What Are the Most Common Autoimmune Conditions and How Do I Know if I Have One?
Reviewed by Dr. Jonathan Bonnet, MD, MPH
Since the first autoimmune disease was recognized clinically just 50 years ago, there are now more than 80 known autoimmune conditions that affect people worldwide.
But how do you know if the symptoms you’re experiencing are signs of an autoimmune condition or something else?
Here, we break down the symptoms, diagnosis, and treatment options of some of the most common autoimmune conditions. Understanding the symptoms and impacts of these conditions can help you to determine whether additional testing or a consultation with your provider is necessary.
The most common autoimmune conditions
Multiple sclerosis (MS)
MS is the most common non-traumatic disabling disease to affect young adults and is increasing in prevalence worldwide. Disease onset typically occurs between ages 20-40 and is more common in women.
There are many ways that patients experience MS. Far and away, the majority experience periods of acute attacks followed by periods of full or partial recovery, otherwise known as relapse remitting MS (approximately 87% of patients present with relapse remitting MS). There can also be incomplete recovery after an attack, but no change in symptoms until another episode occurs.
For those who go on to develop non-relapsing progression of the disease, it usually occurs within 10-20 years of symptom onset.
Symptoms of MS can include:
- Numbness or weakness in one or more limbs located on one side of the body at a time
- Electric-shock sensations that occur with specific neck movements
- Vision problems or changes
- Slurred speech
- Tingling sensations
- Changes in sensory or motor skills
- Problems with sexual, bowel, or bladder function
Though the exact underlying cause is not fully understood, experts believe that Epstein-Barr virus (EBV, or the most common strain of herpes), sunshine (UVB), smoking, vitamin D, and genetics all play an important role in the disease’s development.
Unfortunately, MS is often a hard diagnosis to make because symptoms can vary significantly. Because it’s not a constant disease—meaning symptoms will randomly come and then randomly go away—it usually takes multiple episodes to get a diagnosis.
The primary diagnostic test is an MRI with and without contrast to see if there is evidence of MS lesions in the brain. Eye testing (if you’re experiencing eye or vision symptoms) or lumbar punctures can also be done to help make the diagnosis.
Generally, early diagnosis and treatment can help minimize relapses and prevent any residual symptoms that could arise because of the episodes.
Type 1 diabetes mellitus
Type 1 diabetes mellitus (T1DM), also known as autoimmune diabetes, is a chronic disease marked by insulin deficiency. The insulin deficiency occurs because the body attacks its own insulin producing cells (beta cells) in the pancreas. Disease onset typically occurs between ages 6-13, though symptoms can appear later in life.
Symptoms of T1DM can include:
- Polyuria (frequent urination)
- Unintended weight loss
- Increased thirst
- Bed-wetting (in children who don’t typically wet the bed)
- Extreme hunger
- Irritability or mood changes
- Blurred vision
Several factors can contribute to the development of T1DM, including genetics and some viruses. Tests that can be used to diagnose T1DM include:
- Glycated hemoglobin (A1C) blood test
- Random blood sugar test
- Fasting blood sugar test
- Urine spot test
- Insulin and C-peptide levels
Though there is no cure, lifelong insulin therapy, careful attention to diet (particularly your carbohydrate intake), exercise, and regular follow-up visits with your provider can help to manage the disease.
Crohn’s disease is a type of inflammatory bowel disease (IBD). Disease onset typically occurs between ages 15-30, though symptoms can also peak between ages 60-80. Unlike other autoimmune diseases, Crohn’s is more common in men than women.
A chronic disease, Crohn’s disease can be considerably painful and causes many disruptive symptoms, including:
- Abdominal pain and cramping
- Blood in stool
- Mouth sores
- Reduced appetite and weight loss
- Pain or drainage around the anus
- Inflammation of the skin
- Inflammation of the liver
- Kidney stones
- Iron deficiency
Diagnosis typically involves a combination of a biopsy from an ileocolonoscopy (colonoscopy that extends to the ileum) and CT scan (to determine the extent of disease and areas affected).
Though there is no cure, working with a provider can help you to manage the disease. Most Crohn's disease is treated with steroids (particularly for acute flares, immunomodulatory medications, and biologics (i.e. monoclonal antibodies). Lifestyle modifications, especially dietary modifications and avoidance of certain foods are also important.
Ulcerative colitis (UC) is another type of inflammatory bowel disease (IBD). Like Crohn’s, disease onset typically occurs between ages 15-30, though symptoms can also peak between ages 60-80.
More common than Crohn’s worldwide, UC can cause:
- Bloody diarrhea with or without mucus
- Rectal urgency
- Tenesmus (feeling the urge to defecate even when your bowels are empty)
- Moderate to severe abdominal pain, often relieved by defecation
Endoscopic procedures are the only way to diagnose UC. In addition to getting an accurate diagnosis of UC, it’s important to define the extent and severity of inflammation present, which can help your provider to inform treatment. Similarly to Cronh’s, treatment of UC often includes steroidal and anti-inflammatory drugs, immunomodulatory medications, and biologics (i.e. monoclonal antibodies). Dietary modifications and stress management modifications can also help.
Lupus, also called systemic lupus erythematosus (SLE), is a multisystem autoimmune disease marked by disease flares interspersed with periods of remission.
There isn’t one single cause of the disease, but researchers believe the disease arises from a complex interplay of genetic, epigenetic, and environmental factors.
Though lupus can mimic many other diseases (it’s actually referred to by some as “the great imitator”), symptoms include:
- Weight loss
- Abdominal pain
Lupus is more common in those of African and Asian descent than those of European descent. It is also nine times more prevalent in women than in men.
Unfortunately, there isn’t a single test to identify lupus. Diagnosis is often made with a combination of blood and urine tests, physical examination, and a review of your symptoms. Once diagnosed, treatment can include nonsteroidal anti-inflammatory drugs (NSAIDs), antimalarial drugs, corticosteroids, immunosuppressants, and biologics. There is no cure for lupus.
Rheumatoid arthritis (RA)
RA is an autoimmune disorder of the joints. Disease onset typically occurs between ages 45-55, though some people can experience symptoms earlier in life.
The most common symptoms of RA are:
- Joint pain
- Tender, warm, swollen joints
- Joint stiffness (especially in the morning and of the hands)
- Loss of appetite
Generally, the onset of symptoms is slow, though in rare cases the symptoms can appear more suddenly.
RA can be difficult to diagnose in its early stages and unfortunately there isn’t one unifying blood test to confirm diagnosis. Still, your provider can use blood tests such as Rhemautoid factor and inflammatory markers, as well as a physical examination to diagnose the disease.
Like other autoimmune conditions, there is no cure for RA. Treatment may include medications, like NSAIDs, steroids, or biologics, and physical therapy.
Celiac disease (CD) is one of the most common autoimmune disorders (except in areas with culturally low gluten consumption, like Japan and sub-Saharan Africa) with a prevalence of 0.5-1.7%. Studies show that most cases of CD continue to remain undetected.
The condition is triggered by eating gluten, a protein commonly found in wheat, barley, spelt, rye, and other cereals. Over time, the reaction to gluten damages the small intestine’s lining, which can lead to malabsorption.
Symptoms can vary depending on the individual. Some of the more common symptoms of CD include:
- Loss of appetite
Though there is no cure for CD, there are some things that can help. Chiefly, following a life-long gluten free diet is the best way to manage the disease. Unfortunately, gluten can be hidden in unsuspecting foods, which is why working with a dietician, nutritionist, or provider may be the best way to gradually reduce inflammation in your small intestine and ultimately help you feel better.
Importantly, proper diagnosis and follow-up care is essential when managing CD (there are two blood tests that can diagnose CD). Depending on any nutritional deficiencies you may be experiencing as a result of malabsorption, your provider may recommend supplementing your diet with certain vitamins and minerals.
While Celiac disease is an autoimmune condition, two other conditions that cause people to have reactions to wheat/gluten include wheat allergy and non-celiac gluten sensitivity (NCGS).
A wheat allergy is analogous to other types of food allergies, such as peanuts, and it affects ~0.5-0.9% of children. It generally leads to a near immediate allergic reaction when that food is consumed. Symptoms can include swelling, itching, a rash, hives, or even anaphylaxis.
NCGS is a controversial diagnosis. It is characterized by similar symptoms as celiac disease, though can only be diagnosed if celiac disease and wheat allergy are excluded. There are no direct biomarkers available to confirm it, so instead a 9-week dietary protocol is used to diagnose it.
Hashimoto thyroiditis, also known as Hashimoto’s disease, chronic autoimmune thyroiditis, and chronic lymphocytic thyroiditis, is an autoimmune disease in which thyroid cells are destroyed by the immune system. Hashimoto’s is the most common cause of hypothyroidism (an underactive thyroid) in the US.
Symptoms of Hashimoto thyroiditis are similar to that of hypothyroidism and can include:
- Cold and dry skin
- Brittle nails
- Facial swelling
- Bradycardia a slower-than-expected heart rate)
- Elevated blood pressure
- Slow speech
- Ataxia (or impaired balance or physical coordination)
- Abnormal enlargement of the tongue
Early symptoms of the disease may also include:
- Weight gain
Though more research is needed to determine the exact causes of Hashimoto’s, evidence shows that this chronic condition can lead to a number of serious health problems if left untreated.
Several blood tests can be used to diagnose Hashimoto’s, including thyroid stimulating hormone (TSH),T4 tests, thyroid peroxidase (TPO) antibodies.. After receiving proper diagnosis, your provider may recommend thyroid hormone replacement treatment to help manage the condition. Unfortunately, there is less evidence to support the efficacy of an autoimmune or anti-inflammatory diet alone to help manage the condition.
Can I get tested?
If you’re experiencing any of the symptoms listed above that cannot be explained otherwise, reach out to your provider for more information. Keep in mind that testing for an autoimmune disease will vary depending on several factors, including which symptoms you’re having and which disease your provider recommends screening you for.
At the start of the diagnostic process, your provider may order some basic laboratory tests. If those labs fail to rule out or confirm a diagnosis, your provider may order additional laboratory testing, such as:
- Disease specific markers (i.e. Rheumatoid factor)
- Genetic tests
- Measurements of functional antibodies (i.e. TPO) antibodies)
- Quantitative immunoglobulin measurements (i.e. IgG, IgM, IgA)
- Imaging tests
If and when additional laboratory testing fails to provide conclusive information, a referral to a specialist may be necessary.
Why is prevention key?
Not all autoimmune conditions are preventable. However, early detection and treatment may be key to preventing some autoimmune diseases. In fact, several non-randomized small scale studies suggest that some autoimmune diseases may be preventable if treated prior to manifestations of symptoms. When possible, identifying an autoimmune disease early on may be essential in preventing symptom development.
The bottom line
Regardless of the ultimate diagnosis, it’s important to seek medical attention when you’re experiencing bothersome and unexplained symptoms. There’s no need to suffer—especially when early detection of an autoimmune or another condition is essential to finding the right treatment and lifestyle management plan for you.
Though living with an autoimmune disease can be difficult, finding a provider who cares about managing your symptoms and improving your quality of life can make all the difference.
At Forfend, we’re committed to supporting you and your health. We can help you assess your risk of an autoimmune condition and get you started with the right labs, testing, and treatment plan.