Most people have a general sense that the immune system is supposed to protect you. Fight off a cold, clear out an infection, heal a cut. And most of the time, it does exactly that. But for millions of people, the immune system doesn't just fight foreign invaders — it turns around and starts attacking the body it's meant to protect. That's autoimmunity, and it's at the core of almost everything I treat.
If you've been diagnosed with a rheumatic condition, or you're still trying to figure out what's going on, here's how I explain it to my patients.
Your Immune System
I like to think of it as your body's military. Its job is to detect threats, mobilize, and eliminate them before they cause damage. And like any military, it has different branches.
The innate immune system is like the National Guard — fast to deploy, first on the scene, and it doesn't need to know exactly what the threat is. It just knows something's wrong. That redness and swelling around a cut? That's it doing its job.
The adaptive immune system is more like Special Forces — slower, but trained to lock onto a specific target. And once it does, it remembers. That's how vaccines work: you're training this branch to recognize something before it ever shows up for real.
Together, they do one thing that matters above everything else: they distinguish what belongs in your body from what doesn't. When that ability breaks down, that's where autoimmune disease starts.
When the Intelligence Is Wrong
In autoimmune disease, the military gets bad intelligence. The firepower is real — the inflammation, the immune activation — but it's aimed at the wrong target. Your own tissue.
Where it's aimed determines the disease:
- Rheumatoid arthritis — the lining of joints.
- Lupus — joints, kidneys, skin, other organs.
- Psoriatic arthritis — same immune process behind psoriasis, now hitting joints.
- Ankylosing spondylitis — the spine and sacroiliac joints.
- Scleroderma and myositis — connective tissue and muscles.
- Vasculitis — the walls of blood vessels.
Different target, different disease. Same underlying problem.
Why does this happen? We don't fully know. Genetics, environmental triggers, infections, hormones — usually some combination that tips things in the wrong direction.
About Inflammation
Inflammation isn't inherently bad. It's how you heal. The problem is when it's chronic and misdirected — your immune system keeps activating against your own tissue, and that sustained response causes damage that accumulates over time.
This is why these conditions tend to get worse if they're not treated. And it's why so many of them look similar early on. Fatigue, joint pain, morning stiffness, brain fog — these are all symptoms of immune activation. They show up across a lot of different diagnoses, which is part of what makes sorting things out take time.
What Treatment Is Actually Trying to Do
Most of what I prescribe is aimed at one of two things: calming the overall inflammatory response, or interrupting the specific part of the immune system that's causing the problem. Some medications do this broadly. The newer biologics target very specific proteins or cell types.
The goal isn't to shut the immune system down — that would just trade one problem for another. It's more like turning down a volume knob than cutting a wire.
A Few Things Worth Knowing
They're not the same as a weak immune system. Autoimmune disease isn't your immune system failing to do its job — it's doing it too hard, in the wrong direction.
Getting the right diagnosis takes time, and that's not a failure. A lot of these conditions share overlapping symptoms early on, and it can take months to get to a clear answer. Part of what I do is work through that picture carefully, sometimes over several visits, until we have something solid enough to act on.
← Back to Restore Rheumatology