The Importance of Not Ignoring the Fundamentals of Managing Autoimmune or Chronic Health Conditions
Even those well attuned to the care of their personal health and well-being sometimes overlook these six basic fundamentals of self-care.
Functional medicine is complex because, no “one pill for one symptom” model exists to manage chronic gut health, hypothyroid, autoimmune, or other conditions. Instead, multiple systems in the body typically play a role.
Though evidence-based, a non-pharmaceutical diet and lifestyle approach is not covered by insurance and does not require shopping for a “life-changing” product that will fix everything. Rather, it requires changes, work, and self-education on behalf of the patient.
Many people are not willing to travel down the path of functional medicine until the pain of the problem outweighs the pain of the solution. The good news is that once the path is chosen, the results are often profound and lasting, and people finally feel they are in the driver’s seat of their health.
Although I go over these basics in all my courses, in this article, I cover what I call “Functional Fundamentals”—basics you must implement regardless of your symptoms or conditions.
These fundamentals are so unglamorous that they are easily overlooked. People who become well-versed in managing chronic health conditions can become exceptionally well-educated. I have learned much from my patients over the years and see that they can sometimes get lost in the weeds of the latest study or supplement. Even in my most educated and empowered patients, I often see these simple foundations go ignored.
I’m not saying these basics will fix everything in everyone, however, they are essential to the chronic health puzzle.
1. Do You Eat Enough Protein?
One of the biggest mistakes I see people make is not eating enough protein. It is common for patients with food sensitivities and autoimmunity on limited diets to under-consume protein.
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How Much Protein Is Enough?
Your ideal intake should be .36–1 gram of protein per pound of body weight. Typically, it is suggested to use “ideal” body weight if you are overweight, but it may be appropriate for you to go higher than that, particularly if you’ve been under-eating protein.
There are roughly 7 grams of protein per ounce of meat.
- 4.6 ounces of salmon ~28 grams.
- 5 ounces of strip sirloin steak ~35 grams.
- 4 ounces of cooked, skinless chicken breast ~28 grams.
Sources of Protein
Protein from meat is more bioavailable and complete than protein from plants. Meat proteins are also more complete in terms of amino acids. Vegans and vegetarians need to consume more protein and pay attention to amino acid profiles, including leucine.
I generally don’t recommend plant proteins because they are immune reactive for many people with autoimmunity and leaky gut. Eggs and dairy are also commonly immune reactive. As with most diet-related issues, protein tolerance depends on the individual.
I don’t recommend protein powders that contain whey, milk, soy, egg white, or pea because they are immune-reactive ingredients for many people with chronic health issues. Protein powders made from beef, collagen, or chicken may be more suitable. Again, this depends on the individual.
While periodic fasting can help reduce inflammation in some people, I do not recommend it for those who have long been protein-deficient until they rebuild their protein sufficiency and general resilience.
2. Essential Fatty Acid Diversity
Essential fatty acid (EFA) balance is one of the most overlooked areas in managing autoimmunity, chronic health conditions, and repairing leaky gut. EFAs are converted to prostaglandins, which profoundly affect immune modulation. Industrialized vegetable oils and trans fatty acids promote the synthesis of pro-inflammatory prostaglandins and should be avoided.
Fish Oil Is Best if You Have High Blood Sugar and Insulin Resistance
It’s important to mention that insulin resistance plays a role in which omega-3 fatty acid sources are best for you, as many Americans are insulin resistant. You likely have insulin resistance if your fasting blood sugar is over 100 or your HbA1c is 5.6 or higher. In these cases, fish is the best source as insulin resistance can hinder the body’s ability to convert alpha-linolenic acid (ALA), a type of omega-3 fatty acid found in plant sources like flaxseed, chia, walnut, and hemp seed into a more usable form.
This extreme imbalance between omega-6 and omega-3 creates a highly inflammatory environment that plays a role in many chronic conditions, including heart disease, diabetes, autoimmune disease, leaky gut, and brain degeneration.
The best way to prevent or reverse this inflammatory environment is to increase your omega-3 fats and lower your consumption of omega-6.
How Much Fish Oil Should You Take?
Since most people do not consume enough EFAs, I recommend supplementing with a high-quality fish oil. However, people who take fish oil commonly do not take enough.
Algal oil supplements derived from algae are a good plant-based source of EPA and DHA (omega-3 fatty acids also found in cold-water, fatty fish). Of course, you can also eat fatty fish regularly, and raw nuts and seeds if you tolerate them.
EPA and DHA Serve Different Functions
Most fish oil supplements have a 1:1 ratio of DHA to EPA. Both are important, but each has different functions in the body.
EPA has more of an anti-inflammatory focus, while DHA has the greatest effect on brain health. If your goal is mainly to dampen inflammation, then regular fish oil or fish oil with concentrated EPA is appropriate.
Omega-6 and Omega-9 Fatty Acids
Omega 6 and 9 fatty acids are necessary for good immune health—though caution should be taken as overconsumption of omega 6 is pro-inflammatory.
Arachidonic Acid
Arachidonic acid (AA) is commonly vilified as pro-inflammatory, but we need it for healthy immune function. AA’s reputation for being pro-inflammatory comes from the overconsumption of omega-6 fatty acids in the general population.
Sources of arachidonic acid include fatty meats, shellfish, butter, and ghee. Many people with an intolerance to the dairy protein casein may nevertheless tolerate butter and ghee.
Including diverse sources of these healthy fatty acids in your diet is critical to modulating inflammation and autoimmunity.
3. Blood Sugar Imbalances Are a Powerful Trigger of Inflammation
High and low blood sugar spikes can lead to systemic inflammation, immune flares, hormonal imbalances, and compromised brain function. Supporting balanced blood sugar is critical for recovery from any inflammatory condition.
Many people with chronic health conditions have blood sugar that is too high, too low or swings wildly between the two.
Blood Sugar That Drops too Low Triggers Inflammation
The biggest sign of a blood sugar imbalance is energy changes throughout the day—it should remain stable. One of the most common mistakes I’ve seen
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