Understanding Autoimmune Disease
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. Autoimmune disease usually develops through a combination of genetic susceptibility and environmental influences, which may include infections, smoking, medications, pollutants, 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.
How Autoimmune Disease Develops
Normally, the immune system protects the body from infection 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. Environmental factors and immune-system changes are also involved, although researchers often do not know exactly what initiates a particular disease.
Autoimmune diseases can affect very different parts of the body. Rheumatoid arthritis primarily affects the joints; multiple sclerosis damages the protective covering of nerve fibers; Hashimoto’s thyroiditis affects the thyroid; and type 1 diabetes destroys insulin-producing cells in the pancreas.
This is why a diet, medication, or lifestyle intervention that appears helpful for one autoimmune disease cannot be assumed to work for others.
The Role of Lifestyle
Diet, exercise, sleep, stress, smoking, body weight, and the gut microbiome can influence inflammation and immune function and are receiving increasing attention in autoimmune research.
For some autoimmune diseases, particular lifestyle changes have established benefits. For others, the evidence is still developing.
Some physicians, including Mark Hyman, argue that addressing diet, gut health, metabolic health, stress, and other lifestyle factors may contribute to improvement and, in some circumstances, remission. How often lifestyle changes contribute to remission—and in which autoimmune diseases—remains an important scientific question.
Treatment and Remission
Treatment varies greatly depending on the disease. It may include medications that reduce inflammation, 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 complement medical treatment and help improve symptoms, overall health, or the likelihood of remission.
Key Takeaways
Autoimmune disease is not a single disease, but a large group of disorders with different causes and treatments.
Both genetics and environmental factors contribute to autoimmunity.
Diet, the microbiome, metabolism, exercise, sleep, and stress are legitimate areas of research, but the strength of the evidence varies.
Remission is possible in some autoimmune diseases, but remission is not necessarily cure.
Lifestyle approaches may complement conventional treatment, but their effects should be evaluated disease by disease and evidence by evidence.
Learn More
National Institute of Environmental Health Sciences — Autoimmune Diseases
An overview of autoimmune diseases and research into genetic and environmental factors that may contribute to their development.
National Institute of Arthritis and Musculoskeletal and Skin Diseases — Autoimmune Diseases
Information from the National Institutes of Health about autoimmune diseases, diagnosis, treatment, and research.