The Autoimmune Epidemic: Bodies Gone Haywire in a World Out of Balance--and the Cutting-Edge Science that Promises Hope (No Series) (35 page)

How could it not? Patients with autoimmune disease often deal with the stress of not being able to trust what their bodies might do next, the stress of strained relationships, lost income, and frayed social connections. The normal stressors of life that once seemed so significant—a difficult neighbor or the sick dog or the sales presentation looming next week—become insignificant when faced with problems such as how to meet escalating medical debts or how to get up and down the stairs.

Which brings us back to a catch-22 situation. If mental and emotional stress can cause elevated levels of cytokine activity, which can lead to more episodes and flare-ups of autoimmune disease, how can we break this self-defeating cycle? If emotional stress can promote disease, can finding a way to be calmer and less stressed by whatever challenges come our way help to improve our health?

THE BIOLOGY OF EMOTION

One of the most fascinating findings about how our thoughts and emotions influence our health springs from a study of 180 nuns ranging in age from 75 to 103. Researchers had access to their early journal writings and were able to determine who among them had a mostly positive attitude when faced with stressful situations and who had a more negative response to life’s slings and arrows. Some nuns were in their nineties and were highly functional with full-time jobs, while others were in their seventies and disabled.

What stood out for researchers was this: the nuns who wrote about their lives with the most positive attitudes at a young age were 2.5 times more likely to be in better health in late life than those nuns who saw life through a darker lens. Since the nuns in what is known as the Nun Study were all eating the same food, were nonsmokers, drank little if any alcohol, lived in similar housing, held similar jobs, were receiving the same medical care, and had the same socioeconomic status, the differences were all the more striking. The healthiest nuns were those whose writing showed a clear sense of humor and ability to adapt to life’s stressors—including the normal health challenges that can accompany aging. Researchers suspect that these nuns didn’t live longer, healthier lives because they were never stressed. They lived longer and healthier lives because when they experienced the typical physiological response to stress they were able to recover quickly. By staying primarily at a low baseline of emotional stress, they protected their immune systems from becoming erratic.

For centuries, American medicine has deemed the question of whether our emotions can affect our health as irrelevant. Our two-hundred-year span of medical miracles has led us to revere the technological and scientific approach while giving little thought to the impact that emotions might have on our health. In large part that’s because until very recently we have lacked scientific proof that our feelings can influence our physical well-being. In the last two decades, however, researchers have developed technology to see—in real time—how our emotions influence our bodies’ cells by changing the chemical and electrical activity in our brains. Slowly, the divide that has long separated mind and body is beginning to erode as the two spheres of study increasingly collide, and researchers are focusing on how our emotions, stress levels, and thought patterns might influence our basic immune cells.

Recently, researchers at Harvard Medical School used standard MRI imaging to show visible differences in the brains of those who regularly practice meditation. Over time, areas of the brain that have to do with sensory processing became thicker in the meditators, and these physical changes profoundly changed the day-today modulation of the meditators’ heart rates and breathing. Researchers have found that redirecting our thoughts through meditation literally rewires the brain and drastically decreases the level of stress hormones and chemical secretions that can be so damaging to our bodies when we encounter stressful situations or ideas throughout the day.

As with diet, entire sections of bookstores are chock-full of advice on coping with stress through a combination of prayer, meditation, yoga, keeping a positive attitude, proper sleep habits, and exercise. Recent press release headings that sit on my desk as I type these pages announce “An optimistic view can help protect a person’s health when faced with family member’s death and illness”; “Personality trait may influence immune system response”; “Laughter is good for your heart, according to a new University of Maryland Medical Center study”; “Hotheads may be hurting their hearts”; and “Oscar winners live longer than Oscar nominees.” (This latter study is quite intriguing: researchers looked at 762 actors who fell into three groups: those who had won Academy Awards; a group who were nominated but did not win an award; and a third group who were in award-winning films but were not nominated. Oscar winners lived four years longer than the other two groups, with study authors concluding that winning an Oscar may lead to increased feelings of optimism and mastery that influence health throughout the rest of one’s life. Of course one might well ask: Did winning an Oscar lead to more optimism and better health, or did feelings of optimism and mastery lead to being a better actor, making these actors more likely to take home an Oscar?)

Whether one uses prayer, meditation, medication, therapy, greater attention to sleep, or exercise to lower stress levels and “unplug” from the strains of modern life, one thing is clear: doing so can have a significant effect on our immune systems. According to Douglas Kerr, stress, depression, and interrupted sleep patterns all have a negative effect on the body: these events “decrease the rate at which stem cells divide and create new stem cells in the bone marrow; they cause stem cells to go quiet.” On the other hand, exercise results in a marked increase in the production of stem cells and new motor neurons—those same motor neurons that are so essential for remyelinating myelin sheaths and axonal nerves in neurological autoimmune disease. Likewise, exercise can stimulate injured neurons to regenerate their axons; animals that exercise regenerate significantly more sciatic nerve axons than sedentary animals. Other reports show that children with type 1 diabetes who exercise regularly have improved blood glucose levels compared with those who do not. Another study finds that exercise can improve muscle strength in those suffering from multiple sclerosis.

Of course, when we are suffering from illness, finding the time and energy to recalibrate our stress level is not so easily accomplished. When you can’t do something as simple as drive your kids to school or walk the dog around the block, it’s hard to be bursting with hope. Your overall sense of well-being and optimism takes a bit of a pummeling. Repetitive flares can leave one fearful—rather than hopeful—about what the next week, month, or years may hold. I know this all too well. Still, some studies suggest that a stress-free mood can persist, despite illness. In one study, researchers asked both chronically ill patients and a group of healthy individuals to record their moods into a handheld digital assistant, such as a Palm, every few hours for one week. The findings were both surprising and hopeful for those who assume that being diagnosed with a chronic illness means being sentenced to a lifetime of stress and anxiety. In many cases the moods of those who faced ongoing health challenges were not very different from those in excellent health. In fact, many patients who were chronically ill underestimated how well they were handling their situations. When asked to imagine the moods they would experience if they had never been ill, these patients estimated that they would be enjoying much better moods than those actually experienced by the healthy participants.

HOW THE “PRECAUTIONARY PRINCIPLE” CAN HELP

Ideally, we would all wake up tomorrow morning to an autogen-free world in which the environment is devoid of chemicals and heavy metals, food is always fresh, organic, and free of contaminants, and we do not have to worry about the plethora of triggers to autoimmune disease that surround us.

But tomorrow’s reality looks to be quite the opposite. Each day an average of five new chemicals are put out on the market in the United States without any testing as to whether or not they pose a challenge to the immune system. Although our scientific literacy about links between chemicals, heavy metals, and autoimmunity is growing quickly, it has to date had little impact on federal environmental laws. Today, environmental legislation and regulations that guide the decisions we make about public health and the environment focus on managing current risk (how high a level of trichloroethylene or mercury can humans handle in their bloodstreams before falling ill?) rather than preventing future harm (how do we change manufacturing practices that emit toxic agents into the environment in the first place?).

On the other hand, the precautionary principle, an approach to public health that underscores preventing harm to human health before it happens—and the basis behind much decision-making in European environmental policy—holds that when the health of humans is at stake, it should not be deemed necessary to wait for scientific certainty to take protective action. Had we applied the precautionary principle to global warming, whole pieces of the polar ice caps would not now be crashing into the Arctic Sea.

Although the European Union is moving toward requiring companies to register thousands of chemicals with a new regulatory agency that places the burden on industry to prove that chemicals are safe, rather than on scientists to prove that they are unsafe, that is quite the opposite of the way we do business in the United States. In America, toxicologists at research institutions must demonstrate irrefutable cause and effect in the lab between toxins and human disease—the current scientific standard for burden of proof—which is virtually impossible without subjecting humans directly to toxic agents. As we have seen, almost every study examining the effects of chemicals and heavy metals on human health ends with “further study is needed.” We know that the average American carries more than a hundred chemicals in his or her body, yet we can only guess what the long-term health effects are from living with this toxic cocktail of chemicals. We remain caught in the paralysis of analysis.

I often wonder if in seventy years we will have classrooms of students grilling teachers as to why their grandparents and great-grandparents—you and me—weren’t more concerned about toxic contamination and the immune system. Didn’t we see what we were doing to ourselves, to our foods and water, to future generations, to our children? Didn’t we grasp the connection between the environmental contamination and degradation of the world around us and skyrocketing rates of diseases in which the immune system runs amok?

Getting involved in grassroots activities and political action groups and backing politicians who are committed to taking back the environment are critical if we hope to leave the legacy of a cleaner environment to our children’s children. But the whole planet is not going to be saved from decades of chemical degradation overnight. In the meantime, we need to find ways to lessen the burden of chemicals and potential triggers with which we may come into contact.

PROTECTING YOUR IMMUNE SYSTEM

Once you know what it is like to live every day with an autoimmune disease and experience what it can take from you, the challenge of preventing relapses and flares and finding a way to be as healthy as possible, given your condition, becomes paramount. When you know that even a small relapse or infection can result in large lifestyle changes or the onset of another new autoimmune disease, finding all possible means of aiding your immune system to achieve optimum working order is essential.

Trying to avoid autoimmune-disease triggers can be overwhelming. After all, it seems as if almost anything you touch or eat carries risks. That cup of coffee from the coffee shop? Watch out for the perfluorooctanoic acid lining the inside of your cup. That orange roughy on your dinner plate? Loaded with mercury and PCBs. The newly dry-cleaned suit you just picked up for your cousin’s wedding that’s hanging in the backseat of your car? With each breath you’re taking in a deep whiff of trichloroethylene. It can all seem overwhelming and frustrating. Where do we begin to clean the small sphere within which we live, work, play, and breathe?

What follows is a list of suggestions for minimizing your—and your family’s—exposure to products that may trigger or exacerbate autoimmune disease. Several of these suggestions encourage buying chemical-free products. Doing so not only helps to protect your health but flexes your buying power. If enough Americans refuse to buy chemically laden products, the message to corporations and industry becomes clear: consumers are increasingly educated about how chemicals can affect their immune systems and corporations will have to do business according to the precautionary principle, marketing products that are proven to be safe and chemical free, in order to increase the bottom line.

CLEAN GREEN.
Manufacturers of household cleaners are not required to list toxic ingredients on their product labels even if those products contain toxins. The truth is, you have no idea what is in the polish you use to make your dining room table shine or the spray you use to make your windows gleam. Yet, according to a study by the Environmental Protection Agency, the fumes and gases released into our homes by everyday cleaners help to make indoor air five times more polluted than the air we breathe outdoors. This is true not only in pristine areas like northern Maine, but in cities like New York and Los Angeles. In Los Angeles, approximately 108 tons of volatile organic compounds are released daily from household cleaners, personal grooming products, and paints. These domestic emissions are about to overtake car emissions as the primary source of the city’s outdoor air pollution.