Autoimmune diseases are complex, often misunderstood, and can have far-reaching impacts on family health—especially for women, children, and caregivers. Whether it’s navigating fatigue, identifying red-flag symptoms, or understanding inherited risks, early awareness is key.
In this “Ask the Expert” session, Dr. Anindita Santosa, Consultant Rheumatologist and Founder of Aaria Rheumatology, answers real and relatable questions from parents and individuals concerned about autoimmune risks. Her detailed responses offer clarity, compassion, and practical steps for prevention and early action.
Expert Q&A with Dr. Anindita Santosa
Here are the commonly asked questions about autoimmune diseases to be answered by Dr. Anindita Santosa:
Can a woman with an autoimmune condition get pregnant? Will it affect the mother’s health or the baby?
Dr. Anindita:
Yes, women with autoimmune conditions can get pregnant. With proper planning, disease control, and the right medications, many women have safe pregnancies and deliver healthy babies.
Note: Autoimmune diseases don’t automatically prevent pregnancy. The key is to achieve good disease control before conception. Some medications may need to be stopped or switched before trying for a baby. And while there are some risks to both mom and baby—like preterm birth or neonatal lupus—these can often be mitigated with close monitoring by a rheumatologist and obstetrician. With the right care, most pregnancies proceed smoothly and babies are born healthy. So yes, it’s absolutely possible—just don’t DIY it!
Is autoimmune hereditary?
Autoimmune diseases can have a genetic component, but not all are inherited.
Note: Autoimmunity is influenced by both genetics and environment. Just because someone in the family has lupus or rheumatoid arthritis doesn’t mean others will get it too. It’s more of a shared predisposition than a guarantee.
Can supplements like vitamin D, omega-3, or exercise help prevent or manage autoimmune problems?
Yes, there’s evidence that vitamin D, omega-3 supplements, and regular exercise can help support immune balance and reduce inflammation. While they can’t “cure” or act as “miracle preventers” autoimmune diseases, they may reduce risk and help manage symptoms when used alongside medical treatment.
Note: Vitamin D helps regulate immune responses and low levels have been linked to conditions like lupus, rheumatoid arthritis, and MS. Omega-3 fatty acids (like from fish oil) can reduce inflammation and may ease joint stiffness in some autoimmune diseases.
Exercise is another powerful tool—it improves circulation, reduces stress hormones, and boosts feel-good endorphins. Regular moderate activity (think walking, swimming, yoga) can lower chronic inflammation and may reduce the risk of developing certain autoimmune conditions.
BUT—and here’s the important bit—these are supportive strategies, not stand-alone cures. They work best with your prescribed treatment plan, not instead of it. Think of them like bonus points for your immune system.
Does exercise really help?
Yes, exercise has been shown to help reduce fatigue, improve mood, strengthen muscles, and reduce inflammation—all of which are beneficial in autoimmune disease management.
Note: Regular movement, even gentle forms like walking or stretching, can help regulate immune responses, reduce joint pain, and boost energy. It’s not about intense workouts—it’s about consistency and tuning into your body’s limits. Exercise also helps fight stress, which is a known trigger for flares in some autoimmune conditions. So yes, exercise is your immune system’s friend—as long as you don’t overdo it during active flares!
Postpartum fatigue, hair loss, itches, poor immunity—could it be autoimmune?
Yes, it’s a good idea to go for a check-up. Postpartum symptoms can overlap with thyroid problems, nutrient deficiencies, or early autoimmune conditions. A few blood tests can help screen for common causes.
Note: Postpartum changes can be intense—your immune system, hormones, and sleep are all adjusting. What you’re describing could be a mix of common issues like iron deficiency, thyroid problems (like Hashimoto’s), or even early autoimmune activity. A basic screening panel including full blood count, thyroid function, vitamin D, ferritin, and ANA (autoimmune screen) is a good starting point. Don’t panic—but definitely don’t ignore it. Your body is whispering now; listen before it starts shouting.
Can untreated allergy lead to autoimmune disease? Can we “train” allergies by exposure?
No, allergies don’t directly lead to autoimmune diseases. They are different types of immune system conditions. And while “training” your allergy works in specific cases like immunotherapy, it’s not safe to self-expose without guidance.
Note: Allergy and autoimmunity both involve the immune system, but in very different ways—one overreacts to harmless things, the other attacks your own body. Untreated allergies don’t turn into autoimmune diseases, but they can worsen quality of life and increase inflammation. As for ‘training your allergy,’ yes—there is such a thing as desensitization (like allergy shots or sublingual tablets). But it’s a medical process, done in a safe, controlled setting. Trying to expose yourself to triggers on your own can backfire and cause severe reactions. Always talk to an allergist before trying that route!
Is my parenting fatigue normal, or something immune-related?
It’s common to feel tired as a parent, but if the fatigue is overwhelming, persistent, and doesn’t improve with rest, it could be a sign of something more, including autoimmune or thyroid issues.
Note: Parenting is exhausting—but autoimmune-related fatigue feels different. It’s like running on empty even after sleep and often comes with other signs: joint pain, brain fog, hair loss, or frequent infections. If your fatigue affects your daily function or comes with other unexplained symptoms, it’s worth getting a medical check-up. Blood tests can help rule out thyroid issues, vitamin deficiencies, or autoimmune conditions. Listen to your body—normal tiredness recovers with rest; immune-related fatigue doesn’t.
My child seems tired despite sleeping well—should I worry?
If a child regularly complains of tiredness despite sleeping well, it’s worth checking for underlying causes. It may be something simple like low iron, but chronic fatigue can sometimes point to thyroid or autoimmune issues too.
Note: Kids aren’t usually lazy by nature—if they say they’re tired a lot, it could be their body’s way of asking for help. Consider checking for iron deficiency, thyroid function, or infections like EBV. Rarely, fatigue can be an early sign of autoimmune conditions, especially if there are other symptoms like joint pain, weight loss, or swollen glands. It’s best to start with a paediatrician who can run some basic tests. It might turn out to be nothing, but it’s always better to check early than ignore and regret it later.
Is my joint pain just age—or could it be autoimmune?
Morning joint pain and stiffness can be a red flag for autoimmune conditions like rheumatoid arthritis. If it lasts more than 30 minutes or happens daily, it’s worth getting checked.
Note: Pain that’s worse in the morning and improves throughout the day is a classic pattern in inflammatory arthritis. It’s different from osteoarthritis, which tends to worsen with activity. Blood tests like ESR, CRP, rheumatoid factor (RF), and anti-CCP antibodies can help. An early diagnosis makes a huge difference—don’t brush it off as just ageing. Even young people can get autoimmune arthritis!
Is it true that stress triggers autoimmune disease? How can parents manage stress?
Yes, stress is a known trigger that can worsen autoimmune conditions or even contribute to their onset. Managing stress doesn’t mean eliminating it, but learning how to cope can protect your health.
Note: Chronic stress affects your immune system—it increases inflammation and may trigger or worsen autoimmune flares. While we can’t avoid stress (especially as parents!), we can build in buffers: sleep, mindfulness, regular exercise, asking for help, and taking even short breaks for yourself. Stress doesn’t cause autoimmune disease directly, but it’s like gasoline on a fire if one is already brewing. So managing stress isn’t selfish—it’s survival.
My son gets recurring rashes with no clear cause—could it be autoimmune?
It’s possible, but without seeing the rash and knowing more about other symptoms, it’s hard to say. Some autoimmune diseases do cause recurring rashes, but allergies and viral infections are more common causes in children.
Note: To know whether a rash is from allergy, infection, or something autoimmune, we need to consider how the rash looks, how long it lasts, and if it comes with other symptoms, like fever, fatigue, joint pain, or swollen glands. Autoimmune rashes often have specific patterns and may not itch. If the rashes are frequent, unpredictable, or come with systemic signs, it’s worth seeing a doctor for more tests. A basic workup might include allergy tests, full blood count, and sometimes an ANA test to screen for autoimmune issues. You’re not overthinking it—it’s smart to follow up if things don’t add up.
Sometimes I get itchy red skin patches—not eczema. Could it be autoimmune?
Yes, autoimmune diseases can affect the skin, sometimes with red, itchy patches. But to differentiate it from eczema, hives, or other causes, a proper skin assessment is needed.
Note: Autoimmune skin rashes can show up in many forms—some may mimic eczema or allergies but behave differently. Lupus, dermatomyositis, or vasculitis can present with redness, rashes, or sensitivity to sunlight. If the rash appears with fatigue, joint pain, or lasts longer than usual, it’s worth seeing a dermatologist or rheumatologist. They may suggest a biopsy or blood tests like ANA. Just because it’s not eczema doesn’t mean it’s autoimmune, but recurring unexplained rashes deserve a closer look.
Is there a general blood test to check for autoimmune diseases?
Yes, there are screening blood tests for autoimmune diseases, such as ANA (antinuclear antibody) and others. But they’re best used when there are symptoms, not just as a blanket screen.
Note: Autoimmune diseases are diverse, so there’s no one-size-fits-all test. The ANA test is a common starting point, especially if someone has joint pain, fatigue, rashes, or other unexplained symptoms. But some people can have a positive test without disease, and others may have disease even with a negative test. That’s why it’s important to match the test to symptoms. If you’re worried, start with a discussion with your doctor—they’ll know which tests are worth running. Think of it as a guided investigation, not a lucky dip.
What’s the difference between autoimmune and low immunity?
Autoimmune means your immune system is attacking your own body. Low immunity means your immune system is weak and can’t fight infections well. They’re two very different conditions, even though both involve the immune system.
Note: Think of autoimmune disease like the body’s soldiers turning against their own people—it’s a case of mistaken identity. Conditions like lupus, rheumatoid arthritis, and autoimmune thyroiditis fall under this. Low immunity, on the other hand, means the immune system isn’t strong enough to fight infections, like in primary immunodeficiencies or when someone is on strong immunosuppressants. If someone gets frequent infections (like pneumonia, sinus infections), we think about low immunity. If they have symptoms like joint pain, rashes, or fatigue, we consider autoimmune causes. Blood tests can help distinguish the two.
My mum has lupus—should I be worried about my kids?
Yes, autoimmune conditions can run in families, but that doesn’t mean your children will definitely develop one. It means they may have a higher risk, especially if there’s a strong family history.
Note: Autoimmune diseases often have a genetic component, so if your mum has lupus, it does slightly increase the chance that you or your kids could develop an autoimmune condition. But genetics is only one part of the picture. Environmental triggers, infections, hormones, and even stress also play a role. There’s no need to panic or over-test, but it’s good to be aware. If your children develop unexplained fatigue, joint swelling, rashes, or other persistent symptoms, it’s worth checking early. Being informed helps with early detection, which is the best kind of prevention.
Are there foods that help prevent autoimmune flares, especially for kids?
There’s no single “autoimmune diet,” but a balanced, anti-inflammatory diet rich in whole foods can support the immune system. Avoiding highly processed foods, added sugars, and trans fats may help reduce inflammation.
Note: For both adults and kids, diets rich in colourful fruits, vegetables, whole grains, lean proteins, and healthy fats (like olive oil and omega-3s from fish) can support immune health. Some kids with autoimmune conditions may benefit from gluten or dairy exclusion, but this should only be done with medical supervision. Processed foods, sugary drinks, and excess fast food can fuel inflammation. It’s about habits, not strict rules—focus on balance, variety, and real food over fads. And yes, even the occasional bubble tea is fine in moderation!
Can autoimmune diseases be diagnosed in infants or toddlers? Where to go?
Yes, some autoimmune diseases can be diagnosed in infants or toddlers, though they are rare. If there are concerning signs, a referral to a pediatric specialist is the next step.
Note: Autoimmune diseases are uncommon in very young children, but not impossible. Warning signs may include prolonged fevers, unexplained rashes, swollen joints, poor growth, or frequent infections. If your child shows persistent or unusual symptoms, your paediatrician may refer you to a pediatric rheumatologist or immunologist. These specialists are usually found at children’s hospitals or larger medical centres. Early diagnosis allows for early intervention—so if your gut says something’s off, trust it and ask for further evaluation.
If I have an autoimmune disease, is it safe to get vaccines?
Yes, in most cases, people with autoimmune diseases can and should get routine vaccines. But timing and vaccine type may need to be adjusted depending on your condition and medications.
Note: Vaccines help prevent serious infections, which can be more dangerous in people with autoimmune diseases. Inactivated (non-live) vaccines like flu shots, COVID-19 vaccines, and pneumococcal vaccines are generally safe, and even recommended. Live vaccines (like MMR or varicella) may need to be avoided or timed carefully, especially if you’re on immunosuppressants. Always discuss with your rheumatologist or immunologist before scheduling vaccines—they can help you plan safely. Vaccines don’t cause autoimmune disease or flares in most people, and the protection they offer is important.
Can someone have an autoimmune disease and not know it?
Yes, some autoimmune diseases can develop slowly and silently. Early symptoms may be vague—like fatigue, joint stiffness, or skin changes—so they’re often missed at first.
Note: Autoimmune diseases can smoulder under the radar for months or even years. You might just feel ‘off,’ get tired easily, or notice minor symptoms that come and go. Some people chalk it up to stress, ageing, or parenting exhaustion—until something more obvious shows up. That’s why it’s important to track patterns and get checked if symptoms persist. Early diagnosis makes treatment easier and helps prevent damage. So yes, it’s possible to have autoimmune disease without knowing it—but your body usually gives clues. Trust your gut.
About the Expert: Dr. Anindita Santosa
Dr. Anindita Santosa is a Consultant Rheumatologist and the Founder of Aaria Rheumatology, Singapore’s dedicated autoimmune and immunology center. She previously led rheumatology services at Changi General Hospital and spearheaded digital tools like the RheumConnect chatbot.
She earned her MBBS from NUS, is a member of the Royal College of Physicians (UK), and holds a Master’s in Allergy from Imperial College London. As Deputy Chairman of the National Arthritis Foundation and faculty at Duke-NUS and SingHealth, Dr. Santosa is deeply committed to autoimmune care, education, and advocacy.
Learn more at aariarheumatology.com.sg
