Women are 75 percent more likely than men to contract one of the 80 autoimmune diseases out there. There’s still a lot of mystery surrounding the illnesses, but knowing what to look for and what preventive steps to take can make a big difference.

By Cristina Opdahl

The summer before Ontario, California–based Sandra Mendoza-Daly’s senior year in high school, she started to feel a mysterious pain in her hip. This was followed by pain in her shoulder that grew so intense she couldn’t lift her arm. Sandra’s doctor ran some blood tests and eventually diagnosed her with rheumatoid arthritis, a chronic condition affecting many of her joints and that eventually caused the bones in her wrists to fuse. At 17 she already had type I diabetes—another chronic condition—this one the inability to produce insulin, which had been diagnosed when she was three years old.

Then, in the summer of 2006, at age 31, when her hair was inexplicably falling out and she suffered from an unusual amount of fatigue, another blood test revealed hypothyroidism, a condition in which the thyroid does not produce enough hormones. “I was in tears at the doctor’s office. I broke down crying,” remembers Sandra. “I said, ‘Why me?’” All three of the junior high school teacher’s chronic conditions are autoimmune diseases (ADs), conditions that vary widely but are all caused by the same basic malfunction: the immune system’s launching an assault on healthy tissue or organs. “There are over 80 autoimmune diseases,” says Virginia Ladd, executive director of the American Autoimmune Related Diseases Association (AARDA). “There’s about 75 percent prevalence for women over men. They are on the rise, but we don’t know why.”

These diseases also tend to run in families, although often relatives will contract different ones; and, as Sandra knows all too well, having one disease, says Ladd, “makes you at a higher risk for contracting another.” Experts don’t know what causes most autoimmune disorders; and why women are at greater risk is not entirely understood, although the fact that estrogen can make the immune system more active probably has something to do with it. Theories abound as to other factors.

Some experts believe that the use of refrigerators may be responsible for Crohn’s disease—an inflammatory bowel condition and an AD—because certain bacteria that thrive and multiply in cold temperatures have been found in Crohn’s disease sufferers. Even too much cleanliness is under investigation—a recent theory, presented by the Scripps Research Institute, holds that immune systems that are understimulated as they develop in children are more likely to misfire later in life.

Sufferers of an AD can take heart that some important breakthroughs are in progress. Most exciting is that researchers have begun moving away from drugs that suppress the entire immune system and in favor of pinpointing ways to suppress only the immune system mechanisms that are misfiring.

“New drugs called TNF-alpha inhibitors are showing significant improvement in many patients for rheumatic and psoriatic (a chronic inflammatory disease of the skin) autoimmune diseases. It’s thought that many autoimmune diseases could benefit from this, too,” says Ladd. And in the meantime, Sandra, whose diseases are all managed by medication, has launched a website, www.Rxgirl.net, to act as a clearinghouse for information and advice for sufferers of AD. “Shoes are a thorn in my side. It’s hard to find heels I can wear,” says Sandra, whose rheumatoid arthritis also affects her feet. “That’s the thing—rheumatoid arthritis isn’t who I am; it doesn’t define me. Instead I want to talk about how we can make life easier for those of us who have these diseases.”

Know Your Risk Factors
The earlier you catch an AD, the better off you are. The AARDA has launched a campaign to help with early detection; for more information, go to www.aarda.org. You can also look out for the following symptoms of some common autoimmune diseases.

Hashimoto’s Thyroiditis
The gist: Autoimmune-caused damage to the thyroid, which leads to low thyroid hormone
Symptoms: Fatigue, weight gain, brittle hair or hair that falls out, intolerance to cold

Multiple Sclerosis
The gist: Autoimmune-caused damage to the myelin, the central nervous system’s protective coating, which causes permanent neurological problems
Symptoms: Coordination and balance difficulty; clumsiness; changes in sensation in the arms, legs, or face; partial or complete vision loss; muscle weakness

Lupus Erythematosus
The gist: The immune system attacks the body’s cells and tissue, resulting in inflammation and tissue damage
Symptoms: Fever, joint pain, fatigue, malaise, sometimes a butterfly-shaped reddish or purplish rash on the cheeks and the bridge of the nose

Rheumatoid Arthritis
The gist: Caused by the immune system’s attacking the joints
Symptoms: Muscle and joint stiffness, particularly in the morning; fatigue; lowered appetite; low fever; muscle aches

Graves’ Disease
The gist: Autoimmune attacks on thyroid causes overproduction of thyroid hormones
Symptoms: Weight loss, tremors, difficulty sleeping, increased heart rate and blood pressure.

Prevention

Although you can’t change your gender or your genes, there are steps you can take to help reduce your risk of developing an AD.

• If you smoke, here’s another reason to quit. Smoking has been linked to several ADs, including lupus, multiple sclerosis, and rheumatoid arthritis.

• A link between pesticides and AD hasn’t been scientifically established but is suspected. Buy organic produce whenever possible and focus on maintaining a healthy diet that includes plenty of whole grains, fruits, and vegetables.

• A vitamin D deficiency has been linked to AD risk. If you don’t get plenty of sunlight, which triggers the body to make vitamin D, take a supplement.

• Scientists believe that exposure to some heavy metals— particularly mercury—as well as to silica, a kind of stone dust, plays a role in AD. Use websites such as www.nrdc.org/health/effects/mercury/guide.asp to educate yourself about limiting your mercury exposure from eating fish, a leading source of mercury contamination. And avoid exposure to silica, which is found in some sand and rocks, building materials, and some abrasive cleansers.

• PCBs—polychlorinated biphenyls, chemicals banned more than 30 years ago but still found throughout the environment and in our bodies—are also suspect but not yet proven. Reduce your PCB exposure by washing your fruits and vegetables before eating them and by reducing the amount of high-fat animal products in your diet. And check with state advisories prior to dining on sport-caught fish or shellfish, as they are often high in PCBs.

Find out More

There are countless websites that offer support and information about autoimmune diseases. Here are just a few if you’re interested in learning more.

American Autoimmune Related Disease Association A national non profit dedicated to getting the word out about AD through education, public awareness, research, and patient services; www.aarda.org

Society for Women’s Health Research A national organization whose mission is to improve women’s health through research and advocacy; www.womenshealthresearch.org