Autoimmune disease is on the rise, now affecting 1 in 10 people in the UK (Lancet, 2023). Yet, despite its increasing prevalence, conventional medicine still struggles to understand, diagnose, and effectively manage autoimmune conditions.
A Functional Medicine Perspective on Autoimmunity
Traditionally, autoimmunity is framed as an “aberrant” response—the immune system mistakenly attacking the body’s own tissues. But what if that’s not quite accurate? What if autoimmunity is the immune system doing exactly what it was designed to do: responding to a perceived threat?
In functional medicine, we move away from the idea of “controlling” or “suppressing” the immune system. Instead, we ask: What is the immune system trying to do, and why?
- What needs to be removed that is causing an immune response?
- What needs to be restored for healthy immune function?
Rather than forcing the immune system to “behave,” we work to understand what triggered its response in the first place and address those underlying factors.
The Three Stages of Autoimmune Disease
Autoimmunity doesn’t develop overnight. It progresses through distinct stages:
- Silent Autoimmunity: Elevated antibodies are present, but there are no symptoms and no measurable tissue damage.
- Autoimmune Reactivity: Symptoms appear, but there is still no clinically significant tissue destruction.
- Autoimmune Disease: Symptoms become severe and life-altering, with measurable tissue damage and diagnosable disease.
By identifying autoimmunity in its early stages, we can intervene before irreversible damage occurs.
What Triggers Autoimmunity?
For autoimmune disease to develop, three key factors must be present:
- Genetic Predisposition: Some people have a genetic susceptibility to autoimmunity, but genes alone do not determine disease. It’s also not as simple as single gene – fixed outcome. The genes involved in autoimmunity cover a broad range of mechanisms that determine how our immune systems react to our unique environmental triggers.
- Barrier Permeability: This includes the gut, skin, lungs, sinuses, and other immune barriers.
- Environmental Triggers: These can include:
- Foods (gluten, processed foods, high-sodium diets)
- Toxins (heavy metals, pesticides, mold exposure)
- Infections (viral, bacterial, parasitic)
- Stress & Trauma (physical or emotional stress, unresolved trauma, coping mechanisms and behaviours, ingrained beliefs)
Beyond Leaky Gut: The Role of Other Barriers in Autoimmunity
The idea that all autoimmunity starts in the gut is a dominant narrative in functional medicine. While the gut is crucial, it’s not the whole story. Other immune barriers play a role:
- Leaky Lungs: Environmental toxins, pollution, and infections can compromise lung integrity, driving systemic inflammation and autoimmunity.
- Leaky Gums: Periodontal disease and oral dysbiosis have been linked to conditions like rheumatoid arthritis and lupus.
- Leaky Skin: Skin barrier dysfunction is associated with psoriasis, lupus, and scleroderma.
Autoimmunity occurs when the immune system loses “tolerance” to self-tissues.
Immune Tolerance isn’t a passive baseline setting—it’s an active process influenced by infections, toxins, oxidative stress, and hormones.
Why There’s No One-Size-Fits-All Autoimmune Diet
A common question is: “What diet is best for autoimmune disease?” The answer? It depends.
Dietary interventions should be personalized based on:
- Individual immune and microbiome needs
- Food sensitivities and intolerances
- Ability to prepare and sustain a particular diet
While general principles (anti-inflammatory, nutrient-dense) apply, no single diet works for everyone. The goal is adaptability—identifying and adjusting dietary strategies as the patient’s health evolves.
A New Way Forward in Autoimmune Care
Functional medicine offers a paradigm shift: instead of suppressing the immune system, we work to understand why it’s responding the way it is.
By identifying root causes, addressing barrier dysfunction, and personalizing interventions, we can support immune regulation in a way that restores health—rather than just managing symptoms.
Are you a practitioner looking to improve your approach to autoimmunity? Stay tuned for more insights on solving complex autoimmune cases using functional medicine strategies.
