Lupus is an autoimmune disorder that affects an estimated 1.5 million people in the U.S. How do you know if you have lupus? There are 25 lupus symptoms you can watch for.
What is lupus?
A healthy immune system produces antibodies that attack foreign bodies, such as the flu virus. In a person with lupus, however, the immune system confuses healthy tissues for foreign bodies. Autoantibodies attack healthy tissues. This causes pain, swelling, and damage in the healthy tissues.
Women are more likely to be diagnosed than men. African American and Hispanic women have an even higher likelihood of diagnosis.
Only 33% of people in the U.S. even know what this condition is. That’s one of the major reasons why Lupus Awareness Month is such an important time to look at the symptoms of lupus, especially lupus symptoms in women, as they are the most affected group of people.
There are two main types of lupus, each with distinct symptoms: discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE). There are also two less common types of lupus. One is drug-induced. Certain medications can cause lupus-like symptoms. Usually, stopping the medication that’s causing the symptoms will stop the problems. The final type of lupus is neonatal.
Discoid lupus erythematosus (DLE), chronic cutaneous lupus
Discoid lupus erythematosus (DLE), which is sometimes called chronic cutaneous lupus, mostly affects the skin. This type of lupus typically occurs while the other symptoms of lupus, such as joint or organ damage, aren’t occurring. It causes round (discoid) lesions or sores on the skin. These lesions can sometimes leave scars. If the discoid lesions occur in an area of the body with hair, the hair may fall out; if the lesion leaves a scar, the hair loss may be permanent.
Discoid lesions that are present for an extended time can also become cancerous. To prevent this, you may have to go to a dermatologist, or skin doctor, to make sure they’re treated properly.
Systemic lupus erythematosus (SLE)
Systemic lupus erythematosus (SLE) affects the skin, too; its effects on skin can sometimes be called acute cutaneous lupus. Most often, it causes the characteristic butterfly rash. More dangerous, however, are the other effects of SLE.
In SLE, the disease may attack connective tissues, which can lead to swollen, painful, or damaged joints. It may also attack the membranes around organs too, leading to inflammation or damage of the lungs, heart, kidneys, and brain. Kidney damage is also a fairly common effect of SLE. Some people may even experience depression, confusion, seizure, or strokes as a result of lupus.
The disease can also affect blood vessels, causing Raynaud’s disease discussed below.
25 lupus symptoms you shouldn’t ignore
1. Unexplained fever
Fever is often the first indication of infection in the body, and it is one of the first symptoms to present itself. This is not the only way to diagnose lupus, as unexplained fever is present in many other conditions, but it can be an early warning sign.
Ninety percent of those with lupus report fatigue that is unrelieved by sleep. This can be an especially difficult symptom to cope with, as napping during the day can lead to insomnia at night.
3. Joint stiffness and swelling
Autoimmune disorders often head straight for the tissues in the joint, causing painful inflammation and swelling. Joint stiffness and swelling combined with unexplained fever can be two symptoms that start to point towards a diagnosis.
4. Hair loss
Of the lupus symptoms in women, hair loss can be one of the most traumatic. In general, hair will begin to thin due to inflammation of the skin and on the scalp. Lesions may form, and if they are not able to be successfully treated, scars may prevent hair from growing back. If treatment is successful, the majority of people will see regrowth.
5. Skin rash and lesions
One of the tell-tale markers of lupus is a butterfly-shaped rash that appears across the bridge of the nose and cheeks. For people already diagnosed, this is one of the symptoms of lupus that can indicate that a flare-up is imminent. Another serious (typically uncommon) form of lupus rash is a “bullous” lupus rash, which results in large blisters.
6. Chest pain
Pulmonary issues can be one of the more serious symptoms of lupus. It occurs when the delicate tissues and blood vessels of the lungs become inflamed, making breathing difficult and painful. This is often referred to as pleuritic chest pain. Over time, the size of the lungs can actually decrease, causing chronic chest pain and shortness of breath.
7. Kidney inflammation
Kidney inflammation, also called nephritis, causes inflammation in the kidneys that make it difficult for them to function. Toxins in the body and blood build up, causing swelling in the lower extremities, high blood pressure, darker urine, and pain in the side. When this symptom of lupus goes untreated it can lead to end-stage renal disease (untreatable kidney failure). Signs of nephritis require immediate attention.
8. Thyroid problems
Lupus attacks all systems of the body, and the thyroid is included. The thyroid helps control metabolism and appetite. Any changes to this gland can result in weight loss or gain. If lupus patients are taking corticosteroids to control pain and inflammation in joints, this could result in thyroid-related weight gain as well. Approximately 6% of people with lupus have hypothyroidism (underactive thyroid) and about 1% have hyperthyroidism (overactive thyroid).
9. Sjogren’s syndrome
Sjogren’s syndrome is one of the lupus symptoms in women you cannot ignore, especially if you’re pregnant (or planning to be so). This is an autoimmune condition that makes it possible for a woman to pass neonatal lupus on to her child in utero. Pregnant women with a previous diagnosis of Sjogren’s (or lupus in general) should let their doctors know immediately, as neonatal lupus can cause serious issues for newborns, including congenital heart defects.
Sjogren’s syndrome can also cause dryness in people with this condition. Sjogren’s syndrome affects the glands responsible for tears, saliva, and other mucous membranes in the body (e.g., the vagina). People with Sjogren’s may wake up with a gritty feeling in their eyes and mouth.
As with many chronic illnesses, depression can be a complicated comorbid condition. Approximately 33% of lupus patients report clinical depression, nearly double the incidence in the general population. Some of the causes of depression may be dealing with lupus itself, but medications like steroids taken for inflammation may also play a part.
12. Gastrointestinal issues
Many people with lupus experience gastroesophageal reflux disease (GERD), a disease that can cause severe heartburn. Peptic ulcers can also form due to some medications for lupus.
Although not necessarily gender exclusive and not necessarily a specific symptom of lupus in women, the risk for osteoporosis rises for women who are taking prednisone as a treatment for this condition. This is more of a comorbid condition than a symptom, but it is worth considering the risks that can occur due to steroid medications that decrease bone density.
Some people with lupus will experience anemia, a condition marked by a low red blood cell count that can result in weakness and fatigue. Your doctor can detect this with a complete blood count, a diagnostic tool often used when screening specifically for this condition.
15. Raynaud’s disease
Raynaud’s disease is when fingers and toes turn white or purple in response to stress or exposure to cold. Arteries delivering blood to the extremities spasm, resulting in poor circulation. In severe cases, this can lead to gangrene in the fingers and toes.
16. Heart disease
EverydayHealth reports that one of the most alarming symptoms in women is their increased rates of heart disease: “Women with lupus are 50 times more likely than others of the same age to have a heart attack or chest pain.” If you’re suffering from lupus, make sure to talk to your doctor about this related risk factor as well, so you can take steps to reduce your risk.
17. Mouth sores
One of the more common symptoms of lupus is mouth or nasal sores. As Health.com explains:
“Mouth ulcers are one of the most common symptoms of lupus. But what makes a lupus mouth ulcer unique, says Dr. Gilkeson, is that it usually comes pain-free. And rather than developing on the sides of the mouth or gums, these sores typically reside on the roof of the mouth. Lupus-related ulcers can also appear inside the nose.”
Anxiety is another mental health condition that often affects people with chronic pain conditions. It’s no different with lupus, women in particular. Self.com notes that a lot of the anxiety may be related to noticing and living with other symptoms.
19. Blood in urine
One of the more obvious symptoms is one that can also be indicative of other health conditions. With lupus, it’s related to kidney inflammation. Closely monitor any blood in the urine, persistent bladder infections, and other changes in urine.
20. Sun, or light, sensitivity
The National Institute of Arthritis and Musculoskeletal and Skin Diseases reports that sun sensitivity is another highly common symptom of lupus.
21. Confusion and memory loss
Mayo Clinic notes that one of the major symptoms in women is confusion and memory loss. Talk to your doctor if you’re experiencing confusion, disorientation, or memory loss in a substantial way. These mental disturbances can be similar to the “fibro fog” many fibromyalgia patients experience. And, since 90% of lupus patients report fatigue, this lupus symptom is likely connected to the lack of rest.
Lupus’ effects on the central nervous system can also cause the confusion, memory loss, and fatigue associated with lupus. Another symptom to be aware of is dizziness, the Lupus Research Alliance advises.
Another common symptom of lupus is headaches. However, fibromyalgia or even chronic stress also share this symptom. As with these other shared characteristics, your doctor will look at the complete picture of your symptoms before making a lupus diagnosis.
24. Other blood disorders
In addition to anemia, some people with lupus may experience other blood disorders, as WomenToWomen explains.These include:
- Leukopenia, a low white blood cell count
- Lymphopenia, a low lever of specific white blood cells
- Thrombocytopenia, a low platelet count
- Otherwise abnormal blood clotting
While this is one of the more serious lupus symptoms in women, it is one to watch for. And to take action on. If you’re experiencing seizures, along with any number of these other symptoms, talk to your doctor immediately.
How is lupus diagnosed?
Getting a lupus diagnosis can be complicated, as lupus symptoms are similar to symptoms of other conditions. It’s because of this that many call lupus the “great imitator.” When taken together and combined with a complete medical history and physical examination, however, the symptoms of lupus can lead to a quick diagnosis and management of this disease.
While there is no cure for lupus yet, there are treatments that are usually successful. If left untreated, lupus can become very serious – even life-threatening.
Typically, your doctor can treat your symptoms through a combination of medications and careful lifestyle choices.
Medications used to treat lupus may include immunosuppressants or antimalarials (drugs traditionally used to treat malaria). Corticosteroids or non-steroidal anti-inflammatory drugs (NSAIDs) can also help control inflammation and pain.
Additionally, a healthy diet, regular exercise, and plenty of rest can help control lupus. Avoiding triggers is also very key, so people with lupus shouldn’t smoke. Controlling exposure to UV light is also important, so wearing hats, long sleeves, and long pants, using plenty of sunscreen, and limiting time outdoors during the day will likely aid in controlling your symptoms.
Certain supplements might also be beneficial for people with lupus. Dehydroepiandrosterone (DHEA), fish oil, and vitamin D might all have positive effects, so anyone suffering from lupus should talk to a doctor about potentially starting these supplements.
Want to read more about lupus? Check out our other posts on the subject:
- What does a lupus rash look like?
- Eat this, not that: 5 lupus diet tips
- 4 exciting research breakthroughs for lupus
Finally, do you or someone you love have lupus? If you’re suffering from some or all of these symptoms, contact one of our pain doctors today to see if you’re suffering from lupus.
Since this post helped so many people, since original publication we’ve added more symptoms and information about lupus.