Today, I’m excited to share an important post by one of the practitioners I admire – Dr. Stephanie Davis.
Stephanie is a doctor of chiropractic medicine who has trained extensively in the Functional Medicine approach.
Stephanie fought through her own health struggles with hormone imbalance, hypothyroidism, infertility, and eczema, as well as her husband’s Hashimoto’s. Her personal journey drives her to serve those who want guidance on finding the real root cause of their illness and snuffing it out, for good.
If you’re dealing with eczema, skin issues, and autoimmunity, this article is for you.
If you have chronic eczema, I bet you know some of your “triggers.”
A lot of patients I see with eczema tell me that certain foods (or lack of certain foods) can trigger eczema for them. Stressful situations are another common reason for an eczema flare.
But if you go to a conventional Western medicine doctor or dermatologist for help with eczema, you’ll probably be told the same thing I was when I was diagnosed with eczema: “You’ve got eczema. There’s no known cure. See you later.”
Conventional medicine views eczema as a disease without a cause – something that just “happens” and nobody really knows why.
But I know – and I bet you know, too – that intuitively this doesn’t make any sense. The causes of eczema can be diverse, and what causes an outbreak for me might not bother you, but there is a root cause behind eczema: autoimmunity.
Today, my goal is to debunk the myth that eczema is a “mystery disease.” I’m going to explain the functional medicine approach to eczema and also how you can find the root cause of eczema using a Functional Medicine approach.
How Functional Medicine Is Different From Western Medicine
Conventional medicine views the body as a group of isolated systems. This means you have a cardiologist for the heart, an endocrinologist for hormones, a gastroenterologist for your digestive system, and on and on.
In Functional Medicine (FM), we also recognize the importance of all these systems – but instead of separating them out we focus on how the systems are intertwined. The systems of the body operate together as a response to the environment (kind of like the operating system of a computer). Each system influences the others.
A good analogy to help you understand Functional Medicine versus conventional medicine is to think about a tree. Visualize the entire tree with its roots, trunk, branches, and leaves.
Conventional medicine looks at one branch whereas FM views all of the branches, trunk, and roots. FM practitioners look at the leaves, the bark, and even the little bugs climbing around the tree.
FM practitioners (like me!) take a really detailed history of each patient and to find root causes. The goal is to find out what is foundationally disrupted in your body to figure out what’s causing the eczema flare.
FM Vs. Conventional Approach To Eczema
Conventional medicine views eczema as a skin condition. If you have eczema, you’ll probably be sent to a dermatologist who will prescribe you a topical cream. You’ll likely be told there is no known cause or cure for eczema, and the best you can do is treat the symptoms.
Functional Medicine takes a totally different approach. They view eczema as a whole-body issue that points to imbalances in one or more body systems. In fact, recent research has backed up the FM viewpoint: eczema is now considered by many to be an autoimmune condition with potential root causes.
To find the root causes of eczema, FM uses something called the ATM model: looking at disease as a result of antecedents, triggers, and mediators.
Understanding The ATM Model
Understanding the ATM model is foundational to understanding Functional Medicine. An FM practitioner uses the ATM model to frame an understanding of your entire life history and contributing factors to your condition. We’re looking at all of that to figure out how you got to where you are today.
Let’s start off with the antecedents, which are the predisposing factors. Those are things like genetics and family history, lifestyle, past illness, and exposures (occupational, home, or environmental), and are the underlying or precipitating cause of illness.
(A key point regarding genetics and family history is that they aren’t a death sentence. A lot of people think, “Oh, there’s cancer in my family. I’m going to get cancer.” That’s not necessarily the case. There are so many modifiable factors here that can prevent you from actually having that illness even though you might be very prone to having it.)
Triggers are what provoke the signs and symptoms of illness. Things like infections, allergens, toxins, radiation, surgery, and social conditions can all be triggers. They’re going to combine with the antecedents to actually cause more signs and symptoms.
Last, the mediators perpetuate the illness. You can think about mediators on a biochemical or psychosocial level. Biochemically speaking, the hormones, neurotransmitters, metabolites, free radicals, and inflammatory chemicals are what perpetuate what’s going on.
Psychosocial factors like stress, thoughts, beliefs, and community are extraordinarily powerful mediators, too. Stress is often the primary trigger and tipping point for most people. Stress can be emotional or physiological like trauma or infection. Regardless of the source, it causes systemic biochemical changes.
Once you have the antecedents, plus the triggers, these mediators keep that cycle going. In the case of eczema, it’s going to cause the flare to continue.
Common ATMs For Eczema
Genetics, family history, lifestyle, past illness, and environmental exposures are key antecedents for everyone. But there are some antecedents I see specifically related to eczema. For example, if you have a family history of autoimmunity or allergies, asthma, and eczema (what we call the allergic triad), you’re much more likely to get eczema than the rest of the population.
The most common triggers I see in practice are infections, allergens, toxins, diet, and dysbiosis (an imbalance in the microorganisms in your body—not just in your gut, but all over your body).
In eczema, skin dysbiosis can be an important piece of the puzzle too.
The primary mediators of eczema are:
- Hormone imbalances (especially from stress and sex hormones). Cortisol, DHEA, estrogen, progesterone, and testosterone imbalances can perpetuate inflammation and make eczema flares worse.
- Depleted nutrients. In practice, it’s usually omega 3 fatty acids, vitamin D, antioxidants such as vitamin C and selenium, and minerals such as zinc and magnesium. Protein malabsorption can be an issue too, since you need the amino acids to make collagen and skin tissue.
- Inflammatory chemicals. Histamine, cytokines, and free radicals are major contributors here, though there’s a long list of players in this biochemical pool.
- Impaired liver function. If your liver can’t function optimally, you can’t clear metabolic waste, toxins or hormones efficiently which are essential for a healthy gut and skin. This is often one of the key places we address first.
- Leaky gut. This occurs when many of the above factors cause increased intestinal permeability allowing things into the bloodstream (like bacteria, toxins, proteins, etc.) that shouldn’t be there. This causes inflammation and immune system activation driving the eczema cycle.
For most of the clients we see in our virtual clinic, stress is the most significant factor, either as a trigger or as a mediator, or both.
How Addressing Eczema ATMs Can End The Cycle
To recap, if you’re having an eczema flare or a flare-up of any autoimmune condition, you’re looking at: antecedents + the triggers + the mediators = cause of flare.
It’s a cyclical process that self-perpetuates until you identify the triggers and the root causes to stop this cycle.
The root cause imbalances, such as infections, hormone and nutrient imbalances, allergens, foods, etc., must be eliminated to get this cycle to stop. Then, you actually need to take the proper steps to heal it (replacing nutrients, healing leaky gut, balancing hormones, improving liver function, etc.).
To be able to address the root causes requires introspection (figuring out what those triggers are) as well as the guidance of a skilled Functional Medicine practitioner who can guide the healing process.
My Own Eczema Experience
If you think all FM practitioners eat perfectly – I’m about to burst your bubble.
I’m sharing this story because it’s true, and I want you to understand the complexity of uncovering the ATMs behind eczema.
It started on Halloween – I ate a few pieces of leftover candy.
About an hour later, my left hand started itching like crazy. I knew right away that the candy had triggered a flare.
The candy wasn’t the root cause of my eczema flare, but I knew that processed foods and refined sugar were both triggers for me.
I went downstairs and took some anti-inflammatory nutrients, because I knew I had to get at that flare before it became a full-blown outbreak. (Yes, it is possible to dampen the effect of a flare once you have your eczema under control.)
With my immediate symptoms under control, I decided to review my own ATMs.
Applying The ATM Model To A Real Person (Me!)
My major antecedent is the allergic triad in myself and family members. As I mentioned above, the allergic triad is allergies, asthma and eczema. Most of that manifests in childhood, but not always. I only had allergies in childhood. Eczema started in my 30’s! If you have any of those, you’re also going to be more prone to autoimmunity as an adult.
I also have a family history of autoimmunity and inflammation conditions. There’s lots of cardiovascular disease and diabetes in my family. Historically, I was bottle fed and was around smokers growing up which are also key antecedents in developing eczema.
My main trigger for this flare was hormone imbalance and dysbiosis that developed during pregnancy. In the gut, when your hormones such as progesterone are high, it slows things down in pregnancy. It sets the stage for things like leaky gut and dysbiosis to occur. This was something that I had experienced quite a bit of during my pregnancy (even though I tried my hardest to prevent it since I know what I know!!).
Diet was also a key trigger (especially the candy). My regular diet is anti-inflammatory. However, after the birth, my diet has not been quite as tight. Foods that were very occasional before I gave birth – like a little dairy, beans, or corn – have become more frequent. The candy just happened to be the breaking point for me… that little bit put me over the edge!
My primary mediators were hormone and nutrient imbalances from pregnancy and breastfeeding, leaky gut, and STRESS.
Stress, Sleep & Community
Stress, sleep & community are some of the most important and common mediators. And in this eczema flare, they were all relevant mediators for me.
When this eczema flare occurred, I had a brand new baby. I’ve got a 5 year old. I’ve got work. I’ve got life. Everybody’s got stress. But I currently feel like I have a lot on my plate. That’s the main mediator perpetuating the cycle for me.
For me, stress is probably the number one factor that contributes to my flares every single time. When my stress levels get high, I can get a flare super easily. And I know that’s true for many of the people we work with in the clinic as well.
Another very common but often overlooked mediator is lack of sleep. Lack of sleep is a major contributor to manifesting any autoimmune condition, especially something like eczema. We heal and regenerate when we sleep. If you’re not sleeping well, it’s not happening.
Lastly, there’s the issue of support and community, or a lack thereof. When you first have a baby, everyone comes and sees you for the first couple of weeks. And then suddenly it’s gone. This can leave you with a sense of feeling like you’re lacking community or lacking support. I won’t say that I feel that tremendously, but I feel it a little bit.
All of these things added up and resulted in my eczema flare.
Do You Know Your ATMs?
I didn’t just share my own story because I like talking about myself – I hope that by sharing my story, you can see a bit of YOUR story, too.
Maybe you haven’t just had a baby – but I bet you’re dealing with stress, too! Maybe you also have the allergic triad or a family history of autoimmunity.
Because I understand my own ATMs, when I do have a flare of symptoms, I know how to address it.
I got it under control quickly by tightening up my diet, doing some key supplementation, and topical salves. But for long-term healing, I also had to address the stress, lack of sleep, and lack of community I was feeling. I asked for help from my family and friends and took steps to reduce my commitments where I could, so I had more time to relax.
Because I could recognize what was causing the flare, I was able to prevent this flare from turning into a full-blown eczema outbreak. I believe this is possible for everyone with eczema, and I want to show you how.
Overcoming Eczema Is Possible For You, Too
Did this article raise questions for you about your own ATMs and root causes for eczema?
If you’re looking for more support in healing your eczema and understanding your root causes, you can always book a free, no-obligation, 15-minute consult with our clinic: http://drstephaniedavis.com/consultation/.
During this free call, we’ll take a deep dive into your personal history to start finding the root causes of YOUR eczema. We’ll also come up with strategies to address your own ATMs.
My goal as a Functional Medicine practitioner is to give you a better understanding of your body so you can be empowered to heal.
If you’re ready to learn how to get rid of eczema for good, book a free consultation here.
– Dr. Stephanie Davis