Symptoms of Autoimmune Diseases

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The tricky part about autoimmune diseases is that the symptoms are often subtle, hard to pinpoint, and/or easily mistaken for more common ailments like depression, a viral infection, or run-of-the-mill stress. Symptoms vary depending on the severity and location of related inflammation, but there is significant overlap among many autoimmune disorders. Furthermore, it is not uncommon to have more than one autoimmune disease, making someone's symptom profile even more complicated.

Frequent Symptoms

An autoimmune disease is a condition that results when your immune system wrongly attacks your own organs, tissues, glands, or cells. It's the inflammation that results from this misguided attack that causes symptoms.

Symptoms that are common to most autoimmune disease include:

  • Fatigue
  • Achy muscles
  • Swelling and redness
  • Low-grade fever
  • Trouble concentrating
  • Numbness and tingling in the hands and feet
  • Skin rashes

Individual diseases also have symptoms unique to them and follow different courses. With autoimmune diseases like psoriasis or rheumatoid arthritis (RA), for example, symptoms come and go. Periods of symptoms are called flare-ups. Periods when symptoms recede are called remissions.

By Condition

There are more than 100 autoimmune conditions, and sorting out one from another can be helped, to varying degrees, by looking for their hallmark symptoms. This list is by no means exhaustive, so be sure to report any symptoms you are experiencing to your doctor.

Alopecia Areata

Alopecia areata is a chronic autoimmune disease in which 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 area of the body with hair. Patches vary in size. Symptoms of this condition include:

  • Coin-sized, round, smooth, bare patches where hair once was
  • “Exclamation mark” hairs: Often, a few short hairs occur in or at the edges of the bare spots. These hairs get narrower at the bottom, like an exclamation mark. 
  • Widespread hair loss: With time, some patients go bald. Some lose all their body hair, too. This is not common.
  • Nail problems: Nails can have tiny pinpoint dents (pitting), white spots or lines, be rough, lose their shine, or become thin and split.
An Overview of Alopecia Areata

Antiphospholipid Syndrome

With antiphospholipid syndrome (APS), your immune system makes antibodies that target the cells that line your blood vessels. These antibodies increase the risk of developing blood clots in the arteries and veins. 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 and shortness of breath
  • Pain, redness, warmth, and swelling in the limbs
  • Ongoing headaches
  • Speech changes
  • Upper body discomfort in the arms, back, neck, and jaw
  • Nausea
  • Red rash on wrists and knees
An Overview of APS

Autoimmune Hepatitis

In autoimmune hepatitis, a person's immune system attacks cells in the liver, causing inflammation. While autoimmune hepatitis may cause no symptoms early on, if symptoms are present, they include:

  • Fatigue
  • Jaundice (yellowing of the skin and eyes)
  • Itching
  • Joint pain
  • Nausea
  • Right-sided abdominal pain
An Overview of Autoimmune Hepatitis

Celiac Disease

With celiac disease, the immune system attacks the lining of a person's 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
An Overview of Celiac Disease

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 include:

  • Fatigue
  • Diarrhea with abdominal pain
  • Weight loss
  • Fever

Less common symptoms include:

  • Mouth sores
  • Arthritis
  • Eye redness and pain
An Overview of Crohn's Disease

Dermatomyositis

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

  • Rashes (including one known as Gottron's papules)
  • Gradual muscle weakness that affects both sides of the body. The muscles located closest to the body—like the thighs, shoulders, and neck—are the ones affected in this inflammatory myopathy.
How to Spot the Signs of Dermatomyositis on Your Skin

Grave's Disease

Graves' disease is an autoimmune disease that causes the thyroid gland to be overactive (hyperthyroidism), meaning too much thyroid hormone is made. This causes the body to go into "overdrive," leading to symptoms including:

  • A racing heart
  • Anxiety
  • Weight loss
  • Feeling hot
  • Sweating more than usual
An Overview of Grave's Disease

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 causes symptoms that include:

  • Mild to severe muscle weakness that begins in the legs and moves up to the arms and face
  • Muscle pain
  • Numbness and tingling in the hands and feet
An Overview of Guillain-Barré Syndrome

Hashimoto's Thyroiditis

Hashimoto's thyroiditis causes an underactive thyroid gland (called hypothyroidism), meaning there is a thyroid hormone deficiency. Some of the more common symptoms include:

  • Unusual tiredness
  • Unexplained weight gain
  • Feeling cold when others are hot
  • Muscle cramps
  • Problems concentrating
  • Constipation
An Overview of Hashimoto's Thyroiditis

Multiple Sclerosis

Multiple sclerosis (MS) is a neurological disorder in which a person's immune system attacks the fatty covering surrounding nerve fibers in the brain and spinal cord, called myelin sheaths. Symptoms vary significantly based on where in the brain and/or spinal cord the attacks occur. Some of the more common symptoms include:

  • Fatigue
  • Numbness and tingling
  • Bladder problems
  • Muscle tightness
  • Depression
An Overview of MS

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
  • Trouble lifting one's arms and legs
  • Difficulties with swallowing, talking, breathing, and chewing foods
An Overview of Myasthenia Gravis

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
  • Chest pain
  • Pale skin

Other symptoms of vitamin B12 deficiency include:

  • A swollen, tender tongue (glossitis)
  • Depression
  • Thinking and memory problems
  • Numbness and tingling in the hands and feet
An Overview of Pernicious Anemia

Polymyositis

Polymyositis is an inflammatory myopathy, similar to dermatomyositis, that targets muscles closest to the body, such as those in the upper arms, shoulders, thighs, hips, and neck. Weakness in these muscles may lead to trouble climbing stairs, lifting objects, or swallowing.

An Overview of Polymyositis

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
  • Dry eyes and mouth

As the disease progresses, other symptoms may develop, including:

  • Abdominal pain
  • Nausea
  • Jaundice
An Overview of Primary Biliary Cirrhosis

Psoriasis

Psoriasis is a skin disease that causes patches of red, thickened skin, usually covered by a silvery, flaky scale (called plaques). The "why" behind psoriasis is an immune system attack on the epidermis, or the outer layer of the skin. Besides plaques, people with psoriasis may develop joint pain and stiffness (called psoriatic arthritis).

An Overview of Psoriasis

Rheumatoid Arthritis

When your immune system attacks your joints, rheumatoid arthritis (RA) may develop. At the onset of RA, a person may notice joint pain, stiffness, swelling, and warmth, especially in the joints at the base of the fingers and toes. 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.

An Overview of Rheumatoid Arthritis

Sarcoidosis

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

  • Cough
  • Chest discomfort
  • Shortness of breath

Sometimes, other organs are affected, including the skin, eyes, muscles, heart, brain, joints, and kidneys.

The Role of Inflammation in Sarcoidosis

Systemic Scleroderma

Systemic scleroderma affects the skin, connective tissues, and various organs, including the gut, lungs, kidney, and heart.

The most common symptoms of systemic scleroderma include:

  • Fatigue
  • Raynaud's phenomenon
  • Loss of strength
  • Pain resulting from skin thickening and hardening
  • Sores on the fingers (called digital ulcers)
  • Stiff joints

Depending on which organs are involved, symptoms may also include:

  • Shortness of breath and cough (lung involvement)
  • Acid reflux and problems swallowing (gut)
  • High blood pressure (kidney involvement)
  • Chest pain (heart involvement)
An Overview of Scleroderma

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. Related complications may result, including:

  • Cavities
  • Fungal infections in the mouth
  • Acid reflux
  • Eye pain and blurry vision

Although not very common, other organs like the lungs, kidneys, and joints may be affected. This can cause symptoms linked to that organ involvement, such as cough, frequent urination, and joint pain.

An Overview of Sjögren's Syndrome

Systemic Lupus Erythematosus

Lupus is an autoimmune disease that causes swelling (inflammation) and a wide variety of symptoms. Systemic lupus erythematosus (SLE) 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.

Symptoms usually start in early adulthood, anywhere from the teen years into the 30s. People with lupus generally experience flare-ups of symptoms followed by periods of remission. That’s why early symptoms are easy to dismiss.

Because early symptoms are similar to those of other conditions, having them doesn’t necessarily mean you have lupus. Early symptoms can include:

  • Fatigue
  • Fever
  • Hair loss
  • Rash
  • Pulmonary problems
  • Kidney problems
  • Swollen joints
  • Gastrointestinal problems
  • Thyroid problems
  • Dry mouth and eyes

Whole-body symptoms like fatigue, fever, and weight loss are common in SLE. Examples of symptoms related to the damage of a particular organ include a skin rash after sun exposure, joint pain and stiffness, and chest pain with heart and/or lung involvement.

An Overview of Lupus

Type 1 Diabetes

Type 1 diabetes occurs when the immune system destroys the insulin-producing cells, called beta cells, in the pancreas. Interestingly, symptoms of high blood sugar, like frequent urination, excessive thirst, and blurry vision, do not occur until more than 90 percent of the beta cells have been destroyed.

Understanding Type 1 Diabetes

Ulcerative Colitis

Ulcerative colitis (UC) is an autoimmune bowel disease that causes inflammation of 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

People with severe symptoms can experience:

  • Multiple (up to 10) bloody stools every day
  • Significant abdominal pain
  • Fever
  • Weight loss
An Overview of Ulcerative Colitis

Vitiligo

Vitiligo is an autoimmune skin condition that causes a person to lose the natural color or pigment of their skin. Symptoms include:

  • Patches of white skin. These can affect different areas of the body and manifest in different sizes.
  • Whitening of hair

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.

Why Skin Can Lose Its Pigment

If your doctor suspects your symptoms suggest an autoimmune disease, he or she will 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

Having one autoimmune disease increases the risk of having another one, or in some cases, two or more. In addition, autoimmune diseases can potentially put you at risk for serious complications. These include:

Heart Disease

Conditions that cause inflammation, such as lupus, scleroderma, and RA, can lead to hardening of the arteries and heart disease.

Mood Disorders

Chronic pain and fatigue—the hallmarks of many autoimmune disorders—are often associated with mood disorders, such as depression and anxiety.

Neuropathy

Nerve damage, or neuropathy, can develop in those with autoimmune disorders. Common conditions associated with neuropathy include rheumatoid arthritis and type 1 diabetes.

Deep Vein Thrombosis

If you have RA or MS, or another condition that causes you to be sedentary or in need of a wheelchair, you are at risk of developing deep vein thrombosis, in which blood clots form in the legs; in some cases, these clots can travel to the lungs, resulting in a pulmonary embolism.

Organ Damage

Autoimmune diseases that attack specific organs can ultimately cause significant damage if not treated properly. Autoimmune hepatitis, for example, can lead to liver damage. Type 1 diabetes can cause kidney problems and damage to the retina; in the worst case, retinal damage can lead to vision impairment and loss.

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 Your Doctor

If you are 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 lupus or Sjögren's), an endocrinologist (for Graves' disease and type 1 diabetes), or a gastroenterologist (for conditions such as Crohn's or celiac disease).

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 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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