Life With an Autoimmune Disease

Your first symptoms of an autoimmune disease may be general, such as fatigue, low-grade fever, and difficulty concentrating, making autoimmune diseases difficult to diagnose at first. You also may feel depressed and consult a doctor for that.

According to Mary J. Shomon, author of the book Living Well With Autoimmune Disease: What Your Doctor Doesn't Tell You ... That You Need to Know, what ensues after registering these complaints may be an odyssey to pinpoint which of the almost 60 different autoimmune disorders you might have, all of which affect the body differently.

About 50 million Americans -- the vast majority of them women, especially women of working and childbearing age -- suffer from autoimmune ailments. Rheumatoid arthritis, type I diabetes, psoriasis, alopecia, lupus, thyroid disease, Addison's disease, pernicious anemia, celiac disease, multiple sclerosis, myasthenia gravis, Guillain-Barre syndrome -- these are just a few of the ailments that scientists now think stem from a common phenomenon: the activation of the body's immune system against the body itself. Also suspected of having this as a component are chronic fatigue syndrome and fibromyalgia.

Traits in Common

That such different-seeming diseases as psoriasis and diabetes could stem from a common cause actually is a relatively new notion, according to Noel R. Rose, MD, PhD, professor of molecular microbiology and immunology and pathology at the Johns Hopkins University in Baltimore. Back in the early days of the last century, he says, the idea took hold that if the immune system were to benefit us, it would have to be warding off foreign invaders from outside the body.

Now, scientists know that the immune system is a set of actions and reactions that can be triggered by a number of things besides an invading germ, virus, or bacteria. One thing that puts you at risk for being attacked by your own immune system is your genetics, says Rose. In other words, if your parents have a predisposition to autoimmune disease, you may, too. "And it's an overlapping inheritance," Rose says. "If you have one autoimmune disease, you may have more -- and you may have different ones than your parent did (or your siblings do)."

Another common characteristic of all autoimmune diseases is that it is thought that an outside agent is required to start the process. Even with a genetic tendency, a person may not develop an autoimmune disease without an environmental influence to set it off. Examples of these are infections, certain foods (iodine or gluten products), and toxins (some drugs, smoking, certain hair dyes, chemicals in the workplace).

Dozens of culprits have been identified. Shomon reels off a list of possible suspects in the more common autoimmune ailments: hair dye and certain drugs for lupus, silica exposure for scleroderma; gluten for diabetes; mycoplasmas for rheumatoid arthritis; measles virus for Epstein-Barr; coxsackie virus for diabetes; smoking for thyroid, lupus, and arthritis; hepatitis B infection for multiple sclerosis. She says physical trauma can also touch off the immune response.

As the disease develops -- or more than one, as Rose points out -- vague symptoms start to appear, such as joint and muscle pain (very common), general muscle weakness, possible rashes or low-grade fever, trouble concentrating, or weight loss. More specific signs can point toward something being wrong: numbness and tingling in hands and feet (also common), dry eyes (common), hair loss, shortness of breath, heart palpitations, or repeated miscarriages can also be caused by an autoimmune response.