Who Is Vulnerable to Autoimmune Disease

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Generally, anyone can develop an autoimmune disorder. Some diseases are hereditary, while other diseases, although not directly hereditary, run strongly in families. This is referred to as a genetic tendency or inherited predisposition. Most autoimmune diseases seem to have a genetic tendency with several members of the family showing the same or similar types of autoimmune diseases. Autoimmune thyroid disease is no exception. Often, multiple family members and generations of family members, particularly in female members, will have one or more types of autoimmune thyroid disease. This suggests that there are significant genetic changes related to this disease, but it is far more complex than would be seen in simple directly hereditary situations.

There is some evidence to suggest that stress is one factor that may contribute toward triggering an autoimmune disorder. Clearly, when you are under unusual or extreme stress, many hormonal changes occur in the body, particularly between the brain and the adrenal glands, which affect your immune system. What is labeled

"unusual" or "extreme"? A death or a tragedy in the family is considered to be extremely stressful. Starting a new job, moving, or relocating is also very stressful; getting married or having a new baby is stressful. This psychological stress produces stress hormone responses in the body that may be similar to some of the physical stress responses seen when you have a severe illness or are in a traumatic accident, such as an automobile wreck. It is not clear exactly how this could cause an activation of autoimmune disease, but it seems to be a factor. (See Chapter 22 for stress-reduction strategies.)

Many scientists believe that environmental factors contribute to starting autoimmune thyroid disease. These factors include infections, trauma, drugs, smoking, poor nutrition, pregnancy, and aging. Iodine is one type of nutritional factor that seems to be important. In countries with iodine deficiency, autoimmune disease is less common, although hypothyroidism is very common because of this deficiency. When these countries supply sufficient iodine to their people, hypothyroidism from lack of iodine goes away, but autoimmune thyroid diseases go way up. Smoking is well known to increase the chance of getting Graves' disease and intensify its symptoms if smoking is continued; however, no one knows the exact way this affects the immune system. The reason for the predominance of autoimmune thyroid disease in women likely relates to the differences in hormones between men and women; but again, no one knows the precise reason why this happens. There is some evidence suggesting that certain viruses may infect people and stimulate the immune system in some way that causes the development of autoimmune thyroid disease. Likewise, certain bacteria seem to stimulate the immune system in ways that may generate antibodies that cross-react with parts of the thyroid gland. All of these factors, or none of these factors, may be part of the cause of such thyroid conditions as Hashimoto's thyroiditis or Graves' disease; however, this remains a fertile topic of research for scientists around the world.

Infectious Diseases and Hashimoto's Disease

As already discussed, over the years, some studies have found that people with autoimmune diseases, such as Hashimoto's thyroiditis or Graves' disease, have antibodies that cross-react to various viruses or bacteria more commonly than seen in the general population. The theory is that when fighting other infections, the immune system may turn on autoantibodies, which triggers autoimmune diseases. This theory remains unconfirmed and is only one of many theories regarding the causes of autoimmune diseases. That said, there is no way one can avoid Hashimoto's disease by deciding to be vaccinated against a particular virus or bacteria or by taking antibiotics to ward off particular infections.

Unfortunately, sometimes news that Hashimoto's patients have antibodies to another infectious agent is sensationalized and mischaracterized as something that is new. This is actually old news, and each additional study in this area contributes more suspect infectious agents we can add to the list. What would be news is to define how the immune system attacks a person's own body, once it creates antibodies to other infections; this has not yet been revealed. There are a variety of additional theories regarding the cause of autoimmune diseases that have nothing to do with infectious agents. Time will tell which of these theories proves to be correct.

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