process to training an injured puppy. How many times a day do you need to sit on the floor and take care of however your puppy is doing. At the beginning of this process, we all need to accept that this relationship is up to how badly your immune system puppy has been treated throughout your life.
This analogy isn’t really about a puppy. It is meant to bring your attention to the kind of trainer you plan to be.
This is going to take time.
In my experience, it takes a minimum of four months to down-regulate an active Autoimmune process. It can take two years, but four months is fairly common and there are some immune system characteristics that give this period of time some theoretical credibility.
I choose a Stage Three approach most of the time now.
If I feel like I am in an active Stage Three Autoimmune Flare-Up, it is a guaranteed four months of stew and salads. Sometimes no salad.
How strict your diet needs to be depends on the intensity and momentum of your unique Flare-Up.
This is the point and the importance of seeing Autoimmune Dysfunction as a spectrum.
No matter what is on the menu, I make the most creative and delicious food I can dream up because it is so much enjoyable and worth it for everyone. Like many others on these kinds of protocols or like people focused on fitness or modelling, we all start to fall in love with batch cooking.
In Stage Three, you will have to be very patient and organized.
That is honestly the biggest challenge people face. This will take four months and you may need to repeat this protocol every few years, especially after times of severe stress. Try and think of this as a new family tradition and give yourself permission to be as creative and engaged as possible.
In my experience as a patient and as a clinician, two weeks on the Phase One (Ice Age) \Diet. resets the inflammatory status of the immune system. If there are no changes then a more advanced protocol is advised.
The short term use of Pharmaceuticals may be necessary.
In Stage Three you want to have regular conversations with your Doctor and an Integrative, TCM or Functional Medicine practitioner. Your health team will be able to guide you as to the best supplements and lab-tests to get you started on the journey to restoring your immune system. That usually starts by repairing the damage from chronic inflammation.
The Phase One Diet is all about reducing inflammation and sending a very strong message to your brain, organs, genes and epigenetic pathways.
My next recommendation, again approved by your clinician, would be a very nutrient-dense Phase Two Diet. This protocol focuses on a combination of High Collagen foods and a moderate Ketogenic Diet. This will take about three weeks to get used to, but that is just step two.
What will do you the most good, if your body, mind and lifestyle have the resources to try this, would be intermittent fasting.
If you are catabolic, (have recently lost a lot of weight), then this is not for you.
There are a few other situations that would make this challenging so please talk to a knowledgable clinician and make sure fasting of any kind is a good idea.
If you are confident this is safef, then follow the basic intermittent fasting protocol. A standard cycle is to fast for 16 hours, keeping your feeding opportunity to a strict 8-hour window. This would allow yout eat from 10:00 am to 6 pm.
If you start losing weight that you do not want to, then increase your healthy roots and eat with a focus on maintaining your weight.
Keep in mind that many Autoimmune conditions begin with a period of gradual and potentially dangerous weight loss. If you are losing weight you may need to interrupt your immune system or tranquillize that VERY dangerous and angry dog (that could literally eat you alive) with some immune suppressant drugs.
This has saved my life a few times and it is sometimes a very good place to start. In Stage Three, you will likely (or should) be taking immune stabilizing supplements three times per day. I will get into the details in another article.
After six weeks to two months, if you are doing well and your clinician agrees, it may be a good time to test the resilience of your immune system. If the Autoimmune flare has settled, some people are ok with Nightshades, eggs, some nuts and seeds. I do not usually suggest this before 100 days, but there are always exceptions.
This is a Progressive Ancestral-AIP.
- Two Weeks on the Phase One (Anti-inflammatory) Diet.
- Six to eight weeks on the Phase Two (Collagen/Ketogenic) Diet.
- Transition to the Phase Three Nutrient Dense Diet when your symptoms and lab tests agree that you are ready.
Once things become stable, I would still recommend a two-month reset with a focus on cleansing every year.
Most of us who live with Stage Three Autoimmunity also do better with daily supplementation. I recommend finding a balance between supplements that regulate your immune system and those that give you a boost of energy or help you stay calm and sleep deeply. Your diet should be VERY nutrient dense, so you do not need to take a fist full of vitamins daily for too long.
At the beginning, rebuilding your bodies resources is an essential part of the process.
Michael Smith is an internationally respected Clinician, Author, and Speaker. Michael practices Functional Medicine, Acupuncture, Traditional Chinese Medicine, and encourages his patients to follow an Ancestral approach to lifestyle and diet. Dr. Smith has dedicated 25 years to the research and treatment of Chronic Illness and Autoimmune Disease. As an Autoimmune patient, Michael is intimately aware of the devastating impact these conditions can have on your quality of life.
Dr. Smith is also at the leading edge of the treatment strategies, dietary protocols, and the precise lab testing needed to resolve these complex conditions.
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