Most diseases and disorders have a somewhat fluid but predictable course over time, as the sufferer ages, and autoimmune conditions are no different. The information presented here is in no way absolute for all patients, and many factors affect what signs, symptoms and complications appear at different stages of life, besides simply age. However, there are some commonalities among patients in broad age ranges, and knowing about these age-based variations can help you understand and anticipate certain aspects of your disease.
One example is the fact that type-1 diabetes tends to first occur and be diagnosed during childhood and adolescence. Children’s Hospital of Boston also lists celiac disease, lupus, juvenile dermatomyositis, scleroderma, and juvenile idiopathic arthritis among those most common in this age group. Multiple sclerosis, on the other hand, is very rarely seen in this age range.
In terms of management of my autoimmune conditions during this period of my life (taking into account general health, diet and activity level, kids/no kids, hormones), what can I expect with regard to a) amount/intensity of symptoms, b) difficulty managing flares, and c) onset of additional autoimmune conditions?
Before we answer this question, it’s essential that all sufferers understand the variable nature of these disorders in terms of the parameters listed above. Therefore, there are not always well-defined answers. Having said this, there are some things that occur more frequently than others during the teen years decade.
Many of these conditions will first arise during this decade or the next, as they tend to first appear during the childbearing years. In addition, regardless of age or disease progression, staying generally healthy and active (unless directly instructed differently) is always beneficial, and may lead to reduction in symptomatology. The NIH women’s health division elaborates on this. Finally, it does appear that having had children may affect disease onset and course, as leftover fetal cells can circulate in the mother’s blood for quite a while, exposing her to potential autoimmune triggers. Still, whether this will affect your condition or not will depend on the diagnosis and severity of disease.
It’s difficult to answer a question of expectations of symptoms, flares and onset, since all conditions are different and have different disease profiles. However, since estrogen is a suspected factor in causing women to develop these disorders, and this hormone is very active during this period, it is expected that symptoms may very well first arise or increase in frequency and intensity during this period. In addition, while the numbers differ depending on the specific condition, the presence of one autoimmune disease does predispose one to other similar conditions.
As for managing flares, while it again depends on which condition we’re considering and the cycles of different hormones (flares tend to increase with higher levels), in general, this depends much more on establishing and using the ideal medication protocol tailored specifically to your individual needs. Thus, flares should be amenable to treatment in most cases during this time by having the right medications and procedures on hand when they occur. In the years prior to menopause, when estrogen is a major hormonal factor, such flares may occur more often or with greater intensity, and thus may require increased doses or additional meds.
Though it is not teen-specific, HealthCentral also offers a very brief page of information that highlights some important pearls of knowledge involving these diseases, and can be reviewed very quickly and easily, as a primer for additional information.
How will managing my overall health, the number of children I have, and hormone balance/imbalance affect my symptoms in future age decades?
As noted above, staying healthy and fit, with regular exercise, is almost always a good idea, and beneficial to patients with most conditions, whether autoimmune or otherwise. Thus doing so at an early age will most certainly help manage difficulties that arise later in life, regardless of the nature of the problem.
Likewise, careful management of hormone levels, according to your doctor’s recommendations, will also be crucial to avoiding flares or complications, at any stage of life. Not doing so may result in unnecessary problems, now and later, involving any long-term effects that disordered hormone levels may have on certain organs or other health conditions.
As far as the number of children you have, as mentioned earlier, the effect on your condition will depend on the specific disease in question. Some are completely unaffected by this status, while others may be greatly impacted. There is a fantastic website provided by the University of Wisconsin that offers information and links regarding these diseases, but also information on where and how to find support groups for teens (and others) suffering from these diseases.
Since answers to these questions depend greatly on which disease we’re discussing, a great place to start researching is the American Autoimmune Related Diseases Association website, which provides both information and a host of links to related resources. The Merck Manual home edition also presents a very concise but thorough review that is catered to the layperson.
Questions for your doctor:
- Is my specific condition affected positively, negatively or not at all by whether I have children or not?
- What medications are used to treat my disease, and what are the potential side effects? Are there alternatives to those meds used as primary therapy?
- Since I’m still a teenager, what is your recommendation regarding becoming pregnant in the future?
- Can you recommend other accurate (very important) and comprehensive sources of information for my disease?
- Are there certain foods or activities I should avoid entirely? What about during flares?
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].