Symptoms of Autoimmune Diseases

They can be vague and hard to identify

Autoimmune diseases have some symptoms in common, including pain, swelling, fatigue, skin rashes, low-grade fever, and trouble concentrating. They're often subtle and hard to pinpoint, and they can be easily mistaken for viral infections, depression, or stress. Complicating things, an estimated 25% of people with autoimmune disease have more than one type.

A primary culprit behind autoimmunity symptoms is something they all have in common: inflammation caused by an immune system that attacks healthy tissues. The symptoms vary from one disease to the other depending on the severity and location of the inflammation.

autoimmune disease symptoms

Verywell / Emily Roberts

Frequent Symptoms

In autoimmune diseases, your immune system mistakenly identifies certain healthy organs, tissues, glands, or cells as dangerous pathogens, such as viruses, bacteria, or fungi. It then forms autoantibodies (antibodies to the self) that identify and attack those targets. That leads to damage and inflammation, which is what leads to symptoms.

Symptoms that are common to most autoimmune diseases include:

  • Fatigue
  • Pain and swelling in the muscles, connective tissues, and/or joints
  • Weakness
  • Skin rashes
  • Ulcers (open sores that don't heal)
  • Recurring low-grade fever
  • Dizziness
  • Trouble concentrating
  • Numbness and tingling (paresthesias) in the hands and feet
  • Swollen glands
  • Abdominal pain and/or digestive problems

Autoimmune diseases follow different courses and manifest with different symptoms. Acute symptomatic episodes are referred to as flares or flare-ups. Periods when symptoms recede are called remissions.

Symptoms by Condition

The medical community recognizes more than 100 autoimmune conditions, and looking for their hallmark symptoms can help out one from another. Many of the more common autoimmune diseases and their hallmark symptoms are listed below.

This list is by no means exhaustive and shouldn't be used to self-diagnose. Be sure to report symptoms you're experiencing to your doctor for a proper diagnosis and treatment.

Alopecia Areata

In alopecia areata, the immune system attacks the hair follicles, causing hair loss, mainly from the scalp, though it can involve loss of eyebrows, eyelashes, beards, or any body hair. Symptoms include:

  • Coin-sized or larger, round, smooth patches of hair loss
  • "Exclamation point" hairs in or around bare spots that grow in and break off, leaving stubs that narrow toward the bottom
  • Widespread hair loss
  • Nail pitting, white spots or lines, roughness, dullness, thinning, and splitting
  • In some cases, mild itching or burning sensations in the bald spots
  • Rarely, baldness or loss of all body hair

Antiphospholipid Syndrome

With antiphospholipid syndrome (APS), antibodies damage the cells lining your blood vessels and increase the risk of blood clots in your arteries and veins, which can be extremely serious. APS is more common in people with other autoimmune diseases, especially systemic lupus erythematosus (SLE), but it may also occur on its own. Symptoms include:

  • Chest pain
  • Shortness of breath
  • Pain, redness, heat, and inflammation in the limbs
  • Ongoing headaches
  • Changes in speech
  • Discomfort in the arms, back, neck, and jaw
  • Nausea
  • Blotchy, red rash (livedo reticularis)
  • Ulcers on the legs
  • Tissue death in the fingers and toes

Autoimmune Hepatitis

Autoimmune hepatitis attacks liver cells. While it may not cause symptoms in the early stages, symptoms may develop over time and include:

  • Fatigue
  • Jaundice (yellowing of the skin and eyes)
  • Itching
  • Joint pain
  • Nausea and vomiting
  • Right-sided upper abdominal pain
  • Unexplained weight loss
  • Dark urine
  • Light-colored stools
  • Loss of menstruation
  • Rash, acne, or other skin conditions

Celiac Disease

In celiac disease, the immune system attacks the lining of your small intestines in response to gluten—a protein found in wheat, rye, barley, and many prepared foods. While the symptoms of celiac disease vary from person to person, some of the more common ones include:

  • Diarrhea
  • Weight loss
  • Abdominal pain
  • Excessive gas

Crohn's Disease

Crohn's disease is an inflammatory bowel disease characterized by widespread inflammation of the digestive tract. Common symptoms of Crohn's disease are:

  • Diarrhea
  • Abdominal pain and cramping
  • Weight loss
  • Anemia
  • Fever
  • Fatigue
  • Nausea
  • Loss of appetite
  • Joint pain
  • Eye redness or pain
  • Red, tender bumps under your skin

Dermatomyositis

Dermatomyositis results from widespread muscle and skin inflammation, which causes:

  • Rashes, especially flat-topped red or violet bumps called Gottron's papules
  • Inflammatory myopathy (muscle weakness affecting both sides of the body, especially in the thighs, shoulders, and neck)
  • Raynaud's phenomenon (achy, abnormally cold extremities that turn pale or blue)
  • Dry, rough, scaly skin
  • Thinning hair
  • Red, swollen areas around your fingernails
  • Hard lumps under the skin
  • Trouble swallowing
  • Voice changes
  • Fatigue

Graves' Disease

Graves' disease causes overactivity of the thyroid gland (hyperthyroidism). This leads to excess levels of thyroid hormone, which puts numerous body functions in "overdrive." Symptoms include:

  • A racing heartbeat that may be irregular
  • Anxiety
  • Weight loss
  • Feeling hot
  • Sweating more than usual
  • Frequent bowel movements or diarrhea
  • Fatigue or muscle weakness
  • Shaking hands
  • Sleep problems

Guillain-Barré Syndrome

Guillain-Barré syndrome (GBS) results from an immune system attack on the nervous system after an infection, most commonly with the bacteria Campylobacter jejuni.

GBS is an oddity among autoimmune diseases in that it develops quickly (anywhere from a few hours to a few weeks) and typically improves over the course of a few months. Only about 20% of people who contract it have symptoms a year later. Symptoms include:

  • Weakness in the legs that may spread to the upper body, can affect breathing, and sometimes leads to paralysis
  • Numbness and tingling, especially in the hands and feet
  • Muscle pain

Hashimoto's Thyroiditis

Hashimoto's thyroiditis causes an underactive thyroid gland (hypothyroidism), meaning you have a thyroid hormone deficiency that causes processes in your body to slow down. Some of the more common symptoms include:

  • Unusual fatigue
  • Unexplained weight gain
  • Feeling cold when others are hot
  • Muscle cramps
  • Joint stiffness
  • Problems concentrating
  • Constipation
  • Hair loss
  • Dry skin
  • Heavy or irregular periods
  • Slow heartbeat

Multiple Sclerosis

Multiple sclerosis (MS) is a neurological disorder in which your immune system attacks the fatty covering (myelin sheaths) on nerve fibers in the brain and spinal cord. The process is called demyelination. Symptoms vary significantly based on where in the brain and/or spinal cord the attacks occur, but some of the more common are:

  • Fatigue
  • Weakness
  • Numbness and tingling
  • Electrical shock sensations in the limbs or back
  • Dizziness
  • Bladder problems

Myasthenia Gravis

Myasthenia gravis occurs when the immune system makes antibodies that misguidedly attack the proteins that facilitate nerve and muscle communication. This leads to weakness in the eyes, neck, jaw, limbs, and muscles used for breathing. Some common symptoms of myasthenia gravis include:

  • Drooping eyelids
  • Blurry or double vision
  • Difficulties with swallowing, talking, breathing, and chewing foods
  • Reduced muscle stamina
  • Change in facial expressions and a possible "mask-like" appearance
  • Trouble lifting the arms and legs
  • Pain
  • Excessive eye watering

Pernicious Anemia

In pernicious anemia, the immune system attacks the protein necessary for absorbing vitamin B12 in the gut. Since vitamin B12 plays an important role in making red blood cells, a deficiency leads to anemia. While mild anemia may simply cause fatigue, more severe anemia may cause:

  • Problems breathing
  • Dizziness
  • Headache
  • Chest pain
  • Pale skin
  • Cold, tingling, or numbness in the hands and feet
  • A red, swollen, tender tongue (glossitis)
  • Depression
  • Thinking and memory problems

While similar, pernicious anemia is different from the more common iron-deficiency anemia.

Polymyositis

Polymyositis is an inflammatory myopathy, similar to dermatomyositis, that targets the muscles of your neck, upper arms, shoulders, thighs, and hips. Weakness in these muscles may lead to trouble climbing stairs, lifting objects, or swallowing. Other symptoms can include

  • Joint pain or muscle tenderness
  • Difficulty breathing, swallowing, or speaking
  • Fatigue
  • Irregular heart rhythm

Primary Biliary Cirrhosis

With primary biliary cirrhosis, the immune system attacks the small bile ducts of the liver. Early symptoms of the disease include:

  • Fatigue
  • Itching
  • Abdominal pain
  • Nausea
  • Poor appetite
  • Unexplained weight loss
  • Jaundice

Psoriasis

Psoriasis involves attacks on the outer layer of skin (epidermis). This causes patches of red, thickened skin, usually covered by a silvery, flaky scale (called plaques). Other common symptoms include:

  • Skin that's itchy, dry, cracked, and may bleed
  • Itching or burning skin
  • Pitted, cracked, or crumbly nails
  • Scaly scalp

About a third of people with psoriasis will develop psoriatic arthritis, a related condition characterized by joint stiffness and pain.

Rheumatoid Arthritis

When your immune system attacks your joints, rheumatoid arthritis (RA) may develop. At the onset of RA, you may notice joint pain, stiffness, swelling, and warmth, especially in the joints at the base of the fingers and toes. The same symptoms tend to occur on both sides of the body.

Besides joint symptoms, other early symptoms include:

  • Fatigue
  • Muscle pain
  • Low-grade fever
  • Weight loss

As the disease progresses, inflammation may occur in other parts of the body (besides the joints), like the heart and lungs, causing chest pain and trouble breathing.

Sarcoidosis

Sarcoidosis is an autoimmune disease that causes nodules of inflamed tissue (granulomas) to form within organs, most commonly the lungs and lymph glands. This leads to symptoms like:

  • Persistent dry cough
  • Chest discomfort
  • Shortness of breath, especially with activity
  • Wheezing
  • Fatigue
  • Fever
  • Eye pain, inflammation, blurring, and light sensitivity
  • Joint and bone pain
  • Night sweats
  • Rashes
  • Swollen lymph nodes
  • Unexplained weight loss

Sometimes, sarcoidosis affects other organs, including the skin, eyes, muscles, nervous system, heart, joints, and kidneys.

Sjögren's Syndrome

The primary symptoms of Sjögren's syndrome are dry eyes and mouth, which are due to the immune system damaging the glands that produce tears and saliva. Other symptoms and related complications may include:

  • Dry skin, lips, nasal passages, throat, and vagina
  • Fatigue
  • Painful, swollen salivary glands
  • Difficulty swallowing
  • Changes in taste or smell
  • Concentration or memory problems
  • Headaches
  • Dental cavities and inflamed gums
  • Fungal infections in the mouth
  • Acid reflux
  • Eye pain, infections, corneal damage, and blurry vision

Although not very common, other organs like the lungs, kidneys, and nervous system may be affected. This can cause symptoms linked to that organ involvement, such as cough, frequent urination, and weakness or numbness.

Systemic Scleroderma

Systemic scleroderma attacks soft tissues, causing a build-up of scar tissue that makes them thick and rigid. It affects the skin, connective tissues, and organs including the gut, lungs, kidney, and heart. The most common symptoms of systemic scleroderma include:

  • Fatigue
  • Raynaud's phenomenon
  • Loss of strength
  • Muscle and joint pain
  • Sores on the fingers (called digital ulcers)
  • Rarely, nerve pain or numbness

Some symptoms depend on which organs are involved:

  • Lungs: Shortness of breath and cough
  • Gut: Acid reflux and problems swallowing
  • Kidneys: High blood pressure
  • Heart: Chest pain

Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE or lupus) occurs when the immune system attacks and damages various organs within the body. Lupus affects everyone differently. Some people have only a few mild symptoms and others have many more severe symptoms. Early symptoms can include:

  • Fatigue
  • Fever
  • Hair loss
  • Rashes, especially a butterfly-shaped rash across the cheeks and nose (malar rash)
  • Pulmonary problems
  • Kidney problems
  • Swollen, painful joints and muscles
  • Gastrointestinal problems
  • Thyroid problems
  • Dry mouth and eyes
  • Memory problems or confusion
  • Blood clots, which can lead to miscarriage

Examples of symptoms related to the damage of a particular organ include a skin rash after sun exposure, joint pain and stiffness, or chest pain.

Higher Risk in Some Ethnic Groups

Black, Hispanic, and Native American women have an especially high risk of some autoimmune diseases, including lupus and possibly scleroderma, and may be prone to more severe forms of the disease.

Type 1 Diabetes

Type 1 diabetes occurs when the immune system destroys the insulin-producing cells, called beta cells, in the pancreas. The destructive process can go on for months or years before symptoms develop. When they do occur, though, they can be severe. Symptoms include:

  • Frequent urination
  • Excessive thirst
  • Blurry vision
  • Unexplained weight loss
  • Increased hunger
  • Numbess or tingling in the extremities
  • Fatigue
  • Dry skin
  • Increased infections
  • Sores that heal slowly

Ulcerative Colitis

Ulcerative colitis (UC) is an autoimmune bowel disease that causes inflammation in the lining of the colon. Symptoms can range from mild to severe and may change over time. Mild symptoms include:

  • Diarrhea
  • Cramping abdominal pain
  • Rectal bleeding or blood in the stool
  • Mucus in the stool
  • Urgent need for bowel movements
  • Feeling that you need a bowel movement when your bowel is empty
  • Significant abdominal pain and cramping
  • Fever
  • Unexplained weight loss

Vitiligo

Vitiligo causes a loss of the natural color or pigment of your skin. Symptoms include:

  • Blotchy patches of very light skin, even in people with darker skin tones
  • Whitening of hair on the head and face
  • Loss of color in the eyes, inside of the mouth, and the genitals

Besides the loss of natural skin color, people with vitiligo usually have no other symptoms, although some note itchiness or pain on the affected areas of skin.

If your doctor suspects your symptoms suggest an autoimmune disease, they'll likely start with an antinuclear antibody test (ANA). A positive test means you probably do have an autoimmune condition, but more tests will need to be done to confirm exactly which one you have.

Complications

Autoimmune diseases can potentially put you at risk for serious complications. The specific risks vary by condition, but some of the more common ones include:

  • Heart disease: Conditions that cause inflammation, such as lupus, scleroderma, and RA, can lead to the hardening of the arteries (atherosclerosis) and heart disease.
  • Mood disorders: Chronic pain and fatigue—the hallmarks of many autoimmune disorders—are often associated with depression and anxiety.
  • Neuropathy: Nerve damage can develop in many autoimmune disorders, including rheumatoid arthritis, type 1 diabetes, and Sjögren's.
  • Deep vein thrombosis: Disease activity and/or being sedentary or needing a wheelchair put you at risk of developing blood clots in your legs; these sometimes travel to the lungs and cause a pulmonary embolism.
  • Organ damage: Autoimmune diseases that attack specific organs can cause significant damage if not properly treated; for example, autoimmune hepatitis can lead to liver damage, and type 1 diabetes can cause kidney problems.

Talk to your healthcare provider about what you can do to minimize the risk of complications specifically associated with your condition(s).

When to See a Doctor

If you're worried you may be experiencing symptoms of an autoimmune condition, be sure to see a doctor for a comprehensive evaluation, which will include a thorough physical examination, blood tests, and possibly imaging tests.

If your primary care or family doctor suspects an autoimmune process, you will likely be referred to a specialist, such as a rheumatologist (for conditions such as RA, lupus, or Sjögren's), an endocrinologist (for thyroid diseases or type 1 diabetes), or a gastroenterologist (for conditions such as Crohn's or celiac disease).

Frequently Asked Questions

What type of blood tests are used to diagnose autoimmune diseases?

Several different blood tests may be used to diagnose an autoimmune disease. In addition to a regular complete blood count and metabolic panel, other tests that are likely to be included are anti-dsDNA, anti-RNP, anti-Sm, anti-Sjogren's SSA and SSB, anti-scleroderma, anti-Jo-1, anti-CCP, antibody against cardiolipin, and an antinuclear antibody test. A rheumatoid factor test, which looks for rheumatoid arthritis, is also usually included during the diagnostic phase. The antinuclear antibody test looks for antibodies that could cause an autoimmune response.

When are autoimmune diseases usually diagnosed in women?

The average age of onset and diagnosis of an autoimmune disease in women is during the childbearing years (14-50). For example, lupus manifests between ages 16 and 55, RA appears around age 30-55, and MS usually manifests at age 20-40.

How is an autoimmune disease rash treated?

A rash caused by an autoimmune response is usually treated with corticosteroids and immune-suppressing drugs. While autoimmune diseases are not curable, symptoms like rashes can be managed.

A Word From Verywell

Being diagnosed with an autoimmune disease can be unnerving, but the fact is that most conditions can be managed well, especially if they're diagnosed and treated promptly. If you have symptoms that seem in line with an autoimmune condition, don't hesitate to call your doctor.

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