Salt drives autoimmune disease?

In autoimmune conditions, the body undergoes an inappropriate immune response that causes excessive inflammation with destructive effects on cells and tissues. About 23.5 million Americans suffer from an autoimmune disease, and that number is rising.1 The reasons behind the increasing prevalence are unknown, but environmental influences, such as diet, are believed to play a role. I have reported before that elevated blood pressure is not the only danger associated with salt. In my medical practice, I have observed beneficial effects of a low-salt diet for autoimmune conditions, and for years I have been advising patients with autoimmune disease to avoid added salt. Now, research confirms my clinical observations that salt may increase the inflammation associated with several autoimmune conditions.

What are T helper 17 (TH17) cells?
TH17 cells are immune cells that are involved in the body’s defense against bacterial and fungal pathogens, and help to recruit other important immune cells to sites of infection. TH17 cells seem to come in two different varieties, the standard protective TH17 cell, and the pathogenic TH17 cell, depending on the particular molecules that drive their differentiation from immature T cells to mature T helper cells. Pathogenic TH17 cells produce more pro-inflammatory markers and appear to be involved in the abnormal immune responses associated with rheumatoid arthritis, psoriasis, inflammatory bowel disease and multiple sclerosis.2,3

Studies connect salt intake and pathogenic TH17 cells
Two studies published in Nature collectively suggest that excess sodium drives autoimmunity at the cellular level.4-6 One group of researchers had previously observed increased TH17 cell numbers in the blood of people who consumed fast food more often; hypothesizing salt might be involved, they conducted experiments on the effects of elevated sodium concentrations on the differentiation of immature human T cells into pathogenic TH17 cells. They indeed found that high sodium concentrations drove a dramatic increase (almost ten-fold) in differentiation into pathogenic TH17 cells in culture. To strengthen these findings, they fed mice predisposed to a TH17-related autoimmune disease either a standard or high-salt diet. The high-salt diet accelerated the development of the autoimmune disease, and the symptoms were more severe on the high-salt diet than on the standard diet.4,7

A separate group of scientists was investigating the changes in gene expression that occur during the differentiation process of immature T cells into pathogenic TH17 cells. They noticed increases over time in the expression of a protein called SGK1, which is known to mediate sodium transport and sodium balance in other cell types. They performed additional experiments, and they found that increased salt concentration increased SGK1 expression and, similar to the first study, pathogenic TH17 differentiation. These studies suggest that high salt intake may increase the numbers of circulating pathogenic TH17 cells, contributing to autoimmune inflammation.8

This research raises the possibility that increased salt intake may be a significant environmental influence driving the growing prevalence of autoimmune conditions.

We already know that excess salt intake is associated with elevated blood pressure, heart disease, stroke, kidney disease, osteoporosis, ulcers and gastric cancer;9 now autoimmune inflammation is another danger we can add to the list. For optimal health, we should minimize added salt and strive to consume only the sodium present in natural foods.



1. American Autoimmune Related Disease Association: Autoimmune Statistics []
2. Peters A, Lee Y, Kuchroo VK: The many faces of Th17 cells. Curr Opin Immunol 2011, 23:702-706.
3. Awasthi A, Kuchroo VK: Th17 cells: from precursors to players in inflammation and infection. Int Immunol 2009, 21:489-498.
4. Harmon K: Salt linked to autoimmune diseases. In Nature News; 2013.
5. Leslie M: Salty Food May Be a Culprit in Autoimmune Disease. In Science NOW; 2013.
6. Yandell K: Salt at Fault? In The Scientist; 2013.
7. Kleinewietfeld M, Manzel A, Titze J, et al: Sodium chloride drives autoimmune disease by the induction of pathogenic T17 cells. Nature 2013.
8. Wu C, Yosef N, Thalhamer T, et al: Induction of pathogenic T17 cells by inducible salt-sensing kinase SGK1. Nature 2013.
9. Tsugane S, Sasazuki S: Diet and the risk of gastric cancer: review of epidemiological evidence. Gastric Cancer 2007, 10:75-83.


Can autoimmune diseases (like psoriasis) be treated without drugs?

Autoimmune diseases affect 23.5 million Americans, and that number is rising. Autoimmune diseases are one of the top ten leading causes of death for women under the age of 64.1 In autoimmune diseases, the body undergoes an inappropriate immune response that causes excessive inflammation that becomes destructive to the body. One autoimmune disease in particular, psoriasis, received attention after reality TV star Kim Kardashian was diagnosed with the condition in 2011.

Psoriasis is a chronic inflammatory skin condition – the most prevalent autoimmune disease in the U.S. affecting about 7.5 million Americans; and it is much more than a cosmetic concern.2

Depending on the severity of psoriasis, it can also cause skin cracking and bleeding, pain, and a significant disruption of quality of life. In addition, psoriasis is associated with increased cardiovascular risk.3-5 Even mild psoriasis may increase the risk of heart attack by up to 29%.6
The chronic inflammation characteristic of psoriasis (and other autoimmune diseases such as rheumatoid arthritis and lupus) puts patients at risk.7,8 In addition to cardiovascular disease, psoriasis patients are also more likely to suffer from insulin resistance, depression, cancer, osteoporosis, and liver disease – also likely due to chronic inflammation.9-11

Nutritional intervention should always be tried first, before powerful and potentially dangerous drugs are prescribed.

Conventional treatments for autoimmune diseases suppress the immune system to halt the body’s immune attack on itself. However, this makes the body more susceptible to infections and even cancers – one study found that autoimmune patients with the greatest exposure to immunosuppressive drugs had an almost 5-fold increase in cancer risk.12 The FDA has issued warnings on certain drugs used to treat autoimmune diseases because of increased cancer risk.13 Mild to moderate psoriasis can often be treated with topical medications only – these are safer than systemic medications, but still have significant side effects such as skin thinning, pigmentation changes, bruising easily, stretch marks, redness, and acne. They also may stop working over time.14

Nutrition is a powerful and safe tool for preventing and treating autoimmune diseases.15-20
Although psoriasis has a genetic component (about one-third of patients have a family history2),
it is also influenced by what we eat. Those with a high intake of green vegetables, carrots, tomatoes, and fresh fruits are less likely to develop psoriasis. Oxidative stress, which can be lessened by these antioxidant-rich foods, is thought to contribute to skin inflammation in psoriasis. Furthermore, psoriasis symptoms have been shown to improve using dietary methods in several scientific studies.21

I have been recommending a high-nutrient (nutritarian) diet combined with selected supplements and when needed, and episodic fasting to help the body to calm inflammation and remove cellular toxins. High nutrient plant foods supply substances that support immune system function, allowing the body to have proper defenses against infections and cancers. Supervised water fasting is another important component to autoimmune treatment – I have documented the contribution of fasting to remission of autoimmune disease in published case reports.22 Keep in mind also, that the conditions that psoriasis sufferers are vulnerable to – heart disease in particular – are also those that can be prevented with healthy lifestyle habits. The only side effects of nutritional treatment are positive ones – protective effects against heart disease, diabetes, and cancers. This healthy protocol promotes longevity as it normalizes immune function.

Dietary Intervention for Autoimmune Diseases

Natural methods can help you calm the inflammation in your body and reduce or even eliminate your need for medications. I urge everyone with an autoimmune disease (Kim Kardashian included!) to try these natural methods before resigning themselves to a life of dangerous medications and progressively worsening disease:

1. High-nutrient, vegetable-based diet rich in greens
2. Fresh vegetable juices
3. Fish oil or plant-based EPA and DHA supplements
4. Probiotic supplement
5. Avoidance of salt, wheat, and oils
6. Assuring no micronutrient deficiencies are present.

Using these methods, many of my patients who once suffered from autoimmune diseases have now recovered and are free of illness as well as toxic side effects of the drugs. Some of these recoveries have written me, but I have never met them. All they did was read one of my books and follow the protocols detailed online.

Jodi, who has recovered from psoriasis, and psoriatic arthritis is an excellent example:

Jodi“I started experiencing skin rashes and joint pain as a teenager more than 40 years ago. Back then, in the 60’s, I don’t think doctors knew much about autoimmune conditions (perhaps not even now). I was put on various drugs, including steroids, plaquenil, methotrexate and antihistamines, which swelled my body up like a beached whale. I was on medication for almost 20 years and saw different medical specialists including allergists, dermatologists, hematologists, rheumatologists, and endocrinologists.

By the time I turned 50 in 1999, I was covered from head to toe with psoriasis and tested positive for other autoimmune diseases: rheumatoid arthritis, lupus, Hashimoto’s and Sjogren’s. The medications only helped a little and I suffered with joint pain, unable to function normally for over twenty years in spite of taking all the medications prescribed by rheumatologists.

In my quest for improved health, I read Dr. Fuhrman's books and I have I have followed his eating plan since 2001 with much success. I take no medications, and have no symptoms of psoriasis or psoriatic arthritis.
The body has incredible healing powers if given the proper nutrients and care. I have also lost 20 pounds and breezed through menopause. I consider myself 58 years young.”

Karen’s severe psoriasis improved after only 3 days:
“In January 2006, I developed psoriasis on my hands…My hands continued to deteriorate. They were very scaly and would split open. In early 2007, the cuts on my hands became infected several times, and my hands were very swollen and painful. I was put on antibiotics to treat the infection. During that time, the dermatologist explained I had a severe case of psoriasis and suggested I start taking a chemotherapy drug. I didn’t want to go down that path… A couple of months ago, I heard Dr. Oz interview Dr. Fuhrman on his radio program. I was fascinated when I heard Dr. Fuhrman comment that diet can improve autoimmune diseases. I picked up Eat To Live and read it cover to cover. I wanted to try the diet, but I was afraid that I would not stick with the plan long enough to see results. Finally, I decided to give it a shot. I switched to Fuhrman’s nutritarian diet and within two days, my hands looked incredible! By the third day, I was off the medication!!”

Gary now has no psoriatic arthritis pain, and reduced his medication:
“In May, you kindly responded to my e-mail asking whether your nutritional treatment for psoriatic arthritis is the same as for psoriasis. I bought your book…and feel like I hit the jackpot. Here's the good news. After 11 weeks on Eat to Live…I have no arthritis pain, reduced the methotrexate from 5 pills per week to 3, lost over 50 pounds, and for six weeks now, quit using tar shampoo for psoriasis (first time since age 13 or 14). Awesome! Thanks so unbelievably much.” I plan on stopping the methotrexate next month completely.

Read more stories of recovery from autoimmune diseases.
Read more about nutritional care of autoimmune diseases.


1. American Autoimmune Related Disease Association: Autoimmune Statistics []
2. About Psoriasis: Statistics.: National Psoriasis Foundation.
3. Gelfand JM, Azfar RS, Mehta NN: Psoriasis and cardiovascular risk: strength in numbers. J Invest Dermatol 2010;130:919-922.
4. Mehta NN, Yu Y, Pinnelas R, et al: Attributable risk estimate of severe psoriasis on major cardiovascular events. Am J Med 2011;124:775 e771-776.
5. Dermatologists urge psoriasis patients to be aware of potential link to other serious diseases. In American Academy of Dermatology 70th Annual Meeting; San Diego, CA. 2012
6. Gelfand JM, Neimann AL, Shin DB, et al: Risk of myocardial infarction in patients with psoriasis. JAMA 2006;296:1735-1741.
7. Pieringer H, Pichler M: Cardiovascular morbidity and mortality in patients with rheumatoid arthritis: vascular alterations and possible clinical implications. QJM 2011;104:13-26.
8. Alexandroff AB, Pauriah M, Camp RD, et al: More than skin deep: atherosclerosis as a systemic manifestation of psoriasis. Br J Dermatol 2009;161:1-7.
9. Zanni GR: Psoriasis: issues far more serious than cosmetic. Consult Pharm 2012;27:86-88, 90, 93-86.
10. Mehta NN, Azfar RS, Shin DB, et al: Patients with severe psoriasis are at increased risk of cardiovascular mortality: cohort study using the General Practice Research Database. Eur Heart J 2010;31:1000-1006.
11. Davidovici BB, Sattar N, Prinz JC, et al: Psoriasis and systemic inflammatory diseases: potential mechanistic links between skin disease and co-morbid conditions. J Invest Dermatol 2010;130:1785-1796.
12. Asten P, Barrett J, Symmons D: Risk of developing certain malignancies is related to duration of immunosuppressive drug exposure in patients with rheumatic diseases. J Rheumatol 1999;26:1705-1714.
13. Tumor Necrosis Factor (TNF) Blockers (marketed as Remicade, Enbrel, Humira, Cimzia, and Simponi) August 2009. U.S. Food and Drug Administration; 2009.
14. Topical treatments for psoriasis, including steroids.: National Psoriasis Foundation.
15. Palmblad J, Hafstrom I, Ringertz B: Antirheumatic effects of fasting. Rheum Dis Clin North Am 1991;17:351-362.
16. Kjeldsen-Kragh J, Hvatum M, Haugen M, et al: Antibodies against dietary antigens in rheumatoid arthritis patients treated with fasting and a one-year vegetarian diet. Clin Exp Rheumatol 1995;13:167-172.
17. Hanninen, Kaartinen K, Rauma AL, et al: Antioxidants in vegan diet and rheumatic disorders. Toxicology 2000;155:45-53.
18. Muller H, de Toledo FW, Resch KL: Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol 2001;30:1-10.
19. McDougall J, Bruce B, Spiller G, et al: Effects of a very low-fat, vegan diet in subjects with rheumatoid arthritis. J Altern Complement Med 2002;8:71-75.
20. Darlington LG, Ramsey NW, Mansfield JR: Placebo-controlled, blind study of dietary manipulation therapy in rheumatoid arthritis. Lancet 1986;1:236-238.
21. Wolters M: Diet and psoriasis: experimental data and clinical evidence. Br J Dermatol 2005;153:706-714.
22. Fuhrman J, Sarter B, Calabro DJ: Brief case reports of medically supervised, water-only fasting associated with remission of autoimmune disease. Altern Ther Health Med 2002;8:112, 110-111.


Interview with a Nutritarian: Jodi


Jodi - current imageMost of the interviews here on Onlyourhealth have been with those who’ve discovered Dr. Fuhrman’s nutritional recommendations in their recent past, and are elated about their newfound health and freedom from food addiction and disease. Jodi has been following Dr. Fuhrman’s advice for TEN years, and she’s just as excited today with continual improvements in her health as she was ten years ago.  If you've read Jodi's Success Story on Dr. Fuhrman's website, or read a  previous Onlyourhealth post about her awesome recovery from debilitating psoriasis and other autoimmune diseases, you know that Jodi's healings are medical miracles!  Today Jodi is the epitome of excellent health, and her enthusiasm is contagious.  In fact, she went on to earn her Nutritional Education Trainer (NET) certification and is now helping others in their journeys to get their health restored also. Welcome once again to Onlyourhealth Jodi!  


You've been following Dr. Fuhrman’s nutritarian eating-style for over 10 years now. How has that experience changed your life?

My original reason for contacting Dr. Fuhrman was autoimmune issues; the most serious was psoriatic arthritis where I had a full-body skin rash and history of joint pain. Plus, I had diagnoses of rheumatoid arthritis, lupus, Sjogren's and Hashimotos – all autoimmune conditions.  I consider my success at conquering these ailments as Chapter One of my health journey. [Click here to see Jodi's remarkable before and after pictures of being healed of psoriasis!] Now, Chapter Two is all about the benefits that I've experienced over the years that I did not expect!


Please explain “Chapter Two” to us.  

Jodi at a heavier weightYear after year as I keep following this high-nutrient lifestyle, I continue to be amazed at how powerful and effective it is. For example, ten years ago I did not turn to Dr. Fuhrman for weight loss, yet I now weigh 32 pounds less than my highest weight.  The picture on the right was taken when I was younger and heavier. 

  • My cholesterol is now low, when it had been over 200, and my blood pressure is low, and I take no drugs for either. 
  • I breezed through menopause without drugs.
  • All sinus congestion and seasonal allergies are completely gone.
  • My dentist compliments my healthy gums and how little plaque I have.
  • My bone density has improved. I previously tested in the negative range for osteopenia, the latest score for my spine was ZERO. A zero score is equivalent to the bone density of a healthy, 30- year-old woman. Which means without drugs but following Dr. Fuhrman's exercise advice, I have the spine a 30-year-old....and I'm 62!  [Click here to learn more about preventing bone fractures.] 
  • My eyesight is stronger. Twice over the last 10 years the prescriptions for my contact lenses and glasses, which I use for distance, have been reduced; and I no longer need reading glasses, but I did at age 52, (and now I’m 62!)


Are you surprised by these improvements?

As we age, we expect to have achy joints, ailments, medications, drug side effects, doctors visits, etc., and I don't have any of those issues. In fact, I wake up in the morning and nothing hurts: no joint pain, no stiffness, and no arthritis. Yes, I'm amazed...and grateful.


Do you have any success tips to share with others?

Ten years ago when I started eating high-nutrient foods, I was already over 50-years-old. My psoriasis and joint pain started when I was a teenager, and I was on potent drugs for almost twenty years. Don't think you are too old to benefit; don't think you are too sick or have been on drugs for too long to see a difference. I am so convinced that the longer you follow this program, and the older you get doing it, you continue to reap benefits...benefits you never expected or imagined!


Thank you Jodi for being an example to all of us of the ongoing healing power of high-nutrient foods ~ you truly are a medical miracle!

 Jodi on top of the world!