Our immune system works tirelessly to protect our bodies from foreign invaders that cause disease or infection, such as viruses and bacteria. Autoimmune diseases occur when the immune system mistakenly attacks healthy cells in the body. The reason why this occurs is not yet well understood. Understanding the signs of autoimmune diseases and how they occur is important for getting a prompt diagnosis and effective treatment. Read on to learn more about autoimmune diseases, their causes, symptoms, and treatment options.
What are autoimmune diseases?
Autoimmune diseases are a group of diseases that result from a malfunction of the immune system. When it is working normally, the immune system recognizes foreign invaders (such as parasites, bacteria, cells, viruses, or fungi) and works to destroy them and protect the body. During an autoimmune response, the immune system mistakenly identifies our own cells, tissues, or organs as foreign bodies and attacks them (American Autoimmune Related Diseases Association, 2021).
Prevalence of autoimmune diseases
The prevalence of autoimmune diseases is approximately 3% to 8% worldwide, with 78% to 85% of those affected being women (Ershadinia et al., 2020). Many autoimmune diseases tend to occur in women during times of stress, such as pregnancy or during a major hormonal transition (American Autoimmune Related Diseases Association, 2021). The reason why this occurs is not yet understood.
The most common autoimmune diseases
The most common autoimmune diseases include:
Rheumatoid arthritis (RA): This autoimmune condition attacks and causes inflammation in the joints and the surrounding tissues. RA commonly affects the joints in the hands, wrists, and knees. Tissue damage resulting from inflammation can cause long-lasting or chronic pain, balance problems, and deformity (CDC, 2020).
Systemic Lupus Erythematosus (Lupus): Lupus is an autoimmune disease that can affect multiple parts of the body. Lupus can cause inflammation, joint pain, fever, skin rashes, and organ damage (Cleveland Clinic, 2021). Individuals with lupus usually experience periods of illness (flares) followed by periods of feeling better (remission).
Multiple Sclerosis (MS): MS is a disease that affects the central nervous system, including the brain, spinal cord and optic nerves. During MS, the immune system attacks the protective sheath (myelin) that coats the nerve fibers, causing communication problems between the brain and the rest of the body. Symptoms of multiple sclerosis can vary widely and depend on the location and severity of the damage (Mayo Clinic, 2020).
Type 1 diabetes: Type 1 diabetes occurs when the body attacks cells in the pancreas, preventing them from producing insulin. Insulin allows sugar (glucose) to enter the body’s cells and be used as energy. Without insulin, sugar cannot enter the cells and accumulates in the bloodstream, resulting in high blood sugar (CDC, 2022). People with type 1 diabetes must inject insulin regularly (or wear an insulin pump) to keep their blood sugar under control.
Celiac Disease: Celiac disease is a condition in which the body has an immune reaction to gluten, a protein found in wheat, barley and rye. This damages the intestines (especially the small intestine) so that the body cannot properly absorb nutrients (malabsorption). Celiac disease can cause a range of symptoms, including diarrhea, abdominal pain, and bloating (NHS, 2023). People with celiac disease should avoid gluten for life to prevent long-term damage to the intestines.
Psoriasis: Psoriasis is an autoimmune skin condition that causes a rash of itchy, scaly patches. It most commonly occurs on the knees, elbows, trunk, and scalp (Mayo Clinic, 2022). Psoriasis usually goes through cycles of symptoms getting worse (flare-ups) followed by periods where symptoms improve (remission).
Hashimoto’s thyroiditis: This is an autoimmune disease that causes inflammation of the thyroid gland (thyroiditis). The thyroid gland produces hormones ( e.g. TSH, T3, T4) that help regulate many functions in the body. In Hashimoto’s disease, the hormone-producing cells of the thyroid die, causing a decrease in hormone production (hypothyroidism) (Mayo Clinic, 2022).
Crohn’s disease and ulcerative colitis: Crohn’s disease is an inflammatory bowel disease that can affect the entire digestive tract, although it primarily affects the small intestine. This disease can cause abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition (Mayo Clinic, 2022). Ulcerative colitis is an autoimmune bowel disease that causes inflammation and ulcers in the colon (large intestine) only. (NIDDK, 2023).
Source: Klein, 2020
How do autoimmune diseases develop?
The exact causes of autoimmune diseases are not fully understood, but researchers have explored several factors that may contribute to their development:
- Genetics: Some people have certain genes that make them more susceptible to autoimmune diseases. Autoimmune diseases are often considered to be multifactorial, meaning they could be caused by a combination of environmental factors and different genes.
- Environmental factors: Although this link is difficult to scientifically study, certain environmental factors have been linked to autoimmune diseases. These include:
- Bacterial and viral infections
- Exposure to pollutants and chemicals
- Diet (e.g., gluten or a deficiency in vitamin D)
- Influence of hormones: research shows that hormones, especially female sex hormones such as estrogen, can influence the immune response. This may explain why autoimmune diseases are more common in women than in men (Ngo, Steyn, & McCombe, 2014).
Source: John Hopkins, 2023
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What are symptoms of autoimmune diseases?
The symptoms of autoimmune diseases vary depending on the organs or tissues affected and can be non-specific or specific. Nonspecific symptoms of autoimmune diseases can be similar to several different diseases and can be confused for other health conditions. Common nonspecific symptoms of autoimmune diseases include:
- Joint pain and swelling
- Skin problems
- Digestive problems
- Weight loss
- Difficulty breathing
Specific symptoms of autoimmune diseases may be clearly associated with the part of the body that is affected. For example, specific symptoms of rheumatoid arthritis include swelling, pain, and stiffness in several joints (Mayo Clinic, 2021). Symptoms of ulcerative colitis include pain in the abdomen, weight loss, bloating, diarrhea, or blood in the stool. Autoimmune diseases are also often characterized by alternating periods of disease activity (flare-ups) and periods of symptom improvement (remission) (MedlinePlus, 2021). Because certain symptoms can also occur due to other medical conditions, a thorough medical examination is necessary to correctly identify an autoimmune disease.
How are autoimmune diseases diagnosed?
Diagnosing autoimmune diseases can be challenging because many of the symptoms can overlap with other conditions, and there is often no single diagnostic test. For this reason, doctors use a variety of methods to diagnose autoimmune diseases and rule out other causes, including:
History and physical exam: The first step in making a diagnosis is usually a thorough medical history and physical exam. The doctor will ask questions about symptoms, family history, and possible triggers. During a physical exam, the doctor will look for skin rashes, joint swelling, or organ enlargement, for example.
Blood tests: certain autoimmune diseases can be identified by looking for markers in the blood via a blood test, such as antibodies, proteins, blood cells, and inflammation markers. In addition, other laboratory tests may be performed to assess the function of certain organs.
Depending on the suspected diagnosis, medical imaging such as X-ray, ultrasound, or computed tomography (CT), may also be used to assess the degree of organ involvement or damage.
Source: Cleveland Clinic, 2021
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What influence do diet and lifestyle have on autoimmune diseases?
There is increasing evidence that diet and lifestyle can have an impact on autoimmune diseases. Some research suggests that diets rich in saturated fat, processed foods, and sugar may promote inflammation in the body, which in turn may increase the risk for autoimmune disease (Harvard Health Publishing, 2020). Long-term stress, which is associated with elevated blood cortisol levels, also impacts the immune system and can contribute to the development and exacerbation of autoimmune diseases (Dhabhar, 2014).
How are autoimmune diseases treated?
While there is currently no cure for autoimmune diseases, many treatments can help relieve symptoms and improve quality of life. As many autoimmune diseases consist of periods of flares and remission, treatment is unique to the individual and may change over time. Your healthcare provider will advise you on what treatments are available for your specific disease and how to best manage your symptoms in daily life. Treatments for autoimmune diseases depends on the specific disease, but may include the following:
- Medications: different types of medications can be used to relieve symptoms, reduce inflammation, and suppress the autoimmune response (Cleveland Clinic, 2021).
- Physical therapy: For certain autoimmune diseases, especially those that affect the joints, physical therapy can help relieve pain, improve flexibility, and increase overall well-being (Cleveland Clinic, 2021).
- Lifestyle changes: lifestyle changes also help relieve symptoms, reduce inflammation, as well as improve quality of life. This can include a healthy diet that limits pro-inflammatory foods, regular exercise, and adequate sleep. Although managing an autoimmune disease can be challenging, a comprehensive understanding of the disease and appropriate treatment can help improve quality of life (Stojanovich & Marisavljevich, 2007).
Autoimmune diseases are a group of diseases in which the immune system mistakenly attacks the body’s own cells. Causes are varied and may include genetic predisposition, environmental factors, hormones, and lifestyle factors. Recognizing symptoms and early diagnosis can help those living with autoimmune disease manage disease progression and have a good quality of life.
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