8 Things Doctors Tell Their Friends About Autoimmune Diseases

First of all, don’t overlook your fatigue.

It’s not just you — it really does seem like everyone has an autoimmune disease these days, and women are far more likely than men to join the ranks. While researchers work to find out why, know the signs and be your own best advocate.

HOW THEY MAY START.

“The immune system is like the body’s army — it spends the earliest years of your life distinguishing friends from enemies so it can protect you from invaders. Our culture has become so fastidious about hygiene, however, that doctors worry the immune system may not encounter many threats until adolescence or beyond, when it’s more likely to make a mistake. It’s not uncommon for an autoimmune attack on, say, your joints or thyroid to first happen or flare after an unrelated virus or infection. And an autoimmune attack can come seemingly out of nowhere, possibly due to a combination of genetics and the environment.”

—Anca Askanase, M.D., associate professor of medicine at Columbia University’s Irving Medical Center and director of the Columbia Lupus Center

What you can do: If you have symptoms of something new shortly after you’ve recovered from an infection, see your doctor.

GET A SECOND OPINION.

Many autoimmune diseases — including lupus, rheumatoid arthritis, multiple sclerosis, and Hashimoto’s thyroiditis — have symptoms in common, and that’s just one reason diagnosis is so difficult. Often one of the first clues is extreme fatigue, which might be dismissed by doctors as simply a consequence of motherhood or being overworked. Also, there’s no one blood test for these diseases, and the ones that exist aren’t foolproof. One woman I know was tired and stressed and losing her hair, but her doctor thought her levels of ANA — the rogue antibodies in the blood of patients with lupus or rheumatoid arthritis — were relatively normal. A year later, she had developed the classic lupus butterfly rash on her face as well as painful, swollen joints, and her ANA levels were much higher.”

—Dr. Askanase

What you can do: Push for answers. “If you’re chronically tired, to the point that everyday activities wipe you out, that’s not normal,” she says. “And fatigue accompanied by muscle or joint pain, recurring fever, rashes, swollen glands, hair loss, or mouth sores is a red flag — get checked.”

TUMMY TROUBLE MAY BE A SIGN.

“A friend recently asked if her cramps and frequent trips to the bathroom could be serious. I explained that inflammatory bowel disease (IBD) — a group of autoimmune disorders that cause chronic inflammation of the digestive tract — has symptoms that set it apart from stomach bugs. Your stools may be bloody, and you might also rush to the bathroom in the middle of the night or suffer from night sweats, chills, and fever.”

—Neilanjan Nandi, M.D., the Center for Inflammatory Bowel Diseases at Drexel University College of Medicine in Philadelphia

What you can do: Dr. Nandi’s friend, since diagnosed with the common IBD disorder Crohn’s disease, has changed her diet and exercise routine. “Fiber can help suppress gut inflammation between flares; light exercise triggers the release of feel-good endorphins and helps relieve stress. I also recommend 2,000 to 3,000 IUs of vitamin D daily,” Dr. Nandi says.

THEY MIGHT BE THE REASON YOU’RE DOWN.

“A woman I know was under a lot of stress from taking care of her sick mom. When her gynecologist asked how she was doing, she burst into tears. She told him she was constantly exhausted and overwhelmed and couldn’t seem to remember anything. He chalked it up to the hormonal swings and anxiety that often come with perimenopause and wrote her a prescription for an antidepressant. It helped some, but she still had days when she crawled back into bed after seeing her kids off. When she went to her primary care doctor, blood work revealed something else: Hashimoto’s thyroiditis, an autoimmune disorder that slowly damages the thyroid. Symptoms include fatigue, increased sensitivity to cold, dry skin, brittle nails, hair loss, memory lapses, brain fog, and irregular or heavy periods, many of which can be mistakenly brushed off as perimenopause or depression.”

—Mary Vouyiouklis Kellis, M.D., a board-certified endocrinologist at Cleveland Clinic

What you can do: “If you have any of these symptoms, especially in combination with constipation and weight gain, insist that your doctor check your thyroid levels,” she says.

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