This month, I'll be discussing the latest information on autoimmune diseases and their impact on women's health worldwide, and highlighting successful chiropractic case reports involving autoimmune diseases.

Autoimmune diseases, affecting more than 8.5 million Americans, 80% of them female, are the eighth leading cause of death for women ages 15-64. Their impact is not limited to the United States, but is a worldwide issue. Both the United Nations Commission on the Status of Women and the World Health Organization have been approached to have autoimmune diseases declared a major women's health concern.

A healthy immune system is designed to protect the body from harm, responding to both internal or external triggers -- toxins, cancer cells, substances from another person or species. Disorders in the immune system can occur when the immune response does not meet the body's needs and may be too strong, insufficient or not appropriate.

In autoimmune diseases, it is suggested that as the normal control process is disrupted, the immune system is unable to distinguish between "self" and "non-self," and reacts by attacking its own normal tissues. This response can result in the destruction or alteration in size or function of body tissues and organs, including connective tissue, muscles, joints, skin, endocrine glands, blood cells and vessels.

There are more than 80 disorders identified, with severity ranging from uncomfortable to deadly, including: rheumatoid arthritis, multiple sclerosis, Graves' disease, diabetes, lupus, Hashimoto's thyroiditis, pernicious anemia and psoriasis. It is suggested that those diagnosed with an autoimmune disease are at a higher risk for others.

The current approach in medical research is to view these as a related group of conditions, and identify the elements in common, as evidenced by a recent article in the Journal of the American Medical Association (JAMA) on the suggested association between Epstein-Barr and multiple sclerosis.

Recent research has included the recognition that women and men have distinctions not only at a societal level but also at a physiological level, not limited to differences in hormones. These cellular and molecular rhythms include differences in perception of pain, energy storage, metabolism, and responses to initiating agents, which may impact how health care providers, researchers and the public view and approach health.

In autoimmune diseases, identified differences between the sexes are: rates of occurrence (80% women), and chemical make-up of women's immune system compared to men's i.e., differences in inflammatory response (less), an enzyme associated with chronic inflammatory disease (higher), and natural killer cell activity (less).

Sex Hormones also play a role, the most obvious are the changes observed during pregnancy:

*** Women with rheumatoid arthritis and multiple sclerosis can observe a decrease in symptoms during pregnancy, women with lupus can observe an increase in symptoms.

*** Two-five percent of all non-diabetic pregnant women develop gestational diabetes, a form of diabetes that only occurs during pregnancy and increases the risk for Type II diabetes later in life.

Excluding pregnancy, the influence of sex hormones is considered in:

-- Lupus (systemic lupus erythematosus), which primarily affects women of childbearing age, and typically decreases in intensity in postmenopausal women.

-- Multiple sclerosis (MS), where those affected can notice symptoms worsen in the days preceding menses.

There are is medical cure for autoimmune disease. Control of symptoms is attempted through suppression of the immune system, in hopes of reducing the attack on the body's own system while leaving some resources for responding to invaders.

Evidence indicates that results vary, and safety is questionable as the side effects of immuno-suppressant medications can be toxic. Online, WebMd reports the great difficulty associated with diagnosis and treatment. These illnesses are repeatedly misdiagnosed, and they have yet to identify the cause, hoping that research will have a breakthrough within the next 10 years.

Research into the database of the National Center for Complementary and Alternative Medicine (NCCAM) division of the National Institutes of Health demonstrates that efforts are being made to explore and document natural approaches -- including nutritional supplements, elimination of food allergens, oriental medicine, etc. -- with enough success to stimulate interest in further and more extensive research.

Chiropractic's objective is the detection and correction of the vertebral subluxation, promoting restoration of integrity to the nervous system, and benefits can include enhanced immune function. Chiropractic's objective is not a "cure" for any medical diagnosis, but the behavior of these disorders expresses disorganization, warranting an evaluation of that which organizes all functions of the body -- the nervous system -- and determining clinical (rather than medical) necessity for care.

The malfunction involved in self destruction, i.e. the response does not meet the body's needs (too strong, insufficient, not appropriate) and disruption of the normal control process, are familiar indicators of the impact of subluxations, and I suggest that care/management of these cases without an appropriate chiropractic evaluation, would be at best, incomplete.

Let's discuss chiropractic case studies involving autoimmune diseases.

A Journal of Vertebral Subluxation Research (JVSR) case study, "Upper Cervical Chiropractic Management of a Multiple Sclerosis Patient: A Case Report" by Dr. Erin Elster, reviews the progress of a female patient diagnosed with MS three years prior, with progressively severe symptoms and multiple lesions (MS plaques) evident on an MRI.

Detailed examination revealed evidence of an upper cervical subluxation and included radiographs, digital infrared imaging and a review of the patient's history, including a fall that had occurred 10 years prior (possible causative factor in upper cervical subluxation).

During a two-year course of regular upper cervical care, multiple reassessments documented the absence of new lesions, continued reduction in intensity of original lesions and progressive reduction of symptoms till absent. This success was recorded though post-MRIs, post-thermographic scans, and neurologist evaluation, all suggesting the intervention of upper cervical chiropractic care may have stimulated a reversal in the progression of multiple sclerosis.

In a JVSR case study that I had contributed, during a corporate screening, a 52- year-old male presented for evaluation due to an unresolved musculoskeletal concern. He elected to receive chiropractic care and during a full initial chiropractic evaluation revealed a history of severe psoriasis, whose symptoms had first appeared after following the prescribed protocol for taking beta blockers for hypertension.

A Medline search regarding autoimmune diseases reports the theory that drugs may trigger autoimmune changes, an important factor considering the severity and chronic nature of these disorders for all those evaluating medication as part of how they want to impact their body.

Prior to chiropractic care, medical treatment of psoriasis included immuno-suppressant medication, which reduced the appearance of psoriasis, yet when treatment was discontinued, a severe and immediate flare-up occurred, resulting in resumed use of this potentially harmful intervention.

Results of the chiropractic evaluation confirmed the presence of subluxation and an appropriate care plan was commenced using a tonal model, NSA. During the course of care, the patient noticed significant improvement in reduction of psoriasis symptoms, which was confirmed by his medical provider and medication was reduced and eventually discontinued. The patient transitioned successfully to being free of immune-suppressant medication, without any severe flare-ups.

In addition, as the patient's health continued to restore, he transitioned to being completely drug free, discontinuing use of prescription medications for allergies and hypertension.

Other changes demonstrated considerable reduction of indicators of vertebral subluxation, including range of motion and QOL (improved response to stress, positive feedback from spouse and colleagues, increased sense of ease and better posture).

I encourage chiropractors to include this information when reaching out to their community through screenings, health talks, and in initial exams, to increase awareness of the impact of subluxation on the immune system and the concerns women are faced with.

Chiropractic's immense popularity and success with health care consumers has yet to be reflected and honored by research and grant institutions, but it is one of my goals to help create that shift, and to do further research on the association between enhanced immune function and the response to chiropractic care.

Please feel free to contact me with additional cases involving improved immune function, and also if you would like any references or sources from this column, as they were too numerous to mention here.

Also, the WCA Council on Women's Health looks forward to seeing all of you at the World Chiropractic Alliance Summit in April (call 800/347-1011 to register)!

Feel free to contact me at mbdcawe@aol.com, or Veroncia Gutierrez at veronicapgdc@aol.com.