Autoimmune Disorder

When your body’s defense system turns against you, the result is an autoimmune disorder—a chronic condition where the immune system mistakenly attacks healthy tissues instead of protecting them from harm.

Table of contents

• What are autoimmune disorders?
• Types of autoimmune disorders
• How common are autoimmune disorders?
• Symptoms of autoimmune disorders
• Causes and risk factors
• Diagnosis
• Treatment approaches
• Living with an autoimmune disorder

What are autoimmune disorders?

Autoimmune disorders are health conditions that happen when your immune system attacks your body instead of defending it^[1]. Your immune system normally works like your body’s built-in security system. It automatically detects substances that shouldn’t be in your body, such as viruses, bacteria, or toxins, and sends out white blood cells (special cells that fight infection) to eliminate them before they can damage your body or make you sick^[1].

If you have an autoimmune disorder, your immune system is more active than it should be. Because there aren’t invaders to attack, your immune system turns on your body and damages healthy tissue^[1]. The immune system produces proteins called autoantibodies (antibodies that attack your own cells) that mistakenly target and destroy normal, healthy cells^[2].

At the core of the immune system is the ability to tell the difference between self and nonself—what’s you and what’s foreign. A flaw can make the body unable to tell the difference between self and nonself^[19]. At the same time, special cells called regulatory T cells fail to do their job of keeping the immune system in line^[5].

Autoimmune disorders are chronic conditions (long-lasting health problems). This means if you have an autoimmune disorder, you’ll probably have to manage it and the symptoms it causes for the rest of your life^[1].

Types of autoimmune disorders

There are more than 100 different autoimmune disorders^[1]. They can affect almost any tissue or organ in your body, depending on where your immune system malfunctions^[1]. Autoimmune disorders are broadly grouped into two categories: ‘organ-specific’ means one organ is affected, while in ‘non-organ-specific’ disorders, multiple organs or body systems may be affected^[7].

• Joints and muscles
• Skin and blood vessels
• Digestive system
• Endocrine system
• Nervous system
• Pancreas
• Thyroid gland
• Connective tissue
• Red blood cells

Some examples of autoimmune disorders include:

Joints and muscles: Rheumatoid arthritis causes your immune system to produce antibodies that attach to the linings of your joints, leading to inflammation, swelling, and pain^[4]. Lupus (systemic lupus erythematosus) develops when autoimmune antibodies can attach to tissues throughout your body, most often attacking joints, lungs, blood cells, nerves, and kidneys^[4]. Myositis also affects the muscles^[1].

Skin and blood vessels: Sjögren’s syndrome attacks the glands that produce tears, saliva, and sweat^[8]. Psoriasis causes immune system blood cells called T-cells to collect in your skin, stimulating skin cells to reproduce quickly and producing silvery, scaly plaques^[4]. Other conditions include psoriatic arthritis, dermatomyositis, scleroderma, vasculitis, and vitiligo^[1].

Digestive system: Inflammatory bowel disease causes the immune system to attack the lining of the intestines, leading to bouts of diarrhea, rectal bleeding, urgent bowel movements, abdominal pain, fever, and weight loss^[4]. This includes ulcerative colitis and Crohn’s disease^[4]. Celiac disease occurs when the immune system reacts to gluten (found in wheat and other grains) and damages the small intestine^[8]. Autoimmune gastritis affects the stomach^[1].

Endocrine system: In Type 1 diabetes, antibodies attack and destroy insulin-producing cells in the pancreas^[4]. Graves’ disease causes the immune system to produce antibodies that make the thyroid gland release too much thyroid hormone into the blood^[4]. Hashimoto’s thyroiditis and Addison’s disease also affect hormone-producing glands^[1].

Nervous system: Multiple sclerosis causes the immune system to attack nerve cells, leading to symptoms that may include pain, blindness, weakness, poor coordination, and muscle spasms^[4]. Myasthenia gravis affects nerve and muscle communication^[1]. Guillain-Barré syndrome attacks the nerves controlling the muscles in your legs and sometimes those in your arms and upper body, leading to weakness that can sometimes be serious^[4]. Chronic inflammatory demyelinating polyneuropathy is similar to Guillain-Barré but symptoms last much longer^[4].

How common are autoimmune disorders?

Autoimmune disorders are common, especially because there are so many different types. Experts estimate that around 1 in 15 people in the United States has an autoimmune disorder^[1]. More than 50 million Americans are currently living with an autoimmune disorder^[4], and new cases are rising at an alarming rate. Autoimmunity is the highest cause of morbidity in women in the United States and is one of the top 10 causes of death in women under the age of 65^[14].

For unknown reasons, women are more susceptible than men, particularly during their childbearing years^[7]. Overall, approximately 80% of people with autoimmune disorders are women^[17]. People assigned female at birth between the ages of 15 and 44 are more likely to get an autoimmune disorder than people assigned male at birth^[6].

Symptoms of autoimmune disorders

Autoimmune disorders can cause a wide range of symptoms. They can affect your body almost literally from head to toe^[1]. The symptoms of an autoimmune disorder depend on the part of your body that’s affected^[2].

Different autoimmune disorders may have similar early symptoms. These can include^[6]:

• Fatigue
• Dizziness or lightheadedness
• Low grade fever
• Muscle aches
• Swelling
• Trouble concentrating
• Numbness and tingling in your hands and feet
• Hair loss
• Skin rash

For example, conditions that affect your muscles can cause muscle weakness. You might also have joint pain, swelling, or feel stiffness if you have a condition like rheumatoid arthritis. Type 1 diabetes causes high blood sugar. Some autoimmune conditions affect your vision^[1].

Many autoimmune disorders cause inflammation (swelling and irritation in body tissues), which can include^[1]:

• A feeling of warmth or heat
• Discoloration or redness on your skin
• Swelling
• Pain

Many types of autoimmune disorders cause redness, swelling, heat, and pain, which are the signs and symptoms of inflammation. But other illnesses can cause the same symptoms^[2].

The symptoms of autoimmune disorders can come and go. During a flare-up (period when symptoms get worse), your symptoms may get severe for a while. Later on, you may have a remission (period when symptoms improve or disappear), which means that your symptoms get better or disappear for a period of time^[2]. Lots of autoimmune disorders cause symptoms that come and go. These episodes of more noticeable or more severe symptoms are called flares or attacks^[1].

Nobody knows what’s normal for your body better than you. Visit a healthcare provider if you notice any new symptoms you can’t explain, especially if you don’t feel like yourself more often than usual^[1].

Causes and risk factors

Experts don’t know for certain what causes autoimmune disorders^[1]. The exact cause of autoimmune disorders is unknown. One theory is that some microorganisms (such as bacteria or viruses) or drugs may trigger changes that confuse the immune system. This may happen more often in people who have genes that make them more prone to autoimmune disorders^[5].

Some factors that may increase your risk of developing an autoimmune disorder can include^[6]:

Your sex: People assigned female at birth between the ages of 15 and 44 are more likely to get an autoimmune disorder than people assigned male at birth. It is thought that sex hormones may be at least partly responsible^[7].

Your family history: You may be more likely to develop autoimmune disorders due to inherited genes, though environmental factors may also contribute. Autoimmune disorders do tend to run in families, which means that certain genes may make some people more likely to develop a problem^[2].

Environmental factors: Exposure to sunlight, mercury, chemicals like solvents or those used in agriculture, cigarette smoke, or certain bacterial and viral infections may increase your risk of autoimmune disorder. Viruses, certain chemicals, and other things in the environment may trigger an autoimmune disorder if you already have the genes for it^[6].

Ethnicity: Some autoimmune disorders are more common in people in certain groups. For example, White people from Europe and the United States may be more likely to develop autoimmune muscle disease, while lupus tends to occur more in people who are African American, Hispanic, or Latino^[6].

Nutrition: Your diet and nutrients may impact the risk and severity of autoimmune disorder^[6].

Other health conditions: Certain health conditions, including obesity and other autoimmune disorders, may make you more likely to develop an autoimmune disorder. If you have one autoimmune disorder, you are more likely to get another^[2].

Diagnosis

Doctors often have a hard time diagnosing autoimmune disorders. There’s usually not a specific test to show whether you have a certain autoimmune disorder. And the symptoms can be confusing. That’s because many autoimmune disorders have similar symptoms. And some symptoms, such as muscle aches, are common in many other illnesses^[2].

Diagnosis can take several years, especially when symptoms are not taken seriously and the patient is made to feel by friends or family that the symptoms are all “in one’s head,” contributing to patients feeling uncertain about their own symptoms and questioning their knowledge about their own bodies^[17]. So it can take a long time and some visits to different types of doctors to get a diagnosis^[2].

To help your doctor find out if an autoimmune disorder is causing your symptoms^[2]:

• Learn about the health conditions in your family history. What health problems did your grandparents, aunts, uncles, and cousins have? Write down what you learn and share it with your doctor
• Keep track of your symptoms, including how long they last and what makes them better or worse. Share your notes with your doctor
• See a specialist who deals with the symptoms that bother you most. For example, if you have rash, see a dermatologist (skin doctor)

Tests that may be done to diagnose an autoimmune disorder include^[5]:

• Antinuclear antibody (ANA) tests
• Autoantibody tests
• Complete blood count (CBC) with white blood cell differential
• Comprehensive metabolic panel
• C-reactive protein (CRP)
• Erythrocyte sedimentation rate (ESR)
• Urinalysis

Treatment approaches

There is generally no cure for autoimmune disorders, but the symptoms of autoimmune disorders can be managed^[7]. The treatment depends on the disorder. In most cases, the goal of treatment is to suppress (slow down) your immune system, and ease swelling, redness, and pain from inflammation^[2].

The goals of treatment are to^[5]:

• Control the autoimmune process
• Maintain your body’s ability to fight disease
• Reduce symptoms

Treatments will depend on your disorder and symptoms. Types of treatments include^[5]:

Supplements to replace substances the body lacks: Such as thyroid hormone, vitamin B12, or insulin, due to the autoimmune disorder.

Blood transfusions: If blood is affected.

Physical therapy: To help with movement if the bones, joints, or muscles are affected.

Medicines to reduce immune system activity: Many people take medicines to reduce the immune system’s abnormal response. These are called immunosuppressive medicines (medications that slow down the immune system). Examples include corticosteroids (such as prednisone) and nonsteroid drugs such as azathioprine, cyclophosphamide, mycophenolate, sirolimus, or tacrolimus^[5]. Your doctor may give you corticosteroids or other medicines to help you feel better^[2].

Targeted drugs: Such as tumor necrosis factor (TNF) blockers and Interleukin inhibitors can be used for some disorders^[5].

For some disorders, you may need treatment for the rest of your life^[2]. Treatment usually focuses on reducing immune system activity^[4].

Living with an autoimmune disorder

Most autoimmune disorders are chronic, but many can be controlled with treatment^[5]. Symptoms of autoimmune disorders can come and go. When symptoms get worse, it is called a flare-up^[5]. Living with an autoimmune disorder can be complex, stressful, and exhausting^[15].

Managing an autoimmune disorder is a lifelong journey. By adopting simple lifestyle changes and embracing specific proactive measures, you can maintain greater control over your autoimmune disorder^[18].

Prioritize stress management: Stress can exacerbate symptoms of autoimmune disorders by triggering inflammatory responses. Incorporate stress-reducing activities into your daily routine, such as yoga, meditation, deep breathing exercises, or hobbies you enjoy. You should also get adequate sleep and maintain a healthy work-life balance^[20].

Follow an anti-inflammatory diet: Certain foods can either worsen inflammation or help reduce it. Start focusing on a diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats like fish, nuts, and seeds. You should also limit processed foods, refined sugars, and saturated fats, which can contribute to inflammation^[20]. The right food choices offer the greatest benefits for autoimmune health^[18].

Stay active: Regular exercise is beneficial for managing autoimmune conditions as it helps reduce inflammation, improves mood, and promotes overall well-being. Choose low-impact activities such as walking, swimming, or cycling, and work toward at least 30 minutes of moderate exercise most days of the week^[20]. Exercise is important to boost your energy and immune system without taxing your joints^[18].

Practice good hygiene: Proper hygiene can help prevent infections and minimize the risk of flare-ups in autoimmune conditions. Wash your hands frequently, especially before eating and after using the restroom, and avoid close contact with sick individuals^[20].

Establish a support system: Living with an autoimmune condition can feel isolating at times, so it’s essential to build a strong support network. Surround yourself with friends and family members, and maintain a strong relationship with healthcare professionals who understand your condition and can provide emotional support and encouragement^[20]. For many, the reminder that they are not alone in their experiences with autoimmune disorder can be invaluable^[15].

Communicate with your healthcare team: Maintain open communication with your healthcare team. Staying proactive about discussing your symptoms and concerns and letting them know of any changes in your condition can provide vital information to manage your autoimmune condition successfully^[20]. Collaboration allows development of a comprehensive treatment plan that addresses your unique needs and goals^[20].

Mental health challenges are a common experience among people with autoimmune disorder and other chronic illnesses. Struggles with unprocessed worry, grief, fear, or anger are not unusual to those with chronic illness. Many people find themselves feeling stigmatized or alienated by the circumstances of their illness^[21]. It can be beneficial to work with a therapist that specializes in chronic illness or consider joining a support group^[21].

Living with an autoimmune disorder requires patience, perseverance, and self-care. By incorporating these strategies into your daily routine, you can better manage your symptoms, reduce inflammation, and improve your overall quality of life^[20].