What are Autoimmune Diseases & Does it Affect Pregnancy in Women?
Our bodies have an inbuilt defense system inside them that helps us fight against germs and diseases. An immune system is our body’s line of defense against foreign invaders who try to infect us. It is a complex network made up of special organs and cells that are responsible for defending the body. However, many times, some diseases affect the immune system itself. These diseases are known as autoimmune diseases. An autoimmune disease develops because your immune system starts considering your healthy body cells to be foreign, and thus starts mistakenly attacking them. There is no particular body system that an autoimmune disease attacks. It can affect one or even many types of body tissues, depending on what type of autoimmune disease it is. Some autoimmune diseases can also cause abnormal organ growth and also cause changes in the organ function itself. It has been observed that autoimmune diseases affect women more than men. Scientists theorize that the reason behind why autoimmune diseases primarily affect women more than men is because of hormonal changes. The influence of genes on the sex chromosomes and even indirect genetic differences, such as microchimerism can be responsible for this.
What are Autoimmune Diseases?
Autoimmune diseases occur when your immune system starts attacking healthy body cells thinking they are foreign invaders. Under normal circumstances, your immune system fights off bacteria, viruses, and many forms of infections on a daily basis. Due to a flaw, the immune cells start attacking your own body and many diseases arise. The body starts making autoantibodies that start attacking the healthy cells of the body. While this is going on, regulatory T cells in the body also fail to perform their job of keeping the immune system in check. This also results in the immune system attacking the body itself. The damage that results from this is known as an autoimmune disease. There are more than 80 known types of autoimmune diseases and the part of the body affected is based on what type of autoimmune disease it is.
Most autoimmune diseases have similar symptoms and it is also possible to have more than one autoimmune disease at the same time. Due to the fact that they have similar symptoms, it becomes difficult for doctors to diagnose autoimmune diseases. Such types of diseases generally have periods of remissions where patients experience few to no symptoms and periods of flare-ups, where the symptoms tend to get worse.
Autoimmune diseases tend to run in families and 75% of the times, it affects women. Hispanics, Native Americans, and even African Americans are known to have an increased risk of developing autoimmune diseases.
Why Women are Predisposed to Autoimmune Diseases?
Hormonal changes and genetic differences are seen to be the reasons responsible for why women are more susceptible to getting autoimmune diseases. Taking oral contraceptive pills, fluctuations in hormone levels during menstruation, ovulation, and pregnancy, as well as lifestyle choices are seen as the major factors that impact woman's predisposition to autoimmune diseases. Out of the 5% of the population that gets autoimmune diseases, nearly 80% are women. While there are some autoimmune conditions, such as Goodpasture's syndrome, Guillain-Barre Syndrome etc., which are more common in men; though the number of such diseases remains small.
The hormones estrogen, progestogen, prolactin, and androgens are what determine the susceptibility to autoimmune diseases.
Effect of Gender on Autoimmune Diseases
Most autoimmune diseases occur in women, thus it is believed that the X chromosome has a role to play in this. While this gender bias can be relatively modest, as one can witness in the case of Multiple Sclerosis (MS), or it can be strongly reflected, as in the case of Primary Biliary Cirrhosis (PBC). Genetics further proves the theory of gender carries on autoimmune diseases. For example, a mother may have rheumatoid arthritis; her daughter may have juvenile diabetes; her sister might be having Hashimoto's thyroiditis, and her grandmother could be having Graves’ disease. Autoimmune diseases tend to run in the females of the family.
What Autoimmune Diseases Affect Women More & What Are Their Symptoms?
The Autoimmune Diseases listed below are found to be more common in women than men and while each disease is unique, many of them share similar symptoms. Common symptoms shared by them include fatigue, low-grade fever and dizziness.
- Alopecia Areata: Hair follicles are attacked by the immune system and the person starts losing hair rapidly. It is not threatening to the health of the person, but greatly affects the appearance of a person. Symptoms include patchy hair loss on the face, scalp or any other areas of the body.
- Autoimmune Hepatitis: Liver cells are attacked and destroyed by the immune system, leading to scarring and hardening of the liver. Serious cases may even have liver failure. Symptoms can range from fatigue, enlarged liver, yellowing of the skin, itchy skin, stomach pain etc.
- Celiac Disease: Sufferers are unable to tolerate gluten and this condition is often mistaken for gluten intolerance. The immune system attacks and damages the lining of the small intestine. Symptoms include abdominal pain or bloating, diarrhea or constipation, fatigue, itchy skin rash etc.
- Type-1 Diabetes: One of the most common types of autoimmune diseases found in women these days where the immune system attacks the insulin-making cells of the body. Unable to make insulin, the body starts having high blood sugar. Symptoms include frequent urination, feeling very thirsty, losing weight, sores that heal very slowly, dry and itchy skin, having blurry eyesight etc.
- Graves' Disease: Condition that causes the thyroid to go into overproduction and make too much of the thyroid hormone. Symptoms include insomnia, irritability, weight loss, shaky hands, fine brittle hair, bulging eyes, etc. Many times, this condition presents itself with no symptoms.
- Hashimoto's Disease: Also known as an underactive thyroid, this condition causes the thyroid to not make sufficient thyroid hormone. Symptoms include fatigue, weakness, sensitivity to cold, facial swelling, constipation etc.
- Inflammatory Myopathies: This is a collection of diseases that involves inflammation of the muscles and also causes muscle weakness. Dermatomyositis and polymyositis are the two most common types of inflammatory myopathies seen in women. Symptoms include fatigue while walking or standing, falling or constant tripping, difficulty in breathing or swallowing, etc. Dermatomyositis is a condition in which a skin rash develops with muscle weakness. Polymyositis affects the muscles that are involved with movement making on both sides of the body.
- Multiple Sclerosis: A condition that causes the immune system to attack the protective coating around the nerves, thus damaging the spinal cord and brain. Symptoms include weakness with coordination, walking, speaking, balance; numbness in arms, legs, hands, feet; tremors; paralysis, etc.
Does Autoimmune Disease Affect Pregnancy in Women?
Women with autoimmune diseases can go on to have children. However, there could be some risks involved for both the mother and the child, depending on which autoimmune disease the woman has and the severity of the autoimmune disease. For example, women who suffer from lupus have a higher risk of having preterm birth or a stillbirth. Many women also experience an improvement in their symptoms during pregnancy, while others find their symptoms to worsen through the pregnancy. As some medicines that are used to manage the symptoms of autoimmune diseases are not safe to consume during pregnancy, symptoms tend to worsen due to this. If you are suffering from an autoimmune disease, then it is best to discuss pregnancy and conception chances with your doctor before you begin trying for a baby.
What are the Causes of Autoimmune Diseases?
The exact cause behind autoimmune disease is not known. There are many theories that try to determine what triggers the immune system to start attacking the body's healthy cells. These include:
- Bacterial or viral attack.
- Consumption of drugs.
- Environmental or chemical irritants.
Symptoms of Autoimmune Diseases
There are many different types of autoimmune diseases and many symptoms differ amongst these diseases. However, for many of these autoimmune diseases, the symptoms are very similar and often make it difficult for the physician to diagnose.
Common Symptoms in Autoimmune Diseases include:
- General malaise.
These common symptoms usually weaken during remission periods and worsen during a flare-up.
What Part Of The Body Do The Autoimmune Diseases Affect?
As autoimmune diseases affect different parts of the body, the symptoms also vary accordingly. Some of the common organs or tissues Autoimmune Diseases affect include:
- Red blood cells.
- Blood vessels.
- Endocrine glands.
- Connective tissue.
What are the Common Autoimmune Diseases?
Some Of The More Common Types Of Autoimmune Diseases Are Described Below:
- Rheumatoid Arthritis: An autoimmune disease, which leads to inflammation of joints throughout the body and also the surrounding tissues.
- Celiac disease (also known as Sprue): A reaction to gluten that leads to damage to the lining of the small intestine.
- Lupus Erythematosus: An autoimmune condition that affects the joints, skin, brain, kidneys and other organs as well.
- Hashimoto's Disease: An autoimmune condition that leads to inflammation of the thyroid gland.
- Vitiligo: An autoimmune condition in which white patches develop on the skin due to the loss of pigment.
- Graves' Disease: An autoimmune condition that is marked by an overactive thyroid gland.
- Pernicious Anemia: An autoimmune condition marked by a reduction in red blood cell count and causes an inability to absorb vitamin B12.
- Reactive Arthritis: An autoimmune condition marked by inflammation of the joints, eyes and urethra. Sores may also occur on the skin and mucous membranes.
- Psoriasis: An autoimmune skin condition that leads to irritation and redness along with flaky, thick, and silver-white patches throughout the body.
- Type 1 Diabetes: An autoimmune condition that leads to the destruction of insulin-production cells in the pancreas.
- Inflammatory Bowel Syndrome/Diseases: While IBS is quite common and well known, there are other diseases that cause inflammation of the colon and the small intestine and are clubbed together under inflammatory bowel diseases itself.
- Addison's Disease: An autoimmune disease, which leads to insufficiency of the adrenal hormone.
- Sjogren Syndrome: An autoimmune condition that leads to dry eyes and dry mouth as the glands that produce tears and saliva get destroyed. The condition may affect the kidneys and lungs as well.
Diagnosis of Autoimmune Diseases
On an ordinary basis, the body's immune system produces antibodies when it is under attack from foreign invaders that are harmful to the body. These include: Bacteria, Viruses, Parasites and Fungi. During an autoimmune disease, the body produces antibodies against your own tissues itself. Therefore, for diagnosing autoimmune diseases doctors try and identify the antibodies your body is producing.
Tests Used To Diagnose An Autoimmune Disease Include:
- Antinuclear Antibody Tests: This test looks for antinuclear antibodies that attack the nuclei of cells in the body.
- Autoantibody Tests: This is one of the primary tests that are done to diagnose autoimmune diseases. This test looks for particular antibodies to your own tissues.
- C-Reactive Protein (CRP Test): High levels of CRP in the body indicate presence of inflammation throughout the body.
- Complete Bloody Count: The number of red and white blood cells in the blood is measured through this test. These numbers will be different from their normal levels when your immune system is busy fighting something.
- Erythrocyte Sedimentation Rate: Amount of inflammation in your body is measured through this test, though in an indirect manner.
Treatment of Autoimmune Diseases
As of today, there is no cure for autoimmune diseases. Treatment revolves around management of the symptoms and controlling the process of the disease. Symptoms need to be managed; particularly during flare-ups of Autoimmune Diseases.
Medical Interventions in Autoimmune Diseases include:
- Hormone replacement therapy.
- Immunosuppressive medication.
- Anti-inflammatory medication for inflammations of the joints.
- Pain medications.
- Blood transfusions in the case where blood is affected.
- Physical therapy.
Alternative Therapies in Managing Autoimmune Diseases:
- Herbal medications.
How to Manage your Life with Autoimmune Diseases?
While there is no treatment for autoimmune diseases, nor do they tend to go away after some time, you have to learn to manage your symptoms and live with them. Most women who suffer from autoimmune diseases go on to live full and active lives and it is not necessary that you need to change your life's goals and dreams just because you suffer from an autoimmune disease. In consultation with your doctor, you can go on to adopt a healthy lifestyle and manage the autoimmune disease along with it.