Our immune system is a complex and wonderful system. The main objective is to attack foreign objects like viruses and bacteria, render them inactive, and turn them into something the body can filter out and dispose of. All of our cells have surface markings that are unique to that type of cell. Our immune system knows which markers or receptors are our own and anything that isn't registered as our own is considered foreign and must be attacked. The immune system also controls the initial stages of healing by triggering a response to bring cells to the area that will start to rebuild the damaged tissues. Sometimes the immune system will attack objects that are our own tissue because the surface markers have changed in a way that makes them look foreign. This can be a good thing in the case of cancer cells, which are an abnormal growth in the tissue. Our body is regularly producing these cancer cells but our immune system keeps them in check. When the immune system misses something and it grows too large for the immune system to deal with, then it becomes what most people think of as cancer. If a foreign substance has surface markers that are very close to our own, but not quite, then our immune system can get confused. After it deals with that foreign substance, our own tissues with the similar markers will suddenly look foreign and will be attacked as well. This is the case with Systemic Lupus Erythematosus where the connective tissue of the body suddenly is considered foreign and sets off an immune reaction. Connective tissue is in almost every part of the body: in the skin, surrounding and forming structure to organs and muscle groups, and even inside the muscles themselves! You can imagine how devastating a disease like Lupus can be for someone when it is affecting every part of your body.

"Autoimmune Disorders" is a very large and varied topic. There are many different disorders/diseases that fall under this umbrella (over 80), which makes it hard to simplify into one general picture. An autoimmune disorder is where the body is attacking itself and causing physical problems in the organ or system it is attacking, causing symptoms in that tissue and the whole body. The most common early symptoms are: joint and muscle pain, fatigue, fever, and weight change. In Crohns Disease and Ulcerative Colitis, there is lower abdominal pain, gastrointestinal dysfunction, and lack of absorption of specific nutrients. In acute cases, the patient's pain is often not just localized to the inflamed area, but can also include a generalized body pain. This occurs because of muscle guarding and inability to move the body properly, which can lead to joint and muscle stiffness elsewhere. There are autoimmune diseases that are systemic (whole body) or are specific to tissue like the nervous system, skin, endocrine (hormone producing organs), and even the blood. During my research for this article however, I have come to realize that not all of these disorders are an immunological reaction. Some are a normal physical reaction, which creates an excessive inflammation response in the body that causes the symptom picture. The medical community is in the process of changing the diagnosis to a spectrum from autoimmune-related disease on one end and auto inflammatory-related disease on the other end. Inflammation seems to have a major role in a lot of the autoimmune processes to a greater or lesser degree.

The research shows that people who develop autoimmune disease have a genetic predisposition, but not all people with the genetic predisposition will develop an autoimmune disease. There seems to be a trigger that sets the autoimmune disease in motion and once it is developed there often isn't a cure. Triggers can include environmental agents such as: chemical pollutants, toxins, metals, viruses, bacteria, parasites, hormone imbalances, chronic infections, and certain drug interactions. There are also lifestyle considerations such as: trauma, nutritional factors, and physical or psychological stress. The treatment is often aimed at decreasing the symptoms of the disorder and down-regulating the immune system to control the autoimmune process. Because there are many tissues and organs involved in the different conditions, there can be specific treatments to target a missing hormone or vitamin in each specific case.

As careful as we can try to be, there will be some chemical exposure that is unavoidable like car exhaust and pesticides that have been banned but are lingering in our soil years later. There are still a lot of areas in our life that we can control, like:

• Where is our food coming from: Is it organic and from good soil?
• What additives are added to preserve this product?
• How are we storing or transporting our food and water? For example, plastic wraps and containers leach chemicals such as xeno-estrogens, which are chemical compounds that act like estrogen in our bodies.
• What chemicals are in our homes? You can avoid using harsh cleaning agents with strong perfumes and use microfiber cloths to clean instead with just as good, if not better, results.
• What about home renovations? When painting your house are you using paints that are less toxic, and doing it at a time when you can air out your house properly.

There are many naturopathic recommendations for supporting a healthy immune system and managing autoimmunity. Herbs like Astragalus, Reishi, and Ashwaganda act as immunomodulants, which is an important differentiation to make when treating autoimmunity. When the immune system is over-active, as it is in autoimmunity, it is important that we not over-stimulate it. This is when we would avoid an herb like Echinacea, which is an immune system "booster" or stimulant. Immunomodulants are herbs that encourage balance and regulate the immune system. A healthy, well-functioning digestive system is another important aspect of a healthy immune system. Eating a healthy diet, eliminating aggravating foods and taking a probiotic supplement are indicated in any autoimmune disease. Diet recommendations are always given on an individual basis, but common aggravating/inflammatory foods include dairy products, wheat products, red meat and sugar. Essential Fatty Acids are another important supplement for immune system balance, as well as vitamin D.

Massage Therapy can have significant benefits to someone with an autoimmune disorder or as a preventative measure against developing stress-related diseases. I have a number of clients that find a lot of relief from their symptoms by getting regular massages along with their other medical treatments and medications. Unfortunately, massage is only going to provide short-term relief because in most cases the chronic nature of their disorder is continuous and will re-inflame and re-irritate the body; thus leading to the symptoms getting worse again. Having regular massage won't just target the specific issue of the autoimmune disorder you have, but will help with all of the secondary problems that happen to the body as a result of the pain, fatigue and dysfunction. When people get these diseases their lives change, they cannot do what they used to. Their exercise routine is drastically diminished, the fatigue and body pain prevent even the most basic uses of the body. When we don't move our bodies through the full ranges of motion we lose that full motion of our joints and our muscles become tight, rigid, and painful. Our bodies don't circulate blood well when we are not active. We need the muscle to work and keep body tissues well perfused. Massage has many benefits for autoimmune patients and here are a few key ones:

• Massage works to decrease the sympathetic nervous system, which is the fight-or-flight/high-stress part of your nervous system. By decreasing activity in this part of your nervous system you will decrease the burden on organs like the adrenal glands. The adrenals secrete cortisol and norepinephrine - two of the stress hormones that can cause many problems in the body beyond autoimmune disease.
• Massage will also help to relieve muscle tension and pain. When muscles are tight they put an increased load on the joints they cross, which can then aggravate already sore and inflamed joints. By reducing the muscle tightness, it will give the joint more room and often decrease joint discomfort down to the pain associated with the disease process. By the time most clients come to massage, it has been a long time since the disease first started and they can't remember how it felt just to have the disease symptoms and not the extra symptoms from the muscles. Once they have had enough massage to control the muscle involvement, they are often shocked at how much better they feel, even though they still have the autoimmune condition, like ankylosing spondylitis, or rheumatoid arthritis, or lupus active in their body.
• Massage is excellent at increasing the circulation to the tissues when your body isn't able to do its job. The pressure moving towards the heart helps to pump the fluid out of the extremities and get it moving, and then fresh blood will replace what was squeezed out of the area. There is also a stimulating affect on the blood vessels, which will make them more active even after the treatment. When the blood is flowing through the vessels well there is less of a chance that fluid will get stuck out in the interstitial spaces and in the cells. But if you find you are getting areas of edema then there are special massage techniques which can help. Lymphatic drainage moves lymph fluid out of the spaces outside of the vascular system and back into the circulatory system to prevent swelling and pooling of fluid in the extremities.
• Massage can treat specific issues as a result of the specific disorder you present with. For example, if you have ankylosing spondylitis, massage will focus at lengthening any of the muscles that are shortened to prevent your spine from fusing into a hunched position, or if you are already fused it will work to prevent excessive tightness in those shortened regions. In the case of a lupus patient who is having muscle spasms, the massage will target the specific muscles that are regularly spasming and causing increased pain. In the case of someone with ulcerative colitis, the massage could be visceral manipulation (during a non-flare- up time) to help with the scar tissue and adhesions that form during the flare-ups that can exacerbate the pain. With someone who has rheumatoid arthritis, the treatment could be focused at decreasing the excessive, protective muscle tightness around the inflamed joints.

There are times when massage is not indicated or needs to be modified to be safe for the client's current state. Depending on the specific disorder you present with, the RMT may have to avoid the local area and modify the depth and intensity of the treatment in a disorder that affects a specific joint or organ, during a flare-up. Your RMT will assess your state at each visit and modify the treatment according to how you are that day. There are instances during a flare-up that state that massage is beneficial to calm the nervous system and relax the patient if done in an appropriate way.

In conclusion our message is two-fold: There is no advance knowledge of who is going to develop an autoimmune disorder; however, if you have a chance of putting off or preventing an occurrence then why not try? By decreasing your physical and psychological stresses, having a healthy well-balanced diet, and monitoring your chemical exposure, you can decrease your chance of developing an autoimmune disorder. Besides living more healthily it will make you feel better! Secondly, if you have an autoimmune disorder, you can control or lesson your symptoms by making a few lifestyle changes. These changes may seem difficult or overwhelming at first, but just take it one step at a time. Start somewhere and keep adding to it. Before you know it, you will have a healthier immune system, body and mind.

Sources and resources

• Manole Cojocaru, Inimioara Mihaela Cojocaru, Isabela Silosi; Autoimmune diseases and their environmental triggers; Maedica - a Journal of Clinical Medicine, 2008
• Ljudmila Stojanovich , Dragomir Marisavljevich; Special Issue on Mosaic of Autoimmunity: Stress as a trigger of autoimmune disease; "Bezhanijska Kosa" University Medical Center, Belgrade University, Serbia; Autoimmunity Reviews Volume 7, Issue 3, January 2008, Pages 209-213
• McGonagle D, McDermott MF (2006) A Proposed Classification of the Immunological Diseases. PLoS Med 3(8): e297. August 29, 2006
• Fiona Rattray, Linda Ludwig; Clinical Massage Therapy; Talus Incorporated; 2000.