Autoimmune Diseases

There is a shockingly high number of autoimmune diseases, and each can have its own set of symptoms. Some of them are names you probably know, like rheumatoid arthritis and multiple sclerosis. Others are rarer, which often makes everything under the autoimmune umbrella harder to diagnose. Here’s a rundown of some of the most common, according to the U.S. Department of Health and Human Services.

Type 1 diabetes

With type 1 diabetes, the immune system attacks insulin-producing cells in your pancreas. Insulin is essential for getting glucose (sugar) into your body’s cells for energy. Type 1 is different from type 2 diabetes in that type 2 occurs from gradual changes in the body that make it difficult for the pancreas to produce enough insulin, along with your body being unable to use insulin efficiently (which is called insulin resistance). In the case of type 1, you produce very little or no insulin. If you don’t have insulin, your blood sugar can increase to dangerous levels, damaging the nerves and organs in your body, and leading to a life-threatening complication called diabetic ketoacidosis, which means the acid level (ketones) in your blood is too high.¹ The symptoms can include frequent urination, unusual thirst levels, fatigue, sudden weight loss, and dry skin.

Rheumatoid arthritis

Rheumatoid arthritis (R.A.) is a condition in which your immune system attacks the protective lining of your joints, which leads to pain, stiffness, and swelling. R.A. can also affect your body beyond the joints, causing things like inflammation in the eyes and lungs as well as low blood counts (which is called anemia). Those things can cause fatigue and weight loss.

Multiple sclerosis

Multiple sclerosis (M.S.) is considered an autoimmune neurological condition (because it affects the brain and its functions) that occurs when your immune system attacks myelin, the “insulation” around your nerves that assists in nerve communication. Ultimately, this damage affects your brain’s abilities to communicate with your spinal cord, affecting muscle movement. M.S. manifests itself in a number of different ways, such as issues with coordination and balance, tremors, tingling sensations in the extremities, and problems speaking.

Psoriasis and psoriatic arthritis

With psoriasis, your body attacks skin cells, which spurs an overgrowth of these cells. The skin cells then pile up like scales, often on the knees and elbows, and become inflamed and painful. Some people with psoriasis will also develop psoriatic arthritis, which affects your movement and causes stiff, swollen joints.

Lupus

Systemic lupus erythematosus or lupus is a condition that can impact multiple organs in your body, including the heart, kidneys, and lungs. In this case, your immune system can attack multiple organs and tissues in the body. Because there are so many potential organs affected, the symptoms can vary dramatically. Lupus does typically cause a distinct “butterfly” rash across the face, usually on the nose and cheeks. Other symptoms include fever, hair loss, fatigue, muscle pain, chest pain, seizures, and behavioral changes.

Inflammatory bowel disease

Inflammatory bowel disease is an umbrella term for a group of conditions that cause digestive tract inflammation. The two main ones are:

• Ulcerative colitis, which typically causes damage to the colon’s lining and symptoms like bloody diarrhea, abdominal pain, fatigue, and weight loss.
• Crohn’s disease, which can affect any part of the digestive tract, from the mouth to the anus. That’s why some people experience painful mouth sores as well as symptoms similar to those of ulcerative colitis, such as weight loss, painful bowel movements, and rectal bleeding.

Graves’ disease

Graves’ disease causes the immune system to attack your thyroid, which makes you overproduce thyroid hormone. The results send your body into a hypermetabolic state (feeling like you’re amped up on energy drinks all the time). Symptoms include irritability, unintended weight loss, abnormal sweating, shaking hands, and bulging eyes. You may also feel superhot all the time and have trouble sleeping. Some people with Graves’ disease will have a goiter, an excessive growth on the thyroid, which can make the neck appear swollen. Because your thyroid is close to your airway, this can sometimes result in breathing problems as well.

Hashimoto’s disease

Hashimoto’s disease is like the counterpart to Graves’ disease. It causes your thyroid to not make enough thyroid hormone. This can make you feel sluggish and cause unintended weight gain, cold sensitivity, muscle aches, constipation, and swelling in your face.

Idiopathic thrombocytopenic purpura (ITP)

Idiopathic thrombocytopenic purpura, or ITP, is a condition in which your immune system blocks platelets in your blood. Because your body needs platelets to clot and stop bleeding, you can experience easy bruising and bleeding. ITP can cause a telltale skin condition of small purple or red dots on the skin. These may look like a rash, but it’s actually small bruising under the skin. Other symptoms include easy bruising, heavy menstrual periods, nosebleeds, and bleeding in the mouth.

Ankylosing spondylitis

Ankylosing spondylitis is when the immune system attacks joints and soft tissue, especially the spine and sacroiliac joint (where the pelvis and the hip bones connect). Symptoms of ankylosing spondylitis may be largely back-related, such as back pain and inflexibility in the spine. However, some people also experience joint pain in the shoulders, fingers, toes, and hips. An estimated 5% to 10% of people in Western countries (like the United States) with ankylosing spondylitis also have inflammatory bowel disease, according to an article in the journal Bone Research.⁴

Celiac disease

Celiac disease existed long before forgoing gluten became trendy. This condition affects the body’s ability to tolerate this protein found in wheat, barley, and rye products. With celiac disease, when you ingest gluten, it triggers an autoimmune response in your small intestine, which can lead to serious damage. Bloating and abdominal pain are common symptoms. The only way to avoid symptoms and damage to the small intestine is to eat a gluten-free diet, as recommended by your doctor or dietitian.

Pernicious anemia

Pernicious anemia occurs when the immune system destroys parietal cells in the stomach’s lining. These cells make intrinsic factor, which is a compound that helps your body absorb vitamin B12. While B12 may be 12th in line when it comes to B vitamins, it’s number one in helping your red blood cells divide normally. Without it, your blood cells are too large and can’t leave your bone marrow, which effectively means you don’t have enough red blood cells circulating in your body. That leads to anemia, which can lead to symptoms like fatigue, nerve damage, stomach problems, and even organ damage.

Addison’s disease

Addison’s disease is a condition that causes the adrenal glands to produce lower amounts of the hormones cortisol (which affects things like blood pressure and blood glucose) and aldosterone (which affects blood volume and also blood pressure). Addison’s disease is due to an autoimmune reaction in about 75% of cases, according to the National Organization for Rare Disorders. The most common symptom is fatigue, but it may also cause areas of skin hyperpigmentation (darker skin) to develop, which can look different depending on our skin tone. The condition can also cause low blood pressure, behavioral changes, irregular menstrual periods, and low blood sugar levels.

Sjogren’s syndrome

Sjogren’s causes the immune system to attack glands that are responsible for producing moisture in your mouth and eyes. That causes dry, itchy eyes and dry mouth that leads to sores, cavities, and problems swallowing. Some people with Sjogren’s also experience symptoms such as fatigue, joint swelling, and an affected sense of taste.

Myasthenia gravis

Myasthenia gravis is a condition that causes your immune system to attack nerves and muscles in your body, throwing the communication between the two out of whack. Its manifestations can include very severe effects, such as paralysis. Other symptoms can include double vision, problems swallowing, muscle weakness, trouble holding your head up, and speech issues.

Autoimmune vasculitis

Autoimmune vasculitis causes the immune system to attack and inflame blood vessels. As a result, the blood vessels narrow, and blood can’t move through them very well. Depending on which blood vessels are affected, it can lead to poor blood flow and organ damage. Vasculitis can be tricky to diagnose because you have blood vessels everywhere. Symptoms can depend on which blood vessels are affected. For example, if the blood vessels near the surface of the skin are affected, you might notice a rash. If the blood vessels affect the nerves, you might notice a change in sensations.

Alopecia areata

This occurs when your immune system attacks otherwise healthy hair follicles. These may be on your scalp but also can cause hair loss on your face or other areas of the body where you have hair. Hair loss from alopecia can be very emotionally difficult, so it’s important to reach out to a mental health professional if you’re struggling with self-image or feelings of depression.

This answer really depends on the autoimmune disease. For example, when you have Graves’ disease, a surgeon can perform a surgery known as a thyroidectomy to remove the thyroid to keep it from overproducing thyroid hormone. This surgery is 99% effective in treating Graves’ disease, according to an article in the journal Thyroid.⁵

But for most autoimmune diseases, there is no cure. Instead, there are medications and other treatments that can reduce the condition’s effects and minimize flare-ups. The treatment approach will depend upon your autoimmune disease. For example, the treatment for type 1 diabetes is to inject insulin (multiple times a day) to keep your blood sugar in a healthy range.

However, the treatments for many autoimmune disorders include medications, such as corticosteroids or biologics, to suppress the immune system or to reduce inflammation that leads to symptoms. Another example of this is the drug class anti-tumor necrosis factor or anti-TNF, which helps reduce inflammation and symptoms in conditions such as psoriasis and rheumatoid arthritis.

Autoimmune diseases are serious. If left untreated, they can potentially lead to complications that impact your daily life, like long-term disability. In severe cases, autoimmune diseases can even be fatal.

However, some autoimmune conditions are more severe than others. Working closely with your doctor—often a rheumatologist, but other specialists may be needed—to create a personalized treatment plan will help you experience fewer flare-ups and allow you to live a full life.

The main message is not to ignore your body when you experience unusual, unexplained symptoms. While we all can expect some occasional aches and pains as a side effect of aging, joint swelling, chronic pain, and persistent or uncomfortable skin changes aren’t the norm. Nor are muscle weaknesses or problems with coordination and balance. It’s best to speak with your doctor to make sure there isn’t a treatable underlying condition at play.

Getting a definitive diagnosis for an autoimmune disease can be tough, but seeing your doctor and advocating for yourself and your health is very important to staying well, both physically and mentally.

Sources:

1. StatPearls, Adult Diabetic Ketoacidosis
2. Arthritis and Rheumatology, Increasing Prevalence of Antinuclear Antibodies in the United States
3. Journal of the American Medical Association, Association of Stress-Related Disorders With Subsequent Autoimmune Disease
4. Bone Research, Ankylosing Spondylitis: Etiology, Pathogenesis, and Treatments
5. Thyroid, Patterns of Use, Efficacy, and Safety of Treatment Options for Patients with Graves’ Disease: A Nationwide Population-Based Study