A Harvard-Trained MD On The Biggest Autoimmune Trigger No One Talks About

Autoimmune diseases are increasingly common, affecting an estimated 23.5 million people in the U.S., 80% of whom are women1. If you do struggle with an autoimmune condition, you know that many of the risk factors aren't in your control, but you can identify your specific triggers to avoid flare-ups. But according to Harvard- and MIT-trained integrative medicine doctor Sara Gottfried, M.D., author of The Autoimmune Cure, there's one giant catalyst we're all overlooking: trauma. 

"With autoimmune disease, you look for certain things," she explains on this episode of the mindbodygreen podcast. "You look for genetic predisposition. You look for increased intestinal permeability, or leaky gut. And then you look for a trigger…and what folks often don't understand is that those triggers can often be emotional or spiritual." 

First things first, let's discuss the research. Gottfried references the Adverse Childhood Experiences (ACE) Study2, conducted in 1998 by the CDC and health care company Kaiser Permanente, which found a direct link between childhood trauma and chronic diseases as an adult. 

"Since that time, studies show [a high] ACE score is associated with more than 45 different chronic diseases," says Gottfried. "Not just mental health—of course, it's going to increase your risk of post-traumatic stress disorder, depression, anxiety, [but] we're talking about physical health issues too. A much greater risk of diabetes3, more problems with blood sugar, more problems with autoimmune disease4, more problems with cardiovascular disease…"

She also mentions a NHANES survey5 that analyzed the number of people in the U.S. with anti-nuclear antibodies, which are commonly checked to see if you have an autoimmune disorder. "These are the B cells in your immune system that start to attack your own tissue," says Gottfried. "And what's been shown over time is that over the past 20-plus years, the rate of positive anti-nuclear antibodies has increased significantly." 

Coincidentally, our society is becoming increasingly overworked and overstressed. "There's something about the way that we're living that is increasing the attack of our own bodies," she adds.

Anecdotally, this is something Gottfried has seen in her own practice too. "In my practice, a significant number of people with autoimmune disease have a history of toxic stress and trauma," she declares. She alludes to one patient in particular, a woman in her early 40s who discovered that her husband was having an affair with her best friend (a very difficult trauma).

"A few months later, she started to notice elbow pain—swelling and stiffness—and some knee pain, and she ran a panel of tests with her primary care doctor. She had a positive rheumatoid factor, which is associated with rheumatoid arthritis," Gottfried explains. 

If you aren't familiar with your level of trauma, Gottfried suggests starting with your ACE score. "You may feel like you don't have much trauma from childhood, but unless you're actually measuring it using some validated methods, you may not know how it might be living on in your body," she says. 

She offers an ACE questionnaire on her website, though you can find a few others online. Each has a different rating system, but it will usually grade you on a scale from zero (not exposed to trauma) to 10. "We know that a score of one or higher is associated with a greater risk of chronic disease," Gottfried explains. It's not a perfect science, but the questionnaire can be a helpful tool. 

Trauma isn't the only trigger for autoimmune disease, but Gottfried says it's time we stop overlooking emotional factors. She still recommends a food-first approach to discover what may cause inflammation in your body, but she suggests keeping an eye on these other potential lifestyle stressors.