Autoimmune Diseases: What To Do When The Body Attacks Itself?

Your body is as strong as its immune system, just like a country is as strong as its defence prowess. When your body’s immunity goes berserk, the cells meant to protect your body attack it instead. This is when autoimmune diseases are caused.

Did you know that there are over 80 known autoimmune diseases [1]? Interestingly more women are affected by them than men [2]. So what are autoimmune disorders and why does the body’s own immune system attack itself? Read on for all the information.

Highlights:

• What Is An Autoimmune Disease?
• How Does Autoimmune Disease Affect The Body?
• Signs Of A Weak Immune System
• Some Common Autoimmune Diseases
• Treatments For Autoimmune Diseases
• Foods To Avoid In Case Of Autoimmune Diseases
• Why Do You Have Multiple Autoimmune Diseases?
• When Do You Need To See A Doctor?
• Diagnostic Tests For Autoimmune Diseases

What Is An Autoimmune Disease?

The immune system is your body’s defense mechanism. It protects you from invading germs like bacteria, viruses, fungi, etc. Normally, the immune system recognizes your body’s own cells, tissues and organs (‘self’ antigen). It can differentiate them from the invading or foreign cells, proteins or nucleic acids (‘non-self’ antigen).

Autoimmune diseases occur when your immune system fails to differentiate between ‘self’ and ‘non-self’ antigen. It produces auto-antibodies that attack your own cells, tissues or organs. This not only reduces the body’s capability to defend itself from invading germs, it also weakens the system through self-destruction.

Also it is worth noting that the immune system has a regulatory component (eg. regulatory T-cells) that controls and stops the immune activation once the infection is over. Dysfunctioning of the regulatory component leads to overactivity of the immune system. This overactivity of the immune system can also lead to autoimmune disorders.

How Does Autoimmune Disease Affect The Body?

Autoimmune disorders affect the body in many ways. These effects can be localised or systemic. While localised disorders affect a specific organ or tissue, systemic autoimmune disorders affect multiple organs at the same time.

The most common symptoms of autoimmune disease include fever, rashes, joint pain and inflammation. Gastrointestinal disorders and swollen glands [3] may also be seen. These symptoms can suddenly become very severe, causing a ‘flare-up’. The period between flare-ups, when symptoms are not present, is known as remission.

Signs Of A Weak Immune System

While an overactive immune system leads to autoimmune diseases, in some cases, the immune system may not be weak. Its inability to maintain optimum functioning may then trigger an autoimmune response.

A few symptoms of a weakened immune system are:

• Recurring infections
• Frequent fever and cold
• Constant fatigue
• Abdominal pain and abnormal bowel movements
• Slow healing of wounds
• Skin and hair problems
• Blood disorders
• High levels of stress
• Slow growth and development in children [4]

Some Common Autoimmune Diseases

While the exact reasons of autoimmunity are unknown, the genetic makeup or environmental factors may predispose an individual to these disorders. Some common autoimmune disorders which primarily affect particular organs include: [5]

Many autoimmune disorders may affect multiple organs as they progress. Few examples of systemic autoimmune disorders include: [6] 

• Systemic Lupus Erythematosus (SLE)
• Systemic sclerosis

Treatments For Autoimmune Diseases

Autoimmune diseases present a broad range of symptoms. These vary depending on a particular disorder and also on how far the disease has progressed. Treatment strategies for these disorders can be broadly categorised into the following: [7]

1. Symptomatic Therapy

This aims at reducing the symptoms, especially during flare-ups. For example medication can be used to bring down inflammation, pain, swelling, fever, or rashes. For extreme cases, surgery might be performed.

2. Replacement Therapy

When disorders affect vital systems of the body, like the blood or hormones, replacement therapies are suggested. For example, insulin has to be given to people suffering from type I diabetes, or blood transfusions for hemolytic anemia.

3. Immunosuppression or Immune-Modulation

Since autoimmune disorders are caused by an overactive immune system, drugs can be used to control (immunomodulators) or reduce (immunosuppressants) the immune response of the body.

For example, corticosteroids may be given to control inflammation. Similarly, drugs that block B-cells, T-cells or TNF (tumor necrosis factor) may be given to patients afflicted by psoriasis or autoimmune arthritis.

However, it may be potentially dangerous to use immunomodulating or immunosuppressive drugs over a long period of time, as it can make the patient vulnerable to life threatening infections.

Additionally, a healthy lifestyle with a balanced diet, enough sleep and mild exercise (if possible) can boost your immune system. This can also help reduce the frequency of flare-ups. In certain cases, possible identification of particular triggers (such as food, certain chemicals, or anxiety) and avoiding those may help in keeping the autoimmune disease under control.

Foods To Avoid In Case Of Autoimmune Diseases

The digestive system with its resident microbiota (friendly bacteria and other microorganisms) plays an important role in the immune function of the body. [8] Avoiding certain foods can help reduce inflammatory responses in several autoimmune disorders.

Since the triggers and symptoms of autoimmune disorders vary from person to person, following the AIP (Autoimmune protocol) diet can help identify the particular food items to be avoided. [9] This involves two phases:

1. Elimination Phase

First, certain food items are taken out of the diet completely for up to several weeks as recommended by the dietician. Foods commonly known to trigger inflammation, are usually removed.

Some of these foods include:

• Dairy products
• Nuts and seeds
• Grains such as wheat, barley, oats, etc.
• Legumes
• Eggs
• Meat substitutes such as soy, tofu, etc.
• Vegetables like brinjal, tomatoes, peppers, etc.
• Processed and packaged foods
• Foods with high sugar content
• Coffee
• Alcohol

2. Reintroduction Phase

If the elimination phase results in significant improvement of symptoms, the reintroduction phase is initiated.  Here, you try out one food at a time and note how you feel. Foods that are high in nutrition and have lower chances of causing inflammation are preferred. If reintroduction of a particular food increases discomfort, you eliminate it altogether from your diet. If not, you can continue having this food as a part of your diet.

It is very important to consult a healthcare professional before starting an AIP diet to avoid any serious side effects.

Foods You Can Try If You Have Certain Autoimmune Disorders

Low-FODMAP foods may help reduce gastrointestinal problems in certain autoimmune disorders such as IBS. FODMAPs (Fermentable Oligosaccharides Disaccharides Monosaccharides and polyols) can lead to symptoms such as abdominal pain, bloating, gas, diarrhea,etc.

Low-FODMAP foods can include fresh fruits, vegetables, non-dairy milk and milk products, pulses, rice, quinoa, fish, etc. But you should introduce only one low-FODMAP food at a time and discontinue immediately in case of adverse reactions. Also, do not forget to discuss with your dietician before introducing any changes in your diet.

Why Do You Have Multiple Autoimmune Diseases?

It is not uncommon for a person to develop more than one autoimmune disorder. Polyautoimmunity or the presence of multiple autoimmune diseases in a single individual, has been commonly seen in AITD (autoimmune thyroid disorder), Sjögren’s syndrome, etc. [10]

Many reasons, both internal or external, can be responsible for polyautoimmunity. A few are:

1. Genetics And Heredity

The genes we inherit from our parents play a major role in how our immune system develops and functions. It may also influence our chances of developing multiple autoimmune disorders.

2. Gender And Age

It has been commonly observed that women, particularly of childbearing age, are more susceptible to autoimmune disorders. The exact reason for this is not yet known, but the high hormonal levels might be a contributing factor.

3. Previous Infections

The immune system mounts an immune response during infections and diseases. Prolonged inflammation due to uncontrolled immune response can result in autoimmunity, which attacks healthy body tissues. For example, children with streptococcal throat infection might subsequently develop arthritis in the joints. [11]

4. Body-weight and lifestyle

Excessive body weight or obesity can be a contributing factor for autoimmune disorders. Dysfunction of the adipose tissues leads to abnormal secretion of cytokines which may lead to low chronic inflammation. Lack of exercise, high consumption of junk food, smoking, insufficient sleep, constant stress can all lead to flare-ups or episodes of autoimmunity.

5. Environmental factors

Besides the genetic makeup of an individual, the environmental factors also affect the triggering of autoimmune reactions. The famous ‘hygiene hypothesis’ proposed that if children are less exposed to pathogens in their early childhood, their immune system is not developed properly and they are more susceptible to allergic reactions.

Also the presence of pollen, other pollutants in the environment can trigger autoimmune disorders like asthmatic or psoriatic reactions. Chemicals like fertilisers and hormones introduced to farmed plants and animals that we consume, can also be a contributing factor to autoimmune diseases.

When Do You Need To See A Doctor?

Consult a doctor if you have symptoms such as recurring fever, excessive pain, swelling, or constant fatigue. Since autoimmune diseases can affect various organs, your doctor will guide you to specialists, depending on your condition.

Some specialists who can help you fight autoimmunity are: [12]

Dermatologist

for skin diseases such as psoriasis

Gastroenterologist

for disorders of the digestive system, for eg. IBD, Celiac disease

Endocrinologist

for hormonal disorders like Hashimoto’s syndrome

Rheumatologist

for diseases of the joints like Rheumatoid arthritis

Neurologist

for disorders of the nervous system like Multiple Sclerosis

Nephrologist

for diseases affecting the kidneys.

Nutritionists

can advise a suitable diet, what foods to include and which foods to avoid to alleviate the symptoms. 

Diagnostic Tests For Autoimmune Diseases

Detecting autoimmune disorders isn’t easy, and diagnosing them can be complicated and time consuming. The healthcare professionals take into consideration the physical symptoms and may also prescribe laboratory tests.

Some diagnostic tests commonly used to detect autoimmunity are as follows: [13]

Antinuclear Antibodies Test (ANA)

This is aimed at detecting the auto-antibodies produced by the immune system. A positive ANA might indicate the presence of an autoimmune disorder, but it cannot detect the specific one.

Rheumatoid Factor (RF)

This detects abnormal proteins attacking healthy joints and other cells. This test may indicate the presence of autoimmune arthritis.

Total Blood Count

It detects abnormally high WBCs, which may indicate immune overactivity.

C-Reactive Protein (CRP)

High levels of this protein produced in the liver may indicate inflammation, which is common in autoimmune disorders.

Complement Level

An abnormally low level of this protein is an indicator of autoimmune diseases.

Wrapping Up

Autoimmune disorders are a complex set of conditions that may affect different parts of the body. Although there are no specific cures for these diseases, medication and avoidance of triggers can help reduce incidences of flare-ups. A healthy lifestyle and reduction of stress can go a long way in managing autoimmune conditions, and having a functional and enjoyable life.

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