Dr. Bonnie Feldman is a digital health analyst and business development consultant who seeks to discover and implement new digital tools to help patients in their health and wellness journey. She and Ellen Martin, who assisted in writing this piece, are the co-authors of "Mobile Social Games for Health" and "Big Data in Healthcare—Hype and Hope". To learn more about Dr. Feldman, visit her website or follow her on Twitter.
Question: Beyond their fame, what do singer Bret Michaels, pop songstress Selena Gomez, and TV anchor Cynthia McFadden have in common?
Michaels, lead singer of Poison, was diagnosed with Type 1 diabetes when he was only 6 years old . Actresses Halle Berry, Sharon Stone, and Mary Tyler Moore also have Type 1 diabetes.
Selena Gomez was first diagnosed with lupus erythematosus in her late teens and had to cancel a 2013 tour due to flares; she and singer-songwriter Toni Braxton both suffer from the systemic form of lupus. Singer Seal, whose signature facial scars are a hallmark of discoid lupus, was diagnosed at age 23.
News anchor Cynthia McFadden first experienced the severe intestinal symptoms of Crohn’s as an 18-year-old college student, and has since been through steroid treatment and surgical resection. Actress Shannen Doherty and Pearl Jam guitarist Mike McReady also live with Crohn’s disease.
These days, more and more young people are developing autoimmune diseases.
Otherwise young and healthy, with careers that demand energy and visibility, such celebrities are the last people we think of as having lifelong chronic illnesses. But the reality is that celebrities aren’t immune to these issues, and neither is another “invincible” demographic—young adults.
These days, more and more young people are developing autoimmune diseases. Here’s the info you need to understand what these diseases are, how they manifest, and what you can do to prevent (or, if it comes down to it, diagnose) an autoimmune disease in your life.
Are you at risk? The most common autoimmune diseases in young adults
Young adults are most at risk for seven of the more than 80 autoimmune diseases:
- Type 1 Diabetes. This autoimmune disease strikes mostly in childhood, leaving patients unable to metabolize glucose and requiring a lifetime of insulin injections and blood testing to avoid fatal complications. Incidence of the disease has increased fivefold over the last 40 years (and 23 percent in the last decade), leaving about 450,000 young people with a diagnosis.
- Lupus. Nearly 5 million people worldwide have been diagnosed with some type of Lupus. Ninety percent are women, mostly ages 15 to 44. Lupus can manifest with many different symptoms, including sun sensitivity, joint pain, and kidney failure. The relapsing and remitting pattern of the disease and its odd assortment of symptoms mean that many suffer for years before being diagnosed.
- Crohn’s Disease. Most commonly diagnosed in patients aged 15 to 30, Crohn’s is a chronic and extremely painful inflammatory disorder of the entire digestive tract. Crohn’s is one of several autoimmune inflammatory bowel diseases (IBD) with varying symptoms, including bloating, diarrhea, and gut pain, which may flare up or go into remission for poorly understood reasons. Unlike Celiac disease, this condition doesn’t respond to the elimination of gluten or similar proteins.
- Multiple Sclerosis (MS). MS, a chronic neurological disorder affecting the central nervous system, is the most common neurological disease in young people. Common symptoms of MS include fatigue, weakness, numbness, vision loss, tremors, and depression.
- Psoriasis. There are five types of psoriasis, which generally causes red, scaly patches to appear on the skin as a result of a speeding up of the skin's normal replacement processes. While psoriasis can occur at any age, it tends to peak either between the late teens and early 30s, or between the 50s and 60s.
- Graves Disease of the Thyroid. Graves disease causes the thyroid gland to overproduce thyroid hormone, which affects the body’s metabolism. Young patients may also experience anxiety, difficulty concentrating, fatigue, insomnia, muscle weakness, rapid or irregular heartbeat, tremors, and nervousness.
- Rheumatoid Arthritis (RA). About 1.5 million people in the U.S. have RA, which causes inflammation that can damage joints and organs. Nearly three times as many women than man have the disease, and women tend to exhibit symptoms at a younger age (commonly between ages 30 and 60) than men.
What do these diseases have in common?
Only over the past 40 years have immunologists developed the theory that these diseases have something in common: attacks by the immune system against cells in its own body.
Our immune systems work to defend our bodies against infection by viruses, bacteria, and parasites. The “innate” system provides general defense via white blood cells that attack pathogens. The “acquired” immune system programs different attack cells (namely, T-cells and B-cells) to recognize specific markers (called “antigens”) on infectious microbes—this is the immunity you acquire after recovering from a childhood illness. These are all necessary and helpful bodily processes.
These diseases all share something in common: They are triggered by attacks by the immune system against cells in its own body.
Sometimes the acquired immune system goes rogue—and instead of attacking invaders, immune cells attack their own host. These diseases have such different symptoms because each one attacks different cells: the pancreatic cells that produce insulin (diabetes), cells of the skin (lupus, psoriasis), joints (lupus, RA), and kidney (lupus), the lining of the gut (IBD), or the sheaths of nerves (MS).
What triggers autoimmune diseases?
Unfortunately current theories rely on a big dollop of speculation when it comes to the causes of autoimmune diseases (Hopefully new data analytics tools will speed up scientific discovery and bring us better answers soon.). These theories suggest several contributing factors:
- Genetic predisposition. Some autoimmune diseases run in families, even though many sufferers are the first in their families to be diagnosed. Many families have clusters of different autoimmune diseases that may be from shared genes.
- Environmental influences. These are still poorly understood. Possible triggers include infections by viruses or bacteria, food or chemical sensitivities, intense sunlight, and stress.
- Newly hypothesized factors. New research points to the role of an unbalanced “microbiome” (the microbes that live on our skin and in our guts) and impaired intestinal barrier function (aka “leaky gut”) The human microbiome and autoimmunity. Proal, AD, Albert, PJ, Marshall, TG. Current Opinion in Rheumatology, 2013 Mar; 25(2):234-40 Leaky gut and autoimmune diseases. Fasano, A. Clinical Reviews in Allergy & Immunology, 2012 Feb;42(1):71-8 .
What symptoms may signal autoimmune disease?
Simply by being aware of your health and general wellbeing, you should know what your normal is. Deviations from your normal, especially clusters of new symptoms, may point to autoimmune disorders. Examples include:
- Unexpected weight loss and increasing thirst and hunger, which may suggest diabetes.
- Recurring abdominal pain and diarrhea, which may suggest Crohn’s or IBD.
- Fatigue, sun sensitivity, skin rashes, and joint pain, which may point to lupus.
- Vision problems and intermittent weakness can suggest MS.
What should i do if i Think i may have an autoimmune disease?
Awareness is a good place to start. Educate yourself about your symptoms (there are many resources online, including communities for specific diseases) and observe if you are experiencing flares in response to environmental triggers (such as foods, stress, and sun exposure). This knowledge will be helpful in both managing your lifestyle and seeking professional advice.
Many patients with autoimmune diseases are initially dismissed as hypochondriacs.
It is also helpful to know your genes and to look at your family history for clusters of autoimmune diseases (not necessarily the same one—a genetic predisposition may manifest as different diseases in different members of the same family). That said, many cases of autoimmune diseases arise spontaneously with no family history.
Should you believe you may have an autoimmune disease, it is important to be your own advocate and to be persistent about seeking care. Many patients with autoimmune diseases are dismissed as hypochondriacs in the early stages of their disease, and doctors may be uncomfortable handing down a diagnosis given that treatment can be challenging. For this reason, it can be extremely helpful to have a trusting relationship with your primary physician. Even so, be prepared for a long road to diagnosis.
What can I do to avoid autoimmune diseases?
No matter what, taking good care of yourself is important. There is a growing body of research pointing to the therapeutic effects of nutrition, exercise, and stress management. Eating healthy, getting plenty of sleep, exercising, and reducing stress will certainly not hurt and could help.
A growing body of research points to the therapeutic effects of nutrition, exercise, and stress management.
To find what is best for your body, experiment with these elements and observe how your body responds. The more you care for yourself and learn about your body, the more empowered you will be to take your medical care into your own hands and work effectively with your medical team.