The immune system attacking healthy body cells
Autoimmune diseases are conditions in which your immune system, which is supposed to protect you, mistaking your own healthy tissues for the enemy, mistaking your own cells for the enemy. There are over 100 types, and their development is influenced by the interaction between genes, hormones and environmental factors (stress, infections, toxins).
● Identification: Your system produces autoantibodies that attack healthy tissues.
● Triggers: Genetic factors require an environmental or hormonal trigger to activate the disease.
● Common symptoms: Watch out for chronic fatigue, unexplained joint pain and persistent mild fever.
What is autoimmune disease and how does the immune system work?
What are the most common autoimmune diseases?
Causes and risk factors in the development of autoimmune diseases
Common symptoms of autoimmune diseases
Collagen group diseases and autoimmune rheumatic diseases
Diagnosis and investigations for autoimmune diseases
Treatment and management of autoimmune diseases
Nutrition and lifestyle in autoimmune diseases
Prognosis and quality of life in patients with autoimmune diseases
How to apply this information
Frequently asked questions about autoimmune diseases
What is autoimmune disease and how does the immune system work?
An autoimmune disease is a condition in which your immune system, which is supposed to protect you from external dangers, mistakenly attacks its own tissues and organs. Imagine your own army turning against you, mistaking its citizens for the enemy.
How does the immune system normally work?
To understand why autoimmune disease occurs, you first need to know how your defense system is supposed to work. It is a complex network of cells, tissues and organs that work together to protect you:
● White cells: These are the front-line soldiers who identify and attack threats.
● Antibodies: Specialized proteins that attach to foreign substances, marking them for destruction.
● Complement system: A group of proteins that amplify the immune response.
● Lymphatic system: Essential transportation network for immune cells.
● Spleen and bone marrow: Like factories, they produce immune cells.
● Thymus: The school where T cells learn to correctly recognize threats.
The immune system normally manages to make a clear distinction between your own and foreign cells. This recognition is based on specific molecular markers on the cell surface.
When this recognition ability is compromised, your system produces autoantibodies that attack healthy tissues.
Manifestations of autoimmune diseases
Autoimmune disease occurs when the defense system produces autoantibodies that attack its own tissues.
Your immune attack can be localized to a single organ or systemic, affecting multiple parts of your body.
● Localized attack: In type 1 diabetes, for example, only insulin-producing cells in the pancreas are targeted.
● Systemic attack: Lupus is an example where multiple organs and systems are affected.
This diversity of manifestations makes autoimmunity a complex medical field. In addition to autoimmune diseases, an immune system can also overreact to harmless substances, manifesting as allergies.
Factors to consider
- Variation: Autoimmune disease doesn't look the same in everyone, from one organ to the whole body, the variation is wide.
- Confusion: When your system no longer recognizes the difference between your own and foreign cells, the attack begins.
- Complexity: Because the manifestations are so diverse (diabetes, lupus, etc.), diagnosis and treatment require a very nuanced approach.
What are the most common autoimmune diseases?
Patient with rheumatoid arthritis
Medicine has identified more than 100 types of autoimmune diseases, and each of them has unique features. This diversity shows how complex the immune system is and how many different tissues it can attack.
Table of main autoimmune diseases
|
Autoimmune disease |
Target the immune attack |
Key events |
|
Rheumatoid arthritis |
Synovial membrane around joints |
Pain, swelling and deformation of joints over time |
|
Systemic lupus erythematosus |
Tissues throughout the body (joints, skin, kidneys, brain) |
Characteristic butterfly-shaped rash on the face |
|
Inflammatory bowel diseases |
Intestinal mucosa (Crohn's disease, ulcerative colitis) |
Diarrhea, rectal bleeding and abdominal pain |
|
Multiple sclerosis |
Nerve myelin |
Vision problems, coordination difficulties (various neurological symptoms) |
|
Type 1 diabetes mellitus |
Insulin-producing beta cells in the pancreas |
External insulin dependence |
|
Psoriasis |
Skin cells |
Stimulation of rapid skin cell reproduction |
|
Autoimmune thyroid conditions |
Thyroid (Graves' disease, Hashimoto's thyroiditis) |
Disruption of hormonal balance |
Factors to consider
- Rheumatoid arthritis: It's not just simple joint pain, but a chronic attack that can lead to deformity if not managed.
- Type 1 diabetes: It's a direct, irreversible attack on your body's ability to produce the insulin it needs.
- Variety of attack: From skin (psoriasis) to nerves (multiple sclerosis) or gut (Crohn's disease), the immune system can attack anything.
Causes and risk factors in the development of autoimmune diseases
The onset and development of these conditions lies in the complex interplay of several genetic, hormonal and environmental factors that together contribute to the onset of autoimmune disease. They do not act in isolation but influence each other.
Table of risk factors that increase your susceptibility to autoimmune diseases
|
Risk Factor |
Description and mechanism |
Associated diseases (examples) |
|
Genetic predisposition |
HLA genes (on chromosome 6) are fundamental. Certain variants alter the immune system's ability to recognize cells correctly. |
Rheumatoid arthritis, autoimmune thyroiditis (associated with HLA DR3 and DR4); ankylosing spondylitis (associated with HLA B27). |
|
Hormonal factors |
Estrogen stimulates the immune response. |
It explains why women are two to three times more prone to autoimmune diseases than men. |
|
Environmental factors |
Exposure to industrial toxins, heavy metals (mercury, lead), pesticides and solvents. |
They can trigger autoimmune responses in people with an existing genetic predisposition. |
|
Chronic infections |
Viruses and bacteria can trick the immune system by 'molecular mimicry', when their proteins resemble their own. |
It confuses the defense system, which then attacks healthy structures. |
|
Chronic stress |
Cortisol and other stress hormones disrupt immune balance. |
It creates favorable conditions for autoimmunity through constant inflammation. |
|
Modern nutrition |
Eating processed foods, refined sugar and trans fats. |
It contributes to chronic systemic inflammation and negatively affects the gut microbiome. |
If, for example, you have autoimmune thyroiditis in your family, the presence of the HLA DR3 or DR4 genetic variant, combined with severe stress and a pro-inflammatory diet, may be the trigger.
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Factors to consider
- Genes are not destiny: Genetic predisposition alone is not enough, you need an environmental or hormonal trigger to activate the disease.
- Molecular mimicry: Be aware that a seemingly trivial infection can leave behind a confusion in your immune system, which starts attacking its own tissues.
- Hormones: Being a woman increases your risk because estrogen plays a role in stimulating the immune response, which is relevant in diseases such as lupus.
Common symptoms of autoimmune diseases
A major challenge in making the diagnosis of autoimmune disease is that many conditions in this category have nonspecific, overlapping symptoms. These manifestations can easily be mistaken for other health problems or even the effects of chronic stress, which can delay correct treatment.
Warning signs of autoimmune diseases
You should look out for these signs, especially if they persist and have no clear explanation:
● Chronic fatigue: We're not just talking about a mere limp after a hectic day, but a profound exhaustion that doesn't go away even after rest. Many patients describe it as a feeling of "dead batteries".
● Muscle and joint pain: This can range from mild morning stiffness (when you find it hard to move in the morning) to severe joint pain that limits your mobility.
● Skin manifestations: Your skin can give you clear signals. You may have specific rashes (such as the butterfly rash in lupus), silvery plaques (as in psoriasis), unusual hair loss or increased sensitivity to sunlight.
● Neurologic symptoms: Watch out for numbness, tingling, difficulty concentrating, or feeling "mentally foggy".
● Persistent mild fever: A slightly elevated body temperature that persists without an obvious infectious cause is a sign of internal inflammation.
● Weight changes: You notice that you are losing weight or gaining weight without having made any changes in your usual diet.
● Unexplained swelling: Edema (fluid buildup) may occur in joints or extremities.
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What factors to consider:
- Persistence: None of these symptoms alone confirm an autoimmune disease. Their persistence and combination over a long period of time is what should send you to the doctor for investigation.
- Variety: Don't forget that the same general symptoms (fatigue, pain) are present in diseases that attack different organs, from the liver to the joints, because of the common inflammatory process.
- Beware of confusion: Don't ignore chronic fatigue, blaming it solely on stress, but investigate whether your body is fighting an internal autoimmune inflammation.
Collagen group diseases and autoimmune rheumatic diseases
Connective tissue is the invisible scaffolding that provides vital support for your organs, skin, joints and blood vessels. When the immune system attacks this very basic structure, the result is a group of conditions called collagenosis, which can have serious systemic consequences.
Main collagen diseases and their manifestations
Collagenases are often complex because they attack structures throughout the body.
- Systemic lupus erythematosus: Can affect virtually any organ, from skin and joints to kidneys and brain. Key manifestations of this disease include the characteristic butterfly-shaped facial rash, extreme sun sensitivity and kidney damage.
- Scleroderma: Causes thickening and hardening of the skin. Can progress to serious damage to internal organs, including lungs, heart and kidneys. Patients describe feeling that the skin becomes an "armor" that restricts their movements.
- Sjogren's syndrome: It mainly affects the glands that produce moisture (lacrimal and salivary). It causes chronic dryness of the eyes and mouth, but can progress to systemic complications, affecting the kidneys, lungs and nervous system.
Autoimmune vasculitis: inflammation of the blood vessels
Vasculitis is a collagenosis in which inflammation of the blood vessels manifests depending on the organs they supply. Because blood vessels supply all organs, symptoms vary depending on the area affected:
● Small vessels: May cause rash and muscle aches.
● Large vessels: Can lead to serious neurological problems and damage to vital organs.
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Diagnosis and investigations for autoimmune diseases
The road to a correct diagnosis of an autoimmune disease often requires patience and close collaboration between you and your doctors. Because of the complexity and overlap of symptoms, making the diagnosis can be challenging.
The process of diagnosing autoimmune disease
The diagnosis is established by combining information from a detailed history, serologic tests and imaging investigations or biopsies.
Here are the steps your doctor will follow to reach a clear diagnosis:
● Detailed history: Your doctor will explore in depth your current symptoms, family history, exposures to risk factors, and the precise course of symptoms over time.
● Serologic tests: The antinuclear antibody (ANA) test is a sensitive test that can indicate the presence of an autoimmune process in the body. A positive result does not confirm disease, but signals the need for further investigation.
● Inflammatory markers: Measure the heme sedimentation rate (HSSR) and C-reactive protein (CRP). These don't tell you what disease you have, but they provide information about the intensity of systemic inflammation.
● Complete blood count: May reveal hematologic abnormalities, such as anemia, thrombocytopenia, or other blood cell changes commonly associated with autoimmunity.
Table of essential tests and imaging investigations
|
Type of investigation |
Its specific aim |
Examples of markers/research |
|
Specific antibodies |
It identifies the exact target of the immune system's attack. |
Anti double-stranded anti-DNA (for lupus), Anti-CCP (for rheumatoid arthritis), rheumatoid factor (RF). |
|
Imaging investigations |
Detects structural changes and organ damage. |
X-rays, ultrasound, MRI (for brain lesions in multiple sclerosis or joint damage). |
|
Biopsy |
Provides final confirmation of changes at the cellular level. |
Skin, kidney or bowel biopsy (in some cases of vasculitis, lupus or inflammatory bowel disease). |
What to consider
- ANA positive: Don't panic right away if your ANA comes back positive; this test is sensitive, not specific. Specific antibodies are needed to identify the disease.
- Patience: Be prepared to wait- the diagnosis may take time, as the doctor needs to rule out other causes and observe the progression of your symptoms before diagnosing autoimmune disease.
- Approach: Diagnosis of autoimmune diseases is a process of exclusion and confirmation that requires a holistic approach (symptoms, history, tests, imaging).
Treatment and management of autoimmune diseases
Treatment of autoimmune diseases has evolved from simple symptomatic approaches to targeted therapies that precisely modulate the immune response. Although a complete cure cannot be achieved, effective disease control is possible with personalized strategies.
Treatment options available
Your treatment regimen will depend on the type of disease, the organs affected and the severity of inflammation:
● Nonsteroidal anti-inflammatory drugs (NSAIDs): These are the first line of treatment to manage pain and inflammation in mild forms, for example in arthritis.
● Corticosteroids: Provide rapid control of acute inflammation and are essential in severe attacks. Be aware that their use requires careful monitoring because of long-term side effects.
● Conventional immunosuppressants: Substances such as Methotrexate and Azathioprine are an effective alternative for long-term treatment. They require regular testing to track your response and potential side effects.
● Biologic therapies: These are revolutionary drugs that specifically target the exact molecules or cells involved in your inflammatory process, offering much greater precision than traditional immunosuppressants.
Integrative approach and the role of supplements
In addition to standard medication, you can support treatment by optimizing nutrition, stress management and immunomodulatory supplements.
● Integrative approach: Focus on identifying and eliminating environmental triggers, optimizing nutrition (reducing inflammatory foods), and stress management.
● Vitamin C: Due to its powerful antioxidant properties, Vitamin C can help reduce oxidative stress that is always associated with chronic inflammation.
Vitamin D and preventive protocols
- Vitamin D: Optimal levels of Vitamin D are extremely important, as this substance has demonstrated important immunomodulatory effects, and its deficiency is often associated with an increased risk of developing autoimmune diseases or worsening them.
- Preventive protocols: For long-term support, there are specific nutritional protocols aimed at positively modulating immune cells and continuously reducing systemic inflammation.
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What to look out for
- Biologic therapies: They represent the biggest breakthrough, offering the chance to target the exact source of inflammation in your body.
- Monitoring: Keep in mind that immunosuppressants require regular monitoring through blood tests to prevent side effects.
- Vitamin D: If you have an autoimmune disease, talk to your doctor about the need to maintain an optimal level of Vitamin D (not just normal, but optimal) to support immune system regulation.
Nutrition and lifestyle in autoimmune diseases
The relationship between nutrition and autoimmune diseases has become an area of intense research, revealing links between nutrition and immune function. Dietary changes can have a profound impact on symptoms and progression.
Foods and substances to avoid
● Gluten: Can exacerbate symptoms in people with sensitivities, not just in celiac disease, but in other autoimmune conditions as well
● Dairy: May contribute to systemic inflammation in some patients
● Refined sugars and processed foods: Contribute to systemic inflammation and can disrupt the gut microbiome
Recommended anti-inflammatory food
● Berries: Rich in inflammation-fighting antioxidants
● Green leafy vegetables: Excellent sources of essential nutrients
● Oily fish: Rich in omega-3 with anti-inflammatory properties
● Nuts and seeds: Provide healthy fats and minerals
● Fermented foods: Plain yogurt, kefir and fermented vegetables help restore beneficial microbial balance.
Lifestyle changes
- Exercise regularly: Tailored to individual abilities, it can reduce inflammation and improve overall health
- Stress management: Meditation, yoga or cognitive behavioral therapy can modulate stress response
- Quality sleep: Sleep deprivation can exacerbate inflammation and compromise immune function.
Prognosis and quality of life in patients with autoimmune diseases
The perspective on autoimmune diseases has changed dramatically in recent years. What was seen in the past as a sentence of disability can be effectively managed today, allowing you to lead an active and fulfilling life.
Factors influencing your prognosis
The prognosis of your autoimmune disease is not set in stone, but is influenced by several factors that you can at least partly control:
● Early diagnosis: This is the most important factor. Early medical intervention can prevent irreversible organ damage (such as kidney damage in lupus or joint destruction in arthritis).
● Adherence to treatment: Strict adherence to medical recommendations and participation in regular disease monitoring are vital for maintaining remission.
● Healthy lifestyle: Balanced diet, anti-inflammatories, regular exercise and effective stress management support drug treatment.
● Social support: A strong family and community support network helps you cope with the emotional and physical impact of chronic illness.
Maintaining optimal quality of life
Quality of life is not just the absence of physical symptoms, but also your ability to maintain social relationships, productivity and personal fulfillment.
Emotional impact and solutions
- Don't neglect the psyche: The emotional impact should not be underestimated. Be aware that symptom-related anxiety, depression associated with physical limitations and feelings of isolation can affect your psychological well-being.
- Seek support: Professional psychological support, cognitive-behavioral therapy, and participation in support groups with other patients can make a major difference in the emotional management of the illness.
- Use technology: Modern technology gives you new tools for management. Use mobile apps to track symptoms, telemedicine platforms and online patient communities to create an ecosystem of support.
Factors you should consider
- Opportunity: Be aware that early diagnosis is the opportunity that can completely change the trajectory of your disease.
- Stay active: Don't rely on medication alone. Your lifestyle (diet, stress, exercise) plays an active role in maintaining remission.
- Mental health: Managing autoimmune disease necessarily includes your psychological well-being.
How to apply this information
Understanding the risk factors allows you to make active lifestyle changes. You cannot change your genes, but you can significantly influence the environment and inflammation in your body.
● Eliminate inflammation from your diet: Give up refined sugar, trans fats and highly processed foods that negatively affect the balance of the gut microbiome.
● Actively manage stress: Introduce a daily routine of 15-20 minutes of meditation or breathing exercises to steadily reduce cortisol (the stress hormone) levels.
● Check your thyroid: If you're a woman and have chronic fatigue, order a full set of thyroid tests (TSH, FT4, ATPO, anti-thyroglobulin), as Hashimoto's thyroiditis is very common.
● Toxin testing: If you are occupationally exposed or suspect exposure to heavy metals or solvents, talk to a specialist about testing the levels of these toxins in your body.
● Gut Protocol: Focus on replenishing the microbiome using high-quality probiotics and prebiotic fiber to reduce inflammation and intestinal permeability.
Quick checklist
● I eliminated refined sugar for at least 7 days.
● I started a relaxation technique of 15 minutes daily (e.g. nature walk, meditation).
● I schedule a consultation if I have chronic fatigue and persistent joint pain.
If you find yourself with the symptoms described (chronic fatigue, joint pain or unexplained rash), don't delay. Ask for a referral to a rheumatologist or immunologist to rule out or confirm an autoimmune disease. Early diagnosis is important for maintaining quality of life.
Frequently asked questions about autoimmune diseases
Here are five essential questions patients often ask to give you a complete perspective on managing autoimmune diseases.
Is there a specific diet I should follow?
Although there is no one-size-fits-all diet for all autoimmune diseases, many people with autoimmune conditions report significant improvements by following an anti-inflammatory diet, such as the autoimmune paleo protocol (AIP) or the Mediterranean diet. These diets focus on eliminating processed foods, gluten and dairy, replacing them with vegetables, fruit, healthy fats and high-quality protein to reduce gut and systemic inflammation.
Can stress or emotional trauma trigger autoimmune disease?
Chronic stress and major traumatic events are recognized as important triggers in people who already have a genetic predisposition. Through the constant release of cortisol and other hormones, stress destabilizes the hypothalamic-pituitary-adrenal (HPA) axis, disrupting the balance of the immune system and creating a proinflammatory environment that can activate disease.
Do I need to take permanent sick leave if I have an autoimmune disease?
No, a diagnosis of autoimmune disease does not automatically lead to disability or the need to give up work. With modern treatments (such as biologic therapies) and effective lifestyle management, many people can go into remission and maintain their ability to work. The decision depends on the severity of the disease, the organs affected and how well you manage your symptoms.
Why are doctors reluctant to prescribe high-dose vitamin D for autoimmunity?
Although Vitamin D has a powerful immunomodulatory role and is essential in autoimmune diseases, doctors may be cautious with high doses because Vitamin D is fat-soluble and can accumulate in excess, causing toxicity (hypercalcemia). Also, in certain diseases, some patients may experience paradoxical sensitivity to this supplement. Vitamin D should only be administered under blood level monitoring and on the advice of a doctor.
Is there a risk that treating autoimmune disease could expose me to other infections?
Yes, there is an increased risk. Many key treatments for autoimmune diseases, especially conventional immunosuppressants and biologic therapies, work by suppressing or modulating your immune response to stop the attack on your own tissues. This mechanism has the side-effect of reducing your body's ability to fight off external pathogens, making you more vulnerable to common infections.
Photo source: DepositPhotos, images generated with AI
Bibliography:
● Mayo Clinic, "Autoimmune diseases: Symptoms and causes," 2023, https://www.mayoclinic.org/diseases-conditions/autoimmune-diseases/symptoms-causes/syc-20351660, 2023.
● Cleveland Clinic, "Autoimmune Diseases: Types, Symptoms & Treatments," 2024, https://my.clevelandclinic.org/health/diseases/21624-autoimmune-diseases, 2024.
● Johns Hopkins Medicine, "Autoimmune Diseases," 2023, https://www.hopkinsmedicine.org/health/conditions-and-diseases/autoimmune-diseases, 2023.
● Harvard Health Publishing, "Can autoimmune diseases be prevented?", 2024, https://www.health.harvard.edu/blog/can-autoimmune-diseases-be-prevented-202402083012, 2024.
● WebMD, "Autoimmune Diseases: Causes, Risk Factors, Symptoms, Types & Treatments," 2025, https://www.webmd.com/a-to-z-guides/autoimmune-diseases, 2025.
