Dr. Joseph M. Miller DO

 

Auto-Immune disorders have been a focal area of research for me over the past 15 years. As an Obstetrician / Gynecologist, I have encountered many patients with Auto-Immune Disorders. Women have a higher prevalence of Auto-Immune disorders due to 2 primary factors. 1- monthly cyclic fluctuations in Hormones, which place a burden on the Immune System; 2- Child Birthing Process.

Overall, we have seen a significant increase in auto-immune disorders in both men and woman, secondary to an increased bombardment on our Immune Systems. Increasing Environmental Toxins and chemicals, along with increased exposure to unhealthy ingredients in our food sources; excess Societal and Emotional stress, Workplace chemicals and toxins, all contribute to a significantly increased inflammatory burden on our CELLS and IMMUNE SYSTEM.

This spectrum of disorders, the majority of which are categorized as Connective Tissue Disorders, have a wide range of presentations. Most women present with non-specific symptoms, most commonly arthritis, swelling & fatigue. Arthritis most commonly presents in the hands, and is worse during the morning hours, with reported improvement when placing their hands under warm water.

Simply by history alone, any young woman with complaints of arthritis, without any history of trauma or repetitive wear and tear injury to the affected area, can be assumed to be dealing with an Inflammatory Arthritis, which is Immune System related, versus Osteoarthritis, which originates from injury or wear and tear (Old Age). Meaning, the Immune System is attacking certain connective tissues, starting in the smaller joints of the hand, wrist, elbow, or ankle, with associated swelling, and is usually bilateral.

Initial laboratory testing may be normal. In this case, they are referred to as Sero-Negative Arthritis. This is a very common presentation. In other cases, we may see an elevation in non-specific inflammatory markers such as ESR, CRP, RF Factor, WBC count, specifically lymphocytes and/or eosinophils. If an ANA titer is positive, testing for specific anti-bodies which are more indicative of a specific disorder: Lupus, Rheumatoid Arthritis, Sjogren’s, Scleroderma, Psoriatic Arthritis, MS, UC etc.., is the next step.

Key point is whether you are dealing with early-stage Auto-Immune Inflammatory Condition, or a later stage, and/or more aggressive specific syndrome, the treatment is the same. The causative pathology is the same. The Immune System has been over-worked and burdened for years, from many causes, some of which are described above. Thus, the Immune System reacts aberrantly in an overzealous fashion. Treatments revolve around suppressing inflammation and suppressing the Immune System Response.

Yes, Corticosteroids are very useful, however, they have many serious long term side effects. Therefore, they are usually given in short weaning protocols during acute flares. NSAIDS, such as Ibuprofen, Advil, Aleve, and the prescription NSAIDS are helpful to relieve the pain, however, once again have long term adverse effects on the Gut, Heart, Kidneys and Liver. Both these treatments are not addressing the ROOT Cause of the underlying problem.

The Immune-System is normally programmed to perform by responding to external agents such as Viruses, Bacteria and other pathogens, as well as initiate a repair and heal response once an injury occurs. When the Triggering event or agent has been around for prolonged periods of time, the Immune System becomes over-worked and can be triggered to respond aberrantly and become dysregulated. Most Individuals don’t realize their Immune-System is being overworked until they manifest signs and symptoms.