Lupus is a chronic autoimmune disease that attacks healthy cells in multiple systems and areas of the body. Lupus is a stealthy condition that commonly affects the skin. 13th-century physician Rogerius labeled Lupus (Latin for "wolf") because the skin rashes were like those caused by wolf bites. Today, 90% of lupus cases involve some type of skin rash. However, this is only one area affected by Lupus. Lupus may also involve the kidneys, joints, brain, heart, and immune system.
Types of Lupus
Lupus has four main types, each classified by the area of the body involved. SLE (Systemic Lupus Erythematosus) is the most common type contributing to 70% of lupus cases.
Other types of Lupus:
- Cutaneous lupus erythematosus
- Drug-induced lupus erythematosus
- Neonatal Lupus
This disease can be challenging to diagnose as its symptoms overlap with other autoimmune conditions. Even with its distinctive butterfly rash (or malar rash), only half of lupus cases will exhibit this.
Some struggle greatly with Lupus, while others experience only mild symptoms. Most patients wade through highly unpredictable flare-ups in their symptoms, along with many years of doctors' visits without an accurate diagnosis.
Conventional medicine helps with symptomatic relief through pain relievers, steroids, and hormone replacement. The naturally minded approach of functional medicine provides additional hope and support through diet, proper movement and exercise, and supplements.
Signs and Symptoms of Lupus
Lupus earned the label of "the great imitator" because it mimics the symptoms of other conditions such as fibromyalgia, Lyme disease, and thyroid conditions. Lupus patients generally must weather the inconsistencies of flares and remissions. Meanwhile, doctors diagnose and medicate the symptoms only to have the elusive nature of Lupus evade them. "A Lupus Foundation of America study of over 3,000 adults with lupus found that 46.5% report being misdiagnosed with something other than lupus and more than half (54%) were told that there was nothing wrong with them or that their symptoms were psychological."
Bringing more frustration to Lupus, there are no common early warning signs. Symptoms fluctuate over time and vary between patients. Since Lupus affects many different areas of the body, its symptoms are widespread:
- Chronic fatigue
- Joint pain and stiffness
- Swelling or edema
- Muscle pain
- Shortness of breath
- Chest pain
- Unexplained fever
- Skin rashes
- Malar ("butterfly") rash
- Photosensitivity (sensitivity to light)
- Vision disturbances (blurry vision, dry eyes)
- Brain fog and memory loss
- Mouth sores
- Digestive problems
Additionally, mental-emotional health is stressed by Lupus, causing depression or anxiety. Systemic inflammation from Lupus may also show up as insomnia. Raynaud's disease (extremities turn white or blue when exposed to cold) may also appear with Lupus.
What Causes Lupus?
The medical community does not fully agree on what causes Lupus. So, like most autoimmune diseases, Lupus carries with it the mystery of unknown origins. However, there is enough research to determine that Lupus has a connection to genes responding to their environment.
There are 50 genes associated with Lupus. While no single gene causes Lupus, genetics are known to contribute to the condition.
Research has yet to link a specific environmental trigger to Lupus. For now, the hypothesis is people with an inherited predisposition to autoimmune disease may develop Lupus after exposure to an environmental stimulus. The most agreed upon potential triggers are:
- Sunlight: UVA and UVB waves have been shown to both trigger and exacerbate Lupus.
- Infections: viruses such as EBV, CMV, and HERVs (human endogenous retroviruses) are thought to be associated with inducing Lupus.
- Medications: certain pharmaceuticals are known causes of Lupus; see Drug-Induced Lupus below.
Risk Factors of Lupus
- Sex: women are more likely to develop Lupus than men.
- Age: most cases are diagnosed between the ages of 15 and 44.
- Race/ethnicity: Lupus is more common in those of African American, Hispanic/Latino, Asian American, Native American, Native Hawaiian, or Pacific Islander descent.
- African American women are 3x more likely than Caucasians.
Drug-induced lupus erythematosus is a specific type of Lupus triggered by certain pharmaceuticals. While its presentation is like that of SLE (i.e., inflammation of the joints and lungs), this form of Lupus has a separate classification because of its particular trigger. Generally, stopping the inciting medication resolves the lupus symptoms.
The most common drugs known to induce Lupus:
- Hydralazine: used for hypertension
- Procainamide: used for arrhythmias
- Isoniazid: used for tuberculosis
- Minocycline: used for acne
- Anti-TNF: used for rheumatoid arthritis, psoriatic arthritis, spondyloarthropathy
Complications of Lupus
- About half of those with Lupus have kidney problems called lupus nephritis, which causes severe kidney damage. Its symptoms include edema or swelling of the ankles, high blood pressure, and kidney issues.
- When Lupus involves the brain, headaches and dizziness may occur. Behavior changes, vision changes, strokes or seizures, memory loss, or difficulty expressing themselves may also be experienced.
- Inflammation from Lupus can settle into the cardiovascular system and cause blood conditions like anemia. It may also increase the risk of blood clots or increased bleeding. The heart and blood vessels can also become inflamed, which increases the chance of heart attacks and heart disease.
- The inflammatory processes of Lupus can affect the lungs, making breathing hard or painful. Such inflammation may also cause bleeding in the lungs or pneumonia.
- Being an autoimmune condition, Lupus creates imbalances in the immune system leading to an increased risk of infections and a slightly increased risk of cancer.
- Other complications occur in bone health (bony tissue dies from lack of blood flow).
- In pregnancy (miscarriage or pre-term birth associated with high blood pressure) can occur.
How is Lupus Diagnosed?
Doctors will use medical history, family history (lupus or autoimmune diseases), laboratory tests, and a physical exam to rule out other disorders.
Most people with lupus test positive for ANA. But it's important to note that a positive ANA does not always mean you have Lupus. If you test positive for ANA, your doctor will likely order more tests for antibodies specific to systemic lupus erythematosus.
Labs helpful in diagnosing Lupus
- Autoantibodies are essential in testing for Lupus. Not only do they help confirm a diagnosis, but they can also look for other autoimmune conditions that may be occurring alongside Lupus.
- CBC checks for anemia and immune function.
- CMP tests for kidney and liver function.
- ESR and CRP gauge how much inflammation is in the body.
- Biopsy of the affected area (i.e., rash or kidney). Tissue biopsies examined under the microscope can show signs of an autoimmune disease.
Conventional Treatment Lupus
Currently, there is no cure for Lupus. For now, controlling symptoms is the focus of therapy. Pharmaceuticals used in treating lupus work towards reducing pain and swelling, calming the immune system to prevent further attacks on healthy tissues, reducing and preventing damage to joints, and reducing and preventing damage to organs.
Depending on how many areas of the body lupus affects, treatment may require multiple specialists. Also, SLE is known to occur along with other autoimmune conditions such as Sjogren's syndrome or thyroiditis. When these are present, additional treatments are necessary.
Commonly Used Treatments for Lupus
- Anti-malarials may address joint pain, rashes, fatigue, and lung inflammation. Hydroxychloroquine
- NSAIDs can help with mild pain and swelling.
- Corticosteroids reduce pain and swelling and calm the immune system (prednisone)
- BLyS-specific inhibitors work on abnormal B cells (part of the immune system responsible for producing antibodies).
- Synthetic hormones or birth control pills may regulate endometriosis or blood clotting.
Root Cause Treatment for Lupus
A low inflammatory diet focusing on whole foods and increasing omega-3 fatty acids and antioxidants from a diversity of fruits and vegetables has been shown to be beneficial for managing the lupus disease process. Removing processed foods, sugar, and gluten gives the gut a chance to heal and reduces inflammatory triggers.
If you have lupus nephritis (a kidney disease caused by Lupus), you may need to limit certain foods.
Your doctor can refer you to a registered dietician (a doctor who specializes in nutrition).
Balancing the microbiome is vital for any disease process, but research shows the oral microbiome is particularly involved with Lupus. Those with SLE tend to have more unfavorable conditions in their oral microbiome. Therefore, maintaining good oral hygiene along with gut microbiome support may be a benefit.
Turmeric's anti-inflammatory action and immune restorative properties provide versatile support for Lupus. Much like a steroid, turmeric reduces pain and inflammation but without side effects. Since turmeric balances the immune system, it safely regulates the immune response in autoimmune conditions.
ECGC, or green tea extract, has immunomodulatory and anti-inflammatory effects on Lupus. Research showed green tea supplementation significantly reduces disease activity of Lupus and increases the quality of life.
Vitamin D is a well-proven mainstay in autoimmune conditions. It has a strong capacity for balancing the immune system and can also help with the depression and anxiety that may come with Lupus.
DHEA can help with alleviating lupus symptoms and reducing the need for steroids. However, testing adrenal health and DHEA levels is best before supplementing.
Prioritizing proper sleep and exercise, not smoking, and daily meditation or relaxation techniques help to manage stress and reduce inflammation.
Lupus is a chronic autoimmune condition, with 90% of the cases affecting women aged 15-44. It presents many challenges with its varied difficult-to-diagnose symptoms.
Lupus doesn't hold any punches when it comes to body systems. That means both patient and practitioner must be equipped to treat the whole person. Therefore, the systems-focused approach of functional medicine can offer much assistance and encouragement to those suffering from Lupus.