I have what?
Aside from being hard to pronounce, Sjögren’s syndrome is an autoimmune condition whose unpredictable nature makes it difficult to diagnose and manage.
Those who actually receive a timely diagnosis are often left feeling scared and confused, as they try and grasp what it really means to live with a seemingly mysterious disease.
Unfortunately, many believe they have no other choice than to go down the rabbit hole of lifelong medications with unrelenting side effects.
You may wonder if other options even exist….
If you’re looking for a different option but don’t know where to start, you’re in the right place.
Read on, as we dive into what contributing factors ignite this disease, what role the gut plays in turning it on, what you can do to overcome Sjögren’s naturally and much more.
What Is Sjögren’s Syndrome?
Sjögren’s syndrome (pronounced SHOW-grins) is the second most common autoimmune condition in the world. It primarily affects the salivary (mouth) and lacrimal (eye) glands, which under normal circumstances help produce moisture in the form of saliva and tears.
For those with Sjögren’s, the body fails to produce enough moisture…
Which can lead to a whole host of symptoms such as:
- Dry eyes and mouth
- Difficulty swallowing/eating
- Blurred vision/ Burning sensation in the eyes
- Hoarseness/non-productive cough
- Recurrent mouth infections
Though less common, Sjögren’s can actually affect the entire body. In some cases, it can lead to systemic symptoms like fatigue, rashes, dry skin and joint pain. In one study, 67% of patients reported having an abnormal level of fatigue on a daily basis.
As many as 4 million people live with Sjögren’s – a condition named after the swedish ophthalmologist Henrik Sjögren who described the symptoms in 1933. Despite the number of people suffering from this condition, it’s rare for two people to present with the exact same symptoms.
And this is why a proper examination is so important when it comes to getting the right diagnosis.
Diagnostic Tools for Sjögren’s Syndrome
No single diagnostic test is enough to confirm a diagnosis, but rather a series of strategies are used. Performing a physical exam and reviewing the patient’s medical history is a good starting place, followed by an Antinuclear Antibody (ANA) blood test.
A special X-ray of the salivary glands, called a sialogram, can help determine if the salivary gland or duct is blocked. A biopsy of the salivary glands can help determine whether inflammation is present, and if so, the severity. Most accessible for a biopsy are the minor salivary glands just under the inner surface of the lip – which is a test commonly referred to as a lip biopsy.
The Schirmer tear test is a test used to determine the level of moisture in the eye and serves as a good indicator of how much the eyes are being affected.
Those diagnosed are classified as either primary or secondary. Primary Sjögren’s syndrome tends to be more aggressive and occurs in those who do not have any other autoimmune conditions. Secondary Sjögren’s occurs in those who already have another autoimmune disease with scleroderma, lupus, and Rheumatoid Arthritis being the most common.
Most people are well into their 40’s before they’re diagnosed and women are 9 times more likely to develop the disease than men.
Complications of Sjögren’s Syndrome
In some cases, it’s possible for those suffering with Sjögren’s to also experience complications in other areas such as the kidneys and lymph nodes.
The most serious complication of Sjögren’s is Non-Hodgkin’s Lymphoma (NHL) – a type of cancer that starts in lymphatic cells (these cells are part of the immune system). For those with Sjögren’s, it occurs most commonly in the salivary glands.
The risk of developing NHL is equivalent for both primary and secondary Sjögren’s and some studies estimate the risk to be 44 times greater than that observed in a healthy population.
Persistent enlargement of a major salivary gland should be carefully and regularly observed by your doctor and investigated further if the size changes.
Other symptoms to be aware of are:
- unexplained fever and weight loss
- night sweats
- unrelenting fatigue
- reddened patches on the skin
The Genetic Link in Sjögren’s Syndrome
As seen in our autoimmune series of articles, nearly every condition has a genetic component and Sjögren’s is no different.
Research has discovered that the STAT4 gene variant associated with rheumatoid arthritis and lupus is also associated with primary Sjögren’s syndrome (pSS). In a recent case control study, the risk of developing Sjogren’s was seven times higher among first-degree relatives with autoimmune disease than to the control group.
Another study replicated these observations by showing that first-degree relatives of Sjogren’s patients had an increased risk of developing the condition (as well as systemic lupus, RA, systemic sclerosis, and type 1 diabetes) when compared to the general population.
Both studies above, as well as several others, strongly imply a genetic influence in the development of Sjögren’s syndrome. Researchers also recognize the genes do not act alone. It’s likely the combination of environmental exposures and genetics are what evoke an autoimmune condition.
Contributing Factors in Development of Sjögren’s Syndrome
Factors that contribute to the onset of autoimmune diseases are vital to understanding how to manage the condition naturally.
The most common contributing factors in Sjögren’s syndrome are:
Viral Infection – Researchers found that a chronic cytomegalovirus (CMV) infection could lead to the development of Sjögren’s. The persistence of CMV may initiate tissue destruction in genetically susceptible individuals by attacking the salivary and lacrimal glands via antigenic expression. Ultimately, this can lead to the manifestation of Sjogren’s syndrome.
Studies also show a correlation between an Epstein Barr Virus (EBV) infection and the pathogenesis (development of disease) of Sjögren’s Syndrome.
Hormones – Because Sjögren’s syndrome displays such a large female bias, genetic makeup is an intuitive area to examine. This study shows low levels of the anti-inflammatory sex hormone DHEA is associated with the symptoms found in primary Sjögren’s syndrome and dry mouth symptoms decreased during DHEA therapy.
Stress – Chronic physical, emotional and mental stress all have the ability to lower the body’s immune capabilities. Not only can this exacerbate chronic symptoms, but welcome other infections (like those mentioned above). Those suffering from Sjögren’s say the number one cause of a flare or a relapse is a stressful event. Whether it’s taking a short walk or incorporating a daily meditation routine, finding ways to destress is an important part of managing the condition.
Sjögren’s Syndrome and the Digestive System
Simply put, Sjögren’s syndrome can wreak havoc on the digestive system and seriously impair quality of life. Researchers estimate over 25% have moderate to severe digestive issues.
The most common digestive complaints of those with Sjögren’s are:
Constipation – Sufficient moisture is needed to have a perfect, type 4 on the bristol stool chart. Constipation issues may be a result of the decreased fluid in the intestinal tract when less saliva is produced. A potential link between the effect of Sjögren’s and the smooth muscle that propels food along the intestines is currently being studied, but there are no definitive results at this time.
Chronic Atrophic Gastritis – Also known as inflammation of the stomach lining, gastritis often results in the gradual deterioration of the protective mucosa in the gut. This can lead to a reduction in stomach acid, which is important for optimal digestion. Studies show gastritis occurs more commonly in Sjögren’s syndrome patients versus healthy individuals.
Gastroesophageal Reflux (GERD) – Proper stomach acid levels are needed to keep infections at bay and to properly break down food molecules. Contrary to popular belief, it’s actually the lack of stomach acid that is likely the cause of GERD (vs. too much acid). Testing your acid levels and supplementing with Betaine HCl if necessary is a great place to start in getting to the bottom of acid reflux.
Coeliac Disease (CD) – More commonly known as Celiac disease, this condition is characterized by inflammation of the small intestine and villus atrophy which is in part due to gluten exposure. A Finnish study found that Celiac disease could be diagnosed in 5 of 34 Sjögren’s syndrome patients (14.7%).
Irritable Bowel Syndrome (IBS) – IBS is characterized by pain or discomfort in the stomach area along with bowel changes and occurs in up to 15% of the population. In patients with Sjögren’s syndrome, IBS has been found to affect 39-65% versus 9-15% in healthy controls. Doctors and researchers have identified a root cause of IBS – in up to 84% of IBS cases it’s SIBO (small intestine bacterial overgrowth).
It can be overwhelming to view each of these complaints as separate conditions all independent of one another. The good news is that they’re actually all connected.
The Leaky Gut – Autoimmune Connection
Leaky gut places an unrelenting demand on the immune system. This is especially dangerous for those battling an autoimmune condition with an immune system already working overtime.
One expert summarized it this way:
“Leaky gut syndrome is almost always associated with autoimmune disease. In fact, reversing symptoms of autoimmune disease depends on healing the lining of the gastrointestinal tract. Any other treatment is just symptom suppression.” – Dr. Jill Carnahan, MD
His findings have revealed that in order for an autoimmune condition to develop, 3 conditions must all exist together:
- A genetic predisposition to autoimmunity (i.e. STAT4 gene in Sjögren’s)
- An exposure to the environmental trigger (i.e. Viral Infection)
- Increased intestinal permeability (a.k.a. Leaky Gut Syndrome)
It may be unsettling to hear that a leaky gut plays such a big role in the development of autoimmunity… but we have good news. It’s one factor that’s fully in our control and, beyond that, it can be healed with the right plan.
Speaking of a plan, let’s’ look at what mainstream medicine has to offer.
Medical Treatment for Sjögren’s – Hurtful or Helpful?
Prescription medications remain the cornerstone for the conventional treatment of Sjögren’s syndrome. The goal is to treat the many symptoms that can arise, from dry eyes and mouth to joint pain and fatigue.
The most popular medication used to treat systemwide complications is methotrexate (Trexall), an aggressive drug designed to suppress the immune system. Many patients do report improved symptoms, but are quick to point out the side effects as well.
The most common side effects of methotrexate are nausea, vomiting, stomach pain, drowsiness, temporary hair loss and dizziness. And though this drug is proven to decrease the main symptoms of dry eyes and mouth, this study shows objective parameters did not change.
What does that mean?
It means that while symptoms appeared to improve, actual test measures showed no difference. In other words, it can be thought of as a band-aid type of treatment.
Studies like this (and the side effects of most drugs) leave us with several questions, when it comes to finding the right treatment plan:
- What kind of treatment do I want (quick fix vs. sustained treatment)
- Are the side effects of medications worth it?
- How much am I willing to spend on medications?
- What happens when the medication no longer works?
- Do natural treatments exist?
Until now, you may have thought the medical route was the only option. But, thankfully, there is another way.
How to Turn Off Autoimmune Disease
The power of the human microbiome simply cannot be denied.
Hippocrates, the famous Greek physician, was aware of this even 2,000 years ago when he stated “all disease begins in the gut.” As ancient and current wisdom suggests, the best place to start is the gut and we’re here to help you do just that.
Jordan and Steve hosted a free webinar called, “How to Turn Off Your Autoimmunity and Restore a Healthy Immune System.”
The topic of autoimmunity is complicated and the amount of information out there can be overwhelming. That’s why we’ve done the work for you and are grateful to support you on this journey.
– Lori Jo
P.S. – Let us know what you’re struggling with in the comments below.