5 Things to Know About Autoimmune Disease

In order to understand autoimmune disease, look no further than the word autoimmune itself. The prefix “auto” means “self,” and immune means “resistant.” An autoimmune disease, then, is a condition in which the body becomes resistant to itself. The body’s natural defense systems, which are designed to target outside invaders, instead launch an attack against their own cells. This misdirected assault can cause a myriad of symptoms, from fatigue and rashes to joint pain and excessive inflammation.

Autoimmune diseases come in many types. Since the category of autoimmune disease was first introduced to the medical world in the 1950s, there have been about 80 autoimmune conditions identified. The National Institutes of Health (NIH) estimates that 24 million Americans are affected by autoimmune disease.

Autoimmune diseases tend to be more common in women. The cause of autoimmunity, in general, is unknown, but scientists think genetics, environmental exposures, cigarette smoking, viruses, and nutrition may play a role. Recent research has also shown that stressful life experiences may play a role in triggering autoimmune disease.

Read on for the top five things to know about autoimmune disease.

1. These are the Most Common Autoimmune Diseases

According to the Autoimmune Registry, the following conditions are the top five most common autoimmune diseases in the U.S. population:

• Rheumatoid arthritis (otherwise known as R.A.): A condition which affects the joints, causing inflammation and disfigurement
• Hashimoto’s autoimmune thyroiditis: A condition which causes low thyroid levels
• Celiac disease: A condition in which the small intestine cannot process gluten proteins
• Graves’ Disease: A condition which causes high thyroid levels
• Type 1 juvenile diabetes: A condition in which the body cannot produce insulin

The most common autoimmune disease, rheumatoid arthritis, affects 0.8% of the U.S. population. Other common autoimmune disorders include lupus, psoriasis, multiple sclerosis, ulcerative colitis, and Crohn’s disease. Some inflammatory conditions, such as eczema, are currently thought to be “immune-mediated” but are not considered to be actual autoimmune diseases.

2. Some Autoimmune Diseases Target a Particular Organ

When it comes to autoimmune disease, the body sometimes singles out a particular victim. In the case of Hashimoto’s autoimmune thyroiditis, for example, the immune system attacks the cells of the thyroid, destroying their ability to produce thyroid hormone. This attack triggers the brain to send increased signals to the thyroid to create more hormone (driving up blood levels of “thyroid-stimulating hormone,” or TSH), but these messages are ineffective and cause more inflammation. The thyroid hormone levels in the body remain low, inducing fatigue, weight gain, hair loss, cold sensitivity, constipation, dry skin, and depressed mood.

Similarly, in Type 1 juvenile diabetes, the immune system attacks the cells in the pancreas that are responsible for making insulin. Without insulin, the body is robbed of its ability to take sugar out of the bloodstream and use it for cellular processes; patients with this type of diabetes have to use insulin replacement therapy.

Rather than affecting a single organ, autoimmune disorders can also be systemic. This is true in the case of lupus, also known as systemic lupus erythematosus (SLE). In this condition, inflammatory cells target many organ systems, including the brain, heart, kidneys, skin, eyes, and joints.

3. Autoimmune Diseases Can Be Diagnosed Using These Methods

Often, autoimmune diseases lay dormant for years, slowly smoldering and then finally manifesting in nonspecific ways. Your health care provider may become suspicious that you have an autoimmune disorder if you are complaining of specific vague symptoms that do not seem to be related to an acute infection or other condition.

In many cases, there is not a single way to definitively test for an autoimmune disease; a multitude of factors are used. Many autoimmune diseases have specific criteria that must be met in order to receive an official diagnosis.

If your health care provider suspects you may have an autoimmune disease, he or she will ask questions about your medical history, do a physical exam, and then may order blood tests, such as the following:

• Antinuclear antibody (ANA) panel
• Rheumatoid factor (R.F.)
• ESR or CRP
• Kidney function tests
• Liver function tests
• Complement components (C3 and C4)
• Antibodies to double-stranded DNA
• Anti-citrullinated peptide/protein antibody (CCP)
• Antiphospholipid antibodies
• Lupus anticoagulant test

Your health care provider may also order a chest X-ray or a urine test. Biopsies of certain tissues, such as the kidneys or muscles, may also be helpful in making an autoimmune disease diagnosis.

4. These Therapies Can Be Helpful for Autoimmune Diseases

When it comes to treating autoimmune disease, your particular condition will guide your therapy. However, certain medication classes are beneficial for many autoimmune conditions. Here are a few examples:

• Nonsteroidal anti-inflammatory medications: Known as NSAIDs, these can help with pain and inflammation. Ibuprofen, naproxen, and diclofenac are in this category.
• Steroid medications: These medicines can help shut down the immune response during autoimmune flares. A commonly prescribed steroid is prednisone.
• Hydroxychloroquine: This drug, which is also used to treat malaria, can be helpful in conditions such as lupus and rheumatoid arthritis.
• Immunosuppressive medications: These medications, such as mycophenolate, azathioprine, and cyclophosphamide, can help keep an overly active immune system in check.
• Monoclonal antibodies: These medicines can specifically target problematic cells.

It is important to always check in with your health care provider prior to taking a medication to help with the symptoms of an autoimmune disease as some seemingly benign medications can actually make certain autoimmune conditions worse.

If your health care provider prescribes a medication to help manage or treat an autoimmune disease, make sure to use RxSaver to save up to 80 percent at the pharmacy, as these medicines can be expensive.

5. Many Autoimmune Diseases are Lifelong Conditions

Unfortunately, even with available therapies, many autoimmune diseases are lifelong conditions. Once the thyroid stops producing thyroid hormone or the pancreas stops producing insulin, you will likely need to continue with supplementation of these hormones for life.

The good news is that, with proper treatment, many autoimmune conditions can stay under excellent control without daily symptoms. Some people can go months, or even years, between autoimmune flares. As our technology and therapies continue to advance and evolve, the potential for permanent remission increases.