Lupus is an autoimmune disease where the body’s own immune system attacks its healthy tissue and cells. It is a chronic, long-term condition that can affect anyone but it is more common in women and also in people under 50 years old.
What happens when you have lupus? A healthy immune system is designed to protect the body from harmful elements. However, when an individual has an autoimmune condition, the body fails to differentiate healthy tissues from antigens (viruses, germs and bacteria).
As a result, the antibodies released by the immune system attack both viruses and healthy tissue. This causes inflammation, pain, swelling and tissue damage. In advanced cases, the antibodies get through permeable walls of vital organs and cause failure.
There is no cure for lupus but there are several treatments that can help ease the symptoms. Symptoms differ from person to person. These would depend on which parts or organs in the body are affected. Symptoms can come and go, which makes the disease hard to diagnose. It may take several tests and long periods of observation to get a lupus diagnosis.
The most common symptoms of lupus are:
Fatigue is the most common symptom associated with lupus. About 90% of people who have lupus feel fatigue and malaise at some point.
Not to be confused with the feeling of tiredness, which happens to all of us, fatigue is more extreme and can even be debilitating in severe cases. It can completely affect the whole day and hinder you from accomplishing things because you end up just spending the entire afternoon sleeping.
Medical experts say that fatigue is often caused by underlying medical problems such as anemia, depression and fibromyglia. It can also be a side effect of the medication.
While fatigue can have a significant effect on health, it can still be managed. One of the first steps is to accept the situation. Fatigue is unfortunately part of the lupus battle and while it may be a big challenge, there are several things that you can do to fight it.
Here are some ways to fight fatigue:
- Have a doctor check and treat other underlying medical conditions.
- Check if your current medications need adjustment.
- Boost energy with regular light exercise.
- Get enough rest throughout the day to recharge.
2. Hair Loss
Thinning hair or hair loss is another common symptom. The experience can be different from case to case. Some may suffer from severe hair loss and lose hair in clumps, while there others may experience gradual thinning of hair.
According to the American Academy of Dermatology, it is normal to shed 50 – 100 strands of hair every day. There are a number of different factors that affect how much is shed daily including: stress, genetics and hair products. In cases of lupus, however, hair loss is much more extreme.
There are several reasons why hair loss happens in lupus: inflammation, discoid sores and medication.
Inflammation is one of main effects of lupus. When this is present on the scalp and hair follicles, hair loss and scalp changes happen. The scalp is not the only area that may be affected, this can also occur on eyebrows, eyelashes and beards.
Another reason that hair loss can happen is because of discoid sores. Lesions can on the scalp damage hair follicles and result in permanent scarring and hair loss.
3. Recurring Fever
Recurring low-grade fever is one of the signs of a lupus flare-up. A low-grade fever ranges between 98.5˚F – 101˚F and can occur on and off.
Fevers are usually a sign of inflammation or infection. However, in immunocompromised individuals, low-grade fevers can suddenly appear even without infection. This may be because of lupus disease activity. It is the body’s warning that a flare up is about to happen soon.
Flare ups happen when a trigger is experienced. Some known triggers include emotional stress, viral illnesses, exhaustion and injuries. When a lupus flare happens, symptoms start returning and sometimes increase in severity.
It is important to recognize your own triggers to know how and when to avoid them. Awareness, coupled with proper treatment can help prevent and minimize flare ups. When a low-grade fever resurfaces, it is best to monitor your health closely and prepare for other symptoms to appear.
Many people with lupus get a malar rash. This facial rash is one of the most distinctive signs of lupus because it is clearly visible. It is a red, slightly elevated and sometimes scaly rash that runs across the cheeks and the bridge of the nose. Because it is shaped like a butterfly, it has also been dubbed as the “butterfly rash”.
About 50% of individuals with lupus experience this rash, which often appears after exposure to sun or other sources of UV radiation. Lupus also causes photosensitivity, which is why the skin reacts differently.
This can also signify that a flare up is imminent. According to one study, a malar rash can also be a predictor of airway inflammation in systemic lupus.
It is best to stay away from the sun for prolonged periods of time and also wear sunscreen to protect your skin from harmful rays that can trigger malar rash.
5. Joint Pain
Because of the chronic inflammation, it is not uncommon for individuals with lupus to experience joint pain and muscle weakness. Over 90% of people with lupus experience some kind of joint or muscle pain during the course of the illness. This is reported as one of the first symptoms that is felt in the early stages of the disease.
In lupus arthritis, joints become stiff, swollen and painful. This typically affects fingers, wrists, elbows, knees, ankles and toes. It usually starts upon waking up and then gradually improves as you go through the day.
While there’s pain and stiffness, lupus arthritis is less disabling than rheumatoid arthritis. It is also not very likely to cause major damage to the joints.
There is also another kind of joint pain called Lupus myositis, where the inflammation is in the skeletal muscles. This affects muscles on the neck, thighs, pelvis, shoulders and upper arms. In more severe cases, it becomes difficult to do even the simplest things like combing your hair or turning your head.
This is often treated with over-the-counter pain medications. It is very essential to first determine if the joint pain is really caused by lupus or by another medical condition that may need a completely different treatment.
6. Gastrointestinal Problems
Lupus also affects the gastrointestinal system – a very important pathway that breaks down and processes the food that we eat. When this system is not functioning properly, it can have a major effect on the overall health.
The GI system comprises of several parts, which all have different functions. When one or more of them are affected, it can have a negative impact on the whole system. One of the common GI problems that manifests is GERD or gastroesophageal reflux disease – a condition where the acid in the stomach flows backward to the throat.
Digestive problems can also occur because the muscle of the on the stomach and intestine walls are not properly moving to digest the food. Other digestive difficulties include nausea, vomiting and lack of bowel movements.
If you take NSAIDs or nonsteroidal anti-infllammatory drugs to treat lupus, you can also be at risk for developing peptic ulcers. Strong medications can negatively affect the linings of your stomach and intestines. It is crucial to get the right medications and work closely with your doctor to figure out the best treatment that will be most fitting for your situation.
7. Thyroid Problems
The thyroid is an essential gland that secretes important hormones. These hormones influence metabolism, development, growth and body temperature. When lupus affects the thyroid, the hormones become imbalanced and cause a host of problems such as thyroiditis and hyper/hypothyroidism.
In autoimmune thyroid diseases, the harmful antibodies bind to the cells of the thyroid gland and this results to inflammation. The effects of thyroid dysfunction will depend on the specific disease.
Two of the most common thyroid disorders associated with lupus are:
Hyperthyroidism – This condition happens when the thyroid is overactive and produces too much hormones. The effects include heat intolerance, abnormal menstrual cycles, sweating, palpitations, restlessness and increased bowel movements.
Hypothyroidism – Hypothyroidism is the opposite, when the gland is underactive and not producing enough hormones for the body. This can cause weight gain, weakness, hair loss, impaired memory and even depression.
Thyroid disorders can also happen to people who don’t have lupus but it has been found out that it is more prevalent in those who have systemic lupus erythematosus or SLE. Some of the treatments done to regulate thyroid hormones include radioactive therapy, beta blockers and thyroid hormone replacement.
8. Kidney Problems
The kidneys are one of the major organs that suffer in lupus flare ups. When the kidney starts being affected, the condition can quickly become worse because of how important the kidney’s role is in the body.
These bean-shaped organs are responsible for maintaining fluid balance, filtering minerals from the blood, filtering waste from food, regulating blood pressure and creating hormones that produce red blood cells. Because of its filtering function, the body can become invaded by toxic substances if the kidneys are not working right.
When lupus attacks the kidney organs, this causes inflammation in the nephrons (an important part of the kidney). Without proper treatment and medication, this results to lupus nephritis – a potentially fatal autoimmune disease that destroys the kidneys.
Damaged kidneys will lose function and will no longer be able to properly filter or remove excess waste and fluid in the body. Symptoms of nephritis include:
- Swelling in extremities (feet, legs, ankles, fingers, arms and also eyes)
- Significant elevation in blood pressure
- Bloody urine
- Foamy urine
- Increased urination
Around 25% of people who have lupus nephritis will unfortunately develop end-stage renal disease or kidney failure. The treatment for this condition is highly individualized. Therapies may include corticosteroids or immunosuppressives. In worst cases, a kidney transplant may be necessary to replace the damaged organ.
9. Chest Pain
In the later stages of lupus, the lungs can also be affected. The inflammation can affect the lining of the lungs, the blood vessels or the lungs themselves.
One of the most common lung diseases that happen in lupus patients is pleuritis. In this condition, the pleura (or the outside lining of the lungs) suffer from lupus-caused inflammation. Symptoms include sharp, stabbing chest pains that can be suddenly felt when taking a deep breath, or when sneezing and coughing.
Fluid can also build up inside the lungs and the chest wall, which causes difficulty in breathing and chest pain. Pleural effusion happens to around 40% – 60% of lupus patients.
Inflammation in the lungs that is chronic will also result in scarring. Because of the scar tissue build up, oxygen will have a harder time travelling in and out of the lungs. This can bring about chronic dry cough, pain and difficulty breathing especially during physical activities.
10. Blood Disorder
Blood disorders are common in lupus. The antibodies that the immune system releases can also attack the blood and the bone marrow, which causes abnormalities and disorders. Red blood cells, white blood cells and platelets are the usual parts that get affected.
Anemia is one of the most common blood disorders associated with systemic lupus erythematosus. About 50% of SLE patients suffer from anemia. This can be caused a variety of reasons including inflammation, bone marrow problems, iron deficiency and reduced red cell production.
When there is irregularity in the blood cell production, there won’t be enough hemoglobin to carry and distribute oxygen to other parts of the body. This will result in fatigue, headaches, dizziness, irregular heartbeats and shortness of breath.