5 Strategies for Reducing Your Risk for Autoimmune Disease

Autoimmune disease is when your immune system goes rogue—like a glitchy security system that starts attacking the VIP (you) instead of actual intruders. It’s not a rare problem: 25 million Americans have a diagnosed autoimmune disease, and up to 50 million are dealing with some level of immune dysfunction. That’s a lot of overzealous immune cells mistaking friendly tissues for enemy combatants. The problem?
Conventional medicine often applies a Band-Aid on symptoms rather than getting to the root cause of autoimmune disease—similar to turning off the fire alarm instead of putting out the fire. But don’t worry, you’re not doomed to a lifetime of mystery symptoms and endless doctor visits.

Approximately 41 million Americans show autoimmunity, as indicated by a blood test with positive anti-nuclear antibodies. ¹ Anti-nuclear antibodies (ANA) are the weapon that your immune system uses that mistakenly target the nucleus—the control center—of your own cells, instead of fighting off actual threats like viruses or bacteria. They’re a hallmark of autoimmune diseases like lupus, rheumatoid arthritis, and Sjögren’s syndrome, signaling that the immune system has lost its way. ² When you have positive ANA, we commonly see attack of normal cells, inflammation, tissue damage, and a whole lot of unnecessary drama inside your body.

Increased intestinal permeability, also known as leaky gut, is one of the triad of factors that we believe are at the root of autoimmune disease. ³ The other two factors are genetic susceptibility ⁴ and environmental triggers ⁵ such as trauma or infection or sweeping hormonal changes, such as being post-partum or in perimenopause. Perimenopause is linked to autoimmune diseases through several mechanisms involving hormonal changes and immune system modulation. ⁶

To learn more about autoimmune disease and how to reduce your risk, listen to my recent podcast with Mel Robbins.

The Triad at the Root of Autoimmune Disease: Genetics, Leaky Gut, and a Trigger

Alessio Fasano MD is a pediatric gastroenterologist at Massachusetts General Hospital who has extensively studied the role of increased intestinal permeability in the development of autoimmune diseases. Fasano’s research highlights that the intestinal epithelial barrier, with its intercellular tight junctions, plays a crucial role in maintaining the balance between tolerance and immunity to non-self antigens. Zonulin, a protein that modulates the permeability of tight junctions, is a key factor in this process. ⁷

Fasano’s work suggests that when the zonulin pathway is deregulated in genetically susceptible individuals, it can lead to the development of autoimmune disorders. This is because increased intestinal permeability allows the translocation of macromolecules, such as bacteria and toxins, into the bloodstream, triggering an immune response that can result in autoimmunity. This paradigm shift proposes that restoring the integrity of the intestinal barrier could prevent the onset of autoimmune diseases by blocking the interaction between genetic and environmental factors.

Fasano’s findings are supported by both animal models and clinical evidence, which demonstrate that increased intestinal permeability is a common feature in various autoimmune diseases, including celiac disease and type 1 diabetes.

5 Strategies to Reduce Your Risk of Autoimmune Disease

Here are five science-backed strategies to keep your immune system from going full-on rebel mode and lower your risk of autoimmune disease.

1. Strengthen Gut Health

When you have leaky gut, you may have symptoms of constipation, gas, or bloating, even brain fog, or you may have no symptoms. What happens in leaky gut is there is a loss of the integrity of the intestinal lining that allows things to pass through to the person’s bloodstream that don’t belong, like bacteria and other inflammatory pathogens. This can cause chronic inflammation, which in turn causes the immune system to be reactive all or most of the time, setting the stage for the onset of autoimmunity. The goal is to target the leaky gut and reset the immune system to health.

One of the main ways to improve leaky gut is through diet. To help repair your gut barrier, make sure you are getting nutrients like vitamins A, B, D, zinc, and healthy fats; additional supplements may be required. For many of my patients, I recommend consuming bone broth–based soups and powders containing L-glutamine, which may help improve leaky gut.⁸

Giving up alcohol is another important step. Alcohol is one of the surest ways to damage the delicate cells of your gut and cause leaky gut.⁹

2. Understand Your Genetic Blueprint

Do people in your family have autoimmune disease or mysterious symptoms no doctor seems to be able to diagnose? Consider testing your genetics.¹⁰ However, your genetic code does not tell you if you will develop autoimmune disease; rather, it can inform us about your potential assets and vulnerabilities so that we might be able to work around them with lifestyle management, such as how you eat, move, think, sleep, and navigate toxic stress.

3. Cultivate a Healing Mindset

Trauma can be a trigger for autoimmunity. In my precision medicine practice, I noticed a seemingly unusual pattern: many of my patients who suffer from autoimmune disease and symptoms have a history of trauma. People need to learn how the body processes trauma and learn new ways to cope with stress and resolve their symptoms. If you have experienced trauma in your childhood or later as your adult life, you may have tried talk therapy to help resolve it. But surprisingly, talk therapy is not an effective tool, especially for PTSD. As I tried to unwind the trauma from my body, I tried to connect the dots between my psychology and my physiology by trying mind-body therapies like Hakomi; trauma-informed care; as well as practices such as Holotropic Breathwork® that help you enter a healing state of consciousness. 

4. Track Your Stress

Toxic stress or trauma can be the trigger that sets off autoimmune disease in people with a genetic predisposition and intestinal permeability and chronic inflammation. Many people often don’t notice how high their stress levels are particularly when they live with toxic stress long term. I find that to manage my stress and cortisol levels, I need to track and measure them which then allows me to take steps to improve them.

• Measure your stress baseline. Either check your stress level on the Perceived Stress Scale, or invest in a wearable that checks your heart rate variability or similar metric. If using a wearable, get a solid baseline over several days of measurement and record the average value of the HRV or composite metric, for example, Oura’s “Readiness” score or Garmin’s “Body Battery.”
• Measure your sleep quality. Toxic stress and traumatic life events can disturb your sleep-wake cycle. Consumer sleep trackers are reasonably accurate at measuring total sleep time and at tracking both light sleep and rapid eye movement (REM) sleep. You can use this information to improve your sleep and start a conversation with your doctor. I like to use them for directionality, such as if your REM sleep is low, that usually means you need to go to bed earlier. If you don’t have enough deep sleep, you may need to work on gut health. 

5. Identify and Eliminate Inflammatory Foods

All disease begins in the gut, and autoimmune disease is no exception. Whether you have gut symptoms or not, if you have autoimmunity, research shows that an anti-inflammatory diet is a critical contributor to overall health. To reduce the inflammation caused by diet, many functional medicine clinicians recommend a strict elimination diet. The basic principle of diets like these is: when you remove the food-based triggers that may be contributing to your autoimmune condition, you will likely experience major improvements in your symptoms. The most common trigger foods are dairy, gluten, alcohol, grains, and eggs, but there are more. While the list of foods can feel exhaustive, I find that some people can begin with cutting out a few of the worst offending foods, like dairy and gluten, and feel improvements in symptoms.

Find more details on the Elimination Diet in my latest book THE AUTOIMMUNE CURE.

Conclusion

Autoimmune disease isn’t just bad luck—it’s the result of an immune system gone haywire, often triggered by diet, stress, infections, or environmental toxins. The good news? You have more control than you think. By identifying and eliminating inflammatory foods, repairing the gut with key nutrients like L-glutamine, and tackling hidden triggers (hello, stress, perimenopause, and mold exposure), you can nudge your immune system back into balance. Think of it like rebooting a slow computer—clear out the bugs, upgrade the software, and severything runs smoother. Autoimmunity may be complex, but your action plan doesn’t have to be. Start with small, science-backed shifts, and you’ll set the foundation for a body that works with you, not against you.

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