Why Are Women At Risk For Autoimmune Diseases?

What are autoimmune diseases and how are women hormonally or genetically linked? What do multiple sclerosis, lupus, rheumatoid arthritis and Lyme disease have in common? Besides being life-changing illnesses, they all fall under the umbrella of autoimmune diseases (AI).

Autoimmune diseases arise when antibodies wrongfully target organs or tissues, marking them as foreign instead of self. The signs and symptoms of autoimmune disease reflect this misdirected immune response, and the resultant impact on the targeted organ.

For the average person, dealing with the symptoms comes before they try to understand what’s happening to their body. And these symptoms can alter the way they live.

Autoimmune diseases and women

Women seem to be more susceptible to autoimmune diseases, and the hormonal link is one that doctors say is something to pay attention to.

“We do see an increased prevalence of a number of autoimmune disease – like lupus and rheumatoid arthritis – in women, although this is not necessarily true of all autoimmune diseases,” says Dr. Amanda-Steiman, of the Rebecca MacDonald Centre for Arthritis & Autoimmune Disease at Mount Sinai Hospital in Toronto.

“For those in which we do see a female predominance, it is thought that there can be a hormonal trigger. We see lupus more commonly in women of reproductive age, and think that estrogen can figure into its development. We know that there can be variability in severity of diseases between races, although this is by no means the rule.”

When pain isn’t about injury

For Bernice Hull, 61, and vice-president of corporate strategy and business development at Fanshawe College in London, ON, the disease came to her five years ago, first as an achy shoulder, then a swollen knee and then terrifyingly progressed to a full-blown, full-body autoimmune disease. “I was sent for physiotherapy for my arms, and then my knee started to hurt.” She was eventually passed on to an RA specialist and has been on medication ever since.

Hull came to realize that this was a lifelong disease that would require lifestyle adjustments to help her continue to work and live optimally. She got a personal printer at work so that she didn’t have to endure painful walks to get photocopies. And her husband installed taller toilets at home so that she didn’t have to bend as much – an activity that’s extremely limited when you’re experiencing chronic pain. Then came the list of drugs that doctors prescribed for the inflammation and pain: meloxicam, methotrexate and Plaquenil (hydroxychloroquine) all of which made her feel “physically better” but came with other symptoms.

It started with a headache

Felicity Hardingham, a corporate consultant in her 30s, started getting headaches in March 2016. The headaches “got progressively worse” and then persisted into chronic headaches, night sweats, and debilitating fatigue. Her doctors chalked it up to a simple tension headache and recommended lifestyle tweaks to help her relax. Meanwhile, medical herbalists encouraged her to take a variety of supplements and herbs daily and create affirming visualisations: meditation and drawings to help her reaffirm to herself that she’d get better – a kind of mind over matter for the brain. None of that seemed to help. She continued seeking out medical experts in hopes of answers. “All of them had a different theory and believed they could fix me in a few weeks,” she says. The diagnoses she received ranged from adrenal fatigue to muscle tension and poor liver function.

Then, she saw a neurologist who diagnosed her with new daily persistent headache (NDPH), a persistent headache with no real cause. Not a great answer to her question but at least a reason for her chronic pain.

“Although there’s no magic wand to getting rid of the problem, my neurologist did provide strategies to help manage the pain and most importantly, reassured me that it would go away.” To add to the mystery of her symptoms, all of Hardingham’s blood tests, MRI brain scans, abdominal and pelvic scans are clear and appear normal.

Hardingham started taking Nortriptyline this past November to stop the fatigue, body aches, and night sweats. Now, her headache still remains but she’s better able to cope with the chronic pain. She still practices yoga, meditation, and natural herbal remedies when she can and wears a Cefaly twice a day for 20 minutes. The gadget electrically stimulates the slower nerve pathways of the brain.

Microbiome link?

According to Talia Zenlea, a board-certified internist and gastroenterologist, food as a medicinal fix for AI, is one that Western medicine practitioners have been debating for some time now. And that shows promise for autoimmune diseases and women affected.

“Anecdotally, people noticed that certain symptoms from inflammatory conditions have improved with different diets. The gut contains a rich environment of microorganisms – the code for our genes – and those genes make up the microbiome. Some of these genes drive inflammation.”

But knowledge of how food helps deter or treat symptoms of autoimmune disease is limited. Doctors aren’t sure what the exact remedies are and as a result often prescribe drugs first before recommending natural remedies.

“The problem is, we don’t really know much more than that – we can’t say ‘eat this and not that’ and expect it to treat or prevent a specific AI,” says Dr. Zenlea about using diet to treat autoimmune diseases and the women affected. “That said, we do know that people who eat a healthy diet made up of fruits and vegetables and low in processed foods and red meat tend to have a healthier looking microbiome.”

“Some people with mild inflammatory conditions note improvement in their symptoms when they switch over to these types of diets. The goal, however, is not always just improvement of symptoms. We don’t just want people to feel better, we want them to stay better, and that means making sure that the inflammation is gone, or as suppressed as possible. And I haven’t seen any convincing studies that dietary modification can achieve that (preventative) goal – yet.”

And this kind of news is what frustrates and mystifies many autoimmune disease suffers. There is no real answer. And so sufferers such as Hull and Hardingham do what many people with autoimmune diseases do: they hope for the best, keep taking their supplements and drugs and fit in a bit of yoga; that is, when they can manage to get out of bed, face their symptoms and a very sceptical world with strength and dignity.

For more reading on autoimmune diseases and women: The Top 5 Autoimmune Diseases Affecting Women in Canada