In The Autoimmune Solution,  I walk you through the four pillars of my protocol for preventing and reversing autoimmune disease. This is part four of a four-part series on each pillar. Read the other parts here:

Pillar I: Heal your gut.

Pillar II: Get rid of gluten, grains, and legumes.

Pillar III: Tame the toxins.

Pillar IV: Heal your infections and relieve your stress.

When I see a patient who has not experienced full reversal of their symptoms after simultaneously addressing Pillar I (Heal Your Gut) and Pillar II (Get Rid of Gluten, Grains, and Legumes), I know we’ve got more work to do. Once Pillar III (Tame the Toxins) has been addressed, and I’ve determined that toxins aren’t the issue, I turn to the next piece of the puzzle: underlying infections and stress.

Autoimmunity and Infections

In Pillar I, I talked about gut infections such as Candida overgrowth and small intestinal bacterial overgrowth (SIBO). But some infections associated with autoimmune disease are caused by viruses. Some common culprits I see in my clinic are:

Herpes simplex (HSV): This is the virus that gives you cold sores and/or genital herpes. It’s very common: about 90% of Americans have one or both types of HSV, although they might not show symptoms. 

Epstein-Barr (EBV): EBV is the virus that causes infectious mononucleosis. 95% of all US adults contract this virus by age 40. You’ve likely had mono at some point, even if you don’t remember, because it’s often misdiagnosed as the flu or strep throat.

EBV is the infection that has been studied the most extensively in connection with autoimmune disease, and it has been strongly correlated with multiple sclerosis (MS), chronic fatigue syndrome (CFS), lupus, fibromyalgia, Graves’ disease, and Sjögren’s syndrome. 70% of healthy children test positive for EBV–in children with lupus, the rate of EBV infection is closer to 99%. 100% of people with MS test positive for EBV.

Whether or not you have an autoimmune disease, it’s very likely you’ll test positive for one or both of these infections. What’s more is that if you have an autoimmune disease, you will have a higher “viral load,” or a higher level of the virus in your blood, making it more likely that the infection will be retriggered.

Several bacterial infections are also associated with autoimmunity. Yersinia is associated with autoimmune thyroid conditions, and Klebsiella infections have been implicated in rheumatoid arthritis. These are the few infections with which I do recommend antibiotics to my patients–for a full list, see The Autoimmune Solution. When a patient isn’t getting better on the first pillars of The Myers Way®, I always consider the possibility that they could have another bacterial infection: Lyme disease.

Lyme disease is caused by a bacteria called Spirochaetes, and it shares many similarities to autoimmune diseases. Many people are misdiagnosed with autoimmune disease or another inflammatory condition, like chronic fatigue syndrome, when the underlying issue is actually Lyme. Of course, it’s also possible to have both Lyme disease and autoimmunity at the same time, which is why it is so crucial to be properly tested. It’s estimated that 50% of those who test negative to Lyme on conventional tests are false negatives, meaning they have actually been infected with Lyme. If you suspect you may have Lyme disease, I recommend a test called iSpot Lyme or Igenex which are more accurate than conventional testing. Any practitioner should be able to order it for you. I list more resources in The Autoimmune Solution for those who suspect Lyme disease.

How Do Infections Cause Autoimmunity?

Viruses like EBV and HSV don’t leave your system. When your immune system is healthy, it keeps the viruses in check, but when it is suppressed by stress or illness, the infection can become active once again. Once the virus is active, the inflammatory immune response damages tissue, which then causes more inflammation and a bigger response from the immune system. Autoimmune disease develops from that chronic state of inflammation.

The Stress Connection 

Stress can be emotional, mental, or physical; it can come from physical injury, sleep deprivation, exposure to toxins, leaky gut, or eating a diet full of inflammatory foods. The relationship between stress and infections is complex. I walk you through the science in The Autoimmune Solution, so I recommend going there if you want to dig in a little deeper. I want to highlight a few points here to help you understand the effect of stress on the body.

How the Body Responds to Stress 

Stress isn’t just a feeling. It’s an actual release of hormones that your body produces when it’s met with a challenge. The number one stress hormone is cortisol.

Think of the hormone cortisol as a chemical messenger. When you’re in a stressful situation, cortisol tells your immune system to gear up for a challenge. Your immune system responds by producing inflammation, and then cortisol signals your immune system to calm down when the danger has passed.

This system works really well when you encounter acute stress that happens suddenly and then passes. But too many of us are dealing with chronic stress: constant sleep deprivation, poor diets, long hours at work, problems in our relationships, the list goes on and on. When you have constant stressors in your life, your immune system never really gets to turn off. Your inflammatory immune response is activated for too long and eventually goes rogue, attacking your own bodily tissues. Pretty soon, your stress hormones try to suppress the response but go overboard, leaving you with a weakened immune system. Simultaneously, your body is inflamed and you are vulnerable to infections, including latent infections like EBV and HSV that never left your body in the first place. Each time these viruses are activated–when you have symptoms of mono or an outbreak of HSV–they replicate and damage more of your cells.

This begins a vicious cycle where the infection becomes active, it destroys tissue and provokes an even greater immune response, your body releases cortisol to calm it down, which triggers more infection, and so on.

Heal Your Infections, and Relieve Your Stress 

Addressing your infections and relieving your stress are necessary steps to get your immune system back to proper functioning:

Support your immune system with the other pillars of The Myers Way® that I outline in The Autoimmune Solution. Heal your gut, get rid of gluten, grains, and legumes, and tame the toxins to strengthen your immune system. A healthy immune system is your best defense against the reactivation of latent infections.

Adopt daily stress-relieving strategies. Our bodies were designed to handle acute stress. It may stress you out to sit in a long meeting, or to have an unpleasant phone call with an ex-spouse, but try to leave that behind you once you’ve left the situation. Let go of the stress once the challenge has been overcome, and allow your immune system to calm down. It does take practice, but it makes a big difference! In The Autoimmune Solution I give a long list of different ways to relieve your stress. Here are a few of my favorites:

  • Breathing: When you find yourself overwhelmed with stress, take a moment to connect with your breath. Concentrate on breathing in and out until your anxiety has calmed.
  • Dance: Just moving your body can help you literally “shake off” your stress.
  • Music: Amazingly, half an hour of listening to music can reduce your cortisol levels.
  • Gentle exercise: Try yoga, or a long walk in a natural setting–changing your environment can also help you get away from your stress.

Addressing your stress is just as big a part of your recovery from autoimmune disease as the first three pillars. For many, it’s the missing piece of the puzzle when they’ve done everything else right, but still aren’t seeing full resolution of their symptoms. You can find even more stress-relieving strategies and resources in The Autoimmune Solution.

Additional Resources

For more information, check out my interview with Richard Horowitz, MD, where we discuss how Lyme disease often disguises itself as other autoimmune conditions and mental health disorders. Together, we talked about integrative treatment methods and the importance of accurate and thourough testing.