When Your Own Body Attacks You

What to Know About Autoimmune Diseases

Have you ever heard someone say they had an “autoimmune disease,” and wondered what that meant? Learn more here.

It’s a classic case of mistaken identity, but this time it’s happening in your own body. The perpetrator? Your immune system, a complex network of cells, tissues, and organs that fights infection. The victim? Your own body, which your immune system mistakes for a foreign invader.

We’re talking about an autoimmune disease.

What is an Autoimmune Disease?

An autoimmune disease is any disease in which a person’s immune system attacks their own body, rather than a foreign invader like a virus or bacteria. Your immune system uses a huge army of defender cells to protect you from infection and illness. But if you have an autoimmune disease, it mistakes your own healthy cells, tissues, organs for the enemy and targets them instead.

While we don’t know what causes autoimmune diseases, the most prominent theories focus on genetic predisposition and environmental triggers. In other words, people are more likely to develop an autoimmune disease if they have a family history and they are exposed to something in the environment that triggers the autoimmune reaction. The environmental trigger could be something like a drug, virus, bacteria, food, or pollutant. It could also be related to hormones or stress.

What They Have in Common

There are over 100 different types of autoimmune disease, and each one affects the body in a completely different way. Some autoimmune diseases target specific body parts (such as psoriasis or arthritis), while others affect many parts of the body at once (such as lupus).

However, autoimmune diseases do have a few things in common. One common feature is inflammation, which causes redness, heat, pain, and swelling. Another common feature is symptoms that come and go. Autoimmune diseases often fluctuate between periods of remission, when symptoms get better and disappear, and flare-ups, when symptoms get worse.

A third common feature is fatigue. In a recent survey of more than 7,800 autoimmune disease patients, 9 out of 10 patients called fatigue a “major issue” and 6 in 10 said fatigue was “probably the most debilitating symptom of having an autoimmune disease.”

Across the Spectrum

Under our current medical system, autoimmune diseases do not fall under one particular specialty. Instead, you will see a specialist who focuses on the organ system that is being affected.

Medical specialties that frequently see autoimmune disease include rheumatologists, endocrinologists, gastroenterologists, dermatologists, and neurologists.

“In rheumatology, we deal with many of the prototypical ones. But autoimmune diseases are seen by every type of physician,” says Dr. Jayne L. Crowe, a rheumatologist with University Rheumatology Associates at Erlanger Health System.

Here’s an overview of the most common autoimmune diseases and the specialists that treat them.

How do Different Autoimmune Diseases Affect the Body?

Multiple Organs

Autoimmune diseases that affect multiple organs all at the same time, and are often treated by a rheumatologist, include rheumatoid arthritis, lupus, and Sjögren’s syndrome.

Rheumatoid Arthritis is a chronic inflammatory disorder that typically affects the small joints in your hands and feet.

Lupus is a chronic inflammatory disease that can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs.

Sjögren’s syndrome is a disease that affects the glands that make moisture. It most often causes dryness in the mouth and eyes.

Glands and Hormones

Autoimmune diseases that affect the hormone-producing endocrine glands, and are often treated by an endocrinologist, include Hashimoto’s Thyroiditis, Graves’ Disease, and Type 1 Diabetes.

Hashimoto’s Thyroiditis causes inflammation in the thyroid gland and interferes with its ability to produce thyroid hormones. It can lead to an underactive thyroid gland (hypothyroidism).

Graves’ Disease causes the thyroid gland to produce too much thyroid hormone, which can lead to an overactive thyroid gland (hyperthyroidism).

Type 1 Diabetes attacks the insulin-producing beta cells in the pancreas and destroys them. The pancreas then produces little or no insulin, a hormone needed to allow sugar (glucose) to enter cells to produce energy.

GI Tract

Autoimmune diseases that affect the gastrointestinal system, and are often treated by a gastroenterologist, include celiac disease and inflammatory bowel diseases like ulcerative colitis and Crohn’s Disease.

Celiac Disease causes an abnormal immune reaction to gluten, a protein found in grains. Untreated, it causes inflammation and damage in the intestines.

Crohn’s Disease causes inflammation in the gastrointestinal (GI) tract. Most commonly, it affects the end of the small intestine (small bowel) and the beginning of the colon (large bowel).

Ulcerative Colitis also causes inflammation in the gastrointestinal (GI) tract. However, unlike Crohn’s, it is confined to the colon (large bowel).

Brain, Nerves, and Spinal Cord

Autoimmune diseases that affect the brain and spinal cord, and may be treated by a neurologist, include multiple sclerosis and Parkinson’s Disease.

Multiple Sclerosis attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body.

Skin

Autoimmune diseases that affect the skin, and may be treated by a rheumatologist and/or dermatologist, include psoriasis and scleroderma.

Psoriasis causes itchy, red patches of thick skin with silvery scales on the elbows, knees, scalp, back, face, palms, and feet. About 30% of people with psoriasis also develop a form of inflammatory arthritis called psoriatic arthritis (PsA).

Scleroderma causes skin and connective tissues to become hard and tight. Sometimes, it also harms blood vessels, internal organs, and the digestive tract.

Who Gets Autoimmune Diseases?

Because there are so many types of autoimmune diseases and many have similar symptoms, they can be very difficult to diagnose. However, studies do reveal that these diseases often cluster in families. “If you have a family history of a particular autoimmune disease, you may have a higher risk and want to talk to your doctor about screening,” says Dr. Ana Cornea, an endocrinologist with Parkridge Medical Group’s Diagnostic Center.

Studies also show that individuals with one autoimmune disease are more likely to get another. “For example, we often see thyroid disease in patients with lupus,” says Dr. Crowe.

Finally, studies show a family can often have different types of autoimmune diseases among its members. “For example, an aunt could have Graves’ disease, a cousin could have lupus, and a grandmother could have rheumatoid arthritis,” says Dr. Crowe.

Female to Male Ratios in Autoimmune Diseases

Source: American Autoimmune Related Diseases Association

Hashimoto’s thyroiditis 10:1
Lupus 9:1
Sjogren’s syndrome 9:1
Graves’ disease 7:1
Scleroderma 3:1
Rheumatoid arthritis 2.5:1
Multiple sclerosis 2:1

 

 

 

 

 

 

Autoimmune Diseases in Women

For reasons unknown, many autoimmune diseases disproportionately affect women. Of the 8% of the U.S. population suffering from autoimmune diseases, approximately 78% are women.

This is particularly true for autoimmune diseases of the thyroid. “Thyroid disease affects far more women than men, but we don’t really know why,” says Dr. Melinda Garcia-Rosell, a rheumatologist with CHI Memorial Arthritis & Rheumatology Associates. “There is research into how estrogen can affect your white blood cells, but that’s something we’d love to learn more about.”

Should I Be Screened?

If you do not have a family history of an autoimmune disease or have symptoms that bother you, there is no need to be screened for an autoimmune disease.

“Healthy individuals without specific symptoms of an autoimmune disease do not need any special testing or screening tests,” says Dr. Crowe. “Testing for autoimmune diseases such as lupus in healthy individuals has the potential for false-positive results that can lead to unnecessary follow-up testing and personal stress on patients.”

“I think that autoimmune diseases are something that people shouldn’t be worried or scared about,” says Dr. Garcia-Rosell. “And if you do happen to have one, we have better research and treatment options than ever.”

If you have symptoms that alarm you, Dr. Garcia-Rosell recommends keeping a log or taking a photo if you have swelling or other visible abnormalities. This can be particularly helpful as many autoimmune diseases will flare and then go into remission before a patient can see a doctor for diagnosis.

“I think patients need to be proactive in their care and let their primary care doctor know what’s going on,” she says. “If you’ve developed unusual symptoms, write them down.”

Taking this stance can be helpful in determining whether your symptoms could possibly be caused by an autoimmune disease or just due to the stress of daily life. “Often I see people who are convinced they have a thyroid disorder when what’s going on is that they are really stressed and suffering from high adrenaline levels,” says Dr. Cornea.

Want to learn more?

The American Autoimmune Related Diseases Association (AARDA) is the nation’s only non-profit organization dedicated to bringing a national focus to autoimmunity as a category of disease and a major women’s health issue, and promoting a collaborative research effort in order to find better treatments and a cure for all autoimmune diseases. For more information, please visit aarda.org.

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