Autoimmune diseases occur when the immune system mistakenly attacks the body’s own cells and tissues. More than 80 autoimmune diseases have been identified, including rheumatoid arthritis, lupus, multiple sclerosis, type 1 diabetes, celiac disease, and Hashimoto’s thyroiditis.
There is no single cause. Researchers believe autoimmune disease usually develops through a combination of genetic susceptibility and environmental influences, which may include infections and other exposures. The gut microbiome, nutrition, metabolism, sleep, stress, and other lifestyle factors are also being studied.
Some of these connections are well established; others remain uncertain. Because autoimmune diseases differ greatly, findings about one condition should not automatically be applied to another.
Normally, the immune system protects the body from infections while learning to tolerate its own cells and tissues. In autoimmune disease, this tolerance breaks down and the immune system attacks healthy tissue.
Genetics plays an important role, but genes alone usually do not explain why autoimmune disease develops. Researchers are studying environmental triggers including infections, smoking, medications, pollutants, hormonal factors, and changes in the gut microbiome.
The causes differ from one autoimmune disease to another, and in many cases researchers still do not know exactly what initiates the disease.
The term autoimmune disease covers many very different conditions. In rheumatoid arthritis, the immune system primarily attacks the joints. In multiple sclerosis, it damages the protective covering of nerve fibers. In Hashimoto’s thyroiditis, it attacks the thyroid. In type 1 diabetes, it destroys insulin-producing cells in the pancreas.
This distinction is important when evaluating research. A diet or lifestyle intervention that appears helpful for one autoimmune disease cannot be assumed to work for others.
Lifestyle is receiving increasing attention in autoimmune research. Diet, exercise, sleep, stress, smoking, body weight, and the gut microbiome can influence inflammation and immune function.
For some autoimmune diseases, particular lifestyle changes have established benefits. For others, the evidence is still developing. Researchers are especially interested in whether lifestyle changes can complement medical treatment by improving symptoms, overall health, and quality of life.
Some physicians, including Mark Hyman, argue that addressing diet, gut health, metabolic health, stress, and other lifestyle factors may help some people with autoimmune disease achieve remission. Remission is an important concept, but it does not necessarily mean that a disease has been cured. How often lifestyle changes can produce or contribute to remission—and in which autoimmune diseases—remains an important scientific question.
Treatment varies greatly depending on the autoimmune disease. It may include medications that reduce inflammation, suppress or modify immune activity, replace substances the body can no longer produce, or target particular parts of the immune system.
Modern treatments have made it possible for many people with autoimmune disease to achieve low disease activity or remission. But remission does not necessarily mean cure. Symptoms may return, and continued treatment or monitoring may be necessary.
An important question explored in this section is whether nutrition, metabolic health, exercise, sleep, stress reduction, and other lifestyle changes can increase the likelihood of remission or help people maintain it.
Autoimmune disease is not a single disease, but a large group of disorders with different causes, symptoms, and treatments.
Both genetics and environmental factors appear to contribute to the development of autoimmunity.
Diet, the microbiome, metabolism, exercise, sleep, and stress are legitimate areas of scientific investigation, but the strength of the evidence varies considerably.
Remission is possible in some autoimmune diseases, but remission is not necessarily the same as cure.
Lifestyle approaches may complement conventional treatment, but claims that they can produce remission should be evaluated disease by disease and evidence by evidence.
An overview of autoimmune diseases and research into the genetic and environmental factors that may contribute to their development.
Information on autoimmune diseases, symptoms, diagnosis, treatment, and research from the National Institutes of Health.