Rheumatoid arthritis, Hashimoto's, coeliac disease, psoriasis, multiple sclerosis and type 1 diabetes attack different tissues and are treated by different specialists. They share a great deal upstream, and they cluster in the same people and the same families.
The three-part model
The working framework in the research literature has three components: a genetic predisposition, an environmental trigger, and a loss of barrier integrity that lets the two meet. Genetics loads it; the other two pull the trigger — and unlike the genetics, they are modifiable.
The barrier
- The intestinal lining is a single cell layer held together by tight junctions, separating the immune system from everything you swallow
- Zonulin regulates those junctions, and gliadin from wheat raises zonulin in everyone — more in people with a genetic susceptibility
- When large protein fragments cross into circulation, the immune system responds to them. Where those fragments resemble human tissue, the response can cross over — molecular mimicry
- NSAIDs, alcohol, chronic stress, some infections and certain emulsifiers all degrade the barrier
Increased intestinal permeability is well documented in coeliac disease, inflammatory bowel disease and type 1 diabetes. Whether it causes the condition or results from it is not fully settled in every case — but it precedes onset in several.
What is worth doing
- Remove gluten properly for a trial period. Not reduced — removed, for at least a few months, long enough for antibodies to fall. Test for coeliac disease first, because testing after removal does not work
- Correct vitamin D. Deficiency is consistently associated with autoimmune incidence, and the immune system's regulatory cells depend on it. This is one of the better-supported single interventions
- Address the barrier: fermented food, adequate fibre, glycine from collagen or broth, and stopping the things that damage it
- Consider an elimination protocol if the picture is unclear. Removing likely triggers for thirty days and reintroducing one at a time produces information no blood test will give you
- Sleep and stress, which sound soft and are not. Both directly modulate immune regulation
Where this ends
None of this replaces treatment. Autoimmune disease can do permanent damage and immunosuppressive therapy exists because it prevents that. What the above can do is reduce the load on a system already misfiring — and in some people, that changes how much medication is needed. That conversation belongs with the specialist treating you, with the results in front of you both.
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