FUDiabetes

Is my understanding of autoimmune diseases correct?

I’m in a Facebook group for people with Graves’ disease. I stay in it for answering the odd question, but there are sooooooo many people who are anti-vaccination, anti-medication, pro-supplements, pro-“anti-inflammatory”-diet that it drives me crazy. People will claim that diet and supplements put them into remisson, but Graves’ is known to sometimes go into spontaneous remission (especially for those diagnosed beyond young adulthood) without taking any particular actions… So how do they know it’s their diet and supplements and wouldn’t just have happened anyway?!

Against my better judgement, I commented on someone’s comment about not getting the flu shot because those of us with Graves’ already produce too many antibodies. I replied with my understanding of how autoimmune conditions work, and that we don’t produce “too many” antibodies. The response I got back was basically that I was wrong and that we do in fact produce too many antibodies. Instead of engaging more and making myself crazy, I’m coming here. I know there are people here who understand way more about science and physiology than I do. So, I want to know if my understanding of “what goes wrong” in a high-level sense is correct.

My understanding is that antibodies are produced both upon exposure to foreign substances, but also produced at random, and that this is how we’re protected from bacteria and viruses we may have never encountered before. My understanding is that everyone, at some point, probably produces some autoantibodies thorugh the random-generation method of producing antibodies, but that the body quickly realizes that these antibodies are to tissues within our body and halts the process of them being produced before they can do any damage. My understanding is that autoimmune diseases are, in part, when this mechanism breaks down and these autoantibodies are allowed to move into full production, and the rest we all know.

Is this general understanding correct? Do we all produce autoantibodies, and it’s just something about the regulation mechanism that breaks down in autoimmune diseases? Or do those of us with autoimmune diseases product “too many” antibodies (in other words, produce antibodies that those without autoimmune diseases never produce)?

If my understanding is wrong, does anyone have any links to simple material that explains autoantibodies?

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I don’t think I have found the right thing, but this is what I could find…

https://www.immunopaedia.org.za/immunology/advanced/10-antibody-mediated-autoimmune-diseases/

My response is not specific to autoimmune
Diseases. Just a general thought, and that is maybe you don’t. I feel like I spend a lot of time trying to get people to see a certain something, and I just can’t always make it happen. Maybe you just use whatever you have learned in order to apply it to your own care, regardless of whether or not someone agrees.

I’m all for people doing whatever works for them. The problem with these types of groups is that you get people telling others to do this and that, take this and that, don’t trust this or that treatment. And it’s often presented as if it’s facts, not just someone’s personal experience.

I “un-followed” this group years ago and generally don’t participate. But sometimes I get bored and go in there just to see what people have posted, and sometimes I comment. I should have learned by now not to participate in a thread that I think might get me riled up…

But I was interested in the accuracy of my understanding, so thought I’d bring it here. Because unlike all the “natural” people in that group, if I’m mistaken I would like to know and I would like to know the correct understanding of (at least one of) the way(s) autoimmune diseases work.

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I understand this.

And I understand this.

Hmmm… I’m doing what you’re doing for the exact same reason. Very interesting. You’re here trying tighten up your knowledge about autoimmune diseases, and i’m here trying to tighten up my understanding of basals and everything insulin and everything diabetes. I’m here because I want to either confirm what I know to be true or learn why it’s not. I’m intrigued by my advice to you up there… I wouldn’t take that advice for a second. :expressionless:

Can you just post your own research to their points? Do you have the same privilege? Maybe providing accurate information will help raise the kind of conversation you can engage in… rather than starting with the most stubborn or ignorant?

Oh, I’m definitely also here to learn about basals and boluses! Don’t get me wrong there. :slight_smile: But I’m also really interested in all the science, at least what we know, about how all this fits together.

Most of what I know is from books I’ve read, which aren’t very linkable… And I get the impression most people would not be interested in reading an entire book on how the immune system works. Haha.

Your general understanding is far more correct, than the one expressed by your Facebook “friend”.

The difficulty is that trying to lump all autoimmune diseases into one category is difficult. i.e. it is fine to say I have an autoimmune disease, but then to try and ascribe specific cause and effect to a large variety of diseases just because they share a body system is difficult and fraught with oversimplification.

I don’t pretend to be an expert on autoimmune disorders, but at a basic level for some of the diseases I don’t think the problem is that you have too many antibodies, but rather that a virus or some other unknown mechanism has reprogrammed some of your antibodies to fight your bodies tissue. Of course, once the body detects the “bad” tissue, it will create a bunch of specialized antibodies to go to war, so of course having “too many” antibodies is a symptom in some of the cases. But is too much of an oversimplification for me.

I am sure a few others with better backgrounds will be by soon.

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The last immunology course I followed was a couple of years ago, so forgive me that I don’t remember the details of the antibody production process. I agree with Chris that your understanding is more correct than the anti-vaccination crowd. As far as I know, too many antibodies is not a thing. It’s not about how many different antibodies or the amount we produce of them, but about what they’re against. As long as they’re against pathogens, you’re fine. Antibodies which recognize adenoviruses, influenza viruses, polio viruses etcetera do not harm us. It doesn’t matter how much of these you produce. Problems only arise when you produce a significant amount of antibodies against a self-antigen. Because then perfectly normal processes in our body will be derailed and that has some very unpleasant consequences.
If I have time, I’ll get my immunology book to find out more about the process of antibody production.

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Well, sure, but what’s sad is most people probably wouldn’t even be interested in reading an article. I’m willing to do the reading. In fact, I enjoy the reading, but I’m always concerned with being wrong. My way of handling it is to preface everything with “I might be wrong,” or “it’s my understanding’” and then to go on and make as many points as I want. I wouldn’t blame you for not wanting to do that, but I don’t think not having a linkable article should stop you from sharing what you know in a group that is breeding ignorance. I think you qualify it however you need to, and then you provide what you believe to be true. You’re not claiming to be a scholar or an expert in it… right? :grin:

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@Jen, here is a good source (NIH) that explains how antibodies get generated:

https://www.ncbi.nlm.nih.gov/books/NBK26884/

Here is, also from NIH, a discussion of autoantibody reactions:

https://www.ncbi.nlm.nih.gov/books/NBK27155/

While I don’t think that anyone today understands what exactly causes (and inhibits, in properly functioning immune systems) autoimmune responses, it is clear that autoimmune diseases are not caused by “too many antibodies”. Antibodies are not polyvalent. One antibody (ie a protein generated by a B cell) targets one and only one antigen (ie a normally foreign protein) and binds it, thereby stopping it from being able to bind to other sites.

Saying that having Graves disease means you don’t need a flu shot (or any other vaccine, really) is the same thing as saying that, since you already had smallpox, you don’t need to get vaccinated for polio. Since one antibody is totally specific, your thyroid antibodies (Graves) cannot and do not react with any other protein, and do not give you any capacity to resist any other disease. If anything, it is the opposite, since a malfunctioning thyroid gland may hamper you when fighting a disease.

Similarly, there is a feeling, among some people, that being a PWD means that your immune system is stronger. I don’t know any actual research on it, but I know a lot of PWDs with asthma, many of which catch every respiratory disease around. I feel it is likely an urban legend–but it is not totally impossible, I guess.

Either way, Graves does not provide immunity to anything else. At best, and very doubtfully, it may come with a slightly stronger immune system in general. There is, that I know, absolutely no evidence for that though: we are talking about possibilities at best.

I am no immunologist. My knowledge is based on general scientific education and the research I did when my son was diagnosed. I am sure @Chris and many other members can go in better depth.

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This is what I typically do in forums and posts. I didn’t do so in this case, and I think it comes across as better when I do. I should have done it in this case in particular, since it’s not an area I have any expertise in.

I sometimes think of my immune syste as being stronger, in a sense. I seem to get colds and other illnesses way less than others. But by “stronger” I generally mean my immune system is more prone to launching attacks on things, and it mostly comes from the fact that I have two autoimmune and five allergic conditions. Though I do recognize that this is just a correlation I’ve noticed (not getting traditionally sick often and having lots of immune-mediated conditions) that may not be related at all.

Maybe this is sort of the same thing this person in the group was trying to refer to. But I also think a lot of people with autoimmune conditions who don’t get the flu shot are scared that the flu shot (or other vaccinations) will somehow make a condition worse or set off development of a new condition.

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You’re right that there is randomization somewhere in the process of antibody production. However, it is not in the production of ‘free antibody’ in the blood, but in the generation of B cells that randomization occurs. B cells are the immune cells that produce antibodies, but they don’t do that before exposure to their specific antigen. In this ‘naive’ state, they only produce antibodies which are bound to their surface. Every B cell has its own surface antibody, specific for one antigen. When that antigen binds to the surface antibody, the B cell will start dividing, develop into so-called plasma cells and produce antibodies against that antigen. During the development of B cells in the bone marrow, it is determined which antibody they will express. In B cells, the structure of the gene for antibodies is such that not just one identical antibody will be expressed by all B cells, but that random combinations of gene fragments will be made to ensure that every B cell has its own unique antibody. It may indeed happen that a B cell will be generated with an autoantibody on its surface. Normally, this isn’t a problem, because there is a selection process to prevent such B cells from leaving the bone marrow. If the cell escapes this process, you might get problems with autoimmunity. Activation of B cells is actually more complicated than just binding of antigen to the surface antibody. B cell activation usually requires help from another type of immune cells, T helper cells. These have to recognize the same antigen, otherwise no activation will occur. So the generation of a self-reactive B cell doesn’t always result in autoimmunity.
That, in a nutshell, is how antibodies are produced. Of course there’s a lot more to say about this.

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Thanks for that super clear explanation!

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It’s certainly anecdata at best, but I feel like it’s very true for me—my immune system seems to destroy viruses much more efficiently than others’, to a marked degree. It also seems like there might be some evolutionary advantage for being at higher risk for autoimmunity given how common the genetic component seems to be. Would make sense if some of those genetic predispositions confer an advantage as long as you’re not unlucky enough to experience whatever environmental trigger pushes some of us into actual autoimmunity. Of course there are multiple genetic predispositions that likely contribute and interact to produce autoimmunity so it’s also entirely possible that only some could confer an advantage, or that it depends on the combination of genes as to whether they do etc. Plus, as discussed in another thread, it seemed like a lot of us experience better immunity toward viruses but worse with bacteria/fungus, which makes sense since the latter may thrive if more sugar is available.

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So, I guess I’m always confused by the idea of a “strong” immune system. The thing about the immune response is that it’s hard to tell from how sick you feel whether your immune system did a good or bad job fighting something off. So when someone says “I have a strong immune system I never get sick” it could be that they just happened to not be exposed to that pathogen in sufficient quantities, they were already exposed and had ready-made matching antibodies to quickly launch a defense, or that their immune system isn’t any stronger than someone else’s, it’s just better at tamping down the inflammatory or cytokine response that makes people feel sick when the immune system does mount a response… In any case I think the jury is still out on whether people with autoimmune diseases tend to fight off pathogens more effectively, but it’s certain that people with diabetes on average do not; the high blood sugar levels make them more prone to infection I would think.

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It’s a fair point, but I’d also add that I’ve seen evidence of my immune system in situations like finding out a former partner had a strain of HPV not covered by the vaccine and that all of his partners before and after me had gotten infected and had to have various procedures as a result and never having had a positive HPV result myself despite careful monitoring for over a decade since and definite exposure to the virus. So I’d say that’s evidence for an effective immune response, versus a hyporeactive one. Also, my getting less sick thing is less true when I’ve been physiologically run down—for example, my freshman year of college I got notably sick from everything because I was getting almost no sleep and not taking good care of myself, and that was when I got EBV, among other viral infections. That to me suggests that, at least for me, my usual low levels of symptoms/sickness reflects better immune functioning, vs when I’m depleted. Again, I suspect my immune system is more resistant to viruses and less robust against bacteria/fungal infections (when I’ve gotten super sick, it’s been bacterial, like salmonella and cellulitis), but that’s just a hypothesis.

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I think along the same lines as you. And I appreciate that there’s a place we can discuss and learn about this.

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So, this is sort of funny. I googled allergies and Graves‘ disease, because my eyes are incredibly irritated yesterday and today, and often when that happens I can’t tell if it’s from allergies or from Graves‘ disease.

The first link that popped up was to an article in a clinical immunology journal talking about an association between Graves‘ disease and allergies (IgE antibody levels). And, out of all the allergies they tested for, they specifically mentioned potato (and carrot).

I just thought that it was funny that out of all the common allergens, they mention the one rare allergen that’s my most severe (anaphylactic).

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That is really interesting! Did you decide to contribute the eye issues to the potatoes or to the Graves?

I’ve been doing a lot of reading lately about allergies and candida and gut issues, and come across a few sources which seem reputable (ahem, NOT Healthline, for the record) which have reminded me how frequently things in the body and stuff we ingest are connected.

I do hope your eyes are feeling better!

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Oh, it’s definitely not from potatoes. I’m anaphylactic to potatoes (like someone with a peanut allergy…but to potatoes), so I stay far, far away from them. Except the other day my colleague was eating fries next to me, as he forgot, but I said it was OK as long as he didn’t touch me. But the eye irritation started before that. So I’m thinking it’s environmental allergies, but it drives me crazy because when I check pollen levels, it tells me that the pollen stations are out of season. Which leads me to think it’s dust, or animals, or smoking (I thought my apartment building was non-smoking but discovered that wasn’t the case until very recently). But most of those things aren’t at work. So I don’t know.

And in terms of Graves’, my thyroid came back crazy low (at least crazy low compared to what it’s ever been in the past), which makes me hope maybe it’s a sign that my Graves’ is going into remission, which would mean my antibodies (which cause the eye irritation) would be gone. But I have to ask my endocrinologist to do an antibody test to check when I see him next. It could just mean nothing more than I need to decrease my medication.

Long story short, I don’t know yet. The irritation seems to come and go. It’s mostly anoying when it comes and won’t go away no matter what I do.

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