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Mayo Clinic Q and A: Managing lupus
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DEAR MAYO CLINIC: I was diagnosed with lupus six months ago. I am 23. Are there things I can do now to prevent heart or kidney problems down the road?
ANSWER: Lupus is a complex autoimmune disorder that can affect any organ system in the body. Although you can take steps that may lower your risk for developing complications, it may not always be possible to prevent heart, kidney and other health problems associated with lupus. But treatment is available that often can manage symptoms effectively. Working closely with your care team to get regular checkups and blood tests to monitor your condition can help control lupus.
Lupus develops when your body’s immune system attacks your own tissues and organs. Inflammation caused by lupus can affect many body systems — including your heart, kidneys, joints, skin, blood cells, brain and lungs. Lupus is a chronic disease that does not have a cure at this time.
The severity and frequency of lupus symptoms vary widely from one person to another. In some cases, symptoms may appear suddenly, while they develop slowly in others. Symptoms may be mild or severe, or temporary or permanent. Although lupus sometimes can be life-threatening, many people have a milder form of the disease characterized by episodes, called flares, when symptoms worsen for a while, and then improve or disappear for a time.
One of the most important steps you can take when you’re first diagnosed with lupus is to find a primary health care provider and rheumatologist who are familiar with the disease to guide your treatment. In addition to seeing your care team regularly to check symptoms, blood tests may help your providers better understand what areas of your body the disease is most likely to affect. Results from blood tests also may be able to help your team predict if you are likely to have a flare in the near future.
Seeing your primary health care provider regularly is also important for heart health. In people with lupus, the risk for heart disease, including strokes and heart attacks, is about two times higher than normal. Therefore, they must be checked regularly for risk factors associated with heart disease, such as high blood pressure, high cholesterol and diabetes. If these risk factors arise, they need to be treated aggressively.
If you have a severe form of lupus, or if the disease begins to affects multiple organs, seek care with a health care organization that has a range of specialists who can work together to coordinate your care.
Along with working closely with your health care team, there are self-care steps you can take to help prevent lupus flares. That, in turn, reduces the likelihood of organ damage and other complications.
First, because sun exposure can trigger flares, protect yourself from the sun’s rays. Avoid sun exposure as much as possible. When you spend time outdoors, wear protective clothing. Use sunscreen with a sun protection factor (SPF) of 50 or higher. Apply it at least 20 minutes before going out in the sun.
Second, talk to your health care provider about whether you should take a vitamin D supplement. Research has found some evidence that low levels of this vitamin can be associated with an increase in lupus flares.
Third, engage in a healthy, active lifestyle overall. Don’t smoke. Eat a diet rich in vegetables, fruits and whole grains. Exercise regularly. Reduce and manage stress in your life.
But understand, too, that sometimes lupus can progress despite lifestyle modifications and other prevention strategies. Fortunately, medications can effectively control symptoms and treat flares. Your care team can work with you to monitor, treat and manage lupus over time as your needs change, so you can control the disease and live well. — Dr. Uma Thanarajasingam, Rheumatology, Mayo Clinic, Rochester, Minnesota
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