Cookies on the Healthspan site
Over the past 30 years, autoimmune disease has skyrocketed.1 There are no current statistics showing exactly how many people are affected by any autoimmune disease in the UK. However, it is known there are over 400,000 people with type 1 diabetes, 700,000 with rheumatoid arthritis, 115,000 with Crohn's, 127,000 with multiple sclerosis (MS) and 50,000 with lupus.2
Although there are no cures for autoimmune disease at this stage, there is hope for reducing the risk of developing autoimmunity. And, even if you have been diagnosed with an autoimmune condition, there are steps you can take to minimise symptoms and reduce the risk of flare-ups.
Here, we'll look at why autoimmune conditions occur in the first place, and at steps you can take to prevent them.
An autoimmune disease is any condition in which the immune system attacks the body's own tissues. The protective mechanisms that keep the body safe from microbes can be redirected, causing those same defences to mistake bodily tissues as a foreign threat.2
Autoimmune disease can be classified as either localised or systemic. Localised autoimmunity affects specific organs or tissue. This includes Addison's disease, type 1 diabetes, Crohn's disease and Grave's disease. Systemic autoimmune conditions, on the other hand, can damage multiple organs and tissues, and will often affect the entire body. Joint health conditions such as rheumatoid arthritis, in addition to MS, scleroderma and lupus are examples of systemic conditions.2
From a medical perspective, treatment focuses on managing symptoms and the autoimmune process. For conditions that damage specific organs, medication may be needed to replace the loss of function from that organ. For example, thyroid hormones may be prescribed for Hashimoto's thyroiditis if thyroid hormone levels drop too low, while type 1 diabetes requires lifelong insulin replacement, as the pancreas can no longer produce enough.2
To understand how autoimmunity works, it's important first to know how a healthy immune system functions. The immune system has many complex mechanisms, but its core function is to protect the body; it does this by protecting against harmful outside invaders, known as pathogens, such as viruses and bacteria.2 It also plays a role in healing any damage that has occurred.3
The immune system also protects the body by producing antibodies which are specialised immune proteins that can identify a pathogen for the immune system to attack. They can also neutralise pathogens directly. Some antibodies are specific to just one type of pathogen, and others play a more general role.4
A healthy immune system is tightly regulated to prevent it from attacking its own healthy tissue and cells. But when this regulation fails, autoimmunity can develop. In this situation, the immune system produces antibodies that are primed to attack parts of the body, known as autoantibodies. Many autoimmune conditions are diagnosed when a blood test reveals a high level of autoantibodies.2
There are many theories about why the regulation of the immune system fails. One suggests that the inflammatory response that is triggered by invading microbes can trigger the production of general immune cells. It suggests autoimmunity starts when the body's tissues get caught in the crossfire between microbes and the immune system.5
Another theory is molecular mimicry. Mimicry occurs when a type of cell in the body is similar in structure to a germ that the body has encountered. This can confuse the immune system and cause it to attack those cells.6
These are just a few of the many theories about why autoimmunity occurs. It's possible that many of them are accurate, depending on the person. But with each theory, there are dozens of contributing factors that could be playing a role in its development.
Autoimmunity is complex, and there are many factors that contribute to its development. We simply don't know the exact cause of every autoimmune disease, because every situation is unique. However, there are a few root issues that are suspected to play a role in the autoimmune process.
The immune system and digestive tract have a close relationship. In fact, most of the immune system resides in the gut. This means that, when the gut is impaired or injured, it can directly influence the immune system. This can be through changes in the microbiome (gut bacteria), or changes in gut permeability.
Recent research has discovered that some types of gut bacteria can travel to other organs and trigger an autoimmune response. But when researchers treated those bacterial strains, the effect on the immune system was blunted.7
Gut permeability, or leaky gut, can also be a risk factor that leads to autoimmunity. When the gut wall is damaged, it can allow heavy metals, microbes and chemicals into the body. This can lead to an immune response. Over the long run, it could trigger autoimmune processes.8
Chronic stress can have a devastating effect on the body - and it can even play a role in autoimmunity. Ongoing stress can deplete the body of vital nutrients and strain both the nervous system and the gut. It can also suppress the immune system over time, and lead to regulation issues.
One recent study analysed over 100,000 people diagnosed with a stress-related disorders. It found that people diagnosed with a stress-related disorder were more likely to be diagnosed with an autoimmune disease, and that they were also at a higher risk of developing multiple autoimmune conditions.9
The role of stress could also be linked with other autoimmune factors such as gut bacteria imbalances and exposure to infection.
For more information on how stress can impact your immune system, read about how chronic stress can weaken your immune system.
Some infections may trigger an autoimmune process in vulnerable people, which links in with the theory of infection interfering with the regulation of the immune system. Many autoimmune diseases have also been linked with one or even multiple types of infection.
For example, research has shown the infection Lyme disease could initiate autoantibodies in patients to cause an acute arthritis which, in some cases, may progress to become chronic arthritis, which is an autoimmune disease.5
Type 1 diabetes is another autoimmune condition whose onset has been associated with a number of infections, such as rubella, cytomegalovirus and mumps, while multiple sclerosis has been linked to at least 24 viruses.5
Having any of these infections doesn't mean you are guaranteed to develop an autoimmune disease, but it could put you at a higher risk, especially when combined with other risk factors such as family history.
The immune system helps to defend us from foreign invaders, but when it becomes overwhelmed with environmental pollutants and toxins, problems may arise.
As there are many thousands of environmental toxins, pinpointing one as a cause of autoimmune diseases is nearly impossible. However, there is research pointing to specific toxins such as BPA plastic, mercury and asbestos as triggers for autoimmune disease.10
Gluten, a form of protein found in some grains such as wheat, rye and barley, can cause an autoimmune condition called coeliac disease. This occurs when the immune system makes antibodies against gluten which also attack other tissues, such as the lining of the small intestine. Why this happens it not fully understood, but may result from molecular mimicry. Wheat and coeliac disease are also linked with other autoimmune disorders affecting the thyroid gland, joints, skin and nervous system, as well as type 1 diabetes.11
However, there are dozens of other potential dietary triggers - especially foods that triggers a reaction in the gut or immune system.
With many autoimmune diseases, there is a genetic tendency that runs in the family. Your genes may predispose you to a general increased risk of developing any autoimmune disease or increase your risk of one or more specific conditions.
People who test positive to specific variations of the Coeliac HLA gene, for example, are at a higher risk of developing coeliac disease at some point. On the other hand, people who test negative to these variants have a risk lower than 1% of ever developing it.12
With familial autoimmunity, you may develop a different autoimmune condition to other family members. One person may have type 1 diabetes, for example, while another could have rheumatoid arthritis.13
You won't necessarily develop an autoimmune condition that runs in your family, but you may want to be more vigilant and take measures to minimise your risk.
At this stage, there are no known cures for autoimmune disease and there are no proven vaccines to prevent them. There are ways you can minimise your risk of developing an autoimmune condition, however. What's more, if you've already been diagnosed with an autoimmune condition, there are ways to help maintain remission and reduce flare-ups to improve your quality of life.
One of the best ways to boost your nutrient intake and support a healthy gut is through eating a Mediterranean-style, wholefood diet. Including gut-loving nutrients such as probiotics, prebiotic fibres and antioxidants will help the natural healing process in the gut.
Wholefoods also contain nutrients that may relieve symptoms of autoimmune conditions. Antioxidants, zinc and anti-inflammatory nutrients such as omega-3 fatty acids all have properties that could support autoimmunity.14
Consuming foods you are intolerant to can cause issues with digestion, including gut bacteria imbalances and leaky gut and can increase the chance of a flare-up for people who have an autoimmune condition.15
Common intolerances include wheat, dairy products and fructose. If you're not sure whether you have food intolerances, it's best to seek advice from a qualified nutritionist.
Given the role of stress in autoimmune onset and flare-ups, managing stress levels is an essential step for both prevention and management. The more stress you are currently under, the more important it is to focus on stress management techniques.
There are countless ways to manage stress, depending on what works for you and your situation. Some ideas to start with are meditation, yoga, tai chi, gentle walks, keeping a journal or starting a new hobby.
There is no guaranteed way to prevent an autoimmune disease from developing. But, by taking small steps to support your immune system, you can reduce your risk of autoimmunity. If you have already been diagnosed, you can use these steps to manage your symptoms and flare-ups in a way that complements your current management plan.
For more information on keeping your immune system healthy, select Immunity from the Your health menu above.
Samantha Gemmell RNutr is a qualified nutritionist and health and wellness writer who has contributed to Australian magazine Women's Health & Fitness.
Find out more about Samantha Gemmell.
Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn't possible, supplements can help. This article isn't intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.
1Lerner, A., Jeremias, P. and Matthias, T., (2015). The world incidence and prevalence of autoimmune diseases is increasingInternational Journal of Celiac Disease pp.151-155
2British Society for Immunology (2016). Autoimmunity
3Corthay, A. (2014). Does the immune system naturally protect against cancer?, Frontiers in immunology5, p.197
4Fanning, L.J., Connor, A.M. and Wu, G.E. (1996). Development of the immunoglobulin repertoire,Clinical immunology and immunopathology,79(1), pp.1-14
5Ercolini, A.M. and Miller, S.D. (2009). The role of infections in autoimmune disease, Clinical & Experimental Immunology, 155(1), pp.1-15
6Leech, S (1998). Molecular mimicry in autoimmune disease, Archives of disease in childhood,79(5), pp.448-451
7Vieira, S.M., Hiltensperger, M., Kumar, V., Zegarra-Ruiz, D., Dehner, C., Khan, N., Costa, F.R.C., Tiniakou, E., Greiling, T., Ruff, W. and Barbieri, A. (2018). Translocation of a gut pathobiont drives autoimmunity in mice and humans, Science, 359(6380),pp.1156-1161
8Mu, Q., Kirby, J., Reilly, C.M. and Luo, X.M. (2017). Leaky gut as a danger signal for autoimmune diseases, Frontiers in immunology,8, p.598
9Song, H., Fang, F., Tomasson, G., Arnberg, F.K., Mataix-Cols, D., de la Cruz, L.F., Almqvist, C., Fall, K. and Valdimarsdóttir, U.A. (2018). Association of Stress-Related Disorders With Subsequent Autoimmune Disease, JAMA,319(23), pp.2388-2400
10Vojdani, A., Pollard, K.M. and Campbell, A.W. (2014). Environmental triggers and autoimmunity, Autoimmune diseases
11Vojdani, A. (2014). A potential link between environmental triggers and autoimmunity,Autoimmune diseases
12Coeliac UK (2018) Genetics
13Cárdenas-Roldán, J., Rojas-Villarraga, A. and Anaya, J.M. (2013). How do autoimmune diseases cluster in families? A systematic review and meta-analysis, BMC medicine 11(1), p.73
14Harbige, L.S. (1996). Nutrition and immunity with emphasis on infection and autoimmune disease, Nutrition and Health,10(4), pp.285-312
15Coucke, F. (2018). Food intolerance in patients with manifest autoimmunity. Observational study, Autoimmunity reviews