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.”

Common Autoimmune Disease Symptoms 

Despite the varying types of autoimmune disease, many of them share similar symptoms. Common symptoms of autoimmune disease include:

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

Many women say it’s hard to get diagnosed, something that Orbai agrees with. “It’s not black or white,” she says. “There’s usually no single test to diagnose autoimmune disease. You have to have certain symptoms combined with specific blood markers and in some cases, even a tissue biopsy. It’s not just one factor.”

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. “Telling your doctor helps him or her to 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. 
• 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.”