Lupus

By Dr. Loretta Lanphier, ND, CN, HHP, CH

Have you ever used the term “I feel like I got hit by a Mack truck?” Imagine having numerous days like this, when you feel you can’t even get out of bed. You begin to wonder what in the world is wrong? Then, mysteriously, the symptoms vanish seemingly overnight. You’re fine for a while, but then the fatigue and despair return…Are you crazy? Are you dying from some strange malady? It might feel like it, but probably not. You may be suffering from a disease called lupus.

What is Lupus?

Lupus is an inflammatory autoimmune disorder whereby the immune system turns on itself and can attack almost any system of the body. The joints, skin, kidneys, blood cells, heart, and lungs are the most common victims.

There are three main types of Lupus. Systematic lupus erythematosus (SEL) is the most common. The other two are discoid lupus erythematosus lupus and drug-induced lupus. A rare form called neonatal lupus erythematosus can be passed by mothers to their babies during childbirth.

Lupus is one of many autoimmune diseases. An autoimmune disease involves an abnormal response of the immune system. Something goes wrong, and instead of sending antibodies and white blood cells against invaders like bacteria, viruses, and fungi, the body mistakenly attacks healthy organs and tissues. The results of these attacks in patients with lupus is inflammation. Inflammation is a general term for swelling, redness, increased blood flow, and tissue destruction.

Lupus patients have an immune system that has lost control of certain antibodies. The particular rogue antibodies associated with lupus are called antinuclear antibodies and anti-DNA antibodies. In a healthy immune system, these antibodies play a very useful role. They attack and destroy the nucleus and DNA of enemy organisms. However, in lupus patients these same antibodies turn their weapons against healthy cells of the body.

What Are the Risk Factors for Developing Lupus?

  • Gender: 90% of all lupus cases are found in females.
  • Age: Lupus affects people of all ages, but the largest percentage of cases are found in those between the ages of 15 and 45
  • Race: African-Americans have the highest incidence of lupus among all the races. It is also often found in Native Americans, Asians, and Hispanics
  • Family history: If you have a close family member who has had lupus, your risk is increased
  • Epstein-Barr infections: The Epstein-Barr virus is one of the most common of all human viruses. It is a member of the herpes simplex family, and is also the culprit behind mononucleosis. Recurring Epstein-Barr infections greatly increase an individuals chances of getting lupus.
  • Pregnancy: Lupus often makes its initial appearance during pregnancy or shortly after giving birth. Pregnancy can also cause a relapse (flare) in women who already have the disease.

What Are the Signs and Symptoms of Lupus?

Lupus is one of those diseases that wears a lot of different hats. It has been nicknamed “the disease with a thousand faces.” It is difficult to describe what lupus looks like, because it acts differently in every patient. It may attack quickly and severely, or it may be slow and progressive. It may be temporary, or it may be permanent. The symptoms themselves vary from patient to patient because they are dependent on which parts of the body the lupus attacks. If there is one common factor it is the fact that lupus sufferers almost all experience their symptoms in episodes called “flares.” The illness may attack intensely during a flare, and then go underground for varying lengths of time. Often symptoms will disappear or almost disappear until the next flare.

The list of possible symptoms is long and daunting. Let’s break it down by body systems:

  • Joints:  90% of all lupus patients experience arthritis-like symptoms that include joint pain and stiffness, swelling, and redness. This is often found in the fingers, hands, wrists, and knees.
  • Skin:  A number of distinct skin rashes commonly appear in lupus patients. One of the more common ones is a red butterfly-shaped rash on the face (malar rash). In fact, lupus gets its name from a rash. Doctors at one time thought common lupus rashes looked somewhat like a wolf, and hence the name. Besides rashes, other skin problems are common. These include the “discoid” rash that manifests itself in red, scaly bumps that may leave scars or pits on its victims. The discoid rash is the only symptom associated with the discoid form of lupus. Other lupus sufferers experience skin lesions, hair loss, and ulcers on the roof of the mouth.
  • Kidneys:Lupus victims are susceptible to serious kidney problems. The kidneys of many patients suffer extensive damage. Lupus can cause glomerulonephritis, a condition whereby the kidneys are unable to filter toxins from the blood, leading to kidney failure. Kidney problems in lupus patients can also cause swollen feet and ankles, and high blood pressure.
  • Brain and central nervous system: Lupus can cause headaches, seizures, dizziness, strokes, and even behavioral changes, confusion, and psychosis.
  • Gastrointestinal system:  Common symptoms include nausea, vomiting, diarrhea, weight loss, and abdominal pain caused by peritonitis (inflammation of the lining of the abdomen).
  • Heart and circulatory system:  Serious life-threatening complications may occur due to lupus, such as pericarditis (inflammation of the tissues surrounding the heart) and myocarditis (inflammation of the heart muscle itself). These can lead to blood clots, irregular heartbeat (arrhythmia), heart failure, or death.
  • Lungs: Lupus can cause pleurisy (inflammation of the tissues around the lungs), which involves fluid collecting in the lungs. Coughing and shortness of breath are common signs of pleurisy.
  • Eyes: Red, dry, sore eyes are common. In extreme cases, blindness can result from vasculitis (inflammation of the blood vessels around the retina).

Other common symptoms not specific to a certain body system may include:

  • Fatigue: Ongoing feeling of exhaustion that is not relieved by a good night’s sleep. This type of fatigue is pervasive and many patients say they never feel rested or up to speed.
  • Fever: This may be found in the early stages of lupus. Often it is an unexplained chronic fever of 100 F that comes and goes.
  • Swelling: Often found around the eyes, legs, and in the glands. Swelling of the spleen is also common.
  • Depression: Many patients experience significant depression. How much of this is a direct result of the illness, and how much is a response to dealing with the symptoms, is not known. Most likely a combination of the two.
  • Raynaud’s phenomenon:  Lupus can bring on this condition that causes fingers, toes, nose, and ears to turn pale and numb when exposed to cold temperatures.

What Are the Causes of Lupus?

The exact cause of lupus is unknown. As with most autoimmune diseases, it is thought to be a combination of factors. Some of these factors are suspected in other autoimmune diseases as well. Despite significant amounts of research about lupus and autoimmune diseases in general, the puzzle has yet to be solved. There are some theories that may help us to understand the illness better:

  • Infections:  There is some evidence that certain viral or bacterial infections can possibly trigger lupus in some individuals. Researchers believe some people, for reasons not completely understood yet, are more susceptible to this trigger than others. The hardest evidence points to recurring episodes of Epstein-Barr infections as a possible risk factor for lupus
  • Sunlight: Many lupus patients are photosensitive, or overly sensitive to light. Scientists are not sure exactly what connection sunlight might have in this puzzle, but it appears lupus patients tend to more easily experience flares when overexposed to sunlight. One theory is that sunlight in lupus patients brings certain proteins to the surface of the skin, triggering an abnormal immune system response which causes inflammation.
  • Prescription drugs:  There are four main types of drugs that have been implicated in triggering lupus: chlorpromazine (an antipsychotic), hydralazine (a blood pressure medication), isoniazid (for tuberculosis), and procainamide (a heart medication). This generally does not happen unless folks have been taking these medications for an extended period of time, at least several months or in some cases years. Even then, the occurrence of drug-induced lupus is very low. Incidentally, this is the only form of lupus that has a higher rate of incidence in men than women. This is most likely due to the fact that more men than women are using these medications.
  • Hormones:  This is an area that has caused a lot of interest amongst researchers. A link between hormones and lupus has long been suspected simply because the vast majority of lupus patients are females. Some studies also indicate that many women report their symptoms are worse when menstruating, pregnant, using birth control pills, or undergoing hormone therapy.

There are many other possible causes or triggers for lupus, and many of these are anecdotal, relating to people’s personal experiences. Lupus, I think, is one of those diseases that sufferers take personally. There might not be any hard scientific research to back up their theories, but they know themselves and their bodies and have a pretty good idea of what might have triggered lupus in their own circumstances. Some people have suggested:

  • Food allergies
  • Artificial sweeteners (aspartame)
  • Stress
  • Silicone breast implants
  • Mercury dental fillings
  • Hair dye
  • Pesticides and other toxic chemicals
  • Vaccinations

What Treatments Are Available for Lupus?

Mainstream medicine has not had much success at treating lupus. The best that can be done, from their perspective, is to treat the symptoms with various and sundry medications. A drug that has been used to treat malaria is among the favorites. The truth of the matter is that the best treatment for lupus is to take good care of yourself and keep your body in a state of health through diet and lifestyle choices. Some suggestions that may specifically apply to lupus are:

  • Get plenty of rest. The fatigue from an illness like lupus can be very overwhelming. Some health care providers recommend 8-10 hours of sleep per night, with naps as needed during the day. I know that is not possible for all of us, but get as much good rest as you can.
  • Watch the amount of sun you get.  Stay out of the sun during the heat of the day, which is usually from 10am to 4pm.  If you must be out, stay covered and don’t let yourself get overheated. Even too much exposure to indoor lighting can increase the amount of UV to unhealthy levels. Many lupus patients have to be strict about this or they may have to pay the price of another flare.
  • Exercise:  It may seem absurd to suggest exercise for people who are suffering from debilitating fatigue, but studies have shown that regular exercise for lupus patients can both prevent flares, and help folks to recover faster.

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