Could 'being too nice' raise autoimmune disease risk in women?
Industry Buzz
Autoimmune diseases involve genetics, immune regulation, hormones, and environmental factors, and we shouldn't blame patients for developing them.
—Kristina Galetta, MD
To say that being nice causes autoimmune disease would be an oversimplification.
—Kanika Monga, MD
A young woman stands in her kitchen, removing seeds from a pomegranate into a large bowl. She looks directly into the camera.
“Be a bitch or get an autoimmune disease,” she says.
In a video posted to Instagram,[] the young woman, who calls herself Jenni Mae on social media, references researcher Gabor Maté, MD, who studies the impact of trauma on the body.
“The people most likely to develop autoimmune conditions are often the most agreeable ones in the room,” the woman writes in her Instagram caption. “The helpers, the fixers, the ones who apologize when someone else bumps into them. The ones who learned early that their emotions were an inconvenience, so they buried them and got on with it.”
“Hashimotos, lupus, rheumatoid arthritis, MS, endometriosis,” she continues. “The research doesn’t claim emotions are the sole cause but the pattern is too consistent to dismiss.”
The video from Jenni Mae is one of many making waves across social media.
“Ladies, you can either be a bitch or develop an autoimmune disease, choose wisely,” one TikTok video declares.[]
“Have boundaries or get an autoimmune disease, those are the options,” says another.[]
Related: 3 major shifts in women’s health you probably weren't expecting—and can't afford to missDoes being ‘too nice’ cause autoimmune disease?
Roughly 80% of the people living with autoimmune diseases are female.[] But does being a bitch really offer protective effects against autoimmune diseases for women? The experts aren’t so sure.
“There is research looking at personality, stress, coping, and health outcomes, but that's very different from showing that being ‘too nice’ causes autoimmune disease. I would be very cautious about drawing that conclusion,” Kristin Galetta, MD, a board-certified neurologist at Stanford, told MDLinx.
“I can understand why the idea resonates with people. The appealing part of the message is that it gives people a sense of agency, but the danger is that it can also imply that someone somehow caused their own autoimmune disease by being too agreeable. Autoimmune diseases involve genetics, immune regulation, hormones, and environmental factors, and we shouldn't blame patients for developing them.”
Trauma and autoimmune disease
The videos circulating on social media claim to be inspired by the work of Dr. Gabor Maté.
On his website, Dr. Maté says, “Trauma is an invisible force that shapes our lives. It shapes the way we live, the way we love and the way we make sense of the world. It is the root of our deepest wounds.”[]
In theory, experts say trauma can be a factor in the development of autoimmune diseases.
“Trauma likely contributes to higher autoimmune risk, but it is not clear what the true effect size is because it is one risk among many,” Kanika Monga, MD, FACR, a clinical rheumatologist in Houston, told MDLinx.
Daniel Arkfeld, MD, DDS is a rheumatologist with Keck Medicine of USC. The theory that being “too nice” could cause autoimmune diseases is an idea he hasn’t heard before.
“I don’t think that’s a valid statement,” he said.
Related: Why autoimmune diseases hit women harder—and what clinicians may be missingAn oversimplification
While social media users urge women to be less nice, set boundaries, and “be a bitch” to avoid getting an autoimmune disease, experts say it’s not that simple.
“It is important to prioritize your health and emotional well-being. To say that being nice causes autoimmune disease would be an oversimplification,” Dr. Monga said. “The real causes include genetics, hormones, chromosomes, and environment.”
“The best we can do is work on modifiable risk factors, as they can contribute to disease—things such as stopping smoking, staying active, eating a healthy diet, and managing our stress, weight, and dental health,” says Dr. Monga.
In her Instagram video, Jenni Mae continues to remove the jewel-like seeds from the pomegranate while speaking
“If you've been the good girl your whole life, you've been easy, accommodating, endlessly giving, people pleaser, and your body is now struggling, then this might be worth sitting with,” she says. “Your body always keeps the score.”
Related: When ‘stress’ is in the differential: Preventing diagnostic overshadowing in complex chronic illness