The cartoon showed a doctor in a card shop. “I'd like a sympathy card that also implies he didn't come to me soon enough,” he tells the clerk. I don't remember where or when I saw that cartoon but it made a strong impression on me. The medical profession has preached early detection and treatment for as long as I can remember – but then all too often, they miss the diagnosis when we do go in soon enough.
Autoimmune diseases are some of the most difficult to diagnose. According to author Mary J. Shomon, it takes an average of five years and four doctors to get a correct diagnosis. About half the patients are labeled as chronic complainers before someone takes them seriously. Mary's book, “Living Well with Autoimmune Disease,” includes her own experience with Hashimoto's thyroiditis plus a wealth of information and resources.
Like allergies, autoimmune diseases can range from mild to life-threatening. Some estimates put the prevalence at up to 20 percent of the U. S. population. They strike middle-aged women most often, so the symptoms can easily be blamed on hormone changes or lifestyle stresses from too much work or too little sleep. One hypothesis for why women are more affected than men is that women have a more complicated immune system. During pregnancy, a woman's immune system has to ignore the fetus without shutting down defenses against pathogens. How women's bodies do this and what happens in autoimmunity are still issues for research.
There are 67 conditions listed on the web site of American Autoimmune Diseases Association. The major ones include Grave's disease (hyperthyroidism), Hashimoto's (hypothyroidism), rheumatoid arthritis, vitiligo, diabetes type 1, multiple sclerosis, lupus, Sjogren's syndrome, and scleroderma. Many of the symptoms overlap, and many patients have more than one condition. The illnesses often follow a relapsing and remitting course. I can see why diagnosis is difficult.
Mary Shomon provides a compilation of risk factors and symptoms that point to autoimmune disease. She identified several factors that are common to many conditions:
1. Gluten sensitivity
2. Recent or frequent infections, and low-grade fever
3. Joint or muscle pain
4. General muscle weakness
5. Rashes
6. Fatigue
7. Numbness or tingling in hands or feet
8. Dry eyes and dry mouth
9. Weight loss
10. Hair loss
11. Shortness of breath
12. Heart palpitations
13. Recurrent miscarriage
14. Depression
15. Concentration or memory problems, sometimes described as “brain fog”
Her book encourages those who identify with these factors to keep looking for a doctor who can make the diagnosis and provide timely treatment.
References:
Mary J. Shomon, “Living Well with Autoimmune Disease: What Your Doctor Doesn't Tell You That You Need to Know”, HarperCollins 2002.
American Autoimmune Diseases Association:
http://www.aarda.org/
Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.