You Can't Change Your Genes, But You Can Change What Reaches Them
Our nurse practitioner Jen Henning spent a session on the half of Sjögren's disease you actually get a vote on, and her most useful advice was a filter rating.
If you have Sjögren's disease, you've probably already been told it's genetic, and you've probably already concluded there's nothing to be done about that. The first part is partly true. The second part is where I want to push back, because it leaves out the half of the equation where your leverage actually lives.
Our Immune Confident Institute nurse practitioner, Jen Henning, APRN, FNP-C, built an entire session around that second half for this year's Virtual Sjögren's Summit, and it's up on the channel now as a replay. I've been recommending it to patients ever since. Her framing is simple: Sjögren's disease comes from a mix of your genes and the world around you, accumulated over a long period of time rather than caused by any single thing. We don't get a vote on the genes. We get a surprising number of votes on what reaches them.
What I appreciate most is that she doesn't hand you a lifestyle overhaul. She hands you a filter rating, a dusting technique, and permission to be imperfect.
Why inflammation is stuck in the on position
Sjögren's disease is a condition where the immune system gets its signals mixed up and starts attacking healthy parts of the body. Your body is working overtime, which is where the dryness, the fatigue, and the joint pain come from.
Inflammation itself isn't the villain here. It's how your body fights infection and heals injury, and you want it. The problem in Sjögren's disease is that the switch is stuck on, and a number of things in your daily environment can push it further.
Jen groups those triggers into viruses, chemicals, the air around you, the balance of bacteria in your gut, and stress. Not one cause. A pile-up, over years.
The viruses that have been studied
Several viral infections have been studied in connection with increased inflammation in autoimmune disease, including Epstein-Barr virus, cytomegalovirus, and hepatitis C, with emerging research on COVID-19 and mumps.
None of that means a virus is your fault or that you can dodge every exposure. It does mean the ordinary protective habits carry more weight for you than they do for someone else:
Washing hands with soap and water, and after coughing or blowing your nose
Covering coughs with a tissue rather than a hand
Masking in crowded places, and during peak respiratory season
Talking with your care team about which vaccinations they recommend for you
Cleaning frequently touched surfaces, doorknobs included
The chemicals already in most homes
Here is where Jen gets specific in a way I wish more clinicians would. There's a category of household chemicals called endocrine disrupting chemicals, which is a technical way of saying chemicals that interfere with your body's own messengers, the hormones that tell your systems what to do.
The named ones are phthalates, parabens, triclosans, organophosphate flame retardants, volatile organic compounds, and organic sulfates.
That list is genuinely alarming to read, and Jen says so out loud before immediately making it manageable. You aren't being asked to replace your house. You're being asked to change what comes into it next:
Open a window or run a fan while cleaning, and afterward
Choose fragrance-free and solvent-free cleaning products
Store food in glass or stainless steel rather than plastic
Wet dust, so the dust leaves the room instead of going airborne
Vacuum with HEPA filtration, and add HEPA units in the rooms you use most
Read labels for phthalates, parabens, and flame retardants before you buy
The one number worth memorizing
If you take a single item from this entire post, take this one: HVAC filters rated MERV 13 to 16. That's the rating that meaningfully cleans the air your air conditioning pulls into your home, and it costs the same amount of effort as buying the wrong filter.
Why wildfire smoke doesn't have to be near you
This is the part of Jen's session I keep repeating, because it reframes something my patients blame themselves for constantly.
Several air pollutants have been linked to inflammation in Sjögren's disease. Carbon monoxide, which comes from vehicle exhaust, combustion, and gas stoves. Nitric oxide, from traffic emissions and industrial combustion. Methane, from fossil fuels, agriculture, and landfills. And wildfire smoke, which Jen describes as a big one, associated with immune dysregulation and interstitial lung disease, and which affects breathing and lungs even in people without autoimmune disease.
Then the detail that matters: a wildfire doesn't have to be anywhere near you. Because of the jet streams, smoke travels hundreds of miles.
Think about what that means for the week you did everything right and still felt worse. You audited your food. You slept. You paced yourself. You found nothing, and you concluded the problem must be you. Sometimes the honest answer is that the air changed and nobody told you.
So treat air quality as data, the same way you treat a lab result:
Check your local air quality index, not just the weather forecast
Watch for smoke events well upwind of you, not only local ones
Move activity indoors when the number is bad
Remember that colder air has been linked to higher pollutant levels, so this is a year-round habit rather than a summer one
The general health basics, without the perfectionism
The last third of Jen's session covers the things you've heard before, and I want to frame why she includes them anyway. In Sjögren's disease there tends to be less beneficial bacteria in the gut and more of the unhelpful kind, which can worsen inflammation. Stress, including good stress, drives the immune system harder. Poor sleep interferes with the repair your body is trying to do.
Sleep is treatment, not a reward
Aim for seven to nine hours. Hold a consistent sleep and wake time. Move caffeine, alcohol, and heavy meals earlier in your day. Put the phone away before bed so your mind understands it's allowed to stop. For insomnia specifically, cognitive behavioral therapy has good support.
Jen adds something I want in writing: you should never feel ashamed for giving your body the rest it needs and deserves.
Movement that starts where you are
Resistance training helps fatigue, pain, and quality of life. And, in her words, you don't have to start off running a marathon. Seated exercises count. Stretches count. Start where you are and increase only as you tolerate it.
Eating to lower inflammation
The patterns with evidence behind them are the Mediterranean diet, with its emphasis on olive oil, and high-fiber eating built on legumes, whole grains, fruits, and vegetables, which also supports the gut lining. The things that push inflammation the other way are high-fat foods, heavily processed foods, refined sugars, and saturated fats.
Your mind is part of this
Mindfulness doesn't have to be formal. Sitting in a quiet space and breathing deliberately counts. Cognitive behavioral therapy with a professional helps some people manage stress. And routine screening for depression and anxiety belongs in your regular care, because you should never feel ashamed asking for help with your mental health.
Ask about your vitamins
Vitamin D deficiency is common in Sjögren's disease. Ask your care team about vitamin testing and replace based on your actual lab results rather than guessing.
What I want you to take from this
You're living with a disease that asks a great deal of you and gives back very little in the way of clear instructions. It would be reasonable to hear a list like this one and feel behind before you've started.
So take the ending Jen chose, which is the reason I wanted this session on our channel at all: all of these small changes add up, and you don't have to be perfect. One thing at a time. Work toward the bigger goals as you reach the smaller ones.
You're doing a genuinely hard thing already. Choosing one filter, one window, one earlier bedtime isn't a small gesture when your energy isn't yours to schedule. It's the whole strategy.
Your turn
Which one of these is actually doable for you this week? Not this month, this week. I would like to know which one felt reachable, because that tells us what to teach next.
Free resources:
Lab Conversation Guide, for walking into your next appointment with the right questions
IC Indicator Quiz, free and about two minutes
Go deeper:
Note: The IC Blueprint Checkup is an educational assessment and does not establish a Patient-Physician Relationship. Current ICI patients, please message TERRAIN in your portal rather than purchasing.
The Virtual Sjögren's Summit Encore is open through Friday, July 31, including a new bonus session with rheumatologist Dr. Diana Girnita on GLP-1s, the menopause transition, and metabolic inflammation. Every session, every transcript, and every speaker bonus, yours to keep: sjogrenssummit.com
