- Focus on allergies
- Treatment and research
- Autoimmune Diseases When the Body Attacks Itself with Dr Howard Smith
- Autoimmune Disease Specialist
- How Doctors Treat Autoimmune Disease
Focus on allergies
Allergies are when the immune system produces antibodies against
- Environmental substances like pollens, dander, molds, weeds, and dust mites, or
- Foods like nuts, milk, egg, wheat, shellfish, and others
The antibodies can lead to symptoms like
- Nasal or sinus congestion
- Watery eyes
- Shortness of breath
- Low blood pressure
Our immunology team also treats immune deficiencies, where not enough defenses lead to increased risk of infections, cancers, or autoimmune diseases.
After thorough testing to diagnose your allergy or immunodeficiency, we have many treatment options tailored to your specific condition.
Our diagnostic tests include specialized laboratory testing and safely exposing you to tiny amounts of allergens to see if you react. We also use pulmonary function testing and imaging to measure the severity of your condition.
Our treatments include allergen immunotherapy and immunoglobulin replacement, tailored to your system.
Treatment and research
Members of our immunology team actively conduct research on immune mechanisms. Working in teams in our own academic medical center and partnering with researchers around the country, they are determining new treatments to restore health for people with rheumatologic and immunologic diseases.
They frequently participate in clinical trials, offering patients safe and proven therapies that may not yet be widely available.
Autoimmune Diseases When the Body Attacks Itself with Dr Howard Smith
Howard Smith: Yeah. So, in general, depends on what’s going on with your disease and what medications they’re on with their lupus. So I can’t answer that specifically ’cause I don’t know what medicines she’s on. But she should talk to … I assume she’s probably seeing a rheumatologist with her lupus, and talk about that. But in general, for the … we don’t give the live vaccines to people who are … that have problems with their immune system, we call them immunocompromised. But people can receive, it’s flu season now, all our lupus patients get influenza vaccines. So the typical vaccines can be given that are “dead vaccines.” The live viruses are usually not given. And it also depends on what medications the patient is on. So they should talk to their rheumatologist.
Nada Youssef: Talk to your rheumatologist, okay.
Howard Smith: What vaccines they should be getting.
Nada Youssef: Okay, great. You know what, I will fit in one more, there’s a interesting one here from Eva: “Why avoid the sunlight if it helps in the production of vitamin D, which is essential to our health and most of us are deficient of vitamin?”
Howard Smith: Yep. I jokingly tell my patients if you live in this zip code, if you get your lab tests you’re vitamin D deficient. So vitamin D is sometimes a hormone, and vitamin D is very important to the immune system. We are actually doing a study right now of vitamin D and the immune system in our lupus patients. So vitamin D is important. Unfortunately, I tell my patients two messages. 6 out of 10 lupus patients are sun sensitive, I tell them don’t go out in the sun. And then conversely I tell them, you need a high vitamin D level ’cause it’s good for the immune system. So, we usually supplement. Avoid the sun, don’t get your vitamin D through sunlight, but get your vitamin D through supplementation. But vitamin D is very important to the immune system.
Nada Youssef: Great, great. Alright, well that’s all the time that we have today, but before I let you go anything you want to tell our viewers?
Howard Smith: Well, I think the key is that if you think you have an autoimmune disease, and you’ve been reading about it, the place to start is with your primary care physician. Let them know what’s been going on and they will probably do some preliminary testing and see if they can make the diagnosis, and see if they feel comfortable in treating it. And if they decide that you have lupus or some other autoimmune diseases and they’re comfortable with it, they’ll treat you. And if not, they’ll make the appropriate referral. But I think the key is to start with your primary care physician, ’cause I like to tell my patients they’re the quarterback. They run the show, they know about all your other intricacies of everything’s going on, and they’ll make the appropriate referral.
Nada Youssef: Yeah. And exercise, diet, sleep.
Howard Smith: Exercise and diet I can’t stress enough.
Nada Youssef: Great, well for more health tips and information make sure you follow us on Facebook, Instagram and Snapchat. One word @ClevelandClinic. And next week we’ll be with Dr. Cruz, talking breast cancer so make sure you tune in, and thank you so much for watching.
Nachman: The Internet is full of information. My discussion with patients about this has been mixed. Some people find very useful information, but there is a lot of incorrect information and sometimes the information is downright scary to patients. It’s also important to remember that these diseases are not uniform. Two patients with the same diagnosis may have very different manifestations of disease, and what you might read on the Internet about the disease that carries the same name might not apply to you as an individual patient.
What I do suggest to my patients is to go to sites that are well-vetted. Go to sites of patient advocacy groups, for example, rather than individual sites. Sites where patients and physicians have written information in a well-written but also edited and corrected way. I think that the patient advocacy groups are always a very good source of information. In the groups of diseases that I deal with, for example, the Vasculitis Foundation, they have a web site, local chapters with patients, and they provide very good information. They can also direct you to physicians who have expertise in the disease affecting you. I think that some of the future podcasts are going to be about lupus – the Lupus Foundation has a lot of information. For patients with kidney disease, the UNC Kidney Center has information online that one can access, the National Kidney Foundation has a lot of information online. These sources are far more reliable and accurate than random web sites.
When patients blame themselves for causing the disease
Falk: The patient has had a healthy, normal life, and is now faced with this possibility of having an autoimmune disease. I think the question that most of us get is, “What caused my disease? Did some behavior of mine cause this autoimmune process to unfold?” How do you respond to a patient who says, “Did I do this to myself?”
Nachman: I think the answer is simple here. You did not do this to yourself. I don’t think there is any reason that a patient should feel guilty or ashamed or worried that this is something that they brought on to themselves. Autoimmune disease is a complex disease. We don’t fully understand what caused this. But we do know that this is not something that patients have caused in any way. So there’s really nothing that a patient should feel that somehow they’re guilty about bringing this to themselves.
Falk: As a matter of fact, if a patient had done something that induced the disease, we would know what caused these autoimmune diseases and then we would be able to answer the question. The reality is we don’t know what caused the vast majority of autoimmune diseases. So it’s highly unlikely that a patient would have any ability to actually cause the disease themselves.
Nachman: Yes, this is not a time for self-blame. The focus must entirely be on management, treatment going forward.
A few things that can help patients improve their outcomes
Falk: You talked about a prior podcast from Celeste Lee who talked about patient advocacy. And really, patients who have been successful managing their diseases and take care of themselves really have learned a number of very important lessons. What are some of these factors that result in success? With all the patients you’ve taken care of, what have you learned from them that teach you how to help other patients improve their outcomes?
Nachman: I want to come back to the idea of not walking the road alone – bringing a confidante with you to clinic, keeping track of your care, of the plan, of the management. Quite honestly things as simple as the schedule of treatments and medication is very helpful. Write it down. As much as we love to hate or hate to love our new electronic medical record system, the big advantage that I see with that is the communication has improved and we now have an easy way of writing instructions and sharing it with patients and family. The more the patients does that, or the patient and their support at home does that, the better.
Celeste talks about being in the driver’s seat. I think the patient must be in the driver’s seat but may not be able to drive themselves, so accepting help is very important. Again this is not a time to be shy. Seek help and accept it. I honestly, truly believe that being engaged in patient advocacy group is incredibly helpful, not only for the individual patient themselves, but for their families to understand what’s going on. But also to the medical community in helping all of us get a better handle on what causes the disease and how best to treat it.
I think that considering participating in clinical studies or clinical trials is a good idea. I don’t want to sound self-serving about this, but clinical studies are very well thought of, vetted at a physician level, at an institution level, by the ethics committee and also at the FDA level who reviews everything we do. What clinical trials do is give the physician a path forward when the treatment is not obvious. It gives the patient a path forward, and it also gives the patients access to a group of coordinators, nurses, pharmacists, who are overlooking and following that treatment very, very carefully in ways that is an incredible support system. So if you as a patient feel that this is something that you’re comfortable with, ask about it and try to participate in these things. Again the patient advocacy groups are a great resource to learn about what’s being done, where the expertise is, and what are the new treatments being evaluated. Sometimes the treatments are not new – sometimes they are old medications, but we’re learning how to use them better, more judiciously, how to minimize the side effect profile. This source of information is incredibly helpful in moving the field forward for better treatments.
Falk: If we could sum up what you’ve just said, if a patient has an autoimmune disease, the whole family and the whole support system then participates in the care of the autoimmune process.
Thank you, Dr. Nachman. And thanks to our listeners for tuning in. If you enjoy this series, you can subscribe to the Chair’s Corner on iTunes or like us on FaceBook so you’ll know when we post our next episode. Thanks so much for listening.
Visit these sites for information referenced in the podcast conversation.
- Celeste Castillo Lee’s Work in Patient Engagement
- Clinical trials in the United States
- Lupus Foundation
- National Kidney Foundation
- UNC Kidney Center Patient Education
- Vasculitis Foundation
Autoimmune Disease Specialist
- Neurologist – can treat autoimmune diseases of the nervous system.
- Rheumatologist – is trained to deal with arthritis and related diseases.
How Doctors Treat Autoimmune Disease
Many autoimmune disease doctors offer medications to treat the condition. These may offer relief from symptoms, replace substances which the body can no longer make (such as hormones) and may suppress the immune system.
However, many people do not relish a potentially life-long reliance on medication. At LifeWorks Wellness Center, the first step in treating autoimmune diseases is to immunize the patient to their own blood. In this a simple, effective procedure where a small amount of a patient’s blood is taken and mixed with a homeopathic remedy. This combination is then delivered back into the patient. This has the effect of re-programming the patient’s immune system and in many cases, begins the process of improving their symptoms toward recovery.
Florida’s Top Autoimmune Disease Clinic
LifeWorks Wellness Center is considered by many to be Florida’s top autoimmune disease clinic and patients travel from all over the country to seek treatment. That is because the autoimmune disease treatment at this Tampa Bay clinic exceeds anything available to them where they live.
We have offered autoimmune disease treatment to many patients to help them regain their health and we would love to help you, too. To become a patient, or for more information, feel free to call our New Patient Coordinator at (727) 466-6789 or simply submit an online web inquiry with your request.