What Causes Autoimmune Diseases?
Autoimmune diseases affect more than 24 million people in the United States, according to the National Institutes of Health. And that rate may be rising, suggests a study published in April 2020 in Arthritis & Rheumatology.
Your immune system is supposed to be one of your body’s natural heroes. It’s meant to fight against illness and disease, attacking viruses and bacteria before they have the chance to take you down. But what happens when that immune system loses sight of what it should be attacking, and starts going after your own body instead? In these instances, it can feel like your immune system has morphed from hero to enemy.
What Are Autoimmune Diseases?
Autoimmune diseases are conditions that develop when the immune system “malfunctions” and becomes hyperactive, going after healthy tissues, cells, and organs. In general, autoimmune conditions happen when the immune system goes into overdrive making antibodies against certain antigens (proteins) in our body, causing our immune system to attack and damage that part of the body.
Certain conditions, such as psoriasis and MS, are often referred to as immune-mediated diseases rather than autoimmune diseases because experts aren’t sure whether or not antigens are to blame for these conditions. In them, the overactive immune response will cause inflammation in the body, resulting in symptoms.
Types of Autoimmune Diseases and Conditions
There are thought to be more than 80 autoimmune conditions, including the following:
- Type 1 diabetes
- Multiple sclerosis (MS)
- Rheumatoid arthritis
- Systemic lupus erythematosus
- Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)
- Psoriasis and psoriatic arthritis
Why Do I Have an Autoimmune Disease?
These diseases can be life-altering, so of course people who have them want to know what causes autoimmune diseases or immune-mediated conditions. But a lot remains to be seen. For example, scientists don't know exactly why there appears to be an increased prevalence of autoimmune conditions, especially among teenagers, but some suspect that it may be linked to lifestyle and/or environmental factors.
A Combination of Genetics and Outside Factors
Susan Bard, M.D., a board-certified dermatologist at Vive Dermatology, in New York City, explains that having an autoimmune disorder most likely comes down to a genetic predisposition to erroneously release too many antibodies that then attack an individual’s system.
“I always give patients the analogy of having a bad quality-control inspector at a factory that doesn’t pull the ‘irregulars’ off the assembly line,” Bard says.
In fact, research has found a number of identifiable genetic markers to a variety of autoimmune disorders. One theory is that autoimmune diseases are likely the result of a combination of factors: a genetic predisposition and a trigger.
What Triggers Autoimmune Disease?
How exactly triggers cause illness is still unknown, says Santoshi Billakota, M.D., an epilepsy specialist and clinical assistant professor of neurology at New York University Grossman School of Medicine. “Our best guess is that the person gets exposed to a virus or bacteria, which can confuse the immune system and potentially cause it to attack its own cells and tissues,” Billakota says.
Other potential triggers and risk factors for developing an autoimmune condition include:
- Exposure to environmental toxins
- Infection, such as strep throat
- Dietary choices
- Gut issues
- Being overweight or obese
- Certain medications
Because these are often rare diseases we’re discussing, and because the presentation of these diseases can vary from person to person, it may be a long time before we get a clear-cut answer about what causes each person’s autoimmune disease, if ever.
Vaccines Don’t Cause Autoimmune Diseases
While we may not know exactly what causes autoimmune diseases (likely because there are different causes for different conditions and people), we do have a pretty good idea of what doesn’t cause them.
“Vaccines do notcause autoimmunity,” Bard says. “This is genetically ingrained in you. Anything that triggers your immune system to make antibodies, such as illness or vaccines, can unmask the genetic predisposition responsible for the disease.” For example, a strep infection is a common first-time psoriasis trigger.
Because some people may notice their symptoms after getting a vaccine, it’s understandable why some might think the immunization caused them. But it’s important to understand the different dynamics at play and that a genetic predisposition could be triggered by any number of things—so a vaccine isn’t to blame.
A study published in the journal Pediatrics looked at well-conducted epidemiological studies and found no causal relationship between vaccines and autoimmune conditions in children. Another recent study found no link between vaccines and the onset of autoimmune conditions.
When it comes to whether a person with a genetic predisposition to an autoimmune condition will become triggered, Bard says, “It’s a numbers game mixed in with luck.” If you’ve got the genetic predisposition, it may only be a matter of time before something triggers it.
Focusing on Health and Wellness
If you or a loved one has been recently diagnosed with an autoimmune condition, it’s natural to want to know the cause. But that’s not an answer you may ever be able to find for sure. The more important question is how to maintain the best possible quality of life while living with an autoimmune disease. This often means:
- Managing symptoms by sticking to treatments prescribed or recommended by your doctor
- Maintaining a healthy lifestyle by eating a nutritious diet, getting plenty of sleep, exercising regularly, and managing stress
- Avoiding unhealthy habits like smoking and binge drinking
- Seeking support from a mental professional and/or friends and family members
- Maintaining a social life and engaging in activities you enjoy
Audrey Christie, a nurse and holistic wellness practitioner based in Lake Dallas, Texas, says she wants to bust the myth that autoimmune conditions are a sign of weakness in the body. “It’s simply not true. The body is strong, resilient, with an incredible anatomy, physiological mechanisms, and even a little magic, too,” she says. “Framing your body as weak because you have an autoimmune disease [can] affect your mindset.”
It’s common for a person’s body image and self-esteem to take a hit after an autoimmune diagnosis, agrees Anna Kratz, Ph.D., a clinical psychologist and MS researcher at the University of Michigan. Try to focus on what you can do to keep your body as strong and healthy as you can.
“People can foster their own resilience by practicing good basic health behaviors: exercising, eating healthy foods, prioritizing sleep, building up supportive social networks and avoiding toxic relationships, learning relaxation and other stress management skills, and asking for mental health care if they are struggling emotionally,” says Kratz.
Treatments for Autoimmune Disease
There are also often treatments for certain autoimmune diseases that can help delay their progression. For example, with MS, Billakota says, “There are many treatments, ranging from injectable and oral medications to potent infusions. It’s important to discuss with your doctor what the best treatment for you might be.”
New treatments are being discovered all the time, with research into autoimmune diseases increasing every day. Even if you experience setbacks from time to time, don’t give up hope. With the help of your healthcare practitioners, you are likely to find answers and treatments that will allow you to feel in control of your body once more. Working with a mental health professional who specializes in treating people with autoimmune diseases can help, too.
Finding a Support Group
Another way to help you better live with your autoimmune condition is to join a support group. “Having a support community can greatly accelerate the rate at which a person can learn about their condition—the support network is essentially a crowd source of firsthand information from one patient to another,” Kratz says. “This can be so helpful, particularly when a person may not even know which questions to ask!”
Plus, a support group can help you through any tough emotions you’re experiencing. “These networks of people can serve as a safe place to vent, confess, express vulnerability, and ask for help,” Kratz says. “There is something very healing when a person feels they are not alone, and are supported and cared for by others who are going through the same challenges.”
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