What is autoimmunity?

Autoimmunity is one of the most important topics in modern health — and one of the most misunderstood. Here’s what it actually is, what goes wrong inside the immune system, the three stages it moves through, and the signs worth paying attention to.

Key takeaways
In autoimmunity, the body loses the ability to tell its own cells from foreign ones and attacks itself — a tissue, an organ, or many at once.
The core problem is an imbalance between effector T cells and regulatory T cells; rebuilding the regulatory response is central to recovery.
Autoimmunity moves through three stages — silent, reactive, and diagnosed disease — and earlier detection generally means a better outcome.
Because the gene pool hasn’t changed but rates have soared, environmental factors — diet, toxins, stress — are a large and controllable part of the story.
In this article
I. Who does autoimmunity affect?
II. What goes wrong: immune dysregulation
III. The three stages of autoimmunity
IV. Signs you may have an autoimmune condition
V. Why rates are rising
VI. Common questions

If someone has an autoimmune disease, their immune system has essentially gone awry. The immune system ideally is on guard to protect the body and fight foreign invaders, such as bacteria and viruses. With an autoimmune disease, the body is not able to distinguish between its own cells and foreign cells, and it ends up attacking parts of its own body. This may involve an attack on a particular tissue in the body, an organ in the body, or even a group of organs in the case of a more systemic autoimmune condition.

Who does autoimmunity affect?

Autoimmunity disproportionately affects women, though a recent study that looked for the prevalence of antinuclear antibodies (ANA — the most common biomarker of autoimmunity) showed that autoimmunity rates for men may be on the rise in the United States. Other groups that showed ANA increases included non-Hispanic whites, adults 50 years or older, and adolescents — the most concerning group.1

Scientists know about more than 80 autoimmune conditions.2 Some are more well known and acknowledged, while others are difficult to diagnose. With lesser-known autoimmune conditions, patients may suffer years before getting a proper diagnosis. Some of the more well-known autoimmune conditions include:

Hashimoto’s thyroiditis
Graves’ disease
Rheumatoid arthritis
Systemic lupus erythematosus
Multiple sclerosis
Type 1 diabetes
Celiac disease
Inflammatory bowel disease (Crohn’s, ulcerative colitis)
Psoriasis
Vitiligo

What goes wrong: immune dysregulation

We know that an autoimmune condition involves the immune system becoming dysregulated. But what exactly is going on with the immune system?

This dysregulation involves an imbalance between effector T cells and regulatory T cells. Effector T cells are supposed to protect the body from pathogens by producing an immune response, while regulatory T cells suppress and calm the immune system.

Regulatory T cells maintain tolerance to self-antigens, which are markers on just about every cell in the body. When the immune system identifies a foreign antigen, it will create antibodies against it.

In autoimmune conditions, effector T cells see antigens from necessary parts of the body (such as tissues or organs) as foreign and create autoantibodies against them. In autoimmune conditions, there are not enough regulatory T cells or not enough effective regulatory T cells to control this inappropriate immune response.3,4 When working with autoimmune patients, building the regulatory T cell response is an important part of their recovery.

“In autoimmune conditions, there are not enough regulatory T cells — or not enough effective regulatory T cells — to control this inappropriate immune response.”

In autoimmune diseases, the body has chronic inflammation and an immune system that is always on alert. This consistent state of fight or flight can do significant damage to the body.

The three stages of autoimmunity

There are three main stages of autoimmunity:5

1Silent autoimmunity
Positive antibodies on lab tests, but no noticeable symptoms yet.
2Autoimmune reactivity
Positive antibodies plus some “unexplainable” symptoms. This person may travel from doctor to doctor without getting real answers or solutions.
3Autoimmune disease
The body has been damaged enough to have a diagnosis, and the person has many symptoms.

While we can support healing at any stage, early detection of an autoimmune condition often provides a better outcome. It’s highly beneficial to lower your risk for developing an autoimmune disease by aiming to fill your plate with whole, nutrient-dense foods and by controlling environmental factors the best you can — such as limiting chemical exposure, finding ways to control stress, and getting adequate sleep.

Signs you may have an autoimmune condition

  • Family history of autoimmunity — it’s important to examine family history for the likelihood of developing autoimmunity. If you have a parent or sibling who has Hashimoto’s, for example, you are more likely to develop Hashimoto’s. If this is the case, it’s a good idea to focus on ways to improve and maintain health proactively and to have antibodies tested by a functional medicine practitioner.
  • Symptoms that wax and wane — in autoimmune conditions, you will oftentimes have significant flares in symptoms and then periods where symptoms seem to calm. This waxing and waning is a classic sign of autoimmunity.
  • Stress or lack of sleep worsens your condition — if you notice your symptoms flare when you’re stressed or not getting adequate sleep, that’s another sign you may be battling an autoimmune condition.
  • Body pain and inflammation — you may have signs of inflammation, such as joint pain, muscle aches, redness/swelling, a recurring fever, and/or swollen glands.
  • Food sensitivities or intolerances — signs include nausea, stomach pain, bloating, vomiting, heartburn, diarrhea, constipation, headaches, irritability, and/or nervousness. These are potential indicators of an autoimmune condition.
  • Chronic illness — if your immune system is having trouble fighting off viruses and pathogens you’re exposed to, that may be another sign to investigate whether you have an autoimmune condition.

Why rates are rising

While autoimmune disease rates have been skyrocketing over the last few decades, the gene pool has not changed very much. This leads us to believe that environmental factors — such as diet, toxin exposure, and stress — may be to blame. While this can initially appear overwhelming, it is also empowering, in that there are many factors we can control to take back our health.

What this may mean for you
If several of these signs sound familiar — especially symptoms that wax and wane, flare with stress, and have sent you from specialist to specialist — it may be worth having antibodies tested rather than waiting for a diagnosis to catch up. Catching autoimmunity in the silent or reactive stage gives you the most room to change its course.

Common questions

What is autoimmunity?
In an autoimmune disease, the immune system has gone awry. Normally it protects the body and fights foreign invaders like bacteria and viruses, but in autoimmunity the body can no longer distinguish its own cells from foreign cells and ends up attacking parts of itself — a tissue, an organ, or a group of organs in more systemic conditions.
What goes wrong in the immune system in autoimmunity?
Autoimmunity involves an imbalance between effector T cells, which produce an immune response against pathogens, and regulatory T cells, which suppress and calm the immune system and maintain tolerance to the body’s own cells. In autoimmune conditions there are not enough regulatory T cells, or not enough effective ones, to control an inappropriate immune response, so effector T cells create autoantibodies against the body’s own tissues.
What are the three stages of autoimmunity?
Silent autoimmunity — positive antibodies on lab tests but no noticeable symptoms. Autoimmune reactivity — positive antibodies plus some unexplained symptoms, often with no clear diagnosis. Autoimmune disease — enough damage has occurred to warrant a diagnosis and the person has many symptoms. Earlier detection generally provides a better outcome.
What are the signs you may have an autoimmune condition?
Common signs include a family history of autoimmunity, symptoms that wax and wane, symptoms that worsen with stress or poor sleep, body pain and inflammation (joint pain, muscle aches, swelling, recurring fever, swollen glands), food sensitivities or intolerances, and frequent or chronic illness.
References (5) ▾
  1. Dinse GE, Parks CG, Weinberg CR, et al. Increasing prevalence of antinuclear antibodies in the United States. Arthritis Rheumatol. 2020;72(6):1026-1035. (Summarized by NIEHS. https://www.niehs.nih.gov/news/newsroom/releases/2020/april8/index.cfm)
  2. Autoimmune diseases. National Institute of Allergy and Infectious Diseases. https://www.niaid.nih.gov/diseases-conditions/autoimmune-diseases
  3. Dominguez-Villar M, Hafler DA. Regulatory T cells in autoimmune disease. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3129000/
  4. Sakaguchi S, et al. Regulatory T cells and immune tolerance. National Center for Biotechnology Information. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1782226/
  5. Arbuckle MR, McClain MT, Rubertone MV, et al. Development of autoantibodies before the clinical onset of systemic lupus erythematosus. N Engl J Med. 2003;349(16):1526-1533. https://pubmed.ncbi.nlm.nih.gov/14561795/
This article is educational and is not medical advice, diagnosis, or treatment. Autoimmune concerns should be evaluated with a qualified practitioner.
Bring the thick folder. We read all of it.

If your symptoms wax and wane, flare with stress, and don’t fit a single diagnosis, autoimmunity may be part of the picture. We test thoroughly and work to rebuild the immune balance behind it.

Request a Consultation