The Facts About Autoimmune Disease

Your immune system is the first line of defense against foreign invaders such as viruses, bacteria, fungi and toxins. When that system doesn't work, it can throw your whole body into disarray.

An autoimmune disease occurs when the immune system doesn't respond to these outside invaders as it should. There are more than 100 types of autoimmune diseases, and nearly every part of your body can be affected by abnormal immune system reactions.

People of all genders can be affected by an autoimmune disease, but they occur more often in women, according to a 2020 review published in the journal Cureus. Autoimmune disorders are often difficult to diagnose because of the wide variety of symptoms, and that means the number of affected individuals is likely much higher than reported.

Autoimmune diseases can arise from a number of sources. Some are genetic and others may be triggered by environmental agents, infections and other unknown factors. The most common autoimmune disorders include:

• Addison's disease
• Celiac disease
• Hashimoto's thyroiditis 
• Graves' disease
• Lupus
• Multiple sclerosis (MS)
• Psoriasis
• Rheumatoid arthritis 
• Type 1 diabetes

The range of seriousness varies across the spectrum of autoimmune disorders—some conditions are fatal, while others present as manageable symptoms—but the impact is felt in all cases.

The general cause of autoimmune diseases is unknown. Some conditions are thought to be the result of environmental factors or previous infections. Others seem to just run in the family.

More studies are needed on the connection between environmental factors and autoimmune diseases, but current research indicates that certain factors can influence the development of these harmful conditions. Chemical exposure, dietary components, gut dysbiosis (the imbalance of gut micro bacteria) and infections are all thought to disrupt the immune system response.

Some systemic autoimmune diseases that cause skin and muscle inflammation are thought to be caused, in part, by ultraviolet radiation exposure. Exposure to pesticides is a potential trigger for rheumatoid arthritis in men.

In some situations, certain infections can trigger an immune response in vulnerable people that increases their risk of autoimmune diseases. Infections such as rubella (also known as German measles), cytomegalovirus and mumps (also known as parotitis) have been associated with autoimmune conditions, but more research is needed.

The exact genes at fault for genetic autoimmune disorders are not definitively known, but a slew of studies have identified one particular gene researchers think might be responsible for common conditions such as type 1 diabetes, lupus and MS: tyrosine kinase 2 (TYK2).

TYK2 is a protein responsible for immunity and apoptosis pathways, and when it doesn't work as it should, it can cause your immune system to function incorrectly.

Signs and symptoms of autoimmune disorders run the gamut. The severity and presentation of symptoms also vary depending on the individual and their specific condition. Factors such as biological sex, age and hormones can also impact the appearance of symptoms. Common symptoms include:

• Abdominal pain
• Digestive problems
• Fatigue
• Fever
• Joint pain and swelling
• Skin issues
• Swollen glands

One of the difficulties in diagnosing autoimmune disorders is that these symptoms aren't consistently present. Most people with these kinds of conditions experience flare-ups, or times when the symptoms are present or more severe.

Many autoimmune symptoms are common signs of other disorders, which can make it hard for your doctor to decipher which condition you may be experiencing.

There is no way to prevent an autoimmune disorder. Doctors don't know what exclusively causes these conditions, so it's impossible to pinpoint definitive prevention methods. However, there are ways to prevent and/or manage flare-ups of autoimmune conditions you currently have.

You can support a healthy gut by eating whole foods, focusing on fruits, veggies, whole grains and legumes, and limiting the amounts of processed food you eat. You could also explore food intolerances and test out different diets to see if eliminating any one food source minimizes your symptoms. Try eliminating gluten, dairy and fructose at different times to see if they are triggers.

Reducing stress is another way in which some people manage their flare-ups. While completely eliminating stress is nearly impossible, it is possible to reduce stressful situations. Try adding yoga or meditation to your routine. Identify recurrent situations that bring you stress and see if you can minimize your exposure to those stressors.

A study published in January 2022 explored the connection between vitamin D and autoimmune disorders and found vitamin D supplementation for five years reduced autoimmune disease by 22 percent. However, more research is needed.

Being diagnosed with an autoimmune disease is difficult, as the most common symptoms associated with autoimmune conditions present in many other disorders. Unfortunately, there is no single test to determine if you're suffering from an autoimmune disease.

However, since certain blood markers can indicate an autoimmune disorder, your doctor may order the following tests:

• Antinuclear antibody test (ANA)
• Complete blood count (CBC)
• Erythrocyte sedimentation rate (ESR)

These tests alone cannot diagnose an autoimmune disorder, but combined with certain symptoms, your doctor will likely be able to determine your condition.

There is no definitive cure for any autoimmune disorder, which is why treatment generally focuses on managing individual symptoms. But every situation is unique, so your doctor may recommend trying a wide variety of treatments to see what works best for you.

Common treatments include:

• Anti-inflammatory medications
• Depression and anxiety medication
• Immune system suppressants
• Insulin
• Painkillers
• Plasma exchanges
• Sleeping aids

Alternative therapies include acupuncture and certain herbs, but talk to your doctor before trying anything new.

Chronic conditions are physically and mentally exhausting, and it may be difficult for you to prioritize sex and intimacy—and that's OK. However, autoimmune disorders don't have to be the end of your sex life.

A healthy sex life starts with communication. Talk to your partner about your disorder and symptoms so you can work together to maintain a satisfying sexual relationship for both of you. Plan sex around your flare-ups. If you typically experience joint pain in the evenings, try to schedule sex for the morning.

Look seriously into sex therapy. Chronic conditions can make it difficult to have sex, creating a pattern of low desire or discomfort with the topic. A licensed therapist can help you communicate your needs, prioritize your health and strengthen your relationship with your partner.

It's also important to remember that intimacy is much more than just sex. If sex is out of bounds at the moment, try fostering intimacy through hand-holding, cuddling and conversation.

Many people with autoimmune conditions conceive without issue. However, certain autoimmune disorders, such as type 1 diabetes and lupus, are associated with reproductive challenges.

If you've been diagnosed with an autoimmune disease and are hoping to get pregnant, talk to your doctor about steps you can take to increase your fertility and minimize flare-ups that may get in the way of trying.

Men suffering from certain autoimmune conditions may develop antisperm antibodies or erectile dysfunction (ED), both of which can make conceiving difficult or impossible. If you and your partner are unable to conceive naturally, assisted reproductive technology (ART) is available. Talk with your doctor about the options available to you.

Men suffering from type 1 diabetes are at increased risk of erectile dysfunction.

ED not only causes sexual issues, but often has mental and emotional impacts as well. Thankfully, there are solutions. Medicine and medical devices can help people manage their ED.

Women with type 1 diabetes may also suffer from sexual dysfunction. Certain medications used to treat diabetes can cause issues with arousal, lubrication and overall sexual satisfaction. Lube, sex therapy and exploring alternative medications with a doctor's approval can help women regain a satisfying sex life.

Lupus can negatively impact sexual health in a variety of ways.

The mental health impacts of a chronic condition can make it difficult to experience arousal or interest in sex. Physically, lupus can cause a limited range of motion, decreased lubrication, pain and fatigue, all of which can make sex challenging.

Managing the emotional hurdles of lupus is often the first step to regaining your sex life. The best strategy is to communicate with your partner and get together with a sex therapist to discuss what you're experiencing and what you want to accomplish.

If physical pain is stopping you from engaging in sex, talk to your doctor about how to better treat your symptoms. Your doctor may recommend adjusting your medication, taking pain relievers before sex and going to physical therapy.

Multiple sclerosis can cause muscle weakness, blindness and trouble with coordination, among other symptoms. This often debilitating condition can make dating and relationships difficult but not impossible.

The first question you might have when you're dating and you have MS is when to disclose your condition to your suitor. The answer is that it's personal and different for everyone. You might feel more comfortable telling potential partners immediately or you may want to wait until they get to know you better.

Multiple sclerosis can also impact sexual function. Fatigue and muscle weakness can make sexual activity difficult, and women may experience vaginal dryness. Men with MS often experience ED and difficulty achieving orgasm.

The good news, though, is that there are solutions: medications, different sexual positions and scheduling sex around your flare-ups can help.

Arthritis causes restricted movement, painful joints and inflammation, all of which can make sex difficult.

Insertion might be easier with certain positions, with the aid of pillows or imaginatively making use of different furniture around the house. If penetrative sex is too painful, prioritize "outercourse" and other forms of intimacy.

If a chronic condition is causing you emotional distress, focus on your mental health and talk to a therapist about your experience. Communicate with your partner about your needs and take time to discover what works best for you.

Autoimmune disorders can negatively impact your physical, mental and emotional health, but you're not alone. There are ways to manage your symptoms and continue living your best life. If you're experiencing symptoms, talk to your doctor immediately about a diagnosis or treatment plan.