Women and Autoimmune Diseases

Our bodies are designed to fight infection through our immune system. However, in the case of autoimmune diseases, the immune system attacks healthy tissue and organs that can cause damage and illness. The vast majority of people affected by autoimmune disease are women, particularly women in childbearing ages between the ages of 14-45.

It is estimated that some type of autoimmune disease will affect 1 in 12 women in the United States. Autoimmune diseases are the 3rd most common disease category in the United States, right behind heart disease and cancer. It’s estimated that an autoimmune disease affects over 23 million Americans.

The broad heading of autoimmune disease covers the condition whereby the immune system, which typically fights infections from bacteria and viruses, is unable to distinguish foreign cells and the body’s own healthy cells and essentially “attacks” itself. Depending on the disease, the body releases proteins or autoantibodies that attack healthy cells and organs. Over 80 different autoimmune diseases have been identified, and many share common symptoms ranging from fatigue, swelling and redness, hair loss and skin rashes, numbness and tingling in extremities, muscle pain, and low-grade fevers, to mention a few.

The most common autoimmune diseases are Type 1 diabetes, rheumatoid arthritis or RA, multiple sclerosis, systemic lupus erythematosus or lupus, psoriasis and psoriatic arthritis, Addison’s and Graves’ disease, Crohn’s disease and ulcerative colitis, Hashimoto’s thyroiditis, myasthenia gravis, vasculitis, pernicious anemia, celiac disease, and Sjogren’s syndrome. With so many different diseases and conditions identified, autoimmune disease continue to baffle medical understanding.

The exact cause of autoimmune disease is not yet completely understood; however, it is believed that there are multiple factors that contribute to autoimmune disease. According to the National Institute of Environmental Health Sciences at National Institutes of Health, “There is a growing consensus that autoimmune diseases likely result from interactions between genetic and environmental factors.”

Additionally, the preponderance of women developing autoimmune disease leads researchers to speculate why. Overall women seemed to have more highly developed immune systems than their male counterparts and have a stronger inflammatory response when the immune system is engaged. Researchers believe that inflammation plays a key role in most autoimmune diseases.

Another remarkable difference between men and women vis-á-vis autoimmune disease relates to hormones. Many autoimmune diseases, specific to women will wax and wane with the fluctuations in hormone levels related to menstruation, pregnancy, and use of hormonal contraception. Similarly, some research has shown during pregnancy, fetal cells can remain in a woman’s body for many subsequent years and may be involved in the development of disease flares. Finally, scientist believe that genetics can play a role in some specific autoimmune diseases, and some theorize that since women carry 2 X chromosomes, defects in the X chromosomes may make women more susceptible to these conditions.

Unfortunately, both the study of the causes and methods of diagnosing the myriad autoimmune disease are still many years from completion. Currently, diagnosis of a particular autoimmune disease relies on the expertise of clinicians and healthcare providers who can sift through symptoms and laboratory results to pinpoint a diagnosis. In other words, many autoimmune diseases do not have one specific smoking-gun test that identifies a disease.

Thus comes the frustration and angst that accompanies many autoimmune diseases. Symptoms can mask as other less serious conditions for months or sometimes years before a proper diagnosis can be made. For instance, common symptoms like low-grade fever, fatigue, dizziness can be a sign of many garden-variety illnesses, which will resolve quickly and without any medical interventions. Likewise, skin rashes and muscle and joint pain are common problems of patients with no autoimmune conditions. Complicating issues more is that often times these symptoms come and go and are not sustained for long periods of time, which only adds to the time it takes to properly diagnose a particular disease.

Perseverance is key to uncovering an autoimmune disease, on both the part of patients and physicians. It is critical to tell your healthcare provider about all symptoms you experience, however insignificant you might think they are. Many times, it is the collection of symptoms that can help point your provider to the proper diagnosis. Many autoimmune diseases affect multiple organ systems, and the nature of modern medicine constitutes that providers usually specialize in a particular field. Therefore, a patient may need to see multiple providers to finally land on a diagnosis.

A primary care provider is a great place to start, but following up with a specialist who deals with your chief symptom or complaint will likely be necessary. For example, multiple sclerosis patients will need to be diagnosed and treated by a neurologist, and an endocrinologist will treat patients with Type 1 diabetes and Graves and other thyroid diseases.

Unfortunately, the amount of people diagnosed with autoimmune diseases does not seem to be abating in the United States. Research continues to seek what may be the underlying causes and what treatments and possible cures may be on the horizon.             

Currently, medications and treatments are available to mitigate or alleviate symptoms. In the case of thyroid and diabetes, synthetics are administered to replace the damage to vital organs. Steroids and other anti-inflammatory agents can help alleviate severe symptoms of inflammation. For the most severe cases, autoimmune diseases are being treated with biological treatments that help suppress immune function in the body that can help preserve organ systems.

Hopefully, increased research funding will continue to help scientist hone in on a better understanding of autoimmune etiology and will result in better treatments and possible cures to these diseases that affect so many.

Timothy J. Hardy, M.D.

Dr. Timothy Hardy, M.D. has been practicing medicine in the community for many years. He received his medical degree from Eastern Virginia Medical School and founded his own practice, Atlantic OB-GYN, in 1990, where he has been providing women with exceptional care ever since. Website: www.atlanticobgyn.com
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