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Systemic Lupus Erythematosus and Sjogren’s Syndrome

Something’s wrong with your health, and it’s got you worried. You’re tired, your joints hurt, and you’ve got a rash that makes you self-conscious. Have you considered that it might be an autoimmune disease causing your symptoms? Autoimmune diseases come in all sorts of guises, but a rash and joint pain can be indications of a systemic disease that, without treatment, could start to affect some of your organs. If these symptoms are accompanied by other more serious symptoms like a fever, swelling, or shortness of breath, it’s important to get yourself checked out as soon as possible. You may be dealing with systemic lupus erythematosus, Sjogren’s syndrome – or both.

What Is Lupus?

Systemic lupus erythematosus (SLE) is an autoimmune disease where your immune system is tricked into attacking healthy tissue and organs. Your immune system is stuck in a vicious circle of injuring healthy tissue, promoting inflammation in the area, leading to further immune system attacks. Your body is on high alert.

Lupus is a system-wide inflammatory disease, which can affect your circulatory system, lungs, heart, kidneys, brain, joints, skin, and central nervous system. Each case of lupus is individual, and your symptoms depend on what parts of your body are affected. Symptoms can be mild or severe – and can come on either suddenly or gradually. Patients with lupus can have mild symptoms with the occasional ‘flare’ where symptoms intensify.

Common Symptoms of lupus include:

  • Stiffness, swelling and pain in joints
  • Fever
  • Brain fog, forgetfulness, and fatigue
  • Weight loss
  • Raynaud’s phenomenon – where your fingers and toes can turn blue or white when you’re cold or stressed
  • Headaches
  • Chest pain
  • Shortness of breath
  • Skin lesions made worse when exposed to the sun
  • A facial rash in the shape of a butterfly, covering your cheeks and bridge of nose
  • Skin rash elsewhere on your body

Lupus can be a tiring condition to live with, as it can be unpredictable and often quite debilitating. Left untreated, it can spiral out of control. But first: you need a diagnosis.

How Is Lupus Diagnosed?

There is no one test to diagnose lupus with 100% certainty– your doctor needs to look at a number of biomarkers and symptoms to determine if you have SLE, or whether it’s a different autoimmune disease.

  1. Blood tests – the following tests are useful in the diagnosis of lupus:
    1. Complete Blood Count – checking the number of red and white blood cells and hemoglobin is important, as low levels indicate anemia, a common sign of lupus.
    2. Erythrocyte sedimentation rate (ESR) – a common test when diagnosing autoimmunity, as high levels in the blood can indicate inflammation in the body.  Other inflammation markers like C-reactive protein (CRP) may be tested as well.
    3. Antinuclear antibody (ANA) – a good test to help diagnose lupus, as a positive result for these antibodies can lead to more specific antibody testing (like double strand DNA for example), with a view to narrowing down the diagnosis to lupus.
    4. Kidney and liver function – As lupus can affect the function of these organs, it’s important to check that they’re functioning correctly.
    5. Other immune system markers like compliment levels (C3a and C4a) may also be tested and can be signs of autoimmune disease.
  2. Urine test – An increase of red and/or white blood cells or protein in your urine can indicate that lupus is interfering with kidney function.
  3. Imaging tests – if you’re experiencing shortness of breath or chest pain, your doctor may want to check your lungs or heart for inflammation:
    1. Chest X-ray – checks for fluid or inflammation in the lungs.
    2. Echocardiogram – ultrasound technique that allows for a real-time image of your beating heart. A good way to check for issues with parts of your heart, such as the valves, and to check for fluid around the heart.
  4. Biopsy (optional) – Occasionally needed to check a specific part of your body:
    1. Skin biopsy – to see if lupus is affecting your skin.
    2. Kidney biopsy – to check the level of damage from lupus.

SLE is a serious condition, so it’s important that you see a doctor who has experience with autoimmune diseases and can advise you on how to manage your health effectively.

What Is Sjogren’s Syndrome?

Sjogren’s syndrome often occurs alongside other autoimmune diseases such as lupus and rheumatoid arthritis. This disease is characterized by your immune system attacking the glands that make saliva and tears, but can progress into affecting your lymph nodes, nerves, thyroid – and major organs like lungs, liver, and kidneys.

Early Sjogren’s syndrome symptoms include:

  • Dry mouth – a lack of saliva may make it hard to swallow or speak. Complications include:
    • Increased risk of oral cavities – saliva is integral for a healthy mouth microbiome and without its harmful bacteria can run rampant, causing inflammation and tooth decay.
    • Oral thrush – a disrupted mouth microbiome can also result in a yeast infection of the throat, mouth, and tongue.
  • Dry eyes – a disrupted tear film can make your eyes uncomfortably itchy and sore, often causing photosensitivity. Complications include:
    • Blurred vision that cannot be corrected by spectacles.
    • Corneal damage, as the tear film usually helps protect your eye.

Other symptoms include:

  • Swollen salivary glands – behind your jaw and in front of your ears
  • Dry skin or rashes
  • Chronic dry cough
  • Fatigue
  • Painful, swollen, or stiff joints
  • Vaginal dryness

If Sjogren’s syndrome progresses it can cause the following complications in major organs:

  1. Inflammation in the lungs, that may progress to bronchitis, pneumonia and chronic lung diseases.
  2. Inflammation in the kidneys leading to compromised kidney function
  3. Inflammation in the liver, leading to hepatitis or cirrhosis.

While Sjogren’s syndrome starts off with minor symptoms, like many autoimmune diseases it can set off a cascade of health issues. So it’s important to consult a doctor if you suspect you have Sjogren’s syndrome.

How Is Sjogren’s Syndrome Diagnosed?

Sjogren’s syndrome can be difficult to diagnose, as the symptoms are often similar to those of other diseases – and also to the side-effects of various common medicines. But certain tests can help narrow down the diagnosis.

  1. Physical exam – your doctor may wish to check:
    1. Your mouth, neck, cheeks, and chin to see if your salivary glands are swollen.
    2. Any rashes or patches of dry skin.
    3.  An ophthalmologist can examine your eyes:
      1. Especially your tear rate, using a Schirmer tear test, where filter paper catches tears at your lower lid.
      2. Under a slit lamp to check the surface of your eyes.
      3. Using drops to check your corneas for damage.
  2. Blood test – your doctor can check for:
    1. Anti-SSA and anti-SSB – the most specific biomarkers to Sjogren’s syndrome.
    2. Antinuclear antibody (ANA) – Up to 70% of patients with Sjogren’s syndrome have elevated ANA.
    3. Rheumatoid factor (RF) – a common antibody found in cases of autoimmunity, but useful to note in combination with the above antibodies.
  3. Imaging tests – Useful for checking your salivary glands:
    1. Sialogram – a specific type of imaging study, allowing your doctor to see how much saliva your glands release into your mouth.
    2. Salivary scintigraphy – uses a radioactive isotope to track the rate at which fluid in a vein moves into your salivary glands.
  4. Biopsy – a biopsy can detect large quantities on inflammatory cells within your salivary glands.

These diagnosis tests are so specific in order to pinpoint Sjogren’s syndrome accurately.

How Can Functional Medicine Help Me with My Autoimmune Disease?

Once you’re diagnosed with an autoimmune disease, you may be offered a number of medications and treatments to alleviate the most painful or frustrating symptoms. But few of these approaches tackle the underlying cause of your illness: inflammation.

Functional medicine focuses on treating the root cause of your illness, in a truly individualized way. Your doctor looks at the food you eat, the way you move and exercise, your sleeping habits, your total toxic load, and stress levels, and works together with you to make sustainable changes that can reduce the levels of inflammation in your body. There will also be a big focus on optimizing your digestive health, as about 80% of your immune system is located inside the gut.  You can make big changes to the way you manage your disease, and you can make a positive change in your life!

We can help you in tackling the underlying causes of lupus and Sjogren’s syndrome. If you’re interested in checking out functional medicine in the Phoenix, Scottsdale, Paradise Valley, Arizona area, call to book an appointment at 602 892-4727 or fill out our contact form. If you’re not local to us, why not try 7 Weeks to Your Healthiest Self – our masterclass that provides you with the benefits of functional medicine – from the comfort and privacy of your own home.

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