Autoimmune disease

What is autoimmune disease?

When you have an autoimmune disease, your body begins to produce antibodies that attack and damage your own tissue and organs. These are known as autoantibodies. As a result of the damage from this attack, you may develop a disease.

In normal circumstances, an antibody is an immune cell which identifies, attacks and neutralises foreign particles in your body, such as viruses, bacteria and toxins. It recognises these foreign particles by detecting a pattern on its surface, known as an antigen. 

Your immune system is clever. In normal circumstances, it knows the difference between self and non-self tissue (this is called immune tolerance). However, in an autoimmune disease, there is a breakdown of tolerance. This causes the immune system to attack self tissue, which it begins to recognise as an antigen.

Autoimmune disease: How can nutrition help?

Are you struggling with unhealthy habits that are hindering a successful autoimmune treatment plan? In this video, VJ walks us through the autoimmune paleo diet and shares what foods are helpful (and unhelpful) in symptom management.

How do you know if you have an autoimmune disease?

Autoimmune disease is challenging to diagnose. You can have both organ-specific and non-organ-specific autoimmune disorders. For example, in psoriasis, the skin is affected, but systemic lupus erythematosus, Sjogren's syndrome and rheumatoid arthritis can affect many different systems in your body. 

Non-specific autoimmune diseases are particularly challenging to diagnose. You can go through years of experiencing unpleasant symptoms such as fatigue, sore joints, and inflamed skin, before being diagnosed with an autoimmune disease. 

Doctors might test for antinuclear antibodies (ANA), which indicates autoimmunity in the body. But this does not tell you which body part the immune system affects. Also, as chronic inflammation is a critical driver in autoimmune disease, you may be tested for your C-reactive protein, a marker for inflammation in the body.

The American Autoimmune Disease Association believes there are over 100 different autoimmune diseases, each with various symptom presentations as no two are the same. So, even with signs of these conditions, doctors are cautious about diagnosing these definitively as there are not as many conclusive tests as there are with other diseases. 

What triggers autoimmune disease?

The research suggests that there are three main components which make you more likely to develop autoimmune disease, which includes:

• family history of autoimmune disease 
• environment triggers or stressors, such as exposure to airborne pollutants, infections, or emotional stress
• loss of barrier integrity; this usually occurs in the gut but may affect the blood vessels, gums and brain

Combined with these three factors, you are at a greater risk of developing an autoimmune disease. Here are some of the most common symptoms of autoimmune disease:

• fatigue and muscle weakness
• gut symptoms such as pain, bloating, flatulence, diarrhoea, and constipation
• blood sugar regulation issues
• insomnia or sleep problems
• migraines
• joint and muscle pain
• brain fog and difficulty concentrating
• skin rashes, irritations and acne
• rhinitis and allergies
• mood disorders
• anxiety
• recurrent yeast infections or skin rash (ringworm)
• blood pressure abnormalities
• regular flu-like symptoms 
• weight management problems (either over or underweight)
• susceptibility to infection

Common autoimmune diseases

Some of the most common autoimmune diseases include Hashimoto’s thyroiditis, multiple sclerosis (MS), rheumatoid arthritis and systemic lupus erythematosus. Let’s look at these common autoimmune diseases in more detail.

Hashimoto’s thyroiditis

Hashimoto’s thyroiditis is an autoimmune disease that causes chronic inflammation and swelling of the thyroid gland resulting in the production of low levels of thyroid hormones. 

The thyroid gland is situated at the bottom of the neck and produces vital hormones that regulate the body’s metabolism, including heart rate, body temperature and converting food into energy. With insufficient production of thyroid hormones, as seen with Hashimoto’s, the body can not operate normally, and its functions begin to slow down.

Various symptoms are associated with an underactive thyroid gland and Hashimoto’s, including fatigue, weight gain, sensitivity to cold, joint and muscle pain, dry and thinning hair, and heavy menstrual flow. 

If left untreated, Hashimoto’s can also lead to more severe complications related to the heart, mental health problems and even myxedema coma. The condition may have an effect on fertility and pregnancy, which can lead to pregnancy complications such as miscarriage and congenital disabilities. So if you are experiencing symptoms, it’s worth being proactive and working with a doctor and health practitioner to ensure that you start addressing the underlying root cause of your symptoms. 

Multiple sclerosis (MS)

MS is a chronic disease of the central nervous system and a common cause of neurological issues in young people. In multiple sclerosis, the insulating layer of the nerve fibres called the myelin sheath is targeted by the immune defence system, which is why multiple sclerosis is an autoimmune disease. The myelin sheath protects the nerve cells. Once damaged, the nerve impulses vital for movement, cognition, and autonomic function such as breathing and temperature control, become dysfunctional. 

There are four different types of MS:

1. clinically isolated syndrome
2. relapsing-remitting MS
3. primary progressive MS
4. secondary progressive MS

Treatment will vary depending on the diagnosis. 

Rheumatoid arthritis (RA)

There are over 100 different types of arthritis, and all of them have an inflammatory component. However, a specific subset of arthritis is caused by an autoimmune response in the body, such as RA.

In rheumatoid arthritis, antibodies are sent to the lining of your joints, where they attack the tissue surrounding the joint. As a result, the thin layer of cells called the synovium, which protects your joints, becomes inflamed and releases further immune cells which damage nearby bones, cartilage, tendons and ligaments. 

Rheumatoid arthritis causes stiffness, swelling and pain in the joints, including the wrists, ankles, knees and hip. And ordinarily, pain and stiffness often worsen following rest. Most people with RA will have issues with their hands and wrist, and it typically affects both sides of the body. Rheumatoid arthritis symptoms can range in severity, from mild to severe.

Many people with RA are asymptomatic in the early stages of the condition, but begin to show symptoms as the joints become more damaged.

Systemic lupus erythematosus (SLE)

SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs. SLE is a systemic autoimmune disease, as it targets proteins within cells. Antinuclear antibody (ANA) autoantibodies are a hallmark of lupus. It can affect the joints, skin, brain, lungs, kidneys, and blood vessels. 

Symptoms of SLE include fatigue, fever, loss of appetite, weight loss and feelings of discomfort or illness. You may also experience joint pain, which typically affects the same joint on both sides of the body, as well as muscle pain and weakness. 

How can nutrition intervention help?

There are a number of benefits to seeking nutrition intervention, from gaining a better understanding of aspects of your diet which may be worsening symptoms, to managing stress and making time for general self-care. Let's take a look.

Consider your diet

Eating a whole-food, anti-inflammatory diet such as the Mediterranean diet may help keep inflammatory symptoms in check. The Mediterranean diet appears to support the gut microbiome and helps reduce inflammation and oxidative stress, all modifiable risk factors linked to autoimmune disease.

Understand your triggers

Understand your triggers, especially if these relate to certain foods. For example, in coeliac disease and non-coeliac gluten sensitivity, removing gluten will significantly improve that person’s health. However, there are many foods that you might be intolerant to, and understanding your triggers is vital to start improving your health. 

The autoimmune paleo (AIP) protocol helps you explore and heal from foods you might be reacting to due to a hyperactive immune system. 

Manage stress

You can’t run away from stress entirely in your life, but you can find ways to manage it. Ensuring you have a consistent sleep schedule, spending time outside daily, committing some time for yourself in your diary and doing an activity that brings you joy at least a few times a week will build stress resilience. Once you are more resilient to stress, you will become less affected by it, reducing its effect on your immune system.

Consult a professional

Like many aspects of nutrition, knowledge is critical, and this is particularly relevant in autoimmune disease, as understanding the cause and trigger of the condition helps to tailor a dietary approach to managing and reversing symptoms. A nutrition professional can provide individualised recommendations to encourage a healthy, happy lifestyle.

This page was written by VJ Hamilton (BSc (Immunology), DipION, mBANT).