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Stronger or Weaker? Your Immune System’s Fighting Power With Autoimmune Disease

The human immune system contains complex and powerful machinery capable of keeping us healthy under most circumstances, by attacking a myriad of active and potential pathogens simultaneously.  On occasion, as seen with autoimmune disease and other conditions, this system malfunctions, yielding various disturbances in these immunological mechanisms.  Here we discuss the possibility of autoimmune disease affecting the body’s normal immune function, hindering it from doing its job effectively.

If I have an autoimmune condition (or multiple conditions), what does that mean in terms of my immune system’s ability to attack outside disease?

For example, am I more likely to catch an infection and/or have trouble fighting outside viruses or bacteria because my immune system is so busy attacking itself?

Our immune system is an extremely powerful tool that aids us in the safe navigation of a world filled with viruses, bacteria, fungi and other bugs.  Unfortunately, sometimes this formidable ally partially devotes itself to more nefarious purposes, attacking the body’s own tissues and resulting in autoimmune conditions.  Luckily, the immune system is so robust and potent that in terms of autoimmune disease limiting its ability to perform its normal duties, the vast majority of patients can fight off most infections without a problem, despite the disrupted autoimmune process occurring simultaneously.

Naturally, there are sometimes exceptions, but except perhaps in very special scenarios, there should not be an issue regarding the interaction of normal and dysfunctional immune processes.  If anything, the supercharged immune system may indeed make normal immune responses more vigorous, especially if certain antibodies experience cross reactions between outside and internal real and perceived pathogens.  However, this is merely educated supposition and not material fact.

Additionally, it has been proposed that infection-fighting proteins may be involved in development of autoimmune diseases, suggesting that while not normally influential in altering the body’s ability to fight infections, autoimmune disease may in fact partially be the result of such infectious triggers, according to a University of Michigan study and a Johns Hopkins study.

Alternatively, others believe in something called the hygiene hypothesis, which suggests that the rising incidence of autoimmunity around the world may be the result of actually being “too clean”, so to speak.  This notion states that our lack of encountering as many pathogens as our ancestors has possibly turned our immune systems looking inward, by virtue of no longer having to battle as many outside invaders.  Clearly, our understanding of autoimmune conditions and its causes are still at a very rudimentary stage.

It should be noted that there is a major difference between autoimmunity and immunodeficiency, which despite completely different mechanisms, are often confused by members of the lay public.

In contrast to autoimmune disease, someone with an immunodeficiency (also known as immunocompromised) has one or more defects that render the body incapable of performing its standard duties protecting against foreign invasion, resulting in a host of possible common and opportunistic infections.  The most well-known form of immunodeficiency is probably AIDS, secondary to HIV inoculation, where the virus prevents the immune system from doing its job.  Fortunately, advances in understanding and treatment of the disease have changed this once terminal illness into a usually manageable chronic disease.

And of course as autoimmunity sufferers know all too well, immunosuppressive drugs used to combat their disorder(s), such as steroids and methotrexate, may very well have undesirable effects on the ability to stave off microbial invasion.  But this is a result of the treatments rather than the disease itself.

On the other hand, there are instances in which the two dysfunctional processes (autoimmunity and immunodeficiency) occur together, in which case the patient would clearly experience the manifestations of both illnesses, for example in this study from the University of Florida College of Medicine, which looked at associations between the two.  Such cases would fall under the heading of very special scenarios mentioned above.  Interestingly, though it doesn’t seem well understood, it appears that most cases involve people who have been diagnosed with some sort of immunodeficiency subsequently developing or being diagnosed with autoimmune condition(s).  What this association or the order of appearance means is uncertain.

With an overactive immune system causing autoimmune disease, should I take precaution with putting stress on my immune system, i.e., stay away from flu and other vaccines?

Although as noted above it appears that infection may be among the initial triggers of autoimmune disease, it does not seem that the reverse is true; i.e. autoimmune conditions, in and of themselves, do not particularly predispose someone to more infections and successful foreign invasion.  Still, while the evidence for such a phenomenon in the literature is lacking, there are some patients on forums that believe this to be the case, or at least suspect it as a possibility.

Having said this, it should be mentioned that anytime one has issues with his or her immune system, whether it be overactive or underactive, he or she should absolutely do whatever possible to minimize generalized stress on a daily basis.  As anyone who has been under substantial stress and then developed a cold or other infection can testify, there is certainly something to the notion of such anxiety lowering the barrier to invasion, though the way this occurs is unknown.  Also, undergoing significant stress while dealing with autoimmune conditions may provoke a flare or symptoms, offering another reason for autoimmune patients to try as much as possible to manage stress and anxiety.

In terms of the “stress” put on an immune system during vaccination, this is not normally a problem for autoimmune patients, and should certainly not be a reason on its own, in most cases, for avoidance of immunizations.  However, since many patients with autoimmune conditions may be on some sort of immunosuppressive regimen, such therapy may require (but often still doesn’t) an adjustment or outright avoidance of some vaccines.  Two articles from the CDC and Euro PubMed Central give opinions on the topic. This decision will also likely depend on the type and formulation (live vs. dead, for example) of the specific vaccine in question.  For these reasons, as always, it is best to check with your doctor regarding these situations and whether or not to abstain from certain injections or other vaccinations.

Questions for your doctor:

  • Do you believe that autoimmunity can impact the body’s ability to fight infection?  What is the evidence for/against this possibility?
  • Given my specific condition(s), which immunizations, if any, should I not receive?
  • Can you recommend a good source for more information on the topic of autoimmune and immunodeficient interactions?
  • Which immunosuppressants make it most likely I will experience infections and/or be required to avoid certain vaccines?
  • Is it possible that my autoimmune condition can actually help in fighting some infections because of the hyperimmune state it results in?


About the Author
Dr. Rothbard is a professional medical writer and consultant based in New York City, specializing in medical education articles targeted at a variety of audiences, from children through clinicians.  After leaving medicine, he worked as a biology and medical science educator for several years, before deciding to pursue writing full-time.  He may be reached at [email protected].

This blog post was originally published by AutoimmuneMom.com, written by Dr. Rothbard, and first published on Aug 29, 2013.

This post contains the opinions of the author. AARDA is not a medical practice and does not provide medical advice, diagnosis, or treatment. It is your responsibility to seek diagnosis, treatment, and advice from qualified providers based on your condition and particular circumstances. AARDA does not endorse nor recommend any products, practices, treatment methods, tests, physicians, service providers, procedures, clinical trials, opinions or information available on this website. Your use of the website is subject to our Privacy Policy.


  1. Judy Eaton says:

    I am a woman of 68.
    I am intrigued as to why I’ve never had flu, I never catch infections from others like coughs and colds and I am never ill.
    I am not complaining but am interested in finding out whether this is pure luck or is it connected with my immune system?

  2. keldra says:

    I developed interstitial cystitis 30 years ago and promptly stopped getting the annual cold. I got about 6 colds in a row when I started working w/ preschoolers 20 years later and then I became impenetrable again. I feel in general my resistance is higher to what’s catching around me. Obviously, I’d rather have the colds.

    • Bret says:

      I just started searching for the same thing! I can’t believe there are others with this “SUPER POWER” I have noticed that since I was diagnosed with autoimmune disease, mine being Connective Tissue Disorder, that I don’t get the common cold. I’ve suspected this is the case over the last 2 years. When everyone in my house passes the yearly colds around my throat will become slightly sore for a few hours when it’s my turn. I feel like I’m mildly getting sick and then it’s gone usually the same night or the next morning. My 8 year old just got some of the worst crud that I’ve ever seen. She was down for 7 days. So congested that we almost went to the ER but if slowed and cleared up. My wife had something almost as bad a few weeks previous. So after the 8th day when my kid is done, My throat get super sore for a few hours and my nose runs for a few minutes a couple times in a day. My nose cleared up fast and my throat goes to mildly sore. I’m now starting to realize that because of the autoimmune disease, it fighting more than my own cells with these autoantibodies that are stuck in my system. I don’t like having autoimmune disease, but the benefits have been wonderful. I don’t have a typical serious disease like Lupus or MS, I have a pretty active IBD. Anyone else have this seemingly positive super power?

  3. adelle says:

    if you have lupus does this lower your changes of becoming ill from colds and bugs because your immune system is over active?

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  5. Lynn says:

    Why do I have a normally good immune system, but have granula annul are , skin condition, which is meant to be an auto immune condition, why is one system good and the not? Thanks Lynn

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  8. abi says:

    I honestly believe that my auto immune disease(alopecia ) negatively affects my ability to fight infections and bugs, does anyone else find this, or is it just me? Although my immune system is overactive and fights my hair, it doesn’t seem to fight colds and bugs that I pick up, and I tend to be poorly a lot, and have things for longer than everyone else? admittedly, I work in all primary schools in my area, and so have contact with a lot of kids, which may not help.

  9. i have pots, cfs, jhs and an underactive thyroid….in the past 3 years i have gone from 1 illness to another…is my autoimmune disorder causing lower immunity

  10. bonnie says:

    I have hashimoto’s disease combined with a multi nodule goiter, i suffer from chronic fatigue, severe depression and anxiety. .i have found thatin the last couple of years I’m really struggling to fight off infections, is this normal ..i feel like I’m going insane with the stress and tiredness day in day out .. I’ve just had a really bad stomach bug which took me 6 days to fight off , a cough and cold for 6 weeks. .am i just going mad ?????

  11. Abishay says:

    I want to know can autoimmune disease makes immune system weak … Person with autoimmune disease has higher risk of infection & catches it ?? In Person with autoimmune disease… Does immune system fights outside invaders/viruses that enters in bodyor just attacks its own healthy cells Iam a nurse i wanted to know with autoimmune disease it is safe to work with infected /serious patients or i will catch infection easily???

  12. Joeyinuk says:

    I have had a psoriasis flare up for almost 2 years. In this time I’ve moved from the UK to Australia hoping a better climate would help me manage my condition. I used to get cold and flu regularly in the UK but in the past 2 years my over active immune system has kept them all at bay…. Until today. Everyone has had this cold at work and now I’m afraid I have it too. I’m completely knocked of my feet with extreme exhaustion, high temperature, muscle aches and quite unwell.

  13. Anna says:

    I’m one of autoimmune people who never catch colds or flus. It says above that “there are instances in which the two dysfunctional processes (autoimmunity and immunodeficiency) occur together, in which case the patient would clearly experience the manifestations of both illnesses,”…..so you would suffer from both your autoimmune diseases and be highly susceptible to catching flus and cold….” for example in this study from the University of Florida College of Medicine, which looked at associations between the two. Such cases would fall under the heading of very special scenarios mentioned above. Interestingly, though it doesn’t seem well understood, it appears that most cases involve people who have been diagnosed with some sort of immunodeficiency subsequently developing or being diagnosed with autoimmune condition(s). What this association or the order of appearance means is uncertain.” I was always resistant to colds and flus, except for a couple bad cases on tonsillitis when I was a kid and young teen. At age 25 I started getting weird unexplained symptoms and autoimmune problems: night sweats, bald spots on my head, fainting spells, then psoriasis, ulcerative colitis, iritis, and ankylosing spondylitis. Then, more recently, I’ve been diagnosed with Lyme, Bartonella, two Rickettsial infections, mycoplasma, and HHV6. Crazy! I remember having HSV1 (in the lower area where you usually get HDV2). It was horrible but it did not last long and oddly it has never ever come back in 25 years. I don’t understand that either.

  14. Lauren says:

    Pre-celiac biopsy: Many colds, most turning to bronchitis. Probably sick half the time between ages 10 and 48.

    Since diagnosis via biopsy and unintentional gluten challenge (and by the way, celiac blood tests were negative), just one cold in six years. Also much better thyroid numbers (TSH).

    Always wondered if blood tests are less reliable for those of us with HLA-DQ8?

  15. Virginia says:

    This article would benefit from including the role of specific cytokines and T helper cell systems.

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