What Are Autoimmune Disorders?

Also known as autoimmune diseases, autoimmune disorders are conditions wherein the body’s immune system cells attack other healthy cells by accident. In contrast to allergies and anaphylaxis which are caused as a result of the immune system reacting adversely to an otherwise harmless external agent, in autoimmunity, the cells attack other cells of the body. 

Autoimmune disorders are often considered systemic- even though a group or groups of cells may be attacked, the symptoms are widespread and do not improve with time. 

There are over eighty recognized types of autoimmune diseases, and many of them start with generic symptoms such as a low grade fever, fatigue and cramps. In some cases, the condition may flare up and cause more serious symptoms when the individual is stressed, recovering from another illness or faces a trigger potent enough to set off such reactions. 

Broadly, autoimmune disorders are classified into organ-specific disorders and non-organ-specific disorders. As the titles suggest, organ-specific disorders are those where a specific organ or organs are attacked, and non-organ-specific once are those where the whole body is under attack. 

• Organ-Specific Disorders: Endocrine glands most often come under attack in these types of disorders.
  • Examples include Hashimoto’s Thyroiditis, Addison’s Disease, and type-1 Diabetes.
  • However, pernicious anemia which affects the stomach is also an organ-specific disorder, even though the endocrine system is not involved.
  • Likewise, Crohn’s Disease is an autoimmune IBD (inflammatory bowel disease) that affects the digestive system, more specifically the intestines.
  • Celiac Disease is also an autoimmune condition and people afflicted by it lose the intestinal villi which are essential for assimilating nutrients. 

• Non-Organ-Specific Disorders: In these disorders, many different groups of cells in the body are under attack by the immune system. Some common examples include Rheumatoid Arthritis, Lupus and Multiple Sclerosis. 

Snippet Highlight: Irrespective of the organs, or the organ system affected, all autoimmune diseases are a condition affecting the immune system first. Treating the specific organ systems can only alleviate the problems but does not offer a cure. 

Since there are so many different types of autoimmune diseases, their prevalence rates also vary widely. 

In general, about 10% of the world’s population suffers from one autoimmune disease or another. In news that can only be called bad, women are the major sufferers from autoimmune disease, with women making up 78% of all sufferers. 

In India, people are only just waking up to the reality of autoimmune disorders which for very long were perceived to be a ‘western problem’. Here, rheumatoid arthritis and lupus are among the most common disorders, seen again majorly in women. Perhaps an increase in awareness can also be linked to more people being diagnosed today than a decade ago.

In spite of their wide prevalence and the number of people they affect every year, the exact cause of an autoimmune disorder is not known. This can be attributed, in part, to the fact that we are only just making progress in understanding our immune system better now- the identification of the role of gut bacteria in immunity is still novel and hotly debated. It is thus plausible that we do not understand every condition that affects the immune system.

Genetic causes: In prone people, it is believed that some genes make their immune system more active, and the system can then make no distinction between foreign cells and our own. 

• Environmental causes: Another theory stimulates that exposure to certain bacteria and viruses can confuse the immune system. This theory holds more weight as some pathogens are known to reproduce using portions of the host DNA, meaning that the immune system has more trouble distinguishing between foreign cells and our cells. 

Genetic changes between women and men mean that women produce more antibodies and T-helper 2 related responses to infection than men, whose bodies react more with inflammation. Most autoimmune disorders are antibody-mediated responses, meaning that antibodies produced in the body go on to attack the body’s cells and destroy them. 

The few autoimmune disorders that do occur in men are characterized instead by inflammation and are mediated by a different set of cells called the T-helper 1 cells. 

Here are some risk factors that increase your chances of developing an autoimmune disorder. 

• Being a woman
• Being under fifty years of age
• Being African American, Indian and Latino
• Family history of autoimmune disorders
• Use of medication such as procainamide used to treat cardiac arrhythmia
• Exposure to metals such as mercury, or heavy metals like lead
• (Probably) infections. For example, infection by the Measles virus may increase risk of developing Multiple Sclerosis 

A person suffering from an autoimmune condition may not immediately be able to spot it. Symptoms can vary widely based on the organs affected. 

For example, rheumatoid arthritis manifests as pain in the joints, often accompanied by another autoimmune condition. Hashimoto’s Thyroiditis, on the other hand, manifests first as hyperthyroidism and then as hypothyroidism once the gland has been severely damaged. 

Here are some general symptoms to watch out for: 

• A sudden change in weight or other body parameters. Both weight gain and weight loss are causes for concern.
• An unexplained rash that flares up for no apparent reason.
• Fatigue or inability to perform tasks that you previously enjoyed.
• Pain in the joints and soreness in the muscles.
• A general feeling of being unwell, often described as malaise.
• The inability to gain or lose weight quickly even upon trying 

Snippet Highlight: Do note that not all of these symptoms are indicative of autoimmune disorders and a thorough evaluation alone can pinpoint the problem. Likewise, do not wait for all of these symptoms to manifest before visiting a doctor. Some autoimmune disorders work very silently and can show few to no symptoms until much later in the disease. 

There are a number of tests that can help diagnose an autoimmune condition. In no particular order, they are: 

1. Antinuclear Antibody Tests: A sample of blood is tested for antinuclear antibodies, also known as autoantibodies. These are the first markers of an autoimmune disease.
2. Complete Blood Count: This test helps look for elevations in white blood cell levels in the body. In conjunction with the first test, they confirm the presence of an autoimmune disease.
3. C-Reactive Protein Test: CRP is produced by the liver in response to inflammation. This test is often used as a marker for autoimmune diseases that cause inflammation and rashes in the body.
4. Other Tests: A complete metabolic profile may help evaluate where the problem is coming from. An ESR test is used to look for inflammation and the immune activity in the body. An elevated ESR count indicates that the body’s immune response is active. 

These tests are common markers for autoimmune disorders. However, they cannot pinpoint to the specific disorder in question. Based on the symptoms you experience, your doctor is the best person to pinpoint the problem. 

Snippet Highlight: The prolonged use and stoppage of immunosuppressant drugs, and changes to immunity levels during pregnancy, can cause you to experience symptoms that mimic an autoimmune disorder. However, evaluate with a doctor as to whether what you’re experiencing is a short-term withdrawal, or a much deeper issue. 

Unfortunately, there is no known cure for autoimmune disorders and treatment involves managing the symptoms, preventing the body for inflicting further damage upon itself and replacing any hormones that may have been depleted due to the autoimmune attack. 

Conventional Treatments 

• Commonly used medication includes pain relievers, both NSAIDs and steroidal drugs based on the intensity and frequency of pain.
• Hormone replacement medication is used when the affected organ belongs to the endocrine system. For example, those dealing with Hashimoto’s Thyroiditis are almost always prescribed doses of Thyroxine to keep the metabolic processes stable in the body.
• Immunosuppression is used as a means to keep the immune activity under check, much like in cases where an organ is transplanted, but as is to be expected, the side effects are often severe. The person receiving immunosuppression is prone to other infections that can quickly become life-threatening in the absence of a fully functional immune system. 

Alternative Treatments 

More recently, alternative therapies are being studied to help manage and treat autoimmune disorders. It is important to note, however, that these therapies are being studied as of now, and not many clinical trials exist to prove their efficacy. 

One method of treating these disorders is thinking of them as lifestyle disorders, wherein the cells are damaged for no apparent reason that can be diagnosed immediately. Management involves lifestyle changes, an increase in activity levels coupled with the use of low doses of medication. 

Homeopathy Treatment 

Homeopathy seems to offer some hope in this area. Clinical trials with patients and susceptible individuals have been conducted since the early nineties using arsenic compounds, and show promise in preventing, curing and alleviating symptoms of autoimmune disease. 

Ayurvedic Treatment 

Ayurveda as a treatment option is thousands of years old, and thus offers that much more statistical data. Some studies show that immune system disorders are incurable by approaching them with a tunnel vision, and that they must be studied as a disorder of the whole body. 

With this in mind, ayurveda recommends the use of immunodrugs such as Indian Ginseng, Ashwagandha and related plant products which not only work as ‘sanjeevani’ or anti-ageing compounds, but also work to reset metabolic and systemic conditions from within. 

As always, the best approach to any alternative treatment is to keep your entire medical team in the loop about your action plan, and continuously monitor for strong markers. 

There are several different recommended strategies for managing autoimmune disorders: 

• Elimination Diet: The AIP or Autoimmune Protocol Diet is a stringent, but highly effective diet that promises to help reduce intestinal inflammation by the process of elimination. Grains, gluten, legumes, potatoes, sugar and dairy are prohibited in this diet, as are vegetables of the nightshade family. Such a diet needs to be implemented under close medical supervision as many nutritional deficiencies can quickly crop up. Instead, foods high on the FODMAPs scale are preferred to manage the issue more steadily. 

• Caring For The Gut: The use of probiotics and prebiotic foods helps restore the balance of gut flora and provide food for the healthy bacteria.Some foods high on the list include crucifers, mushrooms, berries and most other fruits, whole wheat products and yogurt. 

• The use of vitamin D supplements can help boost the immune system and restore its healthy function. 

Consume a healthy, balanced diet unless you have been advised to avoid certain foods by your doctor. 

Movement 

The form and intensity of exercise you can participate in depends on the specific autoimmune condition you have. For example, those with rheumatoid arthritis and scleroderma benefit immensely from exercise and physiotherapy because the it restores some movement to the joints. 

Those with interstitial lung disease may not exercise, or should exercise only under careful supervision for fear of lung collapse. In ulcerative colitis too, it is recommended that you exercise in moderation in order to avoid rupturing the intestine any further. 

Yoga 

The general, consistent practice of yoga has shown to improve mood, reduce fatigue and alleviate some symptoms in those suffering from multiple sclerosis. 

Many people report on forums and support groups from across the world that practicing yoga has helped them achieve balance, reduce stress which can be one of the triggers, and feel better overall. A trained yoga practitioner can help you evaluate which asanas work for you based on your specific disorder and symptoms. 

Mindset 

It may be hard to accept that you have an autoimmune condition, more so because they usually last a lifetime. In the developed world, there are many support groups to help people cope and seek help. 

In India, it is recommended that you consult with a clinical psychologist or counsellor if you notice symptoms of depression creeping in. 

If you are allowed to, exercise can help improve your mood significantly and help you experience a sense of accomplishment. 

Support from family and making minor adjustments around your daily routine can help you stay on track and not experience a sense of loss. Be sure to stay in touch with your medical team and report any changes in symptoms to them so they can react immediately. 

Online support groups such as this one can go a long way in helping you stay positive, learn from others and know that you are not alone. While there will surely be days where the symptoms seem even worse, the key is to stay positive on the good days, and stay put on the bad ones. 

• Family history of autoimmune disorder:
  • If you know for a fact that autoimmune disorders run in the family, gene therapy is often suggested to help alter the genes that express autoimmunity and prevent a disease from cropping up. 
  • Look for symptoms early on and speak to your doctor about them.
  • Screen for food allergies and avoid foods that trigger a response in your body. The earliest signs include an unexplained rash, or even diarrhea.
  • Follow a diet that strengthens the immune system with the use of probiotics and prebiotics. Ensure that you are not facing any vitamin deficiencies. 

Some studies suggest that vitamin D has a role to play in preventing autoimmune disease, even though the exact mechanism of it is not yet known. Get tested for a vitamin D deficiency and ask you doctor to help you supplement accordingly. 

*Medical Disclaimer - The following information is for educational purposes only. No information provided on this website, including text, graphic, and images, are intended as substitutes for professional medical advice. Please consult with your doctor about specific medical advice pertaining to your condition(s)