Understanding Autoimmune Disease

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The vast majority of thyroid conditions in the United States are the result of two autoimmune diseases, Hashimoto's thyroiditis, and Graves' disease. These two conditions are among 100 autoimmune diseases. If you have an autoimmune disease, it’s important to learn more about the demographics, risk factors, diagnosis, and treatment.


What is your immune system?

Your immune system is a network of cells and tissues that help protect your body from infection and illness. A normal immune system can recognize what’s known as “self”— your own body — and “non-self”— viruses, bacteria, pathogens, and other elements that are foreign to your body. You have two different types of immunity: acquired/adaptive immunity and innate/inborn immunity.


What are acquired/adaptive and innate/inborn immunity?

When it is working normally, your adaptive immune system encounters foreign pathogens — “invaders” in a sense — and produces proteins called antibodies. The antibodies attach themselves to pathogens and destroy them.

When you have an infection or the body detects a pathogen it doesn’t recognize, your innate immune system can produce extra white blood cells to destroy the offending invader.


What is autoimmune disease?

Autoimmune diseases are a category of diseases characterized by inappropriate reactions in your body’s acquired/adaptive immune system. For reasons not completely understood, your body mistakenly identifies “self” as “non-self,” and produces antibodies to go on the attack. Autoimmune disease is like “friendly fire,” as your immune system inappropriately tries to destroy your own organs, tissues, glands, and cells. The antibody attack is usually accompanied by inflammation.


What are the statistics on autoimmune disease?

According to the American Autoimmune Related Diseases Association (AARDA), more than 50 million people in the United States suffer from more than 100 conditions categorized as autoimmune. Some of the more common autoimmune diseases include thyroid conditions such as Hashimoto’s thyroiditis and Graves’ disease, multiple sclerosis, psoriasis, rheumatoid arthritis, alopecia, type 1 (juvenile) diabetes, pernicious anemia, scleroderma, Sjögren’s syndrome, and systemic lupus erythematosus (SLE).


What are the demographic risk factors for autoimmune disease?

There are a number of factors that increase your risk of developing an autoimmune disease. They include:

  • Gender: Being a woman increases your risk of most autoimmune diseases, and 75 percent of those affected are women.
  • Hormonal change or recent pregnancy: Periods of hormonal shift appear to be a trigger for the onset of autoimmune disease.
  • Race or ethnicity: Some groups are more at risk of certain autoimmune diseases. For example, lupus is more common in African-Americans and Hispanics.


What are the other risk factors for autoimmune disease?

There are other factors that increase your risk of developing an autoimmune disease:

  • Having a family history of autoimmune disease
  • Growing up in a developed country, which have a much higher incidence of autoimmune disease.
  • Infections: For example, the Epstein-Barr virus (mononucleosis), increases your risk of developing autoimmune disease.
  • Toxic exposures to certain solvents and chemicals in water, air, and food, which can raise the risk of some autoimmune diseases.


What are the symptoms of autoimmune disease?

The symptoms vary depending on the organs, glands, or body system being attacked. For example, when Hashimoto’s antibodies attack your thyroid, you may be tired and gain weight as your thyroid slows down. Rheumatoid arthritis attacks the joints, causing pain, swelling, stiffness, and disfigurement of your joints. Multiple sclerosis can cause balance problems. Alopecia results in hair loss. Common to most autoimmune diseases, however, is inflammation, which can cause swelling and pain.


Why do you develop an autoimmune disease?

The cause of many autoimmune diseases is not understood. What is known is that there appears to be a genetic and hereditary tendency, but other factors such as toxic exposures, hormonal changes, smoking, vitamin D deficiency, pregnancy, exposure to viruses and bacteria, physical stress, and mental/emotional stress are considered trigger factors that may precede the onset of full-blown autoimmunity.


How are autoimmune diseases diagnosed?

Diagnosis of an autoimmune disease usually requires a medical history, clinical examination, and tests. The most common tests look for antibodies and inflammation and include Antinuclear Antibody Test (AN), C-Reactive Protein (CRP), and Erythrocyte Sedimentation Rate (ESR). Other tests focus on the affected body system. For example, if Hashimoto’s disease is suspected, thyroid peroxidase (TPO) antibodies are tested, as well as thyroid hormone levels, such as thyroid stimulating hormone (TSH).


What types of doctors diagnose and treat autoimmune disease?

Diagnosis can be made by different types of doctors. Rheumatologists specialize in diagnosing and treating a number of autoimmune diseases, including rheumatoid arthritis and lupus. Organ, gland, or disease-specific specialists are sometimes involved in autoimmune disease diagnosis and treatment, such as:

  • Endocrinologists: type 1 diabetes, Hashimoto’s, Graves’
  • Dermatologist: vitiligo, alopecia
  • Neurologist: multiple sclerosis


How are autoimmune diseases treated?

Ultimately, the treatment of an autoimmune disease depends on the disease. Some of the treatments used for autoimmune disease include corticosteroid treatment and other anti-inflammatory therapies, and immunosuppressive drugs.

When glands have been affected, treatments include replacement of missing hormones, such as use of insulin in type 1 diabetes, and thyroid hormone replacement for people with hypothyroidism as a result of Hashimoto’s thyroiditis.


Where can you learn more about autoimmune diseases?

One of the best sources of information about autoimmune disease is the American Association of Autoimmune Related Diseases. They have a website at https://www.aarda.org and their toll-free information line can be reached at (800) 598-4668. Another excellent resource the National Institutes of Health (NIH) Information Clearinghouse for Autoimmune Disease website. You can also find out about the latest government-sponsored clinical trials regarding autoimmune disease at ClinicalTrials.gov.