Why Autoimmune Conditions Are Harder to Diagnose in South Asians

Autoimmune diseases, where the body’s immune system mistakenly attacks its tissues, are a growing concern across the globe. Conditions like lupus, rheumatoid arthritis, multiple sclerosis, and Hashimoto’s thyroiditis are becoming increasingly common. However, in South Asian populations, diagnosing these conditions presents unique challenges. Despite medical advances, many South Asians suffer from undiagnosed or misdiagnosed autoimmune disorders, often resulting in delayed treatment and worsened health outcomes.

This article explores the key reasons why autoimmune conditions are harder to diagnose in South Asians, shedding light on the cultural, genetic, socioeconomic, and medical factors that play a role.

Lack of Awareness and Health Literacy

One of the primary reasons autoimmune diseases go undetected in South Asian communities is the lack of awareness about these conditions. Symptoms of autoimmune disorders—fatigue, joint pain, brain fog, skin rashes—are often vague and overlap with other more common illnesses.

In many South Asian households, such symptoms are brushed off as signs of aging, stress, or “weakness” rather than indicators of a systemic issue. Cultural taboos around chronic illness, particularly invisible or internal diseases, further discourage open discussions or timely medical consultation. As a result, people may delay seeking professional help until the condition has progressed significantly.

2. Genetic and Biological Diversity

South Asians are genetically diverse, with complex ancestry involving multiple ethnic groups. This diversity can impact how autoimmune diseases manifest and how the immune system functions. Research has shown that autoimmune conditions may behave differently across ethnic groups. For example:

South Asians with lupus may experience more kidney involvement than white populations.

Certain HLA (human leukocyte antigen) variants common in South Asians may predispose individuals to autoimmune conditions differently than in Western populations.

Unfortunately, most medical research and diagnostic criteria are based on Western populations. This Eurocentric bias means many symptoms or lab markers typical in South Asians might not align with standard diagnostic models, making it easier for healthcare providers to overlook the correct diagnosis.

3. Underrepresentation in Medical Research

The underrepresentation of South Asians in clinical trials and autoimmune disease studies has created a significant knowledge gap. Because most autoimmune research is conducted in North America and Europe, findings may not be entirely applicable to South Asian populations.

For example, a diagnostic marker that works well in Caucasian populations might not be as sensitive or specific in South Asians. This lack of tailored research affects everything from disease identification to treatment protocols, leading to a trial-and-error approach in diagnosis.

4. Socioeconomic Barriers to Healthcare Access

Many South Asians, especially in developing countries like India, Pakistan, Bangladesh, and Sri Lanka, face systemic barriers in accessing quality healthcare. These may include:

Limited access to specialists: Autoimmune diseases often require rheumatologists or immunologists, who are scarce in rural or underserved areas.

Financial constraints: Long-term diagnostics, lab tests (like ANA panels or thyroid antibody tests), and autoimmune-specific treatments can be costly.

Reliance on alternative medicine: Ayurveda, Unani, and homeopathy are widely practiced in South Asia. While beneficial for many conditions, reliance on these systems can delay biomedical diagnosis and treatment of autoimmune disorders.

These factors contribute to patients presenting with advanced-stage disease or being mismanaged for years.

5. Gender Disparities in Diagnosis

Autoimmune diseases are more prevalent in women. However, in patriarchal societies prevalent in many South Asian regions, women’s health issues are often deprioritized. Symptoms like fatigue, joint pain, or menstrual irregularities may be normalized or dismissed.

Many women are reluctant to discuss their health openly due to stigma, modesty norms, or lack of agency. This silence can be a major barrier to timely diagnosis. Even when women do seek medical help, their symptoms may be attributed to psychological issues like anxiety or depression, rather than explored as potential autoimmune concerns.

6. Misdiagnosis and Overlapping Symptoms

Autoimmune symptoms often mimic other common conditions, such as:

1. Vitamin D deficiency (prevalent in South Asia)
2. Thyroid imbalances
3. Infections like tuberculosis or hepatitis
4. Anxiety and depression

In regions where infectious diseases are more common, doctors may be more inclined to test for those first. Moreover, many general practitioners are not trained to identify autoimmune red flags, leading to repeated misdiagnoses. Without access to advanced diagnostics or referrals to specialists, the actual autoimmune condition can go undetected for years.

7. Cultural and Language Barriers in Diaspora Populations

Even in countries with advanced healthcare systems, South Asians living abroad—such as in the UK, US, or Canada—face challenges. Language barriers, mistrust of the medical system, and cultural differences can result in communication gaps between patients and providers. Many immigrants may underreport symptoms, avoid frequent checkups, or struggle to navigate the healthcare system effectively.

Moreover, providers unfamiliar with ethnically diverse disease presentations may overlook autoimmune diagnoses in non-white patients, a phenomenon observed in various studies related to racial bias in healthcare.

Moving Forward: What Can Be Done?

Raising awareness and improving early detection of autoimmune diseases in South Asians requires a multifaceted approach:

1. Community education: Public health campaigns in local languages that explain autoimmune conditions and encourage early medical intervention.
2. Training doctors: Equip primary care physicians with better tools and training to recognize diverse autoimmune symptoms.
3. Inclusive research: Increase the representation of South Asians in clinical research to improve diagnostic criteria and treatment outcomes.
4. Empowering women: Promote health literacy and agency among South Asian women to encourage them to seek medical help when needed.

Final Thoughts

Autoimmune conditions are already complex, but in South Asian populations, a web of social, cultural, and medical challenges further complicates diagnosis. Bridging the gap requires collaboration between researchers, clinicians, and communities to ensure timely, accurate diagnosis and equitable care. One practical step individuals can take is to do an Arthritis Profile Test now, helping detect inflammation markers early and enabling more proactive management. Understanding the nuances of autoimmune disease in South Asians is not just a medical imperative—it’s a step toward health equity and improved quality of life for millions.