Autoimmune Disease Doesn’t Exist?

I recently attended IPM2025 with high expectations to hear from some of the brightest minds in functional medicine. One name on my list was Leo Pruimboom, a true pioneer with over three decades of experience in tackling complex, chronic conditions. But nothing prepared me for his opening line:

“Autoimmune disease does not exist.”

Tell that to my patients who are crippled by autoimmune conditions. Or even to myself — I’ve faced not just one, but two autoimmune diagnoses in my own life. So, to say I was shocked would be an understatement.

But as I sat and listened, that startling statement began to make sense.

For decades, we’ve been told that in autoimmune conditions, the immune system has gone haywire — that it gets confused and starts attacking our own tissues by mistake. The story is that the body misidentifies your thyroid, your joints, your nerves, your skin as “the enemy.”

But what if that story is wrong? Or at least, incomplete?

Pruimboom made the case — supported by emerging research in psychoneuroimmunology — that the immune system does not make mistakes. It does exactly what it’s designed to do: detect threat and respond. Infections, viruses, environmental chemicals, heavy metals — these things can damage or change the expression of our tissues at the cellular level. Once that happens, the immune system sees the altered tissue for what it is: damaged, inflamed, or infected. In other words, the immune system is not confused — it’s doing its job.

This flips the entire paradigm on its head. Instead of blaming a “confused” immune system, we might ask: What has changed the tissue so much that the immune system now recognises it as a threat?

Viewed this way, autoimmunity isn’t the immune system malfunctioning — it’s the immune system responding appropriately to abnormal tissue signals. And if that’s true, then suppressing the immune system may be missing the point entirely.

From a psychoneuroimmunology perspective, this is even more powerful. Our brains and immune systems are in constant conversation. If we believe — and tell ourselves repeatedly — that our own body is attacking itself, we reinforce that internal war. But what if we focused instead on supporting the tissue to heal? Reducing the threats — infections, toxins, stressors — that alter our cells in the first place?

This is precisely where functional medicine shines. True functional medicine asks: Why is the immune system responding this way? It asks us to address root causes: hidden infections, chronic viruses, gut permeability, toxic exposures, nutrient deficiencies, unresolved trauma. It asks us to strengthen and restore, not just suppress.

So does autoimmune disease “not exist”? Of course, the suffering is real. But maybe what we call “autoimmune” is not a betrayal by our own immune system — but a sign that our brilliant, complex body is alerting us to damage we haven’t yet resolved.

As someone who has walked this road personally and alongside many patients, I find this perspective both radical and deeply hopeful.

What if our immune system is not the villain — but the hero, pointing us back to where true healing needs to happen?

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