Understanding autoimmune diseases
A healthy immune system defends the body against disease and infection. But if the immune system malfunctions, it mistakenly attacks healthy cells, tissues, and organs. Called autoimmune disease, these attacks can affect any part of the body, weakening bodily function and even turning life-threatening.
Scientists know about more than 80 autoimmune diseases. Some are well known, such as type 1 diabetes, multiple sclerosis, lupus, and rheumatoid arthritis, while others are rare and difficult to diagnose. With unusual autoimmune diseases, patients may suffer years before getting a proper diagnosis. Most of these diseases have no cure. Some require lifelong treatment to ease symptoms.
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To volunteer for a study seeking causes of and possible treatments for autoimmune diseases, visit this clinical trials website, and you may find one that addresses your condition.
Collectively, these diseases affect more than 24 million people in the United States. 1 An additional eight million people have auto-antibodies, blood molecules that indicate a person’s chance of developing autoimmune disease. Autoimmune diseases are affecting more people for reasons unknown. Likewise, the causes of these diseases remain a mystery.
Studies indicate these diseases likely result from interactions between genetic and environmental factors. Gender, race, and ethnicity characteristics are linked to a likelihood of developing an autoimmune disease. 2 Autoimmune diseases are more common when people are in contact with certain environmental exposures, as described below.
The diseases listed here either are more common in women than men or affect many women and men. They are listed in alphabetical order.
Although each disease is unique, many share hallmark symptoms, such as fatigue, dizziness, and low-grade fever. For many autoimmune diseases, symptoms come and go, or can be mild sometimes and severe at others. When symptoms go away for a while, it’s called remission. Flares are the sudden and severe onset of symptoms.
Types of autoimmune diseases and their symptoms
Disease | Symptoms |
Alopecia areata (Al-uh-PEE-shuh AR-ee-AYT-uh) The immune system attacks hair follicles (the structures from which hair grows). It usually does not threaten health, but it can greatly affect the way a person looks. | • Patchy hair loss on the scalp, face, or other areas of your body |
Antiphospholipid (an-teye-FOSS-foh-lip-ihd) antibody syndrome (aPL) A disease that causes problems in the inner lining of blood vessels resulting in blood clots in arteries or veins. | • Blood clots in veins or arteries • Multiple miscarriages • Lacy, net-like red rash on the wrists and knees |
Autoimmune hepatitis The immune system attacks and destroys the liver cells. This can lead to scarring and hardening of the liver, and possibly liver failure. | • Fatigue • Enlarged liver • Yellowing of the skin or whites of eyes • Itchy skin • Joint pain • Stomach pain or upset |
Celiac disease A disease in which people can’t tolerate gluten, a substance found in wheat, rye, and barley, and also some medicines. When people with celiac disease eat foods or use products that have gluten, the immune system responds by damaging the lining of the small intestines. | • Abdominal bloating and pain • Diarrhea or constipation • Weight loss or weight gain • Fatigue • Missed menstrual periods • Itchy skin rash • Infertility or miscarriages |
Diabetes type 1 A disease in which your immune system attacks the cells that make insulin, a hormone needed to control blood sugar levels. As a result, your body cannot make insulin. Without insulin, too much sugar stays in your blood. High blood sugar can hurt the eyes, kidneys, nerves, and gums and teeth. But the most serious problem caused by diabetes is heart disease. | • Being very thirsty • Urinating often • Feeling very hungry or tired • Losing weight without trying • Having sores that heal slowly • Dry, itchy skin • Losing the feeling in your feet or having tingling in your feet • Having blurry eyesight |
Graves’ disease (overactive thyroid) A disease that causes the thyroid to make too much thyroid hormone. | • Insomnia • Irritability • Weight loss • Heat sensitivity • Sweating • Fine brittle hair • Muscle weakness • Light menstrual periods • Bulging eyes • Shaky hands • Sometimes there are no symptoms |
Guillain-Barre (GEE-yahn bah-RAY) syndrome The immune system attacks the nerves that connect your brain and spinal cord with the rest of your body. Damage to the nerves makes it hard for them to transmit signals. As a result, the muscles have trouble responding to the brain. | • Weakness or tingling feeling in the legs that might spread to the upper body • Paralysis in severe cases Symptoms often progress relatively quickly, over a period of days or weeks, and often occur on both sides of the body. |
Hashimoto’s (hah-shee-MOH-tohz) disease (underactive thyroid) A disease that causes the thyroid to not make enough thyroid hormone. | • Fatigue • Weakness • Weight gain • Sensitivity to cold • Muscle aches and stiff joints • Facial swelling • Constipation |
Hemolytic anemia (HEE-moh-lit-ihk uh-NEE-mee-uh) The immune system destroys the red blood cells. Yet the body can’t make new red blood cells fast enough to meet the body’s needs. As a result, your body does not get the oxygen it needs to function well, and your heart must work harder to move oxygen-rich blood throughout the body. | • Fatigue • Shortness of breath • Dizziness • Headache • Cold hands or feet • Paleness • Yellowish skin or whites of eyes • Heart problems, including heart failure |
Idiopathic thrombocytopenic purpura (id-ee-oh-PATH-ihk throm-boh-seye-toh-PEE-nik PUR-pur-uh) (ITP) A disease in which the immune system destroys blood platelets, which are needed for blood to clot. | • Very heavy menstrual period • Tiny purple or red dots on the skin that might look like a rash. • Easy bruising • Nosebleed or bleeding in the mouth |
Inflammatory bowel disease (IBD) A disease that causes chronic inflammation of the digestive tract. Crohn’s (krohnz) disease and ulcerative colitis (UHL-sur-uh-tiv koh-LEYE-tuhss) are the most common forms of IBD. | • Abdominal pain • Diarrhea, which may be bloody Some people also have: • Rectal bleeding • Fever • Weight loss • Fatigue • Mouth ulcers (in Crohn’s disease) • Painful or difficult bowel movements (in ulcerative colitis) |
Inflammatory myopathies (meye-OP-uh-theez) A group of diseases that involve muscle inflammation and muscle weakness. Polymyositis (pol-ee-meye-uh-SYT-uhss) and dermatomyositis (dur-muh-toh-meye-uh-SYT-uhss) are 2 types more common in women than men. | • Slow but progressive muscle weakness beginning in the muscles closest to the trunk of the body. Polymyositis affects muscles involved with making movement on both sides of the body. With dermatomyositis, a skin rash comes before or at the same time as muscle weakness. May also have: • Fatigue after walking or standing • Tripping or falling • Difficulty swallowing or breathing |
Multiple sclerosis (MUHL-tip-uhl sklur-OH-suhss) (MS) A disease in which the immune system attacks the protective coating around the nerves. The damage affects the brain and spinal cord. | • Weakness and trouble with coordination, balance, speaking, and walking • Paralysis • Tremors • Numbness and tingling feeling in arms, legs, hands, and feet • Symptoms vary because the location and extent of each attack vary |
Myasthenia gravis (meye-uhss-THEEN-ee-uh GRAV-uhss) (MG) A disease in which the immune system attacks the nerves and muscles throughout the body. | • Double vision, trouble keeping a steady gaze, and drooping eyelids • Trouble swallowing, with frequent gagging or choking • Weakness or paralysis • Muscles that work better after rest • Drooping head • Trouble climbing stairs or lifting things • Trouble talking |
Primary biliary cirrhosis (BIL-ee-air-ee sur-ROH-suhss) The immune system slowly destroys the liver’s bile ducts. Bile is a substance made in the liver. It travels through the bile ducts to help with digestion. When the ducts are destroyed, the bile builds up in the liver and hurts it. The damage causes the liver to harden and scar, and eventually stop working. | • Fatigue • Itchy skin • Dry eyes and mouth • Yellowing of skin and whites of eyes |
Psoriasis (suh-REYE-uh-suhss) A disease that causes new skin cells that grow deep in your skin to rise too fast and pile up on the skin surface. | • Thick red patches, covered with scales, usually appearing on the head, elbows, and knees • Itching and pain, which can make it hard to sleep, walk, and care for yourself May have: • A form of arthritis that often affects the joints and the ends of the fingers and toes. Back pain can occur if the spine is involved. |
Rheumatoid arthritis (ROO-muh-toid ar-THREYE-tuhss) A disease in which the immune system attacks the lining of the joints throughout the body. | • Painful, stiff, swollen, and deformed joints • Reduced movement and function May have: • Fatigue • Fever • Weight loss • Eye inflammation • Lung disease • Lumps of tissue under the skin, often the elbows • Anemia |
Scleroderma (sklair-oh-DUR-muh) A disease causing abnormal growth of connective tissue in the skin and blood vessels. | • Fingers and toes that turn white, red, or blue in response to heat and cold • Pain, stiffness, and swelling of fingers and joints • Thickening of the skin • Skin that looks shiny on the hands and forearm • Tight and mask-like facial skin • Sores on the fingers or toes • Trouble swallowing • Weight loss • Diarrhea or constipation • Shortness of breath |
Sjögren’s (SHOH-grins) syndrome A disease in which the immune system targets the glands that make moisture, such as tears and saliva. | • Dry eyes or eyes that itch • Dryness of the mouth, which can cause sores • Trouble swallowing • Loss of sense of taste • Severe dental cavities • Hoarse voice • Fatigue • Joint swelling or pain • Swollen glands • Cloudy eyes |
Systemic lupus erythematosus (LOO-puhss ur-ih-thee-muh-TOH-suhss) A disease that can damage the joints, skin, kidneys, heart, lungs, and other parts of the body. Also called SLE or lupus. | • Fever • Weight loss • Hair loss • Mouth sores • Fatigue • “Butterfly” rash across the nose and cheeks • Rashes on other parts of the body • Painful or swollen joints and muscle pain • Sensitivity to the sun • Chest pain • Headache, dizziness, seizure, memory problems, or change in behavior |
Vitiligo (vit-ihl-EYE-goh) The immune system destroys the cells that give your skin its color. It also can affect the tissue inside your mouth and nose. | • White patches on areas exposed to the sun, or on armpits, genitals, and rectum • Hair turns gray early • Loss of color inside your mouth |
How do I find out if I have an autoimmune disease?
Getting a diagnosis can be a long and stressful process. Although each autoimmune disease is unique, many share some of the same symptoms. And many symptoms of autoimmune diseases are the same for other types of health problems too. This makes it hard for doctors to find out if you really have an autoimmune disease, and which one it might be. But if you are having symptoms that bother you, it’s important to find the cause. Don’t give up if you’re not getting any answers. You can take these steps to help find out the cause of your symptoms:
- Write down a complete family health history that includes extended family and share it with your doctor.
- Record any symptoms you have, even if they seem unrelated, and share it with your doctor.
- See a specialist who has experience dealing with your most major symptom. For instance, if you have symptoms of inflammatory bowel disease, start with a gastroenterologist. Ask your regular doctor, friends, and others for suggestions.
- Get a second, third, or fourth opinion if need be. If your doctor doesn’t take your symptoms seriously or tells you they are stress-related or in your head, see another doctor.
Juggling your health care needs among many doctors and specialists can be hard. But specialists, along with your main doctor, may be helpful in managing some symptoms of your autoimmune disease. If you see a specialist, make sure you have a supportive main doctor to help you. Often, your family doctor may help you coordinate care if you need to see one or more specialists. Here are some specialists who treat autoimmune diseases:
- Nephrologist. A doctor who treats kidney problems, such as inflamed kidneys caused by lupus. Kidneys are organs that clean the blood and produce urine.
- Rheumatologist. A doctor who treats arthritis and other rheumatic diseases, such as scleroderma and lupus.
- Endocrinologist. A doctor who treats gland and hormone problems, such as diabetes and thyroid disease.
- Neurologist. A doctor who treats nerve problems, such as multiple sclerosis and myasthenia gravis.
- Hematologist. A doctor who treats diseases that affect blood, such as some forms of anemia.
- Gastroenterologist. A doctor who treats problems with the digestive system, such as inflammatory bowel disease.
- Dermatologist. A doctor who treats diseases that affect the skin, hair, and nails, such as psoriasis and lupus.
- Physical therapist. A health care worker who uses proper types of physical activity to help patients with stiffness, weakness, and restricted body movement.
- Occupational therapist. A health care worker who can find ways to make activities of daily living easier for you, despite your pain and other health problems. This could be teaching you new ways of doing things or how to use special devices. Or suggesting changes to make in your home or workplace.
- Speech therapist. A health care worker who can help people with speech problems from illness such as multiple sclerosis.
- Audiologist. A health care worker who can help people with hearing problems, including inner ear damage from autoimmune diseases.
- Vocational therapist. A health care worker who offers job training for people who cannot do their current jobs because of their illness or other health problems. You can find this type of person through both public and private agencies.
- Counselor for emotional support. A health care worker who is specially trained to help you to find ways to cope with your illness. You can work through your feelings of anger, fear, denial, and frustration.
Further Reading
- Autoimmune Diseases and Women’s Health Spotlighted During Webinar (February 2022)
- Scientific Journeys: From Basic Researcher to Leader in Autoimmunity (July 2021)
- Fred Miller Retires From NIEHS Clinical Research Branch (April 2021)
- Autoimmunity Origins May Lie in Defective Mitochondria (March 2021)
- Autoimmunity May Be Rising in the United States (May 2020)
Additional Resources
- Facts About Autoimmune Diseases – from the NIH Office of Women’s Health
- List of Autoimmune Diseases – from the American Autoimmune Related Diseases Association