Here’s Why Millennials Need to Worry About Autoimmune Diseases—Like Right Now

This group of more than 80 conditions is on the rise—and it attacks young women most often. Here's how to recognize it, and the latest advice on how to prevent it.

Autoimmune diseases are increasing

Impact-Photography/ShutterstockOur immune system helps to fight off infections from viruses and bacteria—but sometimes it can turn on itself by mistake. So what is autoimmune disease, and why do you need to know about it? "Autoimmune disease occurs when the immune system attacks a person's own cells and tissues," says Daniela Cihakova, MD, PhD, an immunologist at Johns Hopkins University. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), this can happen in almost any part of the body, from the brain to muscles, skin, and other organs. And the research is clear—the number of people with one of these conditions has been increasing in the last several decades. The National Institutes of Health (NIH) estimates that 23.5 million Americans are now affected, with the American Autoimmune Related Diseases Association (AARDA) putting the estimate even higher, at 50 million. "Some autoimmune disorders, such as type 1 diabetes and autoimmune thyroid disease, are thought to be on the rise," says Emily Somers, PhD, an epidemiologist at the University of Michigan's School of Public Health. "These changes over time suggest that environmental factors are involved." Find out the difference between type 1 and type 2 diabetes.

They affect young women most frequently

Kjetil-Kolbjornsrud/ShutterstockDr. Cihakova says about 80 percent of people with autoimmune conditions are women, with some diseases like Sjogren's syndrome having a women-to-men ratio as high as 9:1. The U.S. Department of Health and Human Services' Office on Women's Health says these conditions tend to develop during the childbearing years. "Females have a higher susceptibility to autoimmune diseases than men—in fact, autoimmune diseases as a group rank among the leading 10 causes of death for women," Dr. Somers says. "For many years it was assumed that hormones such as estrogen were involved, but more recently, it has been suggested that genetic factors linked to the X chromosome may be involved." Because females have two X chromosomes while men only have one, the second may give an extra "dose" of X that may make women more susceptible to X-linked conditions. A recent study from the University of Michigan showed how different genetic expressions in women could increase their chances of autoimmune-related diseases. Plus, " females and males often differ in their susceptibility to the effects of environmental agents" that might impact autoimmunity, Dr. Somers says. But overall, the reason for the sex disparity is "a mystery," she says. Read how one woman beat the chronic pain of the autoimmune condition multiple sclerosis.

No one realized these diseases were connected

ShutterstockDoctors are ramping up studies on autoimmune conditions because so little is still known about them. "We do not yet fully understand why autoimmune diseases develop," Dr. Cihakova says. Part of the reason for this is in the past, no one connected the dots and realized that these different types of autoimmune diseases were actually related. The AARDA says that much research so far has been specific to singular diseases, instead of looking at autoimmunity as a whole. Plus, the doctors who treat autoimmune conditions tend to be spread out in many disciplines—the Office on Women's Health lists no fewer than seven specialties, including rheumatology, endocrinology, gastroenterology, and dermatology—and so information gathered from each has not always been shared. Without understanding the root cause, it's hard to sort out what's really going on. And with vague symptoms (discussed later) from a generally healthy young population, getting diagnosed is not easy—an AARDA survey found it took autoimmune patients up to 4.6 years and 5 doctors to get a diagnosis. Here are more diseases doctors miss.

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It's partly in your genes

Monkey-Business-Images/ShutterstockThe research we do have suggests it might be a combination of genetics and an environmental trigger that brings on an autoimmune condition, Dr. Cihakova says. Interestingly, families could have a genetic susceptibility to autoimmunity in general, so one family member might have type 1 diabetes while another has lupus, and yet another has rheumatoid arthritis. But it's not just about genetics. "Studies on twins show that genes alone cannot explain why certain individuals develop autoimmune diseases," says Dr. Cihakova. "It is possible that genetically susceptible individuals develop an autoimmune disease after a certain infection, as multiple viruses have been suspected to precede autoimmune diseases." Could an autoimmune vaccine be on the horizon?

Environmental factors could be triggers

Africa-Studio/ShutterstockOr, something outside the body could switch on the autoimmune response. "The rapid increase suggests that environmental factors play a role—a notion also supported by the fact that the increase in incidence of autoimmune disease is evident in recent migrants to western countries," Dr. Cihakova says. In other words, studies show people who move to a western country end up with the same autoimmune rates as people who were born there. Environmental risk factors range from ultraviolet radiation and asbestos to solvents in cleaning products and nail polish. "Silica dust [from working with quartz, granite and other minerals] and smoking are two risk factors for autoimmune disease," Dr. Somers says, as a recent review from the National Institutes of Health found. "Mercury is another toxicant that has been suggested to play a role in autoimmunity." A study from the University of Michigan found that mercury from eating large fish like swordfish, and to lesser amounts tuna, salmon, and other seafood, correlated with higher autoimmunity—even at levels considered safe. Here's why autoimmune and other health problems can feel worse during summer.

So many theories for autoimmunity

Akarat-Thongsatid/ShutterstockAnother theory for autoimmunity's rise is the "hygiene hypothesis," which suggests that in developed countries we've gotten so good at fighting off germs through cleanliness, vaccines, and medicine that our bodies have become out of whack and forget what they're supposed to attack. "Some researchers believe this health trade-off is no coincidence, and suggest that the decrease in acquiring natural infections has caused the increase in allergies and autoimmune disorders," Andrew Weil, MD, an integrative immunologist at the University of Arizona, wrote on his blog. Another theory is that we've messed up the bacteria in our gut through eating too much refined and processed food in our western diet—which could account for the rise in gluten allergies and celiac disease. "The bacteria in the gut regulate the immune system heavily," Robin Berzin, MD, of Parsley Health, told Huffington Post. Read about seven signs you have leaky gut syndrome.

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Some lifestyle factors may protect against it

baibaz/ShutterstockBecause of the gut connection, a diet rich in fruits and vegetables can be one way to ward off autoimmune conditions. "A well-balanced diet and weight control are key," Dr. Cihakova says. "We have considerable evidence now that fat tissue is immunologically active, and that overweight and obese people have more a pro-inflammatory environment in their bodies." Because the main symptom of autoimmunity is inflammation, weight could be a contributing factor. Dr. Cihakova also recommends exercise, which can "prevent debilitating fatigue that is often associated with an autoimmune disease." Dr. Somers advises getting enough vitamin D and omega-3s, both of which have been shown to have a protective effect. Finally, try to avoid stress, which has also been linked with autoimmunity in studies. Here are 16 foods that fight inflammation.

Lupus is difficult to diagnose

Buckner_Variety/ShutterstockThere are many autoimmune diseases, but here are a few you should know about. Famous millennial Selena Gomez has very publicly revealed she has the autoimmune condition lupus. This disease causes inflammation in many different parts of the body, including the joints, skin, kidneys, brain, blood vessels, heart, and lungs. The Lupus Foundation of America says 16,000 new cases are reported each year in the U.S., with 1.5 million Americans living with lupus. According to the Mayo Clinic, symptoms can mimic other diseases and all symptoms aren't always present, making lupus hard to diagnose. Common signs are a butterfly-shaped rash across the cheeks and nose, joint pain, fatigue, skin lesions, and headaches. Because lupus affects major organs, it can have life-threatening effects if not controlled with medications such as corticosteroids or immunosuppressants. Find out more silent signs of lupus you should never ignore.

Rheumatoid arthritis isn't for old people

I'm-friday/ShutterstockThis isn't your grandmother's arthritis: RA affects younger people and is caused by inflammation in the joints, not wear and tear like older people's arthritis. With RA, your body attacks its own healthy joint tissue, according to the American College of Rheumatology. Symptoms include joint pain, stiffness, and swelling, most commonly in the small joints of the hands and feet. Although it's not the debilitating condition it once was, meds are necessary to slow the progression of this incurable disease. These might include "disease-modifying antirheumatic drugs" like methotrexate, and "biologic agents" like Humira that block immune signals. Low-impact exercise is also very important to increase muscle strength and reduce pressure on your joints. Fortunately, "rheumatoid arthritis may actually be decreasing," Dr. Somers says. More good news for people recently diagnosed with RA: A new study from the U.K. showed that those who got treatment within six months of the onset of symptoms had very good long-term outcomes.

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Hashimoto's thyroiditis has an easy fix

Albina-Glisic/ShutterstockIn this autoimmune condition, the body attacks the thyroid gland, causing it to become underactive (hypothyroidism). According to the American Thyroid Association, as with other autoimmune-related diseases Hashimoto's symptoms may come on gradually and be very non-specific. They include fatigue, weight gain, constipation, sensitivity to cold, dry skin, depression, and muscle aches. You may also develop a swelling, called a goiter, in the thyroid, located at the front of the neck. Luckily, a blood test for thyroid-stimulating hormone (TSH) can detect if your levels are low, and thyroid hormone replacement meds are very effective and have no side effects. Another thyroid-related autoimmune condition is Graves' disease, which causes your thyroid to be overactive (hyperthyroid). Should you get your thyroid hormone levels checked?

Celiac disease can have lasting damage

Gayvoronskaya_Yana/ShutterstockThe trigger for celiac disease is clear: When you eat gluten (found in wheat, rye, and barley) the body attacks the small intestine, causing long-term damage that could prevent the absorption of nutrients. According to the Celiac Disease Foundation, it's also genetic, so having an immediate family member with it gives you a 1 in 10 chance of developing the condition yourself. Although adults might have digestive symptoms including diarrhea, abdominal pain, and bloating, more than half do not, according to the Mayo Clinic. Instead, symptoms may include anemia, fatigue, bone or joint pain, depression, or skin rash. Treatment is a gluten-free diet, and since there are so many hidden places to find gluten (including non-foods like vitamins, lipstick, and toothpaste), it's important to work with a dietitian to help you along. Another tummy-related autoimmune condition is inflammatory bowel disease, which includes Crohn's and ulcerative colitis. How is celiac disease linked with an eating disorder?

Psoriasis is very visible

Ternavskaia-Olga-Alibec/ShutterstockAlthough it looks like a bad skin rash, psoriasis isn't contagious. It's caused when the body attacks its own skin cells, making too many new ones and causing a thick, red, scaly buildup. A recent study from Sweden found that severe psoriasis is actually more common in men than women. "Interestingly, men often have worse prognosis and more severe autoimmune diseases than women," Dr. Cihakova says. According to the National Psoriasis Foundation, about 30 percent of people with it will also develop psoriasis arthritis, a joint inflammation, although it's not exactly clear why. For psoriasis, treatments may include topical creams for mild cases, and a combo of creams and oral meds for more severe cases. Controlled exposure to sunlight may also help. Other skin-related autoimmune conditions include vitiligo, in which the skin's pigment is attacked, causing it to lose its color; and scleroderma, which causes an overgrowth of collagen. Here are more surprising signs of disease your skin can reveal.

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