Hashimoto’s, Crohn’s, Psoriasis, and Rheumatoid Arthritis are names of common conditions known as autoimmune disorders.
Autoimmune disorders are the result of the dysregulation of the immune system, but why do some people get these disorders when others do not? We now understand how most autoimmune disorders are being triggered by inflammation and Autonomic Nervous System dysfunction.
Autoimmune disorders occur when someone’s immune system spins out of control and targets tissue within their body instead of fighting foreign invaders like viruses or bacteria.
We name the immune attacks by their location in the body. If the immune system attacks our thyroid, we call it Hashimoto’s thyroiditis. If the immune attack is in the joints of our hands we call it rheumatoid arthritis. If the immune attack is against our small intestine we call it Crohn’s disease. If the immune attack is against our skin we call it psoriasis, or it could be impaired pigmentation of the skin which is known as vitiligo.
Genes in a Family
The two critical elements required to trigger most autoimmune disorders are (1) predisposing genes within our DNA that is passed to us by one of our parents or triggered by an event such as chemical or radiation exposure, and (2) damage to the Autonomic Nervous System that can occur during our lifetime due to unresolved physical, emotional, metabolic, or inflammatory injuries.
Many people believe that if their parents pass on a gene for a medical condition (diabetes, colon cancer, heart disease), that it is inevitable they will develop the condition. This is understandable since we often see specific patterns of disease unfold in family histories.
For instance, if someone’s family has several members with diabetes, we know there is a gene increasing the risk of diabetes being passed from parents to child through birth.
But genes must first be activated by something to trigger disease, and it is not inevitable that the gene will always turn on and that the person will develop diabetes. Many people with brown eyes may also carry a gene for blue eyes which is not yet activated.
I tell my patients to think of the genes in their DNA like breakers inside the electrical boxes in their homes. If the breakers are in the “off position” someone will not develop an illness. We now understand an abnormal chemical condition in the body called metabolic inflammation is the primary element that can flip the gene breaker to the “on position” and trigger an illness.
Metabolic Inflammation Triggers Genes
Metabolic inflammation is the abnormal, persistent release of chemicals from the white blood cells called cytokines. Cytokines should only be released in short spurts, such as when someone has an infection or they are recovering from an injury. Cytokines are released to fight the infection or repair tissue, then they disappear from the blood stream once the problem is resolved.
When there is metabolic inflammation, however, cytokine production is out of control and it never stops. And as the levels of the cytokines climb, they begin stressing the cells of the body and ultimately, they are the invisible hands that reach in and will flip the genetic breakers to the “on position”. This is how most genetically-based diseases such as autoimmune disorders are triggered.
Autonomic Dysfunction Triggers Autoimmune
But there is another piece to the autoimmune trigger process that most people have never heard of. For someone to trigger genes they might be carrying for any particular autoimmune disorder, they also need to have an unresolved injury to their Autonomic Nervous System.
I have been testing and treating the Autonomic Nervous System for 11 years and it is clear to me that our modern Autonomic Nervous Systems have become increasingly prone to injury and dysfunction after some accumulation of stress, poor nutrition, vegetable oils in our foods, childbirth, intestinal infections, metabolic or inflammatory events, medications, adverse or excessive reactions to vaccinations, and both physical and emotional concussions and traumas.
The Autonomic Nervous System is the brain’s master control mechanism and communicates with every organ in the body such as the heart, bladder, stomach, intestines and kidneys. It is how the brain regulates inflammation, the immune system, blood pressure, blood sugar, sleep cycles, and hormones.
There are two main branches in the Autonomic Nervous System. In very simple terms, the Sympathetic branch is responsible for energy expenditure (“fight or flight”) and the Parasympathetic branch is responsible for energy conservation and restoration (“rest and digest”).
Autoimmune Disorders and Parasympathetic Dysfunction
These two opposite Autonomic branches should work together simultaneously and in balance but people with autoimmune disorders commonly have dysfunction or weakness in their Parasympathetic branch. Information from the Parasympathetic branch is carried through the vagus nerve, and has predominate control over inflammation throughout our body.
Dysregulation of inflammation of the Parasympathetic branch is now believed to precede the dysregulation of the immune system seen in autoimmune disorders.
The Parasympathetic branch controls someone’s resting states after a meal and at night, their digestive tract, nutrient storage, immune responses, and healing. It causes slower heart rates, slows respiratory rates, sleep cycles, gastrointestinal motility, increased peripheral vascular flow, blood flow to cells, liver and kidneys, and venous blood flow return to the heart.
When the “rest and digest” Parasympathetic brain commands are disrupted, they have a negative effect on the immune system (autoimmune disorders), the intestinal tract (heartburn or constipation), and produce chronic pain syndromes (fibromyalgia).
People with parasympathetic dysfunction often experience sleep apnea, “restless legs”, morning nausea, night sweats or hot flashes, feel power surge sensations when they should be at rest, or experience non-restorative sleep.
The Autonomic Nervous System is very complex network of different areas of the brain, and dysfunction is not as simple as one branch working and the other branch is not. People with unresolved Autonomic injury very often have symptoms from both Parasympathetic and Sympathetic dysfunction.
When the “fight or flight” Sympathetic brain commands are disrupted people may also feel tired or chronic fatigue, crave salt or sugar, feel excessively hungry, or feel anxious throughout the day. People may get severe (“migraine”) headaches, TMJ, heart palpitations, tingling or numbness in their arms (hands or face), disrupted night vision, varicose veins, E.D., stiff necks and shoulders, or insomnia.
Autonomic Testing Detects Dysfunction
The Autonomic Nervous System may be tested by several methods and I prefer non-invasive spectral analysis that can directly measure Autonomic signaling from the brain to the heart. The results from this test are not just in terms of ‘normal’ or ‘abnormal’, instead spectral analysis testing challenges the branches of the Autonomics and the test results show both Sympathetic and Parasympathetic tone and balance.
The EKG component of spectral analysis Autonomic testing measures heart rate variability (HRV), which is a trace of the intervals between heart beats to within hundreds of a second. HRV is a function of continuous Sympathetic and Parasympathetic activity, and both these signals are imbedded within the EKG communication between the brain and the heart.
This HRV information is valuable because it reveals if someone’s HRV may be too high or too low as their Autonomic dysfunction progresses, which provides me as their physician the opportunity to first identify and then stabilize the problem.
There are five stages in Autonomic dysfunction and Autonomic testing may identify preclinical changes even before someone experiences symptoms in Stage 1 or 2. It is in Stage 3 that people start to experience symptoms that affect their daily life like GI trouble, sleep trouble, headaches, temperature regulation problems, or dizziness.
Stage 4 and Stage 5 are stages of advanced Autonomic dysfunction and progressively low HRV. Like Stages 1 and 2, people may also silently slip into Stage 5’s very weak Parasympathetic function and not even realize it. This very weak Parasympathetic function is also referred to as Cardiac Autonomic Neuropathy (CAN) which has a 50% mortality rate in 5 years if left untreated.
Although Autonomic injuries seem to be becoming more common in the general population, they are easily detectable and fortunately all five stages of Autonomic dysfunction are now reversible or capable of improvement without long term medications.
Vagus-Inflammatory Reflex
We also now understand that inflammation from the immune system is completely controlled by a process in the brain referred to as the Vagus-inflammatory reflex. The Vagus Nerve carries information from the Parasympathetic branch of the Autonomic Nervous System, and operates as the regulator of inflammation throughout the entire body.
The signal carried by the Vagus Nerve operates much like your foot on the break of your car. The stronger the parasympathetic impulse, the more things slow and eventually come to a stop.
Groundbreaking bioelectrical work is being done by stimulating the Vagus Nerve, which has the effect of lowering inflammation. In order words, stimulation of the Vagus Nerve mimics Parasympathetic signals.
The ability to lower inflammation via the Vagus Nerve is thought to be so important that it promises to make many medications obsolete in our lifetimes, and it gives us a whole new understanding of stopping disease pathways.
Implanted devices to stimulate the Vagus Nerve have been done in our country for about 20 years. I commonly recommend the use of transcutaneous (on top of the skin) Vagus Nerve neuromodulators for my patients, and it has become an important tool in my treatment program, The Nemechek Protocol™ for Autonomic Recovery (Patent No. 10,335,396).
Reduce the Triggers of Autoimmune
Knowing that the two critical elements required to trigger most autoimmune disorders are (1) predisposing genes within our DNA that are turned on by metabolic inflammation, and (2) damage to the Parasympathetic branch of the Autonomic Nervous System that is reversible, allows us to act to change our health.
The key to restoring our natural inflammation control mechanisms is through a reduction of inflammation throughout the brain and body by using every scientific, nutritional, and bioelectric tool available.
I am an internal medicine physician (D.O.) from UCLA and my Internal Medicine and Autonomic practice is in the Phoenix area. I use a variety of methods including Vagal Nerve stimulation, and I have discovered a multifaceted formula for Autonomic Nervous System restoration that is so groundbreaking that I filed a patent application for The Nemechek Protocol for Autonomic Recovery (Patent No. 10,335,396).
I have also published The Nemechek Protocol™ for Autism and Developmental Delay at AutonomicRecovery.shop.
For additional information, call my office 623-208-4226 or go to AutonomicMed.com.
This post is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes. This information is not intended to be patient education, does not create any patient-physician relationship.
© 2017. Nemechek Consultative Medicine. All Rights Reserved.
Dear Doctor. My daughter, 5 years old, has a diagnosis of autism derived from a neurological problem, has a cerebral deficiency of folate, ataxia, nystagmus and epilepsy. Due to the deficiency of folate, he takes folinic acid and Levetiracetam due to epilepsy. I want to start your protocol, I read your book, but still I have doubts about whether I should do some adaptation, and if it is not contraindicated with folinic acid?
Thanks in advance
Continue the folinic acid if it was prescribed . by your physician.
My son is 12 years old, 195 lbs and 5’5″ tall. He has a great deal of anxiety, LD’s and could be on the spectrum but there is no diagnosis. He is also mostly homebound and I believe depressed. I have had him on about 3/16 tsp inulin and just increased to 1/4 tsp inulin, he takes 3000mg DHA and 1 tablespoon EVOO. He gets very agitated with every 1/16 tsp increase in Inulin but that has faded in the past. It seems to be a little better if I administer it in the morning. I have read your book… Read more »
If there is minimal improvements at this age, I stop the inulin and give a course of rifaximin.
If there is improvement but only partial, I would continue the inulin and add VNS
Mine is probably an unusual question. Nevertheless, I am compelled to ask. My five-year-old daughter, who is otherwise Neurotypical, began the protocol in February after we saw how much success we were having with our then eight-year-old a ASD son. Additionally we had been giving her probiotics since age 2, and after reading your book, felt it was necessary to begin the protocol and get her in better shape. She has never had any vaccines, nor any kind of over-the-counter or pharmaceutical intervention. Yes, she has had some x-rays. These were for dental purposes. In September 2018, she was afflicted… Read more »
F.I.R.E.S. is believed to be the consequence of an infection. My protocol controls aberrant inflammation and does not prevent infections.
Thank you, Dr., for responding so quickly. Yes, I do understand what you stated. The medical society is still learning about this condition and really doesn’t know much. In fact my daughters recovery is unprecedented. She is the first of her kind. So they have absolutely no answers for me in regards to her! However the doctors have stated to me that it’s an auto immune response that she had. The ecephalopathy caused the seizures. But it was an auto immune disorder that caused the encephalopathy in the first place. They are hypothesizing that it was some sort of febrile… Read more »
The only other aspect I can suggest is vagus nerve stimulation to stablize her inflammatory responses completely.
Thank you.
Respected Doctor,
My 3.5 year old son just got diagnosed with psoriasis (nail and genital area). He has been on the protocol for 3 months with great reduction in anxiety and small gains here and there. Can NP help him get rid of psoriasis? We are feeling so lost and helpless. His current doses are 1/8th tsp inulin (I reduced inulin coz he was bed wetting) , 1ml Nordiac Pro-Omega and Extra virgin olive oil in food.
Please help!!
With further recovery there is a good chance the psoriasis could improve more and even go into remission.
How do I get rifaximin if my doctor refuses to prescribe it?
Ask another doctor
Hi Dr. Nemechek, Any advise for alopecia universalis? I also have been diagnosed with sarcoidosis 7 years ago but I’ve managed to put that into remission. (Presented mostly on my hands, fingers and forearms.. weird I know). Alopecia started at 27 years old and developed into universalis after stopping 20 years of prednisone. I also suffer from heartburn/GERD which I can manage with bone broth and / or aloe Vera juice. I’ve been researching the microbiome and everything else under the sun in hopes to reverse this. I just found you accidently going down rabbit holes in my research. Your… Read more »
Attacking this with my complete protocol including VCNS is the only approach I would have to help this.
I have had several patients with alopecia (mainly areatta but 2 with totalis) improve.
Hello Doctor Nemecheck,
My son 4 year old is diagnosed with Autism and has been on the protocol for past 2 months. He is on 1/4 tsp of inulin twice a day , 2 ml fish oil and 5ml EVOO and cooking with EVOO. Recently, we noticed a small bald spot on his scalp on the back of his head. We consulted the doctor and he confirmed that its Alopecia Areata (Auto immune disorder). Do you think we should continue using the protocol or reduce the inulin dosage. What are your suggestions? Please advise.
I’ve never heard of this with the protocol and alopecia areata is liked with dysbiosis.
I’ve would press ahead with the protocol.
Greetings Doc, I am a 35 year old man who was diagnosed with psoriasis at around the age of 13-14. It has generally always been fairly mild, showing up in the usual places (knuckles, knees, scalp) and comes and goes but has been fairly well controlled with Dovonex cream. I do not recall any specific trauma that occurred, either physical or emotional, preceding the onset of symptoms but it may be that it was just so long ago that I don’t remember. I haven’t really had any other major symptoms, no brain fog, no memory trouble, no trouble sleeping, no… Read more »
Often the VNS is needed but I would certainly expect you would experience some (and possibly a lot) of improvement without it.
Hi Dr N! I started your protocol in July, about the same time I had my thyroid medication adjusted. My free T4 was in the optimal range but my TSH was super low at 0.0058. I was taking 50 mcg of levothyroxin. My Dr told me to drop one dose per week to hopefully bring my TSH up above .4. I just had levels rechecked and amazingly my free T4 was .99 and my TSH was 3.15. I don’t feel great. My Dr was very surprised. I’m now going back up to 7 days per week dose for two weeks… Read more »
Inulin and rifaximin both could improve absorption of your thyroid medication.
Hi Dr. Nemechek, I have been on your protocol for 3 months and have done 1 round of Xifaxan so far. Thank you for your work! I have Chronic Lyme disease and was diagnosed with SIBO in Nov 2017. My health went into a fast & furious downward spiral after the birth of my 3rd child in 5 years. My most pressing issue is severe swollen lymph nodes in my neck every time I eat. It started in Nov 2017 with just a few foods. I went gluten free, dairy free, soy free & sugar free. But the lymph node… Read more »
I’m uncertain of a mechanism to cause sudden swelling of cervical LN after eating.
No one is every guaranteed anything except a visit to me and a customized treatment plan that best suits their situation.
Clinical medicine for chronically ill, complicated patients is far more complicated that many people envision.
We routinely tell people on the phone to not make an appointment if they are anticipating this or that treatment strategy from me.
So I have been on the protocol for about a month now including rifaximin. I have Crohn’s disease and some anxiety issues. I have recently started taking the chicory root inulin after finishing the rx to help with stomach issues and I think it’s helped. I was just diagnosed with Pneumonia last night and had to have a steroid shot, two antibiotics (because I can’t take the one they wanted me on), methylprednisone steriod pack, and an inhaler. Ahhhhh! I did get the urgent care dr to rx me another round of rifaximin for afterwards. My question is since undoubtably… Read more »
Antibiotics don’t always cause relapse but if they do you’ll often experience a return of the symptoms that went away within the 2 weeks after finishing your first round of Rifaximin.
Generally the inulin doesn’t seem to help much after rifaximin and doesn’t seem to prevent relapse. But inulin is pretty harmless stuff and if it seems to help in some way, its fine to continue it.
Hello Dr. Nemechek: First, thank you. My entire family has been on your Protocol since February! I’ve been speaking with my cousin about your Protocol at length. She is in her early 30s and has several health issues, including an autoimmune disorder which causes cysts. She has a history of c diff, but it is not showing active symptoms right now. She has recently started the EVOO and fish oil. She removed oils high in omega 6 quite a while ago (she’s been on a paleo AIP diet to help control the autoimmune issue). She spoke with her doctor about… Read more »
I do not know of any shot that could replace the impact of Xifaxan (rifaximin)
My 4 year old son was diagnosed with autism when he was 2.5 and then PANS when he turned 4 by a positive CaM Kinase II on the Cunningham Panel (none of the antibodies on the panel were elevated). I discovered your protocol right before his diagnosis of PANS. I started in February 2018 on the full protocol. He was on antibiotics and five days of prednisone from end of April until mid June. My issue is he’s always had a very mild eye tic, it went completely away in June, now it’s back worse than ever with his neck… Read more »
The frequency and intensity of tics seem to be related to the extent of bacterial overgrowth. I focus on increasing the dosage of inulin to improve the control of tics.
Dr. Nemechek,
We have a nine-year-old son who may be on the spectrum. We have your book and have been on the protocol since February. He has always been a poor eater and we have always attributed it to constipation. We stopped giving him psyllium as per what we have read from you and started giving him CALM, magnesium supplement. It isn’t as effective, and he continues to struggle periodically. Is it alright to have him drink kefir or any other form of natural probiotic in his diet?
I am against the use of any probiotic.
Constipation is due to autonomic dysfunction (its a brain issue) and recovers slowly over a few months. I don’t know exactly what a “poor eater” really means so I cannot comment on this but to say many kids who have a limited range of foods they are willing to eat (“picky eaters”) will often just start eating a wider variety of foods after several months on the protocol.
Dr Nemechek, I have just recently started your protocol for my daughter who is ADHD. While researching for her i was recently diagnosed with Hidradenitis Suppurativa which as explained to me is an auto-inflammatory disease. Have you had any patients you have treated with your protocol with HS? Or do you think due to the inflammatory processes with this disease it would be successful on your protocol? It has been very painful over the last few months and I believe it has increased due to recent surgery and being placed on antibiotics which may have not been necessary. Thank you… Read more »
The protocol does seem to help HS but I haven’t seen a complete recovery nor tried the use of VNS as part of the protocol for this.
I have had numerous autoimmune disorders (IBS, Ankylosing Spondylitis, Alopecia Areata, Iritis [both eyes at once], Psoriasis). Strong gene disposition from mother’s side of GI dysfunction, RA, and Scleroderma – that I know of. Changed my diet to the Specific Carbohydrate Diet (SCD) and most IBS problems are pretty easily managed; essentially it’s no grains, no starches, and no sugars except a little honey. Starting my 9th year in October, so yes it’s been a long journey. Make most food from scratch but find more and more online vendors manufacturing SCD “legal” items and am very grateful. Believe my basic… Read more »
Hi Dr. N
My son has severe Crohn’s and is doing many things to stay ahead of it.
Since he is a strict organic non-gmo vegan, which fish oil can he soncume?
Thank you for any advice.
I haven’t had any success with patients using vegan omega-3 supplementations.
You should search for the papers discussing the success of rifaximin in Crohn’s disease. A 10-day has the potential of triggering remission in 45-60% of patients.
I have read your book, and have a grand daughter on your protocol who seems to be improving. I have Crohns disease since age 12 ( doing great right now with low dose methotrexate and Entyvio every other month). A year ago was diagnosed with RA, but symptoms appeared only once for a period of several days – swollen hands, but then disappeared. My arms and legs are slightly sore from time to time, but I continue to work out at gym several days per week with no pain. Would the Nemechek protocol help me? I already do fish oil… Read more »
Yes, the Nemechek Protocol can help a great number of individuals with autoimmune disorders but it requires the rifaximin and vagus nerve stimulation to really change the course of the illness.
My daughter had an amplatzer occluder put in place to close an ASD in 2010 -she was 7 years old, could that trigger an auto immune response ie, increased TPO antibodies, Inflammation? Hypersensitivity reactions associated with
endovascular devices – just curious as she’s 14 now and has been having chronic fatigue – high TPO antibodies- echo’s always look good – was just wondering if there was an correlation.
General anesthesia from surgery can trigger or worsen bacterial intestinal overgrowth and I believe this could trigger enough inflammation to activation a pre-disposing gene for an autoimmune disorder.
So my answer is yes.
Before I take a new supplement I wanted to know if insulin will kill off an overgrowth of klebsiella? I had labs done. I was given GI Microb X to take along with supplements to increase vitamin deficiencies as well as probiotics to increase the good bacteria. I have a lot of food sensitivity and allergies and I get very nervous having to take new things. Any assistance is greatly appreciated. (PS…we are looking at the protocol for our son which is how I got here to your blog. ). Thank you for your time.
Inulin doesn’t kill off anything.
It simply reorganizes the gut by increasing the normal healthy small intestinal bacteria and suppressing overgrowth of colonic bacteria.
It is not absolutely necessary to eradicate Klebsiella especially if a patient is asymptomatic in regards to this organism.