An autoimmune disease is a condition that occurs when the immune system attacks the body’s own healthy tissues. The body’s immune system normally makes proteins called antibodies that protect the body from viruses, bacteria and other foreign materials. However, in some people with an autoimmune disease, their immune systems mistake their own tissues and helpful cells for harmful substances. This causes inflammation and damage to healthy cells in the body.
Types of Autoimmune Diseases
There are more than 70 different types of autoimmune diseases. (Read the complete list here) The scientific world is still learning more about many of them. Some of the common autoimmune disorders are Hashimoto’s thyroiditis, Graves, Type 1 diabetes, Rheumatoid Arthritis, SLE/Lupus, Crohn’s disease, Ulcerative Colitis, Multiple Sclerosis and Addison’s disease.
Each of these affects a different part of the body and has different effects on the body. Some of them are not dangerous to life, while a few others can be extremely dangerous if not received appropriate medical care (eg- Lupus)
Type 1 Diabetes Mellitus (T1DM)
Diabetes is a condition in which the body is unable to manage the blood glucose level. This happens either because the body is not responding to the hormone that does this job (i.e insulin resistance), or because the body is not producing enough amount of that hormone (insulin). The former is Type 2 diabetes which occurs primarily due to insulin resistance from poor lifestyle habits, and the latter is Type 1 diabetes, which occurs due to autoimmune factors.
In type 1 diabetes, the body’s immune system attack the beta cells of the pancreas that are responsible to produce the hormone insulin causing low insulin secretion, and leading to elevated serum glucose (blood sugar) levels. T1DM commonly occur at a young age, 10 – 15 years and is hence also called juvenile diabetes. Fasting Blood sugar (FBS), Postprandial sugar and Hba1c (glycosylated haemoglobin) tests are used to measure the presence of blood glucose and the extent of diabetes. Blood tests measuring C-peptide, IAA, ICA and GAD antibody levels are usually done to detect T1DM. Weight management, exercise and lifestyle changes and insulin injections are very important to manage T1DM and keep blood glucose in control. Elevated blood glucose over the long term is highly dangerous and can cause multiple and serious organ damage such as kidney damage and nerve damage.
Also Read: Type 1 Vs Type 2 Diabetes
This is an increasingly common autoimmune disease where the thyroid glands are impacted. It occurs when the immune system attacks an enzyme called thyroperoxidase, which helps in the production of the thyroid hormones T3 & T4. The result is low levels of thyroid hormone leading to an underactive thyroid gland (hypothyroidism), fatigue and weight gain, among other symptoms. The presence of thyroid antibodies called Anti-TPO in the blood is measured to detect this condition along with the thyroid hormone levels & TSH levels.
Your endocrinologist might ask you to keep an eye on the anti-body levels and also may suggest thyroid hormone replacement therapies such as levothyroxine, thyronorm etc.
Also READ: Hypothyroidism Diet
Graves disease is yet another autoimmune disease that impacts the thyroid gland. In Graves disease, the thyroid gland becomes overactive and produces excess thyroid hormones leading to hyperthyroidism. Palpitation, sweating, sudden weight loss, hair loss, insomnia etc are the common symptoms of this condition. The presence of TSI (thyroid-stimulating antibodies) and TBII (thyrotropin binding inhibitory immunoglobulins) is checked to detect this condition, along with the T3, T4 & TSH levels.
Autoimmune Addison’s disease is a condition that impacts the adrenal glands, located above the kidney. This impacts the production of hormones – cortisol and aldosterone by the adrenal glands. Cortisol is produced by the adrenal glands in response to stress and is important for the proper functioning of our immune system, heart and also maintaining stable blood glucose and blood pressure levels. Aldosterone, on the other hand, is a hormone that plays a very important role in maintaining the sodium-potassium balance in the body and thus maintaining the blood pressure, blood volume, kidney function etc. Extreme fatigue, muscle pain, low blood pressure, abdominal pain, nausea, irregular menstrual cycle (for women), salt-craving and hyperpigmentation are some of the common symptoms of Addison’s disease. Addison disease is often diagnosed unexpectedly; it is characterised by low cortisol and low sodium + high potassium levels due to aldosterone deficiency
Since this condition is characterised by insufficient production of such adrenal hormones, Addison’s disease is also known as primary adrenal insufficiency. Addison’s diseases often need close monitoring and follow-ups with the endocrinologist and physicians. This is treated by replacing the hormones cortisol & aldosterone, with their synthetic variants (hydrocortisone & fludrocortisone)
Rheumatoid Arthritis (RA)
Rheumatoid arthritis is an autoimmune disorder that is characterised by inflammation in the joints (synovial joints). This mostly impacts the joints of the knee, hands, fingers etc and causes swelling, and tenderness and even deformity over time. The immune system attacks the soft tissues and cartilages around the joints, and eventually even corrodes the bones. Most often there will be periods of flares, and then a brief period of remission.
Your doctor might ask you to check for Inflammatory markers such as ESR, and CRP. Other parameters such as the presence of Anti-CCP (Anti Cyclic Citrullinated Peptides), Rheumatoid Factor, along with an in-person examination may be needed to diagnose Rheumatoid Arthritis. In some cases, a person can still have RA, without turning positive for the RF factor. This is known as seronegative Rheumatoid Arthritis and is difficult to diagnose.
Rheumatoid arthritis is different from Osteoarthritis (OA). First and foremost, RA is autoimmune, while OA is not! OA occurs due to excessive wear & tear and is hence mostly seen asymmetrically – ie. only one knee or only one elbow that has been overexerted, whereas RA mostly occurs symmetrically – i.e on both sides of the body
Also READ: Arthritis – Causes & Treatment
Sjögren’s syndrome is an autoimmune disease where the immune cells attack the salivary and tear glands. This leads to reduced moisture leading to dry eyes and dry mouth. This disease can occur also as a result of other severe autoimmune diseases such as Lupus and Rheumatoid arthritis which is known as secondary sjögren’s syndrome. Dry and itchy skin, tooth decay, dry mouth, dry eyes, blurred vision, vaginal dryness, joint pain etc are some of the common symptoms.
Sjögren’s syndrome is diagnosed through a series of blood tests (ANA, Anti- SSA, Anti – SSB, RA Factor), eye tests, and imaging tests such as sialometry to measure the saliva flow.
Inflammatory Bowel Diseases (Crohn’s & Ulcerative Colitis)
Crohn’s disease and Ulcerative Colitis (UC) are two types of autoimmune diseases that impact the gastrointestinal tract and are characterised by severe abdominal pain, diarrhea, indigestion, weight loss and blood in the stool. Crohn’s disease is the inflammation of any part of the GI tract which starts from the mouth and ends at the anus. The small intestine and large intestine are most affected by Crohn’s. Ulcerative Colitis on the other hand impacts the large intestine (colon) and the rectum.
Both Crohn’s and Ulcerative colitis are treated with steroids (cortisone, prednisone) and immunosuppressants. Eating a healthy diet that is low in fat and avoiding alcohol or smoking are important to manage both UC and Crohn’s disease.
Celiac disease is yet another condition that occurs due to an excessive immune reaction in response to gluten intake. Gluten is a type of protein found in certain grains such as wheat, barley and rye, that gives a sticky and glue-like consistency when mixed with water. The excessive immune response launched by the body against gluten damages the fine hair-like structures on the lining of the small intestine called ‘Villi’ which plays an important role in digestion & absorption of nutrients. Celiac disease can sometimes cause a life-threatening immune response to gluten; those with such a condition are required to completely avoid gluten!
Also READ: Gluten-Free Diet
SLE / Lupus
Systemic Lupus Erythematosus (SLE) or just Lupus is a life-threatening autoimmune condition that can impact a series of tissues, organs and systems and is most commonly seen among women. Those with SLE are very sensitive to sun exposure and get rashes and flair with sunlight. The butterfly-shaped rash (Malar rash) is the common feature of SLE.
SLE can impact many areas of the body including the skin, joints, heart, lungs, kidneys etc and hence requires the help and treatment of a rheumatology/immunology medical expert. Those with SLE are required to reduce sun exposure, always cover the face, hands, feet, etc with a scarf, long sleeves and trousers. A sunscreen cream, as prescribed by a dermatologist also is suggested. Lupus is treated based on the severity of the disease, age and associated complications. Like in many other autoimmune diseases, doctors resort to immunomodulators, steroid medications etc to manage the symptoms and treat this disease. In advanced cases of this disease, the doctors may prescribe drugs like rituximab, and chemotherapy drugs such as cyclophosphamide and methotrexate.
Other Autoimmune Diseases
- Psoriasis – Psoriasis is a skin condition that causes inflammation, itching and redness. Over time, the inflamed area becomes thick and scaly.
- Psoriatic Arthritis – In some people, along with psoriasis, the joints also get impacted. Those with psoriasis are more prone to Psoriatic arthritis
- Guillain Barre – This is an autoimmune condition where the immune system attacks the peripheral nerves – especially those of feet, hands etc. As nerves get impacted, the body loses the ability to control muscles, leading to muscle weakness, tingling and burning sensation. Your doctor may ask for a series of tests, including nerve conduction studies to detect Guillain barre syndrome
- Multiple Sclerosis (MS) – MS is also a condition that impacts the nervous system, but the nerves of the brain and spinal cord. Myelin sheath, the protective cover of the nerves is impacted and this impacts our body’s ability to send nerve signals impacting coordination
- Myasthenia Gravis (MG) – MG impacts the communication junction between the muscles and nerves leading to muscle weakness, fatigue and even inability to use certain muscles. In MG, the immune system destroys the receptor sites of muscles (acetylcholine receptor) causing the signals from nerves to not reach the muscles
- Ankylosing Spondylitis (AS) – AS is an inflammatory condition that mostly impacts the bones of the spine, leading to the fusing of the vertebral bones severely impacting the flexibility and mobility
- IgA Nephropathy – Also called Berger’s disease, is a condition where the immunoglobin-A builds up in the kidney and impairs its function.
Cause of Autoimmune Disease
The cause of the autoimmune disease is not fully known to modern science. Although there are many factors that can contribute to the development of an autoimmune disorder, it’s important to note that genetic factors play a role in many cases. In fact, if you have one or more family members with an autoimmune condition, your risk for developing one yourself increases significantly.
However, many people who experience symptoms themselves don’t have any family history of autoimmune disorders —and vice versa! This means, there’s still plenty we don’t know yet about why they arise in some people while leaving others unaffected by them. It is believed that external factors such as severe infection, unhealthy lifestyle habits, smoking, exposure to toxins etc may cause this gene to express, leading to such autoimmune conditions. Women are more prone to autoimmune diseases as compared to men – atributed to the additional X chromosome.
Autoimmune inflammation is different from hypersensitivity. Hypersensitivity refers to a heightened response by the immune system to allergens (substances that are not harmful in themselves but can cause an allergic reaction). It is sometimes also known as an ‘allergic response’ or being ‘allergic’. The more stressed you are, the more likely you will be allergic, get sick, and have problems healing from injuries.
Stress also impacts your brain by affecting how well it releases chemicals that regulate moods and feelings of happiness or sadness. The majority of science on how stress affects our bodies has been conducted in animals but there is enough evidence to say that chronic stress alters our immune system and contributes to many health issues including allergies, cardiovascular diseases and autoimmune diseases. Chronic stress also increases inflammation throughout the body which can contribute to heart disease and even cancer.
Medications & Treatment for Autoimmune Diseases
Autoimmune diseases have to be diagnosed and treated by a qualified doctor. The tests involved for detect each condition may vary and requires an expert to analyse and prescribe a future course of treatment. The most common medications used to treat these diseases include corticosteroids such as prednisone and hydrocortisone; anti-inflammatory drugs such as ibuprofen or naproxen sodium; immunosuppressants like methotrexate which work by reducing immune system activity. Your doctor will choose the method and course of treatment and medication weighing in several factors, viz. – age, gender, the severity of the condition, associated illness, other ailments and comorbidities, overall health and the side effects of treatment, if any.
A few autoimmune conditions may need the combined expertise of a panel of doctors including rheumatologists, immunologists, dermatologists, nephrologists etc. It is advisable to be regular with routine checkups and follow-ups to make necessary changes (increase or decrease) in medications depending on the flares and severity of inflammation.
It is EXTREMELY important not to self-medicate or regulate/reduce/change the medications or its dosage without the advice of a qualified doctor.
Lifestyle Changes to manage Autoimmune Diseases
Reversing autoimmune diseases is a very controversial topic, and the evidence is non-conclusive. However, there is no denying that a balanced diet and structured exercises will make a ton of a difference in reducing inflammation & pain, and reducing the chances of other complications, apart from improving the quality of life significantly.
A balanced diet rich in antioxidants are particularly important, as antioxidants can help in reducing inflammation. Avoid smoking, and reduce the consumption of caffeine, junk and processed food that are pro-inflammatory. Omega 3 fatty acids are yet another compound with anti-inflammatory characteristics.
Giving yourself adequate sleep is very important! Inadequate sleep or rest can distort the immune function and exacerbate the existing condition. Exercises involving yoga, and meditation are very useful to manage stress, along with resistance training. However, the extent, type and intensity of exercises need to be structured for each individual based on their specific conditions. For example – certain exercises in yoga may not be a great idea for a person suffering from conditions like Ankylosing Spondylitis.
In conclusion, autoimmune diseases can be managed without impacting the quality of life. It only requires a concerted approach that involves your doctor’s advice and making the right lifestyle choices. Your lifestyle choices will hugely impact how your immune system responds, and your overall health.