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The multi-factorial action plan

Joy Cutrone, Wellness & Certified AIP Coach, FMCHC-Candidate
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A multi-factorial disease

We’ve talked about what is autoimmune disease, how it presents, its common drivers of environmental toxins, microbes, allergens, poor diet, and stress. These offenders are multiple factors, which is why you’ll hear functional medicine practitioners describe autoimmunity as a “multi-factorial disease.”

A multi-factorial plan

The universal approach is to go after these offenders using multiple factors, including some version of the 5Rs plan, since gut permeability or “leaky gut” has been found to be universally present at the onset of autoimmune disease.(1)(2) Each individual protocol, however, will include different specifics for each individual, including a reflection of your DNA indicators, in the opinion of many. According to the U.S. National Institutes of Health:

“The treatment depends on the disease, but in most cases one important goal is to reduce inflammation.” (3)

In a healing-based approach, many experts might argue that reducing inflammation is the primary goal, because inflammation is the ultimate common denominator across autoimmune disease. Yet how you do that involves working with your functional medicine practitioner to identify and remove your individual causes of inflammation from among the common drivers. As Dr. Deborah Anderson noted in The Huffington Post:

“Functional medicine healthcare providers treat autoimmune disease differently. Instead of only using medications to manipulate the immune system and mask the symptoms, they’re focused on getting to the root cause and reversing the process of autoimmunity.

As Dr. Sidney Baker once said, “If you’re sitting on a tack, the answer is not to treat the pain with aspirin. The solution is to find the tack and remove it.”

So, your functional medicine practitioner will “ask the question, ‘why did autoimmunity develop in the first place?’ And, they’ll investigate until they find the answers.”

Root-cause pursuit means actionable steps

The good news is, pursuing root causes means you’ve got something you can do, versus sitting idly by and waiting for the disease process to unfold (I’ve actually been told by my PCP to wait until symptoms developed further, and that THEN she’d intervene – but who wants to wait for things to get worse before acting? It’s better to do what you can). Then, once toxins and infections are removed, you can move on to healing diets and health-supporting lifestyle changes.

So, it actually is within your power to improve quality of life. Because you CAN tackle infections and detoxification, heal your gut, and make changes in diet and lifestyle. I’m not saying it’s easy, but I will say it’s empowering.

You may find that this focus on finding root causes may contradict information you’re given by your conventional specialist – information like, ‘diet doesn’t matter’ to a patient diagnosed with ulcerative colitis, for example. “Eat whatever you want; just avoid raw vegetables in a flare,” was the astounding information given to us when our family member was diagnosed. That caused us to ask ourselves, “How can diet not matter to someone with a digestive disease?” That was, in fact, one of the key disconnections in logic that helped drive our path of inquiry. By contrast, within the discipline of functional medicine, you will find that there is agreement that there are causes, that there are certain common causes that can be identified and treated individually and that, with dietary and lifestyle changes, you can substantially improve quality of life.

Recovery is a process, not an event

I recommend that you read more about functional medicine in our article, “Patient-Centered Healthcare,” which includes tips for finding an appropriate practitioner who can identify the right steps for you individually. Or jump to “Introducing the 5Rs” for an introduction to more specifics of the 5R gut-healing protocol that is at the core of so many recovery plans. And remember our Rules of the Road: recovery is a process, not an event. There are multiple factors at play, and the more you learn about and address them, the more progress you’ll make.

Progress and perspective

Just as autoimmune disease is a chronic, long-term illness, so is there a long-term process through which you can become better — better at identifying causes, better at treating them, and better at recognizing imbalances and early warning signs, so that you can respond accordingly. Over time, your illness can fade into the background, and not be the definition of your life.


  1. Intestinal Barrier Dysfunction Develops at the Onset of Experimental Autoimmune Encephalomyelitis, and Can Be Induced by Adoptive Transfer of AutoReactive T Cellsby Mehrnaz Nouri, Anders Bredberg, Björn Weström, Shahram Lavasani in PLOS One, September 2014.
  2. Which comes first: the leaky gut or the dysfunctional immune system?” by Dr. Sarah Ballantyne, The Paleo Mom.
  3. National Institutes of Health, “Understanding Autoimmune Diseases,” NIH Publication No. 16–7582, March 2016.
  4. Healing autoimmune conditions with functional medicine,” by Dr. Deborah Anderson in the Huffington Post, March 31, 2017.
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