Autoimmune Diseases: Types, Symptoms, Causes, and MoreWhat is an autoimmune disease?
An autoimmune disease is a condition in which your immune system mistakenly attacks your body. The immune system normally guards against germs like bacteria and viruses. When it senses these foreign invaders, it sends out an army of fighter cells to attack them.
Normally, the immune system can tell the difference between foreign cells and your own cells.
In an autoimmune disease, the immune system mistakes part of your body, like your joints or skin, as foreign. It releases proteins called autoantibodies that attack healthy cells.
Some autoimmune diseases target only one organ. Type 1 diabetes damages the pancreas. Other diseases, like systemic lupus erythematosus (SLE), affect the whole body.
Why does the immune system attack the body?
Doctors don’t know exactly what causes the immune-system misfire. Yet some people are more likely to get an autoimmune disease than others.According to a 2014 study, women get autoimmune diseases at a rate of about 2 to 1 compared to men — 6.4 percent of women vs. 2.7 percent of men. Often the disease starts during a woman’s childbearing years (ages 15 to 44).Some autoimmune diseases are more common in certain ethnic groups. For example, lupus affects more African-American and Hispanic people than Caucasians.
Certain autoimmune diseases, like multiple sclerosis and lupus, run in families. Not every family member will necessarily have the same disease, but they inherit a susceptibility to an autoimmune condition.Because the incidence of autoimmune diseases is rising, researchers suspect environmental factors like infections and exposure to chemicals or solvents might also be involved.A “Western diet” is another suspected risk factor for developing an autoimmune disease. Eating high-fat, high-sugar, and highly processed foods is thought to be linked to inflammation, which might set off an immune response. However, this hasn’t been proven.
A 2015 study focused on another theory called the hygiene hypothesis. Because of vaccines and antiseptics, children today aren’t exposed to as many germs as they were in the past. The lack of exposure could make their immune system prone to overreact to harmless substances.
BOTTOM LINE: Researchers don’t know exactly what causes autoimmune diseases. Genetics, diet, infections, and exposure to chemicals might be involved.
14 common autoimmune diseases
There are more than 80 different autoimmune diseases. Here are 14 of the most common ones.
1. Type 1 diabetes
The pancreas produces the hormone insulin, which helps regulate blood sugar levels. In type 1 diabetes mellitus, the immune system attacks and destroys insulin-producing cells in the pancreas.High blood sugar results can lead to damage in the blood vessels, as well as organs like the heart, kidneys, eyes, and nerves.
2. Rheumatoid arthritis (RA)
In rheumatoid arthritis (RA), the immune system attacks the joints. This attack causes redness, warmth, soreness, and stiffness in the joints. Unlike osteoarthritis, which commonly affects people as they get older, RA can start as early as your 30s or sooner.
3. Psoriasis/psoriatic arthritis
Skin cells normally grow and then shed when they’re no longer needed. Psoriasis causes skin cells to multiply too quickly. The extra cells build up and form inflamed red patches, commonly with silver-white scales of plaque on the skin.
Up to 30 percent of people with psoriasis also develop swelling, stiffness, and pain in their joints. This form of the disease is called psoriatic arthritis.
4. Multiple sclerosis
Multiple sclerosis (MS) damages the myelin sheath, the protective coating that surrounds nerve cells, in your central nervous system. Damage to the myelin sheath slows the transmission speed of messages between your brain and spinal cord to and from the rest of your body.
This damage can lead to symptoms like numbness, weakness, balance issues, and trouble walking. The disease comes in several forms that progress at different rates. According to a 2012 studyTrusted Source, about 50 percent of people with MS need help walking within 15 years after the disease starts.
5. Systemic lupus erythematosus (SLE)
Although doctors in the 1800s first described lupus as a skin disease because of the rash it commonly produces, the systemic form, which is most the common, actually affects many organs, including the joints, kidneys, brain, and heart. Joint pain, fatigue, and rashes are among the most common symptoms.
6. Inflammatory bowel disease
Inflammatory bowel disease (IBD) is a term used to describe conditions that cause inflammation in the lining of the intestinal wall. Each type of IBD affects a different part of the GI tract.
Addison’s disease affects the adrenal glands, which produce the hormones cortisol and aldosterone as well as androgen hormones. Having too little of cortisol can affect the way the body uses and stores carbohydrates and sugar (glucose). Deficiency of aldosterone will lead to sodium loss and excess potassium in the bloodstream.Symptoms include weakness, fatigue, weight loss, and low blood sugar.
8. Graves’ disease
Graves’ disease attacks the thyroid gland in the neck, causing it to produce too much of its hormones. Thyroid hormones control the body’s energy usage, known as metabolism.
Having too much of these hormones revs up your body’s activities, causing symptoms like nervousness, a fast heartbeat, heat intolerance, and weight loss.One potential symptom of this disease is bulging eyes, called exophthalmos. It can occur as a part of what is called Graves’ ophthalmopathy, which occurs in around 30 percent of those who have Graves’ disease, according to a 1993 studyTrusted Source.
9. Sjögren’s syndrome
This condition attacks the glands that provide lubrication to the eyes and mouth. The hallmark symptoms of Sjögren’s syndrome are dry eyes and dry mouth, but it may also affect the joints or skin.
10. Hashimoto’s thyroiditis
In Hashimoto’s thyroiditis, thyroid hormone production slows to a deficiency. Symptoms include weight gain, sensitivity to cold, fatigue, hair loss, and swelling of the thyroid (goiter).
11. Myasthenia gravis
Myasthenia gravis affects nerve impulses that help the brain control the muscles. When the communication from nerves to muscles is impaired, signals can’t direct the muscles to contract. The most common symptom is muscle weakness that gets worse with activity and improves with rest. Often muscles that control eye movements, eyelid opening, swallowing, and facial movements are involved.
12. Autoimmune vasculitis
Autoimmune vasculitis happens when the immune system attacks blood vessels. The inflammation that results narrows the arteries and veins, allowing less blood to flow through them.
13. Pernicious anemia
This condition causes deficiency of a protein, made by stomach lining cells, known as intrinsic factor that is needed in order for the small intestine to absorb vitamin B-12 from food. Without enough of this vitamin, one will develop an anemia, and the body’s ability for proper DNA synthesis will be altered.Pernicious anemia is more common in older adults. According to a 2012 study, it affects 0.1 percent of people in general, but nearly 2 percent of people over age 60.
14. Celiac disease
People with celiac disease can’t eat foods containing gluten, a protein found in wheat, rye, and other grain products. When gluten is in the small intestine, the immune system attacks this part of the gastrointestinal tract and causes inflammation.A 2015 studyTrusted Source noted that celiac disease affects about 1 percent of people in the United States. A larger number of people have reported gluten sensitivity, which isn’t an autoimmune disease, but can have similar symptoms like diarrhea and abdominal pain.
Autoimmune disease symptoms
The early symptoms of many autoimmune diseases are very similar, such as:
With autoimmune diseases like psoriasis or RA, symptoms may come and go. A period of symptoms is called a flare-up. A period when the symptoms go away is called remission.
BOTTOM LINE: Symptoms like fatigue, muscle aches, swelling, and redness could be signs of an autoimmune disease. Symptoms might come and go over time.
When to see a doctor
See a doctor if you have symptoms of an autoimmune disease. You might need to visit a specialist, depending on the type of disease you have.
No single test can diagnose most autoimmune diseases. Your doctor will use a combination of tests and a review of your symptoms and physical examination to diagnose you.
The antinuclear antibody test (ANA) is often one of the first tests that doctors use when symptoms suggest an autoimmune disease. A positive test means you may have one of these diseases, but it won’t confirm exactly which one you have or if you have one for sure.
Other tests look for specific autoantibodies produced in certain autoimmune diseases. Your doctor might also do nonspecific tests to check for the inflammation these diseases produce in the body.
BOTTOM LINE: A positive ANA blood test may be indicative of an autoimmune disease. Your doctor can use your symptoms and other tests to confirm the diagnosis.
How are autoimmune diseases treated?
Treatments can’t cure autoimmune diseases, but they can control the overactive immune response and bring down inflammation or at least reduce pain and inflammation. Drugs used to treat these conditions include:
Eating a well-balanced diet and getting regular exercise may also help you feel better.
BOTTOM LINE: The main treatment for autoimmune diseases is with medications that bring down inflammation and calm the overactive immune response. Treatments can also help relieve symptoms.
THE BOTTOM LINE
More than 80 different autoimmune diseases exist. Often their symptoms overlap, making them hard to diagnose.Autoimmune diseases are more common in women, and they often run in families.Blood tests that look for autoantibodies can help doctors diagnose these conditions. Treatments include medications to calm the overactive immune response and bring down inflammation in the body.
The oral cavity is the intersection of medicine and dentistry and the window into the general health of a patient. Hundreds of diseases and medications impact the oral cavity, and pathologic conditions in the mouth have a greater systemic impact than many providers appreciate. It is unclear whether there is true causality or just an association between periodontal disease and certain other systemic conditions, including atherosclerotic vascular disease, pulmonary disease, diabetes, pregnancy-related complications, osteoporosis, and kidney disease. Diabetes has a true bidirectional relationship with periodontal disease, and there is strong evidence that treating one condition positively impacts the other. A shared trait of periodontal disease and these medical conditions is that they are chronic conditions that take a long time to develop and become clinically significant. Primary prevention, treating the patient prior to the onset of symptoms, myocardial infarction, stroke, diabetic complications, or significant periodontal disease is the challenge. Complications associated with these conditions cause significant morbidity and mortality and are incredibly costly to the healthcare system. Unfortunately, a lack of access to primary medical or dental care prevents some patients from engaging the system until a negative event has occurred. Despite the absence of clear evidence of causality and the direct impact of treatments, the consequences of these chronic conditions for the population are well understood. Dentists, family physicians, and all primary care providers must increase their collaboration and communication to maximize the benefit to patients. The oral cavity has been described as “the window to general health.” The oral cavity is also the intersection of dentistry and medicine, semi-independent professions that share the same common goal of improving the health and quality of life of patients. At the heart of each profession is the basic concept that appropriate interventions within the framework of that discipline will have an overall positive impact on patients’ health, welfare, and quality of life.It has been estimated that more than 100 systemic diseases and upward of 500 medications have oral manifestations, which are typically more prevalent in the older population. Hippocrates reportedly cured systemic conditions by pulling infected teeth. Despite this, the relationship and impact of oral conditions on systemic conditions has not been fully appreciated until recently. Is there direct causality between oral and systemic health conditions, or is it just coincidence? This is the main question that may have slowed the understanding of these processes as well as the interaction and collaboration between dentistry and medicine. Bidirectional relationships between oral and systemic conditions are becoming better understood, but more research into this area is needed. As the impact of oral health on systemic health is clarified and proven, dental and medical professionals need to develop closer ties. Whether causal or coincidental, the impact and importance of oral health on overall health has been the focus of multiple surgeons general of the United States as well as the World Health Organization. Access to dental and medical care is a complicated issue; availability of care, cost of care and insurance, cultural issues, and fear are all factors that keep patients out of the office. From a population health perspective, it should not matter who initially examines the patient and identifies a risk factor or early evidence of a disease; what matters is that the patient gets the care he or she needs.
The mouth and oral cavity are focal points for the interaction of the body with the external environment. Speech, chewing, swallowing, and the early stages of digestion are all vital physiological functions that involve the oral cavity, and the mouth plays a role in psychological identity. There are multiple surface types in the oral cavity, and each is colonized with a unique population of 500-700 species of bacteria, viruses, fungi, and protozoa, a good number of which are significantly virulent and many of which have not been cultivated.The level of oral hygiene significantly impacts the makeup of the oral microbiome. Individuals with good oral hygiene tend to have a simple flora dominated by gram-positive cocci and rods and some gram-negative cocci, while those with poor oral hygiene have a shift to a more diverse and complex flora dominated by anaerobic gram-negative organisms.The oral cavity is also bathed in a complex mixture of fluids, composed primarily of saliva and gingival crevicular fluid, that plays a major role in maintaining a healthy oral environment. Saliva, like many other bodily functions, has an optimal range; underproduction (xerostomia), overproduction (sialorrhea), and alterations in chemical makeup can lead to bidirectional impacts on health. Bacteria and saliva play a direct role in the development of the dental biofilm, which is commonly referred to as plaque in the lay community. Currently, there is a better understanding that not all plaque is bad and that the interrelationship between saliva and bacteria can protect the teeth by helping maintain mineralization and reducing exposure to dietary acid.The initial bacteria attach to salivary molecules that are absorbed on the tooth surface. The bacteria multiply and lay down a polymer matrix that serves as the framework for more bacteria to attach themselves. A commensal microflora of streptococcal species characterizes the biofilm associated with healthy teeth and gingiva. These organisms prove to be beneficial by interfering with the colonization of more pathologic species. However, a disruption in the oral ecosystem (dysbiosis) can lead to the predominance of carbohydrate-fermenting gram-positive species, which leads to tooth demineralization, thereby beginning the process of oral pathosis.
Oral pathology is a broad topic, but this article will focus on the oral conditions that have an established or accepted relationship with systemic health: caries and the periodontal diseases of gingivitis and periodontitis. Dental caries is probably the most common infectious disease across humanity. The prevalence varies across different populations, as public water fluoridation programs have greatly impacted the disease in those areas where it is available, but caries still occurs in epidemic proportions in disadvantaged areas. Caries is a polymicrobial disease that results from the breakdown of dental enamel by lactic acid that is created when cariogenic bacteria in the biofilm digest dietary fermentable carbohydrates. Periodontal diseases are a group of chronic immuneinflammatory diseases caused by the bacteria in the biofilm and primarily affecting tooth-supporting structures. Gingivitis and periodontitis are two forms of periodontal disease that exist on a spectrum ranging from bleeding, erythematous, and inflamed gingival tissue to the loss of attachment and alveolar bone. Gingivitis, the milder form of periodontal disease, is characterized by local erythema, swelling, and easy bleeding. Gingivitis is usually pain free; as a result, patients can go years without diagnosis of the disease, but it is easily treatable once identified. Periodontitis, the loss of connective tissue and bone, is the result of chronic inflammation caused by the persistent presence of pathologic bacteria in the biofilm (Figure). The bacteria accumulate in pockets and pull the gingiva away from the teeth. This process triggers the body’s immune response, which leads to damage to the supporting structures. Periodontitis is a leading cause of tooth loss around the world.
Systemic conditions impacted by oral health
The benefits of good oral health are well studied and include economic, social, psychological, and physical health.16 Garcia et al reported that the greater the number of missing teeth, the poorer the quality of life. Poor dentition also leads to issues with chewing and can negatively impact nutritional intake. These relationships are obvious, but the significant impact and relationship of oral and serious systemic conditions are areas that call for increased collaboration. Figure. Development of periodontal disease. Normal tooth Periodontitis Bone loss Bone Enamel Healthy gingiva Healthy bone level Inflammation Plaque and calculus Deepening pocket The effects of oral health on systemic health. Chronic health conditions create a massive burden on the health of individuals as well as the entire healthcare system. Routine and regular dental care not only prevents periodontal disease but also helps to stratify patients who are at significant risk for more serious systemic conditions. It has been estimated that 75% of baby boomers will enter long-term care facilities with the majority of their natural teeth, and it is well understood that patients with good oral care require fewer healthcare dollar expenditures. Among the systemic conditions that are impacted, either coincidentally or causally, by oral conditions are atherosclerotic disease, pulmonary disease, diabetes, pregnancy, birth weight, osteoporosis, and kidney disease.
Atherosclerosis, the pathologic narrowing of arteries due to the deposition of cholesterol and cholesterol products in vessel walls, is the primary cause of most cases of coronary heart disease and cerebrovascular disease.18 Studies done many years ago have shown that patients with a history of myocardial infarction or cerebrovascular attacks have worse oral health than control individuals. Annually, cardiovascular disease accounts for approximately 32%-50% of deaths in the United States and 29%-31% worldwide and may be one of the best-studied relationships between oral health and systemic health. Elevated blood cholesterol, hypertension, diabetes, and smoking are the traditionally discussed risk factors for cardiovascular disease. Growing bodies of evidence indicate that chronic inflammation, metastatic infection, and vascular injury from endotoxins are possible oral cavity–based etiologies of cardiovascular diseases. Patients with periodontal disease and poor oral hygiene suffer from frequent and severe gingival inflammation and frequent bacteremia, both of which activate the host inflammatory response. This chronic inflammatory state triggers multiple proinflammatory cytokines, such as C-reactive protein, tumor necrosis factor α, interleukin 1β, and interleukin 6, which, in conjunction with bacteremia, appear to stimulate the process of atherogenesis as well as increase the susceptibility of the vascular endothelium for injury (a precursor to atherogenesis). In addition, during episodes of dental bacteremia, streptococci of the viridans group can induce platelet aggregation and possibly thrombus formation. Atherosclerotic cerebrovascular disease plays a major role in the etiology of cerebrovascular accidents (strokes) and transient ischemic attacks. While several studies have demonstrated that periodontal disease and poor oral hygiene have a strong association with the risk of coronary heart disease and acute myocardial infarction, other studies have not shown this link; as a result, there is insufficient evidence to prove a causal link between them.There is better evidence to support the causal relationship between poor dental health and cerebrovascular disease.Can a patient’s risk of heart disease and stroke be reduced by treating periodontal conditions and improving oral health? From a population health standpoint, with the high prevalence of each condition, it would be a major benefit to know that improving oral health would reduce the risk of conditions with significant morbidity and mortality. Similar to the causality data, the intervention data are not conclusive, but current research is trending in favor of the interpretation that improvement of oral health decreases the risk of atherosclerotic disease.
Pulmonary diseases such as pneumonia, chronic obstructive pulmonary diseases (including emphysema), and exacerbations of chronic bronchitis all involve the aspiration of bacteria from the oropharynx into the lower respiratory tract. At one time, it was thought that only patients with endotracheal and orogastric tubes, swallowing disorders, and impaired consciousness were at risk of aspiration. However, studies have shown that up to 50% of healthy individuals aspirate oropharyngeal contents while asleep. The teeth, periodontium, and biofilm all can harbor and serve as reservoirs for pathologic bacteria, and the presence of periodontal disease changes the milieu, making it easier for pathogens to attach and multiply. The development of an infection is multifactorial and depends on more than just the presence of bacteria, as the body has multiple echelons of defense to prevent bacteria from seeding the lower respiratory tract. These defenses are limited in patients who are critically ill and intubated, and multiple intervention studies have shown that improving the oral hygiene of ventilated critical care patients decreases the risk of ventilator-associated pneumonia.The evidence on the causality and relationship between pulmonary infections and oral health is inconclusive but trending toward a positive unidirectional relationship. Many high-quality studies have shown that improving the oral hygiene of institutionalized and ventilated patients has a positive outcome on their systemic health.
Diabetes is a disease of disrupted glycemic control resulting from a lack of insulin production (type 1) or systemic insulin resistance (type 2). In 2008, it was estimated that 18 million people worldwide had diabetes.20 Diabetes presents multiple challenges to the patient, and prolonged exposure to hyperglycemia is the primary cause of the litany of complications created by diabetes. Prolonged hyperglycemia has negative effects on the heart, eyes, kidneys, and peripheral nerves, and researchers now suggest that periodontal disease should be considered a major complication of diabetes. The relationship between diabetes and periodontitis is truly bidirectional, as it is well proven that hyperglycemia negatively impacts oral health and severe periodontitis can negatively impact glycemic control. Individuals with diabetes have at least a 3 times greater risk of periodontitis than those without diabetes. However, studies have shown that patients with well-controlled diabetes have no increased risk of periodontitis compared to individuals without diabetes. Gingival pockets that are deeper than 4 mm are more common in diabetics than nondiabetics, and patients with pockets greater than 2 mm deep are at an increased risk of diabetes compared to patients with pockets less than 1.3 mm deep. Individuals with diabetes also suffer from greater amounts of alveolar bone loss, abscess formation, and poor healing. Why do diabetics have all of these oral complications? The prolonged exposure to hyperglycemia results in the production of advanced glycation end products. Advanced glycation end products have a systemic impact that results in the increased excretion of cytokines, leading to local inflammation and a loss of connective tissue. Local inflammation in the mouth has a systemic effect—glycemic control is more difficult, and the risk of infection is increased— explaining the bidirectional relationship of the condition. Although periodontal disease can have negative adverse effects on diabetes, its impact is modifiable and treatments can greatly improve the health of the patient. Multiple studies have looked at the best way to treat periodontitis and positively impact glycemic control. The combination of mechanical removal of the biofilm and use of oral antibiotics has the greatest impact on glycemic control and periodontal disease in diabetic patients. Aggressive prevention and treatment of periodontal disease in diabetic patients is an effective way to mitigate the medical complications of this chronic disease.
Pregnancy complications and low birth weight
Pregnancy is a time of great change in a woman’s body, and the changes impact both the oral cavity and the maternal-fetal complex. Gastric acid secretion and the reflux of the acid into the oral cavity leads to worsening of enamel erosion, increased caries risk, xerostomia, and increased tooth mobility and loss. Although pregnancy is a normal condition, non-obstetric providers are often hesitant to care for pregnant patients out of concern for the potential impact on the pregnancy. It is estimated that between 22% and 34% of pregnant women will consult a dentist while pregnant, and only 50% of women would address an oral issue while pregnant. Despite the fact that there is some good evidence that oral conditions can negatively impact pregnancy (increasing the incidence of preeclampsia, low birth weight, stillbirth, and spontaneous abortions), there are no guidelines for the management of oral condition in pregnant women.To reassure patients and providers, it might be time for professional societies to join forces and create some guidelines for addressing conditions that are known to impact the mother and her unborn fetus. The changes in the gingiva that occur during pregnancy are associated with the changes in estrogen and progesterone levels. These hormonal changes are most dramatic between the second and eighth months of pregnancy, and the gingival changes coincide with this period. The hormones cause capillary dilation that results in gingival hypertrophy and inflammation. Subsequent to the changes in the gingiva, there is a change in the oral flora, including an increase in the amount of anaerobic bacteria. These anaerobes initiate an inflammatory process that has systemic impacts.This distant oral infection triggers an inflammatory process similar to bacterial vaginitis, resulting in myometrial contractions and preterm birth. Preterm, low–birth-weight infants are probably the beststudied obstetric complication of periodontal disease; the presence of periodontal disease in the mother results in a 7.5 times greater risk of this complication. Unfortunately, the data on the impact of treating periodontal disease during pregnancy are mixed. Multiple systemic reviews have been completed, and some show a positive impact if periodontal disease is treated while others show no change or a less than statistically significant change. Despite the lack of solid evidence, it is intuitive that anything that optimizes the health of the mother and the fetus is beneficial. It would be prudent for women who are planning a pregnancy, especially those with known periodontal disease, to consider undergoing a thorough periodontal examination and necessary treatment.
In osteoporosis, an imbalance between bone loss and formation results in decreased bone mineral density. Decreased bone density in the jawbone leads to greater alveolar bone resorption, increasing the depth and number of gingival pockets, which in turn allows invasion by periodontal pathogens.This chronic infection leads to local and systemic increases in interleukin 6, which is a known predictor of bone loss. As with many of the conditions already discussed, it is impossible to state that periodontal disease is causal to osteoporosis, but the studies seem to lean toward a positive relationship between the conditions.Currently there is no strong evidence to suggest that treating periodontal disease will have an impact on osteoporosis. Periodontal disease and other conditions that result in poor oral health are common in patients with chronic kidney disease. These oral conditions can lead to systemic inflammation, infection, protein wasting, and the development of atherosclerotic lesions, all of which worsen morbidity and mortality in chronic kidney disease patients. It is unclear whether treating periodontal disease will positively impact patients with chronic kidney disease, but optimizing the patient’s overall health cannot have a negative impact.
Optimization of patients’ health is the goal of both the medical and dental professions. Atherosclerotic vascular disease, pulmonary disease, diabetes, and pregnancy-related complications are the major conditions that effect a large percentage of the population and have been well studied for their relationship to oral health, but it is probably safe to assume that there are other conditions that have some degree of association. Although many of the studies on treatment of oral disease have not shown a statistically significant impact on these systemic conditions, neither profession will deny that maximizing a patient’s health is advantageous. Primary prevention of disease is the best approach but often difficult to achieve. From a primary care standpoint, it is vital that physicians and dentists increase collaboration and share information that can impact the patient’s health. Most patients with these chronic conditions probably do not think that a problem in their mouth can affect their heart or bones. Modifying any coexisting condition may be enough to prevent a significant, possibly life-threatening medical outcome.
Massage therapy uses manual manipulation of soft tissue, including muscle and connective tissue, to improve well-being. This can be done in a relaxing or rehabilitative setting. Massage therapy has been studied as a methodology to improve cancer or treatment-related symptoms and overall quality of life, particularly among patients with breast cancer.
Cancer or Treatment-Related Symptoms
Multiple small randomized controlled trials (RCTs) have evaluated the effect of massage on breast cancer related symptoms and quality of life, but the results are mixed. A meta-analysis that included 18 RCTs with 950 patients found that regular massage significantly improved anger and fatigue. Anxiety, however, was found to be significantly improved. Several individual RCTs showed that massage improved anxiety, anger, and depressed mood immediately after the session compared with control, with some benefits persisting after massage therapy ended, such as less hostility and reduced depression and anger. One study found that five twenty minute massage visits significantly reduced nausea compared with control, but there was no difference observed in levels of anxiety or depression. Some RCTs evaluated the effect of massage on the immune system. One study of ten twenty minute effleurage massage visits found that massage therapy increased natural killer cells, NK cell and lymphocyte numbers by the end of the study. Massage therapy was also found to ameliorate the NK cell deterioration associated with radiation therapy. Massage therapy was found to improve quality of life measures and symptom concerns. Markers of stress, such as cortisol levels and blood pressure, were improved in some studies. According to a subjective study, patients with breast cancer who received massage therapy reported that they felt relaxed, cared for, and a general sense of well-being. Patients also noted that massage provided a distraction from the anxiety of chemotherapy.
Studies have shown that massage therapy can be beneficial for cancer patients both during and following treatment. Massage therapy can counteract many of the negative physical and emotional symptoms of cancer and side effects of cancer treatment for patients. More and more cancer patients are interested in finding ways to enhance their conventional treatment with complementary therapy options, including massage therapy.
Some of the potential benefits of massage therapy as a complementary treatment for cancer patients:
Have you ever had a gut feeling or butterflies in your stomach? These sensations emanating from your belly suggest that your brain and gut are connected. What’s more, recent studies show that your brain affects your gut health and your gut may even affect your brain health. The communication system between your gut and brain is called the gut-brain axis.
How Are the Gut and Brain Connected? The gut-brain axis is a term for the communication network that connects your gut and brain. These two organs are connected both physically and biochemically in a number of different ways. The Vagus Nerve and the Nervous System Neurons are cells found in your brain and central nervous system that tell your body how to behave. There are approximately 100 billion neurons in the human brain. Interestingly, your gut contains 500 million neurons, which are connected to your brain through nerves in your nervous system. The vagus nerve is one of the biggest nerves connecting your gut and brain. It sends signals in both directions. For example, in animal studies, stress inhibits the signals sent through the vagus nerve and also causes gastrointestinal problems.Similarly, one study in humans found that people with irritable bowel syndrome (IBS) or Crohn’s disease had reduced vagal tone, indicating a reduced function of the vagus nerve. An interesting study in mice found that feeding them a probiotic reduced the amount of stress hormone in their blood. However, when their vagus nerve was cut, the probiotic had no effect. This suggests that the vagus nerve is important in the gut-brain axis and its role in stress. Your gut and brain are also connected through chemicals called neurotransmitters. Neurotransmitters produced in the brain control feelings and emotions. For example, the neurotransmitter serotonin contributes to feelings of happiness and also helps control your body clock. Interestingly, many of these neurotransmitters are also produced by your gut cells and the trillions of microbes living there. A large proportion of serotonin is produced in the gut.
Your gut microbes also produce a neurotransmitter called gamma-aminobutyric acid (GABA), which helps control feelings of fear and anxiety. Studies in laboratory mice have shown that certain probiotics can increase the production of GABA and reduce anxiety and depression-like behavior. Gut Microbes Make Other Chemicals That Affect the brain.The trillions of microbes that live in your gut also make other chemicals that affect how your brain works.Your gut microbes produce lots of short-chain fatty acids (SCFA) such as butyrate, propionate and acetate.They make SCFA by digesting fiber. SCFA affect brain function in a number of ways, such as reducing appetite. One study found that consuming propionate can reduce food intake and reduce the activity in the brain related to reward from high-energy food.
Another SCFA, butyrate, and the microbes that produce it are also important for forming the barrier between the brain and the blood, which is called the blood-brain barrier. Gut microbes also metabolize bile acids and amino acids to produce other chemicals that affect the brain. Bile acids are chemicals made by the liver that are normally involved in absorbing dietary fats. However, they may also affect the brain. Two studies in mice found that stress and social disorders reduce the production of bile acids by gut bacteria and alter the genes involved in their production. Gut microbes affect Inflammation. Your gut-brain axis is also connected through the immune system. Gut and gut microbes play an important role in your immune system and inflammation by controlling what is passed into the body and what is excreted. If your immune system is switched on for too long, it can lead to inflammation, which is associated with a number of brain disorders like depression and Alzheimer’s disease.
Lipopolysaccharide (LPS) is an inflammatory toxin made by certain bacteria. It can cause inflammation if too much of it passes from the gut into the blood. This can happen when the gut barrier becomes leaky, which allows bacteria and LPS to cross over into the blood. Inflammation and high LPS in the blood have been associated with a number of brain disorders including severe depression, dementia and schizophrenia.
Your gut and brain are connected physically through millions of nerves, most importantly the vagus nerve. The gut and its microbes also control inflammation and make many different compounds that can affect brain health. Probiotics, Prebiotics and the Gut-Brain AxisGut bacteria affect brain health, so changing your gut bacteria may improve your brain health.
Probiotics are live bacteria that impart health benefits if eaten. However, not all probiotics are the same. Probiotics that affect the brain are often referred to as “psychobiotics”. Some probiotics have been shown to improve symptoms of stress, anxiety and depression. One small study of people with irritable bowel syndrome and mild-to-moderate anxiety or depression found that taking a probiotic called Bifidobacterium longum NCC3001 for six weeks significantly improved symptoms. Prebiotics, which are typically fibers that are fermented by your gut bacteria, may also affect brain health. One study found that taking a prebiotic called galactooligosaccharides for three weeks significantly reduced the amount of stress hormone in the body, called cortisol.
Probiotics that affect the brain are also called psychobiotics. Both probiotics and prebiotics have been shown to reduce levels of anxiety, stress and depression. What Foods Help the Gut-Brain Axis? Health Tip: The Foods Your Brain Craves.
A few groups of foods are specifically beneficial for the gut-brain axis.
Here are some of the most important ones:
A number of foods such as oily fish, fermented foods and high-fiber foods may help increase the beneficial bacteria in your gut and improve brain health. The gut-brain axis refers to the physical and chemical connections between your gut and brain. Millions of nerves and neurons run between your gut and brain. Neurotransmitters and other chemicals produced in your gut also affect your brain. By altering the types of bacteria in your gut, it may be possible to improve your brain health. Omega-3 fatty acids, fermented foods, probiotics and other polyphenol-rich foods may improve your gut health, which may benefit the gut-brain axis.