Symptoms Of Autoimmune Polyendocrine Syndrome

October 1, 2023

Our immune systems are designed to protect us from disease and infection. We all house an army of extraordinarily complex and sensitive white blood cells, all equipped with chemically coded instructions for exactly how and when to launch an assault on a microscopic invader. Though powerful, the immune system is not always perfect, and sometimes can be misled to mistake a person’s healthy tissues for the enemy, resulting in an autoimmune disorder. Autoimmune polyendocrine syndrome (APS), a rare disorder brought on by a faulty regulatory gene, occurs when the immune system directs its actions toward the bodily glands that produce essential hormones and biochemicals. Our endocrine system plays a critical role in regulating all other bodily functions. Disruptions in endocrine function result in a host of disabling symptoms that can affect the heart, kidneys, intestinal tract, and other systems.

Shortness Of Breath

Individuals with autoimmune polyendocrine syndrome can sometimes experience shortness of breath. There are a couple of reasons why this might happen.

The adrenal glands, located above each of the kidneys, are a frequent target for APS. These glands produce cortisol, adrenocorticotropic hormone, antidiuretic hormone, and other essential biochemicals. They serve a critical function in blood pressure control and heart function, as well as fluid balance. Autoimmune polyendocrine syndrome patients can find themselves in a downward spiral of dehydration, low blood pressure, increased pulse, decreased cardiac efficiency and, as a result of it all, chest pain with shortness of breath.

APS is also known to interfere with iron absorption and red blood cell production, which will lead to anemia. Anemias can be caused by a lowered production of red blood cells, or simply the inability to attach enough iron to the surface of blood cells, rendering them incapable of carrying out their primary duty, to transport oxygen to bodily tissues. A decrease in oxygen levels signals the heart to pump faster to deliver more oxygen, which after a time will cause the patient to feel short of breath.


This is the most debilitating symptom and most common complaint of autoimmune disease patients, and autoimmune polyendocrine syndrome offers no exception. Different from simply being 'run down,' APS-related fatigue can be profound, causing even simple daily tasks to become difficult or overwhelming. There is a definite, well-documented correlation between autoimmune disorders like autoimmune polyendocrine syndrome and the fatigue individuals experience, but the exact mechanism is unknown.

Addressing this has become a central issue in the treatment of autoimmune disorders. Because it is such a vague complaint, it often goes unvalidated by medical professionals or even the patient themselves. Being tired can seriously complicate a patient’s condition, though, and should be acknowledged and managed like any other symptom.

Rapid Heartbeat

Patients with autoimmune polyendocrine syndrome may experience a rapid heartbeat. Rapid pulse, or tachycardia, is defined as anything over one hundred beats per minute, and when sustained, it can exacerbate some of the other symptoms as well, such as chest pain or shortness of breath.

Because APS affects such a wide variety of endocrine glands, such as the adrenal glands or thyroid, the normal chemical signals these organs produce to regulate appropriate heart rhythm may be off. Addison’s disease, a disorder of the adrenal glands in which fluid electrolytes cannot be maintained, can develop as a secondary disorder caused by autoimmune polyendocrine syndrome. Adrenal insufficiency has a significant impact on heart function over time, as chronic dehydration and falling blood pressures cause the heart to pump blood less efficiently, and consequently, faster and weaker.

As mentioned before, anemia is common for autoimmune polyendocrine syndrome patients, and can also contribute to tachycardia. Accelerating the heart rate is a compensatory response to low levels of hemoglobin, the iron-oxygen binding protein on the surface of red blood cells. When there isn’t a normal amount of oxygen being shunted along, the heart attempts to move the blood faster.


Autoimmune polyendocrine syndrome affects the lining of certain areas of the stomach. And like all autoimmune disorders, it is characterized by chronic inflammation, something that is never good for bodily tissues. APS can cause the immune system to target part of the gastric mucosa, specifically the parietal cells, resulting in frequent complaints of stomach pain and indigestion.

Complicating this symptom is the tendency for autoimmune polyendocrine syndrome patients to develop chronic candida infections of the mouth and esophagus. Because APS interferes with normal immune function, these patients do not have the same resistance to environmental pathogens, like yeast, that others do. As a result, the infection can take a toll on the esophagus, making reflux or indigestion more likely to occur.


Weakness may be experienced in autoimmune polyendocrine syndrome if certain endocrine organs are compromised, namely the parathyroid or the ever-important adrenal glands.

The four small parathyroid glands sit on the outer wings of the butterfly-shaped thyroid gland at the base of your neck. Their purpose is to constantly monitor calcium levels in the bloodstream, a critical element for neuromuscular and neuroelectrical functions in our body. The parathyroid glands quickly detect low calcium levels and release hormones to correct it. Damage to these glands can result in hypocalcemia, which causes tingling, and muscle cramping with weakness.

Patients with APS who develop Addison’s, the adrenal insufficiency, may also experience a different type. Adrenal issues tend to be chronic, and the onset may be slow and insidious. As the disease progresses, the person will produce less of the regulatory hormones needed to control blood pressure, blood sugar, and other important functions. Electrolytes go awry, and blood pressure and glucose levels fall precipitously. Diarrhea and weight loss are common side effects, all contributing to a growing sense of physical loss.

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