Symptoms of Autoimmune Diseases

Inflammation, which can cause tissue and organ damage, is the main trigger behind the symptoms of autoimmune diseases.

Generally speaking, an autoimmune disease symptom checklist includes:

• Fatigue
• Pain and swelling in the muscles, connective tissues, and/or joints
• Skin rashes
• Stomach ache
• Swollen glands
• Recurring low-grade fever
• Trouble concentrating
• Numbness and tingling in the hands and feet

These signs and symptoms are common to most autoimmune diseases. But there are many conditions that fall under this umbrella. And while they share some symptoms, there are also features that set them apart.

The intensity of the symptoms can change. Flare-ups refer to periods when symptoms worsen, while remission refers to having few or no symptoms during a stretch of time.

This article explains the common signs and symptoms of specific autoimmune conditions, as well as potential complications and when to reach out to your doctor.

Symptoms by Autoimmune Condition

There are more than 80 autoimmune conditions. There is an overlap in symptoms among many of these conditions, and distinctive symptoms can help differentiate between them.

Alopecia Areata

Alopecia areata is a condition in which the immune system attacks the hair follicles, causing hair loss. This mainly occurs on the scalp, though it can affect the eyebrows, eyelashes, beard, or any body hair.

Symptoms include:

• Coin-sized or larger, round, smooth patches of hair loss
• Hair thinning
• Exclamation point hairs, which are hairs that break off when they grow in, leaving shorter pieces of hair
• Widespread hair loss
• Nail pitting, which is when dents and ridges form in the nail
• Nail thickness
• Baldness or loss of all body hair (rare)

Antiphospholipid Syndrome

Antiphospholipid syndrome (APS) is a condition in which antibodies—proteins produced by the immune system—damage the cells lining the blood vessels. This increases the risk of blood clots in the arteries and veins.

Symptoms include:

• Chest pain
• Shortness of breath
• Pain in the arms or legs
• Warmth and redness in the arms or legs
• Headaches
• Changes in speech and memory loss
• Nausea
• Red rash on wrists and knees

Autoimmune Hepatitis

Autoimmune hepatitis is when the body attacks the liver, an important organ that has many functions. This condition may not cause symptoms in the early stages.

Symptoms may develop over time and include:

• Fatigue, exhaustion, and lack of motivation
• Jaundice, which is yellowing of the skin and eyes
• Joint pain
• Nausea and vomiting
• Upper abdominal pain
• Decreased appetite
• Dark urine
• Light-colored stools
• Rash, acne, or other skin conditions

Celiac Disease

Celiac disease occurs when the immune system attacks the lining of the 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
• Nausea and vomiting
• Stomach pain
• Excessive gas
• Joint or bone pain
• Fatigue

Crohn's Disease

Crohn's disease is an inflammatory bowel disease that causes widespread digestive tract inflammation.

Common symptoms of Crohn's disease include:

• Diarrhea
• Stomach pain and cramping
• Weight loss
• Anemia (low red blood cell count)
• Fever
• Fatigue
• Nausea
• Decreased appetite
• Joint pain
• Eye pain
• Red, bumpy skin rash

Dermatomyositis

Dermatomyositis is a rare condition that can cause muscle swelling and inflammation, as well as skin-related issues.

Inflammation can lead to symptoms such as:

• Red or purple bumps called Gottron's papules
• Muscle weakness
• Raynaud's phenomenon, which describes fingers or toes that ache, turn blue or white, and feel stiff in cold environments
• Dry and rough skin
• Thinning hair
• Red, swollen areas around the fingernails
• Hard lumps that can be felt under the skin
• Difficulty swallowing
• Voice changes
• Fatigue

Graves' Disease

Graves' disease causes hyperthyroidism (overactivity of the thyroid gland). This leads to an increase in thyroid hormone production, which impacts multiple organs, including the heart.

Symptoms include:

• A racing heartbeat that may be irregular
• Anxiety
• Weight loss
• Feeling hot
• Sweating more than usual
• Diarrhea
• Fatigue or muscle weakness
• Shaking or tremors of the hands
• Sleep problems

Guillain-Barré Syndrome

Guillain-Barré syndrome (GBS) results from an immune system attack on the peripheral nervous system, usually after a bacterial or viral infection.

The nervous system is responsible for coordinating movement and processing sensory information, so a variety of symptoms can occur.

These include:

• Leg and arm weakness
• Breathing muscle weakness
• Difficulty swallowing
• Numbness and tingling, especially in the hands and feet
• Muscle pain

Guillain-Barré can develop quickly and may improve within a few weeks, but it can also lead to permanent damage.

Hashimoto's Thyroiditis

Hashimoto's thyroiditis causes an underactive thyroid gland, also known as hypothyroidism.

The decrease in thyroid hormones causes:

• Unusual fatigue
• Weight gain
• Feeling cold when others are not
• Muscle cramps
• Joint stiffness
• Constipation
• Hair loss
• Dry skin
• Heavy or irregular periods
• Slow heartbeat
• Hives
• Infertility

Multiple Sclerosis

Multiple sclerosis is a neurological disorder in which the immune system attacks the fatty covering, or myelin sheath, on nerve fibers in the brain and spinal cord. Nerve fibers help with brain/body communication.

Symptoms vary significantly based on where in the brain and/or spinal cord the attacks occur. Some of the more common signs are:

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

Myasthenia Gravis

Myasthenia gravis occurs when the immune system makes antibodies that 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
• Facial expressions that appear mask-like
• Trouble lifting the arms and legs

Pernicious Anemia

Pernicious anemia occurs when 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.

Mild anemia may cause fatigue, and severe anemia may cause:

• Breathing issues
• Dizziness
• Headache
• Chest pain
• Pale skin
• Difficulty walking
• Cold, tingling, or numbness in the hands and feet
• A red, swollen tongue
• Depression, which is a mental health condition that can cause sleep issues, low mood, and loss of interest in previously enjoyed activities
• Thinking and memory problems
• Diarrhea, bloating, and heartburn

Polymyositis

Polymyositis is an inflammatory condition that targets the muscles of the 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

Primary biliary cirrhosis occurs when the immune system attacks the small bile ducts—tubes that connect the liver to the small intestine.

Early symptoms of the disease include:

• Fatigue
• Itching
• Stomach pain
• Poor appetite
• Unexplained weight loss
• Jaundice
• Yellow bumps on the skin

Psoriasis

Psoriasis is a condition in which skin cells build up too quickly. This causes patches of red, thickened skin that are usually covered by silvery, flaky scales called plaques.

Other common symptoms include:

• Skin that's itchy, dry, cracked, and may bleed
• Pitted, cracked, or weak nails
• Scaly scalp

About 30% of people with psoriasis will develop psoriatic arthritis, a related condition that causes joint stiffness and pain.

Rheumatoid Arthritis

Rheumatoid arthritis is characterized by inflammatory attacks on joints and other tissues. This can lead to joint pain, stiffness, swelling, and warmth, especially in the joints in the hands and knees. These symptoms affect 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, like the heart and lungs, causing chest pain and trouble breathing.

Sarcoidosis

Sarcoidosis is an autoimmune disease that causes lumps of inflamed tissue to form within organs, most commonly the lungs and lymph nodes. The lymph nodes are part of the immune system.

This leads to symptoms like:

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

Sjögren's Syndrome

The main symptoms of Sjögren's syndrome are dry eyes and mouth. These are caused by 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
• Swollen salivary glands, which make spit
• Difficulty swallowing
  
• Changes in taste or smell
• Concentration or memory problems
• Headaches
• Dental cavities
• Stomachaches
• Eye infections

Although not very common, other organs like the lungs, liver, and kidneys may be impacted as well.

Systemic Scleroderma

Systemic scleroderma, also called systemic sclerosis, causes connective tissue to build-up too quickly, which leads to scarring. This affects the skin and organs.

The most common symptoms of systemic scleroderma include:

• Fatigue
• Raynaud's phenomenon
• Loss of strength
• Muscle and joint pain
• Sores on the fingers
• Tingling and numbness
• Dry skin that feels tight or stretched
• Difficulty breathing

Some symptoms depend on which organs are involved. For example, if the heart is impacted, an individual may experience chest pain and heart failure.

Systemic Lupus Erythematosus

Systemic lupus erythematosus occurs when the immune system attacks and damages various organs within the body.

Lupus affects everyone differently. Some people have a few, mild symptoms, while others may have numerous, more severe symptoms.

Symptoms can include:

• Fatigue
• Fever
• Hair loss
• Rashes, especially a butterfly-shaped rash across the cheeks and nose, and/or a rash on the eyelids
• Lung problems
• Kidney problems
• Swollen, painful joints and muscles
• Dry mouth and mouth sores
• Dry eyes
• Difficulty remembering or confusion
• Blood clots, which can lead to miscarriage

Type 1 Diabetes

Type 1 diabetes occurs when the immune system destroys beta cells in the pancreas. These cells produce insulin, a hormone that helps blood sugar get processed into energy.

This attack on the beta cells can go on for years without symptoms showing up.

Symptoms that can occur include:

• Peeing often
• Excessive thirst
• Blurry vision
• Unexplained weight loss
• Increased hunger
• Numbness or tingling hands and feet
• Fatigue
• Dry skin
• Increased infections
• Sores

Ulcerative Colitis

Ulcerative colitis is an autoimmune bowel disease that causes inflammation in the lining of the colon.

Symptoms can range from mild to severe and may include:

• Diarrhea
• Cramping stomach pain
• Blood or mucus in the stool
• Urgent need to go to the bathroom
• A feeling of needing to poop, even if the bowel is empty
• Fever
• Unexplained weight loss
• Exhaustion

Vitiligo

Vitiligo causes a loss of the natural color (pigment) of the skin and may include symptoms like:

• Blotchy patches of very light or white skin
• Whitening of hair on the head and face
• Loss of color in the eyes, inside of the mouth, and the genitals
• Itchiness and pain (for some individuals)

Complications of Autoimmune Conditions

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

• Heart disease: Conditions that cause inflammation, such as lupus and rheumatoid arthritis, can affect the heart.
• Mood disorders: Long-term pain and fatigue, which are symptoms of many autoimmune diseases, are often associated with depression and anxiety.
• Neuropathy: Nerve damage or neuropathy can develop with many autoimmune disorders, including rheumatoid arthritis and Sjögren's syndrome. This can lead to feeling numb and weak in the arms or legs.
• Deep vein thrombosis: Ulcerative colitis and Crohn's disease lead to an increased risk of developing blood clots. These clots may travel to the lungs and cause a blockage, known as a pulmonary embolism.
• Organ damage: Autoimmune diseases that cause harm to specific organs can lead to significant damage if not properly treated. For example, type 1 diabetes can cause kidney failure.

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

When to See a Healthcare Provider

If you're worried you may be experiencing symptoms of an autoimmune condition, or if you have a strong family history of autoimmune disease, see your healthcare provider. They can give you a comprehensive evaluation and a physical exam to help provide a diagnosis.

Your doctor may also order blood tests such as:

• The antinuclear antibody test, which checks for specific antibodies to see if your immune system is attacking itself
• Complete blood count (CBC), which measures your blood cells
• Erythrocyte sedimentation rate, which checks for inflammation

If your healthcare provider thinks that you may have an autoimmune disease, you will likely be referred to a specialist. This might include a rheumatologist (a doctor who focuses on musculoskeletal diseases) or an endocrinologist (a doctor who specializes in hormonal conditions).

Summary

Autoimmune diseases occur when the body mistakenly attacks healthy tissues or cells. This leads to inflammation, which may trigger symptoms such as fatigue, rash, pain, swelling, difficulty focusing, and a tingling or numb sensation.

There are dozens of autoimmune diseases, and each affects people somewhat differently.

Possible complications can also vary depending on the specific autoimmune disease. Common complications include heart disease, mood disorders, nerve damage, blood clots, and organ damage.

If you have symptoms that seem in line with an autoimmune condition, call your healthcare provider. Also, be aware that autoimmune conditions can be difficult to diagnose. Be patient and engaged with the process as your practitioner works to sort out what's affecting you. And remember that no symptom is too insignificant to mention.