
What happens when the body turns on itself?
Your immune system is a powerful ally. It’s responsible for identifying and attacking organisms that invade the body and cause disease.
When it works, it’s a beautiful thing. When it doesn’t, it can wreak havoc. Sometimes, the immune system makes a mistake and attacks the body’s own tissues or organs. This is called autoimmunity—and it’s an area of health that researchers are working hard to fully understand.
Understanding Autoimmunity
There are more than 80 autoimmune diseases—each one with a slightly different mechanism of attacking the body. According to the American Autoimmune Related Diseases Association (AARDA), nearly a fifth of the U.S. population — or 50 million people — suffers from an autoimmune disease. More than 75 percent of those affected are women.
“It is clear there are some genetic risk factors that predispose you to developing autoimmunity,” says Gary Gilkeson, M.D., an expert in microbiology and immunology and the chair of the medical advisory board for the Lupus Foundation of America. Experts believe it’s the interaction of specific genes and environmental factors that lead to autoimmune diseases, but scientists don’t yet know exactly how.
One thing researchers are trying to better understand is why autoimmune diseases are becoming more prevalent. Although autoimmune diseases run in families, the increase is occurring faster than genetics can account for. Type 1 diabetes, for example, is increasing at a rate of 2 to 5 percent per year worldwide. And one 2015 study looking at autoimmune diseases shows the annual increase to be about 3 to 7 percent.
To understand autoimmunity, take a closer look at a few of the more common autoimmune diseases.
Rheumatoid Arthritis
- Disease where the immune system attacks healthy joints, causing pain, stiffness and swelling, leading to limited motion and function
- Estimated to affect more than 1.3 million Americans
- More common in people older than 40
Once Rheumatoid Arthritis is diagnosed, it’s important to see a doctor who is experienced in treating it. Ziv Paz, M.D., a member of the American College of Rheumatology and a practicing rheumatologist, says it’s also important to take any medication you’re prescribed. “You have to treat this disease,” he says. If not, the disease can progress, leading to joint pain that can restrict simple daily activities or cause deformed joints and permanent disability.
Lupus
- Inflammatory disease where the immune system attacks healthy tissue in almost any part of the body
- Estimated to affect 1.5 million Americans, 90 percent of whom are women
- Wide-ranging symptoms, including fatigue, headaches, painful joints, fever, anemia, pain in the chest when breathing deeply, a butterfly-shaped rash across the cheeks and nose, hair loss and sun sensitivity
Diagnosing lupus can be challenging because many of the symptoms are indicators of other conditions, explains Gilkeson. If you have several symptoms, he suggests you talk to your primary care doctor about testing for positive antinuclear antibodies, which are evidence of a stimulated immune system. If the results are positive, you’ll need a further workup by a rheumatologist to determine if indeed you have lupus.
Gilkeson states a healthy diet, staying active, getting proper ongoing care and taking prescribed medications mean the majority of lupus patients can live a relatively normal life.
Type 1 Diabetes
- An autoimmune disease that attacks the pancreas and its ability to produce insulin
- About 1.25 million Americans have type1 diabetes
- Symptoms include extreme thirst, frequent urination, fatigue, sudden weight loss, increased appetite and sudden vision changes
The treatment for type 1 diabetes is daily insulin injections or an insulin pump to ensure the body gets the right amount of insulin to manage blood sugar levels, says Jessica Dunne, PhD, director of prevention for JDRF, an organization that funds type 1 diabetes research. It’s not a cure, but with daily insulin and good blood sugar control, a person with type 1 diabetes can live a long and healthy life.
Celiac Disease
- Occurs when the body’s immune response to gluten (a protein found in wheat and other grains) damages the lining of the small intestine, preventing the body from properly absorbing nutrients
- Estimated to affect 1 percent of the population
- Symptoms can include abdominal pain, diarrhea, vomiting, anemia, fatigue and joint pain
“Celiac disease is not a fad,” says Talia Hassid, the communications manager for the Celiac Disease Foundation.
The treatment is a gluten-free diet, which works for most people. It’s possible to have celiac and not experience symptoms—but still experience intestinal damage. Left undiagnosed and untreated, celiac disease can lead to other autoimmune disorders and long-term health problems.
Living with an Autoimmune Disease
For people with an autoimmune disease, managing the physical impact of their chronic condition is critical. But treating the problem is not the same as eliminating the disease.
“This is a common misconception with many chronic conditions,” Paz says. “We talk about remission — not a cure.”
“It’s normal to feel discouraged when you’ve been diagnosed with a chronic illness,” says Patricia Rickenbaker, a licensed clinical social worker at Beaufort Memorial Sea Island Psychiatry. “You may feel a loss when you learn how it’s going to limit you.”
As you adjust to your new life, you may feel anxious and stressed, which could lead to depression. “You can’t think your way out of being depressed,” Rickenbaker says. “Recognize that you’re being negative and find a distraction to get your mind off of it. Call a friend. Take a walk. Play with your dog. Just get up and do something different.”
It’s important to have support and understanding from loved ones. If you’ve been diagnosed with an autoimmune disease—or any chronic condition—talk to your doctor about a referral to a support group or a mental health expert who can help you cope with your thoughts and feelings.
“Give yourself credit for the things you are able to accomplish,” Rickenbaker says. “All of this is meant to empower you, so you don’t feel like you’ve lost control of your life.”
Need support managing a chronic condition? Search for a Beaufort Memorial physician or support group.