different story you've likely heard of
disorders like graves disease
lupus
ms and rheumatoid arthritis and they're
all autoimmune diseases data shows
nearly one in ten people worldwide
suffer from some type of autoimmune
disease but there's a statistic within
that number that may be more alarming
studies show about eight out of ten
patients with multiple autoimmune
diseases are women
you heard that right roughly eighty
percent for some diseases such as lupus
more than 85 percent of patients are
female and the impacts can be life
changing
researchers are still trying to pinpoint
why women are more likely to have an
autoimmune disease keenan smith with our
station in detroit share some doctors
ideas
autoimmune disorders are a set of
diseases where the body's immune
protections turn inward attacking tissue
and organ i'm living with lupus
nephritis which is lupus that affects
the kidneys detroiter can may wright was
first diagnosed with systemic lupus at
13. the diagnosis changed her life i
have to have
a lot of appointments in a lot of
different doctors like i have
rheumatologists hematologists
nephrologists unfortunately kame's
experience isn't unique autoimmune
disorders can affect the entire body
from our brain all the way down to our
toes we can have that because we have
immune system anywhere but why is it
that the autoimmune system in women is
more likely to go into hyperdrive dr
alireza misami says part of it may be
hormonal autoimmune diseases often
emerge or flare around puberty pregnancy
and menopause but genes and a woman's
who x chromosomes with an area related
to immunity are thought to play a larger
role imagine if you have two x
chromosomes that actually they carry
your immune system gene so you have
higher chance of having surge in your
immune system that immunity surge can
lead to any of more than 100 autoimmune
diseases like the joint pain and
swelling found in lupus rheumatoid or
psoriatic arthritis psoriasis and skin
issues thyroid problems responsible for
graves and hashimoto's disease and the
fatigue and abdominal issues with ms
since these diseases can affect the
entire body they can be difficult to
diagnose they are not on top of the
differential diagnosis of our primary
care or referring physician so it takes
time to actually recognize those
patients dr masami says it can take
years before the classic symptoms emerge
in any of these diseases and that's a
major problem since early diagnosis is
key most of this disease unfortunately
can cause major disabilities major and
organ damage and sometimes death came
lupus is well managed she says working
with her medical team and managing her
diet and stress allow her to live a
fulfilling life despite her diagnosis a
lot more energy to do things with my
family it's easier for me
i'm keenan smith for newsy
our thanks to keenan rates of autoimmune
disease have been steadily climbing over
the last 30 years and among women ages
65 and younger they've become one of the
leading causes of death dr alex shikhman
is a rheumatologist and is the ceo and
founder of the institute for specialized
medicine it is the nation's first clinic
for integrative rheumatology dr shikhman
thank you for being here
thanks for inviting me so i know you
know you heard in the piece doctors say
the significance of autoimmune diseases
among women can be due to hormonal
reasons it can be due to genes what have
you found in your work
uh i think that both statements are
correct
so we do see definitely a difference
between the frequency of autoimmune
diseases in men and women primarily in
women before the menopause so
and definitely has been shown in many
publications and we know this from
our clinical practice to this that for
example estrogens can facilitate
development of some not all but some
autoimmune diseases
and definitely x chromosome because
remember that
males they have x y chromosome and women
have
two x chromosomes and definitely x
chromosome is longer than y chromosome
it has much more genetic material and in
part it carries genetic material which
is responsible for immune responses
so that's
that's definitely
an issue yeah on par with what you've
you've seen along with the other doctors
we've heard from you know we've learned
it can take years before patients are
able to really spot symptoms why is that
the case
well uh it is also well recognized that
quite a few autoimmune diseases present
in a very non-specific way for example
patients can suffer from fatigue for a
number of years which may be the first
symptom of lupus or they may have
dryness which may be the first symptom
of sugar and syndrome and they don't pay
attention so i'm dry so what
but then they start having joint pain
and more debilitating symptoms and
finally they start looking for medical
care
i want to pull up a chart that we saw in
keenan's story you know there are more
than 100 autoimmune diseases and you see
some of them on your screen like lupus
graves disease and multiple sclerosis as
we've mentioned how difficult is it to
detect which exact disease someone may
be dealing with
uh you're talking about semantics in
reality
it's not so important what kind of label
you put on a patient but how to treat
the patient because in real life we see
a lot of overlaps like lupus and
sjogren's syndrome and psoriatic
arthritis and ankylosing spondylitis and
rheumatoid arthritis with something else
so but the bottom line is to define what
is the underlying immunological problem
what kind of treatment will be
appropriate and
in addition to everything else in our
practice we're trying to identify what
is the driving force my bottom line
question for you doctor if you can sum
it up for us
why are autoimmune disorders more common
in women
again uh there are two things so number
one hormones hormones and hormones again
so
number two is probably increased use of
birth control pills especially those
which contains high estrogen content
high estrogen level right so uh
number three women around the menopause
so they're trying to stay younger
they're using estrogens
which also known to promote autoimmune
diseases and finally a double x
chromosome
so these are main things
also
if you look at uh
information outside of autoimmune
diseases like infectious diseases for
example right so in general women react
to infectious agents much much stronger
than men
and as a byproduct you develop
autoimmune disease especially in those
who are genetically predisposed i see dr
alex shikhman thank you so much for
joining the why and sharing your insight
on this we really appreciate it
thanks a lot