Autoimmunity is where the body’s immune system becomes confused and starts treating body parts like an enemy.  Normally, when viruses, pathogens and bacteria invade or there is an injury in the body, the immune system sends out an army of cells to counteract the assault.  Normally, the immune system can differentiate between foreign cells and it’s own cells, but when an autoimmune condition develops, there is a loss of immune tolerance and body parts such as thyroid, connective tissue, and joints are attacked.  Some autoimmune conditions attack one body part e.g. Hashimoto’s thyroiditis or Graves disease attack the thyroid, and some attack the whole body e.g. systemic lupus erythematosus.

Autoimmune conditions are incredibly common and the last few decades has seen a dramatic increase in these types of conditions, particularly in women, who are twice as likely to develop an autoimmune disease as men.  Research has shown that there are a few factors that may be driving a rise in these conditions such as a very unhealthy Western diet, high toxin exposure in our environment, and genetics (you can have the gene, but the other 2 factors are the trigger!)


The most common autoimmune conditions are:

  • Type 1 diabetes
    • The immune system attacks the insulin producing beta cells of the pancreas requiring lifelong insulin replacement
  • Rheumatoid arthritis (RA)
    • The immune system attacks the joints in a bilateral pattern (both wrist joints, both knee joints etc).  These attacks cause redness, heat, swelling, stiffness etc.
  • Psoriasis/psoriatic arthritis
    • Causes skin cells to multiply too quickly leading to inflamed red patches with silver-white, scaly plaques of skin on top.
  • Multiple Sclerosis
    • The immune system attacks the myelin sheath surrounding nerve cells in the central nervous system causing them to lose insulation and misfire between the brain and the spinal cord.  Symptoms include numbness, weakness, loss of balance and trouble walking.
  • Systemic lupus erythematosus (SLE)
    • The immune system attacks connective tissue throughout the body and many organs such as joints, kidneys, brain and heart can be affected.  There is often a distinctive butterfly rash across the nose that accompanies the symptoms.
  • Inflammatory bowel disease (IBD)
    • High inflammation in the lining of the intestinal wall.  Crohn’s disease can inflame any part of the GI tract from mouth to anus.  Ulcerative colitis only affects the large intestine and rectum.
  • Addison’s disease
    • The immune system attacks the adrenal glands which produce hormones such as cortisol, aldosterone as well as androgen hormones.  The adrenals are no longer able to produce these hormones and lifetime hormone support is required.
  • Grave’s disease
    • The immune system attacks the thyroid gland in the neck and causes it to produce too much thyroid hormone.  Thyroid regulates metabolic rate and basal temperature so excess leads to sweating, irritability, heat intolerance and rapid weight loss.  Bulging eyes and neck are also tell-tale signs of Grave’s disease.
  • Sjogren’s syndrome
    • The immune system attacks the glands that provide lubrication to the eyes and mouth leading to dry eyes and dry mouth, and sometimes affecting joints and skin.
  • Hashimoto’s thyroiditis
    • The immune system attacks the thyroid until it is destroyed.  Pre destruction can lead to hypothyroidism and symptoms such as weight gain, cold intolerance, hair loss, dry skin, heart palpitations, heavy menstrual periods, fatigue, low mood etc.  When the thyroid is destroyed, hormone replacement is required for life.
  • Myasthenia Gravis
    • Affects the nerve impulses that help the brain control the muscles so communication from nerves to muscle are impaired.  The main symptom is muscle weakness that gets worse with activity and improves with rest.  Other symptoms include weakness in the muscles of the eyes and eyelids, problems swallowing and a lack of control of facial movements.
  • Autoimmune vasculitis
    • The immune system attacks blood vessels, narrowing arteries and veins and restricting blood flow.
  • Pernicious anaemia
    • Causes a deficiency of intrinsic factor, a protein made by stomach lining cells that is required for absorb vitamin B12 from food.  Symptoms include anemia and an alteration in DNA synthesis (and hence repair of most body parts).
  • Coeliac Disease
    • An inflammatory reaction to gluten (found in wheat, barley, rye etc) that results in gut damage and discomfort.


When I work with my autoimmune clients, I look at all aspects of their diet and lifestyle that may be causing their immune system to hypersensitize, and lose immune tolerance towards healthy tissue.  A very unhealthy diet is an easy fix with some sensible long-term changes making a marked difference in antibody levels.  However, working out what is triggering a client’s own personal autoimmunity is key to success on a long-term basis.  

I always treat the gut in autoimmune clients.  Our gut is the first line of defence as a barrage of food antigens enter our body every day.  Our gut cells are held firmly together with tissue known as tight junctions.  These tight junctions have an enzyme in them called Zonulin that controls how the tight junctions open and close to allow essential nutrients to enter our systemic blood stream.   If these tight junctions become compromised, then the defence line breaks down and become leaky and this allows larger molecules to get through the cracks.  When these molecules appear in the blood stream, the immune system attacks them.  If the leaky gut is ongoing and reactive foods continue to be consumed, then the immune system becomes over sensitised, more and more gut symptoms appear and autoantibodies increase.  Some food particles are also thought to be similar in structure to body parts on a molecular level and this may encourage our immune cells to attack some body parts and not others. Leaky gut may be a major driver of autoimmunity and is usually the first thing I work on.  Gluten has been shown to activate Zonulin and encourage cracks in the gut lining, and dairy is also a big gut irritant that may drive autoantibodies.  Generally when I work with Hashimoto’s thyroiditis clients taking gluten and dairy out completely can normalise autoantibodies in a few months.  If the thyroid is in a reasonable state of health it can be saved and no need for medication on a long-term basis. Gluten and dairy aside, I always encourage my autoimmune clients to do food allergy and intolerance testing so we can assess if there are any other food drivers of leaky gut and autoimmunity.


The gut microbiome has also been shown to have a profound relation to immune tolerance.  Our gut bacteria should stimulate the immune system to keep it strong (after all we allow all those trillions of bacteria to live in our gut), but not over stimulate to the point where it starts attacking either the bacteria or self.  It is thought that in autoimmune conditions, particularly in the gut-based ones such as ulcerative colitis, that the body no longer tolerates the bacteria housed in the intestine.  Our microbiome is very specific to us and can be easily manipulated through diet, lifestyle changes and supplementation so working on the state of the microbiome may alleviate autoimmunity.  At the very least, developing a health mix of gut bacteria will help to keep the gut lining healthy.

Nutrient deficiencies such as vitamin D have also been linked to autoimmunity, and consistently low vitamin D levels have been found in those with type 1 diabetes, multiple sclerosis and systemic lupus erythematosus.  Many of our immune cells such as monocytes, dendritic cells, and activated T cells have vitamin D receptors on them showing vitamin D to have an effect on immune responses.  Therefore, I always blood test my autoimmune clients for vitamin D (I’m looking for an optimum level of 100mcg in blood).

I also encourage my autoimmune clients to carry out a hair mineral analysis to assess for heavy metal exposure.  Heavy metals (cadmium, lead, aluminium, mercury) that we are exposed to in our environment via the air we breathe or food we consume can end up stored in out fat stores and may cause oxidative damage and immune hypersensitivity.  This ‘metal-induced’ hypersensitivity is due to immune T-cell over sensitization to metal ions in other words they can see the metal ion as a threat and attack it.  I had one client in particular who had been given aluminium pans decades ago as a wedding present and had been using them ever since.  Her aluminium levels were high and her health was suffering.  Another one of my clients was pescatarian and had high mercury levels due to high fish consumption.

A high toxic load in our everyday life may affect our immunity.  We are constantly bombarded by chemical exposure in our cosmetics, cleaning products, gardening products and occupations such as builders, painters, hairdressers etc have a very high load.  I always encourage my clients to minimise their toxin exposure as much as possible.  Only use natural cosmetics and body products, go organic in the garden and if your job involves lots of chemical, then wear masks and gloves (or change jobs).

As you can see there is no one size fits all when it comes to autoimmunity.  There may be only one factor that is causing the problem or there can be quite a few.  The key when working with autoimmune clients is to start ticking boxes – are they eating a healthy diet, do they have any gut issues, do they have any food intolerances, do we have major heavy metal or toxin exposure, how is their bloods looking and is their vitamin D at optimal levels.  And the list goes on.  Pinpointing the issues specific to you, and treating them with dietary and lifestyle changes and supplementation can have a major effect on your long term health outcomes.


Fiona is one of my all time favourite people. After high school, I weighed in at 99kg. At 174cm, I have been overweight by 15-20 kgs for all my adult life. Until, at age 53, I met Fiona. She immediately diagnosed my primary problem and by following her dietary coaching, I lost 16 kgs in 5 months. More importantly, I have maintained this for more than a year now. Now, well into the second half of my life, life is good, very good. As I said, Fiona will always be one of my all time favourite people. Thank you Fiona.

Fiona ran a course at work and it was fantastic – I learned so much and she tailored the programs to each individual which worked really well. I reached my weight loss and health goals and it really wasn’t too hard and I still have treats!  More importantly, I feel much better in myself for making food changes and continued to see her independently when the course at work finished.
Charlotte Carlish
Indigestion, stomach pain and abdominal cramps, were an every day occurrence for me. I was quite desperate by the time I found Fiona. With the help of some supplements and allergy testing, Fiona Took me on a journey of discovery. Thanks to her professional and kind guidance, I now  know which foods to avoid and which ones will help my gut to stay healthy.  For the very first time in a long time, my tummy now feels quite normal and I no longer suffer any of the above conditions. To say Fiona has change my life may sound rather dramatic but it is completely true and I will be forever grateful to her.

Feeling Great, Losing Weight!

I have been working with Fiona at Physical Nutrition for about 10 weeks through a corporate program run my employer.  Losing weight and making some real changes to my dietary lifestyle has been a game changer for me.  Through her weekly tutorials, Fiona has taught me about the food I eat, what is best for my body and to gauge how I feel after each meal.  Combined with a sensible exercise routine of walking and cycling, I have managed to drop my weight by 7kgs during this period.  My energy levels are up, I’m feeling fitter and I’m eating much more balanced meals and now know which foods to avoid and which to eat more of!  It’s been a great experience and I would highly recommend Fiona’s program.

I have recently completed the Physical Nutrition 10kg in 20 weeks program and I couldn’t be more thrilled with the support and guidance Fiona has provided.
The 10 in 20 program not only helped me change my habits by giving me a coach that kept me accountable but also helped to educate me to make better nutrition choices in the future.
Thank you again Fiona & this is just the beginning, I’m not going anywhere ☺️
Paris Doran
Fiona has been working with the City of South Perth over