Dr. Kharrazian's Immune System Primer

From the book, Why Do I Still Have Thyroid Symptoms When My Lab Tests Are Normal?

By Dr. Datis Kharrazia

http://www.amazon.com/Still-Thyroid-Symptoms-Tests-Normal/dp/0985690402

 

Although the book is written with emphasis on thyroid auto-immune issues, this book is a most excellent introduction to the immune system and auto-immunity.  Nothing that I quote here, however, can do the complex systems involved justice because these are just bits and pieces of bigger picture that really needs to be understood in its entirety in order to to understand how these bits and pieces fit into it.  I highly advise anyone with thyroid issues, with immune system issues or needs, or who is facing auto-immune issues get and read this book.  It is in our library system, however, it is one of those books that you may find yourself really wanting to underline and highlight because there is just so much in this book.  Anyways, enough said...

 

Notes From The Book On Supporting/Building One’s Immune System:

 

Dr. Kharrazian likens the function of the immune system to the metaphor of a burglar breaking into your house.

 

1.  The first aspect of one’s immune system are the barriers (walls of the house): namely your skin and the lining of your intestines, lungs, and brain…and he mentions holes in the barriers.

 

2.  When these have holes in them, what gets in (the burglar) are “antigens” and “haptens."

 

3.  The first responders on the scene (security guards with no guns) are the “macrophages,” Greek for “big eater,” are stationed in body tissue always on the lookout for intruders.  The macrophages envelope the invader creating an “Antigen Presenting Cell” or “APC” that acts like a burglar alarm.

 

4.  The first responders to the call for help are “T-Helper Cells” who organize the attack.  The T-helper cells send messengers to bring the elite police force the “Natural Killer Cells” and “Cytotoxic T-Cells” to swarm the intruder and destroy it.

 

5.  Back at the police station (sergeants), “T-Regulatory Cells” monitor the scene to ensure there are enough T-helper cells and “T-Suppressor Cells” which stop the immune reaction once the intruder is disarmed.

 

6.  Since the immune system wants to take no chances of a second attack, it assumes that every burglar is a member of organized crime.  T-helper cells also fetch the detectives, “B-Cell Antibodies,” which attach to the intruder and put all its information in a memory bank which will allow the natural killer cells and cytotoxic T-cells to become increasingly efficient at destroying the burglar if it ever comes around again.

 

A breakdown can happen in any of these areas, or combination areas, of the immune system.  Since each aspect of our immune system requires different support, it is therefore vital to first figure out where the breakdown is occurring.

 

Some of the possible scenarios are:

 

1.  Some people do not make enough T-suppressor cells so the immune system’s attack goes on and on and innocent bystanders can often be mistaken for the enemy.

 

2.  Some people make too much “Interleukin 2” or “IL-2,” which is a chemical messenger that deploys the natural killer cells and cytotoxic T-cells.  When these are in over abundance, like in the first scenario, innocent tissue is at risk.

 

3.  Some people make too much “Interleukin 4” or “IL-4,” a chemical messenger that deploys B-cells.  An overabundance of B-cells just looking for intruders may mistakenly tag innocent bystanders.

 

Then there are other causes of immune system breakdowns, such as:

 

1.  People eating high carbohydrate diets which affects blood sugar, causing insulin surges that stimulate overproduction of B-cells.

 

2.  A parasitic infection and/or multiple food intolerances drive up IL-4, causing an overproduction of B-cells.

 

3.  A chronic viral infection drives up IL-2 causing an overproduction of natural killer cells and cytotoxic T-cells.

 

So it could be systemic, or idiopathic, meaning for some unknown reason the body is doing this, or it could be driven by something we ourselves are doing…or, not-doing, as the case may be.  So, to ask the question, is it an actual auto-immune disease or is it something that we are doing causing something that looks like an auto-immune disease?

 

Auto-immune is “not based on the tissue being attacked, but on how the immune system is behaving.”

 

“It is not always possible to pinpoint what exactly triggers a person’s genes to turn on an auto-immune disease.”  And…“Once the gene for auto-immune disease has been turned on, it cannot be turned off.”

 

“The trick,” he says, “is to discover which side of your immune system is more active – the side that deploys natural killer cells and cytotoxic T-cells, or the side that deploys B-cell antibodies.”  If you are “producing too many natural killer cells and cytotoxic T-cells […] then you are TH-1 dominant.”  If you are “producing too many B-cells […] you are TH-2 dominant.”

 

TH = T-Helper Cells

Cytokines are like hormones – they are chemical messengers that make things happen.

 

You “determine whether someone is TH-1 or TH-2 dominant by measuring cytokines.”

 

“Also, it is important to note that not all auto-immune diseases can be traced to a TH-1 or TH-2 dominance; other possible causes include immune defects and deficiencies.  In other words, no cookbook recipes exist for managing an auto-immune disease.  Instead, a basic understanding of immunology is key.”

 

The TH-1 Cytokines include:

- IL-2

- IL-12

- TNFa (tumor necrosis factor alpha)

- Interferon

 

The TH-2 Cytokines include:

- IL-4

- IL-13

- IL-10

 

“When addressing auto-immune disease, the goal is to restore balance to the immune system.”

 

Beyond all the various things he addresses in his patients, he states:

 

STEP ONE:  SUPPORT THE T-REGULATORY CELLS

 

- Emulsified Vitamin D (cholecalciferol).  Emulsification is important so that someone with poor digestion can absorb the nutrient.  It also prevents toxicity at higher doses.  He does not recommend Cod Liver Oil, stating:  “Cod liver oil, although high in vitamin D and possessing necessary cofactors for its absorption, does not provide enough of the vitamin to modulate an auto-immune disease.”  He also states, “The EPA and DHA in fish oil also supports the T-regulatory cells.  (Taken in large amounts, cod liver oil delivers too much EPA and DHA, which has blood thinning properties).”  He goes on to state, “Vitamin D supplementation is important for another reason:  Studies have shown that more than 90 percent of people with autoimmune thyroid disease have a genetic defect affecting their ability to process vitamin D.  Therefore, they need higher amounts of vitamin D to maintain health.  This can be the case even if a blood test shows sufficient vitamin D: The defect is at the cellular receptor site, so not enough vitamin D can gain entry into the cells.”

 

- Glutathione Cream.  “Glutathione works best when delivered intravenously or absorbed through the skin.”

 

STEP TWO:  BALANCE THE TH-1 AND TH-2

 

“I do this by stimulating the side of the immune system that is not dominant.”

 

Compounds That Stimulate TH-1

(NOTE: “These dampen a TH-2 dominance and will worsen the auto-immune condition of a TH-1 dominant person.”):

- Astragalus

- Echinacea

- Beta-Glucan Mushroom

- Glycyrrhiza (from licorice)

- Melissa Officinalis (Lemon Balm)

 

Compounds That Stimulate TH-2

(NOTE: “These dampen a TH-1 dominance and will worsen the auto-immune condition of a TH-2 dominant person.”):

- Caffine

- Green Tea Extract

- Grape Seed Extract

- Pine Bark Extract

- White Willow Bark

- Lycopene

- Resveratrol

- Pycnogenol

 

Compounds That Modulate BOTH TH-1 and TH-2

- Probiotics

- Vitamin A

- Vitamin E

- Colostrum

 

Compounds That Dampen IL-1 Activating BOTH TH-1 and TH-2

- Boswellia

- Pancreatic Enzymes

- Tumeric (Curcumin)

 

 

“I always use immunological lab tests to determine whether a person is TH-1 or TH-2 dominant so that I know how to properly tame and support her overactive and poorly regulated immune system.”

 

^ I think this is important, and am a bit irritated that a number of things on his lists are regular parts of Lyme protocols (hence, why I cannot express deeply enough the importance of first understanding the biological pathways you are working with)…and this is also, no doubt, a big part of the answer why some protocols work for some and not others.  It also suggests a good argument for antibiotic-only treatments because in cases of auto-immune issues it is not tripping any of the triggers (or not in the same way).

 

He goes on to say, “How do I know if the protocol for immune modulation is working?  Monitoring symptoms is important of course, but I also use blood tests to monitor cytokines and T and B cell populations along the way, too.  They should begin to reach normal levels and antibody test should become negative.  That doesn’t mean that the condition is cured, but it is dormant.”

 

“NOTE: A challenge test should only be done under the supervision of a licensed health care professional.  Also, some people develop auto-immune reactions to brain and nerve tissue […]. It is important to NOT use this protocol when destruction of nerve or brain tissue is at risk.”

 

“Quite often I will find that a specific antigen – a food, mold, bacteria, chronic virus, or parasite – is provoking the autoimmune attack.”

 

“People can also develop an immune response to haptens, which are environmental chemicals or heavy metals that provoke an immune response.  It is important to note that not everyone will develop an autoimmune response to antigens or hapten.  For instance, we all have varying degrees of heavy metal toxicity, but not everyone’s immune system will mount an attack against mercury, lead, cadmium, or other metals.”

 

Antigen = organic compoundsHapten = inorganic compounds

^ He tends to use “antigen” to refer to both.

 

“When an antigen is to blame for stimulating an autoimmune attack, an immune panel of tests may show both the TH-1 and TH-2 cytokine are high and T-suppressor cells are low.  This indicates that the body is currently in a heated battle against something the immune system recognizes as an enemy.”

 

“Another essential immune panel measures the ratio of T-helper cells to T-suppressor cells.  This is the CD4/CD8 test (CD4 measures T-helper cells and CD8 measures T-suppressor cells).”

 

“Another clue that a hapten may be responsible for driving an autoimmune disease is when a person’s response to both TH-1 and TH-2 stimulators makes them feel worse.”

 

Restoring the Immune Barriers

 

"Sometimes the active antigen infection can be due to a heavy metal such as mercury.  Although most people have some degree of mercury in their bodies, not everyone’s immune system will respond as if it is an infectious agent.  If mercury or other environmental compounds are creating an autoimmune response, this can be verified by antibody tests against that particular compound. If the test comes back positive, removing the compound is one way to address Hashimoto’s.  A recent study, for instance, looked at the impact of dental amalgams on Hashimoto’s disease in people having an immune response to mercury.  The researchers concluded that the removal of mercury-containing dental amalgams contributed to the successful management of those with the thyroid disorder.”

 

^ I think it is important to note, that there is a simple test to see if your mercury fillings are affecting you.  If they are, then that would be your answer on removing them…and if not, it is unlikely that they are having anything to do with why you are not improving.  It is important, I think, to note the pathway of things like mercury.  When the body has too much it stores it safely away in the body so that it can no longer hurt you.  Some people feel that they need to go to great lengths to try to get the stored toxins out of the body, but doing so can do more harm than good.  Anyways, he goes on to state:

 

“In other cases, however, liberating stored mercury with methods like chelation can exacerbate an autoimmune response.  A good example involves autism.  Many doctors peg autism on heavy metal toxicity and prescribe chelation.  I, on the other hand, think that an immune response to mercury can trigger an autoimmune attack on nerve or brain tissue, causing autism.  Chelation releases stored mercury into the system and can exacerbate an autoimmune autistic condition, causing more tissue death and a worsening of symptoms.”  Later on he says, “It is better to live in peace with mercury than permanently destroy brain tissue in an attempt to eliminate it.”