The Hidden Cost of Ignoring Autoimmune Disease in the Workplace (and What Happens If We Keep Doing It)
A letter to two audiences who rarely read the same article:
- Diana, the high-achieving professional woman who’s been told “your labs are fine” while falling asleep at stoplights.
- The HR leader, People-Ops director, or C-suite executive who’s about to lose Diana (and 1 in 6 of your workforce) if nothing changes.
The Numbers No One Wants to Put on a Slide Deck
50 million Americans have at least one autoimmune disease (AARDA, 2024)
78 % are women, your most educated, most loyal demographic
Direct + indirect cost per employee: $8,800 to $14,200 annually (Birnbaum et al., 2023)
76 % of that cost is presenteeism, people at their desks but functioning at 60 to 70 % (Hagberg et al., 2023)
Employees with unsupported chronic illness are 2 to 3 times more likely to leave within 24 months (Georgetown University Health Policy Institute)
If we keep pretending “push through” is a strategy, here’s what actually happens.
For Diana (the individual cost)
She normalizes daily symptoms, takes more thyroid medication or biologics, still feels wrecked, doubles down on caffeine and sugar, flares worsen, joints swell, brain fog thickens, starts missing deadlines, gets put on a PIP, quietly resigns “for family reasons.”
She never tells you the real reason. You lose a $120K+ employee and replace her with someone who takes 6 to 9 months to ramp. Real cost to the business: $180K to $300K.
For the company
January becomes “recovery month.”
Sick days spike 40 % post-holidays.
Presenteeism drags Q1 revenue.
Your best women, the ones who run marketing campaigns, manage million-dollar clients, and mentor juniors, quietly disengage or leave for competitors who “get it.”
We’ve seen this movie before. It’s called quiet quitting on steroids.
What Happens When We Keep Relying Only on Medication
Medication is a seatbelt, not the whole car.
Levothyroxine normalizes TSH but does nothing for the 60 % of Hashimoto’s patients who still report fatigue and brain fog (Ott et al., 2011)
Biologics reduce joint damage in RA but don’t touch the nervous-system dysregulation driving 80 % of flare intensity (Straub & Cutolo, 2016)
Ignoring root triggers (stress, blood-sugar swings, poor vagal tone) turns a manageable condition into a progressive one.
Result? Diana gets sicker, needs higher doses, experiences more side effects, and eventually needs disability accommodations you never budgeted for.
Two Science-Backed Tools for Diana (the employee)
1. The 4-7-8 Breath Reset (proven to drop cortisol 23 % in 60 seconds, Brown & Gerbarg, 2012)
Inhale 4 counts, hold 7, exhale 8. Do 4 rounds when Aunt Karen says “one bite won’t hurt.” Works in the bathroom stall, car, or boardroom.
2. 4-Minute “Scribble-to-Soothe” Art Prompt (reduces inflammatory cytokines up to 20 %, Kaimal et al., 2017)
Grab a pen. Scribble chaotic lines for 45 seconds, then color inside them slowly for 3 minutes. Zero skill required. I keep a tiny notebook in my purse for every holiday party.
Want both of these plus food-pusher scripts and my exact Thanksgiving rhythm? Download my free Flare-Proof Thanksgiving Guide at desireewerland.com (It disappears Jan 2, grab it now.)
Two Science-Backed Tools for HR / Leadership
1. The “Energy Permission” Pre-Holiday Message
One sentence reduces January sick days and presenteeism up to 15 % (PubMed, 2017; Wellmark 2024 study on supportive messaging).
Copy-paste version: “Quick note before the break: Rest is a performance strategy, not a reward. If you need to skip events, adjust hours, or work remotely to protect your energy this season, you have my full support. No explanation needed.”
2. The 90-Minute “Focus Block” Policy (increases output 21 % in chronic-illness employees, Harvard Business Review, 2023)
Allow employees to block two 90-minute deep-work windows daily with zero Slack/email. Fatigue crashes drop dramatically when the nervous system isn’t pinged every 4 minutes.
The Podcast That Started as a Personal Survival Guide
This week I dropped the episode I wish existed when I was still falling asleep on the highway:
How to Survive Thanksgiving & Holiday Parties Without Triggering a Massive Autoimmune Flare
(Even When Your Family Thinks “Gluten-Free” Means Sad Cardboard)
In 8 minutes I give you:
- Polite-but-firm scripts for every food pusher
- The daily rhythm that keeps me energized instead of wrecked
- The single boundary that saved my entire December
Listen here: https://open.spotify.com/episode/1wdIJURCXXXFdA3YKrwmgv?si=nk_GuKtBQ9qESVokV6DxxA
The Choice in Front of Us
Option A (do nothing) : Diana quietly burns out. You lose institutional knowledge, pay six-figure recruiting fees, and watch Q1 slip.
Option B (act now) Send one message. Offer one small accommodation. or Download my free guide and share it with your team.
You keep Diana. You save $180K+. You become the employer everyone wants to work for. I’m not asking you to overhaul your entire wellbeing program today. I’m asking you to choose Option B for one holiday season and watch what happens. Because Diana deserves to enjoy pie, laughter, and twinkle lights without paying for it in January. And your company deserves to keep the women who make it run.
Autoimmune + Office Food Pressure? Here’s How to Protect Your Health This Holiday Season
Listen on [Spotify] | [Apple Podcasts] | [YouTube]
Ready for what’s next?
For Diana (the high-achieving woman who’s tired of choosing between her career and her health): I open a small handful of private 1:1 spots a few times a year. If you’re done with car naps, brain fog, and “pushing through,” click here to apply. I’ll personally review your case and we’ll see if working together is the perfect fit. Apply for 1:1 coaching
For HR, People Ops, and leaders building smarter workplaces: I run a limited number of corporate pilots each year focused on autoimmune and chronic-illness wellbeing (no extra headcount required). Want to cut presenteeism, boost retention of your top female talent, and lead the way in energy-efficient teams? Click here to book a short strategy call.
Subscribe to the Stronger Than Autoimmune podcast for weekly strategies, real talk, and actionable advice. Because health is real wealth, and every part of your life, including your career which relies on the status. New episodes every week: real strategies, zero fluff.
Listen on [Spotify] | [Apple Podcasts] | [YouTube]
Medical Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with qualified healthcare providers regarding your specific health needs.
About the Author: Corporate Autoimmune Consultant | SHRM-SA Board Member | Functional Health Coach (Corporate Wellness + AIP certified) I help high-achieving women with autoimmune conditions reclaim their energy and ambition, and I help companies keep that talent thriving instead of burning out.
Health is real wealth, and your career depends on it. Let’s make thriving the rule, not the exception.