Why Autoimmunity Happens and What You Can Do

Written by: Ryah Nabielski, MS, RDN

Autoimmune diseases are complex chronic conditions affecting up to 50 million people in the United States; only cancer and heart disease affect more folks. Interestingly, 80% of those with autoimmunity are women. Chances are you know someone who suffers from one of over 80 autoimmune diseases. 

Today’s article will dive into this important health topic. We’ll discuss autoimmunity, its causes, and why so many women are affected. Plus, you’ll learn some tools and strategies that may be supportive. Keep reading to learn the answers to these questions:

• What is autoimmunity? 
• What are common autoimmune diseases? 
• What causes autoimmunity? 
• Why do women get more autoimmune diseases than men?
• How can I support healthy immune function with lifestyle? 

Let’s go! 

What is Autoimmunity?

The immune system’s primary role is to identify and eliminate outside invaders. To do its job, the immune system needs to distinguish self vs. non-self. 

In autoimmunity (meaning “self-immunity”) the system gets confused and mistakes the body’s own tissues as foreign, which leads to a self-attack. The immune system makes antibodies to itself and mounts an attack, leading to inflammation and tissue destruction. 

Autoimmunity can occur anywhere in the body, depending on the specific antibodies involved. Most people with an autoimmune disease see a doctor who is an expert in the part of the body where the autoimmunity occurs. However, ultimately, autoimmunity is an immune system problem. 

Common Autoimmune Diseases

Scientists have identified over 80 autoimmune diseases. Some of the most common ones are: 

• Hashimoto’s thyroiditis 
• Graves’ disease 
• Celiac disease
• Crohn’s disease
• Ulcerative colitis
• Multiple Sclerosis
• Lupus
• Lyme disease
• Scleroderma
• Type 1 diabetes
• Sjogren’s syndrome
• Interstitial cystitis
• Eczema

• Endometriosis 
• Fibromyalgia

If you have one autoimmune disease, you have a greater chance of developing a second because of the shared underlying causes. Two or more autoimmune diseases are called polyautoimmunity. 

What Causes Autoimmunity? 

Autoimmune diseases have both genetic and environmental root causes. There are genetic components, and autoimmune diseases tend to run in families. Additionally, having two X chromosomes plays a role (as you’ll see below.)

Genetics load the gut, but the environment pulls the trigger. In other words, you can’t change your genetics, but you don’t get autoimmune diseases from genetics alone. Genetics is the primer, but you need something to trigger the autoimmune process. 

The environment influences genetic expression and the immune system. In this case, the environment refers to lifestyle, nutrition, pollution, and any external factor that affects how the body functions. 

Environmental factors that may play a role in autoimmunity include: 

• Food sensitivities, such as gluten
• Viral infections, such as Epstein Barr and Covid 
• Bacterial infections
• Air pollution and cigarette smoke
• Radiation
• Toxin exposures
• Stress
• Childhood trauma 

Gut health also plays a role. Intestinal permeability, called leaky gut, occurs when the intestinal barrier is compromised. Large food proteins, pathogens, and toxins that are meant to stay in the small intestine make their way into the body. Leaky gut and microbiome imbalances can lead to an increased immune response and more risk for autoimmune development in those who are susceptible. 

Autoimmune Disease and Women’s Health 

Most autoimmune diseases occur in women, but why? First, sex hormones, including estrogen, are involved in immune system regulation. Compared to men, women’s hormones fluctuate a lot with the monthly cycle, pregnancy, and perimenopause. 

Times of low sex hormones, such as the postpartum period and perimenopause/menopause, are associated with increased autoimmune disease diagnoses and flares. Puberty is another time when autoimmunity can rear its head.

There also seems to be something about having two X chromosomes (instead of one X and one Y) that underlies autoimmunity. Essentially, there are genes on the second X chromosome the body doesn’t need, so the body makes a special type of RNA, called Xist, to silence the extra genes. In fascinating new research, scientists have discovered that antibodies to Xist might contribute to autoimmunity. 

Lifestyle Support 

Autoimmunity can feel complicated and isolating. Often, someone will appear fine on the outside while facing profound challenges with their health. There isn’t a magic pill or cure for autoimmunity, but lifestyle factors can be profoundly healing and supportive. Of course, please work with your healthcare team for personalized guidance and support. You can discuss these ideas with them:

• Adopt a personalized anti-inflammatory diet. Since inflammation drives tissue destruction in autoimmune diseases, using nutrition to reduce inflammation can be powerful. What works for one person may not work for another, so work with an immune-knowledgeable dietitian if you can. It’s important not to restrict food so much that you can’t meet your nutrient needs. Focus on nourishing, nutrient-dense food and avoiding the foods you are sensitive to. 

• Dial in gut health. Even if an autoimmune disease doesn’t affect your digestive system, your gut health plays a role. Building and balancing the microbiome with fermented foods, fiber-rich foods, and prebiotics is foundational. A probiotic supplement can be supportive, too. Beyond the foundations, you may need to dive deeper with your healthcare team to address underlying imbalances and ensure a strong gut barrier. 

To learn more about gut health, the microbiome, and what foods are helpful, please read How to Improve Your Gut Health. 

• Manage stress. I know, it’s easier said than done! Many people with autoimmune disease report a stressful or traumatic event preceding their initial symptoms and diagnosis. Stress is also related to autoimmune flares, leaky gut, and hormonal changes. While we can’t control all stress in life, we can adopt habits and tools to help build our resiliency. 

For 15 stress management ideas, read Lifestyle Habits for Stress and Anxiety. 

• Manage toxin exposures. This strategy is becoming increasingly difficult with so many environmental chemicals, but controlling what you can control really goes a long way. Drinking filtered water, filtering indoor air, and choosing clean home goods, cleaning products, and personal care products is where to start. The Environmental Working Group is an excellent resource. You don’t need to overhaul everything at once; focus on one area at a time. 

Additionally, to ensure that you aren’t getting toxins and contaminants in your supplements, choose quality products from companies with transparent testing practices, like Twenty2 Nutrition.  

• Support hormonal balance. This topic is vast and deeply personal, but it’s important to pay attention to hormonal transitions, such as the postpartum time. High stress, poor sleep, and low hormones are a recipe for immune dysregulation. You may benefit from putting more resources and support in place, especially if you have an autoimmune disease or autoimmunity runs in your family. 

Read more about postpartum strategies in Perinatal Mood Disorders and the Importance of Postpartum Nutrition.  

• Optimize vitamin D levels. Vitamin D isn’t just for healthy bones; it is critical to immune health. Low vitamin D levels increase the risk of developing autoimmunity. Most of us don’t get enough in our diet or make enough from time in the sun (even in Colorado!) Most people will need to supplement vitamin D to optimize levels. 

Twenty2 Nutrition Prenatal/Women’s Multivitamin contains 37.5 mcg (1500 IU) of vitamin D, and Twenty2 Nutrition Men’s Multivitamin contains 50 mcg (2000 IU), which is an excellent start. Ask your doctor to check your vitamin D levels and adjust supplementation accordingly. 

• Reduce inflammation with omega-3s. Omega-3 fats from cold water fish are essential for immunity and balancing inflammation. Again, most of us aren’t getting enough in our diet or have an omega 6-to-3 ratio that’s out of balance. 

Discover the dietary strategies and what to look for in omega-3 supplements in Health Benefits of Omega-3 Fats. Consider Twenty2 Nutrition Omega 3 Fish Oil for additional support. 

Autoimmunity is complex and scary, but the first step is education and information. The more you know, the more you can advocate for yourself (or your loved ones) in the medical system. If something doesn’t feel right, trust your inner wisdom and find a healthcare professional who will listen and help you find solutions. Lifestyle changes, nutrition, and targeted supplements can help support your journey. 

This article is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider before changing your diet or beginning a new supplement, especially if you are pregnant or breastfeeding, take medication, or have a medical condition. 

Ryah Nabielski, MS, RDN is a Registered Dietitian, functional nutritionist, writer, and recipe creator. Ryah helps clients use a natural, food-as-medicine approach to improve fertility, pregnancy, hormone balance, autoimmunity, and discover a healthy relationship with food and body. Learn more about Ryah and her private practice at econutrition.co.

References

1. https://www.niehs.nih.gov/health/topics/conditions/autoimmune 
2. https://onlinelibrary.wiley.com/doi/10.1111/joim.12395 
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3266166/ 
4. https://onlinelibrary.wiley.com/doi/10.1111/joim.12395 
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246018/ 
6. https://pubmed.ncbi.nlm.nih.gov/36764434/ 
7. https://pubmed.ncbi.nlm.nih.gov/18190880/ 
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9222834/ 
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9271567/ 
10. https://www.cell.com/cell/fulltext/S0092-8674(24)00002-3 
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10490553/