What are autoimmune conditions?

Your immune system is essential for your health because it protects you against things that can make you ill, such as viruses, bacteria and parasites. But your immune system may not always behave the way it should, and in some cases it can turn against you. This is called autoimmune disease.

If you have an autoimmune condition it means your immune system attacks normal, healthy tissues, not just organisms that can harm you. The British Society for Immunology describes it as the immune system being ‘inappropriately misdirected against our own tissues and cells’ (i). Nobody knows exactly why this happens, but there are several theories on the subject (see ‘What causes autoimmunity?’ below)..

Autoimmunity is more common than you may think, with hundreds of thousands of people in the UK affected (i). We can’t say how many, exactly, but there are figures that reveal how many people are living with many individual autoimmune conditions (see ‘Types of autoimmune conditions’, below).

What we do know, however, is that far more women have autoimmune conditions than men, with some experts suggesting 75 per cent of those affected are female (ii). Indeed, it’s thought that up to 95% of people with two specific autoimmune conditions – namely systemic lupus erythematosus (SLE or simply lupus) and Sjogren’s syndrome – are women, while some other autoimmune conditions may be 60 per cent more prevalent in women than men (iii).

Nobody knows why this is the case, but female hormones – most likely those involved in the menstrual cycle – may have something to do with it. Some think it’s because X chromosomes have more immune system-relating genes than Y chromosomes (women have two X chromosomes, compared with men’s X and Y chromosomes). Neither of these theories has been proven, however, and it’s likely other factors are involved too.
 

Are you at risk?

Being female can increase your risk of developing an autoimmune condition. But there are other things that can make your risk higher, including:

• Your genes: some autoimmune conditions are thought to run in families, which suggests certain genes may play a part in their development.

• Being overweight or obese may make your risk of developing certain autoimmune conditions higher.

• Smoking has been associated with some autoimmune conditions.

• Your age may also be important, with some autoimmune conditions developing in younger and middle-aged adults than older people.
   

Types of autoimmune conditions

To date more than 80 autoimmune conditions have been identified (i). Some affect one tissue or organ, while others affect various parts of the body (these are known as systemic autoimmune conditions). Some of the ones you may have heard of include:
 

Rheumatoid arthritis

This is a type of arthritis caused by the immune system attacking tissues in the joint lining, causing inflammation and pain and eventually permanent joint damage. Rheumatoid arthritis can also cause inflammation in other parts of body, including around the heart and lungs, and may affect more than 400,000 people in the UK (iv). See our guide to rheumatoid arthritis for more information.
 

Lupus

A complex condition that can affect many parts of the body – including the joints, skin, heart, lungs and nervous system – lupus causes a variety of symptoms. It’s thought to be triggered by a widespread systemic autoimmune reaction, and affects around 15,000 people in England and Wales, 90 per cent of whom are women (v). Lupus also affects more people of African-Caribbean, South Asian and Chinese descent than white Europeans.
 

Scleroderma

Caused by the immune system attacking the connective tissue under the skin, scleroderma can affect areas of skin, making them hard and thickened. It can also cause scarring and thickening of the tissue around internal organs and blood vessels, as in severe cases the immune system can attack these areas too. Around 19,000 people have been diagnosed with scleroderma in the UK (vi).

 

Psoriasis

When overactive immune system cells speed up the turnover of skin cells, the result is a skin condition called psoriasis. This causes red, raised, flaky, scaly and itchy patches of skin. Psoriasis can affect anyone of any age, but it most commonly starts before the age of 35. Around two per cent of people in the UK are affected (vii). Around one in three people with psoriasis also develop a type of arthritis called psoriatic arthritis, which makes their joints swollen, stiff and painful (vii). This too is an autoimmune condition, as it’s caused by the immune system attacking the joints. However, nobody knows why some people with psoriasis develop psoriatic arthritis while others don’t.
 

Multiple sclerosis

MS is a neurological condition that damages nerve fibres in the brain and spinal cord, causing a wide range of symptoms. This damage is caused by immune cells called T cells attacking the myelin sheath, an insulating substance that protects nerve fibres. More than 130,000 people in the UK are thought to have MS, with women having a two-or-three-times higher risk than men (viii).
 

Crohn’s disease

This is one of two main types of inflammatory bowel disease, where any part of the digestive system can become inflamed. Crohn’s disease causes a range of gastrointestinal problems and is a result of the immune system attacking the lining of the intestines. It’s thought to affect around 145 people in every 100,000 (ix).
 

Coeliac disease

Also causing digestive problems, coeliac disease is an autoimmune disease and not a food allergy, as is often thought. It is caused by a problem with the immune system, which reacts every time you eat gluten – a substance found in many foods. The immune system reacts by causing damage and inflammation in the gut, which means your intestines cannot absorb and digest food effectively. Around one in 100 people in the UK has coeliac disease, with an estimated 500,000 going undiagnosed (x).
 

Type 1 diabetes

Also known as diabetes mellitus type 1 (or insulin-dependent diabetes mellitus), this is a result of the immune system destroying cells in the pancreas, the organ that produces insulin (a hormone that controls the level of glucose in your blood). If left uncontrolled, type 1 diabetes can lead to serious health problems, and if untreated it can even be fatal. In the UK there are 3.8 million people diagnosed with diabetes, 10 per cent of whom have type 1 diabetes (xi).
 

Hashimoto’s disease

If you have an underactive thyroid, it’s quite likely that it’s caused by autoimmunity, where your immune system attacks your thyroid gland and stops it from making sufficient amounts of a hormone called thyroxine. Hashimoto’s disease (or Hashimoto’s thyroiditis) is the most common type of autoimmune reaction that causes an underactive thyroid. We don’t know how many people in the UK have Hashimoto’s disease, but it’s thought that around two per cent of the UK population are affected by an underactive thyroid (this increases to five per cent of women aged 60 and older) (xii).
 

Grave’s disease

Hyperthyroidism – or an overactive thyroid – is often caused by an autoimmune condition called Grave’s disease. This happens when your immune system produces antibodies that mimic thyroid stimulating hormone, which in turn makes your thyroid gland produce too much thyroxine. Around two per cent of women and 0.2 per cent of men are affected by hyperthyroidism – it’s though that between 60 and 80 per cent of these are a result of Grave’s disease (xii).
 

What causes autoimmunity?

 

Your body has systems in place that regulate your immune system and make sure everything within it is working normally. When something goes wrong with this system, however, antibodies – proteins in your blood – and some types of immune cells can start attacking your tissues, causing an autoimmune condition. But why does this happen?
 

Hereditary factors

Genetics are thought to play a part in autoimmunity but experts still don’t quite understand how. There seems to be a hereditary component in some people with certain autoimmune conditions (xiii), but many people with family members who have an autoimmune condition aren’t affected by autoimmunity themselves. In other words, if you have a family member with an autoimmune condition, it doesn’t mean you’ll definitely develop one too. It may well depend on whether or not other factors come into play as well.
 

Environmental factors

The fact that some people with a genetic predisposition to autoimmunity never develop an autoimmune condition does suggest something else is needed to trigger it. One of these things may be environmental factors such as exposure to toxins and chemicals. Indeed, some air pollutants and organic solvents have been linked with the development of certain autoimmune conditions (xiv). And since some toxic compounds are thought to affect your genes, it’s possible – though not yet proven – that the combination of a genetic predisposition and exposure to environmental pollutants could be at least one of the things that may lead to autoimmunity.
 

Exposure to infections

Our immune systems are designed to protect us from infections, but it’s also thought that infections can sometimes lead to autoimmunity (xv). For instance, some people who get a sore throat caused by a bacterial infection – such as tonsillitis or pharyngitis, sometimes called strep throat – can develop psoriasis. Meanwhile it’s been noticed that some people who are infected by the Zika virus develop Guillain-Barré Syndrome, a rare autoimmune syndrome that can cause paralysis (xvi). The SARS-CoV-2 coronavirus that causes Covid-19 symptoms has also been linked with Guillain-Barré Syndrome (xvii).
 

Autoimmune conditions and your health

Besides the symptoms that are specific to each different condition, some autoimmune disorders can also cause wider implications for other aspects of your health. For instance, many of the autoimmune conditions that cause inflammation – such as lupus, scleroderma, psoriatic arthritis and rheumatoid arthritis – can also increase your risk for heart disease. This means if you have one of these conditions, it’s even more important to lead a heart-healthy lifestyle (see the Heart Health section of our health library for more details).

Other health issues that have been known to affect people with autoimmune conditions include depression, some types of cancer and an increased risk of developing other autoimmune conditions. For instance, scientists have discovered people with coeliac disease have an increased risk of having another autoimmune condition if they also have a family history of autoimmunity and were overweight when they were diagnosed with coeliac disease (xviii).

According to the Global Autoimmune Institute, people with three or more autoimmune conditions make up 25 per cent of autoimmune patients, with the condition known as Multiple Autoimmune Syndrome (MAS) (xix).
 

Exposure to infections

The symptoms of autoimmunity vary widely between the distinct autoimmune conditions. However, many have certain symptoms in common, including:

• Feeling tired all the time

• Muscle aches and pains

• Swollen and painful joints

• Recurring high temperature

• Swollen glands

• Skin rashes

• Hair loss

• Digestive problems (including abdominal pain)

• Numbness and tingling in your hands and feet

• Difficulties with concentration
   

Should you see your GP?

Many of the above symptoms can be common and it doesn’t mean you have an autoimmune condition if you notice one or more of them. But if you do – and the symptoms keep coming back – it’s a good idea to get a check-up from your GP.

Depending on your symptoms, your doctor may suggest one or more tests. Then if your test results come back positive you may be referred to a hospital consultant, such as a dermatologist, rheumatologist, endocrinologist or gastroenterologist. They – or your GP – can then decide on a treatment that aims to help keep your symptoms under control.
 

Treatments for autoimmune conditions

Autoimmune conditions can’t be cured, but the symptoms can be treated. Many of the medicines used to treat autoimmunity work to calm and control the overactivity in your immune system – these are called immune-suppressing medicines – as well as reduce any inflammation that your immune system has caused (for instance steroid medicines and non-steroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen, naproxen and diclofenac).

Other medicines aim to reduce fatigue, soothe skin rashes and reduce pain, or – in the case of Hashimoto’s disease – to replace hormones that your body needs (in the case of an underactive thyroid, the hormone thyroxine).
 

Self-help measures

There may also be some things you can do to help yourself. Making sure your lifestyle is as healthy as possible is a good idea. This includes eating a nutritious balanced diet, staying physically active, not smoking, limiting yourself to a moderate amount of alcohol and making sure you take any medicines your doctor has prescribed for you correctly.

Some nutritional supplements may also help if you have an autoimmune condition that causes inflammation:
 

High-strength fish oils

The omega-3 essential fatty acids found in oily fish such as salmon, fresh tuna, sardines, mackerel, herring and pilchards is widely thought to help inflammation, with some experts believing they affect the body’s natural production of inflammation-reducing compounds called prostaglandins (xx). They may be helpful in many autoimmune conditions, since it’s thought fish oils may help reduce joint and muscle pain, as well as improve skin health (xxi). Several studies, for instance, suggest fish oils may be helpful for the autoimmune condition lupus, thanks to their anti-inflammatory properties (xxii).

If you don’t like eating fish you may like to try a high-strength fish oil supplement. And if you’re a vegetarian or vegan you can still benefit from an omega-3 supplement, thanks to the availability of products that contain the natural triglyceride (TG) form of omega-3 This is sourced from plant organisms called microalgae rather than fish.
 

Turmeric

The main active ingredient in turmeric – the spice that gives curry its yellow colour – is curcumin, a compound thought to have a strong anti-inflammatory effect. Studies suggest it may be as effective as some conventional anti-inflammatory drugs, but without the side effects associated with them (xxiii).

There is also some evidence that curcumin may improve autoimmune conditions – though this evidence comes from in vitro studies, which isn’t as robust as data from human trials (xxiv).
 

Quercetin

This flavonoid antioxidant found in richly coloured fruit and vegetables has been shown not only to reduce inflammation but to also regulate the immune system (xxv). There is evidence that quercetin may reduce inflammatory pain, which suggests it may be helpful for those with autoimmune conditions such as inflammatory forms of arthritis (xxvi). Like turmeric, quercetin is also available in supplement form.
 

Vitamin D

Also try to make sure you’re getting plenty of vitamin D, since experts believe vitamin D deficiency may be associated with increased autoimmunity (xxvii).

Vitamin D deficiency is thought to be common in some countries including the UK, which is why the Scientific Advisory Committee on Nutrition advises that adults and children over the age of four should consider taking a daily supplement containing 10mcg of vitamin D during the autumn and winter months, and indeed throughout the year if they avoid sun exposure or keep themselves covered up in the summer (xxviii).

The recommended form of vitamin D is vitamin D3 or cholecalciferol, as it’s the natural form of vitamin D that the body makes when it’s exposed to sunlight. Vitamin D3 supplements are available in tablet form, and now you can get them in veggie-friendly drops too.

However, most vitamin D3 supplements are made from the fat of lamb’s wool, which means they’re unsuitable for vegans. The good news is that vegan vitamin D3 supplements sourced from lichen are now more widely available.
 

There’s lots more to discover about immune health in our Immunity Pages. Meanwhile if you want information about a wide range of health issues, visit our pharmacy health library.


 

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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.

 

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