Lupus

Lupus describes a collection of autoimmune diseases. An autoimmune disease is where your immune system becomes hyperactive and attacks healthy cells and tissues by mistake. This can damage many parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels, and brain.

There are several kinds of lupus

Systemic lupus erythematosus (SLE) is the most common type of Lupus. It can be mild or severe, and can affect many parts of the body.
Discoid lupus causes a chronic red rash that doesn't go away
Subacute cutaneous lupus causes sores after being out in the sun
Drug-induced lupus is caused from taking certain medicines. It usually goes away when you stop taking the medicine.
Neonatal lupus, which is rare, affects newborns. It is probably caused by certain antibodies from the mother.

1. Latest News

Vitamin D and Systemic Lupus Erythematosus: Myth or Reality?

Updates on the latest treatment research from Lupus Research Alliance.

2. Symptoms

2. Symptoms and Solutions

There is no known cure for Lupus so it is a case of managing symptoms and controlling the disease with the goals to prevent and treat flares

when they occur, and reduce organ damage and other potential problems. It is important that the patient coordinates with their primary care doctor and collectively develop a plan with different health care providers and specialists and treat other problems as they come up. The most common symptoms of Lupus are

Extreme fatigue (tiredness)
Headaches
Painful or swollen joints
Fever
Dry eyes
Anemia (low numbers of red blood cells or haemoglobin, or low total blood volume)
Swelling (edema) in feet, legs, hands, and/or around eyes
Pain in chest on deep breathing (pleurisy)
Seizures
Depression
Butterfly-shaped rash across cheeks and nose
Sun- or light-sensitivity (photosensitivity)
Hair loss
Abnormal blood clotting
Blood disorders
Kidney disorders
Fingers turning white and/or blue when cold (Raynaud’s phenomenon)
Mouth or nose ulcers

Note: Always seek advice from a doctor before beginning any listed treatments. Treatments can affect everyone differently.

Inflammation

Many of the symptoms of lupus are caused by inflammation. Anti-inflammatories are the most common drugs used to treat lupus, and symptoms such as fever, arthritis or pleurisy, which generally improve soon after beginning treatment

Medical Treatments

Aspirin for:

is an over the counter pain reducing medication with anti-inflammatory and anticoagulant (blood-thinning) properties. It can control some of the symptoms of lupus.

Acetaminophen:

(Panadol or Tylenol) an over he counter medication to help relieve pain. This medication will not reduce inflammation or Lupus disease activity.

Nonsteroidal anti-inflammatory drugs (NSAIDs):

Are over the counter medications such as naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, others), that can be used to treat pain, swelling and fevers caused with lupus. Stronger NSAIDs are available by prescription. These medications can be harsh on the stomach and are best taken with food.

Corticosteroids:

are a group of stronger prescription medications that help regulate blood pressure and the immune system and are also a powerful anti-inflammatory. They work quickly to decrease the swelling, warmth, tenderness and pain that are associated with inflammation from Lupus. They work by lessening the immune system’s response. Note that Infections are one of the leading causes of death in people with lupus and long-term steroid use can increase your risk of infection. If you are taking steroids, take extra care to clean and protect any open wounds and report any infections to your doctor immediately.

Immunosuppressive medications for Lupus:

are prescription drugs used to control inflammation and the overactive immune system. These medications are sometimes used when a patient does not respond to steroids or cannot tolerate a high dosage of steroids, especially when steroids have been unable to bring lupus symptoms under control, or when a person cannot tolerate high doses of steroids. There can be serious side effects from these drugs as these medications reduce your body’s ability to fight off infections and increase the chances that you could develop viral infections. They also may increase your chances of getting cancer so careful discussion and monitoring by your doctor is essential. Whilst on immunosuppressants it is extremely important that you pay attention to your body and even the smallest cut or wound, and let your doctor know if any sign of infection begins, such as redness, swelling, tenderness or pain.

Antimalarials such as hydroxychloroquine (Plaquenil) and chloroquine (Aralen):

can be effective in mild forms of lupus where inflammation and blood clotting are factors. Antimalarials improve lupus by decreasing autoantibody production, protecting against the damaging effects of ultraviolet light from the sun. They can help improve skin rashes, mouth ulcers and joint pain. This medication is usually used in conjunction with other meds like steroids. Antimalarials are slow acting and can take a few months before they become effective.

Monoclonal Antibodies:

Antibodies normally fight invading organisms however in autoimmune diseases, such as lupus, antibodies attack the body's own tissues. Monoclonal Antibodies are in certain Lupus specific drugs (such as Benylsta) that reduce antibody production and inflammation that may cause organ damage in Lupus.

Repository Corticotropan Injection for Lupus:

Acthar contains a naturally occurring, highly purified hormone called ACTH and is thought to work is by helping your body produce its own natural steroid hormones, such as cortisol. These hormones may assist your immune system by helping your body defend itself against inflammation.

Professional Support:

Working with a trained practitioner can assist you to develop skills to calm anxiety and can also equip you with knowledge to find your next steps towards wellness. Please ensure that you find a practitioner who understands how to navigate the territory of complex chronic health conditions.

Alternative Treatments

Supplements for Lupus:

Omega-3 fish oil (2,000 milligrams daily): EPA/DHA in fish oil can help reduce inflammation.
DHEA (200 milligrams daily): can help with symptoms. Discuss with your doctor first.
Vitamin D3 (2,000–5,000 IU daily): can help modulate the immune system
MSM (2,000–8,000 milligrams daily): anti inflammatory properties and can also greatly improve digestive symptoms
Green superfood supplements: Works by alkalizing the body and assisting liver and kidney functions.
Turmeric: helps reduce inflammation and pain

Diet for Lupus:

An unprocessed wholefoods diet may help manage lupus because it helps control inflammation stemming from poor gut health. The best foods for lupus include:

Raw vegetables: promote an alkaline body, reduce inflammation and improve digestion
Wild-caught fish: provide omega-3 fats to help reduce inflammation
High-antioxidant foods (vegetables and fruit): include leafy greens, garlic, onions, asparagus, avocado and berries.
Bone broth: can reduce autoimmune and inflammatory symptoms that are associated with lupus. Consume eight to 16 ounces of bone broth daily as a beverage or as part of a soup.

Stress Reduction for Lupus:

Stress can cause Lupus flare ups so stress reduction can play a major role in reducing symptoms. Some options for stress reduction include yoga and acupuncture, spending time in nature, breathing techniques, exercising, praying, keeping a journal, reading, joining a support group, counselling, using essential oils and mindfulness.

Mindfulness for Lupus:

is a set of skills for healing, intuition, insight, calmness, focus, resilience and hope that you can develop to counter the stresses that chronic illness brings. You can literally "train your mind to promote healing. Mindfulness has a positive flow on affect into every aspect of a person’s life. For more info click here.

Blood Clotting

Blood clotting is a potentially life threatening symptom of Lupus that needs to be managed and monitored.

Medical Treatments

Anticoagulants for Lupus:

Anticoagulant medications include low-dose aspirin and prescription heparin (Calciparine, Liquaemin) and warfarin (Coumadin). Patients using warfarin must be monitored by their doctor to ensure their blood does not become too thin.

Fatigue

Fatigue with lupus is sometimes caused by an underlying medical problem, such as anemia, chronic fatigue, fibromyalgia, depression, or possibly a kidney or thyroid problem. It is important to rule out any other potential causes or factors of the patients fatigue with their doctor.

Medical Treatments

Pacing for Lupus:

Patients are advised to set manageable daily activity/exercise goals and balance their activity and rest to avoid possible over-doing which may worsen their symptoms. People who can function within their individual limits may then try to gradually increase activity and exercise levels (GET) while maintaining pacing methods.

Exercise for Lupus:

It seems like the opposite would be true, but exercise that gets your muscles moving and makes you sweaty can actually lessen fatigue. Studies show that people with lupus who exercise often feel more energetic as well as more hopeful and happy about life. Stronger muscles and bones are an added benefit.

Support Networks:

Reach out to your friends or partner. Studies have shown that people with lupus that communicate well with their friends and family feel more in control and better about themselves and are less likely to feel fatigued.

Rest for Lupus:

Ensuring you have enough sleep and take enough rests during the day when required can make a big difference to the amount of fatigue experienced. For sleep solutions, refer to our section on "Poor Sleep" under CFS symptoms here

Alternative Treatments

Vitamin D:

Many Lupus patients have low levels of vitamin D so supplementation of this may go well to reducing fatigue.

Acupuncture:

Some people with Lupus find relief from acupuncture. Acupuncture clears any blockages in the body and assists the body to repair and heal itself.

Tai Chi for Lupus:

An ancient martial art/exercise that has been used to help patients.

Mindfulness for Lupus:

An excellent "no drugs" way to calm the immune system is through mindfulness techniques. More info

Lupus Skin Disease

Approximately two-thirds of lupus patients will develop some type of skin disease known as cutaneous lupus erythematosus. Symptoms include rashes or sores (lesions), most of which will appear on sun-exposed skin areas. Any changes to lesions must be discussed with the patients doctor as cancer can develop in long term lesions.

Medical Treatments

Lupus Skin Disease Prevention:

Can help be achieved by avoiding sunlight between 10am and 4pm, wearing sunscreen, wide brim sunhats and sun protective clothing when outside. Also it is advisable to minimise time under indoor fluorescent lighting. It is also important to stop any nicotine intake such as smoking or nicotine patches as nicotine may exacerbate symptoms. If Lupus skin symptoms are drug-induced, stop the responsible medication (discuss with your doctor).

Corticosteroid creams:

ointments, gels, solutions, lotions, sprays, foams help to reduce inflammatory symptoms.

Calcineurin inhibitors for Lupus Skin Disease:

such as pimecrolimus cream or tacrolimus ointment are medications that act on the immune system to reduce inflammation.

Intralesional corticosteroid for Lupus Skin Disease:

can be injected into small lesions which are resistant to topical therapy.

Topical Retinoids:

are creams, lotions and gels containing one or other of group of medicines derived from Vitamin A. They have been reported to have helped some patients.

Oral Retinoids:

an oral retinoid that works in psoriasis by slowing down the proliferation of the skin cells.

Isotretinoin:

is a vitamin-A derivative and is an effective medication for skin diseases.

Antimalarials for Lupus Skin Disease:

especially hydroxychloroquine are a systemic approach that also can help with Lupus skin issues.

Immunosuppresive Medications:

is another systemic approach that can also benefit Lupus skin issues.

More Extreme Medications for Lupus Skin Disease:

That must be discussed with your doctor include

Procedures:

that can treat or remove skin lesions include

Phototherapy using UVA1 may be useful to treat skin lesions
Photodynamic therapy (PDT) has been reported to clear chronic cutaneous Lupus
Vascular laser can reduce telangiectasia (a condition in which widened venules (tiny blood vessels) cause threadlike red lines or patterns on the skin)
Surgery may improve appearance of disfiguring scars.

Apple Cider Vinegar:

Some people have benefited by dabbing apple cider vinegar on Lupus skin irritations.

Alternative Treatments

Pain

These pains include joint pain, muscular pain, headaches and chest\abdominal pain. Widespread muscle and connective tissue pain is known as Fibromyalgia. Fibro does not cause inflammation, arthritis, skin rashes, or damage to tissues, organs and bones like lupus. Medications to treat lupus have little or no effect on Fibro patients - more information on Fibromyalgia here

Medical Treatments

NSAIDs for Lupus:

work by reducing inflammation. Diclofenac, ibuprofen and naproxen are good for sprains, strains, infection related pain and joint pain associated with arthritis. These medications can be quite harsh on the stomach and some patients cope better with a subsidary medication known as COX-2 inhibitors such as celecoxib.

Alternative Treatments

Mindfulness for Lupus:

Mindfulness is a strategy that has many health benefits including controlling pain. More info

Acupuncture and Hypnosis:

Are methods that have been proven to relieve pain in some individuals.

Detox Baths for Lupus:

Using Epsom Salts.

Willow Bark:

A natural painkiller that contains the same active ingredient as aspirin. Avoid if you have an aspirin sensitivity.

Omega 3 Fish Oils:

Help to block inflammatory cytokines, and may give pain relief to some.

Olive Oil for Lupus:

Contains similar properties to ibuprofen.

Capsicum Cream:

Can be used for localised joint or muscle pain. Use carefully and avoid broken skin as it can burn.

Headaches

Many lupus patients suffer from headaches on a daily basis. Lupus headaches are thought to be caused by abnormalities in the blood vessels that prevent the brain from receiving a continuous flow of blood. Management of lupus headache requires patients to work closely with their doctor and rheumatologist.

Medical Treatments

NSAIDs for Lupus:

Can help reduce the severity of Lupus headaches. Some are available over the counter such as ibuprofen and stronger NSAIDs require a prescription.

Antimalarials:

like Plaquenil are systemic drugs to treat Lupus and have been found effective in the treatment of lupus headaches, as well as other lupus symptoms.

Corticosteroids:

like prednisone are drugs that work quickly to suppress inflammation in the body, which is a leading cause of headaches in lupus patients.

Rest:

Adequate rest and naps during the day can reduce the frequency of Lupus headaches.

3. Diagnosis/Tests

Alternative Treatments

Stress Relieving:

activities such as a warm bath or mindfulness can reduce the severity of headaches and help with management of the pain.

Mindfulness for Lupus:

Mindfulness is a strategy that has many health benefits including controlling pain. More info

Acupuncture and Hypnosis for Lupus:

Are methods that have been proven to relieve pain in some individuals.

3. Diagnosis and Tests

There is no one test to conclusively confirm that a patient has Lupus. Diagnosis is made by the doctor examing all symptoms that the patient is experiencing and performing the following tests.

Blood tests:

including CBC (complete blood count), anitbody bloodtests, complement proteins, CRP (C-reactive proteins), ESR (erythrocyte sedimentation rate)

Blood clotting time tests:

Prothrombin time (PT) measures blood clotting and can show whether you may be at risk for not clotting quickly enough at the site of a wound. Partial thromboplastin time (PTT) also measures how long it takes your blood to begin to clot. Modified Russell viper venom time (RVVT) platelet neutralization procedure (PNP), and kaolin clotting time (KCT).

Urine Tests:

Spot urine test shows kidney functioning.

Tissue biopsies:

Usually taken from the skin and kidneys. This can show inflammation and any tissue damage. It can also help determine autoimmune antibodies.

Which medications or supportive therapies have helped your Lupus?

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