In The Autoimmune Wellness Handbook, authors Mickey Trescott and Angie Alt, the trusted names behind Autoimmune-Paleo.com and authors of The Autoimmune Paleo Cookbook and The Alternative Autoimmune Cookbook, respectively, provide the comprehensive guide to living health fully with autoimmune disease.

"The Autoimmune Wellness Handbook will help you understand exactly what steps to take to help you achieve health and wellness. Mickey and Angie are two autoimmune warriors speaking from the heart, and with years of practical experience, to their community."--Terry Wahls, M.D., author of The Wahls Protocol“Autoimmune wellness advocates Mickey and Angie have created a must-have resource for each and every one of the estimated 60 million Americans battling autoimmune disease, an epidemic now spread across the globe. This comprehensive guidebook not only brims with compassion and understanding but also gives you all of the information, tools and inspiration you need to live your best life with autoimmune disease.”--Dr. Sarah Ballantyne, PhD, New York Times bestselling author of The Paleo Approach“The road to recovery from autoimmune disease can feel like an overwhelming expedition full of twists and challenges. Autoimmune disease is not a quick fix and often times patients need multiple interventions to get themselves well. Mickey and Angie have created a comprehensive and practical handbook that will guide you down the path to recovery from autoimmune disease.The Autoimmune Wellness Handbook is a roadmap that can accelerate the journey to health for autoimmune patients!”--Izabella Wentz, PharmD, FASCP New York Times bestselling author of Hashimoto’s the Root Cause “Packed to the gills with applicable solutions, The Autoimmune Wellness Handbook is my new favorite resource for today’s #1 emerging health challenge. If you or a loved one suffers from autoimmunity, and aren’t sure where to begin--START HERE.”--Russ Crandall, The New York Times bestselling author of Paleo Takeout and The Ancestral Table“It is normal to meet an autoimmune diagnosis with a tremendous sense of confusion, loss, and betrayal, and the information overwhelm can leave the initiate tumbling in its wake. This is where Mickey and Angie’s book comes in. The Autoimmune Wellness Handbook is an elegant and encouraging guide that not only succinctly reviews the nuts and bolts of autoimmune disease management, but also leads you through an often tumultuous inner journey with loving wisdom. In its own unforgiving way, autoimmune diseases forces us to honor human design, not society’s (often shaming) version. The autoimmune patient must learn to rest, self-advocate, love and be loved, self-nourish, move appropriately, release toxic people and situations, and lift the veil on buried shadows. Like all of life’s best rewards, autoimmune management is hard won. But, as this handbook shows you, the autoimmune journey can also be an enriching path to a more authentic you.”--Dr. Datis Kharrazian, author of Why Do I Still Have Thyroid Symptoms? and Why Isn’t My Brain Working?

The autoimmune wellness handbook provides a simple plan of action for anyone suffering from autoimmune diseases or chronic illness, demystifying what can be an overwhelming, complex, and isolating process so that it becomes a liberating journey of recovery, including practical tools, resources, and self assessments.

CHAPTER 1Inform"Nothing in life is to be feared, it is only to be understood."--MARIE CURIETHE FIRST STEP TO LIVING WELL with autoimmune disease is being informed about your illness. We have chosen this as the first step, because the burden of truly understanding lies with you. Although there is a lot of information to be gained in working with a skilled doctor, relying on him or her to also be your teacher detracts from your personal responsibility in healing. You may find learning the details about your disease to be unnerving, because knowing makes it hard to hide from your new reality. After the initial fear subsides, understanding inspires a level of courage you previously didn't have and empowers you to take control of your health and start on the path toward healing. In this chapter, we aim to give you an overview of what autoimmune disease is, how to get and cope with a diagnosis, the different treatments you might expect, and how to gather and store information.WHAT IS AUTOIMMUNE DISEASE?Simply put, autoimmune disease occurs when your immune system, which is designed to protect you from foreign invaders (pathogens like viruses and bacteria), starts attacking your own tissue. This is done through the creation of antibodies, which are ordinarily used to identify and destroy pathogens and help you recover from an illness. In the case of autoimmunity, however, these antibodies target your own healthy tissue, which leads to inflammation and destruction of your cells. This is like your own team playing against you--not fair!The American Autoimmune Related Diseases Association (AARDA) estimates that more than 50 million Americans (roughly 1 in 6) suffer from autoimmune diseases, 75 percent of which are women. Medical science has identified more than 100 autoimmune diseases, with another 40 suspected to have an autoimmune component. Autoimmune disease is one of the most significant health-care issues facing our world today. According to the AARDA, in the United States alone, more than $100 billion is spent annually on the conventional treatment of this condition. Its incidence is on the rise, with some disease prevalence tripling in the last decade. It remains poorly understood, with no medical specialty to support it and a severe lack of research funding, as well as treatment options that only manage symptoms, but do not produce lasting wellness.Autoimmune disease can involve any organ or system in your body, including joint, skin, digestive, hormonal, connective, nerve, and muscle tissues. If you have rheumatoid arthritis, your joints are affected; if you have Hashimoto's thyroiditis, it's your thyroid; and if it's multiple sclerosis, the myelin, the protective layer around your nerves, is destroyed. While it may seem that these conditions are vastly different, the common thread of an immune system gone haywire links them together. Often, autoimmune disease affects multiple organs or systems, which can cross medical specialties and make getting proper treatment extremely difficult.Some autoimmune diseases cause chronic, consistent symptoms, while others are characterized by periods of remission (little or no disease activity) and flare (more disease activity). Autoimmune diseases commonly present with nonspecific symptoms like pain and fatigue, which are not easily identified with a particular condition and make diagnosis difficult. Symptoms can also vary widely from person to person, making a correct diagnosis tough to nail down.The symptoms of autoimmune disease can range from life-threatening and serious, rendering a patient in need of round-the-clock care, to a mild annoyance that barely disrupts a person's life. Most of us, however, fall in the middle of the spectrum--we live with chronic symptoms that impact our productivity and abilities, yet our health-care providers and those in our support network often don't understand and are unable to provide lasting relief.If you have an autoimmune disease, it's likely you will find the diagnosis process and treatment options challenging, at best. There is no medical specialty focusing on autoimmune disease in general. As a patient, you are treated by a specialist focused on the organ or system involved in the condition, rather than your whole body. If you are feeling isolated and lacking support, you are not alone--many of us have felt this way. If we have you worried, it's not all doom and gloom! There are ways of using the conventional system to your advantage and tools at your disposal for living well despite autoimmune disease.WHAT TYPES OF AUTOIMMUNE DISEASES ARE THERE?Autoimmune diseases are usually classified into two categories. There are organ-specific diseases, like Hashimoto's thyroiditis (which affects the thyroid gland) and type 1 diabetes (which affects the pancreas) and non- organ-specific diseases, like rheumatoid arthritis (which affects the joints) and lupus (which affects connective tissue). The most commonly affected organs are those of the endocrine system, such as the thyroid, pancreas, and adrenal glands. The most commonly affected non-organ tissues are those of the blood, like red blood cells, or connective tissue, like muscles and joints. Some diseases seem to occur between the two types and some people may experience several autoimmune diseases at the same time. Additionally, many autoimmune diseases commonly coexist with others, for example celiac disease and Hashimoto's thyroiditis. If you have three or more autoimmune diseases, you have multiple autoimmune syndrome.The autoimmune process itself can also take different forms. Specific cells or tissues might steadily be damaged, an organ might grow excessively large, or the function of an organ may be disturbed. Some diseases are life threatening, others are disabling, and still others, if they are recognized early, can be successfully treated or managed relatively easily.WHAT ARE THE RISKS FOR AND CAUSES OF AUTOIMMUNE DISEASE?Autoimmune disease affects millions of Americans and many more people worldwide, but there are particular groups who are most at risk. In addition, research has identified three contributing factors that interact with each other to cause the development of autoimmune disease.1. GENETICS--The genes you inherit from your parents play a part in determining your predisposition for developing an autoimmune disease, and because of this, it is very common for them to run in families. For instance, the incidence of celiac disease in the general population is 1 in 100 people, while the incidence in those with a first-degree family member who has it, like parents, siblings, or children, is 1 in 22.Unlike genetic diseases, however, where one or two gene mutations are responsible for the disease, there are countless genes that affect your risk for autoimmune disease. Instead of inheriting one specific autoimmune gene, you inherit a larger collection that puts you at risk for developing an autoimmune disease. This may place you at more or less risk for certain diseases and it is why specific diseases are not always inherited in families, but many members of the same family suffer from different related autoimmune diseases. For instance, your mom may have type 1 diabetes, while your aunt has Crohn's, and your sister has Hashimoto's thyroiditis. Similarly, those who already have an autoimmune disease are at a higher risk for developing additional diseases, because they most likely have acquired the collection of genes that predisposes them to autoimmune disease.Disproportionately 1 of the greatest risk factors is gender, with females making up 75 percent of the diagnosed autoimmune population, most likely because of the hormonal differences between the sexes. Your ethnicity is also a factor. African-Americans, Native Americans, and Latinos are at a greater risk than Caucasians.2. ENVIRONMENTAL TRIGGERS--Although it can be handy to blame autoimmune disease all on genetics, it only accounts for about one-third of your risk of developing one. It is often said that while genes load the gun, environment pulls the trigger. Pathogens, chemicals, and substances your immune system is exposed to in your daily life can have an impact on whether or not you develop an autoimmune disease.Certain bacterial and viral infections, both acute and chronic, have been linked to the development of autoimmunity--most likely because they contain proteins that closely resemble your own, confusing the immune system. Exposure to toxins and chemicals can similarly trigger autoimmunity. You are exposed to these components through pollution, the water supply, pesticides and herbicides in foods, cleaning products, personal-care products, chemical exposure in your home or in your workplace, and more.3. DIET AND LIFESTYLE--A poor diet contributes to the development of autoimmune disease by exacerbating intestinal permeability, creating nutrient deficiencies, and overactivating the immune system. Similarly, sleep issues, lack of movement, and drug exposure, both prescription and recreational, can also increase your risk of developing autoimmune disease.Stress also plays an important part in the autoimmune disease process. People experiencing acute and unmanaged stress or chronic stress are often at higher risk for developing autoimmune disease.Finally, your geographic location may play a role. For example, in the United States, it has been shown that those living in the Pacific Northwest have a higher incidence of certain autoimmune diseases, which may be in part due to lack of natural sunlight at higher latitudes, contributing to vitamin D deficiency.While you can't do much about your genetic inheritance and exposure to infectious disease, you can do something about managing your dietary and lifestyle choices, as well as limiting your contact with toxins and chemicals, and we'll get into this in more depth in Chapters 3 and 6.DOES HAVING ONE AUTOIMMUNE DISEASE PUT YOU AT RISK FOR DEVELOPING OTHERS?Roughly 25 percent of those of us with 1 autoimmune disease will go on to develop additional autoimmune diseases. Having 3 or more diagnosed autoimmune diseases is classified as multiple autoimmune syndrome (MAS). This syndrome usually includes one skin disorder, such as psoriasis or vitiligo. Awareness of the autoimmune diseases related to your current diagnosis can be helpful if signs of new diseases become apparent, as it can make these new diagnoses easier for health-care providers by pointing them toward likely disorders and allowing for earlier identification of multiple autoimmune syndrome. For instance, celiac disease is associated with type 1 diabetes, Hashimoto's thyroiditis, Graves' disease, and Addison's disease. Delay in diagnosis allows more time for further autoimmune diseases to develop, which is a second reason that awareness of MAS is so important.I have multiple autoimmune syndrome (MAS), which is defined as having three or more diagnosed autoimmune diseases. Mine are celiac disease, endometriosis, and lichen sclerosus. Lichen sclerosus (LS) is an autoimmune skin condition, and due to its nature (affecting the genitals and causing discomfort, tearing, and bruising of the skin), most sufferers are incredibly private about their diagnosis. When I received mine, I had no idea that it was an autoimmune disease, that my risks of developing further autoimmune diseases were heightened, or that MAS existed and how it often includes a skin condition. LS was my very first autoimmune diagnosis, and I learned about it many years before my next. Had I understood and been fully informed, perhaps I could have taken more preventative measures in my health care or proactively advocated for myself with doctors in order to be vigilant about developing new diseases. I might have even discovered the new diseases more quickly, if I had been able to point out my existing condition as autoimmune and help direct my doctor's suspicions as I grew more ill with autoimmune disease. I decided several years ago to begin speaking about LS publicly in the hope that others would feel less ashamed in seeking treatment for skin conditions, even ones that were difficult to reveal, in order to catch disease progression early and possibly prevent going on to develop additional autoimmune diseases.List of Confirmed Autoimmune, Suspected Autoimmune, and Autoimmune-Related ConditionsWhile some diseases have a clear autoimmune component, many are suspected to have an autoimmune component, and in some cases, that has yet to be proven. Other conditions are known to be pathogenic in origin, but the initial infection can trigger an autoimmune response (such as Lyme or Chagas disease). We've compiled this list to include all conditions on the autoimmune spectrum ranging from specifically autoimmune to those that are suspected to be autoimmune in nature.Acute disseminated encephalomyelitis (ADEM)Acute necrotizing hemorrhagic leukoencephalitis (AHL)Addison's diseaseAgammaglobulinemiaAlopecia areata (AA)AmyloidosisAnkylosing spondylitisAnti-GBM/Anti-TBM nephritisAntiphospholipid syndrome (APS)Autoimmune angioedemaAutoimmune aplastic anemiaAutoimmune dysautonomiaAutoimmune hemolytic anemia (AIHA)Autoimmune hepatitis (AIH)Autoimmune hyperlipidemia (AIH)Autoimmune immunodeficiencyAutoimmune inner ear disease (AIED)Autoimmune myocarditisAutoimmune oophoritisAutoimmune pancreatitis (AIP)Autoimmune retinopathy (AIR)Autoimmune thrombocytopenic purpura (ATP)Autoimmune urticariaAxonal and neuronal neuropathiesBalo diseaseBehcet's diseaseBullous pemphigoidCastleman's disease (CD)Celiac diseaseChagas diseaseChronic inflammatory demyelinating polyneuropathy (CIDP)Chronic recurrent multifocal osteomyelitis (CRMO)Churg-Strauss syndrome (CSS)Cicatricial pemphigoid/benign mucosal pemphigoid (MMP)Cogan syndromeCold agglutinin diseaseCongenital heart blockCoxsackie myocarditisCREST syndromeCrohn's diseaseDermatitis herpetiformis (DH)Dermatomyositis (DM)Devic's disease/neuromyelitis optica (NMO)Discoid lupusDressler's syndromeEndometriosisEosinophilic esophagitis (EoE)Eosinophilic fasciitis (EF)Erythema nodosum (EN)Essential mixed cryoglobulinemiaEvans syndromeExperimental allergic encephalomyelitis (AEA)Fibrosing alveolitisGiant cell arteritis/temporal arteritis (GCA)Giant cell myocarditisGlomerulonephritisGoodpasture syndromeGranulomatosis with polyangiitis (GPA) (formerly called Wegener's granulomatosis)Graves' diseaseGuillain-Barré syndrome (GBS)Hashimoto's encephalopathy (HE)Hashimoto's thyroiditisHenoch-Schönlein purpura (HSP)Herpes gestationisHypogammaglobulinemiaIdiopathic pulmonary fibrosis (IPF)Idiopathic thrombocytopenic purpura (ITP)IgA nephropathyIgG4-related sclerosing diseaseInclusion body myositis (IBM)Interstitial cystitis (IC)Juvenile arthritis (JA)Juvenile diabetes (type 1 diabetes)Juvenile myositis (JM)Kawasaki syndromeLambert-Eaton myasthenic syndromeLeukocytoclastic vasculitis (LCV)Lichen planusLichen sclerosusLigneous conjunctivitis (LC)Linear IgA disease (LAD)Lyme disease, chronicMèniére's diseaseMicroscopic polyangiitis (MPA)Mixed connective tissue disease (MCTD)Mooren's ulcer (MU)Mucha-Habermann diseaseMultiple sclerosis (MS)Myasthenia gravisMyositisNarcolepsyNeonatal lupusNeutropeniaOcular cicatricial pemphigoid (OCP)Optic neuritis (ON)Ord's thyroiditisPalindromic rheumatism (PR)Paraneoplastic cerebellar degeneration (PCD)Paroxysmal nocturnal hemoglobinuria (PNH)Parry-Romberg syndromeParsonage-Turner syndrome (PTS)Pars planitis (peripheral uveitis)Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus (PANDAS)Pemphigus vulgarisPeripheral neuropathyPerivenous encephalomyelitisPernicious anemiaPOEMS syndromePolyarteritis nodosa (PAN)Polymyalgia rheumatica (PMR)Polymyositis (PM)Postpericardiotomy syndrome (PS)Primary biliary cirrhosis (PBC)Primary sclerosing cholangitis (PSC)PsoriasisPsoriatic arthritisPure red cell aplasia (PRCA)Pyoderma gangrenosumRaynaud's diseaseReactive arthritis/Reiter's syndromeReflex sympathetic dystrophy (RSD)Relapsing polychondritis (RP)Restless legs syndrome (RLS)Retroperitoneal fibrosis (RPF)Rheumatic feverRheumatoid arthritis (RA)SarcoidosisSchmidt syndromeScleritisSclerodermaSjögren's diseaseSperm and testicular autoimmunityStiff person syndrome (SPS)Subacute bacterial endocarditis (SBE)Susac's syndromeSympathetic ophthalmia (SO)Systemic lupus erythematosus (SLE)Takayasu's arteritisTemporal arteritis/Giant cell arteritis (GCA)Thrombocytopenic purpura (TTP)Tolosa-Hunt syndrome (THS)Transverse myelitisType 1 diabetesType 1, 2, and 3 polyglandular autoimmune syndromes (PAS)Ulcerative colitis (UC)Undifferentiated connective tissue disease (UCTD)UveitisVasculitisVesiculobullous dermatosisVitiligoSEEKING DIAGNOSISWhy Do You Need a Diagnosis?In order to prevent complications from the damage caused by autoimmune disease, early diagnosis is essential. A correct diagnosis helps you to connect with the specialists and other medical providers you need, weigh treatment options, and think about how you want to navigate dietary and lifestyle modifications. Unfortunately, obtaining a proper diagnosis is often the most difficult part of the process for those of us suffering from autoimmune disease.According to the American Autoimmune Related Diseases Association (AARDA), those with an autoimmune disease spend an average of 4 years seeking diagnosis, with visits to more than 4 physicians in the process. Some go undiagnosed for years, while others get misdiagnosed with other conditions. The undiagnosed and misdiagnosed rate for just 1 of these diseases, celiac disease, can be as high as 83 percent, which shows how difficult it truly can be to obtain answers. Autoimmune disease symptoms can be nonspecific, mild, and gradually build over time, making it difficult for you to determine if you need to see your physician about them. Often, when you do, you are told everything is fine and further testing that could uncover early warning signs isn't ordered.