column logo Alithea Athans

Ever since I was diagnosed with cold agglutinin disease (CAD), I have often wondered what triggered it. CAD has been known to be triggered by viruses and other diseases, but what other factors can cause this overreactive immune response?

I have primary CAD and have been stable after the initial response that led to my diagnosis. There have been years of symptoms that never amounted to anything and fit into too many boxes that held up the CAD diagnosis. I reject the notion that unbeknownst to me my cells got together one day and decided to wage war.

While I do have the antibodies for Mycoplasma pneumoniae, CAD is supposed to subside when it is triggered by a virus. Mine has not. It is possible that there is something else going on, on a very low level, that is undetectable. I pray that is not the case. I am good, I don’t want anything else.

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There are so many things that can help and hinder your immunity. The main thing, I think, that can hinder healthy immunity is the environment. This can be broken down in various ways, but I am speaking specifically about our physical environment.

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I am from Long Island, New York, where I spent the majority of my life. I almost never got sick before being diagnosed with CAD, and enjoyed a pretty healthy life. I moved off the island over a decade ago, and that’s when things changed. For instance, I developed seasonal allergies, which is an immune overreaction. Something as simple as a mosquito bite would cause me to break out in welts.  I asked the doctors, and they said that I just wasn’t used to my new environment. I never thought much about it. After years of torturous allergies, I learned that the local raw honey could help build up my immunity. It didn’t seem to work for me.

Our bodies are so amazing in the way we can adapt to our environment. A healthy immune system is shaped by a variety of microorganisms—contact with humans, animals, and the environment.  The body is able to develop a system of reaction and tolerance based on exposure to many different organisms. Through all of this, the body is able to develop a way to stop the overreaction that occurs in autoimmune diseases. It will, however, continue to be altered by diet and pharmaceuticals.

So what are the exposures that could or did make that change for me? I wasn’t born with CAD; I didn’t have it growing up. Where did this overacting immune response come from?

We know that genetics can have a huge impact on our health. That piece doesn’t fit into my puzzle, though, as CAD is not supposed to be related to genes. I investigated the environmental impact on autoimmunity and found many research papers on how the environment plays a key role in autoimmunity.

Read more about experimental therapies for CAD

I can recall things that could have an impact on my health like the mosquito-spraying trucks that would go through spraying a large mist of chemicals. In fact, my parents told me about how when they were kids, the children in the neighborhood used to chase the trucks. They didn’t know what it was and no one stopped them.

There are reports showing that nitrogen has washed into the waterways from fertilizers, car exhaust, faulty sewage treatment plants, leaky gas tanks, the use of pesticides, and industrial waste. These all can seep into the water supply and air, affecting not only us but also marine life in the area.

The question is, can these things cause autoimmune responses, and the answer is yes—which is pretty scary. What is just as scary is that this is not just an issue from where I grew up, but all over the country. These are unavoidable, and although many cities and towns are working to clean up and make our environment healthy again, it doesn’t change the fact that we’ve already exposed.