When you do not have enough hydrochloric acid (stomach acid) and pepsin (also made in the stomach) production, macronutrients (especially protein) are left partially digested or undigested. This may set the body up for food reactions, but also allows harmful microbes to survive and reproduce throughout the digestive tract.
When undigested macronutrients and microbes move into the small intestine, under specific conditions (such as genetic tendency, a time of stress, etc.) they have the potential to inflame and damage the mucosal layer of the intestinal wall. Undigested proteins may be particularly problematic as they are more likely to trigger an adaptive immune response. Without a healthy mucosal lining, tight cellular junctions of the epithelium may weaken. These same undigested food particles and microbes can now move through an inappropriately permeable intestine and into the bloodstream (known as “leaky gut”). The food particles may appear foreign to the body and trigger an immune response. Genetics and the health in your microbiome will have a huge effect on the specific immune response you might have and the way it manifests in your body.
Major histocompatibility complex (MHC) is a group of genes that code for proteins found on the surfaces of cells that help the immune system recognize foreign substances. There are two types of MHC complexes, MHC Type I and MHC Type II, T cells use them to determine what to attack and how to differentiate between “self-cells” and “non-self-cells”. Because of this, some scientists propose that MHCs play a key role in autoimmunity.
“Leaky Gut” contributes to allergies, inflammation, auto immune diseases, and progressive degeneration.
Other causes of “Leaky Gut” are:
Lack of breast-feeding during infancy
Consuming GMO’s
High alcohol consumption
Chronic stress
Antibiotic use
Aspirin and all other nonsteroidal anti-inflammatory drugs (NSAIDs)
Food allergies and immunologic sensitivities
Dysbiosis
So how does this cause autoimmune disease?
The development of autoimmunity can be thought of as a “3-legged stool” as seen in the figure above (Dr. Pompa, 2014).
‣ Genetics, there is often, but not always, a genetic setup, you have certain genes for certain diseases.
‣ Epigenetic exposures are generally required to trigger the expression of the autoimmune disease process. Some epigenetic exposures common in Hashimotos are: Diet, medications, hormone imbalances, environmental chemicals, microbiota, viruses, inflammation, stress, and trauma.
‣ Cross-reactivity (of foods or other environmental exposures) and/or molecular mimicry (of an infectious agent, like a bacteria or virus) Numerous genetic mutations (called single nucleotide polymorphisms, or SNPs) and combinations of SNPs (called haplotypes) have been linked with various autoimmune diseases. These gene mutations alone, however, will not create autoimmunity. The co-occurrence of autoimmune disease in identical twins is only 12-67% (L. Wang, FS Wang, Gershwin, 2015), indicating the roles of environmental factors and other epigenetic factors.
Because of this, the second leg of the autoimmune “stool” is epigenetic exposures. Exposures that change the expression of our genes, or “activate” our genes, include:
‣ Diet
‣ Physical activity
‣ Medications
‣ Aging
‣ Sleep
‣ Environmental chemicals
‣ Hormonal imbalances
‣ Trauma
‣ In utero environment
Light exposure
‣ Microbiota
‣ Viruses
‣ Stress
‣ Smoking
‣ Lack of oxygen
‣ Inflammation
Cross-reactivity/Molecular mimicry, the third leg of the stool is cross-reactivity and/or molecular mimicry. The following chart shows some examples of this:
“Molecular mimicry”
An unexpected cross-reaction of the antibodies with autologous components may occur. This process is in fact at the basis of the progression of autoimmune diseases and is called molecular mimicry. In the gut, inflammatory pathologies that are related to dysbiosis associated with various factors, such as genetic factors and food, cause alterations of the immune system characterized in IBD and CD (9, 10, 14). Those enteric eco-events induce systemic inflammatory responses, leading to the systemic manifestations of IBD and/or CD, affecting remote organs including the thyroid (10, 14).” (Gut-thyroid axis and celiac disease; Aaron Lerner, Patricia Jeremias, and Torsten Matthias, May 2017)
The reason that once you have one autoimmune disease, that you are at risk of developing others, is the lack of healing and SEALING the gut. This step has to happen in order to stop the leaking of proteins that trigger an adaptive immune response.
Recommendations to help a person with Hashimotos Thyroiditis:
It would be a good idea to eliminate gluten and dairy. Also, any inflammatory foods and any food sensitivity foods as shown on a Cocas Pulse Test or through using the Autoimmune Paleo Diet (AIP). The gut needs to be healed and sealed, and stomach acid replaced. Good bacteria will have to be replaced as well.
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