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Autoimmunity And Immunodeficiency

Explore the difference between autoimmunity and immunodeficiency and how they affect your health.
Autoimmunity And Immunodeficiency
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Did you know your immune system constantly works behind the scenes to keep you healthy? When everything works well, your immune system protects against infections.

Sometimes, your immune system faces challenges, resulting in immunodeficiency and its counterpart, autoimmunity. These two conditions can cause various health issues, some of which are chronic. Please keep reading to learn more about these two immune system-related conditions and what they mean for your health.

How the immune system works

The immune system is a complex network of cells, tissues, and organs that work together to defend the body against harmful invaders, known as antigens. Antigens can be viruses, bacteria, parasites, and even chemicals or toxins. Its primary function is to identify and destroy these foreign substances before they can cause harm to the body.

The immune system consists of two main parts: the innate immune system and the adaptive immune system. The innate immune system provides immediate, nonspecific defense mechanisms against various pathogens. This includes physical barriers like the skin and mucous membranes, as well as immune cells like macrophages and natural killer cells that provide a general defense against invaders.

On the other hand, the adaptive immune system is a more specific and targeted defense mechanism activated in response to particular pathogens. This system involves the production of antibodies by B cells and the activation of T cells, which are specialized immune cells that can recognize and destroy specific pathogens.

When a foreign substance enters the body, the immune system goes into action. This is known as the immune response. The first line of defense is the innate immune system, which acts quickly to try and contain the threat. If the innate immune system cannot control the infection, the adaptive immune system is activated. B cells produce antibodies (special proteins) that bind to the pathogen and mark it for destruction, while T cells directly attack and destroy infected cells. During the immune response, your immune system recruits other cells to help fight the infection.

Your immune system doesn’t stop there. It has a memory. Once it has seen and fought off a specific antigen, it remembers it. Now, suppose that same antigen enters your body again. Your immune system can recognize it and start the immune response before you get sick. This protective mechanism prevents you from getting sick from a familiar threat known as immunity.

What is the difference between immunodeficiency and autoimmunity?

When the immune system doesn’t ramp up and respond as it should to an infection, this is called immunodeficiency. Immunodeficient people are more likely to develop infections and diseases.

In contrast, autoimmunity is when the immune system is overactive. The immune system mistakenly attacks healthy cells instead of attacking foreign invaders like germs. This internal confusion results in autoimmune diseases

So, while both these conditions involve the immune system, they are different. And having one doesn’t mean you will have the other. For instance, not all people with immunodeficiency will develop autoimmunity. The opposite is also true - not all people with autoimmunity develop immunodeficiency.

Let’s learn more about immunodeficiency and autoimmunity to help us understand the difference and connection between the two.

The basics of autoimmunity

As mentioned, autoimmunity results from an overactive immune system that attacks healthy cells. This attack results in damage to cells. Experts aren’t sure why the immune system turns on itself. They believe it is due to a combination of factors. These factors often include genetics and environmental triggers, such as

  • Infection
  • Repetitive exposure to chemicals or toxins
  • Chronic stress
  • Poor dietary choices causing changes in the gut microbiome

There are many autoimmune diseases,  including

Symptoms of autoimmunity

Symptoms of autoimmunity will vary based on the part of the body the immune system is attacking. Some early signs of an autoimmune disorder may be:

  • Low-grade fever
  • Difficulty concentrating
  • Numbness or tingling in your extremities
  • Skin rash
  • Fatigue
  • Achy muscles
  • Changes in your bowel movements

Treatment options

Treatment options vary based on the autoimmune disorder. Autoimmune disorders result from an overactive immune system. So, many treatments aim to calm the immune system. This helps manage the underlying inflammation. Certain medications, such as immunosuppressants and anti-inflammatory medications, can do just that.

Sometimes, treatment involves correcting hormonal imbalances caused by damaged cells. For example, in people with type 1 diabetes, pancreatic cells don’t make enough insulin. Because of this, these individuals need daily insulin injections to meet the body’s insulin needs. Similarly, those with Hashimoto’s thyroiditis will likely need to take thyroid hormone medication. This medication replaces the amount of thyroid hormone the thyroid can no longer make. By correcting the hormonal imbalance, when present, symptoms improve.

Besides medication therapy, changes to your lifestyle can also help manage symptoms of an autoimmune disorder. Lifestyle changes could include

Immunodeficiency 101

A compromised immune system results in immunodeficiency. This can occur when the immune system is weakened, or critical components are missing. In both cases, the immune system can’t safeguard the body against bacterial infections, viral infections, and other infectious diseases. 

Immunodeficiency can manifest in two primary forms:

  • Primary immunodeficiency: Generally identified in infancy or childhood, this type is genetically determined.
  • Acquired immunodeficiency: Also known as secondary immunodeficiency, this form emerges in response to a specific trigger. Triggers include medications such as immunosuppressants or chemotherapy treatments and health conditions like diabetes or acquired immune deficiency syndrome (AIDS) caused by HIV.

Natural aging may also affect how the immune system functions. As you age, your body makes fewer T-cells. Your immune system needs T-cells to mount a proper immune response. And without enough T-cells, individuals are more prone to infections.

Undernutrition, or when caloric intake is not met, can also affect how your immune system functions. Your immune system needs three nutrients - calcium, vitamin E, and zinc - for optimal function.

Regardless of the cause of immunodeficiency, those who are immunodeficient are at a heightened risk of infections.

Signs of immunodeficiency

Frequent infections: The most common sign of immunodeficiency is recurrent infections. One of the most common signs of immunodeficiency is a high frequency of infections. This can include recurrent respiratory infections such as sinus infections, pneumonia, and bronchitis, as well as frequent ear infections, urinary tract infections, and skin infections.

Slow healing: Individuals with immunodeficiency may also experience slow healing of wounds, cuts, and sores. This is because the immune system is not functioning correctly and cannot effectively fight off bacteria and other germs that can enter the body through open wounds.

Chronic fatigue: Constant fatigue and tiredness can be a sign of immunodeficiency. The body constantly fights infections and illnesses, which can leave individuals exhausted and drained of energy.

Digestive issues: Immunodeficiency can also affect the digestive system, leading to chronic diarrhea, abdominal pain, and other gastrointestinal problems. The immune system plays a crucial role in maintaining a healthy gut flora and fighting off harmful bacteria and viruses that can cause digestive issues.

Allergies: Individuals with immunodeficiency may also develop allergies, as the immune system cannot properly regulate the body’s response to allergens. This can lead to symptoms such as sneezing, itching, wheezing, and hives.

Autoimmune disorders: In some cases, immunodeficiency can lead to the development of autoimmune disorders, where the immune system mistakenly attacks healthy tissues and cells in the body. 

There are lab tests and imaging studies your healthcare provider can order to help diagnose secondary causes of immunodeficiency.

Treatment strategies

Several treatments are available for immunodeficiency, depending on the underlying cause and severity of the condition. Here are some common treatments for immunodeficiency:

Immunoglobulin therapy: Also known as antibody replacement therapy, immunoglobulin therapy involves administering antibodies to help strengthen the immune system and fight off infections. This treatment is commonly used for individuals with primary immunodeficiency disorders.

Bone marrow transplant: For individuals with severe immunodeficiency disorders, a bone marrow transplant may be recommended. This procedure involves transplanting healthy stem cells into the body to help rebuild the immune system.

Antiviral or antibiotic medications: In some cases, antiviral or antibiotic medications may be prescribed to help prevent or treat infections in individuals with immunodeficiency. These medications help to fight off pathogens and prevent the spread of infections.

Lifestyle changes: Making lifestyle changes such as maintaining a healthy diet, getting regular exercise, and practicing good hygiene can help support the immune system and reduce the risk of infections in individuals with immunodeficiency.

Avoiding exposure to pathogens: Individuals with immunodeficiency should avoid exposure to pathogens such as bacteria, viruses, and fungi that can cause infections. This may involve avoiding crowded places, practicing good hand hygiene, and avoiding contact with individuals who are sick.

If I have Hashimoto’s, am I immunodeficient?

Many people with Hashimoto’s may wonder if they are immunodeficient, as having an autoimmune disorder can affect the immune system. However, it’s essential to understand that Hashimoto’s does not necessarily make you immunodeficient.

While Hashimoto’s involves an immune system malfunction, it is specific to the thyroid gland and does not typically lead to a weakened immune system. But, sometimes, people with an autoimmune condition develop another autoimmune condition. When this occurs, it is called polyautoimmunity. If you have Hashimoto’s, you may be at higher risk of developing another autoimmune condition. This new autoimmune condition may cause immunodeficiencies. To help manage other autoimmune disorders, an individual may take an immunosuppressant medication. Immunosuppressant medications suppress the immune system. So, taking immunosuppressant medication would cause you to become immunodeficient.

To recap, Hashimoto’s doesn’t cause you to become immunodeficient. But, it can put you at risk for other autoimmune disorders that may make you immunodeficient.

A note from Paloma Health

A weakened immune system may increase your risk of developing an autoimmune thyroid disease like Hashimoto’s thyroiditis. Symptoms of Hashimoto’s thyroiditis include:

If you suspect you have autoimmune thyroid disease,  Paloma’s at-home thyroid test kit can help you understand how well your thyroid is working. Based on your results, you will know if further evaluation is needed. Order your testing kit today to jump-start your thyroid health.

Dealing with Hypothyroidism?  Video chat with a thyroid doctor

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Emilie White, PharmD

Clinical Pharmacist and Medical Blogger

Emilie White, PharmD is a clinical pharmacist with over a decade of providing direct patient care to those hospitalized. She received her Doctor of Pharmacy degree from Massachusetts College of Pharmacy and Health Sciences. After graduation, Emilie completed a postgraduate pharmacy residency at Bon Secours Memorial Regional Medical Center in Virginia. Her background includes caring for critical care, internal medicine, and surgical patients.

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