Demystifying Lupus: Part 1


This is Part 1 of a three-part article series in which I attempt to demystify the autoimmune disorder lupus. So keep up with me and over the next couple of weeks, I will teach you about Lupus.

This article provides a background on our conventional understanding of lupus: what it is, who gets it, common symptoms, and how it’s diagnosed. In Part 2 , I review our current understanding of what causes lupus and autoimmune diseases in general. In Part 3 , I will discuss how the Paleo diet can help to overcome lupus and other autoimmune diseases.

What is Lupus?

lupus-what-is-lupus-300x194.jpgPerhaps you’ve heard of, or know someone with the autoimmune disease lupus. Or maybe, like me, you’ve been diagnosed with lupus. The incidence of lupus is widespread (affecting more than 1.5 million Americans and approximately 5 million people worldwide), yet there remain many questions and uncertainties regarding exactly why and how people develop lupus. The Lupus Research Institute claims that lupus is “one of America’s least recognized major diseases” due to the difficulty in diagnosing the condition, which can mimic the symptoms of other diseases. Hence lupus is often referred to as the “great mimicker” and the “great imitator.” While the term ‘lupus’ is used rather broadly, people are most often referring to Systemic Lupus Erythematosus (SLE), which is the most common, and often more serious form of the disease. The other major types of lupus are discussed briefly below.

Systemic Lupus Erythematosus (SLE)

Lupus is a chronic (long-term) autoimmune disease. Stated simply, autoimmune diseases result from an immune system gone haywire, in which the body mounts attacks against itself by producing autoantibodies that mistakenly destroy healthy tissues. As far as autoimmune diseases go, SLE is one of the worst due to the widespread nature of its destruction. In SLE, a person’s own immune system targets and attacks virtually any organ or tissue in their body such as the skin, kidneys, liver, brain, nervous system, heart, lungs, blood vessels, and joints. SLE ranges in severity from mild to severe, and can even be fatal, which most often results from kidney failure, cardiovascular diseases, or serious infections (often related to immunosuppressive drug therapies used to treat lupus).

Who Gets Lupus?

Like other autoimmune disorders, SLE occurs more commonly in women, with more than 90% of SLE sufferers being female. Women of color are 2-3 times more affected than Caucasians. Lupus can also affect men, children and teens, but most people who develop SLE are women in their 20s and 30s. Lupus is NOT contagious, meaning you cannot ‘give’ or ‘get’ lupus to or from anyone else.

Diagnosing SLE

No two cases of lupus look exactly the same, and the outward manifestations can largely vary between individuals. Because SLE can affect virtually any organ in the body, a wide array of symptoms can be present depending on what tissues are currently under attack by the immune system. Many of these symptoms also appear in other illnesses, such as rheumatoid arthritis or fibromyalgia, hence the difficulty in accurately diagnosing lupus, and its nickname as “the great imitator.” Due to the difficulty in diagnosing SLE, the American College of Rheumatology has listed 11 common criteria to help doctors with the diagnosis. Having four or more of these criteria (currently or in the past) strongly suggests that a person may have SLE.

While there is no single test that can accurately diagnose a person with lupus, it is estimated that more than 95% of people with lupus will have a positive ANA (antinuclear antibody) blood test. However other diseases may also cause a positive ANA test, and up to 15% of “healthy” people also test positively. More specific tests for lupus involve detecting autoantibodies that attack native DNA (anti-DNA) and Sm nuclear antigen (anti-Sm). Approximately 50% of people with SLE have antibodies in their blood directed against the phospholipid components of cell membranes, known as antiphospholipid antibodies, which can lead to blood clots, miscarriages, and other complications.

Symptoms of SLE

The signs and symptoms of lupus are essentially the same across all ages, ethnicities, and in both sexes. The symptoms of lupus may come and go, and when a person is experiencing active symptoms it is called a “flare.” When symptoms temporarily subside, the disease is said to be in “remission.”

Common symptoms of SLE include rashes (i.e. butterfly/malar rash, discoid rash, and rashes triggered by sunlight), nose or mouth ulcers, sensitivity to the sun (photosensitivity), arthritis, kidney disorders, inflammation in the lungs or heart (pleuritis or pericarditis), mental health disorders (i.e. seizures, strokes, psychosis), and blood disorders (i.e. abnormally low levels of red blood cells, white blood cells, lymphocytes, or platelets).

Other symptoms of SLE include extreme fatigue, malaise, depression, fever, headaches, memory problems, edema (swelling in the feet, hands, legs, glands, or around the eyes), Raynaud’s phenomenon (fingers turn white or blue when cold or stressed), alopecia areata (bald spots), abnormal blood clotting, shortness of breath, dry eyes, and other skin lesions that may worsen with exposure to the sun. While SLE can attack anywhere in the body, the areas generally affected are the skin, joints, and kidneys.

Major Types of Lupus

The four major types of lupus include SLE, cutaneous (discoid) lupus, drug-induced lupus, and neonatal lupus. Cutaneous lupus erythematosus (AKA discoid lupus) is a form of lupus that affects only the skin, and can cause rashes anywhere on the body, generally on the face, neck and scalp. In discoid lupus, the main organ affected is the skin, however some patients with SLE will also experience discoid lesions (i.e. the butterfly rash), and approximately 10% of people with discoid lupus will eventually develop SLE. Drug-induced lupus (DIL) can result from taking certain medications for a long time, and the symptoms often disappear within 6 months of stopping the provoking medication. Neonatal lupus is more rare than the other forms, is not a true lupus, and occurs when a baby is born to a mother who herself has lupus. While babies can be born with serious issues from a mom who has lupus, their symptoms often subside within the first few months of life without causing any permanent damage.

lupus-rheumatologist-200x300.jpgTreating Lupus

As you can see, lupus is a very serious disease, and conventional treatments depend on a person’s current symptoms and their severity. Most people diagnosed with lupus will be referred to see a rheumatologist, a doctor who specializes in treating autoimmune diseases. Commonly prescribed treatments include anti-inflammatory medications, immune suppressing medications, antimalarial drugs, and biologics. As implied by their names, these drugs carry significant risks by inhibiting our body’s natural immune responses. Also, not everyone responds to these treatments, and as is the case with many medications, there can be significant side effects. While there may not be a “cure” for lupus, I urge you to not lose hope, as many people have successfully used the Paleo diet to put and keep their lupus and other autoimmune diseases in remission.

In the next article , I review our current understandings about what causes lupus and autoimmunity, and in Part 3 , we’ll discuss how the Paleo diet can help to overcome autoimmune disorders, including lupus.

In good health,

Kinsey Jackson, MS, CN