Akil Palanisamy, MD, is a Harvard-trained physician who practices integrative medicine, blending his conventional medical expertise with holistic approaches including functional medicine and Ayurveda. “Dr. Akil” attended Harvard University and graduated magna cum laude with a Bachelor of Arts in biochemical sciences. He earned an MD from the University of California, San Francisco (UCSF) and completed family medicine residency training at Stanford University. He then graduated from a fellowship in integrative medicine with Dr. Andrew Weil at the University of Arizona, and received certification in mind-body medicine from the Georgetown University Center. He is the Department Chair for Integrative Medicine at the Sutter Health Institute for Health and Healing (IHH). He also serves as IHH Physician Director for Community Education and leads their educational initiatives and programs. Dr. Akil has been a consultant with the Medical Board of California for many years.
A widely known speaker and educator, he is the author of THE TIGER PROTOCOL and The Paleovedic Diet: A Complete Program to Burn Fat, Increase Energy, and Reverse Disease. As he has done for over two decades, Dr. Akil sees patients and conducts clinical research studies in the San Francisco Bay Area. In his free time, he enjoys playing tennis, traveling, and spending time with his wife and daughter.
I had a chance to learn more about autoimmune disease in this interview.
How are autoimmune diseases a silent epidemic?
Autoimmune disease is undoubtedly a silent epidemic in modern times. Unlike Covid-19, autoimmune disorders have insidiously expanded to huge levels without attracting much attention. In just the past 10 years, some autoimmune diseases have increased by 300 percent. Others have risen up to 5,000 percent in the past few decades.
In fact, one out of every five Americans suffers from some form of autoimmune condition. Hundreds of millions of people worldwide are struggling with autoimmunity. The prevalence and cost of autoimmune disease are greater than heart disease, cancer, and diabetes—combined.
There are more than 100 autoimmune conditions affecting people today, including Hashimoto’s thyroiditis, type 1 diabetes, multiple sclerosis, and rheumatoid arthritis. Sadly, the list continues to grow. Recent research has even shown that irritable bowel syndrome, the most common digestive disorder, is autoimmune in nature.
They comprise a silent epidemic especially because many people do not even realize they have an autoimmune condition – studies show that it typically takes five years and four different doctor visits to get the correct diagnosis.
Why isn't conventional medicine always effective with autoimmune diseases?
In conventional medicine, once patients actually receive the autoimmune diagnosis, they will typically be referred to a specialist who will be highly trained and skilled in recommending and managing medications, but perhaps less skilled in addressing root causes such as diet, the microbiome, and toxins.
Conventional medicine is very effective at treating acute situations like flareups. We have very powerful medications that suppress inflammation and bring symptoms under control. But after that, my patients are seeking out holistic changes that they can make proactively to prevent the flareup from recurring.
Often, my patients tell me that their specialist told them that food has no impact on their condition, and they have been frustrated that connections they have observed between nutrition and their own symptoms have been dismissed. Therefore, people are hungry for natural tips and tools they can use to improve their immune health and decrease autoimmunity.
What role does nutrition play in treating autoimmune disease with elimination and reintroduction?
Nutrition plays a key role in autoimmunity and all chronic disease. I believe that food is medicine, and therefore if food is part of the initial problem, it can be part of the solution. But we have to remember that autoimmune disease is about more than just our diet.
The development of autoimmunity is a multistep process, with factors like nutrition being one factor – but in addition, infections, toxins, the gut bacteria in our microbiome, hormone imbalances, and stress are also important in driving the progression.
Most people know about food allergies but food sensitivities are less well-known, and they play a bigger role in autoimmune disease.
Food sensitivities usually cause reactions that are less severe than food allergies, but nonetheless can be very bothersome. These include fatigue, joint pain, rashes, digestive symptoms, cognitive changes, or other nonspecific symptoms. Unlike food allergies which trigger IgE antibodies, food sensitivities are mediated either by IgA or IgG antibodies.
IgG-mediated food sensitivities have been associated in the literature with an array of common clinical conditions including eczema, migraine, obesity, asthma, irritable bowel syndrome, and – pertinent to our discussion – autoimmune conditions.
Food sensitivities can also develop at any age, but unlike food allergies they may resolve themselves over time. They are affected by the gut microbiome, intestinal permeability, and the overall state of the immune system. Addressing these factors can have a huge impact in the severity of food sensitivities, and in some cases allow patients to resume foods that they were sensitive to in the past.
Food sensitivities are more common in patients with autoimmune conditions. For example, in patients with rheumatoid arthritis, elevated levels of food sensitivity antibodies have been found at higher levels than in normal controls.
Therefore, elimination plays a key role by clearing out some of these food sensitivities for two months so that the body and gut can heal. After that, in my Phase 2 Diet, I teach people how to reintroduce the foods they have eliminated while monitoring for reactions. This way, they can achieve a broader and more diverse diet, which is critical for long-term health in autoimmune conditions.
In fact, I would argue that the diet plan outlined in my book, with its emphasis on building gut microbiome diversity with prebiotic and fermented foods, offers the healthiest, most well-rounded approach to eating out there—one that all people should follow.
We know that a diverse microbiome—which depends largely on your diet—is one of the most important factors in living a long and healthy life. Centenarians have been shown to have much more diversity in their gut bacteria. My protocol provides people with the most up-to-date understanding of the dietary approach that can best achieve this, including specific foods, 35+ recipes, and meal plans to try.
WEBSITE AND SOCIAL MEDIA:
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