“What’s wrong with me?” you wonder. “Why can’t anyone find out what’s going on?” You’ve been to multiple doctors and still no answers. Maybe you’ve been told it’s “all in your head”, but maybe you are suffering from one or more of over eighty Autoimmune Disorders (AD’s), which can be difficult to diagnose or even be misdiagnosed. What is an autoimmune disorder? Simply put, autoimmune disorders are those in which the body’s normally protective immune system decides to attack itself, setting the stage for a potential myriad of problems. Perhaps you never heard of autoimmune diseases, or maybe you did but didn’t know what they were. Maybe you sort of knew what they were but didn’t think you knew anyone with one. Consider Type I Diabetes, Rheumatoid Arthritis, Systemic Lupus Erythematosus (SLE), Guillian Barre Syndrome, Grave’s Disease, Multiple Sclerosis (MS) or Psoriasis. These are only a few of the conditions where the body has it out for itself.
What does that mean? In a normal immune system, when harmful pathogens (disease-causing microorganisms) enter the body, such as through the respiratory system or skin, the body sends specialized cells to seek and destroy the invader. Medications may be necessary to completely rid your body of the germ, but your immune system is hard at work at the same time to keep you safe from disease. Sometimes, however, the signals in your body that are designed to detect an enemy go a little haywire. In cases of allergies, the body interprets things like pollens, molds, dust, and animals, substances that a normal immune system merely yawns at, as dangerous, and sets out to destroy them. It releases chemicals such as histamine to eradicate the threat, thus setting off a cascade of responses known as an allergic reaction.
In the case of an AD, it is not an external invader your body is battling; it’s your body itself. For reasons not yet fully understood, your body decides to attack one of its own organs or systems. It releases specialized defense cells that can attack body tissues directly, or result in the production of antibodies (special proteins produced by the body’s immune system to protect itself) to do the work. But regardless of the mechanism of action, the end result is the same: inflammation, the hallmark of AD’s. The inflammatory response created can manifest as symptoms such as redness, warmth, swelling, pain, fever, fatigue, or malaise. AD’s can occur anywhere in your body and the types of symptoms you experience will depend on which organ is being attacked. They are characterized by flare ups and remissions, which can add to the difficulty in diagnosing. It is worthy to note that an AD is not the same as AIDS (Acquired Immune Deficiency Syndrome). Whereas AIDS is caused by a contagious and potentially deadly virus, AD’s are not contagious. They are caused by a malfunction within your own body and not by a germ.
According the National Institute of Health, autoimmune disorders affect more than 23.5 million Americans and are a leading cause of death and disability in the United States. (http://www.aarda.org/autoimmune-information/autoimmune-statistics/) There are no known causes, but there are certain risk factors that can predispose people to developing them. They can run in families and tend to affect more women, particularly in their childbearing years, than men. Ethnicity appears to play a part, as in the case of Type I Diabetes, which is more prevalent in Caucasians than other groups. This is in contrast to Type II Diabetes, not classified as autoimmune, which is more prevalent in the African American and Hispanic populations. These latter groups, however, are more likely to have SLE than Caucasians. Environmental triggers such as infections, chemicals, stress, sunlight, medications, and even hormones can put people at risk for AD’s.
Diagnosing these diseases can be challenging, as presenting symptoms can be vague and often mimic other diseases. The most important diagnostic tool is a comprehensive personal and family medical history and history of symptoms. Lab studies are aimed at determining the presence of inflammation or antibodies in the blood and can support data gained through the history and physical exam, but they are not always conclusive. Common studies that test for inflammation include a Complete Blood Count (CBC), Erythrocyte Sedimentation Rate (ESR, or “Sed Rate”), and C Reactive Protein (CRP). In addition to inflammatory markers, an ANA blood test can determine the presence of Antinuclear Antibodies, proteins your body produces to fight against the perceived internal danger. X-rays and other imaging studies can be helpful as well.
There is no cure for autoimmune disorders, but they can be treated. Treatment is directed at reducing inflammation and targets symptoms specific to the area of the body affected. Non-steroidal anti-inflammatory drugs (NSAIDS), corticosteroids, and in more severe cases, immunosuppressive drugs, can be prescribed to alleviate pain and inflammation. Many of these drugs can have serious side effects, however, particularly with long term use, and must be monitored carefully. Avoidance of known triggers is important in avoiding flare ups. Maintaining a healthy lifestyle can help us to prevent any illness, and AD’s are no exception. Getting enough rest, exercise, and reducing stress in your life are all measures to take to help minimize problems. There has been much interest recently in the “Anti-Inflammatory Diet” f or autoimmune diseases. Inflammation in the body has been shown to be a factor in many diseases, including cardiovascular problems. It is similar to the Mediterranean Diet, but basically, is just plain well balanced eating. I encourage you to check other resources to learn more.
Ongoing research and clinical trials continue in an effort to demystify and, hopefully, find cures for, Autoimmune Disorders. Until then, they can be treated to make your life more manageable.