One of the biggest questions we get asked in our clinic is whether or not someone has an autoimmune disease. Autoimmune diseases are not easy things to diagnose. But if you know you have a lot of inflammation, it’s worth getting a thorough work up for an autoimmune disease. Here we will walk through the process of that work up.
Symptoms of an Autoimmune Disease
Autoimmune diseases are difficult to diagnose because there are many symptoms that are present. Symptoms also differ from person to person with the same disease as well. Conditions can often be misdiagnosed if the symptoms are vague. Here are some common symptoms that can be present in autoimmune diseases.
Musculoskeletal Symptoms: joint pain, joint swelling, joint stiffness, muscle weakness, muscle pain/aching.
Skin Symptoms: rashes, redness, thickening of skin, blisters, flaking, itching, dryness.
Hormone Symptoms: changes in menstrual cycles, blood sugar, mood, urination, insomnia.
Intestinal Symptoms: diarrhea, nausea, vomiting, constipation, mucus in stool, blood in stool, abdominal pain.
Respiratory Symptoms: difficulty breathing, chest pain, asthma, wheezing.
Neurologic Symptoms: weakness, numbness, tingling, brain fog, difficulty with balance.
General Symptoms: hair loss, nail changes, fatigue, headaches, dry eyes, dry mouth, ringing in ears, hearing loss.
Testing for Autoimmune Diseases
Testing for autoimmune diseases is complicated. It used to be assumed that all autoimmune diseases could be diagnosed with blood tests. But this is not always the case. Some conditions like rheumatoid arthritis, Hashimoto’s thyroiditis and lupus have antibodies that are commonly elevated in the blood. Elevation of those antibodies will aid in the diagnosis of those conditions.
Other conditions like psoriatic arthritis, ulcerative colitis, or multiple sclerosis do not have antibodies that you can measure in the blood. Diagnosing these conditions takes a thorough assessment of the symptoms as well as imaging or biopsy.
Imaging can be really important for autoimmune diseases. Imaging like x-rays or MRIs can help to determine whether or not an autoimmune disease is likely in the joints. Biopsies are helpful for conditions in the thyroid, intestines and skin.
But because diagnosis can’t happen with testing alone, a knowledgeable physician that can take all these things into consideration is important.
Making the Diagnosis
Diagnosing an autoimmune condition is often complicated. It requires a combination of symptoms, lab testing, imaging or biopsies. Ruling out other conditions is also important.
Some autoimmune diseases cannot be definitively diagnosed. If all testing is normal, and symptoms are not strong enough to fit within a neat diagnosis, sometimes a presumptive diagnosis can be made. Some things to take into consideration when trying to make a diagnosis:
Is there inflammation? The immune system is always involved in autoimmune diseases. If you think that your condition is inflammatory, then this is a good first start.
Are multiple systems involved or just one? Some autoimmune diseases only affect one area, like the thyroid. Other autoimmune diseases affect the entire body (systemic) like rheumatoid arthritis or lupus. If you think your symptoms are isolated to a certain area or the entire body it can help you narrow down a diagnosis.
Does anyone in your family have an autoimmune disease? Autoimmune diseases run in families. If your grandma had rheumatoid arthritis, or your mother had a thyroid issue, then your risk is higher. Also, if you already have one autoimmune disease, you are more likely to have a different autoimmune disease.
If you think you have an autoimmune disease, get worked up by your doctor. If you get a work up that you don’t think is complete, get a second opinion! Our clinic specializes in autoimmune diseases. We can help decode symptoms and conditions. If you have questions, you can contact our office to schedule a free 15 min consult.
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