My story....autoimmune comorbidity?

I’m relatively new here, so my apologies if this is a horse still being beaten post mortem. :smirk: I’ll do some other looking too. I was curious about the links between autoimmune diseases. Actually, I’m kinda afraid to ask, but I also want some additional information and perspective for the sake of my children (currently healthy…hard for a mama not to worry, though). We are planning to test them for antibodies through Trialnet in the spring. I’m grateful in advance for this community. I’ve already learned so much here.

So, a little background. Prior to my LADA diagnosis (at 37), I’d been relatively healthy–some weird neurological things unaccounted for, but largely healthy. My mom? Not so much. She was a lupus/MS patient. Her diabetes, we were assured, originated with her long term steroid use owing to those diseases. We lost her when she went low in her sleep one night (pre CGM years). She was never screened for antibodies.

Fast forward to this spring. I was pregnant and got the call that I’d failed the GTT. Was assured by my doctor that it would resolve post pregnancy. Assured with very specific and oh-so-helpful phrases like, “Well, now you know you just can’t gain 50 lbs after pregnancy or you’ll end up with diabetes.” Or “I’m confident you can manage this with diet!” OR “Now you know your body just doesn’t handle carbs very well.” Or “Chase harder (with insulin)” when I was having so much trouble meeting the 120 1 hr cutoff. I did manage to meet that cutoff eventually, but not without insane lows multiple times/day. Why not prescribe a CGM? Just why? okay…sorry. Rant over.

The point of this is to say post pregnancy things didn’t resolve. I asked for an antibodies screen, which was met by my Endo NP with “I guess we could do that.” No surprise to most who have endeavored to read this far, it was positive for GAD antibodies.It was a matter of weeks before I required insulin for every meal and basal. Cpeptide 0.3 ng/mL.

Now, after switching NPs, I have a CGM and an omnipod. Grateful for both, despite some of the frustrations. I’m considering inquiring about Afrezza at my next appointment.

The point here in addition to an introduction is to ask what sorts of comorbitity others have experienced with autoimmune diabetes? Are there any studies that you have found particularly helpful?

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I was diagnosed with a low thyroid condition about three years after my T1D diagnosis at the age of 30. It’s easily treated with one pill per day. I’ll let others speak for themselves but there are other autoimmune comorbidities coincident with T1D.

Autoimmune conditions are genetic in the sense that the genetic tendency for the immune system to start reacting to the body’s own cells is inherited. It’s not the specific autoimmune conditions that are passed down (usually). So someone’s grandmother may have had rheumatoid arthritis while an aunt had hypothyroidism while the son develops Type 1 diabetes. The same is true of allergies, the genetics are the tendency for the immune system to react to external substances is passed down, not the specific allergy. So grandma may have been allergic to cats while mom had asthma and eczema while the daughter has a peanut allergy.

In my case, I have a history of autoimmune conditions on one side of the family and a history of allergies on both sides of the family. So, I won the genetic immune-system-overreactivity lottery. Of course, these genetic predispositions also need an environmental trigger in both cases for autoimmune conditions and allergies to actually develop. I’ve apparently encountered multiple environmental triggers, because in my 30s I’ve so far developed two autoimmune conditions (Type 1 diabetes and Graves’ disease) and about six allergic conditions (severe environmental allergies, anaphylactic food allergies, oral allergy syndrome, eosinophilic esophagitis, eczema, asthma, and some other allergic conditions that I’ve outgrown).

But, just to show that genetics are only half of the story (environment is the other half), my two brothers have nothing except for mild seasonal and animal allergies (one brother also had asthma as a kid, which he’s outgrown).

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I am the proud owner of three autoimmune conditions. My lifetime goal? I want five before I depart this earth. Oh yeah, it’s obtainable.

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Nothing for me, but my son has T1D and my father, who had 10 siblings, has 3 or 4 siblings with rheumatoid arthritis and one who died of an unspecified autoimmune disease that destroyed her kidneys (potentially lupus). One grandmother on my mother’s side with MS.

This chart shows genes common to several autoimmunes.

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i didnt know there were so many little loci to consider. look at all that RA, holy cow!

I have vitiligo, which is an autoimmune skin condition. no other family members with any autoimmune disorders

I believe there are many, many more actually – at least 18 that are considered reliable and and additional several handful that are considered potentially suspect. Not to mention likely many more rare SNPS and ones that may be more dispositive in ethnicities other than European.

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Just like MarieB, not family members with Autoimmune but I have four…and if you consider PCOS and Endometriosis to be one (some do, some don’t) then I’ve reached the magic five…RA is one of them by the way…

I was diagnosed with T1D just over 3 years ago (at 29) and 18 months later got the Celiac diagnosis. I know the comorbidity of these 2 is actually pretty high.

Some related things, like autoimmune hypothyroidism, are widely acknowledged to be strongly correlated with the autoimmune aspects and not believed to be the result of high bg’s.

Many complications, like retinopathy, neuropathy, and kidney disease, seem to be very strongly correlated with high bg’s.

Other inflammatory conditions associated with diabetes, like “frozen shoulder” and the inflammatory aspects related to heart disease, it’s not so clear. I have read a couple of medical journal articles about frozen shoulder and many of them argue that high bg’s lead to frozen shoulder. At the same time - the research shows that frozen shoulder actually seems to be slightly anticorrelated with bg’s which is why I believe that these are autoimmune inflammations and not just the result of high bg’s.

When I was diagnosed (nearly 40 years ago now) the thought that T1 was autoimmune was just an unproven thought but a hunch that some docs had. Since then they’ve found many of the autoimmune markers related to T1 and it’s pretty well accepted today.

I also hold the (completely unsupported by any published study that I know of) opinion that T2 has some autoimmune inflammatory causes as well (but not the same antibodies that mark T1). My mental model is that some kind of inflammation reduces the cells sensitivity to insulin. But they haven’t found the T2 antibody markers quite so conclusively yet.

I believe this is the case for (at least) two main reasons: 1. Type 2 is a “catch-all” diagnosis for all cases of diabetes that are not Type 1 (in which category I consider Type 1.5 or LADA), Gestational, MODY, or Monogenic (have I left any out?). 2. I predict that, when discovered, there will be more genetic markers for what we currently term “Type 2” than there are for “purely” autoimmune-mediated diabetes (primarily because I believe “Type 2” involves multiple etiologies).

I believe even with the textbook complications: retinopathy, neuropathy, and kidney disease, a huge chunk of risk is NOT due to BGs (you can dramatically reduce risk by lowering blood sugar but the remaining risk as compared to the general population is not correlated with BG levels). So that makes me think autoimmunity, or some common genetic risk/physiological factor plays a role in a ton of the effects seen in T1D.
And I agree with you; I’m pretty sure that T2D has some inflammatory/autoimmune component.

I have been directly diagnosed with at least 4 AD diseases, the first of course bing T1D, but that led to excema or the other term for it… basically truly bad dandruff, but is an actual allergy to my own skin. Severe arthritis and now alarming issues with my Thyroid glands. All of these are also related to a different blood disorder where I have a truly abnormally high white blood cell count that has been called “white man’s cycle cell” which is a truly bad name as it does not react the same as Cycle Cell does for the African American population does. This high white cell count has existed longer than the diabetes, and actually was a positive thing to have as my system fought disease and infection so much better than anyone else that I ran across. I could have scraped injuries, like falling from a bicycle onto gravel type, and have them heal in days… I could have and actually did have a 3 inch long 1.5 inch deep knife cut that healed without ANY stitches sorts of things… was great until my teenage years when I finally developed T1D, after that, well, the healing started to slow down and has reached the point of dangerousness that all T1D’s face with injuries… requiring extra anti-biotics when I have surgery or get cut etc.

I would be willing to be that I have other Auto-Immune issues that just have not been diagnosed yet. Hyper active system can be a curse or a blessing… mine started with the heightened white cell count which WAS a blessing for many years… But the rest of my system started being attacked by the hyper active immune system so I am now facing all the additional issues associated with the various so-called diseases.

My biggest concern, and most damage, has been caused by too much insulin over the years… the age old “ohhh, it’s a miracle treatment for diabetics” is actually almost a lie. Man made insulin completely destroys your blood vessels over time. Making them brittle, which makes them accumulate damage over time which in turn makes them clot up with cholesterol even when the cholesterol levels are not abnormally high, it just accumulates at the various broken bits along all the minor blood vessels, thus causing even more serious circulation issues leading to a heart attack from blocked major artery requiring a stint.

The family, well, the rest of the family has various instances of the various AD issues as well, thyroid problems are rampant, and issues more closely related to sex are also prominent for the women in the family. The Arthritis runs rampant and for some of us is so severe that the hands are no longer usable due to the enlarged knuckles preventing the bending of fingers in normal fashion to the point that some of the fingers are already permanently bent at odd angles etc.

Having a mix of European bloodlines AND American Indian Bloodlines has made strict diagnosis a bit harder it seems. Irish father, from what we can tell, ALL Irish on his side, while my mother is a mix of European from Switzerland, France with 50% American Indian from two separate tribes of Cherokee Indian. Quite a mix there.

I think most of the Autoimmune issues came from the Irish side, at least it is my Father’s side of the family that has the most history of those types of issues, from my Mother’s side not enough records were kept to know exactly what to expect but she definitely has the issues that tend to follow the female sides of families and not the male sides of issues. That is where the 2nd exposure to Arthritis comes from and is what is making that diagnosis harder. It appears that I have at least two forms of Arthritis and the GP’s never seem to be able to figure out which one to treat.

Fighting insurance companies means that getting treatment for anything is a problem as most of us are more than familiar with. I would get coverage to start on a pump only to have the insurance drop the coverage almost immediately after I had met the initial deductibles… so now, I am back to 3-4 shots of insulin per day to attempt to keep the sugar levels within a reasonable range. Severely underweight, so having difficulties with having NO fallback if sugar level drops, my lows are so severe that I end up below 40 on a quite regular basis just due to a very slight increase in activity levels.

I was diagnosed with MRSA when I had a very small infection on my right foot, but because of insurance, I was stuck with a physician that stated on first meeting that since I was a diabetic I was going to lose the leg regardless and proceeded to not treat me correctly to the point that yes, I did develop a very bad infection and thus lost the leg. There is more to that story but not worth the effort of describing how bad the insurance issues are nor how bad our hospitals are in treating people at the lower income levels.

Sorry, not sure where I am really going with this post except to cover the different Auto-Immune issues related to the T1D that I have also been diagnosed with. Ohh, and the fact that insurance refuses to allow treatment for about 80% of those diagnosis at this stage of things. The ACA has helped to a certain extent, but they are very difficult to get them to cover anything. Being in Pennsylvania there is even less help available since the Republican controlled State Govt refuses to accept the Federal help with Medicaid coverage, and thus reduced total coverage options that I have here. Being completely disabled now, I am forced to accept the Medicare at the most basic level and have absolutely NO options to get additional coverage for the 20% that is not covered, I can choose to not get any help and flat out purchase better coverage, complete with that extra 20% medi-gap coverage plan, but I am not legally allowed to purchase a medi-gap package unless I pay for the whole coverage package from a SINGLE provider. That is what the Republicans have blocked here in PA.

No longer really matters much, as my life expectancy has recently been cut way back due to heart issues and no way to get coverage for help with that aspect of my health.

Losing that leg means that I have to manually exercise daily, just to keep the muscles toned enough to be able to haul around this 25lb piece of steel that is all that is covered by ACA, and still have to pay that 20% bit out of a pocket that prevents me from eating more than a single meal per day, which is part of the reason I have such an issue with low BS, especially late night, during sleep.

Oh, the system is set up in such a way that if I actually do find work, and earn more than $400 per month, I lose ALL aid. Our system here in USA is so badly broken that folks like me have no way out of the hole. Unless we may be lucky enough to have a wealthy family member die with a large life policy that might be left to us. I can attest that MY family has no-one to fill that role.

I would prefer working, but I physically can only handle so much, I can no longer lift and carry 50lb boxes, which seems to be a minimum requirement on all the job applications I have filled out, and can not afford a part time job that would only cut my total care coverage and not give me health care since it is only part time… worst catch 22 I have faced so far in my life despite having worked since I was 12 years old, and paid into the Social Security system as well as the other tax they take to cover health related stuff. Those taxes are taken regardless of your age, so 40+ years of work, but only a very minimum disability that prevents me from even attempting to earn my way out of the hole.

It can be hard to distinguish autoimmune and allergic conditions, and I actually think they are very closely related in that they’re both caused by the immune system attacking when it shouldn’t, which is why I included the six allergic conditions I live with in the same post as the two autoimmune conditions I live with. I’ve had one of my conditions, eosinophilic esophagitis, called “autoimmune” by some doctors and “allergic” by others, and journal articles have the same type of flip-flopping between the two terms, so it seems even the medical community can’t decide on whether some things are autoimmune or allergic. And, although I’ve always considered my eczema as allergic in the past, the fact that I’ve had it on my hands for about six months non-stop now is making me seriously doubt that it’s actually being caused by any allergen exposure as opposed to my body attacking my own skin just for the sake of attacking.

@Jen; Eczema can be caused by stress as well as allergens. Mine is actually called contact dermatitis, but as well as contact with things that caused it can appear for no real reason but stress, sometimes some mild stressor.

I have multiple sclerosis, Sjogren’s Syndrome, Hashimoto’s Thyroiditis, pernicious anemia and t1 diabetes.

It’s kind of a pain in the butt, you know? I’m so sorry about your mom. MS is easier now because of advanced treatment options for some patients. I’m down to 1 relapse a year with minimal progression (you wouldn’t know I have MS by looking at me). The others are easy to manage. Medication, eye drops, B12 injections, supplements and whatever.

My family is littered with lupus, rheumatoid arthritis and Hashimoto’s.

I recently had my genetics analyzed and I carry a gene that is associated with five or six autoimmune diseases. I shouldn’t have procreated - lol.

…would be curious to know what similar environmental triggers we could have been exposed to if you have any theories. I was diagnosed with Graves disease at 21, asthma at 32 (although I think it developed in my late 20’s), and T1D earlier this year at 34. Prick test a couple years ago showed I’m allergic to a lot of different things–grass, molds, weeds, trees, cats, dogs, etc. Father has asthma, mother has eczema (which my brother inherited), and there is a history of type 1 and type 2 diabetes on my father’s side of the family. No history thyroid disease that I know of though. I only had moderate seasonal allergies as a child.

I’ve joked that my body must really hate itself, even though it’s truly not all that funny. I still don’t let it stop me from most things, but I’ve learned the hard way since T1D diagnosis that I have to mind my body and my limits.

LOL @Rphil2, #lifegoals

Has anyone read the book Eat Dirt? I just started it last night and the author’s premise is that autoimmune diseases can be controlled and potentially cured with diet alone. Has anyone had success with this? So far diabetes is my only autoimmune disease, and I’m hoping it will be the only one.