What is an autoimmune disease?
A healthy immune system offers protection against the bacteria and viruses that cause illness, deploying antibodies that attack these invaders. An autoimmune disease occurs when the immune system cannot differentiate between germs and the body’s own cells and mistakenly attacks various tissues and organs.
There are more than 80 of these conditions, with variation in the affected area of the body; some of the most common autoimmune disorders involve the joints and muscles, digestive tract, nervous system, and skin. There is also significant variation in day-to-day life with autoimmune disorders. Some, like type 1 diabetes, require daily management, while others may have periods of intensified symptoms known as flare-ups. In all cases, there are treatment options that can reduce discomfort and help you experience a better quality of life. Here’s what to know about the most common types of autoimmune disorders.
Causes and symptoms of autoimmune disorders
Many autoimmune disorders do not have a specific known trigger, but the following factors may play a role in the development of certain conditions.
- Genetics — some autoimmune disorders such as lupus and multiple sclerosis run in families and likely have a genetic component.
- Sex — of the 23.5 million Americans living with an autoimmune disease, 78% are women. Specific autoimmune disorders that are more common in women than men include rheumatoid arthritis, psoriasis, celiac disease, inflammatory bowel disease, lupus and multiple sclerosis, among others.
- Obesity — being overweight or obese may increase an individual’s risk of developing rheumatoid arthritis or psoriatic arthritis.
- Smoking — research suggests a connection between cigarette smoking and lupus, rheumatoid arthritis, hyperthyroidism, and multiple sclerosis.
- Medications — some medications including blood pressure medications, statins (which are commonly used to treat high cholesterol), and antibiotics may increase a person’s risk for certain autoimmune disorders. Consult with your doctor about medication side effects if you have concerns.
While exact symptoms and treatment options vary by condition, as explained in more detail below, there is also some overlap. Fatigue, joint pain and swelling, rashes and other skin issues, digestive issues, and swollen glands are common signs of a variety of autoimmune disorders.
How is an autoimmune disease diagnosed?
Most autoimmune disorders do not have one single test to confirm or rule out a diagnosis. With the majority of these conditions, the diagnosis process involves several steps including a physical exam and multiple tests.
If you have potential symptoms of an autoimmune disease, a common first step is an antinuclear antibody (ANA) test. This is a blood test that checks for antinuclear antibodies, the type of antibodies that attack healthy cells. If you have a positive ANA result, your doctor will likely recommend additional tests to identify the specific autoimmune disease.
A negative ANA test does not necessarily mean that you do not have an autoimmune disease. If you have negative ANA results, your doctor may recommend additional tests for other antibodies or inflammation markers depending on your symptoms. Tests used to diagnose autoimmune disorders include:
- An erythrocyte sedimentation rate (ESR) test — which examines how quickly your red blood cells sink to the bottom of a test tube — may be used to diagnose rheumatoid arthritis and lupus. Higher rates of settlement may indicate inflammation.
- A c-reactive protein (CRP) test — which identifies your blood levels of CRP, an inflammation-linked protein produced in your liver — may be used to diagnose rheumatoid arthritis, lupus, and inflammatory bowel disease.
- A rheumatoid factor (RF) test checks for rheumatoid factor, an antibody found in about 80% of individuals with rheumatoid arthritis.
Depending on your symptoms, your healthcare provider may refer you to one of the following specialists:
- A rheumatologist who treats autoimmune disorders of the joints and muscles including rheumatoid arthritis and lupus.
- A gastroenterologist who treats autoimmune disorders of the digestive system including Crohn’s disease, celiac disease, and ulcerative colitis.
- An endocrinologist who treats autoimmune disorders of the endocrine system including Graves’ disease and Hashimoto’s thyroiditis.
- A dermatologist who treats skin-related autoimmune disorders including psoriasis.
Common autoimmune disorders and treatment
These are some of the most common types of autoimmune disorders affecting individuals in the U.S. Symptoms, treatment, and diagnostic tests vary by condition.
Rheumatoid arthritis occurs when your immune system attacks the lining of your joints, causing pain and inflammation throughout your body. It is a progressive condition, and getting an early diagnosis and staying proactive about treatment can help prevent more severe damage to your joints.
Several medications may be used to reduce the pain and inflammation caused by rheumatoid arthritis, including over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil®), aspirin (Bayer®) or naproxen (Aleve®); acetaminophen (Tylenol®); and Janus kinase (JAK) inhibitors such as baricitinib (Olumiant®), tofacitinib (Xeljanz®), and upadacitinib (Rinvoq®). In addition, avoiding or reducing your intake of sugars and refined carbohydrates and gluten can also help reduce inflammation.
Disease-modifying anti-rheumatic drugs (DMARDs) like methotrexate (Rheumatrex®), sulfasalazine (Azulfidine®), and leflunomide (Arava®) and injectable biologic DMARDs like etanercept (Enbrel®), infliximab (Remicade®), adalimumab (Humira®), and certolizumab pegol (Cimzia®) are often prescribed to slow tissue damage.
Type 1 diabetes
Type 1 diabetes is an autoimmune condition that occurs when the body mistakenly attacks the pancreas with antibodies. This destroys the pancreas’s insulin-producing cells, so individuals with type 1 diabetes cannot produce any insulin and rely on daily insulin therapy to manage their blood sugar.
For more information on managing type 1 diabetes, read our previous blogs:
Psoriasis is a skin disorder that occurs when inflammation caused by an immune response causes new skin cells to grow too quickly. It is characterized by thick patches of skin covered with white or silver scales, also referred to as plaques. There is a genetic component, and psoriasis often runs in families.
Many individuals with psoriasis experience periodic flare-ups. While not all psoriasis flare-ups can be attributed to a specific cause, skin injury, stress, and cold weather are common triggers.
There are a variety of treatments for psoriasis, including steroid creams; anthralin (Drithocreme HP® and Zithranol®), an anti-inflammatory medication; moisturizers; UV light therapy; vitamin D3 ointment; and vitamin A creams.
Systemic lupus erythematosus (SLE), the most common type of lupus, affects many different parts of the body including the skin, joints, kidneys, brain, and heart. Common symptoms include joint pain and swelling, severe fatigue, and rashes. Without effective treatment, lupus can lead to other health complications over time, including blood clots and inflammation of the heart or kidneys, and increase your risk for a heart attack or stroke. Getting diagnosed early and starting treatment as soon as possible is critical to managing lupus.
Lupus treatment varies depending on the severity of symptoms and which part of the body is affected. Other-the-counter NSAIDs and oral corticosteroids including prednisone (Deltasone®, Prednicot®) may be used to treat joint pain and stiffness. Antimalarial medications including hydroxychloroquine (Plaquenil®) are often prescribed to reduce pain and inflammation, prevent flare-ups, and treat rashes.
Inflammatory bowel disease
Inflammatory bowel disease refers to several autoimmune diseases that affect the digestive tract including Crohn’s disease, which involves any part of the small or large intestine, and ulcerative colitis, which involves the colon, rectum, or both organs.
Common symptoms of both Crohn’s disease and ulcerative colitis include diarrhea, abdominal cramps, bloody stools, fever, fatigue, loss of appetite, and weight loss. Many individuals with these conditions experience periods of time without symptoms, also known as remission. Treatment options include the following:
- Antidiarrheal and anti-inflammatory medications such as oral 5-aminosalicylates and corticosteroids
- Immunomodulators, a group of medications that act on the immune system to reduce the inflammation that causes Crohn’s
- Biologics, a group of medications that are derived from antibodies and used to prevent inflammation in more severe cases, such as adalimumab (Humira®), golimumab (Simponi®), infliximab (Remicade®), tofacitinib (Xeljanz®), ustekinumab (Stelara®), and vedolizumab (Entyvio®)
Other common autoimmune diseases include:
- Multiple sclerosis, which affects the nervous system
- Addison’s disease, which affects the adrenal glands
- Graves’ disease, which affects the thyroid gland in the neck
- Celiac disease, which affects the digestive tract
Your partner in health
Living with any chronic condition is easier with a reliable pharmacy partner by your side. Our pharmacists have specialized training in the treatment of autoimmune diseases and can answer any questions you may have, from medication side effects to non-pharmacological treatment options and navigating lifestyle changes. In addition, we offer free, same-day delivery and medication management tools like reminders and auto refills in our app to make it as simple as possible to stay on track with your treatment.
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This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.
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