Doctors Got Autoimmunity All Wrong

A German physician and bestselling gut-health author says your doctor has been using the wrong words to explain why your body hurts itself.

Story Snapshot

Physician Giulia Enders pushed back on the phrase “your immune cells are attacking your own body” in a Big Think interview
She argues immune cells act overprotective, not aggressive, when autoimmune disease develops
Major health institutes, including the National Institute of Allergy and Infectious Diseases, still describe autoimmune disease as the immune system mistakenly attacking healthy tissue
The real disagreement may be about word choice for patients, not the underlying science

What The Physician Actually Said

Giulia Enders, known for her work explaining digestion and the body in plain language, took aim at a common phrase doctors use. She said patients often hear that their “immune cells are attacking your own body” when diagnosed with an autoimmune disease. Enders called that sentence scientifically outdated and misleading, arguing it paints the immune system as intentionally hostile toward its own host.

Her bigger point is about tone, not just terminology. Enders compared the “attack” language to how trauma survivors sometimes blame themselves for what happened to them. She suggests immune cells become overprotective rather than malicious, reacting to signals they misread as danger. That reframing matters for patients who already carry guilt or fear about their own bodies turning against them.

What The Official Medical Record Says

The National Institute of Allergy and Infectious Diseases, part of the National Institutes of Health, defines autoimmune disease plainly: the immune system mistakenly attacks healthy, working parts of the body, damaging them in the process. Researchers there count between 80 and 150 distinct autoimmune diseases falling under that description.

The same institute’s disease-specific research page uses nearly identical language for lupus, stating the immune system attacks healthy cells and tissues by mistake, damaging joints, skin, blood vessels, and organs. Textbook definitions echo this. One widely cited immunology reference states that tissue injury in autoimmune disease happens because the effector mechanisms of the immune system are directed at the body’s own tissues.

A Dispute Over Words, Not A New Discovery

Peer-reviewed research offers a more technical explanation that doesn’t necessarily contradict Enders. One study describes the core problem as defective elimination or control of self-reactive immune cells, called lymphocytes, rather than a system that simply decides to go rogue. Another review traces the breakdown to faulty immune tolerance, the body’s normal process for teaching immune cells to leave healthy tissue alone.

That distinction matters. Immune tolerance failing is different from immune cells choosing to attack. Both descriptions can be true at once. The immune system loses its ability to tell friend from foe, and the result still looks like an attack from the outside, even if the root cause is a broken filtering process rather than aggression.

Why The Framing Fight Matters To Patients

This isn’t a case of fringe theory versus settled science. Every major source cited here, from government health agencies to peer-reviewed journals, agrees the immune system ends up damaging the body’s own tissue in autoimmune disease. What’s genuinely up for debate is whether telling patients their body is “attacking itself” helps them understand their condition or just adds unnecessary fear and self-blame on top of a hard diagnosis.

The science backs the attack description as accurate shorthand for what happens in the body. Enders raises a fair point about bedside manner and how doctors deliver hard news. Patients deserve accurate information, but they also deserve language that doesn’t leave them feeling betrayed by their own biology.

For readers managing an autoimmune condition, the takeaway isn’t to distrust your diagnosis. It’s to ask your doctor better questions about what’s actually happening inside your immune system, and to recognize that a broken filtering process, not a personal failure, is driving the disease.