Between taking care of yourself and family members and trying to manage a social life and career, it’s common for women to feel tired and achy. But are these symptoms of a stressful life, or could they be tied to an underlying condition like autoimmune disease? 

Ana-Maria Orbai, M.D., M.H.S., is a rheumatologist at the Johns Hopkins Arthritis Center. Rheumatologists specialize in diagnosing and treating musculoskeletal diseases and autoimmune conditions (rheumatic disease). Orbai talks about how to recognize common autoimmune disease symptoms and when you should see a doctor.

Autoimmune Disease Basics 

Autoimmune disease happens when the body’s natural defense system can’t tell the difference between your own cells and foreign cells, causing the body to mistakenly attack normal cells. There are more than 80 types of autoimmune diseases that affect a wide range of body parts.

Common autoimmune diseases in women include:

• Rheumatoid arthritis, a form of arthritis that attacks the joints
• Psoriasis, a condition marked by thick, scaly patches of skin
• Psoriatic arthritis, a type of arthritis affecting some people with psoriasis
• Lupus, a disease that damages areas of the body that include joints, skin and organs
• Thyroid diseases, including Graves’ disease, where the body makes too much thyroid hormone (hyperthyroidism), and Hashimoto’s thyroiditis, where it doesn’t make enough (hypothyroidism) of the hormone

• Type 1 diabetes, a condition in which the immune system damages the insulin-producing cells in the pancreas

Symptoms of autoimmune disease may be severe in some people and mild in others. “There are different degrees of autoimmune disease,” says Orbai. “The symptoms a person gets likely relate to multiple factors that include genetics, environment and personal health.”

The Link Between Autoimmune Disease and Women

 Doctors do not yet fully understand why autoimmune diseases develop or why they are more common in women than in men. One theory is that sex hormones may influence immune activity, and that hormonal changes during the reproductive years could affect susceptibility to autoimmune disease. However, this has not been proven as a single explanation. Autoimmunity is thought to result from a combination of genetic, hormonal and environmental factors, and researchers are still working to understand why women are affected more often than men. Important clues continue to emerge.

Autoimmune Disease Basics 

Autoimmune disease happens when the body’s natural defense system can’t tell the difference between your own cells and foreign cells, causing the body to mistakenly attack normal cells. There are more than 80 types of autoimmune diseases that affect a wide range of body parts.

Common autoimmune diseases in women include:

• Rheumatoid arthritis, a form of arthritis that attacks the joints.
• Psoriasis, a condition marked by thick, scaly patches of skin.
• Psoriatic arthritis, a type of arthritis affecting some people with psoriasis.
• Lupus, a disease that damages areas of the body that include joints, skin and organs.
• Thyroid diseases, including Graves’ disease, when the body makes too much thyroid hormone (hyperthyroidism), and Hashimoto’s thyroiditis, when it doesn’t make enough of the hormone (hypothyroidism).
• Type 1 diabetes, a condition in which the immune system damages the insulin-producing cells in the pancreas.

Common Autoimmune Disease Symptoms 

Symptoms of autoimmune disease may be severe in some people and mild in others. “There are different degrees of autoimmune disease,” says Orbai. “The symptoms a person gets likely relate to multiple factors that include genetics, environment and personal health.”

Despite the varying types of autoimmune disease, many of them share similar symptoms. These are common symptoms of autoimmune disease:

• Fatigue
• Joint pain and swelling
• Skin problems
• Abdominal pain or digestive issues
• Recurring fever
• Swollen glands

How is an autoimmune disease diagnosed?

Many women say it’s hard to get a diagnosis, something that Orbai agrees with. “There’s usually no single test to diagnose autoimmune disease. You have to have certain symptoms combined with specific blood markers, imaging and, in some cases, a tissue biopsy.”

Diagnosis can also be difficult because these symptoms can come from other common conditions. Orbai says women should seek treatment when they notice new symptoms.

“If you’ve been healthy and suddenly you feel fatigue or joint stiffness, don’t downplay that,” she says. “Sharing this at your healthcare appointments helps your doctor look closer at your symptoms and run tests to either identify or rule out autoimmune disease.”

Autoimmune Disease Risk Factors

Researchers don’t know what causes autoimmune disease, but several theories point to an overactive immune system attacking the body after an infection or injury. We do know that certain risk factors increase the chances of developing autoimmune disorders, including:

• Genetics: Certain disorders such as lupus and multiple sclerosis (MS) tend to run in families. “Having a relative with autoimmune disease increases your risk, but it doesn’t mean you will develop a disease for certain,” says Orbai. Researchers also believe sex chromosomes may contribute to autoimmune risk. People with two X chromosomes normally inactivate one X chromosome in each cell through a process called X-chromosome inactivation. This process is regulated in part by XIST, a long non-coding RNA that coats the inactive X chromosome and helps recruit proteins that maintain silencing. Some studies suggest that immune responses to XIST-associated molecules or to proteins involved in this process may play a role in autoimmunity. This may help explain why autoimmune diseases are more common in people with two X chromosomes, but the biology is still being studied.
• Weight: Obesity has been associated with a higher risk of several autoimmune diseases, including rheumatoid arthritis, psoriatic arthritis, multiple sclerosis and lupus. This may be due in part to inflammation from fat tissue, which produces substances that can promote inflammation, and to shared metabolic and immune factors. In psoriatic arthritis, extra weight may also place more stress on the joints, which can lead to microtrauma; researchers believe this may help trigger or sustain inflammation.
• Smoking: Research has linked smoking to a number of autoimmune diseases, including lupus, rheumatoid arthritis, hyperthyroidism and MS.
• Certain medications: “Certain blood pressure medications or antibiotics can trigger drug-induced lupus, which is often a more benign form of lupus,” Orbai says. “Our myositis center also discovered that specific medications used to lower cholesterol, called statins, can trigger statin-induced myopathy.” Myopathy is a rare autoimmune disease that causes muscle weakness. Before starting or stopping any medications, however, make sure to talk to your doctor.  

Autoimmune Disease and Your Health

Having lupus, rheumatoid arthritis or psoriatic arthritis raises your risk for heart disease. While taking steps to reduce heart disease is always a good idea, it is even more essential if you have one of these conditions. Talk to your doctor about what you can do to keep your heart healthy and strong. For example, keeping your blood pressure and cholesterol levels within healthy ranges, eating a nutritious diet and exercising regularly can be lifesaving.

These interventions may also help reduce symptoms of autoimmune disease. In severe cases, clinicians may use systemic immunosuppressive therapies to suppress immune activity and limit ongoing tissue damage. Because these medications reduce immune function, they can increase the risk of infection and other treatment-related complications. For patients with severe autoimmune disease, however, the risks of inadequate treatment may outweigh these harms. Newer targeted therapies may offer improved specificity and fewer adverse effects, and this area continues to evolve with ongoing research. 
 
Orbai acknowledges that making time for healthy habits can be difficult, especially given the demands of many women’s fast-paced lives, but she says finding balance is key to living well with autoimmune disease. She adds that staying in close communication with your physician and leaning on your support system can be important parts of managing the condition.

 “It takes commitment, and there will be difficult days,” she says. “But learning how your body responds and understanding your triggers can help you manage your disease. It’s one way to take control of your health.”

Medically reviewed by Ana-Maria Orbai, M.D.

Autoimmune Disease Risk Factors

Researchers don’t know what causes autoimmune disease, but several theories point to an overactive immune system attacking the body after an infection or injury. We do know that certain risk factors increase the chances of developing autoimmune disorders, including:

• Genetics: Certain disorders such as lupus and multiple sclerosis (MS) tend to run in families. “Having a relative with autoimmune disease increases your risk, but it doesn’t mean you will develop a disease for certain,” says Orbai. 
• Weight: Being overweight or obese raises your risk of developing rheumatoid arthritis or psoriatic arthritis. This could be because more weight puts greater stress on the joints or because fat tissue makes substances that encourage inflammation. 
• Smoking: Research has linked smoking to a number of autoimmune diseases, including lupus, rheumatoid arthritis, hyperthyroidism and MS.
• Certain medications: “Certain blood pressure medications or antibiotics can trigger drug-induced lupus, which is often a more benign form of lupus,” Orbai says. “Our myositis center also discovered that specific medications used to lower cholesterol, called statins, can trigger statin-induced myopathy.” Myopathy is a rare autoimmune disease that causes muscle weakness. Before starting or stopping any medications, however, make sure to talk to your doctor. 

Autoimmune Disease and Your Health

Having lupus, rheumatoid arthritis or psoriatic arthritis raises your risk for heart disease. While taking steps to reduce heart disease is always a good idea, it is even more essential if you have one of these conditions. Talk to your doctor about what you can do to keep your heart healthy and strong. For example, keeping your blood pressure and cholesterol levels within healthy ranges, eating a nutritious diet and exercising regularly can be lifesaving.

These steps can also help reduce the symptoms of autoimmune disease. In serious cases, global immune suppressing drugs are used to restrain the body’s immune response, preventing it from doing further harm. Unfortunately, immunosuppressants render people more susceptible to infections.

Orbai admits that making time for healthy living can be hard, given women’s fast-paced lives, but she insists that finding the balance is key to living with autoimmune disease.

“It’s something that’s going to involve commitment, and sometimes it’s going to be tough,” she says. “But learning to listen to your body and being smart about what triggers your disease is important. It’s something you do for yourself.”