Autoimmune diseases can be complex and difficult to diagnose, often lacking visible symptoms. Providing insights to this vast and diverse category of diseases is Mary Beth Humphrey, M.D., a rheumatologist with OU Health in Oklahoma City.
“Autoimmune diseases most often occur when the immune system is unable to distinguish healthy cells and tissues (self) from foreign or abnormal tissues (non-self), such as those resulting from infections or cancer,” says Humphrey. “Autoimmunity results from a combination of genetic factors that lead to increased stimulation or decreased ability to turn off the immune system, coupled with environmental triggers, including infections, sex hormones, chemicals or toxins and smoking, among others.”
She says there are many autoimmune diseases, with estimates ranging from 80 to 150, depending on classification criteria. Some target specific organs, like Hashimoto’s thyroiditis, Graves’ disease and Type 1 diabetes. Others are systemic, affecting multiple organs and tissues, such as lupus and scleroderma.
While autoantibodies are detectable in many cases, diagnosis requires clinical symptoms.
“For some diseases, autoantibodies may be found many years before the autoimmune disease causes symptoms,” says Humphrey. “At this time, there are no cures for autoimmune diseases, but most can be managed lifelong with therapies. In the near future, we may achieve cures with advanced cellular therapies, including genetically engineered immune cells that will target the autoreactive cells.
More than eight percent of the United States population has an autoimmune disease. The most common include psoriasis, rheumatoid arthritis, type 1 diabetes, Hashimoto’s thyroiditis and Graves’ disease. Others include multiple sclerosis, myasthenia gravis, Sjogren’s disease, systemic lupus erythematosus and inflammatory bowel diseases.
Some autoimmune diseases are more common in women due to several factors including sex hormones and X chromosome genes, with lupus occurring nine times more often in women than men. However, some conditions like type 1 diabetes and Crohn’s disease are more common in men.
Humphrey explains that early in the course of the disease, symptoms like painful joints, severe fatigue, mouth sores and headaches may come and go, making diagnosis challenging. Patients may feel unwell but lack obvious signs of illness like casts or surgical scars, which could lead others to underestimate their condition.
Humphrey says there are many ways to help manage chronic illnesses, including autoimmune diseases.
“It is very important to find a provider that listens to you and offers you treatment plans that address your symptoms and conditions,” she says. “Staying active with walking, Tai Chi, yoga and water aerobics can help maintain joint and muscle health and improve pain and sleep. Some people find that changing their diet to a Mediterranean diet or a more restrictive elimination diet for autoimmune conditions (Autoimmune Protocol) can improve their symptoms. For those working or avid hobbyists, an occupational therapy assessment can be useful for modifying their environment and work or hobby tools to help them be as productive as possible.”
In addition, she says illness-specific support groups can help with anxiety and depression while providing practical management tips, and cognitive behavioral therapy and meditation can help manage illness-related stress.
Humphrey also shares that recent research breakthroughs have led to new treatments providing sustained remission for many autoimmune diseases, with promising new therapies using genetically engineered immune cells in early trials.
“We also now understand that uncontrolled diseases like lupus, rheumatoid arthritis and psoriasis lead to early heart disease, causing strokes and heart attacks,” she says. “Therefore, we treat these diseases more aggressively to prevent these early conditions. Overall, we have significantly improved our ability to get patients into remission and allow them to remain free of disability or early death.”
