Is Fatigue The First Sign Of An Autoimmune Disease?

As anyone with an autoimmune disease knows, fatigue is a common symptom. But could fatigue also be an early warning sign that you’re on the way to developing autoimmunity?

A 2015 study reported 98% of those with an autoimmune disease said that their fatigue was profound and debilitating. In fact, the fatigue was cited as being so bad that it interfered with participants overall quality of life, their ability to work, their romantic lives, their professional relationships, and their self-esteem. (1)

We know that fatigue is a symptom of autoimmunity. But what if it was also an early indicator that something is not quite right in your body?

Are autoimmune diseases common?

Autoimmune disease affects nearly 8 percent of people in the United States. That’s more than 26 million people in the United States alone. In the European Union, it is thought that 9% of the population suffers from autoimmunity. Most alarmingly, nearly 80 percent of those affected by autoimmune disease are women. (2)

In all first-world nations, autoimmunity continues to rise. Worth mentioning, autoimmune disease rarely (if ever) occurs in developing nations. It is a first world illness. Consider the following alarming statistics:

Worldwide, rheumatic autoimmune disease rose 7.1% between 2014 and 2015.
Autoimmune disease of the digestive tract rose 6.3% between 2014 and 2015. (3)
Autoimmune diseases are among the leading causes of death among women under the age of sixty-five. (4)
On average, an autoimmune disease will shorten your lifespan by eight years!

Autoimmune disease poses a serious concern for those in developed countries.

What exactly is an autoimmune disease?

An autoimmune disorder is a malfunction of the body’s immune system that causes the body to attack its own tissues. In autoimmune conditions, your body becomes challenged in identifying cells that are foreign from cells that are self.

When functioning well, your immune system defends the body against what it perceives to be foreign or dangerous invaders. This includes:

Viruses
Bacteria
Parasites

The above substances have molecules that your immune system can use to identify them as foreign. These molecules are called antigens. Antigens may be contained within cells, on the surface of cells, or be part of a virus. Some antigens, such as pollen or food molecules, exist on their own. (5)

Your own cells also have antigens. Normally, your immune system reacts only to antigens from foreign or dangerous substances. Not from antigens to your own tissues. Think of antigens as a bar-code – your immune system scans the bar-code to see if the cell is part of you or a foreign invader.

Imagine all your body’s cells have the letter “x” as the first letter in their bar-code. If, after scanning the cell’s bar-code, it can find an x, it recognizes the cell as self. If no “x” can be found, the cell is likely foreign and an immune response begins.

When an immune response is triggered, your system creates antibodies. Antibodies are specialized proteins created specifically for an antigen. (6) Antibodies are the specific recipe needed to kill or remove the invading microbe. The antibodies are then directed towards the foreign cells in an effort to remove them from the body.

Sometimes, your immune system malfunctions. When this occurs, your immune system interprets its own tissues as foreign. In these instances, your immune system produces antibodies to itself. These are called auto-antibodies. These immune cells target and attack particular cells or tissues of your body. This is the hallmark sign of an autoimmune reaction.

The most common autoimmune diseases include:

Multiple Sclerosis
Celiac Disease
Rheumatoid Arthritis
Inflammatory Bowel Disease
Type 1 Diabetes
Psoriasis
Graves Disease
Hashimoto’s Thyroiditis
Lupus
Allergies
Asthmatic Disorders

What causes an autoimmune reaction?

Autoimmune reactions can be triggered in several ways:

Your body’s cells become altered
- This can happen when a virus attaches onto one of your body’s own cells. The altered substance may appear foreign to the immune system. For example, a virus can infect and thus alter cells in the body. The virus-infected cells stimulate the immune system to attack.
A foreign substance that resembles a natural body substance may enter the body
- Imagine that the shape of a gluten protein is a triangle. Let’s also imagine that the shape of your thyroid hormone is also a triangle shape. For the sake of this example, let’s also say you’re allergic to gluten.
- When you ingest gluten, these triangle shaped proteins enter your body. Since you’re allergic to them, your body creates an immune response that is targeted towards killing triangle cells.
- In this example, the immune system will inadvertently target the thyroid hormone as well as the gluten protein because they both resemble the triangle shape.
Cells that control antibody production become altered
- For example, B cells (an immune defending white blood cell) may malfunction and produce abnormal antibodies that attack some of the body’s cells. (7)
A substance in the body that is normally confined to a specific area (and thus is hidden from the immune system) is released into the bloodstream
- For example, a blow to the eye can cause the fluid in the eyeball to be released into the bloodstream. The fluid stimulates the immune system to identify the eye as foreign and attack it.
- The eye is considered foreign because fluid from your eye should not enter the bloodstream.

It is unknown why something will trigger an autoimmune reaction in one person but not another. Some people have genes that make them likely to develop an autoimmune disorder. (8)

The increased susceptibility to an autoimmune disorder, rather than the disorder itself, is inherited. If your mom has multiple sclerosis, you will have an increased likelihood of developing an autoimmune disorder. That autoimmune disorder will not necessarily be multiple sclerosis.

In susceptible people, a trigger, such as a viral infection or tissue damage, may cause the disorder to develop. 25% percent of people with an autoimmune disease will go on to develop another autoimmune condition. (9)

Is Fatigue The First Sign Of An Autoimmune Disease?

The hallmark sign of an autoimmune disease is inflammation. (10, 11) Unfortunately, it’s unlikely that you’ll be able to “feel” this inflammation occurring within your body. If you do, it’s likely that the disease has already progressed to a substantial point.

What you will likely notice is that you’re energy levels are lower. You’ll probably brush off this mild fatigue as irrelevant or, a consequence of staying up too late but it could actually be one of the first signs your body is malfunctioning.

It is all too easy to rationalize why you’re feeling tired. But if your fatigue continues without reprieve, no matter how many hours of sleep you get, this could be an early indicator of autoimmunity.

Other early warning signs of autoimmunity include:

Unexplained joint pain
Headaches
Chronic malaise
Skin rash(es)
Gut symptoms (heartburn, alternating stool frequency/consistency)

Notice how all these symptoms are relatively mild. This is how autoimmunity starts. You do not develop Multiple Sclerosis overnight. It is a slow disease progression that starts with seemingly benign symptoms like fatigue, headaches, or joint pain. Over many years, the disease process develops into a full-blown autoimmune disease.

How is an autoimmune disease diagnosed?

Since inflammation is the hallmark sign of an autoimmune disease, testing should determine if general inflammation is present.

Often, your doctor will run a test called the erythrocyte sedimentation rate (ESR). This test measures how quickly red blood cells settle to the bottom of a container. When inflammation is present, the ESR rate will generally be elevated. (12)

More important than general inflammatory markers are tissue-specific antibodies. Recent research has shown that antibodies to a tissue will show up years before any clinical symptoms will manifest. (13)

It has been clearly demonstrated that many auto-antibodies have the ability to predict the development of an organ-specific autoimmune disease in those not exhibiting any symptoms. It is also clear that the progression towards a given autoimmune disease, and its severity, can be predicted from the type of antibody, the antibody level, and the number of positive antibodies. (14)

That last point is so important, I’m going to emphasize it again:

You will be creating antibodies to your own tissue (beginning the journey towards developing an autoimmune disease) well before any symptoms manifest. (15)

This mild level of inflammation and it’s corresponding antibody creation is what starts you down the road to autoimmune disease. You do not suddenly wake up with ulcerative colitis or Crohn’s disease. The disease develops silently, below the surface for years.

Remember, at these early stages of the disease, your only symptom may be fatigue. It’s not “normal” to feel tired on a regular basis. That is a sign that something in your body is amiss. If you’re feeling fatigued without a good explanation why, find a knowledgeable functional medicine practitioner who can screen you for tissue antibodies before they become an autoimmune disease.

How do you treat autoimmune disease?

As you now know, autoimmune disease involves your immune system attacking another part of your body. To stop the progression, Conventional Medicine will apply drugs or medication that suppress immune system function. With a weakened immune system, your body is no longer able to attack itself with the same ferocity. This will often result in a decrease in symptoms.

These medications can be life-saving. And in a lot of cases, they result in the remission of the illness. But these medications do not address the underlying or root cause of the autoimmune disease. You will be required to maintain a dose of the immune-suppressing medication for the remainder of your life. In my opinion, this is not a solution. Especially since a lot of the medications come with a swath of undesirable side-effects.

Instead, an investigation should be done to determine what is triggering the autoimmune response. Below are the practices we recommend at Flourish Clinic for all those suffering from an autoimmune disease:

NB: The below recommendations are also ideal practices to ensure autoimmune disease never develops.

Adopt an anti-inflammatory diet
- We recommend a paleo-style nutrition plan. For more information on how to perform a paleo-reset diet, click here.
- Anti-inflammatory diets should be free from refined sugars, wheat/grains, dairy, and industrial seed oils.
- More information on an auto-immune paleo template can be found here.
Check for hidden food sensitivities
- Food sensitivities can contribute to developing a leaky gut.
- This can be done through a blood test or by following the above paleo diet and carefully re-introducing foods.
Heal your gut
- The prerequisite for an autoimmune condition to develop is intestinal permeability (aka: leaky gut)
- Stool testing should be performed to identify potential bacterial or parasitic infections in the gut. These can contribute to a leaky gut.
- Ensure (at least) one serving of fermented foods are consumed every day.
Ensure you’re getting eight hours of sleep on a regular basis
- Proper sleep is required for us to regulate our natural anti-inflammatory hormones like cortisol.
Exercise at a moderate intensity at least three times each week
- Exercise is naturally anti-inflammatory!