Autoimmune Disease: Treatments and Outcomes

Flat lay of a cutting board filled with an assortment of colorful vegetables and greens. showing nutrition as an effective autoimmune treatment.

Autoimmune diseases encompass more than 80 health disorders and affect more than 24 million people in the US and an estimated one in ten people worldwide.^1,2 To compound this problem, studies indicate that a rise in detected antinuclear antibodies, biomarkers of autoimmunity, may indicate a rise in the future development of autoimmune diseases.³ Rheumatoid arthritis, type 1 diabetes, psoriasis, multiple sclerosis, and inflammatory bowel disease are among the more common autoimmune diseases, and recent studies have reported that while autoimmune diseases are more prevalent among females,⁴ they may also disproportionately impact specific racial groups.^5,6

While the direct economic cost of autoimmune disease in the US is difficult to determine,⁷ the National Institute of Allergy and Infectious Diseases has estimated that the annual cost to the healthcare system is more than $100 billion, not including the cost of uninsured individuals, which is estimated to be at least another $25 billion per year, according to the American Autoimmune Related Diseases Association.⁸ This may be a substantial underestimation of the economic burden, however. A 2022 report found that the estimated combined direct and indirect costs associated with just one autoimmune disorder in the US, multiple sclerosis, was $85.4 billion annually.⁹

Medications and Biologic Drugs

Medications and biologic drugs used in the management of autoimmune diseases attempt to control disease flares, limit inflammatory damage, and extend periods of remission. However, consistent results may not be seen in each patient, there may be potentially serious side effects, and higher financial costs have also been noted for some drug options.^10,11 The goal of contemporary treatment for rheumatoid arthritis (RA), as an example, is to halt or slow the progression of the disease before joint damage occurs,¹⁰ and treatment with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and biologic DMARDs in the early stages of RA is usually recommended.¹² But not all patients respond to or tolerate DMARDs, and researchers continue to clarify associations between DMARDs and potential severe adverse health effects such as interstitial lung disease¹³ and dementia.^14,15What are the nonpharmaceutical, cost-effective treatment options that may help improve symptoms and quality of life for autoimmune disease patients?

Modifiable Lifestyle Factors: Nutrition and Exercise

Dietary patterns that promote the consumption of anti-inflammatory foods may help alleviate physiological biomarkers associated with inflammation¹⁶ and symptoms of chronic inflammatory conditions.^17,18 A 2020 systematic review of randomized controlled trials found that as an adjunctive treatment, patients living with RA may turn to dietary interventions such as the Mediterranean diet to reduce systemic inflammation associated with their disease.¹⁹ In addition, a 2018 systematic review identified beneficial effects from following a Mediterranean diet in reducing pain and increasing physical function for those patients living with RA.²⁰

Physical activity is proven safe and beneficial in most autoimmune diseases. A 2021 meta-analysis found that home-based physical activity interventions reduced autoimmune rheumatic disease symptoms and pain and improved functional capacity as well as quality of life for patients compared to controls.²¹ Another meta-analysis reported improvements in balance and functional walking ability for patients living with multiple sclerosis who engaged in exercise routines such as yoga, aerobic training, and aquatic exercise.²²

Conclusion

While prescription medications remain at the forefront in the battle against autoimmune disease, researchers are identifying other treatment modalities to help improve patients’ quality of life. Functional medicine offers an alternative to symptom suppression—by addressing the underlying mechanisms that cause autoimmunity. Through collaborative therapeutic partnerships with patients and creating effective, personalized, and sustainable treatment and health strategies, functional medicine practitioners support the health journey for each individual patient.

At IFM’s upcoming Immune Functional Medicine Advanced Practice Module® (APM), learn more from functional medicine experts about autoimmune disorders and the clinical applications and lifestyle-based tools that help support immunity and health outcomes.

Medications and Biologic Drugs

Modifiable Lifestyle Factors: Nutrition and Exercise

Conclusion

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