Autoimmune illnesses spread quietly: Experts share early signs to watch for

A mix of genetics, polluted cities, stress and lifestyle shifts is fuelling a rise in autoimmune disorders. Doctors outline the warning signs and steps that help manage these conditions

Autoimmune diseases are no longer rare medical oddities. Doctors across India report a steady rise in cases, from thyroid disorders and rheumatoid arthritis to lupus, psoriasis and conditions affecting the gut and nervous system. Because these illnesses often begin quietly, mimic other problems and flare unpredictably, early recognition can help prevent long-term organ damage.

 

What happens inside body during an autoimmune response?

 

In a healthy body, the immune system targets harmful organisms. In autoimmune diseases, this process goes awry. “The immune system erroneously recognises body tissues as foreign,” explains Dr Rohit Deshpande, internal medicine specialist at Lilavati Hospital, Mumbai. This triggers auto-antibodies and T-cell activity that inflame and damage organs.

 

Dr Deshpande says this misfire results from a loss of immune tolerance influenced by genetics, infections and epigenetic changes.

 

According to Dr Anurag Aggarwal, Consultant, Internal Medicine, Fortis Escorts Hospital, Faridabad, mechanisms such as molecular mimicry, defective regulatory T cells and chronic inflammation push the body into “self-attack” mode and lead to persistent tissue injury.

 

He adds that autoimmune diseases usually develop due to a combination of genes, infections, pollution, hormonal changes and even gut microbiome imbalance.

 

Why are autoimmune diseases increasing in India?

 

“The rise is due to increased city strain, low air quality and western dieting habits,” says Dr Deshpande. Chronic infections, environmental toxins and better screening are also raising case numbers.

 

Dr Aggarwal points to the hygiene hypothesis — the idea that limited exposure to germs in early childhood may leave the immune system undertrained, increasing susceptibility later in life.

 

Experts commonly see autoimmune thyroid disease, rheumatoid arthritis, spondyloarthritis, lupus, psoriasis, vitiligo, type 1 diabetes, coeliac disease, inflammatory bowel disease and neurological disorders such as multiple sclerosis and myasthenia gravis. Stress, poor sleep, pollution exposure, smoking and endocrine-disrupting chemicals can aggravate symptoms.

 

What early symptoms do people often miss?

• Fatigue that does not improve
• Persistent joint aches
• Morning stiffness
• Low-grade fevers
• Rashes or mouth ulcers
• Unexplained hair loss

 

Symptoms can come and go, causing delay in diagnosis. “Constant fatigue, unexplainable joint pain and muscle weakness are usually ignored,” says Dr Deshpande, noting many patients attempt self-medication first.

 

“Patients should seek urgent medical care if they develop new severe headaches or vision changes, chest pain, sudden shortness of breath, a swollen painful calf, blood in the urine, rapidly worsening weakness or paralysis, high fever while on immunosuppressive treatment, or any sudden pregnancy-related complications,” cautions Dr Aggarwal.

 

How do doctors diagnose autoimmune diseases?

• Clinical examination: Doctors assess patterns involving joints, skin, kidneys, nerves or eyes.
• Blood tests: ESR, CRP, autoantibody tests (ANA, anti-dsDNA, RF, anti-CCP), thyroid antibodies, complement levels and coeliac screening.
• Imaging: X-rays, ultrasound or MRI to detect inflammation.
• Biopsies: Skin, kidney or gut samples when needed.
• Specialised tests: Stool calprotectin or endoscopy for suspected inflammatory bowel disease; nerve conduction tests for neurological symptoms.

Early test results may be normal, symptoms may overlap, and false positives are common, making diagnosis challenging. Limited access to rheumatologists and neurologists in many regions adds another barrier.

 

How are autoimmune diseases treated and managed long term?

 

Autoimmune diseases cannot be cured, but they can be controlled. Treatment may include immunosuppressants, corticosteroids, disease-modifying drugs (DMARDs), biologics and targeted therapies.

 

Lifestyle measures — anti-inflammatory diets, physiotherapy, quitting smoking, adequate sleep and stress management — play a major role. Tracking personal triggers and flare patterns helps prevent worsening.

 

“Multidisciplinary care assists in regulating organ-specific damage,” says Dr Deshpande.

 

Dr Aggarwal adds that long-term management requires routine blood tests, organ-function monitoring, drug-specific safety checks and screening for cardiovascular risk and osteoporosis. Mental-health support and patient groups also ease long-term treatment.