Ann, a lawyer in San Francisco, had been to see her doctor, but felt frustrated. When she described her symptoms of fatigue, weight loss without trying, and just not feeling well, her doctor said she needed to relax more, or maybe take a vacation. The doctor shrugged off Ann's concerns, saying she was young and in her prime and that she had nothing to worry about.

When Ann's symptoms worsened, she went to another doctor recommended by a friend and was diagnosed with lupus, an autoimmune disease. With the cause of her symptoms finally identified, she was able to begin a treatment plan that helped control the symptoms that were upsetting her life.

Difficulty Getting Diagnosed

Autoimmune diseases include more than 80 different, serious chronic illnesses. Many are rare, but as a group they affect more than 50 million Americans. Autoimmune diseases may be a leading cause of death in young and middle-aged women.

Ann's experience is not uncommon. The American Autoimmune Related Disease Association (AARDA) found that almost half of patients with autoimmune diseases had been labeled chronic complainers during the early stages of their illnesses. This may be because the symptoms: are vague, tend to come and go, and are often hard to describe. Additionally, autoimmune diseases tend to strike women during their childbearing years, when a woman typically looks healthy.

Getting a correct diagnosis may be difficult in the beginning stages, but it is crucial. The inability to quickly identify an autoimmune disease can take a serious toll on a person, both physically and mentally.

Finding the Connection

Researchers do not know why more women suffer from autoimmune diseases. In fact, little is known about what causes autoimmune diseases. It appears that hormones may play a role.

The involvement of hormones has been hypothesized because the expression of autoimmune diseases and their symptoms seems to be related to changes in hormone levels. Symptoms often appear after puberty and before menopause. More research needs to be done to confidently link autoimmune diseases to hormonal changes.

Searching for a Cause

The immune system defends the body's health by fighting foreign invaders. The key to proper functioning of the immune system is its ability to distinguish "self" from "non-self" tissues. Autoimmune disorders occur when the control process is faulty and the immune system reacts to normal, "self" body tissue. The body actually attacks its own tissues and can destroy body then, changing organ function, or causing abnormal organ growth.

Is It Genetic?

Genetics play a role in the development of the disease. Numerous genes are involved and work together to increase a person's susceptibility. You may inherit genes that make you more likely to get an autoimmune disease. A combination of genes and other factors can trigger an autoimmune disease to start.

Autoimmune diseases tend to cluster in families. Interestingly, though, the clusters manifest as different autoimmune diseases: a mother may have diabetes; a daughter may have lupus; and a grandmother may have rheumatoid arthritis. If someone in your family has an autoimmune disorder, you are at risk for developing an autoimmune disorder yourself.

Is It Something in the Environment?

There appear to be agents in the environment that trigger the disease or exacerbate symptoms. These agents include:

• Sunlight, which can not only worsen the symptoms of lupus, but may also bring about the disease
• Solvents—liquids or gases that can cause health problems with longterm exposure
• Silica, which has been found to possibly induce scleroderma
• Viral and bacterial infections, which may bring on or heighten certain immune diseases
• Stress and anxiety, which have been shown to increase the severity and frequency of some symptoms

Although researchers believe there may be some association between autoimmune diseases and the environment, the relationship is not clear and much remains to be discovered.

Managing Autoimmune Diseases

Most autoimmune diseases are chronic and few can be cured. Treatment focuses on reducing the severity of the symptoms. In some cases, symptoms may be reduced with steroidal or other anti-inflammatory medicines. With severe diseases, it may be necessary to suppress the immune system with immunosuppressive medicines.

Until effective treatment or preventive measures are discovered, experts say that learning to cope with the disease is the best strategy. Developing coping mechanisms can be challenging and even frightening. You may not only question your own ability to cope but also the ability of those around you.

AARDA highlights the following 2 areas on which to focus your coping efforts: