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Frequently Asked questions Autoimmune Q: How common are autoimmune diseases? A: Overall, autoimmune diseases are Diseases: 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. http://www.womenshealth.gov 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 Muscles Mouth and viral and bacterial infections are Nerves Spinal Cord linked to many autoimmune diseases. Trachea Thyroid Blood and Blood Vessels Lung • People of certain races or ethnic Heart Stomach backgrounds — Some autoimmune Skin Joints diseases are more common or more Pancreas Esophagus Large Intestine severely affect certain groups of people Liver Kidney Small Intestine more than others. For instance, type page 1 Uterus Bladder 1 diabetes is more common in white Vagina Ovary people. Lupus is most severe for Cervix 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. http://www.womenshealth.gov 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 http://www.womenshealth.gov • 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 http://www.womenshealth.gov 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 http://www.womenshealth.gov • Symptoms vary because the location and extent of each attack vary 1-800-994-9662 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 http://www.womenshealth.gov • Eye inflammation 1-800-994-9662 • Lung disease TDD: 1-888-220-5446 • Lumps of tissue under the skin, often the elbows • 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 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 • 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 http://www.womenshealth.gov • 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. http://www.womenshealth.gov • See a specialist who has experience • Hematologist. A doctor who treats 1-800-994-9662 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. disease. • 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 http://www.womenshealth.gov 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 http://www.womenshealth.gov 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. page 10 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 http://www.womenshealth.gov You have some power to lessen for illness. Most people need at least 1-800-994-9662 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. page 11 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 womenshealth.gov 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 http://www.womenshealth.gov 226-4267 Internet Address: http://www.niddk.nih.gov Internet Address: http://www.niams.nih.gov 1-800-994-9662 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: http://www.nhlbi.nih.gov Internet Address: http://www3.niaid.nih.gov 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: http://www.aarda.org Internet Address: http://www.ninds.nih.gov 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. page 12 U.S. Department of Health and Human Services, Office on Women’s Health
"Autoimmune Diseases Overview"