By Krysten Godfrey Maddocks, Union Leader Staff
Women are almost twice as likely as men to be diagnosed with an autoimmune disease and make up nearly 80% of those affected. Many women with symptoms like fatigue or joint pain are often told these issues are just part of postpartum recovery, aging, menopause, or stress. However, New Hampshire doctors urge women to take their symptoms seriously and pursue further testing if their current treatments aren’t helping.
Genetic predisposition
Being a woman predisposes a person to autoimmune diseases because of genetic makeup. Women usually have two X chromosomes, while men have one X and one Y. Early in development, each cell in a female turns off one X chromosome to avoid making too much of certain proteins. However, the X chromosome that should be turned off is not always completely silent, which is called “leaky” X-chromosome inactivation, Albert said. This means some women may produce extra immune proteins that make them more susceptible to developing an autoimmune disease.
Family history raises the risk further. Still, most autoimmune diseases are caused by both genetics and environmental factors. Scientists believe genetics accounts for only about 30% of the risk. But if a person already has one autoimmune disease, the risk of developing another is higher.
“In lupus patients, there’s about a 6% risk of having coexisting celiac disease,” Albert said. “And if you have Hashimoto’s, which is really quite common, you have an increased risk for lupus.” Women with Hashimoto’s disease won’t necessarily develop lupus, TypeGenetic predisposition Being a woman predisposes a person to autoimmune diseases because of genetic makeup. Women usually have two X chromosomes, while men have one X and one Y. Early in development, each cell in a female turns off one X chromosome to avoid making too much of certain proteins. However, the X chromosome that should be turned off is not always completely silent, which is called “leaky” X-chromosome inactivation, Albert said. This means some women may produce extra immune proteins that make them more susceptible to developing an autoimmune disease. Family history raises the risk further. Still, most autoimmune diseases are caused by both genetics and environmental factors. Scientists believe genetics accounts for only about 30% of the risk. But if a person already has one autoimmune disease, the risk of developing another is higher. “In lupus patients, there’s about a 6% risk of having coexisting celiac disease,” Albert said.
“And if you have Hashimoto’s, which is really quite common, you have an increased risk for lupus.” Women with Hashimoto’s disease won’t necessarily develop lupus, Type 1 diabetes or eczema, said Dr. Mikhail Signalov, an endocrinologist with St. Joseph Hospital Endocrinology. “It’s not the relationship of causality. It’s just the explanation that this particular patient has certain genetics that predispose them for autoimmune diseases. But I never say watch for Type 1 diabetes or watch for lupus because you will develop it. You may never develop this ever in your life.”
Weight gain and thyroid
Weight gain is another symptom that women commonly struggle with after age 40. While extra pounds can be a hallmark of perimenopause, they can also be a symptom of Hashimoto’s thyroid disease. However, weight gain in and of itself doesn’t necessarily mean a person has an underactive thyroid, according to Signalov.
“The problem starts when you lose the thyroid function as a result of the autoimmune disease. In this case, yes, the metabolism slows down. Most of the time I see symptoms such as fatigue and change in hair quality, but not that much weight gain,” he said. “Because weight gain is, in the case of severely underactive thyroid, mostly associated with fluid retention, not the formation of fat tissue.”
Many women receive later-than-necessary care for underactive thyroid diagnoses after childbirth. Many of Signalov’s patients’ initial complaints were fatigue, changes in hair quality and poor concentration after delivery.
“It was explained to them as, ‘You’re a new mom, you should be expected to be fatigued, you should expect to be tired, and you should expect to have some hair changes,’” he said. “I will say no. You should expect to be happy, focused and to start losing weight after the first 12 months to reach your pre-pregnancy weight.”
Signalov suggests that women who have recently given birth get tested if they continue experiencing these symptoms.
“It’s better to just check the levels and at least make sure that there is no thyroid disease or onset of thyroid problems versus blaming the recent pregnancy for symptoms,” he said.