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Autoimmune Diseases Overview


									                                                                            Frequently Asked questions

                                                                                      Q: How common are autoimmune
                                                                                      A: Overall, autoimmune diseases are

                                                                                          common, affecting more than 23.5
                                                                                          million Americans. They are a leading
                                                                                          cause of death and disability. Yet some
                                                                                          autoimmune diseases are rare, while

                              Overview                                                    others, such as Hashimoto’s thyroiditis,
                                                                                          affect many people.
                                                                                      Q: Who gets autoimmune diseases?
         1-800-994-9662       Q: What are autoimmune diseases?                        A: Autoimmune diseases can affect any-
                              A: Our bodies have an immune system,                        one. Yet certain people are at greater
  TDD: 1-888-220-5446
                                   which is a complex network of special cells            risk, including:
                                   and organs that defends the body from
                                   germs and other foreign invaders. At the           	   •	 Women of childbearing age —
                                   core of the immune system is the ability to               More women than men have
                                   tell the difference between self and nonself:             autoimmune diseases, which often
                                   what’s you and what’s foreign. A flaw can                 start during their childbearing years.
                                   make the body unable to tell the difference        	   •	 People with a family history —
                                   between self and nonself. When this                       Some autoimmune diseases run in
                                   happens, the body makes autoantibodies                    families, such as lupus and multiple
                                   (AW-toh-AN-teye-bah-deez) that attack                     sclerosis. It is also common for dif-
                                   normal cells by mistake. At the same time                 ferent types of autoimmune dis-
                                   special cells called regulatory T cells fail              eases to affect different members of
                                   to do their job of keeping the immune                     a single family. Inheriting certain
                                   system in line. The result is a misguided                 genes can make it more likely to get
                                   attack on your own body. This causes the                  an autoimmune disease. But a com-
                                   damage we know as autoimmune disease.                     bination of genes and other factors
                                   The body parts that are affected depend on                may trigger the disease to start.
                                   the type of autoimmune disease. There are          	   •	 People who are around certain
                                   more than 80 known types.                                 things in the environment —
                                                                                             Certain events or environmental
                                    Body Parts That Can Be Affected
                                                                                             exposures may cause some autoim-
                                       by Autoimmune Diseases
                                                                                             mune diseases, or make them worse.
                                   Others:                          Brain                    Sunlight, chemicals called solvents,
                                    Glands                          Eyes
                                                                                             and viral and bacterial infections are
                                                                    Spinal Cord              linked to many autoimmune diseases.
                                  Blood and
                               Blood Vessels                        Lung
                                                                                      	   •	 People of certain races or ethnic
                                      Heart                         Stomach                  backgrounds — Some autoimmune
                                       Skin                         Joints                   diseases are more common or more
                                                                    Large Intestine
                                                                                             severely affect certain groups of people
                                     Kidney                         Small Intestine          more than others. For instance, type
                   page 1            Uterus                         Bladder                  1 diabetes is more common in white
                                                                                             people. Lupus is most severe for
                                                                                             African-American and Hispanic people.

                                             U.S. Department of Health and Human Services, Office on Women’s Health
                                                                    Frequently Asked questions

                              Q: What autoimmune diseases                             Although each disease is unique,
                                 affect women, and what are                           many share hallmark symptoms, such
                                 their symptoms?                                      as fatigue, dizziness, and low-grade
                              A: The diseases listed here either are more             fever. For many autoimmune diseases,
                                  common in women than men or affect                  symptoms come and go, or can be mild
                                  many women and men. They are listed                 sometimes and severe at others. When
                                  in A-to-Z order.                                    symptoms go away for a while, it’s
                                                                                      called remission. Flares are the sudden
                                                                                      and severe onset of symptoms.                  Types of Autoimmune Diseases & Their Symptoms
         1-800-994-9662                        Disease                          Symptoms
  TDD: 1-888-220-5446         Alopecia areata (Al-uh-PEE-shuh AR-ee-            •	 Patchy	hair	loss	on	the	scalp,	face,	or	other	
                              AYT-uh)                                              areas of your body
                              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.
                              Antiphospholipid (an-teye-FOSS-foh-lip-ihd) •	 Blood	clots	in	veins	or	arteries
                              antibody syndrome (aPL)                          •	 Multiple	miscarriages
                              A disease that causes problems in the inner      •	 Lacy,	net-like	red	rash	on	the	wrists	and	
                              lining of blood vessels resulting in blood clots    knees
                              in arteries or veins.
                              Autoimmune hepatitis                             •	 Fatigue
                              The immune system attacks and destroys the •	 Enlarged	liver
                              liver cells. This can lead to scarring and hard- •	 Yellowing	of	the	skin	or	whites	of	eyes
                              ening of the liver, and possibly liver failure.
                                                                               •	 Itchy	skin
                                                                                •	 Joint	pain
                                                                                •	 Stomach	pain	or	upset
                              Celiac disease                                    •	 Abdominal	bloating	and	pain
                              A disease in which people can’t tolerate          •	 Diarrhea	or	constipation
                              gluten, a substance found in wheat, rye, and      •	 Weight	loss	or	weight	gain
                              barley, and also some medicines. When people
                              with celiac disease eat foods or use products     •	 Fatigue
                              that have gluten, the immune system responds      •	 Missed	menstrual	periods
                              by damaging the lining of the small intestines.   •	 Itchy	skin	rash
                                                                                •	 Infertility	or	miscarriages

                   page 2

                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                   Frequently Asked questions

                                            Types of Autoimmune Diseases & Their Symptoms
                                              Disease                          Symptoms
                              Diabetes type 1                                  •	 Being	very	thirsty
                              A disease in which your immune system            •	 Urinating	often
                              attacks the cells that make insulin, a hor-      •	 Feeling	very	hungry	or	tired
                              mone needed to control blood sugar levels.
                              As a result, your body cannot make insulin.      •	 Losing	weight	without	trying
                              Without insulin, too much sugar stays in your    •	 Having	sores	that	heal	slowly
                              blood. Too high blood sugar can hurt the eyes,   •	 Dry,	itchy	skin
                              kidneys,	nerves,	and	gums	and	teeth.	But	the                                                    •	 Losing	the	feeling	in	your	feet	or	having	tin-
                              most serious problem caused by diabetes is
         1-800-994-9662                                                           gling in your feet
                              heart disease.
  TDD: 1-888-220-5446                                                          •	 Having	blurry	eyesight
                              Graves’ disease (overactive thyroid)             •	 Insomnia
                              A disease that causes the thyroid to make too •	 Irritability
                              much thyroid hormone.                         •	 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) syn-           •	 Weakness	or	tingling	feeling	in	the	legs	that	
                              drome                                               might spread to the upper body
                              The immune system attacks the nerves that        •	 Paralysis	in	severe	cases
                              connect your brain and spinal cord with          Symptoms often progress relatively quickly,
                              the rest of your body. Damage to the nerves      over a period of days or weeks, and often
                              makes it hard for them to transmit signals. As   occur on both sides of the body.
                              a result, the muscles have trouble responding
                              to the brain.
                              Hashimoto’s	(hah-shee-MOH-tohz)	disease          •	 Fatigue
                              (underactive thyroid)                         •	 Weakness
                              A disease that causes the thyroid to not make •	 Weight	gain
                              enough thyroid hormone.
                                                                            •	 Sensitivity	to	cold
                                                                               •	 Muscle	aches	and	stiff	joints
                                                                               •	 Facial	swelling
                   page 3                                                      •	 Constipation

                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                   Frequently Asked questions

                                            Types of Autoimmune Diseases & Their Symptoms
                                              Disease                          Symptoms
                              Hemolytic anemia (HEE-moh-lit-ihk uh-            •	 Fatigue
                              NEE-mee-uh)                                      •	 Shortness	of	breath
                              The immune system destroys the red blood         •	 Dizziness
                              cells. Yet the body can’t make new red blood
                                                                               •	 Headache
                              cells fast enough to meet the body’s needs.
                              As a result, your body does not get the oxy-     •	 Cold	hands	or	feet
                              gen it needs to function well, and your heart    •	 Paleness   must work harder to move oxygen-rich blood       •	 Yellowish	skin	or	whites	of	eyes
                              throughout the body.
         1-800-994-9662                                                        •	 Heart	problems,	including	heart	failure
  TDD: 1-888-220-5446         Idiopathic thrombocytopenic purpura              •	 Very	heavy	menstrual	period
                              (id-ee-oh-PATH-ihk throm-boh-seye-toh-PEE-       •	 Tiny	purple	or	red	dots	on	the	skin	that	
                              nik PUR-pur-uh) (ITP)                               might look like a rash.
                              A disease in which the immune system             •	 Easy	bruising
                              destroys blood platelets, which are needed
                                                                               •	 Nosebleed	or	bleeding	in	the	mouth
                              for blood to clot.
                              Inflammatory bowel disease (IBD)                 •	 Abdominal	pain
                              A disease that causes chronic inflammation of    •	 Diarrhea,	which	may	be	bloody
                              the	digestive	tract.	Crohn’s	(krohnz)	disease	   Some people also have:
                              and	ulcerative	colitis	(UHL-sur-uh-tiv	koh-
                              LEYE-tuhss)	are	the	most	common	forms	of	        •	 Rectal	bleeding
                              IBD.                                             •	 Fever
                                                                               •	 Weight	loss
                                                                               •	 Fatigue
                                                                               •	 Mouth	ulcers	(in	Crohn’s	disease)
                                                                               •	 Painful	or	difficult	bowel	movements	(in	
                                                                                  ulcerative colitis)
                              Inflammatory myopathies (meye-OP-uh-             •	 Slow	but	progressive	muscle	weakness	
                              theez)                                              beginning in the muscles closest to the
                              A group of diseases that involve mus-               trunk of the body. Polymyositis affects
                              cle inflammation and muscle weakness.               muscles involved with making movement
                              Polymyositis (pol-ee-meye-uh-SYT-uhss) and          on both sides of the body. With dermato-
                              dermatomyositis (dur-muh-toh-meye-uh-SYT-           myositis, a skin rash comes before or at the
                              uhss) are 2 types more common in women              same time as muscle weakness.
                              than men.                                        May	also	have:
                                                                               •	 Fatigue	after	walking	or	standing
                                                                               •	 Tripping	or	falling
                                                                               •	 Difficulty	swallowing	or	breathing
                   page 4

                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                    Frequently Asked questions

                                             Types of Autoimmune Diseases & Their Symptoms
                                               Disease                          Symptoms
                              Multiple sclerosis	(MUHL-tip-uhl	sklur-OH- •	 Weakness	and	trouble	with	coordination,	
                              suhss) (MS)                                   balance, speaking, and walking
                              A disease in which the immune system             •	 Paralysis
                              attacks the protective coating around the        •	 Tremors
                              nerves. The damage affects the brain and spi-
                                                                               •	 Numbness	and	tingling	feeling	in	arms,	legs,	
                              nal cord.
                                                                                  hands, and feet
                                                                               •	 Symptoms	vary	because	the	location	and	
                                                                                  extent of each attack vary
                              Myasthenia gravis (meye-uhss-THEEN-ee-           •	 Double	vision,	trouble	keeping	a	steady	
  TDD: 1-888-220-5446         uh	GRAV-uhss)	(MG)                                  gaze,	and	drooping	eyelids
                              A disease in which the immune system             •	 Trouble	swallowing,	with	frequent	gagging	
                              attacks the nerves and muscles throughout           or choking
                              the body.                                        •	 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	        •	 Fatigue
                              sur-ROH-suhss)                                    •	 Itchy	skin
                              The immune system slowly destroys the liv-        •	 Dry	eyes	and	mouth
                              er’s	bile	ducts.	Bile	is	a	substance	made	in	the	
                                                                                •	 Yellowing	of	skin	and	whites	of	eyes
                              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.
                              Psoriasis (suh-REYE-uh-suhss)                     •	 Thick	red	patches,	covered	with	scales,	
                              A disease that causes new skin cells that grow       usually appearing on the head, elbows, and
                              deep in your skin to rise too fast and pile up       knees
                              on the skin surface.                             •	 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.

                   page 5

                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                    Frequently Asked questions

                                             Types of Autoimmune Diseases & Their Symptoms
                                               Disease                          Symptoms
                              Rheumatoid arthritis (ROO-muh-toid ar-          •	 Painful,	stiff,	swollen,	and	deformed	joints
                              THREYE-tuhss)                                   •	 Reduced	movement	and	function
                              A disease in which the immune system attacks    May	have:
                              the	lining	of	the	joints	throughout	the	body.
                                                                              •	 Fatigue
                                                                              •	 Fever
                                                                              •	 Weight	loss                                                   •	 Eye	inflammation
         1-800-994-9662                                                       •	 Lung	disease
  TDD: 1-888-220-5446                                                         •	 Lumps	of	tissue	under	the	skin,	often	the	
                                                                              •	 Anemia
                              Scleroderma (sklair-oh-DUR-muh)                 •	 Fingers	and	toes	that	turn	white,	red,	or	
                              A disease causing abnormal growth of con-          blue in response to heat and cold
                              nective tissue in the skin and blood vessels.   •	 Pain,	stiffness,	and	swelling	of	fingers	and	
                                                                              •	 Thickening	of	the	skin
                                                                              •	 Skin	that	looks	shiny	on	the	hands	and	
                                                                              •	 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                 •	 Dry	eyes	or	eyes	that	itch
                              A disease in which the immune system tar-       •	 Dryness	of	the	mouth,	which	can	cause	
                              gets the glands that make moisture, such as        sores
                              tears and saliva.                               •	 Trouble	swallowing
                                                                              •	 Loss	of	sense	of	taste
                                                                              •	 Severe	dental	cavities
                                                                              •	 Hoarse	voice
                                                                              •	 Fatigue
                                                                              •	 Joint	swelling	or	pain
                                                                              •	 Swollen	glands
                   page 6
                                                                              •	 Cloudy	eyes

                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                           Frequently Asked questions

                                                  Types of Autoimmune Diseases & Their Symptoms
                                                    Disease                          Symptoms
                                  Systemic lupus erythematosus	(LOO-                 •	 Fever
                                  puhss ur-ih-thee-muh-TOH-suhss)                  •	 Weight	loss
                                  A	disease	that	can	damage	the	joints,	skin,	kid- •	 Hair	loss
                                  neys, heart, lungs, and other parts of the body.
                                                                                   •	 Mouth	sores
                                  Also	called	SLE	or	lupus.
                                                                                   •	 Fatigue
                                                                                     •	 “Butterfly”	rash	across	the	nose	and	cheeks                                                          •	 Rashes	on	other	parts	of	the	body
         1-800-994-9662                                                              •	 Painful	or	swollen	joints	and	muscle	pain
  TDD: 1-888-220-5446                                                                •	 Sensitivity	to	the	sun
                                                                                     •	 Chest	pain
                                                                                     •	 Headache,	dizziness,	seizure,	memory	prob-
                                                                                        lems, or change in behavior
                                  Vitiligo (vit-ihl-EYE-goh)                         •	 White	patches	on	areas	exposed	to	the	
                                  The immune system destroys the cells that             sun, or on armpits, genitals, and rectum
                                  give your skin its color. It also can affect the   •	 Hair	turns	gray	early
                                  tissue inside your mouth and nose.                 •	 Loss	of	color	inside	your	mouth

                              Q: Are chronic fatigue syndrome                                   applied to them. Other symptoms
                                 and fibromyalgia autoimmune                                    include fatigue, trouble sleeping, and
                                 diseases?                                                      morning stiffness. FM mainly occurs
                              A: Chronic fatigue syndrome (CFS) and                             in women of childbearing age. But
                                      fibromyalgia (feye-broh-meye-AL-juh)                      children, the elderly, and men are
                                      (FM) are not autoimmune diseases.                         sometimes can also get it. The cause
                                      But they often have symptoms of some                      is not known.
                                      autoimmune disease, like being tired all
                                      the time and pain.                              Q: How do I find out if I have an
                              	       •	 CFS	can	cause	you	to	be	very	                   autoimmune disease?
                                         tired, have trouble concentrating,           A: Getting a diagnosis can be a long and
                                         feel weak, and have muscle pain.                  stressful process. Although each auto-
                                         Symptoms of CFS come and go.                      immune disease is unique, many share
                                         The cause of CFS is not known.                    some of the same symptoms. And many
                              	       •	 FM	is	a	disorder	in	which	pain	or	                symptoms of autoimmune diseases are
                                         tenderness is felt in multiple places             the same for other types of health prob-
                                         all over the body. These “tender                  lems too. This makes it hard for doctors
                                         points” are located on the neck,                  to find out if you really have an autoim-
                                         shoulders, back, hips, arms, and legs             mune disease, and which one it might
                                         and are painful when pressure is                  be. But if you are having symptoms that
                   page 7                                                                  bother you, it’s important to find the

                                           U.S. Department of Health and Human Services, Office on Women’s Health
                                                                    Frequently Asked questions

                                  cause. Don’t give up if you’re not get-     	   •	 Rheumatologist. A doctor who
                                  ting any answers. You can take these               treats arthritis and other rheumatic
                                  steps to help find out the cause of your           diseases, such as scleroderma and
                                  symptoms:                                          lupus.
                              	   •	 Write	down	a	complete	family	            	   •	 Endocrinologist. A doctor who
                                     health history that includes extended           treats gland and hormone problems,
                                     family and share it with your doctor.           such as diabetes and thyroid disease.
                              	   •	 Record	any	symptoms	you	have,	           	   •	 Neurologist. A doctor who treats
                                     even if they seem unrelated, and                nerve problems, such as multiple
                                     share it with your doctor.                      sclerosis and myasthenia gravis.
                              	   •	 See	a	specialist	who	has	experience	     	   •	 Hematologist. A doctor who treats
                                     dealing with your most major symp-              diseases that affect blood, such as
  TDD: 1-888-220-5446                tom. For instance, if you have symp-            some forms of anemia.
                                     toms of inf lammatory bowel disease,
                                                                              	   •	 Gastroenterologist. A doctor who
                                     start with a gastroenterologist. Ask
                                                                                     treats problems with the digestive
                                     your regular doctor, friends, and
                                                                                     system, such as inf lammatory bowel
                                     others for suggestions.
                              	   •	 Get	a	second,	third,	or	fourth	opin-
                                                                              	   •	 Dermatologist. A doctor who treats
                                     ion if need be. If your doctor doesn’t
                                                                                     diseases that affect the skin, hair, and
                                     take your symptoms seriously or tells
                                                                                     nails, such as psoriasis and lupus.
                                     you they are stress-related or in your
                                     head, see another doctor.                	   •	 Physical therapist. A health care
                                                                                     worker who uses proper types of
                                                                                     physical activity to help patients with
                              Q: What types of doctors treat                         stiffness, weakness, and restricted
                                 autoimmune diseases?                                body movement.
                              A: Juggling your health care needs among
                                                                              	   •	 Occupational therapist. A health
                                  many doctors and specialists can be
                                                                                     care worker who can find ways to
                                  hard. But specialists, along with your
                                                                                     make activities of daily living easier
                                  main doctor, may be helpful in manag-
                                                                                     for you, despite your pain and other
                                  ing some symptoms of your autoim-
                                                                                     health problems. This could be
                                  mune disease. If you see a specialist,
                                                                                     teaching you new ways of doing
                                  make sure you have a supportive main
                                                                                     things or how to use special devices.
                                  doctor to help you. Often, your family
                                                                                     Or suggesting changes to make in
                                  doctor may help you coordinate care if
                                                                                     your home or workplace.
                                  you need to see one or more special-
                                  ists. Here are some specialists who treat   	   •	 Speech therapist. A health care
                                  autoimmune diseases:                               worker who can help people with
                              	   •	 Nephrologist. A doctor who treats               speech problems from illness such as
                                     kidney problems, such as inf lamed              multiple sclerosis.
                                     kidneys caused by lupus. Kidneys are     	   •	 Audiologist. A health care worker
                                     organs that clean the blood and pro-            who can help people with hearing
                                     duce urine.                                     problems, including inner ear dam-
                   page 8                                                            age from autoimmune diseases.

                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                   Frequently Asked questions

                              	   •	 Vocational therapist. A health care             underactive thyroid.
                                     worker who offers job training for       	   •	 Suppress the immune system.
                                     people who cannot do their current              Some drugs can suppress immune
                                     jobs because of their illness or other          system activity. These drugs can help
                                     health problems. You can find this              control the disease process and pre-
                                     type of person through both public              serve organ function. For instance,
                                     and private agencies.                           these drugs are used to control
                              	   •	 Counselor for emotional sup-                    inflammation in affected kidneys in
                                     port. A health care worker who is               people with lupus to keep the kid-
                                     specially trained to help you to find           neys working. Medicines used to          ways to cope with your illness. You             suppress inflammation include che-
         1-800-994-9662              can work through your feelings of               motherapy given at lower doses than
                                     anger, fear, denial, and frustration.           for cancer treatment and drugs used
  TDD: 1-888-220-5446
                                                                                     in patients who have had an organ
                                                                                     transplant to protect against rejec-
                              Q: Are there medicines to treat                        tion. A class of drugs called anti-TNF
                                 autoimmune diseases?                                medications blocks inflammation in
                              A: There are many types of medicines                   some forms of autoimmune arthritis
                                  used to treat autoimmune diseases. The             and psoriasis.
                                  type of medicine you need depends on
                                  which disease you have, how severe it           New treatments for autoimmune dis-
                                  is, and your symptoms. Treatment can            eases are being studied all the time.
                                  do the following:
                              	   •	 Relieve symptoms. Some people            Q: Are there alternative treat-
                                     can use over-the-counter drugs for          ments that can help?
                                     mild symptoms, like aspirin and ibu-     A: Many people try some form of com-
                                     profen for mild pain. Others with            plimentary and alternative medicine
                                     more severe symptoms may need                (CAM) at some point in their lives.
                                     prescription drugs to help relieve           Some examples of CAM are herbal
                                     symptoms such as pain, swelling,             products, chiropractic, acupuncture,
                                     depression, anxiety, sleep problems,         and hypnosis. If you have an autoim-
                                     fatigue, or rashes. For others, treat-       mune disease, you might wonder
                                     ment may be as involved as having            if CAM therapies can help some of
                                     surgery.                                     your symptoms. This is hard to know.
                              	   •	 Replace vital substances the                 Studies on CAM therapies are limited.
                                     body can no longer make on its               Also, some CAM products can cause
                                     own. Some autoimmune diseases,               health problems or interfere with how
                                     like diabetes and thyroid disease, can       the medicines you might need work.
                                     affect the body’s ability to make sub-       If you want to try a CAM treatment,
                                     stances it needs to function. With           be sure to discuss it with your doctor.
                                     diabetes, insulin injections are need-       Your doctor can tell you about the pos-
                                     ed to regulate blood sugar. Thyroid          sible benefits and risks of trying CAM.
                                     hormone replacement restores thy-
                                     roid hormone levels in people with
                   page 9

                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                  Frequently Asked questions

                              Q: I want to have a baby. Does                    autoimmune diseases lead full, active
                                 having an autoimmune disease                   lives. Your life goals should not have to
                                 affect pregnancy?                              change. It is important, though, to see
                              A: Women with autoimmune diseases                 a doctor who specializes in these types
                                 can safely have children. But there            of diseases, follow your treatment plan,
                                 could be some risks for the mother or          and adopt a healthy lifestyle.
                                 baby, depending on the disease and
                                 how severe it is. For instance, pregnant   Q: How can I deal with flares?
                                 women with lupus have a higher risk of     A: Flares are the sudden and severe onset
                                 preterm birth and stillbirth. Pregnant         of symptoms. You might notice that      women with myasthenia gravis (MG)              certain triggers, such as stress or being
         1-800-994-9662          might have symptoms that lead to               out in the sun, cause your symptoms to
                                 trouble breathing during pregnancy.            f lare. Knowing your triggers, following
  TDD: 1-888-220-5446
                                 For some women, symptoms tend to               your treatment plan, and seeing your
                                 improve during pregnancy, while oth-           doctor regularly can help you to prevent
                                 ers find their symptoms tend to f lare         f lares or keep them from becoming
                                 up. Also, some medicines used to treat         severe. If you suspect a f lare is coming,
                                 autoimmune diseases might not be safe          call your doctor. Don’t try a “cure” you
                                 to use during pregnancy.                       heard about from a friend or relative.
                                 If you want to have a baby, talk to your
                                 doctor before you start trying to get
                                                                            Q: What are some things I can do
                                 pregnant. Your doctor might suggest
                                                                               to feel better?
                                 that you wait until your disease is in
                                 remission or suggest a change in medi-     A: If you are living with an autoimmune
                                 cines before you start trying. You also        disease, there are things you can do
                                 might need to see a doctor who cares           each day to feel better:
                                 for women with high-risk pregnancies.      	   •	 Eat healthy, well-balanced
                                 Some women with autoimmune diseas-                meals. Make sure to include fruits
                                 es may have problems getting pregnant.            and vegetables, whole grains, fat-free
                                 This can happen for many reasons.                 or low-fat milk products, and lean
                                 Tests can tell if fertility problems are          sources of protein. Limit saturated
                                 caused by an autoimmune disease or an             fat, trans fat, cholesterol, salt, and
                                 unrelated reason. Fertility treatments            added sugars. If you follow a healthy
                                 are able to help some women with                  eating plan, you will get the nutri-
                                 autoimmune disease become pregnant.               ents you need from food.
                                                                            	   •	 Get regular physical activity. But
                                                                                   be careful not to overdo it. Talk
                              Q: How can I manage my life now
                                                                                   with your doctor about what types
                                 that I have an autoimmune dis-
                                                                                   of physical activity you can do. A
                                 ease?                                             gradual and gentle exercise program
                              A: Although most autoimmune diseases                 often works well for people with
                                 don’t go away, you can treat your symp-           long-lasting muscle and joint pain.
                                 toms and learn to manage your disease,            Some types of yoga or tai chi exer-
                                 so you can enjoy life! Women with                 cises may be helpful.
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                                      U.S. Department of Health and Human Services, Office on Women’s Health
                                                                   Frequently Asked questions

                              	   •	 Get enough rest.	Rest	allows	your	             reduce stress, lessen your pain, and
                                     body tissues and joints the time they          deal with other aspects of living with
                                     need to repair. Sleeping is a great            your disease. You can learn to do
                                     way you can help both your body                these through self-help books, tapes,
                                     and mind. If you don’t get enough              or with the help of an instructor.
                                     sleep, your stress level and your              Joining a support group or talking
                                     symptoms could get worse. You                  with a counselor might also help you
                                     also can’t fight off sickness as well          to manage your stress and cope with
                                     when you sleep poorly. When you                your disease. n
                                     are well-rested, you can tackle your
                                     problems better and lower your risk                                                   You have some power to lessen
                                     for illness. Most people need at least
                                     7 to 9 hours of sleep each day to feel
                                                                              your pain!
  TDD: 1-888-220-5446                well-rested.                             Try using imagery for 15 minutes,
                              	   •	 Reduce stress. Stress and anxiety        two or three times each day.
                                     can trigger symptoms to f lare up        1. Put on your favorite calming music.
                                     with some autoimmune diseases.           2.	Lie	back	on	your	favorite	chair	or	sofa.	
                                     So finding ways to simplify your            Or if you are at work, sit back and
                                     life and cope with daily stressors          relax in your chair.
                                     will help you to feel your best.
                                                                              3.	Close	your	eyes.
                                     Meditation, self-hypnosis, and guid-
                                     ed imagery, are simple relaxation        4. Imagine your pain or discomfort.
                                     techniques that might help you to        5. Imagine something that confronts this
                                                                                 pain	and	watch	it	“destroy”	the	pain.

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                                       U.S. Department of Health and Human Services, Office on Women’s Health
                                                                  Frequently Asked questions

                              For more information
                              For more information about autoimmune diseases, call at 1-800-994-
                              9662 or contact the following organizations:

                              National Institute of Arthritis and           National Institute of Diabetes and
                              Musculoskeletal and Skin Diseases             Digestive and Kidney Diseases, NIH,
                              (NIAMS), NIH, HHS                             HHS
                              Phone: 301-495-4484; Toll-Free: 1-877-        Phone: 301-496-3583   226-4267                                      Internet Address:
                              Internet Address:
                                                                            National Heart, Lung, and Blood
  TDD: 1-888-220-5446         National Institute of Allergy and             Institute (NHLBI), NIH, HHS
                              Infectious Diseases (NIAID), NIH, HHS         Phone: 301-592-8573
                              Phone: 866-284-4107                           Internet Address:
                              Internet Address:
                                                                            American Autoimmune Related
                              National Institute of Neurological            Diseases Association (AARDA), Inc.
                              Disorders and Stroke (NINDS), NIH,            Phone: 586-776-3900; 1-800-598-4668
                              HHS                                           (for literature requests)
                              Phone: 1-800-352-9424                         Internet Address:
                              Internet Address:

                                  This FAQ was reviewed by:
                                  Ellen Goldmuntz, M.D., Ph.D.
                                  Medical Officer
                                  Division of Allergy, Immunology, and Transplantation
                                  National Institute of Allergy and Infectious Diseases
                                  National Institutes of Health
                                  Bethesda, MD

                                  Audrey S. Penn, M.D.
                                  National Institute of Neurological Disorders and Stroke
                                  National Institutes of Health
                                  Rockville,	MD

                                  All material contained in this FAQ is free of copyright restrictions, and may be copied,
                                  reproduced, or duplicated without permission of the Office on Women's Health in the
                                  Department of Health and Human Services. Citation of the source is appreciated.

                                  Content last updated April 14, 2010.
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                                     U.S. Department of Health and Human Services, Office on Women’s Health

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