Women are significantly more likely than men to develop autoimmune diseases, particularly during their reproductive years, making early awareness and stress management essential for maintaining long-term health, according to a Universitas Gadjah Mada (UGM) expert.
Professor Nyoman Kertia, a rheumatology, internal medicine, and herbal medicine specialist at UGM’s Faculty of Medicine, Public Health, and Nursing (FK-KMK UGM), said autoimmune diseases occur when the immune system mistakenly attacks the body’s own healthy tissues instead of protecting it from harmful pathogens such as bacteria, viruses, and parasites.
“If we estimate that around two percent of Indonesia’s adult population is affected, that would amount to approximately four million people living with autoimmune diseases,” Professor Nyoman said on Tuesday (July 21).
He explained that autoimmune diseases can affect virtually any organ, including the skin, kidneys, lungs, liver, and joints. While some patients experience only mild symptoms or remain symptom-free for years, others may develop severe, life-threatening complications.
Women account for approximately 80 percent of autoimmune patients, while men represent about 20 percent. According to Professor Nyoman, hormonal factors play an important role, as estrogen influences immune system activity, making women more susceptible to autoimmune disorders during their reproductive years. The condition can also pose serious risks during pregnancy, underscoring the importance of early detection and appropriate medical care.
Although genetics contribute to autoimmune diseases, Professor Nyoman emphasized that hereditary factors alone do not determine whether someone will develop the condition. Environmental factors—including air pollution, unhealthy diets, and psychological stress—also play a significant role.
“Many patients search for information about their condition online. Unfortunately, misunderstandings often make them even more anxious. In fact, stress itself can worsen autoimmune diseases,” he said.
Among these risk factors, Professor Nyoman identified stress as one of the most important triggers. He noted that autoimmune diseases increasingly affect university students as well as working professionals because of prolonged psychological pressure.
“I have treated many students from UGM and other universities who were previously healthy but developed autoimmune diseases after experiencing academic pressure and various life challenges,” he said.
Professor Nyoman classified autoimmune diseases into two broad categories. Organ-specific autoimmune diseases affect a single organ, such as Hashimoto’s disease, which attacks the thyroid gland and may cause fatigue, weight gain, and reduced daily functioning. Other examples include autoimmune disorders affecting the pancreas, which can lead to type 1 diabetes, as well as diseases involving the kidneys and other individual organs.
Systemic autoimmune diseases, by contrast, affect multiple organs simultaneously. Lupus is among the most common examples, potentially involving the skin, joints, kidneys, lungs, and other organs. Other systemic autoimmune diseases include rheumatoid arthritis, scleroderma, and several autoimmune rheumatic disorders.
To reduce the risk of flare-ups, Professor Nyoman encouraged patients to manage three major triggers: excessive fatigue, stress, and prolonged exposure to sunlight.
“In my opinion, these are the three most important things: avoid excessive fatigue, manage stress, and limit prolonged sun exposure,” he said.
He advised patients to balance daily activities with adequate rest and sleep, avoid becoming overwhelmed by their diagnosis, and use sun protection whenever prolonged outdoor activities are unavoidable.
Professor Nyoman added that no strong scientific evidence currently links specific foods to autoimmune flare-ups because triggers vary from one patient to another.
“That is why I encourage patients to understand their own bodies. In Javanese, we call it dititeni—carefully observing what you eat and whether certain foods make your symptoms worse,” he explained.
He also highlighted the importance of long-term treatment adherence. Some patients discontinue medication once they begin feeling better, mistakenly believing they have fully recovered. Others become discouraged after receiving their diagnosis and lose hope, both of which can complicate treatment.
Current therapies rely largely on immunosuppressive drugs that reduce immune activity to prevent the body from attacking itself. While these medications remain essential, Professor Nyoman said researchers continue exploring approaches that restore normal immune function rather than simply suppressing it.
“I became interested in herbal medicine research because I hope future therapies will be able to restore normal immune function instead of merely suppressing the immune system,” he said.
Professor Nyoman concluded by emphasizing that maintaining both physical and mental well-being remains one of the most effective ways to reduce autoimmune risk. He encouraged people—particularly those with a family history of autoimmune diseases—to manage stress, avoid excessive fatigue, limit prolonged sun exposure, and adopt healthy lifestyles by avoiding smoking and alcohol while maintaining a clean environment.
“The principle remains the same: avoid excessive stress, do not push yourself to the point of exhaustion, and limit excessive sun exposure,” he concluded.
Author: Jelita Agustine
Editor: Gusti Grehenson
Post-Editor: Priyanandaningrat
Photo: Magnific