That “immune-boosting” supplement almost put me in the hospital. That fitness program everyone loves left me unable to get out of bed. Those “normal” lab results while I was actively dying.
If you have autoimmunity, you’ve probably experienced the frustration of trying to do everything right and still ending up in flares. In this episode, I’m breaking down the six major trigger categories that keep you stuck, and more importantly, what to do about them.
WHAT YOU’LL LEARN:
- Why herbs like echinacea and mushroom coffee might be destroying you (TH1/TH2 explained)
- The actual science behind food triggers and molecular mimicry
- Why you can’t work out like that fitness influencer (and what to do instead)
- The truth about cold plunges and why they’re harmful for women with autoimmunity
- Why your “normal” labs don’t invalidate your very real symptoms
- Practical stress management tools that actually work
This isn’t about restriction or fear. This is about understanding what your body needs so you can move through life with confidence instead of confusion.
RESOURCES MENTIONED:
- Cyrex Labs: https://www.cyrexlabs.com/
- Sequencing.com for genetic testing: https://sequencing.com/
- Therapist matching: https://www.theraplist.com/
- Psychology Today therapist directory: https://www.psychologytoday.com/
- Desbio Mental Emotional Detox Kit: https://dbscript.com/?direct=dralison
đź”— WORK WITH DR. ALISON:
Ready for personalized support to identify YOUR specific triggers? Learn about working together at https://www.littleblackbagmedicine.com
CONNECT WITH ME:
Instagram/Facebook: @AlisonDiBartoGoggin
Website: https://www.littleblackbagmedicine.com
Podcast: Functional Wellness with Dr. Alison
Listen Here:
Transcript:
Welcome back to Functional Wellness with Dr. Alison. We are on a roll this year talking about autoimmunity. I’ve shared my personal story and struggle, as well as talking about some root causes.
I am so passionate about working with women, men, and children who have autoimmunity or think they may have it, because it is such a widely misunderstood, under-researched, and under-treated issue in our society right now.
Most autoimmune diseases are considered or labeled as “zebras” because we were taught that it’s so rare, or it only happens to people when they’re over 60, and there isn’t any point in testing or looking for autoimmunity. But that couldn’t be further from the truth.
So hang in there with me, because we are going to cover exactly what you need to know about autoimmunity triggers of all kinds. There are so many hidden factors like herbs, supplements, exercise types, and current trends like cold plunges or extreme heat. You need to know what could trigger you and why, so you can continue your healing journey with confidence, not fear and restriction.
TESTING FOR AUTOIMMUNITY
Before we talk about testing, I want to comment on a few really important things that might save you from years of frustration.
First, testing is not a gold standard for all disease. You can have absolutely normal labs but all of the symptoms. When I was dying from end-stage colitis, my IBD antibody panel came back NORMAL. How crazy is that?
Second, your numbers can change depending on your state. Many women tell me that their markers switch from positive to negative all the time. That is normal and common and based on how your body is reacting in that moment. And here’s the thing: the correlation between high numbers and low numbers to symptoms doesn’t really exist. You can have a low ANA ratio but all of the symptoms. Or it can be extremely high, but you feel okay.
Third, we live with “silent autoimmunity” for years before it will show up on labs. When I work with women in their 20s, their labs are almost always perfect and there are no markers. Hell, even women in their 40s with every symptom under the sun. It takes years for the immune system to have active, testable antibodies. So it’s okay to be discouraged if your labs are perfect but you feel like death. Or are like me and actively dying.
I think it’s important to have the testing done and have baselines and an understanding of what’s going on, and then have the additional testing from ultrasounds to colonoscopies.
What Tests Are Available?
There are a few blood test markers that we commonly use. There are specific ones for the thyroid, for IBD like Crohn’s and colitis, and for arthritis. And then we have the mysterious ANA, which is a test that can only see that there is autoimmunity to the cell’s nucleus. We can see different patterns and look at the ratios.
From there, based on symptoms, we match up to lupus, mixed connective tissue disease, or Sjogren’s. Which is why when you look up what your lab values mean, there are about ten conditions labeled with each. We don’t have that specific testing, and I am really hopeful when I say “yet.” But I don’t know of any research going on right now that includes labs that differentiate between these conditions clearly.
There is the Cyrex Lab company that offers very deep dives into autoimmunity, the different types of cells and tissues, as well as food sensitivity testing, brain health, and more. I love their lab. The biggest issue is the cash cost barrier due to the expense.
And lastly, there is genetic testing, and I am referring out to Sequencing.com because they have such a large menu that includes Ehlers-Danlos. Again, that is cash pay. Yet it is easier to get this test than it is to go through insurance, finding a geneticist. Honestly, I tried using Invitae and it was just impossible to get covered.
HOW DO WE MANAGE TRIGGERS?
This is the biggest part of today’s conversation. And this is where you can take real action.
- Know the Difference Between TH1 and TH2
Our immune system is incredibly complex, and when it comes down to what you can actively do, this piece is key.
Think of TH1 and TH2 as a seesaw. One will be active for viral loads, one will be active for longer infections or more complex issues. And with autoimmunity, the path tends to get jammed in one direction and becomes dominant.
This is why I get so freaked out by general herbal recommendations for women who have autoimmunity. For me, I am TH1 dominant. So when I use herbs that support this part of my immune system, I land in a flare.
I took a good amount of astragalus because that is what my body muscle-tested me for, and after about three days, I was almost in the hospital because my immune system said, “Let’s go,” and instead of dealing with Epstein-Barr, it took down my intestines.
So as we are in the winter months right now, and you want to take echinacea, lemon balm, or you want to cut out coffee and go for the mushroom coffee… be careful. These herbs will slowly but surely take you down, and you might not recognize it.
TH1-Stimulating Herbs (avoid if TH1 dominant):
- Echinacea
- Astragalus
- Lemon Balm
- Medicinal mushrooms (reishi, lion’s mane, cordyceps)
- Panax ginseng
- Chlorella
- Grape Seed
- Maitake mushroom
- Melatonin
TH2-Stimulating Herbs (avoid if TH2 dominant):
- Caffeine
- Green tea extract (EGCG) and Matcha
- Grape seed extract
- Lycopene
- Resveratrol
- Pine bark extract
- Curcumin and quercitin (in some cases)
If you don’t know your dominance, work with a functional medicine practitioner who can help you figure this out through symptoms, testing, and careful observation.
- Food and Molecular Mimicry
This is the most complex to talk about over a podcast, and I usually get out my crappy posters to talk about food, sensitivities, and autoimmunity. But let me make it as simple as I can.
Think about when you eat a piece of bread. That bread has the gluten protein, and let’s say it has the chain of “GLUT” as a full protein. It needs to be broken down into its individual parts, which we call amino acids. So instead of a full GLUT, it is now an individual G and a separate L, and so on.
But because this is so hard to digest, our stomach and intestines can’t break it into amino acids. Then, as this comes into contact with our immune system, it doesn’t like full proteins and it will tag it as an invader, like a bacteria.
And over time, not immediately, the immune system keeps seeing this invader (but it’s just food) and will start to mount a bigger defense.
Now, with autoimmunity, this is key because our organs have protein tags on them so our immune system knows what they are. For example, our thyroid tag looks very similar to gluten’s. For this example, we can say the thyroid tag is “GLUD.” Similar, not the same.
But the immune system is smart, but not specific. So it sees this similar protein and thinks it is an invader and attacks. Which is why so many people go gluten-free and their autoimmune symptoms clear up, especially thyroid symptoms.
There is a wealth of research on gluten mimicking thyroid, pancreas, ovaries, joints, and the brain. So we come to this concept called molecular mimicry that causes our immune system to attack our own body. And because food looks like food, your immune system can also see corn, dairy, and soy as invaders as well.
How do we reduce this?
Option 1: You can do food sensitivity testing, like Everlywell or Cyrex, but you have to be eating all of the foods so there will be a response. If you are currently avoiding gluten, it will not show up on the test.
Option 2: Just cut it out. All dairy and gluten first, and you will need to give it about six weeks. Our body takes about two weeks for the immune system to calm down, then another 2-4 weeks to clear the reaction and inflammation from the constant onslaught of food.
Option 3: Be very careful. These foods are in everything, so yes, you need to have all your condiments gluten-free too. Read every label.
- Fitness and Overtraining
This is a big one. Because I know you are like me if you are listening to this.
We go to the gym. We start our workout program. We feel so good. We are getting stronger. And the next week: we feel like literal death. We overtrained. We “overdid it.” And then you are in a flare, in constant pain, and you wonder what the hell just happened.
So what happened is that you worked out. Yay, awesome job. Then your cortisol bumped up. Nice, normal. Which triggered your immune system to become a little more active. Also normal. Which is why we say exercise is so good to stay healthy, because you get that immune system bump.
BUT, if you’re autoimmune, your immune system targets YOU and not the bugs. What a pain.
How do we fix it?
We avoid overtraining.
How do you know you overtrained?
Usually it’s the next two days where you can’t walk. You have DOMS (delayed onset muscle soreness), maybe even post-exertional malaise. Your symptoms flare.
My tip is that when I watch my heart rate, I can’t get over 140 bpm. If I go over, then I will be in a flare. Also, moving slower. I love to lift weights, and my cardio is just lifting weights faster. So I do have to slow down, take my time, space out workouts, add in yoga, Pilates, walking, gentle movement. Not beat myself up for not being able to follow a hardcore program.
Listen, your genetics and immune system are built different from a woman who is an ultra-marathoner with no illnesses. She may be able to run, train, lift, have 15% body fat, and you may think, “I should be able to do that too.”
You take all her supplements she sells. You do her programs. And yet you gain weight. You feel worse. You can’t get out of bed.
It’s not you. It’s your immune system. Take care of YOU by YOUR standards, not other people’s.
- Stress-Inducing Therapies
Also known as oxidative stress therapies like cold plunges, ozone, and HBOT (hyperbaric oxygen therapy). These create “good” stress in the body, causing a shift to reduce inflammation, clean up dead cells, and invigorate metabolism. FOR MEN and women without autoimmunity.
These high-stress treatments, though you may not feel it in the moment, may actually be harmful for women, especially with autoimmunity.
Cold plunges that are very, very cold cause the neuroendocrine system to respond with a sharp spike in sympathetic activity and cortisol. Over time, that can disrupt menstrual regularity, blunt thyroid function, and impair recovery.
Now, some studies show that medium cold, not “fill the whole thing with ice” cold, may be beneficial for muscle recovery for women. But we are not small men. And the very few human research studies show that thyroid function decreases with cold plunges. Not something you want.
Most women prefer warmth, and that is where heat and saunas are safer and more metabolically aligned with our immune system.
Now, of course, there are many who are heat-sensitive and may have worsening issues with heat because of POTS, MCAS, or really any reason. So of course, avoid extreme heat. And I recommend middle-of-the-road here as well.
When I did sauna therapy, I talked with the owner of the spa so she knew that I was coming in first thing in the day, and the sauna could be warmed up to the lowest heat. I think I started around 110 degrees, and as I got better, I was able to tolerate more. And of course, I had bad days when I couldn’t tolerate it and took breaks during the session.
- Emotional Stress
The same goes for emotional stress, which you already know. Stress triggers a cascade of hormones that can impact your health as well as impact your nervous system and how your body innately reacts.
From trauma anniversaries to day-to-day stress, this is another area where you need to make sure you are doing the best you can to support your mental health.
A few general tips that I use in my personal life:
Find a great, trauma-informed therapist. A shout-out to www.theraplist.com to help you match to a provider that meets your needs, your insurance, your vibes. They are amazing. As well as psychologytoday.com.
Meditation is wonderful, but can also be triggering to your fight-flight systems and amygdala. So if you feel worse with meditation or triggered, that is actually a normal response. Find a different method. Maybe chanting, walking meditation, guided imagery. But keep trying.
I am using a homeopathic clearing from Desbio called the Mental Emotional Detox Kit, which I have found is very helpful for reducing my overreactions or spiraling. I have felt more calm, able to have difficult conversations, and I feel that my body is responding as well.
And lastly, medication may be the route that is best for you as well. If you find that an antidepressant or anti-anxiety medication is what is needed for the phase of life you are in, there are some amazing psychiatric NPs and doctors that can help guide you with the right tools.
- It’s All About Combination
This is all about the combination of all the tools. I know we want the one thing that is going to fix us, but we know we need to pay attention to all of it. All aspects of our health, from mental and emotional to food, to movement, to supplements.
And understanding our triggers is such a great key to making sure we stay flare-free.
- Ready for Personalized Care?
And if you’re ready for personalized care, this is where we start. This is the foundation of the work I do with women in my practice. We identify your specific triggers, your immune system patterns, and create a plan that works for YOUR body, not some influencer’s body.
I hope this episode gives you real, actionable tools to understand your autoimmunity better and avoid the triggers that have been keeping you stuck in flares.
Remember, this is not about restriction and fear. This is about knowledge and empowerment. When you understand what your body needs and what it doesn’t, you get to move through your life with so much more confidence and freedom.
If you found this helpful, please share it with someone who needs to hear it. And as always, you can find me at littleblackbagmedicine.com and on Instagram.
Take care of yourself. You deserve it.