What makes someone prone to Ankylosing Spondylitis? 

What did your doctor talk about when you were first diagnosed with Ankylosing Spondylitis?

It’s likely they didn’t spend a lot of time talking about what made you prone to this condition. 

Instead, they would have focussed on treatment options and the need to monitor progression in the years ahead. 

There’s no doubt focussing on future management is essential, but there is also value in looking at why you developed AS in the first place. 

Understanding what factors may have led to the onset of disease can provide vital clues around which lifestyle changes will have the most impact moving forward. 

More than your genes 

The most common discussion around what causes AS relates to the genetic marker HLA-B27. 

Ninety percent of people with AS test positive for this variant, and it occurs in around 5% of the general population. It’s often used when diagnosing AS, even though 10% of sufferers are HLA-B27 negative. 

Genes only indicate a tendency towards illness, not a guarantee it will develop. A popular saying around chronic illness is “genetics loads the gun, environment pulls the trigger”. 

In other words, the genes which have potential to cause disease are activated by what we are exposed to. 

What sets off AS? 

In the case of AS, many people can identify something in their past that occurred around the time symptoms began. Often that’s an injury, a car accident, a major emotional trauma or an infection. 

One of these factors is unlikely to be responsible on its own, but when it comes on the back of other health issues this can be the last straw. Years of poor nutrition, no exercise, high stress, toxic exposure or a multitude of other factors can act as a recipe for disease onset. 

Even seemingly healthy people can be weathering a perfect storm without knowing it. Maybe your gut-flora was compromised in early childhood, or you have a silent parasite from that tropical holiday in your 20’s. You could be coeliac without knowing it, or live in a house harbouring mould. 

The factors that combine to put us into a state of disease are unique to each of us. 

How can health history be helpful? 

Root cause analysis can provide crucial data when you’re plotting your way forward with AS. 

There is no one size fits all in a treatment approach, but piecing together clues from your personal heath history allow you to formulate a customised and much more targeted plan. 

Part of the reason many people are unwilling to look at root cause is the idea it implies blame. It is not your fault you have AS. Looking back should never be an exercise in regret, but an opportunity to learn. When we know more we can make different choices. 

A common trait amongst those doing well with AS is a willingness to take responsibility for their health.  These people proactively self-manage their own condition in between appointments, adding in lifestyle change that supports their recovery rather than relying on medical treatment alone. 

How do I determine what’s actually healthy? 

The Centre for Disease Control in the US publishes a list of habits proven to reduce your risk of developing disease. It includes not smoking, minimising alcohol, getting regular health checks, enough sleep, maintaining a healthy weight, eating well, exercising and so on. 

These broad based categories are a great place to start when looking for clues in your own health history. They seem so basic, but they really do underpin good health. Give yourself an honest appraisal: which of these areas were you neglecting in your own life? What could you change in your current lifestyle to support that aspect of your health? 

Getting started 

Doing a Past Health Audit is one of the early steps I undertake with all of my clients. This information is unique to each person and referred back to many times as we create a blueprint for getting back on track. 

There is so much benefit to be gained from reverse-engineering your health and beginning to tackle change.

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