How Autoimmune Diseases Are Treated
By Lana Bandoim
Updated on August 09, 2023
Medically reviewed by Stella Bard, MD
An autoimmune disease is a condition in which your immune system attacks your body's cells. The primary goal of treating an autoimmune disorder is to control the immune response in your body. Your treatment options usually involve reducing inflammation and other symptoms.
Once you have been diagnosed, some autoimmune diseases can be difficult to treat. You may need to try different options before finding the right combination that works for you. In general, treatment usually cannot cure the disease, but it may reduce symptoms and help you manage the condition better.
Specific treatments will vary depending on the type of autoimmune condition you have and its severity. However, most treatments fall into one of the categories below:
Complementary and alternative medicine
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Over-the-Counter (OTC) Therapies
Over-the-counter (OTC) therapies do not require prescriptions and may be some of the first treatments your healthcare provider recommends for an autoimmune disease. Usually, OTC medications help relieve mild symptoms, such as pain. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help with inflammation, swelling, stiffness, fever, and pain.
Common OTC drugs include:
The right OTC medication will depend on the type of autoimmune disease you have and how far the condition has progressed. Your healthcare provider may have you try different OTC drugs. Some people need only OTC therapies to manage their disorders, but NSAIDs do pose some risks.
If you have severe symptoms or OTC therapies are not working, you may need to take prescription drugs for autoimmune disorders. These medications can help with different symptoms like fever, pain, anxiety, swelling, depression, fatigue, sleep problems, skin problems, rashes, or digestive issues.
Prescription drugs usually cost more than OTC medications, and they may have more side effects. Work with your healthcare provider to find the best treatment option for you.
Immunosuppressive therapies can treat many types of autoimmune diseases. These medications target different parts of your immune system by suppressing it. Immunosuppressants can help manage your condition and protect organ function, such as by controlling inflammation. Some common immunosuppressants include low-dose chemotherapy and drugs to prevent rejection after organ transplants.
Immunosuppressive therapies to treat autoimmune disease include:
CellCept (mycophenolic acid)
Cytoxan, Neosar (cyclophosphamide)
Biologic therapies are a type of immunosuppressant that can target specific parts of the immune system, such as blocking certain receptors on cells. You usually get these medicines through an injection or an intravenous line.
Immunosuppressive biologics include:
IL-1 blockers (Kineret or anakinra)
IL-6 blockers (Actemra or tocilizumab)
TNF-inhibitors (Humira or adalimumab)
Biologics that block T cell activity (Orencia or abatacept)
Biologics that affect B cells (Truxima or rituximab)
Immunosuppressant medicines are often considered a gold-standard treatment for many conditions, but they can come with major side effects. One of the most common concerns is a higher risk of infection. Talk to your healthcare provider about the possibility of adverse effects before taking any medicine.
Common side effects of immunosuppressants include:
JAK Inhibitors—Side Effects
Use of JAK inhibitors (Xeljanz/Xeljanz XR, Olumiant, or Rinvoq) come with some possible risks, including serious heart-related events, cancer, blood clots, and death. Be sure to tell your doctor if you are a current or former smoker, have had a heart attack, other heart problems, stroke, or blood clots as these may further increase your risk while using these drugs.
Drugs for Treating Pain
Your healthcare provider will first recommend NSAIDs for treating mild pain. If an autoimmune disease causes severe pain that interferes with your quality of life and ability to function, however, you may need to take prescription pain medications.
Prescription pain medications usually include opioids such as:
Long-term use of opioids may lead to tolerance and addiction. In addition, opioids can have side effects, including constipation, drowsiness, or sleepiness.
Drugs for Treating Fatigue
Autoimmune disorders can cause fatigue, and you may have another underlying medical condition that contributes to it. Additionally, some drugs for treating autoimmune diseases have fatigue as a side effect. Your healthcare provider may need to adjust your medications if fatigue is a serious problem.
Medicines for treating fatigue include:
Iron supplements and erythropoietin hormone
Vitamins and supplements
Drugs for Other Symptoms
Since there is a wide range of autoimmune diseases, your medications will vary based on the condition you have and your specific symptoms. For example, you may need to take substances, such as insulin or thyroid hormone replacement drugs, to replace what is missing in your body because of an autoimmune condition.
Other treatment options that may help include:
Disease-modifying anti-rheumatic drugs to slow down the autoimmune disease
Intravenous immunoglobulin to help the immune system
Antimalarial drugs to help skin rashes and other symptoms
Anticoagulants to prevent blood clots
Steroids to help symptoms like pain, swelling, or tenderness
Lifestyle changes can help you manage an autoimmune disease. Since most medical treatment options do not offer a cure, lifestyle modifications can be an important part of helping you feel better. The goal of making these changes is to lower inflammation in the body and control other symptoms.
Keep in mind that making and sticking to lifestyle changes can take time and effort. Your healthcare provider can make recommendations, but you must be willing to alter how you live. Consider asking friends and family to help keep you accountable. Also, avoid trying to make all of the recommended changes you may hear at the same time, so you do not feel overwhelmed. Healthy lifestyle changes are most successful when they're established over time.
You want to follow a healthy, balanced diet that includes vegetables, fruits, and whole grains. Try to limit trans fat, saturated fats, sugar, and salt. Focus on eating lean protein and healthy fats. The goal is to avoid processed foods with extra sugar and salt that do not have nutritional value. In addition, limit or avoid alcohol and caffeine. Nourishing your body is essential for managing an autoimmune condition.
You may want to discuss specific dietary changes with your healthcare provider. Tests can show if you have any nutritional deficiencies that require supplementation or additional diet modifications.
Sleep is essential for your overall health, but some autoimmune diseases can make it more difficult to get enough of it. In addition, specific medications used to treat your condition can affect sleep. Rest gives your body a chance to heal and recover. When you do not get enough sleep, it can make symptoms worse.
In general, most adults need seven to nine hours of sleep per night. Your sleep requirements can vary. If you are having trouble falling asleep, eliminate distractions and limit alcohol, caffeine, and nicotine before bedtime. Try to fall asleep and wake up at the same hour every day. In addition, make your bedroom comfortable and dark. You want to avoid using electronic devices before bed.
Exercise can help with fatigue and other symptoms of an autoimmune disease. You want to perform regular physical activities that turn into a healthy habit. However, it's also important to be kind to your body and not overdo it. You may want to start with a low-impact exercise program, such as tai chi or a gentle form of yoga.
When you exercise, your body makes endorphins that affect mood, helping you feel better. Physical activity also improves flexibility, range of motion, muscle mass, and blood circulation. You may have less pain and more energy after exercising. You may even sleep better at night after working out during the day.
Stress can contribute to health problems and make the symptoms of an autoimmune disease worse, such as causing a flare-up. Although your stress-relief strategies will be personal, there are some general recommendations that can help.
Getting enough sleep, following a healthy diet, and exercising regularly can all help reduce stress. Try to eliminate any sources of stress when it is possible. To this end, you may also want to try cognitive-behavioral therapy, yoga, meditation, and other relaxation techniques. The goal is to practice these techniques on a regular basis.
You can find ways to relieve stress on your own. However, you may also benefit from joining a support group or seeing a therapist.
Complementary and Alternative Medicine
Complementary and alternative medicine (CAM) describes substances and methods that are not considered part of standard medical care. This may include herbs, supplements, or modalities like hypnosis, massage, or acupuncture. Some people with autoimmune diseases may benefit from CAM and find relief from symptoms with it. However, research on many supplements and methods is limited.
Many CAM substances and methods focus on the mind-body connection. CAM techniques and products are designed to help the whole body. There is also a strong focus on relaxation, nutrition, and stress reduction.
It is possible for certain elements of CAM to cause problems, such as herbs interfering with your medications. Discuss your plans to use CAM treatments with a healthcare provider to make sure you do not encounter any issues.
Physical therapy is a non-medication treatment option for autoimmune diseases. It involves performing specific exercises with a trained physical therapist. It can be especially useful for joint pain and muscle weakness.
Physical therapy can help with symptoms such as:
Numbness or weakness in the limbs
Physical therapy can also help improve your cardiovascular health by strengthening the heart muscle as well as maintain bone density with weight-bearing exercises.
If you have to use an assistive device, such as a cane or a walker, because of your condition, physical therapy can provide training for it. A physical therapist can assist you in using the device and maintaining muscle strength.
Occupational therapy focuses on making daily activities easier for you if you have pain or other symptoms. The goal of occupational therapy is to help you live an independent and productive life. An occupational therapist can teach you different methods to reduce symptoms and reduce discomfort and show you how to use new devices. You may want to make changes in your house or at work if the occupational therapist recommends them.
Stiffness, weakness, and pain can make it difficult to do things. Occupational therapy can teach you how to bathe, get dressed, cook, and do other activities in a different way, so that they are easier to accomplish. For example, an occupational therapist can help a person with joint problems learn how to brush their teeth using an assistive device that makes holding the toothbrush less painful.
Mind-body therapy can include different products and methods that treat the whole body. Instead of viewing the brain and body as separate entities, this type of CAM works on integrating them. Usually, it involves relaxation techniques that work on both the mind and body.
Breathing, focusing, and moving are important parts of mind-body therapy. The methods can range from doing art to trying hypnosis. Some other examples include meditation, biofeedback, yoga, tai chi, and guided imagery.
You may want to experiment with different types of mind-body therapies to find the right one. The techniques are usually safe for most people to try without the risk of side effects of complications.
Supplements and Herbs
There are many different types of supplements and herbs that you may find. Some have been studied and show promise in helping those with autoimmune disorders. However, there is a possibility that specific herbs and supplements can interfere with OTC and prescription medications. You should discuss the types you plan to take with your healthcare provider.
Experimental treatments have risks, but some are showing promise for treating autoimmune diseases. You may be able to join a clinical trial or try an experimental medication. Ask your practitioner if there are any clinical trials you can join for your condition.
Keep in mind that experimental treatments carry risks and may not work. Since research on them is limited, it's also possible to have an adverse event or reaction.