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Written by
Lindsey Gainer
Medically Reviewed by
Dr. Danielle Desroche

Your immune system is a complex network of cells, tissues, and organs that all work together to protect your body from pathogens such as viruses, bacteria, cancer, parasites, and other microscopic invaders. Any time there’s a threat to your health, your immune system is ready to neutralize it. If your body loses the ability to differentiate between these very real threats and your own healthy tissue, however, it may start attacking itself — a phenomenon known as autoimmunity. (Source)

Autoimmune diseases in women develop when this confusion takes root, and the immune system begins producing autoantibodies that target and destroy the healthy cells and tissues it has errantly identified as problematic.

Experts aren’t exactly sure what sets this cascade into motion, but it’s thought to be a complex interplay between genetics and sex chromosomes, hormones, inflammation, and a person’s environment and lifestyle choices.

Unfortunately, these diseases are incredibly common and only becoming more so. A 2020 study supported by the National Institutes of Health found the levels of antinuclear antibodies indicative of autoimmune disease are rising in the general population year after year. (Source)

Higher Rate of Autoimmune Diseases in Women

According to the Autoimmune Association, over 24 million people in the United States are currently living with an autoimmune disease, and approximately 80% of those 24 million people are women — that’s a staggering 19 million women in America alone. And not only are women more likely to suffer from an autoimmune disease, they’re also more likely to have multiple autoimmune diseases at the same time, a phenomenon known as polyautoimmunity. (Source, Source)

This brings up an important question: Why are these diseases so much more common in women than men?

Unfortunately, there’s no easy answer. Scientists are working hard to unravel this mystery, though, in hopes it will help direct future treatments.

Female Hormones and Sex Chromosomes

Female hormones undoubtedly play a role in autoimmunity, as do the large number of genes relating to immunity and immune system regulation that are found on the X chromosome. There are more than 10 times as many genes contained within an X chromosome as within a Y chromosome — about 1,000 versus about 80 — and women have two X chromosomes, while men have just one. While this is advantageous in the sense that women suffer fewer infections and typically have a more robust immune response than their male counterparts, it also means autoimmune diseases are more likely to develop in women when mutation or dysfunction occurs at a cellular level. (Source)

Women also undergo huge hormonal upheavals at least twice in their lives, once during puberty and again in menopause. Any pregnancies they may carry also bring major endocrinological changes. Each of these hormonal transitions is deeply connected to immune system function, and may set the stage for autoimmune disease to take hold or to worsen (or improve) symptoms in existing disease. (Source)

Studies have shown, for example, that certain established autoimmune diseases like multiple sclerosis (MS) may go into remission during pregnancy while others worsen, suggesting a strong correlation between hormones, immune regulation, and the physiological environment. (Source)

Furthermore, menopause exacerbates symptoms of diseases like systemic lupus erythematosus, rheumatoid arthritis, and MS. Despite a decrease in the amount of flares a woman with lupus may experience after menopause, the damage caused by each flare is likely to worsen. Rheumatoid arthritis sufferers have also been shown to exhibit greater joint damage post-menopause, and MS symptoms tend to become more severe as well. (Source)

What Causes Autoimmune Diseases in Women?

In addition to the hormone and sex chromosome factors at play in the development of autoimmune diseases in women, genetics and ethnicity are risk factors that influence lifetime risk as well. The propensity to develop one or more of these diseases often runs in families and varies between ethnicities. 

The Role of Chronic Inflammation

Because chronic inflammation in the body may contribute to the development of autoimmune disease, environmental and lifestyle factors that promote inflammation in the body, such as an inflammatory diet, smoking, toxin and chemical exposure, stress, and improper sleep, are also thought to play a role. Even viruses and certain drugs can sometimes trigger an autoimmune disease in someone with a genetic predisposition. (Source, Source)

Scientists have just recently begun to truly understand the complex and dynamic relationship between the gut microbiome — the billions of bacteria and microorganisms that colonize the digestive tract — and health, specifically immunity. It’s estimated that up to 70%–80% of immune system cells are found in the gut, intrinsically connecting our gut health to overall health and immunity. (Source)

It stands to reason, then, that autoimmunity may stem from issues originating in the gut, and that treatments and lifestyle interventions targeted toward restoring a healthy balance to the intestinal microbiome may be hugely beneficial for people suffering from autoimmune diseases. (Source)

Holding hands, autoimmune diseases in women

Common Autoimmune Diseases in Women & Their Symptoms

There are over 100 recognized autoimmune diseases that can affect anyone, regardless of gender. Certain diseases are more common in women, however, sometimes by a ratio as high as 10:1. Autoimmune diseases are unique in their ability to have both systemic and local effects, meaning some diseases affect the entire body, while others only affect certain tissues or organs. (Source

Regardless of the specific disease, people with autoimmune diseases often cycle through phases of active disease and remission and can experience “flares” in their symptoms during times of high stress or hormonal changes.

The following are some of the most prevalent autoimmune diseases in women, and their common symptoms.

Autoimmune Thyroid Diseases

Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis affects 10 times as many women as men and is the most common thyroid condition in the United States. Hashimoto’s causes the body to attack and destroy the thyroid, resulting in the inability of the gland to produce proper levels of thyroid hormones. Symptoms include weight gain, fatigue, brain fog, intolerance to cold, tingling in the extremities, hair loss, and fertility issues. (Source)

Graves’ Disease

Affecting seven times more women than men, Graves’ disease causes the thyroid gland to become overactive, releasing excessive amounts of thyroid hormones into the body. Symptoms are often the opposite of Hashimoto’s and include nervousness, racing heart, unintentional weight loss, intolerance to heat, and bulging eyes. (Source)

Sjögren’s Disease

When a person suffers from Sjögren’s, their body attacks the glands responsible for producing tears and saliva, causing extremely dry eyes and mouth. Dryness can occur in other parts of the body as well, such as the throat and nose, and joints, organs, and nerves may also be adversely affected. Most people diagnosed with Sjögren’s are over the age of 40, and nine out of 10 are women. (Source, Source)

Systemic Lupus Erythematosus (SLE)

People suffering from SLE, the most serious form of lupus, often experience generalized joint pain and swelling, fever, rashes (often on the face, sometimes referred to as a “butterfly rash”), fatigue, muscle aches, and sun sensitivity. Symptoms can range from mild to life-threatening, and almost any organ in the body can be affected. (Source, Source)

Rheumatoid Arthritis (RA)

When the body’s immune system begins attacking joints, rheumatoid arthritis is the result. Although more common in middle and older age, children and young adults can also develop this painful form of arthritis and its characteristic joint pain, swelling, and stiffness. The fingers and wrists are most commonly affected, but any joint is susceptible to RA’s damaging effects. (Source, Source)

Multiple Sclerosis (MS)

Multiple sclerosis is typically diagnosed between the ages of 20 and 40, and women are more likely than men to develop the disease by a ratio of 2:1. In patients with MS, the body destroys nerve coverings (called myelin sheaths), resulting in a disruption of signals between the brain and spinal cord. Hallmark symptoms include weakness, visual disturbances, difficulty with memory and mental processing, “pins and needles” or numbness, and trouble balancing or coordinating movement. (Source, Source)

Psoriasis and Psoriatic Arthritis

In patients with psoriasis, one of the most common autoimmune skin diseases, skin cell turnover happens at an extremely accelerated rate. This leads to thickened patches of skin all over the body that are typically red and scaly in appearance, and feel itchy or sore. Some people also develop psoriatic arthritis, which affects the joints in addition to the skin. (Source)

Type 1 Diabetes

People suffering from type 1 diabetes cannot produce enough insulin, the hormone that moves glucose out of the bloodstream and into the cells that need it for energy. Because a type 1 diabetic’s pancreas can’t make the insulin they need, they must inject synthetic insulin to keep their blood glucose levels stable. Diabetes symptoms may include increased thirst and hunger, unintentional weight loss, frequent urination, dry and itchy skin, fatigue, numbness or tingling in the feet, and blurred vision. (Source)

Woman standing in nature

Diagnosing Autoimmune Diseases in Women

The process for diagnosing an autoimmune disease is rarely linear or straightforward. Because there often is not a single test that can confirm the diagnosis, health care providers usually rely on a battery of tests, in combination with symptom journals and physical exams, to piece together the puzzle.

Confounding that process, autoimmune diseases share symptoms with a variety of other conditions, don’t present in the same way in every patient, and often vary in severity, making misdiagnosis or a delay in diagnosis extremely common.

In a survey conducted by the Autoimmune Association of people with serious autoimmune diseases, it was found that it took nearly four years for the majority of survey participants to receive a diagnosis, and then only after seeing multiple specialists and initially receiving incorrect diagnoses. Many respondents also reported that their complaints were often not taken seriously or were attributed to stress, with some even reporting being told their symptoms were “all in their head.” (Source)

If you’re experiencing symptoms and suspect autoimmune disease, the Autoimmune Association recommends taking the following steps to expedite the path to a diagnosis:

  • Record your family’s medical history, and review it in detail with your healthcare provider. Autoimmune diseases often run in families, so it’s important to know whether someone in your immediate family suffers from one as well.
  • Keep a comprehensive list of symptoms, and don’t leave out anything you think might be significant. Symptoms of autoimmune disease can be vague and may not immediately seem related. Record any troubling symptoms you’ve experienced throughout your life to share with your healthcare provider.
  • Find a healthcare provider you trust and treat them as a partner. You will likely need to see one or more specialists (depending on your symptoms and which body systems are affected) before a diagnosis is reached, and having a primary care provider to coordinate the process is key. The Autoimmune Association has compiled this helpful resource page to assist patients in selecting the right health care professional for their situation.
  • Seek multiple opinions, if necessary. If you feel your symptoms aren’t being taken seriously or are being dismissed, find a different health care provider. No one can advocate for your health better than you! Don’t give up until you find someone who will take you seriously and partner with you to find answers.
  • Consider joining a support group so you can connect with others who are also searching for answers. Having support from your loved ones and fellow autoimmune disease sufferers is invaluable. At WellTheory, coaching and community support are two of the biggest keys to our clients’ success.

Does Having an Autoimmune Disease Affect Fertility?

Many women with autoimmune diseases have successful, uncomplicated pregnancies. Just because you have an autoimmune disease does not automatically mean you will experience fertility issues or pregnancy complications.

However, certain diseases such as type 1 diabetes, autoimmune thyroid diseases, and lupus are all known to make conception and pregnancy more difficult. An elevated antinuclear antibody level in the blood, even without active disease present, has also been shown to have an effect on the ability to conceive. (Source, Source)

In much the same way that autoimmune disease is highly individualized, pregnancy in someone with an autoimmune disease is equally unique. No two patients will be exactly the same, so it’s important to work closely with your health care provider before, during, and after pregnancy to determine what interventions, if any, are needed to ensure optimal health for both you and your child.

At WellTheory, our Nutritional Therapy Practitioners help women holistically manage their autoimmune disease symptoms and can support women’s nutrition throughout their pregnancy journey .

How Are Autoimmune Diseases in Women Treated?

Treatments for autoimmune disease have traditionally been aimed at modulating the immune response, controlling symptoms, and reducing inflammation in the body. Immunosuppressants, corticosteroids, and anti-inflammatory drugs are commonly prescribed, as are drugs to alleviate pain. Depending on the disease and presentation, surgery or physical therapy may also be utilized.

In addition to these interventions, some patients rely on supplemental alternative treatments to help manage symptoms, including chiropractic, acupuncture, massage, and herbal remedies.

Interventions to modify lifestyle and environmental factors that contribute to autoimmune disease can also be extremely beneficial.

WellTheory’s Approach to Helping Women with Autoimmune Diseases

At WellTheory, we believe in taking a holistic approach to treating autoimmune diseases, and we work alongside women and their health care providers as members of a comprehensive care team. We recognize that this family of diseases is highly complex and unique to every individual, and requires a multi-faceted treatment plan. This plan is best coordinated by health experts who themselves have firsthand experience with these diseases.

Our team of Certified Nutritional Therapy Practitioners, Health Coaches, and Care Coordinators take each individual’s personal health journey into account when identifying lifestyle factors that may be contributing to and exacerbating their disease. Then, we partner with them to make the changes necessary to heal their body from the inside out.

blueberries

Utilizing the Autoimmune Protocol (AIP) to Manage Autoimmune Disease

One of our programs is the Autoimmune Protocol (AIP), a nutrition and lifestyle reset that focuses on balancing the microbiome and restoring gut health. The protocol helps calm inflammation, identify food sensitivities, and establish healthy daily habits. A focus on proper nutrition, high-quality sleep, stress management, movement, and toxin avoidance allows the body to truly heal and potentially put symptoms into remission.

Two separate research studies have shown an increased quality of life for people suffering from an autoimmune disease who take part in multi-disciplinary AIP coaching programs like ours. But more importantly, we’ve seen it firsthand — we have the privilege of watching our members gain control over their disease symptoms through lifestyle interventions every single day. In fact, 89% of our members report a decrease in fatigue after 12 weeks. (Source, Source

The program consists of three phases — elimination, reintroduction, and personalization. During the elimination phase, foods that are known to trigger inflammatory responses are removed from the diet and replaced with healing, nutrient-dense foods. Not every food that's eliminated is "unhealthy" — eggs and nuts, for example, are eliminated for a short time, as they are common triggers for someone with a sensitivity. AIP lifestyle pillars like movement, toxin avoidance, stress management, and healthy sleep are also incorporated in this phase of the program.

Eliminated foods are then slowly added back into the diet during the reintroduction phase, to see if symptoms return. Reintroductions are accomplished in a systematic, purposeful way, and the body's responses are closely monitored.

Finally, during the personalization phase, members continue to work with their Nutritional Therapy Practitioner, health coach, and peer community to establish a diet and lifestyle that best suits their individual needs and disease.

If you’re interested in having WellTheory practitioners as part of your comprehensive care team, you can learn more here.

The Bottom Line on Autoimmune Diseases in Women

Autoimmune diseases develop when the body mistakenly begins identifying its own healthy tissue as foreign and mounts an immune response, attacking itself from the inside out. These diseases present with a complex array of symptoms ranging from mild to debilitating, depending on the disease and body system affected. While experts aren’t exactly sure what causes autoimmunity to take hold in the first place, it’s known that women are twice as likely as men to develop these diseases. Factors including hormones, sex chromosomes, chronic inflammation, gut dysbiosis, and other lifestyle and environmental factors are all thought to play a role.

Because these diseases present differently in different people, it’s important to work with a comprehensive care team to develop an individualized plan targeted at your specific situation. In addition to conventional treatments, lifestyle and behavioral modifications are proving invaluable pieces of the puzzle as well. Learn more about how WellTheory partners with members to manage their autoimmune disease in tandem with their doctors. 

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