What do health conditions like rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, Hashimoto’s thyroiditis, and bowel disease) all have in common? They are all classified as autoimmune conditions, or autoimmune diseases, a group of disorders in which the immune system mistakenly attacks the body's own tissues, leading to inflammation and damage to various organs and tissues. They are a large problem for female health, with menstruating people making up 80% of cases (1).

Autoimmune diseases can affect different parts of the body, including the skin, joints, muscles, connective tissues, and internal organs.

The underlying causes of autoimmune diseases are not fully understood, but it is believed to involve a combination of genetic and environmental factors. While autoimmune diseases cannot be cured, treatments are available to help manage symptoms and slow the progression of the disease.

Depending on the condition, menstruating people are up to 10 times more likely to develop autoimmune diseases than males. The reason for this gender disparity is not fully understood, but it is believed to be related to differences in hormonal, genetic, and environmental factors. And, as we know, the female body is largely misunderstood due to medical research historically focusing on the way that male bodies work.

In this article, we will be diving into autoimmune issues and what they mean for female health. 

What are symptoms of autoimmune disease?

Symptoms of autoimmune disease can vary depending on the specific condition, but some common symptoms include (2):

1. Fatigue: People with autoimmune diseases often experience extreme tiredness, even after getting enough sleep.
2. Joint pain and stiffness: Many autoimmune diseases can cause joint pain, stiffness, and swelling.
3. Skin changes: Some autoimmune diseases can cause skin rashes, hives, or other changes.
4. Digestive problems: Autoimmune diseases can also cause digestive symptoms like diarrhea, bloating, and abdominal pain.
5. Hair loss: Some autoimmune diseases can cause hair loss or thinning.
6. Muscle weakness: Certain autoimmune diseases can lead to muscle weakness or even paralysis.
7. Numbness and tingling: Some autoimmune diseases can cause numbness, tingling, or weakness in the hands and feet.
8. Fever: Fever is a common symptom of autoimmune diseases, particularly during flare-ups.

It should be noted that this list is by no means exhaustive. Autoimmune diseases can often cause “mystery” symptoms that take years to diagnose, so if you have been experiencing new-to-you symptoms that seem abnormal for your body, be sure to make an appointment with your doctor. 

How are autoimmune conditions diagnosed? 

Diagnosing autoimmune diseases can be challenging because symptoms can be similar to those of other conditions. However, there are several diagnostic tests that doctors can use to help determine if someone has an autoimmune disease. Here are some common methods:

• Blood tests: Doctors can order blood tests to check for specific antibodies that are associated with autoimmune diseases. These antibodies are proteins that the immune system produces when it attacks the body's own tissues. Examples of these tests include antinuclear antibody (ANA) test, rheumatoid factor (RF) test, and erythrocyte sedimentation rate (ESR) test.
• Imaging tests: Doctors may use imaging tests such as X-rays, MRI, or CT scans to look for signs of inflammation or damage to organs or tissues.
• Biopsy: In some cases, doctors may perform a biopsy, which involves taking a small sample of tissue from the affected area for laboratory analysis.
• Physical exam and medical history: Doctors may ask about symptoms and perform a physical examination to look for signs of inflammation or damage.
• Genetic testing: In some cases, genetic testing may be used to identify specific gene mutations that are associated with autoimmune diseases.
• Consultation with a specialist: Depending on the type of autoimmune disease suspected, a specialist such as a rheumatologist, gastroenterologist, or dermatologist may be consulted for further evaluation.

It's important to note that the diagnostic process for autoimmune diseases can be complex and may involve multiple tests over time. If you are experiencing symptoms of an autoimmune disease, it's important to talk to a healthcare provider to determine the underlying cause and appropriate treatment.

What are common autoimmune conditions?

There are over 80 known autoimmune diseases, and likely even more that have not been identified or defined by the medical community yet. 

Some of the most common autoimmune conditions include:

1. Rheumatoid arthritis: A chronic inflammatory disorder that primarily affects the joints, causing pain, stiffness, and swelling. Women are 2 to 3 times more likely than men to develop rheumatoid arthritis.
2. Lupus: A systemic autoimmune disease that can affect multiple organs and tissues, including the skin, joints, kidneys, and blood vessels. Lupus affects women 9 times more often than men.
3. Multiple sclerosis: A chronic neurological disease that affects the central nervous system, causing problems with movement, balance, and coordination. Women are 3 times more likely to develop multiple sclerosis than men.
4. Hashimoto's thyroiditis: This autoimmune disorder, where one’s body starts producing antibodies that attack the thyroid gland and can lead to hypothyroidism, is more common in women than in men.
5. Graves' disease: Another autoimmune disorder that affects the thyroid gland, leading to hyperthyroidism (an overactive thyroid).
6. Type 1 diabetes: A chronic autoimmune disease that occurs when the immune system attacks and destroys insulin-producing cells in the pancreas.
7. Inflammatory bowel disease (IBD): A group of disorders that cause chronic inflammation in the digestive tract, including Crohn's disease and ulcerative colitis.
8. Psoriasis: A chronic autoimmune disorder that causes patches of thick, red, scaly skin.
9. Sjogren's syndrome: an autoimmune disorder that primarily affects the glands that produce tears and saliva, causing dry eyes and dry mouth.

In addition, some autoimmune diseases can affect women differently than men. For example, women with rheumatoid arthritis may experience more severe symptoms during pregnancy, while men with lupus may be more likely to develop heart disease.

What causes autoimmune conditions? 

The exact cause of most autoimmune conditions is unknown. Some possibilities include:

• Genetics: While genetics alone do not cause most autoimmune conditions, they can leave some people more predisposed to certain conditions. 
• Viral and bacterial infections: Viral infections such as Epstein-Barr, hepatitis B and C, Rubella (measles), and even common bacterial infections such as Escherichia coli, Klebsiella pneumonia, and Lyme disease have been linked to the development of autoimmune conditions (3). 
• Environmental factors:  There is research that shows that autoimmune conditions are becoming more prevalent, such as a 2020 study that concluded that over time there has been a rise in ANA levels in the general population (4). Research indicates that a significant reason behind this could be environmental factors such as toxins in our food, household products, air, water, and more in addition to general diet. In fact, a 2019 study estimates that 70% of autoimmune conditions are catalyzed largely by environmental factors (5).

While it may seem frustrating that there is not necessarily a definite answer behind why you have an autoimmune condition, adopting a root cause perspective like Pollie’s approach has a better chance of identifying why you are experiencing symptoms than the traditional care model of reactively treating symptoms. 

Can autoimmune disease cause long-term health problems? 

Autoimmune can lead to a number of future health risks if not managed properly. Below are some potential future health risks associated with autoimmune diseases:

• Organ damage: Over time, chronic inflammation caused by autoimmune diseases can lead to damage of organs and tissues, including the kidneys, heart, lungs, and liver.
• Infections: Many autoimmune diseases are treated with medications that suppress the immune system, which can increase the risk of infections.
• Reduced fertility: Some autoimmune conditions can potentially negatively affect female fertility. Conditions like lupus can lead to primary ovarian insufficiency (POI) and early menopause, and autoimmune thyroid disorders like Hashiomoto’s thyroiditis and Graves’ disease can disrupt ovulation, thereby making it harder to get pregnant. Other conditions which are not officially classified as an autoimmune condition but have been linked to autoimmune problems and systemic inflammation, such as endometriosis and PCOS, are also leading causes of infertility. 
• Cancer: Some autoimmune diseases, such as lupus and rheumatoid arthritis, have been linked to an increased risk of certain types of cancer, such as lymphoma.
• Disability: Autoimmune diseases can cause significant pain, fatigue, and disability, which can affect a person's ability to work and perform daily activities.
• Reduced life expectancy: Some autoimmune diseases, such as lupus, have been associated with a reduced life expectancy, particularly if the disease affects major organs such as the heart or kidneys and goes left unmanaged.
• More autoimmune conditions: Roughly 25% of people with autoimmune diseases will develop additional autoimmune diseases at some point in their lifetime (6).
  

However, it's important to note that with proper management and treatment, many people with autoimmune diseases are able to live full and active lives. 

What are treatment options for autoimmune diseases?

Treatment options for autoimmune diseases include medications, lifestyle changes, and alternative therapies such as acupuncture and dietary changes.

Autoimmune treatment options recommended by your doctor will depend on the specific condition and the severity of symptoms. The goal of treatment is to relieve symptoms, slow or stop the progression of the disease, and prevent complications. Below are some common treatment options for autoimmune conditions:

1. Lifestyle changes: Research shows that lifestyle changes can also help manage autoimmune diseases, which makes sense given that environmental factors are likely a leading catalyst behind most cases. In general, encouraging addressing inflammation and chronic stress is key when it comes to our routines and autoimmune issues. These changes - which are best made with the support of a behavior change specialist such as a registered dietitian (RD), certified nutrition specialist (CNS), or health coach may include eating a healthy diet, getting regular exercise, reducing stress, and getting enough sleep.
2. Medications: Medications are often the first line of treatment for autoimmune diseases. The type of medication prescribed depends on the specific condition and may include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease-modifying antirheumatic drugs (DMARDs), and biologic therapies. These medications help reduce inflammation and manage symptoms.
3. Immunosuppressive therapy: Immunosuppressive therapy involves medications that suppress the immune system to reduce inflammation and prevent further damage. However, these medications can also increase the risk of infections and other complications.
4. Stem cell transplant: In some cases, stem cell transplant may be recommended for people with severe autoimmune diseases. This involves replacing the immune system with stem cells from a donor.
5. Alternative therapies: Some people with autoimmune diseases find relief through alternative therapies, such as acupuncture, massage, and yoga. However, it's important to talk to your healthcare provider before trying any alternative therapies.
6. Surgery: In some cases, surgery may be necessary to remove damaged tissues or repair organs damaged by autoimmune diseases.
7. Fertility treatment: If you have an autoimmune condition and are concerned about your current or future fertility, make sure to discuss this with your primary care provider or OBGYN. In some cases, fertility treatments, such as in vitro fertilization (IVF), may be recommended to help women with autoimmune conditions conceive.

It's important to work closely with your healthcare provider to develop a treatment plan that's right for you. Treatment plans may need to be adjusted over time based on changes in symptoms and disease progression.

Conclusion

It is important for women and menstruating people to be aware of the signs and symptoms of autoimmune diseases and to seek medical attention if they suspect they may have an autoimmune condition. These conditions have a significant impact on our current and future health, and they can also hinder our quality of life. 

If you suspect you have an autoimmune condition, be sure to go to your doctor and ask for robust testing or even a referral out to a specialist. If managed proactively, most autoimmune conditions can become just a “special” thing about our bodies rather than an illness that defines us. 

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Sources

1. Angum F, Khan T, Kaler J, Siddiqui L, Hussain A. The Prevalence of Autoimmune Disorders in Women: A Narrative Review. Cureus. 2020 May 13;12(5):e8094. doi: 10.7759/cureus.8094. PMID: 32542149; PMCID: PMC7292717.
2. https://newsinhealth.nih.gov/2022/06/understanding-autoimmune-diseases 
3. Arango MT, Shoenfeld Y, Cervera R, et al. Infection and autoimmune diseases. In: Anaya JM, Shoenfeld Y, Rojas-Villarraga A, et al., editors. Autoimmunity: From Bench to Bedside [Internet]. Bogota (Colombia): El Rosario University Press; 2013 Jul 18. Chapter 19. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459437/
4. Dinse GE, Parks CG, Weinberg CR, Co CA, Wilkerson J, Zeldin DC, Chan EKL, Miller FW. Increasing Prevalence of Antinuclear Antibodies in the United States. Arthritis Rheumatol. 2020 Jun;72(6):1026-1035. doi: 10.1002/art.41214. Epub 2020 Apr 30. PMID: 32266792; PMCID: PMC7255943.
5. Khan MF, Wang H. Environmental Exposures and Autoimmune Diseases: Contribution of Gut Microbiome. Front Immunol. 2020 Jan 10;10:3094. doi: 10.3389/fimmu.2019.03094. PMID: 31998327; PMCID: PMC6970196.
6. Cojocaru M, Cojocaru IM, Silosi I. Multiple autoimmune syndrome. Maedica (Bucur). 2010 Apr;5(2):132-4. PMID: 21977137; PMCID: PMC3150011.

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