[HN Gopher] Autoimmune disease can attack the brain, cause psych...
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       Autoimmune disease can attack the brain, cause psychiatric symptoms
        
       Author : donohoe
       Score  : 160 points
       Date   : 2023-06-01 12:56 UTC (10 hours ago)
        
 (HTM) web link (www.washingtonpost.com)
 (TXT) w3m dump (www.washingtonpost.com)
        
       | refurb wrote:
       | I have no idea if the theory has been disproven, but
       | schizophrenia was thought to be autoimmune because the disease
       | waxes and wanes, like multiple sclerosis and other immune
       | diseases.
        
       | tomohawk wrote:
       | After many doctor fails, a family member resolved their symptoms
       | through diet. Specifically, they follow the plant paradox diet.
       | It's not just microbes that cause autoimmune issues, but also
       | food you eat.
        
       | londons_explore wrote:
       | I'm going to take a wild guess that 90+% of things we describe as
       | 'autoimmune' are in fact initially caused by some
       | bacteria/virus/pollution we haven't yet identified.
       | 
       | I'd like to see research done on mice to reduce the number of
       | viruses and bacteria they are exposed to - for example by
       | sterilizing all air, water, and food for many generations. Then
       | see which ailments go away.
        
         | refurb wrote:
         | That's still autoimmune though.
         | 
         | The body has a immune reaction against something foreign -
         | however the antibodies created co-react with proteins found in
         | your own body.
        
         | reubenswartz wrote:
         | I am not a doctor, but I'm guessing that your experiment would
         | solve some problems and create others. If the immune system has
         | nothing to deal with, it may deal cause more autoimmune
         | problems (see the "hygiene hypothesis").
        
         | LatteLazy wrote:
         | Don't autoimmune disorders get WORSE in "cleaner" environments?
        
         | jvanderbot wrote:
         | My expectation is it's mostly environmental pollution like
         | pm2.5 causing inflammatory responses, which trigger immune
         | function unnecessarily.
         | 
         | I base this on the fact that when I moved to a pollution filled
         | city my hair fell out from autoimmune disease, then when I
         | moved out, it stopped happening.
        
         | bawolff wrote:
         | > I'm going to take a wild guess that 90+% of things we
         | describe as 'autoimmune' are in fact initially caused by some
         | bacteria/virus/pollution we haven't yet identified.
         | 
         | Wouldn't it still be described as autoimmune? An autoimmune
         | disease initially caused by an external agent is still an
         | autoimmune disease.
        
         | thenerdhead wrote:
         | I don't think you can only say germs/pollution. You also have
         | the many elements of "stress" as described in "The Stress of
         | Life" by Hans Selye.
        
         | haldujai wrote:
         | > I'm going to take a wild guess that 90+% of things we
         | describe as 'autoimmune' are in fact initially caused by some
         | bacteria/virus/pollution we haven't yet identified.
         | 
         | As a wild guess probably a bit high but viruses like EBV are
         | being increasingly suggested as causative of many autoimmune
         | diseases.
         | 
         | > I'd like to see research done on mice to reduce the number of
         | viruses and bacteria they are exposed to - for example by
         | sterilizing all air, water, and food for many generations. Then
         | see which ailments go away.
         | 
         | May not be the panacea you expect, on the other hand some
         | people think too clean is the problem.
         | 
         | https://en.m.wikipedia.org/wiki/Hygiene_hypothesis
        
           | PaulKeeble wrote:
           | Herpes viruses generally. It seems to reactivate on other
           | infections and spread to new cells causing increasing
           | problems in the body. EBV and Herpes seem to hack the immune
           | system to stop these cells from being destroyed. We could do
           | with antivirals that expose these cells or recognise them and
           | destroy them.
        
           | londons_explore wrote:
           | I think the hygiene hypothesis will turn out to be false, and
           | data pointing in its direction will be the effects of
           | cleaning products.
        
             | bckr wrote:
             | Yes or volatile organic compounds offgassing from
             | manufactured goods
        
           | Buxato wrote:
           | All the herpes family causes tons of health problems, HSV 1 &
           | 2, EBV, Citomegalovirus .... (some of that problems recently
           | discovered but also the main suspect in many other diseases)
        
             | haldujai wrote:
             | The question becomes why do only certain people get the
             | illness?
             | 
             | 50-90% of the US population are EBV or CMV positive yet
             | it's a much smaller percentage that develop autoimmune
             | illnesses.
             | 
             | I'm the farthest thing from a rheumatologist but it seems
             | like the favored explanation is a combination of infection
             | and abnormal immune response.
        
               | TeMPOraL wrote:
               | At which point could this just be pure random chance?
               | I.e. what if EBV or CMV or similar viruses poking at the
               | immune system are like comic rays hitting non-ECC RAM?
               | Most people won't notice most of the time, and some
               | people will experience mysterious crashes or data
               | corruption that don't seem to have any apparent cause.
        
               | haldujai wrote:
               | Good question, I'm much more familiar with the oncology
               | literature and there is definitely causative evidence
               | linking EBV and to a lesser extent CMV with
               | lymphoma/lymphoproliferative disorders (particularly in
               | the post-transplant setting).
               | 
               | I believe the evidence for autoimmune disorders is much
               | weaker (with the caveat that this is well outside my
               | scope of practice), I've heard it being implicated in MS
               | from my neurology colleagues but my understanding is it's
               | a weak correlation at the moment. I can't offer more than
               | uneducated conjecture on other autoimmune diseases.
               | UpToDate says the following:
               | 
               | "One difficulty in proving a link between EBV and MS is
               | that serological evidence of EBV can be found in 83 to 90
               | percent of adults in the Western hemisphere [99,101,102].
               | On the other hand, EBV seropositivity among adult MS
               | patients is near 100 percent, significantly higher than
               | healthy controls [91,102-106]. Additionally, children
               | with MS are significantly more likely than healthy peers
               | to have serological evidence for prior EBV infection, at
               | an age when EBV seropositivity is much less common than
               | in adults [107]. However, there is conflicting evidence
               | concerning the presence of EBV in brain tissue of
               | patients with MS [108-111]."
        
               | zanfr wrote:
               | SARS 1 & 2
               | 
               | same deal
        
               | onlyrealcuzzo wrote:
               | For similar reasons why ~30% of the population has HSV-1
               | and never has any outbreaks and don't even know they have
               | it.
        
               | [deleted]
        
               | djmips wrote:
               | I have a thought that only applies to the brain - perhaps
               | mechanical injuries which can allow viruses to cross the
               | blood brain barrier which only happen in a small subset
               | of the population are the ones that are more likely to
               | develop autoimmune disease in the brain. So a car
               | accident which leads to a tear which allows virus into
               | the brain which leads to autoimmune disease that affects
               | the hippocampus which manifest as physical symptoms.
        
             | RobotToaster wrote:
             | I guess the question is, how do we get rid of them?
        
         | deemster wrote:
         | My wild guess aligns with Dr Gabor Mate. Dr. Mate emphasizes
         | the significance of psychosocial factors, including stress,
         | trauma, and emotional experiences, in the development and
         | progression of various diseases, including autoimmune
         | conditions. He suggests that chronic stress, adverse childhood
         | experiences, and unresolved emotional issues can contribute to
         | dysregulation of the immune system, potentially triggering or
         | exacerbating autoimmune diseases.
         | 
         | According to Dr. Mate, unresolved emotional stress and trauma
         | can disrupt the body's natural balance, leading to chronic
         | inflammation and an overactive immune response. He emphasizes
         | the importance of understanding the underlying emotional and
         | psychological factors that may contribute to the development or
         | worsening of autoimmune diseases.
        
           | meindnoch wrote:
           | Quackery.
           | 
           | Modern humans have extremely sheltereled lives compared to
           | our ancestors. Yet, autoimmune diseases seem to be getting
           | more common in modern societies.
        
             | [deleted]
        
           | irdc wrote:
           | > According to Dr. Mate, unresolved emotional stress and
           | trauma can disrupt the body's natural balance
           | 
           | How does that differ from Germanic New Medicine? (see
           | https://rationalwiki.org/wiki/Ryke_Geerd_Hamer)
        
             | panxyh wrote:
             | Come on, really? It differs in that it _can_ cause, not
             | _always is the_ cause.
             | 
             | There is no doubt that stress has physiological effects on
             | body.
        
           | fidotron wrote:
           | This is a circular argument. If you have an undiagnosed auto
           | immune condition the result of it will be things constantly
           | occurring outside of your control and thus you will have
           | chronic stress which probably will make things worse.
        
             | monktastic1 wrote:
             | It would only be a circular argument if autoimmune
             | conditions were the only way to become stressed. As it
             | stands, this sounds more like a "vicious circle" (whereby
             | one caught in this cycle has a hard time exiting it).
        
               | 2devnull wrote:
               | Is there evidence that stress can occur and not lead to a
               | vicious cycle of inflammation and autoimmune disease?
               | 
               | I am a big fan of Mate, but I think his ideas are
               | oversold if not by him then by many he has "helped".
        
           | wing-_-nuts wrote:
           | >Dr. Mate emphasizes the significance of psychosocial
           | factors, including stress, trauma, and emotional experiences,
           | in the development and progression of various diseases,
           | including autoimmune conditions. He suggests that chronic
           | stress, adverse childhood experiences, and unresolved
           | emotional issues can contribute to dysregulation of the
           | immune system, potentially triggering or exacerbating
           | autoimmune diseases.
           | 
           | Yep, if you read books like 'the body keeps score' and 'the
           | deepest well', the link between trauma and autoimmune
           | diseases AND depression is remarkably high. I'm not saying
           | every case of depression or autoimmune disease is linked to
           | trauma, but wow, is it about as good of a risk factor as
           | smoking is to lung cancer.
        
             | haldujai wrote:
             | I think Dr. Mate raises some interesting theories. Chronic
             | stress is poorly understood and not well addressed in
             | modern medicine (because it's really hard to study and
             | treat) but:
             | 
             | > is it about as good of a risk factor as smoking is to
             | lung cancer
             | 
             | I wouldn't go that far. Smoking has a well understood
             | pathophysiology and extensive evidence as it relates to
             | lung cancer.
        
           | EMM_386 wrote:
           | > My wild guess aligns with Dr Gabor Mate. Dr. Mate
           | emphasizes the significance of psychosocial factors,
           | including stress, trauma, and emotional experiences, in the
           | development and progression of various diseases, including
           | autoimmune conditions.
           | 
           | Well I had what most would consider to be a perfect childhood
           | and I got Graves Disease at 18 and had to have my thyroid
           | gland fully removed.
           | 
           | So I guess you can count me out of this one.
        
             | meindnoch wrote:
             | Clearly a case of subconscious trauma.
        
         | m3kw9 wrote:
         | But I'd say even if it is, it's because one's genes are
         | susceptible to it while others won't have issues
        
         | A_D_E_P_T wrote:
         | > "I'm going to take a wild guess that 90+% of things we
         | describe as 'autoimmune' are in fact initially caused by some
         | bacteria/virus/pollution we haven't yet identified."
         | 
         | Not directly. Autoantibodies are the direct cause of many, if
         | not all, autoimmune diseases.
         | 
         | It's possible that certain environmental factors, combined with
         | genetic factors, kickstart autoantibody production. (i.e. are
         | upstream of autoimmune diseases, and causative.) But nobody
         | knows for certain. And the reverse hypothesis is also quite
         | popular: An environment that's too clean, that leaves too
         | little for the immune system to do, can induce a restless
         | immune system into producing autoantibodies. "Idle hands"...
        
         | heavenlyblue wrote:
         | And then when they accidentally catch something very mild the
         | whole population is dead because they never developed the means
         | of fighting it.
        
           | haldujai wrote:
           | This is a bit dramatic but many think the RSV crisis was a
           | result of naive immunity due to COVID-19 public health
           | measures.
           | 
           | https://onlinelibrary.wiley.com/doi/abs/10.1002/ppul.25582
        
             | giraffe_lady wrote:
             | OR immune damage due to covid itself, which was a more
             | popular theory with more mainstream medical support last
             | time I looked into it about ten months ago.
        
               | haldujai wrote:
               | This isn't true (that your hypothesis is mainstream),
               | there is no evidence the virus itself was more severe or
               | resulted in more severe illnesses than expected to
               | support the impaired immune system theory[0].
               | 
               | There is endless literature on this but the majority of
               | "mainstream medicine" subscribes to the "every kid got
               | sick at once for the first time" theory[0-2].
               | 
               | Anecdotally, I was working at a pediatric hospital for
               | parts of the RSV wave and my conversations with PICU/ER
               | colleagues was condordant with literature in this space.
               | 
               | [0] https://publications.aap.org/pediatrics/article/149/2
               | /e20210...
               | 
               | [1] https://www.thelancet.com/journals/laninf/article/PII
               | S1473-3...
               | 
               | [2] https://www.sciencedirect.com/science/article/pii/S14
               | 7330992...
        
           | londons_explore wrote:
           | Thats why you don't do this for humans :-P
           | 
           | But it would help the search to find out which
           | viruses/bacteria/pollutants are harming us, and eventually
           | when they are identified they can be eliminated, for example
           | with a vaccine.
        
         | janeway wrote:
         | I have to argue against this - humbly as an expert with several
         | degrees in microbiology, immunology, genetics, host-pathogen
         | interaction, university lecturing, etc. The genetic basis of
         | immunology is amazingly complex. To assign 90% autoinflammatory
         | type disease triggered by pathogens is an unfounded assertion.
         | There are many strong examples of monogenic causes of complex
         | phenotypes, while separately the clinical microbiology
         | explanation of many diseases is also perfectly clear. I am
         | certain that there will be many pathogen triggers, as you say,
         | but the number 90% does not make sense based on the last 100
         | years of the science.
        
         | francisofascii wrote:
         | There is also a school of thought (don't know how prevalent)
         | that many autoimmune cases are not autoimmune at all. And that
         | the unidentified bacteria/virus/pollution etc. is still present
         | or persisting, so the immune system is continually fighting
         | that hidden pathogen rather than one's own normal cells. And so
         | conventional autoimmune treatments that suppress the immune
         | system are allowing to unidentified pathogen to persist.
        
           | bschne wrote:
           | Couldn't you tell this apart by the kind of damage caused to
           | one's own cells and what kind of antibodies are present? e.g.
           | https://en.wikipedia.org/wiki/Antinuclear_antibody
        
             | haldujai wrote:
             | Ah ANA, the wonderful test that everyone orders and then
             | shamefully consults rheumatology because no one knows how
             | to interpret it[0]. Almost a rite of passage in medical
             | training now.
             | 
             | I jest but I think these tests are still a bit of a mystery
             | (as in why these autoantibodies are made and what their
             | significance is) especially as some people with high titres
             | have no symptoms and vice versa although there is an
             | association.
             | 
             | I think what parent is alluding to is that the trigger for
             | production may be an infection, even if the damage is
             | mediated by one's own immune system.
             | 
             | [0]for a chuckle this is a humorous but accurate depiction:
             | https://twitter.com/DGlaucomflecken/status/1371901346413117
             | 4...
        
               | bschne wrote:
               | I keep being fascinated by how medicine is simultaneously
               | things like "that death sentence is a minor inconvenience
               | now" and others and things like... this
        
               | FollowingTheDao wrote:
               | And then try convincing your primary care doctor that an
               | ANA test could be negative and you can still have lupus
               | or any other autoimmune disease.
        
             | francisofascii wrote:
             | Depends on the type and quality of the test. Serological
             | tests can yield incorrect readings.
        
         | greenthrow wrote:
         | That's not how infection works. You don't clear it up by just
         | stopping exposure. The patients in the article weren't
         | constantly being exposed to lupus for decades. Putting them in
         | a bubble would not have cleared up the infection.
         | 
         | You are making wild guesses from a place of ignorance. If you
         | want to learn more about the science of immunology the
         | resources are out there to learn about it.
        
           | londons_explore wrote:
           | Putting them in a bubble _for multiple lifetimes_ might...
           | 
           | Clearly that isn't practical for humans, but for mice, it is,
           | and the results of that can inform further research.
        
         | ckemere wrote:
         | Whoa - the microbiome is hugely important for health in
         | multiple ways. Most humans have about the same number of
         | bacteria in their bodies as their own cells
         | (https://www.nature.com/articles/nature11234). I think the
         | consensus is just the opposite as what you're suggesting - that
         | early exposure to more things is beneficial for a healthy
         | immune system.
         | 
         | I suspect that the culprit is much more likely environmental
         | contamination (microplastics, PFAS, etc), which I guess is one
         | thing that you list. But "sterile" is not the solution, and
         | unfortunately we have pretty badly contaminated the whole
         | planet at this point...
        
         | PragmaticPulp wrote:
         | The Hygiene Hypothesis actually suggests that limiting exposure
         | to microorganisms in childhood might result in worse immune
         | tolerance, leading to a higher rate of autoimmune issues:
         | https://en.m.wikipedia.org/wiki/Hygiene_hypothesis
        
         | pyrale wrote:
         | > I'd like to see research done on mice to reduce the number of
         | viruses and bacteria they are exposed to - for example by
         | sterilizing all air, water, and food for many generations. Then
         | see which ailments go away.
         | 
         | If something is common in the environment and would not cause
         | harm to people if not for disproportionate response from the
         | immune system, I would say that the issue is the immune system,
         | not the common element.
        
           | londons_explore wrote:
           | Remember that the population of humans a million years ago
           | used to be ~20,000. It is now 7 billion.
           | 
           | Some diseases have big and obvious effects, while others are
           | undetectable/unknown. Assume that diseases mutate a fixed
           | amount per human they infect.
           | 
           | All 7 billion of those people are one 'pool' for disease
           | spread - as evidenced by covid.
           | 
           | That means that the rate your immune system 'sees' entirely
           | novel diseases - not only novel to you, but also novel to all
           | your ancestors - is 350,000x higher than it used to be. The
           | true figure is probably lower, because many diseases infect
           | multiple species. But still, there is a strong argument that
           | we are asking our immune system to do something far outside
           | what it has evolved to handle.
        
             | pyrale wrote:
             | > Some diseases have big and obvious effects, while others
             | are undetectable/unknown.
             | 
             | A disease is a pathological process, something that goes
             | wrong. If someone lives their life without a symptom, they
             | are not diseased.
             | 
             | Your immune system doesn't see "novel diseases", it
             | encounters molecules it doesn't know. These molecules may
             | be pathogenic (i.e. they cause a disease), or they may be
             | harmless. Your immune system reacting disproportionately to
             | harmless stuff, is what's called autoimmune disease.
        
               | mrcode007 wrote:
               | The part about immune system reacting to harmless stuff
               | is not true.
               | 
               | Autoimmune diseases are diseases in which a body responds
               | to itself. Not to external factors.
               | 
               | Think of it as threat classification errors
        
               | pyrale wrote:
               | Ok. I wasn't sure there was a clear classification of
               | what's external and what's "the body". My point was about
               | making a distinction between disease and the thing being
               | responded to.
        
           | zanfr wrote:
           | we will have to sterilize the air as evidenced since 2020
        
         | ajuc wrote:
         | There's a significant psychological factor in many autoimmune
         | diseases.
         | 
         | For example I had asthma and allergy since forever, but I got
         | colitis ulcerosa for the first time when I was 18 and had final
         | exams in the high school, which decided what university I can
         | go to.
         | 
         | Even asthma attack can be caused by stress alone.
        
           | aksss wrote:
           | Asthma is, of course, an immune system response but is not an
           | autoimmune disease[1]. That said, mental and _physical_
           | stress are a significant factor in autoimmune disease flare-
           | ups and chronic hypertension is linked (one of many things)
           | to AI disease onset.
           | 
           | [1] https://www.healthline.com/health/asthma/is-asthma-an-
           | immune...
        
         | mondocat wrote:
         | That's... what happens:
         | https://www.science.org/content/article/can-dirty-mice-save-...
        
       | meindnoch wrote:
       | Ummm... how is this news? Just ask anyone with multiple
       | sclerosis.
        
         | johnisgood wrote:
         | It is not news to us, but my neurologist (specialized in MS)
         | and psychiatrist have no clue about the fact that the disease
         | itself can indeed cause depression and anxiety (or any other
         | neuropsychiatric symptoms[1]), and this is not even mentioning
         | the perception of the disease itself along with its symptoms
         | such as difficulty walking and the like.
         | 
         | According to my personal experiences, these doctors are
         | clueless. I have been told that the tremor in my leg will never
         | be cured, yet it disappears after taking Kratom. It is also
         | much less frequent now after I have done some exercises for
         | some time now, along with a massage that I receive once a week.
         | 
         | By the way, I do not wish to talk about this touchy subject,
         | but I know someone who works at a social home and around 80% of
         | the patients have gotten worse after having received the 4th
         | booster. That, and in general, after COVID-19 and COVID-19
         | vaccines there have been many more people who have been
         | diagnosed with MS, most likely from either COVID-19 or the
         | vaccine. It is known that those vaccinations may cause
         | autoimmune diseases (check PubMed). Personally I have received
         | the diagnosis long before COVID-19. At any rate, this is why I
         | was reluctant to get the vaccine. As far as I know, I never had
         | COVID-19.
         | 
         | [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6933139/
        
         | Mezzie wrote:
         | Yeah, that was my first thought as an MS patient. Personal
         | evidence aside, MSers depression and anxiety rates suggests
         | some kind of relationship - as a population I believe we have
         | some of the worst depression rates even controlling for the
         | severity of the disease. We beat out cancer patients, for
         | example.
        
         | DANmode wrote:
         | Have you ever asked people without MS to describe it?
         | 
         | If you don't know someone who has it, and weren't lucky enough
         | to learn about it in school, chances are you don't really know
         | what it is, or how it can present in a patient.
         | 
         | Neuro is poorly understood in general by a large portion of the
         | population.
        
           | aksss wrote:
           | IME, most times when you mention "autoimmune disease", people
           | think AIDS. Explaining that your autoimmune disease is kind
           | of the opposite of AIDS, that it's not contagious, are
           | annoyingly common experiences.
           | 
           | And it still amazes me - personally I knew about autoimmune
           | diseases before I ever had one. Probably because of Seal,
           | frankly. The reality is that a large portion of any
           | population doesn't care to learn about anything outside of
           | their immediate lived experience. Easy to forget this when
           | hanging out on HN and having a nerdy and wonky social circle.
        
       | onewheeltom wrote:
       | Why did it take them 20 years to notice the autoimmune disorder?
        
       | aksss wrote:
       | The following video conference with Robert Lahita is one of the
       | more substantive discussions on the understanding of systemic
       | lupus erythematosus (SLE) that I've seen in a while.
       | 
       | https://youtu.be/FYYfHWR7WwY
       | 
       | In his presentation (~36:20) he has a slide stating that *67% of
       | those with SLE have psychological or psychiatric issues*, 8-20%
       | seizures, 3-16% cranial neuropathy. Of course, "psychological or
       | psychiatric" could be depression and anxiety, and I don't mean to
       | minimize those issues at all, but cognitive dysfunction is a bear
       | in the room for all SLE patients and probably far more serious if
       | one is unlucky enough to have that symptom manifest (most do not,
       | as I understand it).
       | 
       | I will say that at disease onset and adjusting to having a
       | disease, depression is common. It's life-changing, so to be
       | expected. Ongoing, I think it's a constant battle as you're
       | constantly reminded of limitations and pain is like an everyday
       | companion that you learn to live with but sometimes the mental
       | load can get overwhelming, triggering episodic depression. I know
       | this from personal experience, but also my exposure to others
       | with SLE and MS. As you go, it can be hard to know whether some
       | mental and attitudinal issues are related to SLE and its side
       | effects or just aging (e.g. increased anxiety, timidity,
       | depression, memory loss, mental fog, fatigue).
       | 
       | And speaking of mental load, blocking out chronic pain takes a
       | lot of mental energy, which is a zero-sum game - it indirectly
       | results in a decreased ability to focus, engage, etc.
       | 
       | Regarding other comments here:
       | 
       | 1) There are well over 200 identified "autoimmune disorders", and
       | any amount of research that's compelled by having one of them
       | will reveal how much and ironically how little the scientific
       | community knows about causes, dynamics, and treatments for
       | autoimmune disorders. In fact, the immune system itself is
       | monstrously complex and it's amazing how mysterious it remains
       | considering how much really is known about its mechanics.
       | 
       | 2) Animal models for SLE (and I assume most autoimmune disorders
       | of the same severity - not talking allergies and asthma here) are
       | traditionally hard to create and have faith in, though this has
       | been getting better. It makes sense that this has been
       | challenging considering we don't know specific causes.
       | 
       | 3) Pathogenesis - Environment (UV light, drugs, viruses,
       | pollutants, etc.), hormones/epigenetics, genetics, stochastic
       | factors (chance), comorbidities (e.g. hypertension), all seem to
       | play a role, and none seem - on their own - to be good predictors
       | of risk. It's thought that there's some "trigger" in the sense
       | that all these factors reach some threshold that cause breakage
       | in the system at a point in time and BAM! now you have Lupus or
       | MS, for example. So it could be that you get infected with
       | something and experience an extraordinary level of physical and
       | mental stress at the same time, and it tips the scales. But on
       | their own neither of these factors would be causal, and even
       | together these wouldn't necessarily have the same impact on you
       | at a different time in life or affect another the same way.
       | Clearly there are missing links here.
        
       | whatthesmack wrote:
       | https://archive.is/vc5Bl
        
       | Zamicol wrote:
       | This is common knowledge in the celiac community. Conditions like
       | gluten ataxia are real and serious, which is understood to be
       | distinct from "gluten fog". https://www.beyondceliac.org/celiac-
       | disease/related-conditio...
        
       | lincon127 wrote:
       | We've been seeing stuff like this with COVID-19. Long term,
       | COVID-19 can increases susceptibility to autoimmune diseases,
       | diseases which end up having dramatic impacts on brain health. I
       | know some of the scientists that are having a field day
       | publishing research measuring biomarkers that can predict brain
       | health, and they are absolutely seeing an uptick after COVID-19,
       | and have linked it to malfunctioning immune systems.
        
         | xenonite wrote:
         | Could provide a link to which biomarkers there are increasing?
         | Can they be correlated to the variants of virus and vaccine?
        
       | pkoird wrote:
       | It is remarkable how I keep on stumbling upon connections between
       | Scizophrenia and Gut Bacterias and it is equally remarkable, the
       | connection now being discovered between Gut Bacterias and Auto
       | Immune disorders. And now when I find such anecdotes between
       | possible connections of Auto Immune disorders and Schizophrenia,
       | it just blows my mind to see how every thing is just connected to
       | one another. This demonstrates just how much we still do not
       | understand and on a more positive note, just how much we can in
       | future.
        
         | janeway wrote:
         | Agreed, however a massive fallacy in science is that the more
         | people keep repeating "hypotheses", the more likely you are to
         | be persuaded by spurious results / false positives. With enough
         | attention large scale statistical analysis should be able to
         | define clear causal effects, but we often just see weak results
         | about "maybes" and "might bes".
        
         | teachrdan wrote:
         | If this is a causal relationship, how can we explain the
         | apparent heritability of schizophrenia? Some cursory Googling
         | shows 79% heritability found in one Danish study.
         | 
         | https://www.healthline.com/health/is-schizophrenia-hereditar...
        
         | zoogeny wrote:
         | As a barely related tangential thought: I've wanted to write a
         | short science-fiction story about an alien life-form slowly
         | colonizing our planet by invading human gut micro-biome through
         | our diet. Through this process they alter our food preferences
         | to choose diets most conducive to their own flourishing and
         | then eventually effect our minds. We become convinced that diet
         | choices are for the benefit of our own health but in reality we
         | are eating foods that really benefit the alien bacteria in our
         | guts.
         | 
         | The idea is very roughly based on the cat poop parasite
         | (Toxoplasma gondii) that is theorized to alter human brain
         | chemistry to change risk-taking behavior.
        
         | fnord77 wrote:
         | and yet no viable, actionable treatment has come about from
         | these connections despite them being around for a decade or
         | more
        
         | tomjakubowski wrote:
         | When I hear a person say their thoughts are being controlled by
         | microscopic creatures living inside them, I won't write it off
         | as a paranoid delusion. I'll hear them out.
        
       | PretzelPirate wrote:
       | There's a musician named Ren (@renmakesmusic) who was told for
       | years that he had various psychiatric diseases and eventually it
       | was discovered that he had an autoimmune disorder caused by Lyme
       | disease. He writes songs about his experiences and how he thought
       | his life was over.
       | 
       | He mentioned in a podcast that he only got a proper diagnosis
       | because he lied to a doctor about his symptoms to get specific
       | meds, and those meds just happened to work. Because they worked,
       | another doctor was able to put all the info together and diagnose
       | Lyme.
        
         | haldujai wrote:
         | Lyme disease can be "autoimmune" like in clinical manifestation
         | but is more accurately described as a tick borne infectious
         | disease treated primarily with antibiotics, as opposed to the
         | viruses being discussed here which are more weakly linked and
         | treated with immunosuppressants.
        
         | PragmaticPulp wrote:
         | Be careful with anything related to "chronic Lyme". While it is
         | true that Lyme disease can trigger long-term symptoms, Lyme has
         | also become a catch-all haven for pseudoscience practitioners
         | and quackery.
         | 
         | It has become so bad that most patients with unexplained
         | chronic conditions who use internet health forums will
         | eventually go through a phase where they think they might have
         | Lyme disease. The "chronic Lyme" alternative medicine industry
         | has evolved to cater to these desperate patients by offering
         | convenient, albeit unprovable, answers to the question of
         | what's causing their symptoms. The chronic Lyme proponents
         | claim that it can't be tested for, won't show up on normal
         | tests, or can only be diagnosed through vague symptoms. As a
         | result, anyone showing up with vague symptoms gets a diagnosis
         | of chronic Lyme.
         | 
         | Their proposed treatments usually involve extended rounds of
         | expensive antibiotics which have no proof of working and have
         | not shown any difference from placebo in clinical trials of
         | supposed "chronic Lyme" patients. Sadly, some quick research on
         | the musician you cited shows that he has been taken by one such
         | alternative medicine practitioner and has been attempting to
         | raise tens of thousands of dollars to pay this practitioner for
         | antibiotic treatment. I'm sorry to say but I suspect this
         | musician has been caught up in the chronic Lyme alternative
         | medicine industry without much, or any, scientific basis for
         | the expensive treatments he's being peddled.
        
           | haldujai wrote:
           | Interesting, at first I thought you were referring to "post-
           | treatment Lyme disease syndrome" which has _some_ medical
           | legitimacy to it. It appears that there is a distinct
           | "chronic Lyme disease"[0] rooted in quackery, learned
           | something new.
           | 
           | I also assumed the poster was referring to "genuine"(?) Lyme
           | disease (B. burgdorferi infection) which can go untreated and
           | have neurological manifestations.
           | 
           | [0] https://en.wikipedia.org/wiki/Chronic_Lyme_disease
        
           | [deleted]
        
           | spondylosaurus wrote:
           | Fun fact: if you have _any_ kind of autoimmune disease, it 's
           | easy to get a false positive on certain blood tests commonly
           | used to diagnose Lyme disease, because the less-specific
           | tests can pick up general immune activity regardless of its
           | cause.
           | 
           | I fear for how many people have (falsely) tested positive for
           | Lyme disease, despite never having been exposed, and fallen
           | down a rabbit hole of pseudoscientific treatments while their
           | actual health issues remain untreated. And of course your
           | symptoms will only worsen, which seems to reinforce the need
           | for useless "chronic Lyme" treatments, and so on and so
           | forth.
        
           | lispisok wrote:
           | "Leaky gut" is the exact same kind of pseudoscience and
           | quackery
        
             | FollowingTheDao wrote:
             | Leaky gut is not pseudoscience. It's actually a real
             | medical condition called intestinal permeability.
             | 
             | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8427160/
             | 
             | That's not to say that any quack can just diagnose you with
             | intestinal permeability without doing any tests, so I agree
             | with you on that.
        
               | haldujai wrote:
               | I think you may be misunderstanding this article.
               | Intestinal permeability is not a diagnosis in this paper,
               | they are referring to the physical permeability of the
               | gut which can be altered in many diseases and is not in
               | dispute (i.e. "altered gut permeability" is a symptom of
               | a disease, not the disease itself).
               | 
               | "Leaky (or permeable) gut syndrome" is not a recognized
               | disease.
        
               | FollowingTheDao wrote:
               | No, I did not misunderstand.
               | 
               | Having higher intestinal permeability is a disorder that
               | causes suffering. Call it whatever you want, it increases
               | autoimmunity issues.
               | 
               | https://gut.bmj.com/content/55/10/1512 "increased
               | intestinal permeability is observed in association with
               | several autoimmune diseases. It is observed prior to
               | disease and appears to be involved in disease
               | pathogenesis;"
        
               | haldujai wrote:
               | Right, I don't think anyone doubts that altered
               | intestinal permeability may be seen in several
               | conditions. The etiological theory of "leaky gut" (i.e.
               | leaky gut is the cause of disease) is not accepted in
               | medicine.
               | 
               | This article again suggests a theoretical mechanism that
               | altered gut permeability is involved in the pathogenesis
               | of an autoimmune disease and the evidence cited does not
               | exclude the possibility of a common etiology[0], it also
               | does not suggest the presence of a "leaky gut disorder".
               | 
               | As an aside an association does not mean causation and in
               | any case does not discriminate between symptom vs
               | disorder. A fever is associated with nearly every
               | infection, it doesn't cause it.
               | 
               | [0]e.g. 'These studies provide intriguing data that
               | abnormal permeability may be involved in disease
               | pathogenesis, although they cannot exclude an alternative
               | explanation that mild gut damage (measured by increased
               | permeability) is associated with the development of IBS
               | by another mechanism. ' from the IBS studies cited.
        
               | FollowingTheDao wrote:
               | > Right, I don't think anyone doubts that altered
               | intestinal permeability may be seen in several
               | conditions.
               | 
               | Right, so leaky gut is a real issue. If it is a cause or
               | a condition remains to be seen. But to say it is
               | psuedoscience is invalid.
               | 
               | You just keep moving the goal posts.
        
               | haldujai wrote:
               | OP is referring to "leaky gut disorder" that people
               | (quacks) will try to treat today. It is not a recognized
               | disorder that requires or has a treatment so it is
               | correctly classified as pseudoscience (there is no
               | scientific basis for the treatment of an unrecognized
               | disease).
               | 
               | Simultaneously altered gut permeability may be seen with
               | some disorders, significance not yet determined.
               | 
               | I have never changed that position.
        
       | FollowingTheDao wrote:
       | It's so frustrating that the story is actually "new". We've known
       | about neuropsychiatric lupus for decades yet for people like me
       | with disabling mood disorders to get to see a rheumatologist is
       | nearly impossible.
       | 
       | I have bipolar disorder or schizoaffective type and I am also in
       | the initial stages of ankylosing spondylitis and consistent
       | leukopenia, they think it's a coincidence but I know it's a
       | mitochondrial disorder. (Complex I and III deficiency)
       | 
       | We've gone nowhere in Treatment of mood disorders in over 70
       | years. My last episode of depression that landing in the
       | hospital. What did they have to offer me? Electro shock
       | treatment. No new tests, nothing.
        
         | stef25 wrote:
         | > they think it's a coincidence but I know it's a mitochondrial
         | disorder
         | 
         | Not saying you're wrong, just be very careful assuming you know
         | more than your doctors
         | 
         | > My last episode of depression that landing in the hospital.
         | What did they have to offer me? Electro shock treatment. No new
         | tests, nothing.
         | 
         | Unfortunately there aren't that many tests for depression (I'm
         | aware of none actually). Testing every fringe theory out there
         | (which may well no longer be fringe in x time) is simply not
         | feasible. Saying this as someone currently heavily medicated
         | for depression.
        
           | FollowingTheDao wrote:
           | > Not saying you're wrong, just be very careful assuming you
           | know more than your d
           | 
           | This almost sounds like you are stereotyping me...
           | 
           | I do know more than my doctors. For one, they never even know
           | what receptors most of the medication I was taking affected.
           | But also I have my own genetics and I spent the last 15 years
           | studying genetics and neuro-biology. I often fake out
           | researchers telling them I have a PhD and I talk with them
           | with no problem. And I am currently offering assistance to a
           | research study at Stanford who are looking into the possible
           | genetic roots of a specific neurological disorder.
           | 
           | So when I say I have a mitochondrial disorder that is causing
           | multiple issues for me I know what I am talking about [1]. My
           | mitochondrial haplotype is U [2]. I have rare gene changes in
           | ND4 [3], ND4L, and MT-CYB [4} which are all linked to Mood
           | Disorders and I have been treating them mostly successfully
           | with high dose riboflavin [5] (this lowers glutamate [6]
           | witch seems to be the mechanism that helps me most).
           | 
           | > Testing every fringe theory out there (which may well no
           | longer be fringe in x time) is simply not feasible. Saying
           | this as someone currently heavily medicated for depression.
           | 
           | My point is they are testing NOTHING. And these are not
           | fringe theories. I am fighting for you and for my family who
           | keeps wanting to end their life. By saying these are fringe
           | theories you are playing into some stereotype (again). Take a
           | look at pyridoxine for depression, or zinc or iron. These are
           | not fringe theories, they are neglected theories because they
           | would mean the end of treatment. I am not on zero meds but
           | klonopin as needed. I have tried no less than 12 medications
           | that "worked" but left me numb, over weight, and useless.
           | 
           | Please do not give up and let these doctors tell you what the
           | only truth is. I am now working with a family with TRMPSS6
           | mutations that leave them all iron deficient and oral iron
           | was not helping. They all have severe depression and fatigue
           | and anemia. The doctors gave up on them. Turns out all they
           | needed was to take their iron with citric acid.
           | 
           | [1] https://ibpf.org/wp-content/uploads/2020/02/Andreazza-
           | Duong-...
           | 
           | [2] https://www.sciencedirect.com/science/article/abs/pii/S00
           | 223...
           | 
           | [3] https://academic.oup.com/ijnp/article/8/4/515/652752
           | 
           | [4] https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1399-56
           | 18....
           | 
           | [5]
           | 
           | https://headachejournal.onlinelibrary.wiley.com/doi/abs/10.1.
           | ..
           | 
           | https://pdfs.semanticscholar.org/4948/b1d517ca7333fe0149f5bd.
           | ..
           | 
           | https://www.nature.com/articles/pr199327
           | 
           | [6]
           | 
           | https://journals.lww.com/neuroreport/Abstract/2004/10050/Gro.
           | ..
           | 
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5517396/
        
             | paradox242 wrote:
             | Having watched my wife interact with the American medical
             | system over the last 10 years for very similar symptoms, I
             | have a much lower opinion of the amount of attention and
             | care the average doctor is able to provide. There have been
             | a few standout exceptions (her psychiatrist in particular)
             | but overall there is little collaboration between the many
             | specialists, and after billing our insurance for a battery
             | of tests, there often little to no follow up.
        
               | haldujai wrote:
               | As a physician I also fully support the not hot-at-all
               | take that we do a huge disservice to these patients and a
               | very poor job with psychiatric and constitutional
               | symptoms/illnesses in general with "good care" being the
               | exception, as you unfortunately experienced.
        
               | FollowingTheDao wrote:
               | Just wanted to thank you for coming out and saying that.
        
             | stef25 wrote:
             | Was expecting you to protest but really it wasn't my
             | intention to stereotype you.
             | 
             | I have a Bsc Neuroscience myself but I guess not up to date
             | enough. All I'd heard about Paxil / paroxetine was all
             | negative yet for me it does make a little difference
             | without any side effects at all. Not numb, not gaining
             | weight, although I am curious about what you mean by "being
             | useless"? I feel that way as well, but it could just be the
             | depression. Modafinil helps.
             | 
             | Admittedly I still feel like total shite most days and cry
             | and have very dark thoughts more than I'd like to admit.
             | 
             | Regarding insomnia I thought I knew all the treatments (and
             | tried them, and they didn't work) until I was prescribed
             | Trazodone. Did nothing for the depression but does give me
             | 8-10 solid hours of sleep.
             | 
             | Klonopin I get myself on the black market and it certainly
             | can kick your ass but don't see how that helps against
             | depression since it's mostly an anxiolytic?
             | 
             | The only things that _really_ help are illegal and I guess
             | it just gets me more down in the long run, so round and
             | round we go.
             | 
             | Will def check out your theories & references, thanks for
             | that.
        
               | FollowingTheDao wrote:
               | Being useless includes the depression, not really going
               | away, or putting me in a zombie like state that makes me
               | pretty unaware of what was going on around me. I better
               | stay to be in when I was manic for sure, but nowhere to
               | live indefinitely.
               | 
               | I highly recommend you get your genetics and start
               | learning about it all.
               | 
               | There is such a huge, genetic risk and diversity that
               | underpins mood disorders. It is the only way I found
               | myself out of the mess I was in.
               | 
               | I really don't have an issue with depression as much
               | anymore as I do the mania and insomnia. And the
               | psychosis. That's where the Klonopin helps me. But
               | lowering glutamate, for some people has been shown to
               | improve stress induced depression.
               | 
               | As for depression, I suggest you look at inflammation an
               | immune system as a regulator. And as for nutrients? I
               | suggest checking your iron panel, B6, and zinc. These
               | will help make the catecholamines implicated to be lower
               | in depression.
        
               | stef25 wrote:
               | > I highly recommend you get your genetics and start
               | learning about it all
               | 
               | What's the best place to do this? I'm in the EU
               | 
               | > As for depression, I suggest you look at inflammation
               | an immune system as a regulator
               | 
               | I made some decisions that sent my life in a downward
               | spiral, I don't think those factors have anything to do
               | with it
        
               | FollowingTheDao wrote:
               | > What's the best place to do this? I'm in the EU
               | 
               | I do not know. I am in the U.S.
               | 
               | >I made some decisions that sent my life in a downward
               | spiral, I don't think those factors have anything to do
               | with it
               | 
               | So the difference between psychological depression and
               | biological depression are immense. Not to say that your
               | genetics did not put you at more risk for depression
               | after a stressful event.
               | 
               | It still sucks and I'm sorry. But if it was triggers by
               | life choices I would suggest therapy.
               | 
               | At times I have rapid cycling Bipolar. There were
               | sometimes I would be depressed and manic within four hour
               | cycles. No life situation triggers it. Just noting the
               | difference.
        
           | laserlight wrote:
           | > Unfortunately there aren't that many tests for depression
           | (I'm aware of none actually).
           | 
           | Beck Depression Inventory [0] is one.
           | 
           | [0] https://en.wikipedia.org/wiki/Beck_Depression_Inventory
        
         | taylorportman wrote:
         | I'm still reading this recent bulletin article about tDCS -
         | turning that journalist into a sharpshooter and after seeing
         | this: "She said those people have this overactive angry cortex
         | guy just sitting there. When you apply the electric field, it
         | shuts him right up and those people find that their depressive
         | symptoms are alleviated." definitely want to look further into
         | consumer tDCS devices. Presently I've been trying to fix myself
         | by jogging more and drinking less.
         | https://thebulletin.org/2023/05/qa-how-darpa-hacked-a-scienc...
        
           | FollowingTheDao wrote:
           | The only reason I have nothing good to say about tDCS for
           | depression is that they still do not know how it works and
           | what they are targeting are if there are any repercussions.
           | 
           | tDCS seems to boost gamma brain waves. That is pretty much
           | where I live according to an the last time I was tested.
           | 
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6491895/
        
         | DANmode wrote:
         | > What did they have to offer me? Electro shock treatment.
         | 
         | Which State did this take place in?
        
           | haldujai wrote:
           | Electroconvulsive therapy is an evidence-based intervention
           | for certain types of depression. It should be "accessible" in
           | every state although access to psychiatric care is often
           | questionable unfortunately.
        
             | phkahler wrote:
             | >> Electroconvulsive therapy is an evidence-based
             | intervention for certain types of depression.
             | 
             | And evidence that it can cause memory problems and maybe
             | more.
        
               | haldujai wrote:
               | Your point being..?
               | 
               | Every treatment for anything has benefits and harms,
               | there is evidence that the benefits of ECT outweighs the
               | harms in select patients (like those refractory to
               | conventional treatments) so it has been accepted medical
               | practice for a while now.
               | 
               | You certainly wouldn't jump to put a patient on ECT. This
               | is jogging my medical student memory but when I rotated
               | on psychiatry the patients who underwent this procedure
               | had quite severe and disabling symptoms, it seemed to
               | help although I'm outside of my scope.
               | 
               | It's certainly accepted in the medical community though.
        
           | FollowingTheDao wrote:
           | North Carolina. At a leading university research center...
        
         | pacaro wrote:
         | Getting to see a rheumatologist is way too hard. I have a more
         | mundane autoimmune disease (psoriasis/psoriatic-arthritis) and
         | excellent insurance, and it's still a struggle. And then it's a
         | struggle to get authorization for the medication, even with
         | good insurance
        
           | FollowingTheDao wrote:
           | I have nearly constant back pain, bone spurs and disc
           | degeneration on my MRI, and a family history of ankylosing
           | spondylitis which required surgery in two cases, and I still
           | can't see a rheumatologist for some reason. Probably because
           | i am on Medicare.
        
           | John23832 wrote:
           | Where I live, you basically can't get without a referral. And
           | primary care doctors are clueless about rheumatic symptoms,
           | so they don't refer.
           | 
           | You're basically forced to suffer until there is visible
           | irreversible damage (crooked fingers, permanent hunch, eroded
           | joints, eye damage) for them to say "oh shit, yea, you should
           | see someone".
           | 
           | That's not to say that the meds the rheumatologist will put
           | you on will treat you any better.
        
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