Lupus

Lupus is an autoimmune disorder that affects over 1.5 million people in the United States and over 5 million people all over the world. Around 90 percent of people with this condition are women, but men can get it too.
There are several different types of lupus including; Systemic Lupus Erythematosus (SLE), Cutaneous Lupus, and Drug induced Lupus. The rate of Lupus runs higher in ethnic groups with darker skin (Native Americans, African Americans, etc.), but it is found in all ethnic groups.
Lupus is often a lifelong and chronic disorder, but with proper medication and management most sufferers live near normal lives.

Lupus is an autoimmune disorder that causes chronic inflammation in the body. An autoimmune disorder is when the body senses its own cells are foreign and attacks them as if they were an infection. The inflammation caused by lupus affects the organs (brain, kidneys, heart, lungs, and skin), the joints, and the blood.
Diagnosis is tricky due to the disorder occurring in “flares,” where there are periods of symptoms that come and go. The symptoms can often be misdiagnosed as another disease and not all people have the same symptoms. It may be hereditary or triggered by an outside factor. To date, no cure has been found and it persists for life.

It is believed that autoimmune disorders, like lupus are caused by a number of factors. There is most likely underlying genetic tendencies for autoimmunity and triggers. Some of the factors that contribute to lupus include:
Family History. It is believed there is a genetic component to autoimmune disorders, so if you have a family history you may be at higher risk for one.
Exposure to Sun. No one knows why, but sunlight seems to be a trigger for lupus flares and problems with the skin in lupus patients.
Infection. The body may fight off an infection, but continue to fight once the infection is gone attacking the body’s own tissues and cells.
Environmental Exposure. Exposure to toxins in the environment may trigger the body’s immune system.
Medication Use. Medications used for things like; high blood pressure, seizures, and antibiotics may cause a temporary “lupus like” flare. This type will often clear up if the medication is stopped. Always see your doctor before stopping any medication.

The symptoms of lupus can be pretty widespread all over the body. Most of them tend to occur during flares, but some may be present all the time. These include:
Disabling fatigue

Joint pain

Joint swelling

Headaches

Low-Grade Fever (99.0)

Puffiness in the hands, feet, and legs

Chest pain

Rash on cheeks and nose

Sensitivity to sunlight

Mouth ulcers

Blue fingers with temperature changes (Reynaud’s)

Hair loss

Blood clots

When lupus flares, many people complain of “feeling like they have the flu” because your body is attacking itself as if its own cells were foreign. The disorder is often mistaken for; chronic fatigue syndrome, fibromyalgia, Lyme disease, or arthritis.

You may have a higher risk of lupus if you have any of the following:
Family history of autoimmune disease (Mother, Father, Sibling)

Female gender

Age between 15 and 40 years

Darker skinned ethnicity

History of viral infection

Chronic exposure to chemicals

Since the symptoms of lupus can mimic other disorders, it may be hard to diagnose at first. Often blood testing only comes back positive during flares and those may not show up very often. Doctors first look at “Eleven Criteria” which are classic signs of lupus. If you have four or more of the criteria, the doctor can officially diagnose lupus, sometimes even without blood testing. These include:

Malar Rash. Rash shaped like a butterfly over the nose and cheek area)
Discoid Rash. Raised Red Rash that appears in patches on the skin.
Sensitivity to Sunlight.
Mouth/Nose Ulcers.
Arthritis. Must be in two or more joints and have swelling, pain, and tenderness.
Cardio-Pulmonary Signs. Inflammation of the heart and lungs.
Neurological. Psychosis, seizures, anxiety, depression.
Kidneys. Protein in the urine, cellular casts in urine.
Blood. Clotting, anemia, low white blood cells, low platelets.
Immunity. Cardiolipin antibodies, abnormal Compliment levels, antibodies to double stranded DNA.
Positive ANA. This may or may not be positive and there is also a high possibility of false positives. It isn’t always a confirmation of lupus.

You will most likely be referred to a Rheumatologist for treatment of lupus. Together, you will come up with a treatment plan that best fits your symptoms. The treatments include:
NSAID’s – Non-Steroidal Anti-Inflammatory Drugs. Anti-inflammatories help lower the inflammation in the body and reduce the activity of the autoimmune disorder if taken every day on a regular basis. They also treat local symptoms like; fever, joint swelling, and pain. They have to be closely monitored due to side-effects of long-term use like; kidney issues, effects on the heart and possible stomach bleeding.
Anti-Malaria Drugs. Malaria drugs help to reduce the severity of lupus and control the disorder. This drug also has side-effects such as: upset stomach and retinal damage.
Immunosuppressant Medications. In severe Lupus, the doctor may opt to give drugs that lower the immune system reaction. Using these raises your risk of getting a serious infection, along with; liver damage, risk of cancer, nausea, fever, and diarrhea.
Corticosteroids. These are reserved for severe flares because they can stop an immune system reaction quickly, but come with severe side-effects if used too often. These include; diabetes, osteoporosis, risk of infection, bruising, and weight gain.

Lupus can be managed with a good treatment plan and lifestyle changes. Things you can do to help your quality of life and feel better are:
Avoid Sun. Sun can increase the chances of a flare and cause a rash. If you go out in the sun, use at least a 15 sun block and wear a hat. Use extra caution in the middle of the day, at the beach, and in the mountains where sun exposure is the highest.
Eat Healthy. Eat a healthy balanced diet with a variety of fruits and vegetables. Increase your intake of fish, which contains Omega-3 fatty acids. This seems to help with joint pain. Use caution with alfalfa sprouts that may increase inflammation. If you are put on steroids for a flare, lower your consumption of carbohydrates and sugar to avoid increased blood sugar levels.
Exercise. With your doctor’s okay, try some gentle exercise such as; low-impact aerobics, yoga, swimming, or walking. If you are having a flare, give yourself some rest because you can injure your joints easier. Your doctor will help you come up with a good and safe exercise plan.
Use Heat. When you have joint pain and inflammation, try warm moist heat or soak in a bathtub. Ice isn’t always recommended for lupus pain, but can be used early in an injury to reduce swelling.
Don’t Smoke. The chemicals in cigarettes can trigger lupus flares. It also reduces blood flow and can worsen Raynaud’s phenomenon (fingers turn blue).
Rest. It is common for lupus to make you feel more tired. Pace your activities and give yourself frequent rest periods. If you overdo it one day, you may have to take three days to feel better.
Report Infections Promptly. If you develop an illness or infection and are on drugs to suppress your immune system, tell your doctor right away. Infections in people with lupus can become life threatening quickly.

It is very important to discuss alternative medicine for lupus with your physician. Please note that any herbal remedies that “boost” the immune system are contraindicated in autoimmune disorders. They can make a flare worse. One of these is Echinacea that you may take to relieve a viral infection. Still, there are a few things you can add to your regimen to help relieve symptoms:
Vitamin D. An important prohormone that helps way more than your bones. Make sure you are getting enough vitamin D other than sunlight, since lupus requires you to avoid the sun. Your doctor can recommend the best supplements.
Fish Oil Capsules. Omega-3 fatty acids may help, but use with caution if you are on blood thinners.
DHEA – Dehydroepiandrosterone. There are some indications that DHEA may help relieve symptoms and inflammation. People on high doses of steroids have been able to lower the dosage when using this supplement.

Lupus Prognosis & Complications
If left untreated, lupus continues to attack the body. Severe complications can result, including:
Lung Damage

Kidney Disease

Blood Vessel Problems

Brain and Nervous System Issues

Heart Disease

Severe Infections

Osteoporosis

Cancer

Pregnancy Complications

With good care and management, lupus has a very good prognosis. Before medical advances, lupus was often fatal. While there is no cure, there are very good treatments to manage the effects on the body.