Founder, Hystelica

As we learn more about how our bodies often carry an invisible load, brought about by the physical and mental stressors of our lives, we see that this burden seems to blight the physical wellbeing of women more than men.

Whether this is due to differences in the physiology of our biological make up, the differences in our psychological stress responses or perhaps even differences in the lived experiences and societal burden between the sexes, or probably a much more complex mix of all plus more – the data show us that around 80% of autoimmune disorders occur in women [1]. As autoimmune diagnoses rise, it is increasingly clear that for many women the boundary between mental and physical health is far more porous than our health systems acknowledge [2, 3].

“For many women, the boundary between mental and physical health is far more porous than our health systems acknowledge.”

Over the past decade, the immunology field has begun to unpack why biological sex so strongly shapes autoimmune risk, moving beyond simple hormone-based explanations. Women tend to mount stronger innate and adaptive immune responses than men, with higher B-cell counts, more robust antibody production, and a greater propensity for inflammatory T helper 17 responses. This enhanced reactivity is excellent for clearing infections, but it also makes loss of self-tolerance more likely, particularly when combined with X-linked immune genes, skewed X-chromosome inactivation, and sex-specific environmental exposures. Together, these sex differences in immune wiring help explain why the same triggers – infections, stress, tissue injury – are more likely to tip women into chronic autoimmunity.

Why Autoimmune Disease is a Women’s Issue

Globally, women are two to three times more likely to develop an autoimmune disease than men, and for some conditions as many as four in five patients are female [1, 2]. Lupus, rheumatoid arthritis, multiple sclerosis, and autoimmune thyroid diseases cluster in key hormonal windows such as puberty, pregnancy, and menopause, as well as during times of acute stress – hinting at an intimate crosstalk between sex hormones, the immune system, and the brain [1, 4].

Large epidemiological studies show that this is not a niche problem but a major driver of disability in women across the lifespan [1]. Yet many women spend years being told their fatigue, pain, and brain fog are “just stress” or “just anxiety” before anyone thinks to screen for autoimmunity [4, 5].

The Mind–Body Connection is Not “Woo”

The idea that chronic stress and trauma can drive such disorders – and not just genetics and “bad luck” – is no longer speculative; it is measurable in immune markers and disease outcomes [6, 7]. A recent two-cohort study using UK Biobank data and an Icelandic population sample found that adverse childhood experiences (ACEs) were linked to higher rates of autoimmune disease in adult women, with depression, anxiety, and PTSD mediating around a quarter of that risk [8].

Meta-analytic work on PTSD and autoimmunity shows a similar picture: trauma-related stress disorders are associated with roughly a 29% higher risk of developing an autoimmune condition, even after adjusting for lifestyle factors [7, 9]. For many women, this sits on top of the “everyday” stress of caregiving roles, financial pressure, and gender-based violence, creating a chronic allostatic load that keeps the nervous and immune systems in a high-stress state [8, 10]. Women, after all, have half the upper body strength of men, and so it seems rational that we would feel less safe in the world than men.

When we talk about mind–body connection in this context, we are really talking about stress biology: dysregulated HPA-axis signalling, changes in inflammatory cytokines, and immune cells that learn to respond as if the world is constantly unsafe [7, 11]. With autoimmune disorders, it appears that biology is then written into tissues – joints, gut, thyroid, brain [1, 4].

Where Do Psychedelics Fit In?

So where might psychedelics belong in this landscape, if at all? First, they are not a magic bullet and there are, as yet, no large-scale clinical trials demonstrating that psilocybin, LSD, or MDMA “treat” autoimmune disease in humans [12, 13]. What we do have are converging strands of early evidence and theory pointing towards two plausible pathways: modulation of trauma-related stress circuits and direct neuroimmune effects [12, 13].

On the psychological side, psychedelic-assisted therapies have shown promising effects for conditions such as PTSD, depression, and anxiety – the very mediators that link early adversity to autoimmune risk in women [8, 14]. A recent review argues that by helping people process and integrate trauma, psychedelics may reduce maladaptive chronic stress responses that otherwise keep the immune system in a pro-inflammatory, self-attacking state [13].

On the biological side, classic serotonergic psychedelics act at 5-HT2A receptors, which are expressed not only in the cortex but also on certain immune cells [12, 13]. Pre-clinical studies show that compounds like LSD can reduce pro-inflammatory cytokine release and suppress B-cell proliferation, while new work in animal models indicates that psychedelics can “reset” pathological neuroimmune interactions that amplify fear responses [12, 13, 15].

Together, these findings raise the possibility that a single intervention could influence both the psychological roots of chronic stress and the immune pathways through which that stress is embodied.

Beyond immune cells, psychedelics also appear to interact with the HPA axis – the brain’s central stress-response system. Human and animal data suggest that psilocybin and related compounds can acutely shift cortisol, adrenocorticotropic hormone, and other stress biomarkers, and may, over time, help normalise dysregulated HPA signalling that underpins chronic anxiety and depression. Although the evidence base is still small and heterogeneous, early findings raise the possibility that psychedelic-assisted therapy could support a more flexible, less hyper-reactive stress axis – an appealing prospect for women whose autoimmune symptoms are tightly coupled to stress flares.

For women living with autoimmune conditions, this dual action is conceptually attractive. Many describe feeling stuck in looping patterns of hypervigilance, pain, and fatigue; therapies that can safely loosen those loops at both mind and immune level could offer a very different trajectory of care in future [13, 15].

One anonymised case that has stayed with me comes from a woman living with Hashimoto’s thyroiditis who attended an ayahuasca retreat. Before travelling, she had blood tests showing markedly elevated thyroid autoantibodies. After returning, repeat tests from the same laboratory showed a 72% reduction in those antibody levels, alongside her subjective report of improved energy, mood, and cognitive clarity. She shared photographs of the results as proof, with the post-retreat value clearly lower than the pre-retreat one.

This is, of course, a single story, not a controlled trial. Antibody levels can fluctuate over time, and many other factors – diet, sleep, medications, the intensity of the retreat itself – could have contributed to the change. Yet hers is not the only account I have heard of autoimmune markers or symptoms shifting after carefully held psychedelic work. Taken together with the emerging mechanistic science, these narratives suggest that more structured, prospective research in this area is not only justified, but overdue.

Caution, Ethics, and the Road Ahead

It is crucial to stress what we do not yet know. The evidence base for psychedelics in autoimmunity currently consists of mechanistic studies, case reports, and theoretical reviews – not definitive clinical trials. Psychedelic experiences can also be psychologically intense and, without appropriate screening and support, may be destabilising, particularly for people with complex trauma histories that are already over-represented among women with autoimmune disease [8].

Any future clinical pathways here must therefore be trauma-informed, gender-sensitive, and collaborative with rheumatology, endocrinology, and primary care, rather than sitting in a siloed “mental health only” frame. For now, the most evidence-based approach remains comprehensive care that validates women’s symptoms, screens proactively for both autoimmune and mental health conditions, and offers integrated support across psychology, lifestyle, and immunology.

As a neuroscientist working in women’s psychedelic health, I see psychedelics not as a replacement for existing autoimmune treatments but as a potential future layer in a genuinely biopsychosocial model of care. If we can continue to build rigorous, inclusive research – with proper attention to menstrual cycles, hormones, trauma histories, and gendered experience – we may eventually be able to offer women living with autoimmunity something they have been promised for a long time but rarely given: joined-up care for their whole selves.

References

[1] Angum, F., Khan, T., Kaler, J., Siddiqui, L., & Hussain, A. (2020). The prevalence of autoimmune disorders in women: A narrative review. Cureus, 12(5), e8094. https://doi.org/10.7759/cureus.8094

[2] Fairweather, D., & Rose, N. R. (2004). Women and autoimmune diseases. Emerging Infectious Diseases, 10(11), 2005–2011. https://doi.org/10.3201/eid1011.040367

[3] Dantzer, R. (2018). Neuroimmune interactions: from the brain to the immune system and back. Physiological Reviews, 98(4), 2031–2070. https://doi.org/10.1152/physrev.00039.2017

[4] Ragusa, F., Fallahi, P., Elia, G., Gonnella, D., Paparo, S. R., Giusti, C., Churilov, L. P., Ferrari, S. M., & Antonelli, A. (2019). Hashimoto’s thyroiditis: Epidemiology, pathogenesis, clinic and therapy. Best Practice & Research Clinical Endocrinology & Metabolism, 33(6), 101367. https://doi.org/10.1016/j.beem.2019.101367

[5] Siegmann, E. M., Müller, H. H., Luecke, C., Philipsen, A., Kornhuber, J., & Grömer, T. W. (2018). Association of depression and anxiety disorders with autoimmune thyroiditis: A systematic review and meta-analysis. JAMA Psychiatry, 75(6), 577–584. https://doi.org/10.1001/jamapsychiatry.2018.0190

[6] Song, H., Fang, F., Tomasson, G., Arnberg, F. K., Mataix-Cols, D., Fernández de la Cruz, L., Almqvist, C., Fall, K., & Valdimarsdóttir, U. A. (2018). Association of stress-related disorders with subsequent autoimmune disease. JAMA, 319(23), 2388–2400. https://doi.org/10.1001/jama.2018.7028

[7] Roberts, A. L., Malspeis, S., Kubzansky, L. D., Feldman, C. H., Chang, S. C., Koenen, K. C., & Costenbader, K. H. (2017). Association of trauma and posttraumatic stress disorder with incident systemic lupus erythematosus in a longitudinal cohort of women. Arthritis & Rheumatology, 69(11), 2162–2169. https://doi.org/10.1002/art.40222

[8] Köhler-Forsberg, O., Ge, F., Aspelund, T., Wang, Y., Fang, F., Tomasson, G., Thordadottir, E., Hauksdóttir, A., Song, H., & Valdimarsdóttir, U. A. (2025). Adverse childhood experiences, mental distress, and autoimmune disease in adult women: findings from two large cohort studies. Psychological Medicine, 55(1), 235–244. https://doi.org/10.1017/S0033291724003544

[9] Mandagere, K., Stoy, S., Hammerle, N., Zapata, I., & Brooks, B. (2025). Systematic review and meta-analysis of post-traumatic stress disorder as a risk factor for multiple autoimmune diseases. Frontiers in Psychiatry, 16, 1523994. https://doi.org/10.3389/fpsyt.2025.1523994

[10] McEwen, B. S. (2007). Physiology and neurobiology of stress and adaptation: Central role of the brain. Physiological Reviews, 87(3), 873–904. https://doi.org/10.1152/physrev.00041.2006

[11] Danese, A., & McEwen, B. S. (2012). Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiology & Behavior, 106(1), 29–39. https://doi.org/10.1016/j.physbeh.2011.08.019

[12] Szabo, A. (2015). Psychedelics and immunomodulation: Novel approaches and therapeutic opportunities. Frontiers in Immunology, 6, 358. https://doi.org/10.3389/fimmu.2015.00358

[13] Nkadimeng, S. M., Steinmann, C. M. L., & Eloff, J. N. (2021). Anti-inflammatory effects of four psilocybin-containing magic mushroom water extracts in vitro on 15-lipoxygenase activity and on lipopolysaccharide-induced cyclooxygenase-2 and inflammatory cytokines in human U937 macrophage cells. Journal of Inflammation Research, 14, 3729–3738. https://doi.org/10.2147/JIR.S317182

[14] Mitchell, J. M., Bogenschutz, M., Lilienstein, A., Harrison, C., Kleiman, S., Parker-Guilbert, K., Mithoefer, M. C., Feduccia, A. A., Jerome, L., Emerson, A., Doblin, R., et al. (2021). MDMA-assisted therapy for severe PTSD: A randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine, 27(6), 1025–1033. https://doi.org/10.1038/s41591-021-01336-3

[15] Inserra, A., De Gregorio, D., & Gobbi, G. (2021). Psychedelics in psychiatry: Neuroplastic, immunomodulatory, and neurotransmitter mechanisms. Pharmacological Reviews, 73(1), 202–277. https://doi.org/10.1124/pharmrev.120.000056