Autoimmune diseases: Causes, symptoms, treatment

Autoimmune diseases are conditions in which the body's immune system mistakenly attacks healthy cells and tissues. These diseases are problematic because they can lead to inflammation, tissue damage, and a wide range of symptoms. One example is ulcerative colitis, in which the immune system attacks the lining of the colon, leading to inflammation. This article discusses various autoimmune diseases, their causes, and treatment options.

Table of Contents

• What are autoimmune diseases?

• How common are autoimmune diseases?

• Which conditions are classified as autoimmune diseases?

• What causes autoimmune diseases?

• What are the symptoms of autoimmune diseases?

• How are autoimmune diseases diagnosed?

• What is the impact of diet and lifestyle?

• How are autoimmune diseases treated?

• Summary

What are autoimmune diseases?

Autoimmune diseases belong to a category of health disorders that result from a malfunction of our own immune system. The immune system identifies the body’s own cells, tissues, and organs as foreign invaders or infections and attacks them (American Autoimmune Related Diseases Association, 2021). There are about 100 autoimmune diseases that cause a wide variety of symptoms, including pain, fatigue, skin rashes, nausea, headaches, and more. The specific symptoms that may occur depend on the individual disease. Autoimmune diseases have a genetic component but are not contagious (Cleveland Clinic, 2021).

How common are autoimmune diseases?

The global prevalence of autoimmune diseases is estimated to be between 3% and 8%, with 78% to 85% of those affected being women (Ershadinia et al., 2020). Many autoimmune conditions tend to occur in women during periods of intense stress, such as pregnancy or significant hormonal changes (American Autoimmune Related Diseases Association, 2021).

Which conditions are classified as autoimmune diseases?

The most common autoimmune diseases include:

• Rheumatoid arthritis: A chronic disease that causes inflammation particularly in the joints, but also in surrounding tissues. In most cases, joints in the hands, wrists, and knees are affected. The resulting tissue damage can lead to long-lasting or chronic pain, balance problems, and joint deformities (CDC, 2020).

• Systemic lupus erythematosus (SLE): Lupus is an autoimmune disease that can cause joint pain, fever, skin rashes, and organ damage (Cleveland Clinic, 2021).

• Multiple sclerosis: This condition affects the central nervous system – the brain, spinal cord, and optic nerves. The immune system attacks the protective covering (myelin) of nerve fibers, leading to communication problems between the brain and the rest of the body. Symptoms of multiple sclerosis can vary greatly depending on the location and severity of the damage (Mayo Clinic, 2020).

• Type 1 diabetes: In type 1 diabetes, the body attacks its own pancreas, preventing it from producing insulin. Insulin enables blood sugar to enter the body's cells for energy use. Without insulin, blood sugar cannot enter the cells and builds up in the bloodstream. High blood sugar levels are harmful to the body (CDC, 2022).

• Celiac disease: Celiac disease is a condition in which the body reacts to gluten—a protein found in wheat, barley, and rye—by launching an immune response that attacks its own tissues. This damages the gut, particularly the small intestine, impairing the absorption of nutrients (malabsorption). Celiac disease can cause symptoms such as diarrhea, abdominal pain, and bloating (NHS, 2023).

• Psoriasis: Psoriasis is a skin condition that causes a rash with itchy, scaly patches. It most commonly affects the knees, elbows, torso, and scalp (Mayo Clinic, 2022).

• Hashimoto’s thyroiditis: This is an autoimmune condition that leads to inflammation of the thyroid gland (thyroiditis). The thyroid produces hormones (e.g. TSH, T3, T4) that help regulate many functions in the body. In Hashimoto’s disease, the hormone-producing cells of the thyroid die off, leading to reduced hormone production (hypothyroidism) (Mayo Clinic, 2022).

• Crohn’s disease and ulcerative colitis: Crohn’s disease is an inflammatory bowel disease that mainly affects the small intestine and can cause abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition (Mayo Clinic, 2022). Ulcerative colitis is also a chronic inflammatory bowel disease. In this condition, abnormal immune responses lead to inflammation and ulcers particularly on the inner lining of the colon (NIDDK, 2023).

Source: MedicalNewsToday, 2020

What causes autoimmune diseases?

The exact causes of autoimmune diseases are not fully understood, but researchers have examined several areas that may contribute to the development of these conditions:

• Genetics: Some individuals have a genetic predisposition or susceptibility that makes them more likely to develop autoimmune diseases. Autoimmune conditions are considered polygenic (multifactorial) diseases because numerous genes can increase the risk of developing them.

• Environmental factors: Although these associations are difficult to scientifically prove, certain environmental factors have been linked to autoimmune diseases. These include:

  • Bacterial and viral infections

  • Exposure to pollutants and chemicals

  • Diet (e.g. gluten or vitamin D deficiency)

• Hormonal influence: Research suggests that hormones—especially female sex hormones like estrogen—can influence the immune response. This could explain why autoimmune diseases are more common in women than in men (Ngo, Steyn, & McCombe, 2014).

Source: John Hopkins, 2023

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What are the symptoms of autoimmune diseases?

The symptoms of autoimmune diseases can affect various parts of the body, including muscles, joints, skin, and internal organs such as the kidneys, liver, heart, lungs, brain, nerves, and blood vessels. The most common complaints include fatigue, joint pain, muscle aches, and skin rashes. In autoimmune diseases, the immune system becomes overactive and may attack the body’s own tissues inappropriately, leading to chronic inflammation and damage. The symptoms and severity vary depending on the specific autoimmune disease.

As a result, the symptoms of autoimmune diseases can be either non-specific or specific. Non-specific symptoms can occur in many different conditions and do not allow for direct conclusions about a specific illness. Common non-specific symptoms of autoimmune diseases include:

• Fatigue

• Joint pain and swelling

• Skin problems

• Digestive issues

• Fever

• Weight loss

• Dizziness

• Difficulty breathing

Specific symptoms, on the other hand, can clearly be associated with a particular disease. In autoimmune diseases, specific symptoms are often the result of damage or dysfunction in a specific organ or tissue type. Specific symptoms of rheumatoid arthritis include swelling, pain, and stiffness in multiple joints (Mayo Clinic, 2021). Autoimmune diseases are also often characterized by alternating phases of disease activity (flare-ups) and remission, during which symptoms may worsen or subside (MedlinePlus, 2021). Because non-specific symptoms in particular can also occur in other illnesses, a thorough medical examination is essential to obtain an accurate diagnosis if you experience symptoms.

How are autoimmune diseases diagnosed?

Diagnosing autoimmune diseases can be challenging because many symptoms overlap with those of other conditions. For this reason, doctors use a variety of methods to diagnose autoimmune diseases, including:

• Medical history and physical examination: The first step in diagnosis typically involves a thorough medical history and physical exam. The doctor will ask about symptoms, medical history, and potential triggers. During the physical exam, the doctor will look for signs such as rashes, swollen joints, or organ enlargement.

• Blood tests: Certain autoimmune diseases can be identified by testing for antibodies in the blood that the immune system produces against the body’s own cells. Additional specific lab tests may also be performed to assess the function of particular organs.

• Imaging tests: Depending on the suspected diagnosis, imaging methods such as X-rays, ultrasound, or CT scans may be used to assess the degree of organ involvement or damage.

Source: Cleveland Clinic, 2021

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What is the impact of diet and lifestyle?

There is growing evidence that diet and lifestyle can significantly influence autoimmune diseases. Some research suggests that diets high in saturated fats, processed foods, and sugar can promote inflammation in the body, which may increase the risk of developing autoimmune diseases (Harvard Health Publishing, 2020). Chronic stress, which is associated with elevated cortisol levels in the blood, also affects the immune system and can contribute to the development and worsening of autoimmune diseases (Dhabhar, 2014).

How are autoimmune diseases treated?

Although there is currently no cure for autoimmune diseases, treatments aim to relieve symptoms and improve quality of life. Treatment depends on the specific condition but may include the following:

• Medications: Various types of medications can be used to relieve symptoms, reduce inflammation, and suppress the immune system (Cleveland Clinic, 2021).

• Physical therapy: For certain autoimmune diseases, especially those affecting the joints, physical therapy can help reduce pain, improve flexibility, and enhance overall well-being (Cleveland Clinic, 2021).

• Lifestyle changes: Adjusting lifestyle habits can also help relieve symptoms, reduce inflammation, and improve quality of life. This may include a healthy diet that avoids inflammation-promoting foods, regular physical activity, and adequate sleep. Although managing an autoimmune disease can be challenging, a comprehensive understanding of the condition and appropriate treatment can contribute to a better quality of life (Stojanovich & Marisavljevich, 2007).

Summary

Autoimmune diseases are a group of conditions in which the immune system mistakenly attacks the body’s own cells. The causes are varied and may include genetic predisposition, environmental factors, and hormonal differences. Diet and lifestyle can also play a significant role. Recognizing symptoms and receiving an early diagnosis can help manage the disease progression and improve the quality of life of those affected.