Moodle at CCNM

Autoimmune disease is growing at epidemic proportions with a very strong predominance of women being affected. Standard interventions are based on symptom control and immune suppression. This presentation reviews a proactive integrative, systems biology, approach for the naturopath to address disease prediction, prevention and treatment, including various evidence-based modalities. Presentation elements also include an exploration of why females are at such increased risk. The role of estrogen and other hormones, the GI microbiota, food immune reactions, stealth infections and molecular mimicry in autoimmune disease pathogenesis will be explored along with how these may serve as leverage points for naturopathic clinical interventions. The hygiene hypothesis and changes in early environmental antigen exposure are also explored. New opportunities for proactive screening for at risk subjects for autoimmune disorders such as rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel diseases, diabetes, multiple sclerosis, lupus, and others using emerging predictive antibody testing are also reviewed and discussed from the perspective of the naturopathic doctor.

Autoimmune diseases are the third leading cause of morbidity and mortality in the industrialized world, surpassed only by cancer and heart disease. According to Fred Miller, director of the Environmental Autoimmunity Group at the National Institute of Environmental Health Sciences, autoimmune diseases are now recognized as among the leading causes of death for young and middle-aged women in the United States. What more, prevalence rates for some of these illnesses are rising for what Miller says must largely be environmental reasons.

Autoimmune diseases are the third leading cause of morbidity and mortality in the industrialized world, surpassed only by cancer and heart disease. According to Fred Miller, director of the Environmental Autoimmunity Group at the National Institute of Environmental Health Sciences, autoimmune diseases are now recognized as among the leading causes of death for young and middle-aged women in the United States. What more, prevalence rates for some of these illnesses are rising for what Miller says must largely be environmental reasons.

The development of autoimmune disease is a complex process that varies between individuals. Yet research and clinical observations over the past 30 years have led to many general insights into autoimmunity. The identification of Th17 cells as well as the increased role of oxidative stress involved in pathogenesis has allowed researchers to explore the development and progression of autoimmune reactions. This talk highlights a deeper understanding of autoimmune mechanisms. It will help clinicians develop novel clinical approaches for treatment aimed at reducing autoimmune processes and balancing immunity and tolerance.

Autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus are common, debilitating, and expensive diseases to manage. Current treatment strategies rarely achieve full remission, and the side effects of treatment can be severe. New research is uncovering that the immune system, like any other organ system in the body, has metabolic changes during the disease process. We are now understanding that immune mediated diseases can develop a metabolic signature, and therapies that modulate energy utilization within immune cells is uncovering new and exciting therapies.

Why is autoimmunity is increasing in the United States and worldwide? The rate of increase suggests environmental mechanisms. While genetics clearly play a role in autoimmunity, current research suggests that infectious disease, diet, toxic chemicals, and gut dysbiosis may be more to blame. This seminar will examine the current mechanisms for autoimmune disease, environmental triggers, and controversies associated with autoimmune disease.

The Ayurvedic model provides a comprehensive medical world view based upon creating balance within the body to promote optimal function and healing. Dr. Shailinder Sodhi discusses how these concepts can be integrated with naturopathic concepts to give practitioners more treatment tools and improved outcomes.  He begins with basic explanations of Ayurvedic theory that can add to the understanding of the autoimmune disease model. Dr. Sodhi then discusses various treatment modalities including yoga and breathing techniques but focusing primarily on herbal formulations. The presentation also covers some case studies illustrating how these techniques are used in the clinical setting.

Selected attendees and patients (both diabetic and non-diabetic) are connected to a continuous glucose monitoring system for 72 or more hours. Real-time glucose numbers will be transmitted and interesting highlights of the glucose data and dietary diaries are analyzed during the presentation. Relevant patient data from Dr. Chapman's diabetes-focused practice are also presented. Dr. Chapman also discusses the clinical utility of CGMS (continuous glucose monitoring system) in the naturopathic primary care setting in prevention and treatment of both autoimmune and type 2 diabetes mellitus. Clinical relevance will include cost, safety, CGMS initiation, dietary analysis, prevention of hypoglycemia, medication adjustments, and reduced hospital interventions. Audience participation will be implemented through questions and case studies. The presentation on CGMS will be followed by a more general discussion on autoimmune diabetes management with Julie Verfuth, ND. Drs. Chapman and Verfurth discuss various approaches to optimal glucose management.

Multiple sclerosis (MS) is the most common autoimmune disorder affecting the central nervous system. MS affects approximately 400,000 people in the United States, symptoms can start anywhere from 10-80 years of age. No single test can diagnose MS and currently there is no cure. This presentation reviews MS diagnosis, FDA approved disease modifying therapies, and evidence-based natural therapies.

A healthy immune system should be responsive to infectious disease and tolerant to self. As we gain a better understanding of how the immune system goes awry during autoimmune disease, we have discovered new mechanisms of self-tissue destruction. This presentation provides an update on three aspects of the immune system, and their role in autoimmunity. IL-17 is involved in the elimination of extra-cellular bacteria and fungi. However, IL-17 is also found in autoimmune lesions, suggesting that it can be pathogenic or beneficial depending upon the context. Likewise, while TNFalpha helps keep tumors at bay, it can be highly destructive in autoimmunity. Finally, we will examine the breadth of auto-antibodies to determine which are ubiquitous and which are truly predictive of disease. We will discuss the immunological chemicals as well as the pharmaceuticals – biologics – used to block these chemicals.

Traditional naltrexone has been used to help patients struggling with addiction to opiates or alcohol. However, for decades we have recognized that at lower dosages, aptly named Low Dose Naltrexone (LDN), we see an entirely different effect on the body. LDN has been shown to have a significant impact on immune function and inflammation. It has been studied and used clinically in Multiple Sclerosis (MS), Crohn’s, Sjogren’s, Hashimoto’s, Lupus, Rheumatoid Arthritis and more. Understanding its mechanisms of action and analyzing literature as well as clinical practice can help practitioners ascertain which patients might benefit from LDN as part of their treatment protocol. There will be a short discussion of adjunctive compounded therapies used in these various conditions, such as biotin and methylcobalamin in MS, topicals for Sjogren’s and thyroid for Hashimoto’s.

Research into the role of the microbiome in autoimmune disease has advanced rapidly in recent years, implicating microbiome-immune system interactions as critical factors may promote the development of autoimmunity. Microbial dysbiosis may lead to decreased immune tolerance and increased inflammatory activity, both of which are thought to be essential features of many autoimmune diseases. In addition, certain normal (commensal) microbes and pathogens can promote autoimmune reactivity via specific mechanisms, such as molecular mimicry and protein modification. Current understanding of the role of microbiome-immune interactions will be discussed in the context of specific autoimmune diseases. Clinical applicability of the information presented will be illustrated through examples of functional testing results (including microbiome, immune and genomic tests), and microbiome-based therapeutic approaches. We will conclude with a brief discussion of the prospects for a paradigm shift in the understanding – and treatment - of autoimmune diseases.

Autoimmune and Inflammatory Arthritis is a special consideration in musculoskeletal pain management. Understanding what these conditions are, how they manifest, what standard of care is, where it fails the patient, and how/where naturopathic medicine can be of benefit is critical in the management of these debilitating disease processes. This lecture includes discussion of when/where therapeutic joint injections may be indicted and red flags to be aware of.

Autoimmune thyroid diseases (AITDs), particularly Hashimoto thyroiditis, are common conditions presenting in naturopathic practices. In this seminar, the epidemiology, pathophysiology, diagnosis, and treatment of AITDs are reviewed with an emphasis on the naturopathic clinical management of Hasimoto thyroiditis. Evidence-based herbal therapies indicated for reducing hyperactive immune responses in Hashimoto thyroiditis are also explored.

Autoimmune disease is growing at epidemic proportions. Standard interventions are based on symptom control and immune suppression. This presentation with review a proactive integrative, systems biology, approach for the naturopath to address disease prediction, prevention and treatment, including various evidence-based modalities. The role of the GI microbiota, food immune reactions, stealth infections and molecular mimicry in autoimmune disease pathogenesis will be explored along with how these may serve as leverage points for naturopathic clinical interventions. The hygiene hypothesis and changes in early environmental antigen exposure will also be explored. New opportunities for proactive screening for at-risk subjects for autoimmune disorders such as rheumatoid arthritis, ankylosing spondylitis, inflammatory bowel diseases, diabetes, multiple sclerosis, lupus, and others using qPCR molecular methods of assessing the GI microbiota, as well as emerging predictive antibody testing, will also be reviewed and discussed from the perspective of the naturopathic doctor.

The autoimmune protocol (AIP) is a nutrition and lifestyle protocol specifically designed to help those with autoimmune disease find relief from their autoimmune symptoms and learn to live well with autoimmune disease. While the AIP has the potential to be life changing, it can feel all kinds of overwhelming to clients.Shanna Nemrow, FNTP, will present the ins and outs of the autoimmune protocol, as well as how to simplify the AIP for clients, approaches to starting the AIP to offer your clients, troubleshooting the AIP with your clients when they are not seeing results, why the AIP is not a one size fits all approach, and more.

This talk will cover clinical indications for ordering an Anti-nuclear Antibody test, as well as a review of optimal lab methodology. We will cover a clinical review of the following ANA positive diseases: Systemic Lupus Erythematosus, Sjogrens, Scleroderma, Dermatomyositis ,Polymyositis. While the focus is on recognizing these disorders, will also discuss conventional and integrative approaches to treating these disorders.