The waxing and waning of symptoms in autoimmune diseases often follow seasonal patterns. Read on to learn why this happens and what you can do to avoid these effects.
Autoimmune diseases are caused by a combination of genetic and environmental factors. That is, people with certain genes develop autoimmune diseases and experience flares and relapses when they’re exposed to certain environmental triggers. For instance, people with autoimmune diseases often notice significant seasonal influences on their symptoms, whether they live in a mild tropical climate or fully experience all four seasons.
In temperate zones, the fall in barometric pressure heralding a summer thunderstorm can cause joints to swell and throb, and skyrocketing pollen counts in spring can cause flares, worsening symptoms in all but a handful of autoimmune disorders. And while sunshine can improve the scaly shins of pretibial myxedema in Graves’ disease patients and the rash of progesterone-related dermatitis, sunlight can worsen symptoms in patients with lupus.
Sun cycles, humidity, barometric pressure, temperature and altitude also influence autoimmune disease development. Studies show that exposure to sunlight, which provides active vitamin D, helps protect the skin from cellular damage and offers protection from certain autoimmune diseases, particularly multiple sclerosis.
Studies show that low vitamin D levels are common in patients with MS and patients with Graves disease. In patients with Graves’ disease it’s suspected that a mutation to the vitamin D receptor might reduce the absorption of vitamin D.
Allergies, Relapses and Flares
It’s no wonder that the waxing and waning of symptoms, as well as the periods of remission that alternate with periods of relapse, are often attributed to seasonal changes. In Japan, allergies to cedar pollen in both spring and fall are responsible for most new cases of Graves’ disease and relapses in patients who had previously achieved remission.
In one study from the University of Tokyo a florist with autoimmune thyroiditis and seasonal allergic rhinitis was found to have two postpartum and 7 spontaneous episodes of transient hypothyroidism during a five-year observation period. The spontaneous episodes occurred in the spring and fall, recurring twice each year during the seasons of her allergic rhinitis. In most of these spontaneous episodes and also during the postpartum episodes, a period of transient hyperthyroidism occurred before the onset of hypothyroidism.
The contribution of allergies was demonstrated by her markedly increased levels of immunoglobulin E, which is produced during the allergic response, and high antigen-specific IgE levels for pollen extracts of cedar and ragweed. This correlation between high IgE levels and a worsening of symptoms or disease flare is a common occurrence in patients with Graves’ disease and in celiac disease.
Stress
Periods of stress are known to worsen autoimmune disease symptoms because of the detrimental effects of stress on the immune system. The winter holidays often trigger flares especially in patients who allow themselves to become exhausted, both physically and financially. Falling temperatures are also known to exacerbate symptoms in patients with Raynaud’s syndrome, Sjogren’s syndrome, and rheumatoid arthritis.
And although taking a tropical vacation and relaxing in the sun may seem the perfect solution, avoiding the time spent in the chilly outdoors, dressing properly, and relaxing inside with a glass of red wine or cup of hot tea rich in catechins can go a long way toward combating seasonal stressors. So can watching pollen counts and limiting pollen exposure by covering hair and skin, keeping windows closed during peak pollen periods, and showering soon after coming indoors when the pollen count is high.
Resources:
Moore, Elaine, Autoimmune Diseases and Their Environmental Triggers, Jefferson, NC: McFarland Publishing, 2002.
Yamamoto M, Shibuya N, Chen LC, Ogata, E, Seasonal Recurrence of Transient Hypothyroidism in a Patient with Autoimmune Thyroiditis, Endocrinology Jpn, 1988 Feb; 35(1): 135-142.
Chandra Shekhar, Vitamin D Protects the Skin? The Scientist, Feb 30, 2007, http://www.the-scientist.com/news/home/44290/
