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There are more than 80 unique autoimmune diseases, but what they have in common is a misfiring of the body’s immunity to mistakenly attack healthy cells rather than attacking the foreign or harmful cells, like a normal functioning immune system does. Some autoimmune conditions target just one organ and others target the whole body. While researchers don’t know exactly what causes autoimmune diseases, certain people are at higher risk. Women are twice as likely as men to suffer from autoimmune diseases, especially during childbearing years (ages 15 to 44). And certain autoimmune diseases tend to run in families or affect certain ethnic groups more. The 12 most common autoimmune diseases (listed here from highest prevalence) are:
- Autoimmune thyroiditis (Hashimoto’s thyroiditis and other types): affects the thyroid, causing it to over- or under-produce hormones that control metabolism
- Psoriasis: affects skin cells, causing them to multiply too quickly
- Rheumatoid arthritis: affects the joints
- Type 1 diabetes: affects insulin-producing cells in the pancreas
- Multiple sclerosis: affects the protective coating around nerve cells and the central nervous system
- Ulcerative colitis: an inflammatory bowel disease affecting the large intestine and rectum
- Celiac disease: affects the gastrointestinal tract when gluten is ingested
- Systemic lupus erythematosus: affects many organs, including joints, kidneys, brain, heart and skin
- Myasthenia gravis: affects nerve impulses that help the brain control muscles
- Systemic sclerosis: affects the skin and connective tissue
- Sjogren’s syndrome: affects glands that lubricate the eyes and mouth
- Crohn’s disease: an inflammatory bowel disease affecting any part of the gastrointestinal tract
Symptoms of autoimmune diseases are similar and also highly individualized. The same condition can show up in different ways and intensities among different people, and may come and go (called a flare-up or remission, respectively). Early symptoms of many types of autoimmune conditions are fatigue and confusion, aches and numbness in extremities, hair loss, skin rashes, swelling and low-grade fever.
It’s important to see a specialist who can identify and help create a treatment plan for different types of autoimmune diseases. Treatments usually involve medications that target the flare up, as well as identifying and eliminating any trigger foods, medications or environmental factors. Type 1 diabetes is an exception, where hyper- and hypoglycemia (too high blood sugar and too low blood sugar) is controlled with a combination of glucose monitoring and insulin, however, lifestyle modifications like nutritious eating and movement help control type 1 diabetes, as well.
What to eat to help control autoimmune disease
Nutritious eating plans to control or reduce flare-ups associated with different autoimmune diseases should be individualized. Working with a healthcare provider or registered dietitian who specializes in your autoimmune condition can help determine the best approach for you. For example, some people with ulcerative colitis and Crohn’s disease may have difficulty eating raw vegetables and fruit, and would then need to use alternative approaches to incorporating such foods into their diet (such as cooking, pureeing and mashing for easier digestion). Some common nutritional therapies for autoimmune diseases include:
Gluten-Free Diet: A strict gluten-free diet is necessary for people with celiac disease, an autoimmune condition where ingesting even small amounts of gluten can trigger an immune response that attacks the lining of the intestine. Gluten appears in products that contain wheat or wheat derivatives, barley, rye or triticale. People with other autoimmune conditions, such as psoriasis or Hashimoto’s thyroiditis, may experience fewer flare-ups when on a gluten-free diet, whereas some conditions may worsen, depending on the overall healthfulness of the gluten-free diet (it’s important to emphasize whole and fresh gluten-free foods versus packaged and processed gluten-free foods, for example).
Anti-Inflammatory Diet: During an immune response, there is an increase in the production of free radicals, which can result in an imbalance of pro-oxidants to antioxidants, known as oxidative stress. Therefore, an eating approach that is full of anti-inflammatory and antioxidant foods while eliminating known inflammatory foods could be beneficial at reversing the oxidative stress that comes with many types of autoimmune conditions. This style is similar to a Mediterranean Diet that leans heavily on fresh produce, whole grains, and healthy fats from fish, olives and nuts. Learn more about Eating to Beat Inflammation.
Plant-Based Diet: A diet that emphasizes either all (vegan) or mostly (vegetarian) plant-based foods has been connected to higher antioxidant intake, which can benefit people with many types of autoimmune conditions. Plant-based diets center around foods that grow from the ground, including beans, legumes, vegetables, fruits, nuts, seeds, grains and plant-derived oils.
Autoimmune Protocol (AIP): This temporary eating method is similar to the paleo diet and involves some phases of elimination and reintroduction of certain foods to identify triggers. Eliminated foods often include coffee, oils, alcohol, grains, dairy, eggs, legumes, nuts, seeds, nightshade vegetables, refined sugars, tobacco and more. During this phase (which typically lasts 1 to 3 months), the emphasis is on fresh produce, minimally processed meat and seafood, fermented foods and bone broth. After the elimination phase, foods are methodically and slowly reintroduced, usually one at a time, taking note of any reactions.
Foods to reduce when you have autoimmune disease
Simple sugars: Foods that contain added sugars or high-fructose corn syrup, as well as foods that are highly processed and high in carbohydrate (like white bread and pasta, cereals, pastries and baked goods) have been connected to increased inflammation. These foods are often low in fiber and other beneficial nutrients.
Certain oils: Vegetable oils (like vegetable blends, soybean oil and corn oil) and seed oils (like cottonseed, sunflower seed and sesame oil) plus peanut oil, palm oil and rice bran oil have a high ratio of omega-6 fatty acids to omega-3 fatty acids, which has been linked to chronic inflammation. These oils are cheap and chemically extracted, appearing in many highly processed foods.
Trans fats: Everyone should reduce or eliminate trans fats for overall health, and this is especially true for people with autoimmune disease, since trans fatty acids are strongly associated with inflammation. Artificial trans fats have been banned by the FDA, but despite this, foods that contain less than 0.5 grams of trans fat per serving can list 0 grams trans fat on the Nutrition Facts label. While this amount is small, it can add up quickly. Trans fats exist mostly in packaged baked goods, some margarine and vegetable shortenings, some microwave popcorns, fried fast food, non-dairy creamers, and refrigerated doughs and biscuits. If a product contains “partially hydrogenated oil” that’s a good indication it has trans fats.
Processed meat: Advanced glycation end products (AGEs) in processed meats like sausages and hot dogs, deli meats and blackened burnt meat are known to cause inflammation, and may be especially triggering for ulcerative colitis and Crohn’s disease.
Dairy: People with autoimmune disease sometimes react negatively to lactose, a natural sugar in dairy, and have fewer symptoms when dairy is limited. Foods highest in lactose include cow’s milk, cream and ice cream, and soft cheeses like spreadable cheese, Brie, Camembert, mozzarella and cottage cheese.
Excessive alcohol: Research shows that excessive alcohol consumption is often associated with “leaky gut,” which can move inflammation from the colon into other parts of the body. Avoid alcohol completely or limit it to two drinks or less per day for men and one drink or less per day for women, which is equivalent to 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof spirits.
Supplements that can help with autoimmune disease
Additional support from certain supplements could help reduce or lessen an immune response in people with autoimmune disease. Always consult your doctor before starting a new supplement.
Vitamin D: This vitamin helps keep the immune system functioning by decreasing the production of proinflammatory cytokines. Deficiency in vitamin D has been connected to several autoimmune diseases, including multiple sclerosis and type 1 diabetes. Some studies show that taking 400 IUs or more per day can reduce the risk of some autoimmune conditions by 40%.
Prebiotics, probiotics and synbiotics: A healthy gut and flourishing microbiome can help counteract the severity of several autoimmune symptoms, as well as prevent worsening “leaky gut.”
Omega 3s: The anti-inflammatory properties of EPA and DHA – two potent omega-3 fatty acids – is useful in managing autoimmune diseases, and are often recommended in therapies for rheumatoid arthritis, Crohn’s disease, lupus erythematosus and multiple sclerosis.
Anti-inflammatory supplements: Studies point to compounds in certain herbal and algae supplements as powerful suppressors of pro-inflammatory enzymes, especially curcumin, boswellia, resveratrol, ginger and spirulina.
Have autoimmune disease? Do this first.
If you suspect you have an autoimmune disease but don’t have a diagnosis yet, start there. Insist on meeting with a healthcare provider who specializes in autoimmune conditions and be prepared to take a combination of tests and discuss your symptoms and suspected triggers. If you already have a diagnosis of one or more autoimmune diseases, start by eliminating alcohol and highly processed foods first.
What else to know about autoimmune disease
Beyond food, there are several factors that can make autoimmune conditions better or worse. Consider the above recommended dietary approaches with the following in mind:
Medication: Since autoimmune conditions often come with acute or chronic pain, providers may prescribe NSAIDs or immune-suppressing drugs. NSAIDs should be avoided in the elimination phase of an AIP Diet, however, so discuss this with your doctor if you’d like to try that approach. Also, antibiotics can be helpful in treating some autoimmune diseases, such as in Crohn’s disease, but can have a negative impact on gut microbiota. If an antibiotic is prescribed, ask about following it with a probiotic or synbiotic (a probiotic + prebiotic formula).
Get some sleep: Sleep problems, including fatigue, insomnia and daytime sleepiness, are often a warning sign of autoimmune disease. And not getting enough sleep can be further harmful to the immune system. Establishing a regular sleep schedule (on weekends, too) and creating a relaxing ritual one hour before bedtime can help, as can seeing a sleep specialist.
Keep a journal: Keeping a journal to track daily food intake, as well as medication, sleep, mood, stress, movement and more can be one of your most helpful tools in helping to identify any patterns or triggers connected to flare-ups of your autoimmune disease.
Do low-impact exercises: If you’ve experienced a flare, such as the joint pain and fatigue associated with rheumatoid arthritis, you know that it can be difficult to exercise. But getting into a regular and daily movement pattern can improve quality of life with any autoimmune disease. Start with low-impact activities that are easier on joints, such as walking, yoga or swimming, and add in aerobic or cardio exercises a few times a week.
Reduce environmental toxin exposure and smoking: Smoking tobacco or long-term exposure to other toxins like air and water pollutants, crystalline silica, ultraviolet radiation or other solvents have been associated with the development of autoimmune diseases like multiple sclerosis and rheumatoid arthritis.
Jessie Shafer is a registered dietitian, team member at The Real Food RDs, former magazine editor, avid cyclist, and busy mom of two who loves to share her enthusiasm for the fun of eating well.