Autoimmune diseases are increasingly recognized worldwide, and they’re now the third most prevalent disease category in the United States. While autoimmunity has often been associated with middle-aged females, childhood autoimmunity is a growing concern. It’s estimated that 5% of kids worldwide have at least one autoimmune condition, with many experiencing multiple autoimmune challenges.
In addition to affecting quality of life, pediatric autoimmune conditions may increase the risk of various health issues, including cardiometabolic concerns, cancer, and mental health challenges. Conventional treatments can provide some relief but may not address all underlying factors of autoimmunity. In this article, we’ll explore how integrative approaches can help identify potential underlying factors and how combining holistic interventions with traditional therapies may support improved quality of life and health outcomes.
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What is Pediatric Autoimmunity?
The immune system, composed of innate and adaptive components, is designed to protect us from intruders like microbes, neutralize environmental toxins, and manage potentially harmful cells. To do this, the immune system must distinguish between foreign elements and the body’s own cells. In kids with autoimmunity, this distinction becomes unclear, leading the immune system to produce antibodies that may target various cells and tissues. If this inflammatory cycle continues, it can lead to significant health challenges.
There are over 100 identified autoimmune conditions. Some commonly known in kids include:
- Type 1 diabetes—where the immune system affects the beta cells of the pancreas, impacting insulin production.
- Celiac disease—where the immune system reacts to gliadin, a protein in gluten-containing foods, affecting the small intestine lining.
- Juvenile idiopathic arthritis—where the immune system produces markers that primarily affect the joints.
- Pediatric lupus—where the immune system targets various tissues, including the lungs, skin, and kidneys.
While the exact causes of autoimmune conditions in children are not fully understood, research suggests there may be a complex interplay between environmental factors, genetics, and increased intestinal permeability.
Challenges in Diagnosing Pediatric Autoimmunity
Individuals with autoimmunity may experience symptoms for years before receiving an accurate diagnosis. This can be due to symptoms that come and go, the lack of definitive diagnostic markers, and symptoms that resemble other conditions. Diagnosing in children can be even more challenging as they may struggle to accurately describe their symptoms, which can include:
- Brittle hair or hair loss
- Dizziness
- Dry eyes or mouth
- Fatigue or feeling unwell
- Low-grade fever
- Skin rashes or lesions
- Stiff joints
- Weight loss
Traditionally, autoimmune disorders are diagnosed by ruling out other conditions. If a child shows symptoms of autoimmunity, a healthcare provider will conduct a thorough physical exam, including family history, medical history, and surgical history. Additional tests may include:
- Blood tests such as antinuclear antibody (ANA), rheumatoid factor (RF), complete blood count (CBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), anti-cyclic citrullinated peptide (anti-CCP), and complement proteins
- Magnetic resonance imaging (MRI) or ultrasound
- Biopsy
Diagnosing a pediatric autoimmune disorder can be challenging, but early identification and appropriate management are important for supporting long-term health.
Root Cause Diagnostics in Pediatric Autoimmunity
Conventional methods for diagnosing pediatric autoimmune conditions can be limited and non-specific. Functional medicine practitioners use conventional testing and also consider a patient’s unique history to identify potential factors contributing to autoimmune development.
A comprehensive patient history, including information about exposures during pregnancy, genetics, delivery type, feeding mode, trauma, toxin exposure, adverse food reactions, infections, diet, and medication usage, is foundational for understanding autoimmunity in pediatric patients. Functional medicine testing may include genetic tests, comprehensive stool analysis, blood panels to assess nutritional status, saliva and urine testing, and breath tests.
Interventions for Managing Pediatric Autoimmunity
Standard treatment for pediatric autoimmune conditions often includes medications to help manage inflammation (non-steroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs, and biologics), support immune system function (corticosteroids), or modulate immune system activity (intravenous immunoglobulin). While these can be necessary and effective, they may have side effects.
Integrative treatments are tailored to the patient based on their specific needs. Addressing potential underlying factors may help manage symptoms, reduce reliance on medication, and support long-term health.
Increased intestinal permeability may be a factor in pediatric autoimmunity. Supporting the integrity of the small intestine lining through diet, lifestyle, and supplements may help promote healthier immune system function.
Dietary Modifications
Adverse food reactions and an ultra-processed diet may contribute to gut dysbiosis, which can increase inflammation, affect zonulin levels, and trigger an immune response. Pediatric autoimmune patients may benefit from an elimination diet and reintroduction to identify food sensitivities. After this process, integrative providers may suggest a personalized anti-inflammatory, nutrient-dense meal plan to help manage inflammation, support gut health, and meet nutrient needs for healthy immune function.
Lifestyle Factors: Sleep and Activity
Among other important purposes, sleep is closely linked to immune system development and function, and poor sleep may influence autoimmune condition development. Caregivers and pediatric patients can benefit from learning about healthy sleep habits, such as maintaining a routine sleep schedule, avoiding bright lights and electronics before bed, getting early morning natural light exposure, and avoiding heavy meals before bed. The amount of sleep pediatric patients need varies by age:
- Newborns: 14-17 hours
- Infants: 12-16 hours
- Toddlers 1–2 years old: 11–14 hours
- Toddlers 3–5 years old: 10–13 hours
- School-Age 6–12 years old: 9–12 hours
- Teenagers 13–17 years old: 8–10 hours
In addition to healthy sleep, regular physical activity is important for pediatric patients with autoimmune conditions. Exercise can enhance gut microbiome diversity, support beneficial gut microbes, and help manage inflammation. Additionally, physical activity can improve blood sugar regulation and support cardiometabolic health, which may be a concern for some kids with autoimmune conditions.
Kids ages 3–5 should be active throughout the day. Those ages 6–17 should aim for at least 60 minutes of moderate-to-vigorous physical activity each day, including aerobic exercise and muscle and bone-strengthening activities. Some autoimmune conditions may cause joint discomfort and affect muscle strength, so consulting an exercise professional for tailored interventions may be beneficial.
Dietary Supplements
Children with pediatric autoimmune conditions may have nutrient deficiencies. Dietary supplements can help address these deficiencies and support healthy immune function. While supplements alone may not provide significant benefits, they can be an important part of a comprehensive treatment plan when combined with other therapies:
- Omega-3 fatty acids may help support a healthy inflammatory response and act as prebiotics for beneficial gut bacteria.
- Vitamin D may help regulate immune function and support overall health.
- Probiotics may help support gut health and a balanced immune response.
Mind-Body Practices
Pediatric patients with autoimmune conditions may experience stress due to medication side effects, pain, missing events with peers, frequent doctor visits, and generally feeling unwell. Learning to manage stress may help support a healthy inflammatory response, gut barrier function, and overall quality of life.
Yoga may help manage stress and gastrointestinal symptoms, as well as pain; mindfulness meditation may support a healthy inflammatory response and immune function; and biofeedback may help manage symptoms of depression and anxiety.
Integrative Therapies and Their Efficacy
Including integrative therapies in a comprehensive treatment plan may be beneficial for kids with autoimmune conditions. Acupuncture is considered safe for children and may support immune system balance and gut health. Acupuncture may also help manage stress and discomfort.
Herbal options like ginger may support a healthy inflammatory response in conditions like rheumatoid arthritis, psoriasis, and lupus. Curcumin may also support a healthy inflammatory response and immune function in pediatric patients with autoimmune conditions.
Various homeopathic remedies are available but may lack sufficient research or safety data to support their use in children.
Family and Caregiver Support
Pediatric autoimmune conditions can impact the physical and mental health of both the child and the entire family unit. Families and caregivers can benefit from having a plan to manage the emotional and logistical challenges of caring for a child with an autoimmune condition.
Autoimmune condition support groups can provide opportunities to share experiences and access additional resources. Other ways to seek and provide support include:
- Family meetings where everyone can express their feelings, support the patient, or discuss the treatment plan
- Family game nights to relieve stress
- Family meal planning sessions where each person can choose favorite options for an anti-inflammatory meal plan
- Family or group outdoor activities to help meet physical activity needs
- Online or in-person educational opportunities like anti-inflammatory cooking classes, learning more about autoimmune conditions and new treatments, stress management techniques, or sleep improvement strategies
- Family therapy with a professional counselor to learn healthy coping strategies
Future Directions in Pediatric Autoimmune Care
Receiving a pediatric autoimmune diagnosis can be challenging for both the patient and caregiver. Some autoimmune conditions may go into remission, while others may have long-term impacts. A personalized approach that explores and addresses potential underlying factors with diet, lifestyle, integrative therapies, and supplements offers hope for comprehensive support and improved outcomes for kids.
While there’s currently no cure for autoimmunity, emerging research on the gut microbiome’s role in autoimmune condition development and symptom management offers a promising approach to treatment. Additionally, artificial intelligence models may enhance the accuracy and speed of autoimmune condition diagnosis in the future, allowing for earlier intervention.
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Key Takeaways
Pediatric autoimmune conditions are becoming more common.
Genetics and environmental factors are important considerations, and increased intestinal permeability may also play a role.
Conventional treatments can provide relief but may not address all underlying factors, such as gut health.
A comprehensive, multidisciplinary approach that combines traditional options with integrative therapies like diet, lifestyle, acupuncture, and supplements offers hope for managing symptoms and improving quality of life for kids with autoimmunity.
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