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Living with a skin rash, joint pain, fatigue, and photosensitivity can be emotionally and physically difficult to deal with. These are just some of the symptoms that characterize lupus, a chronic autoimmune disease. Understanding what lupus is and how to treat it are great first steps toward managing symptoms. This article gives an overview of what lupus is and what can be done to treat it.
What is lupus?
Lupus is a chronic autoimmune disease that can affect the joints, kidneys, skin, brain, heart, lungs, and blood cells. According to the Lupus Foundation of America, nearly 1.5 million people have lupus in the United States. The most common symptoms of lupus include joint pain, skin rashes, fatigue, fever, and hair loss.
Even though lupus can’t be cured, flare-ups and symptoms can be managed with proper treatment. A doctor may prescribe certain medications such as immunosuppressants or corticosteroids to help manage symptoms. Lifestyle changes like exercising regularly and not smoking may also be part of a doctor's recommended treatment plan.
Doctors and researchers are always looking for new ways to bring relief to people with lupus through new treatment options. Lupus research looks into everything from how genes play a role in lupus to stem cell transplants that could help with organ damage. This article by the U.S. National Library of Medicine explains how some new treatments are focused on blocking disease pathogenesis. As treatment options become better, more and more people with lupus are experiencing an improved quality of life.
How is lupus diagnosed?
Lupus occurs when the body’s immune system doesn’t function properly and attacks healthy tissues and organs. Lupus is caused by many different factors, but most doctors say that it’s commonly caused by genetics, hormones, or external triggers such as medications or infections. Anyone can get lupus, but women have an increased risk of getting the disease, along with those of African American, Native American, Hispanic, and Asian descent.
There are four different types of lupus: neonatal and pediatric lupus erythematosus (NLE), discoid lupus erythematosus (DLE), drug-induced lupus (DIL), and systemic lupus erythematosus (SLE). Systemic lupus erythematosus is the most common type of lupus and affects multiple organs in the body.
Many people who have lupus will develop what’s called cutaneous lupus erythematosus, which is a skin disease that causes rashes and sores that are made worse by sun exposure. If someone has a rash, sores, or lesions, this may make it easier for a doctor to diagnose someone with lupus.
Some people may develop what is called lupus nephritis, which is inflammation in the kidneys that can cause high blood pressure or kidney failure resulting in dialysis. People with lupus who have this condition may have swollen hands, ankles, or feet, blood in their urine, or high blood pressure.
There is no single test that can confirm whether or not someone has lupus. Doctors will look at a person’s medical history, do a physical exam, and ask about any family history of autoimmune disease. Sometimes, a blood or urine test and skin or kidney biopsy may be required. An antinuclear antibody test (ANA) can help determine whether or not your immune system is making autoantibodies of lupus.
A doctor, rheumatologist, or other healthcare professional may ask the following questions to help confirm a diagnosis:
- Does anyone in your family have any autoimmune diseases?
- When did your symptoms first appear?
- Are you currently taking any medications?
- Are you allergic to any medications or do you have any allergies?
Lupus treatment options
There is no cure for lupus, but symptoms and flare-ups are often successfully managed with proper treatment methods. Antimalarial drugs, immunosuppressants, and corticosteroids are just a few examples of the types of medications that doctors prescribe to prevent lupus flare-ups and manage symptoms. The type of medication prescribed will depend on the individual, what type of lupus they have, and their individual response to treatment.
Certain lifestyle changes are an important part of a well-rounded treatment plan for lupus. Not smoking, keeping a healthy weight, eating well, and exercising regularly can help people with lupus live higher-quality lives with fewer symptoms. Some people turn to natural and home remedies like turmeric and MSM to help manage symptoms like pain and anxiety.
Speaking with a healthcare professional is the best way to determine the right treatment plan based on individual symptoms and needs.
“Lupus is an incredibly challenging autoimmune disease and requires a comprehensive treatment plan," says Elroy Vojdani, MD, an Institute for Functional Medicine certified functional practitioner in Los Angeles. "All patients should be seen routinely and regularly by a rheumatologist who can help guide them through appropriate medical options for controlling or reducing the activity of this autoimmune disease—typical choices include oral steroids, oral immunosuppressants, and oral/injectable biologics (medication that disables portions of the immune system)."
Functional or integrative medicine specialists can recommend other treatments such as proper diet, lifestyle, and supplements that may help to improve the overall condition.
Lupus medications
The type of medication that’s prescribed to treat lupus will depend on individual symptoms and responses to medication. A healthcare professional can determine the proper dosage and form of medication on a case-by-case basis. Antimalarial drugs, BLyS-specific inhibitors, corticosteroids, NSAIDs, and immunosuppressants are all examples of medications that a doctor may prescribe. Medications will be prescribed to help reduce pain and swelling, balance hormones, prevent joint damage, and to manage flare-ups.
Antimalarial drugs
Antimalarial drugs have been known to help with lupus flare-ups and can also help those with lupus live longer lives. Plaquenil (hydroxychloroquine) and Aralen (chloroquine phosphate) are two examples of popular antimalarial drugs that can help with symptoms of joint pain, fatigue, and skin rashes. Common side effects of antimalarial drugs include stomach pain, nausea, vomiting, and diarrhea.
BLyS-specific inhibitors
These types of drugs limit the amount of abnormal B cells found in people with lupus. Benlysta (belimumab) is a BLyS-specific inhibitor prescribed for lupus. Common side effects of this type of medication include allergic reaction, dizziness, and depression.
Corticosteroids
Corticosteroids can help relieve pain, swelling, and tenderness associated with lupus. High doses of corticosteroids are sometimes used to calm the immune system, but side effects like depression, allergic reaction, and stomach pain may occur. Commonly prescribed corticosteroids for lupus include Dexamethasone Intensol and Solu-Cortef (hydrocortisone).
Non-steroidal anti-inflammatory drugs
For mild pain and swelling, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can be helpful. These drugs are available without a prescription and are not meant to replace any other lupus medication that a doctor might prescribe.
Immunosuppressants/cancer medications
For people with severe cases of lupus where organs are affected, a doctor might prescribe immunosuppressive medications. These types of medications are typically only used in severe cases when other medications haven’t worked. They can cause serious side effects and lower the body’s ability to fight off infection. Cellcept (mycophenolate mofetil) is an example of an immunosuppressant sometimes prescribed for lupus.
Cancer medications are also occasionally used to treat lupus. They work by suppressing the immune system, which helps to keep it from attacking healthy tissue and organs. Rituxan (rituximab), Cytoxan (cyclophosphamide), and Trexall (methotrexate) are examples of cancer medications. Cancer medications may have serious risk factors like brain infection, allergic reaction, and trouble breathing.
What is the best medication for lupus?
There is no one universal lupus medication that’s best for everyone. Individual symptoms and responses to treatment vary. A doctor can determine the best medication for lupus based on an individual’s symptoms, medical history, and response to treatments. Here’s an overview of popular medications that a doctor may prescribe.
| Best medications for lupus | ||||
|---|---|---|---|---|
| Drug name | Drug class | Administration route | Standard dosage | Common side effects |
| Benlysta (belimumab) | BLyS-specific inhibitor | Injection | 200mg injected once per week on the same day | Allergic reaction, dizziness, and depression |
| Dexamethasone Intensol | Corticosteroid | Oral | 0.75-9mg taken daily as directed by a healthcare professional | Stomach pain, vomiting, and depression |
| Plaquenil (hydroxychloroquine) | Antimalarial | Oral | 1-2 200mg tablets taken 1-2 per day | Headache, nausea, and diarrhea |
| Solu-Cortef (hydrocortisone) | Corticosteroid | Injection | Injected by or as directed by a healthcare provider | Allergic reaction, depression, and joint pain |
A prescribing mental health professional determines the best dosage based on medical conditions, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
What are some common side effects of lupus medications?
As with any medication, there is always the potential for side effects. Common side effects associated with lupus medications include depression, stomach pain, vomiting, dizziness, joint pain, chest pain, and skin rashes. Contact your doctor or pharmacist if your side effects persist or worsen.
Lupus medications may cause allergic reactions that result in hives or difficulty breathing. Allergic reactions can be life-threatening. You should seek immediate medical care if you believe you are experiencing an allergic reaction.
This list of side effects is not comprehensive. Ask a healthcare professional for more details regarding the possible side effects of a particular medication.
What is the best home remedy for lupus?
Some people find relief from their lupus symptoms through natural and home remedies. Certain lifestyle changes, home remedies, and natural treatment options may help prevent lupus from worsening. Many natural supplements are not approved by the FDA but have been known to bring symptomatic relief to people. Here are some of the most popular natural and home remedies for lupus:
- Reducing stress: Finding ways to reduce stress can help prevent lupus flare-ups. Managing psychological and emotional stress can be very beneficial, especially since lupus can lead to a stressed-out nervous system. Meditation, yoga, acupuncture, and being in nature are all good ways to help calm the nervous system down. Different people find some things work better for reducing stress, so it’s just a matter of finding what works best for you.
- Exercising regularly: Keeping a regular exercise schedule can help people with lupus feel less stress, get better sleep, and experience less joint pain. Lupus is known to cause fatigue, so walking, biking, swimming, or other low-intensity workouts are a good place to start.
- Eating a healthy diet: Eating a healthy diet with lots of fresh fruits and vegetables can help people with lupus experience fewer side effects from their medication, have more energy and reduce the risk for further medical conditions. Anti-inflammatory foods that are good for lupus include wild-caught fish, bone broth, garlic, onions, and avocados.
- Taking supplements that lower inflammation: Herbal supplements can help lower inflammation in the body that’s caused by lupus. MSM and turmeric both work to combat inflammation, and turmeric can help relieve pain. The EPA/DHA found in omega-3 fish oil is also known to reduce inflammation. Vitamin D can help with symptoms of anxiety and depression that often come from having lupus.
Frequently asked questions about lupus
What is the best treatment for lupus?
There is no single treatment that is best for lupus. The type of treatment will depend on the specific type of lupus a person has, their individual symptoms, and medical history. Lupus is commonly treated with medicines that help reduce pain, calm the immune system, and reduce organ damage. Here is a list of medications that are commonly prescribed for lupus:
- Benlysta (belimumab)
- Dexamethasone Intensol
- Plaquenil (hydroxychloroquine)
- Solu-Cortef (hydrocortisone)
How long do you have to live if you have lupus?
With appropriate treatment and monitoring, most people with lupus can expect to live a normal lifespan. Listening to your doctor and taking required medications is an important part of treating lupus and preventing flare-ups. People with mild or moderate cases of lupus have the highest chances of living a normal lifespan. Those with severe lupus or lupus that causes other medical problems like heart disease are at a higher risk of having a shorter life span.
Is having lupus serious?
Lupus is a chronic disease that can sometimes be fatal, but new treatments and advances in healthcare mean that many people with lupus live long lives. Lupus can potentially cause more serious health conditions like kidney problems, heart disease, or infections. Most people who talk with their doctor regularly and live healthy lifestyles that include eating healthy, not smoking, and exercising can reduce the severity of their lupus. It’s important to remember that even though lupus can be treated, it can never be completely cured.
How does a person get lupus?
Lupus is thought to have several different causes. Some people may be more likely to have lupus because of their genetics. A family history of lupus means that people in that family will be more likely to develop the disease. Lupus may be related to the hormone estrogen. Women are more likely to get lupus than men, with pregnant women having an even higher risk. Exposure to viruses, medications, drugs, ultraviolet rays, and trauma can also cause lupus.
Can lupus be cured?
Lupus is a chronic autoimmune disease that currently has no cure. Doctors and researchers are always looking for new treatment options to bring relief to people with lupus. Lupus symptoms can be treated with medications, lifestyle changes, and some natural and home remedies, but the disease will never completely go away.