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Could I Have an Autoimmune Disorder?

By Susan Peck, MSN, APN

Could I Have an Autoimmune Disorder?

Our immune system keeps us healthy and fights off viruses and bacteria so we don’t get sick. But with autoimmune disorders (Ads), the immune system does quite the opposite—it attacks and damages the body itself.

So, chances are you know someone affected or may have wondered if the way you feel could mean you have an AD. There are more than 75 different autoimmune disorders that affect close to 50 million Americans. More than 75% of people with ADs are women – mostly ages 18-40s.

The challenge with ADs are that many times their symptoms are vague and come from inflammation, such as fatigue and muscle aches. Sadly, with many autoimmune disorders, there’s not 1 test that will say “yes or no.” So, getting out a diagnosis can be as frustrating for you and your family as it is for your healthcare provider.

On average, it takes most autoimmune disorder patients 4.6 years and 5 health care providers before they get a correct diagnosis! Symptoms can come and go, which also makes diagnosis tricky.

Understanding autoimmune disorders

ADs are chronic diseases; there’s no cure. With treatment, many people with these disorders live healthy, happy lives. Perhaps you’ve heard of some of the more common ADs:

  • Lupus
  • Multiple Sclerosis
  • Fibromyalgia
  • Rheumatoid Arthritis

Others include Type 1 diabetes, psoriasis, chronic fatigue syndrome, celiac disease, Sjogren’s syndrome, and Hashimoto’s thyroiditis (thyroid gland inflammation). If you think you may have an autoimmune disorder, see your healthcare provider right away. They may refer you to a specialist like a rheumatologist or neurologist.

Lupus

Lupus is an autoimmune disorder that can damage many different parts of your body including skin, kidneys, blood vessels, joints, lungs, and heart. Lupus affects more than 5 million people worldwide; there are about 16,000 new cases diagnosed each year—most of whom (9 out of 10) are women ages 15-44. Women of color are more commonly affected.

The most common type of Lupus is SLE, systemic lupus erythematosus, which affects many parts of the body. Other types include discoid, which affects the skin, drug-induced, and the more rarely seen neonatal Lupus.

Symptoms of Lupus include:

  • Severe muscle and/or joint pain
  • Red butterfly rash on the face that covers the nose and cheeks
  • Feeling very tired
  • Swollen glands

Lupus is usually managed by a rheumatologist. Because Lupus differs for each person, it’s hard to diagnose. Your care provider may order blood tests, x-rays and/or a biopsy.

Treatments include anti-inflammatory drugs such as Aleve or Advil, steroids, anti-malarial drugs such as Plaquenil, and in severe cases, drugs that suppress your immune system. If you have Lupus and are planning a pregnancy, make sure your Lupus is under control, such as checking that your kidneys and heart are working properly.

Also, you may not be able to use certain drugs to treat Lupus during pregnancy. You’ll want to consult with a high-risk obstetrician because Lupus can put you at risk for pregnancy complications such as pregnancy-induced high blood pressure, fetal growth restriction, and preterm labor and preterm birth.

Fibromyalgia

Fibromyalgia is the most common musculoskeletal disorder after osteoarthritis. This autoimmune disorder affects over 12 million people and like Lupus, most often affects women ages 25-60. It’s poorly understood, but may be a nerve disorder.

Symptoms of fibromyalgia include:

  • Severe muscle aches and pain – your muscles often feel very tender to touch
  • Feeling very tired
  • Problems sleeping
  • Morning stiffness
  • Tingling in the hands and feet
  • Memory loss
  • Depression

Fibromyalgia is usually managed by a primary care provider, rheumatologist, neurologist or pain management specialist. There’s no one test to diagnose fibromyalgia; as a result, it may take a long time to diagnose, especially while other diseases are excluded.

Treatments for this fibromyalgia include medications that help with nerve pain, anti-depressants, anti-inflammatory drugs, sleep aids, exercise and stress reduction.

If you have fibromyalgia and are planning a pregnancy, manage your pain and fatigue well – and check with your care provider about any medications you’re taking. Pain and fatigue may increase in pregnancy, especially if you’re stressed. The good news is that this autoimmune disorder will not harm your baby.

Multiple Sclerosis

Multiple Sclerosis (MS) is a disease in which the immune system affects the central nervous system: Your brain, spinal cord and optic nerve. Myelin, the insulation of our nerves, is attacked and becomes scarred and damaged. This prevents the normal operation of your nervous system and produces many different symptoms.

MS affects more than 400,000 people in the US and about 2.5 million worldwide. Like Lupus and fibromyalgia, MS affects more women than men, and rates are higher in Caucasian and Northern Europeans.

There are 4 types of MS: relapsing-remitting, primary progressive, secondary progressive and progressive relapsing. Symptoms of MS include:

  • Tingling
  • Severe fatigue
  • Numbness
  • Walking problems
  • Vision changes
  • Bladder and bowel problems
  • Depression

Like other ADs, symptoms may be mild or severe, may come and go, and are different for each person. MS may also be hard to diagnose – usually blood tests, MRIs of the brain and spine and spinal taps are needed.

MS is usually managed by a neurologist. Treatments for MS include disease-modifying injections and pills, medications to manage pain or fatigue, steroids, exercise, and stress reduction. If you have MS and are want to start a family, the great news is that your MS symptoms will probably get better during pregnancy, especially in the 2nd and 3rd trimesters.

In the first 6 months post-partum, there is an increased risk of relapse – so talk to your neurologist about this transition. None of the standard MS medications are approved for use in pregnancy or lactation. Like fibromyalgia, MS will not harm your baby.

Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is an autoimmune disorder in which the immune system attacks the tissue that lines the joints. RA affects 1.3 million people worldwide and women ages 30-60 are 2.5 times more likely to have RA then men.

Symptoms of RA include:

  • Redness
  • Warmth
  • Swelling
  • Pain in your joints; more likely to start in the hands and toes
  • Bumps under the skin
  • Severe fatigue
  • Morning stiffness

Like other ADs, symptoms can also come and go with RA. A rheumatologist is needed to manage RA; blood tests and x-rays to help diagnose this condition.

Treatments for RA include anti-inflammatory drugs, steroids, biologic drugs and disease modifying drugs such as methotrexate. If you have RA and are planning a pregnancy, talk to your healthcare provider about any drugs you may be using as many can’t be taken in pregnancy and may harm your baby. Like MS, RA symptoms may improve in the 2nd and 3rd trimester, but may worsen in the post-partum period. Like MS and fibromyalgia, RA will not harm your baby.

Susan Peck, MSN, APN, is a nurse practitioner in New Brunswick, NJ, and an expert advisor to Healthy Mom&Baby.


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