Featured Expert:
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Ana-Maria Orbai, M.D., M.H.S.
Between taking care of yourself and family members and trying to manage a social life and career, it’s common for women to feel tired and achy. But are these symptoms of a stressful life, or could they be tied to an underlying condition like autoimmune disease?
Ana-Maria Orbai, M.D., M.H.S., is a rheumatologist at the Johns Hopkins Arthritis Center. Rheumatologists specialize in diagnosing and treating musculoskeletal diseases and autoimmune conditions (rheumatic disease). Orbai talks about how to recognize common autoimmune disease symptoms and when you should see a doctor.
Autoimmune disease happens when the body’s natural defense system can’t tell the difference between your own cells and foreign cells, causing the body to mistakenly attack normal cells. There are more than 80 types of autoimmune diseases that affect a wide range of body parts.
Common autoimmune diseases in women include:
- Rheumatoid arthritis, a form of arthritis that attacks the joints
- Psoriasis, a condition marked by thick, scaly patches of skin
- Psoriatic arthritis, a type of arthritis affecting some people with psoriasis
- Lupus, a disease that damages areas of the body that include joints, skin and organs
- Thyroid diseases, including Graves’ disease, where the body makes too much thyroid hormone (hyperthyroidism), and Hashimoto’s thyroiditis, where it doesn’t make enough (hypothyroidism) of the hormone
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Type 1 diabetes, a condition in which the immune system damages the insulin-producing cells in the pancreas
Symptoms of autoimmune disease may be severe in some people and mild in others. “There are different degrees of autoimmune disease,” says Orbai. “The symptoms a person gets likely relate to multiple factors that include genetics, environment and personal health.”
Common Autoimmune Disease Symptoms
Despite the varying types of autoimmune disease, many of them share similar symptoms. Common symptoms of autoimmune disease include:
- Fatigue
- Joint pain and swelling
- Skin problems
- Abdominal pain or digestive issues
- Recurring fever
- Swollen glands
Many women say it’s hard to get diagnosed, something that Orbai agrees with. “It’s not black or white,” she says. “There’s usually no single test to diagnose autoimmune disease. You have to have certain symptoms combined with specific blood markers and in some cases, even a tissue biopsy. It’s not just one factor.”
Diagnosis can also be difficult because these symptoms can come from other common conditions. Orbai says women should seek treatment when they notice new symptoms.
“If you’ve been healthy and suddenly you feel fatigue or joint stiffness, don’t downplay that,” she says. “Telling your doctor helps him or her to look closer at your symptoms and run tests to either identify or rule out autoimmune disease.”
Autoimmune disease affects 23.5 million Americans, and nearly 80 percent of those are women. If you're one of the millions of women affected by this group of diseases, which includes lupus, rheumatoid arthritis and thyroid disease, you may be wondering why your immune system is attacking itself.
Researchers don’t know what causes autoimmune disease, but several theories point to an overactive immune system attacking the body after an infection or injury. We do know that certain risk factors increase the chances of developing autoimmune disorders, including:
- Genetics: Certain disorders such as lupus and multiple sclerosis (MS) tend to run in families. “Having a relative with autoimmune disease increases your risk, but it doesn’t mean you will develop a disease for certain,” says Orbai.
- Weight: Being overweight or obese raises your risk of developing rheumatoid arthritis or psoriatic arthritis. This could be because more weight puts greater stress on the joints or because fat tissue makes substances that encourage inflammation.
- Smoking: Research has linked smoking to a number of autoimmune diseases, including lupus, rheumatoid arthritis, hyperthyroidism and MS.
- Certain medications: “Certain blood pressure medications or antibiotics can trigger drug-induced lupus, which is often a more benign form of lupus,” Orbai says. “Our myositis center also discovered that specific medications used to lower cholesterol, called statins, can trigger statin-induced myopathy.” Myopathy is a rare autoimmune disease that causes muscle weakness. Before starting or stopping any medications, however, make sure to talk to your doctor.
Virtually every major medical breakthrough in the past half-century has been achieved because a biomedical scientist unraveled one more mystery of biology. The discoveries of Johns Hopkins scientists have led to vaccine, treatment and diagnostic breakthroughs. The Johns Hopkins Institute for Basic Biomedical Sciences continues the legacy by leading research into the causes and treatments of numerous biomedical conditions.
Having lupus, rheumatoid arthritis or psoriatic arthritis raises your risk for heart disease. While taking steps to reduce heart disease is always a good idea, it is even more essential if you have one of these conditions. Talk to your doctor about what you can do to keep your heart healthy and strong. For example, keeping your blood pressure and cholesterol levels within healthy ranges, eating a nutritious diet and exercising regularly can be lifesaving.
These steps can also help reduce the symptoms of autoimmune disease. In serious cases, global immune suppressing drugs are used to restrain the body’s immune response, preventing it from doing further harm. Unfortunately, immunosuppressants render people more susceptible to infections.
Orbai admits that making time for healthy living can be hard, given women’s fast-paced lives, but she insists that finding the balance is key to living with autoimmune disease.
“It’s something that’s going to involve commitment, and sometimes it’s going to be tough,” she says. “But learning to listen to your body and being smart about what triggers your disease is important. It’s something you do for yourself.”
One of the best things you can do to protect and improve your health is to stay informed. Your Health is a FREE e-newsletter that serves as your smart, simple connection to the world-class expertise of Johns Hopkins.
Autoimmune diseases occur when the immune system produces antibodies that attack the body’s own cells. There are many types, including Coeliac disease, lupus and Graves’ disease. Although they can’t be cured, there are various treatment options to manage the symptoms and reduce further damage to your body.
What is the immune system?
The immune system incorporates different parts of the body – including certain blood cells, skin, bone marrow and more – that work to keep you healthy. The immune system protects you from infection by detecting and fighting diseases.
If infectious agents such as bacteria or viruses get into your body, immune cells usually kill or overwhelm them, removing the infection. This is known as the immune response.
Autoimmune disease occurs when, instead of attacking bacteria, viruses or other sources of infection, the immune system attacks healthy organs and tissues.
Causes of autoimmune disease
It's not known why autoimmune diseases develop, although most people who have an autoimmune disease have a genetic predisposition. An environmental factor such as an infection, stress, medication, diet or even ultraviolet radiation then triggers the symptoms of the autoimmune disease.
Types and symptoms of autoimmune disease
There are more than 100 different autoimmune diseases. Most of them are long-term illnesses, with the severity of symptoms changing over time.
Some of the more common autoimmune diseases include:
- Coeliac disease – the immune system reacts to gluten (found in wheat and other grains) and damages the small intestine. Coeliac disease causes flatulence, diarrhoea and abdominal pain.
- Lupus – many parts of the body can be affected, including the skin, muscles, joints, lungs, heart and kidneys.
- Rheumatoid arthritis – bone and cartilage are damaged, causing tender, swollen and stiff joints.
- Graves’ disease – the thyroid gland is overactive, causing anxiety, heart palpitations, weight loss and irritated or bulging eyes.
- Multiple sclerosis – the nervous system is affected, causing muscle weakness and poor coordination, sight problems and, in some cases, cognitive difficulties.
- Type 1 diabetes – the pancreas does not produce enough insulin to manage blood sugar levels. Initial symptoms can include thirst, hunger and frequent urination.
Most people have signs and symptoms of autoimmune disorders for a long time before they seek help. It can also take a long time to diagnose an autoimmune disease because some symptoms, such as tiredness and ‘just not feeling right’, are commonly felt by many adults, while symptoms can come and go. With most conditions, there is no one test that confirms a diagnosis.
If you think you might have an autoimmune disease, use the healthdirect Symptom Checker and see your doctor. They will investigate your symptoms more closely, examine you and ask you about your general health. They might arrange a blood test, x-ray, MRI or biopsy.
Depending on your condition, your doctor might also refer you to a specialist for further investigation or advice on treatment options.
Treatment of autoimmune disease
While there is no cure for autoimmune diseases, help is available. People diagnosed with autoimmune diseases often benefit from:
- a healthy diet
- maintaining a healthy weight
- plenty of sleep
- achieving the right combination of rest and exercise
- reducing stress where possible, and finding ways to deal with unavoidable stress
Specific medicines and lifestyle changes can help. For example, people with type 1 diabetes inject insulin, while those with autoimmune diseases that affect skin receive advice about the sun, bathing, creams and lotions. People with coeliac disease must follow a gluten-free diet.
In some people, autoimmune diseases can be mild, while others will need to invest a lot of time and care in managing their condition. However, most people with autoimmune conditions are able to live a full and enjoyable life.
Where to seek more help
You can find organisations that support people with specific autoimmune diseases at these sites: