Functional Medicine for Lupus

What is lupus?

Systemic lupus erythematosus, usually called lupus, is a chronic (long-lasting) autoimmune disease. Normally, the immune system protects you from infection. In lupus, it attacks the body's own tissues instead. This causes inflammation and, in some cases, lasting damage.^{1, 4}

Lupus can affect the skin, joints, heart, lungs, kidneys, blood cells and brain. People with lupus may have flares, when they feel unwell, and periods of remission, when they feel well. Flares can be mild or serious, and they are hard to predict.¹

Anyone can get lupus, but women get it about nine times more often than men. It most often starts between ages 15 and 45. It is more common in African American people, and in people of American Indian and Asian descent, than in White people. The exact cause is not known. Genes play a part, and things like viral infections, sunlight, certain medicines and smoking may trigger it.^{1, 3, 4}

Common symptoms of lupus

Lupus can also inflame organs, including the kidneys (called lupus nephritis), heart, lungs and blood vessels. It can raise the risk of blood clots and lower blood cell counts. This is one reason regular check-ups matter.^{1, 2, 3}

Lupus looks different from person to person. Symptoms can be mild or severe, may come and go, and can change over time. Common symptoms include:^{1, 2, 4}

• Painful, swollen joints and stiffness in the morning¹
• Fatigue (feeling very tired)^{1, 4}
• Fevers¹
• A "butterfly" rash across the nose and cheeks, or other rashes^{1, 4}
• Rashes or skin reactions after time in the sun^{1, 3, 4}
• Hair loss^{1, 4}
• Sores in the mouth or nose, which are often painless¹
• Fingers and toes that change color in the cold or with stress (Raynaud's phenomenon)¹
• Swelling in the legs or around the eyes¹
• Pain when breathing deeply or lying down¹
• Headaches, dizziness, confusion, low mood or depression¹

How lupus is diagnosed and treated

No single test can diagnose lupus. Doctors combine your medical and family history, a physical exam, blood and urine tests, and sometimes a small tissue sample (biopsy). A blood test called ANA is positive in nearly all people with lupus. But healthy people can also test positive, so this test cannot confirm lupus on its own.^{2, 3, 4}

There is currently no cure, but treatment options have grown. Treatment aims to manage symptoms, prevent or limit flares, keep disease activity as low as possible, and prevent or slow organ damage. Depending on your needs, your doctor may prescribe anti-inflammatory medicines, antimalarial medicines such as hydroxychloroquine, corticosteroids, medicines that calm the immune system, or biologics.^{2, 3, 4}

For most people with lupus, a rheumatologist (a doctor who specializes in conditions such as lupus and arthritis) is the main specialist. Other specialists may join your care if lupus affects organs like the kidneys, heart or skin. Regular visits help your care team track the disease and any side effects of treatment, so staying in ongoing care with your rheumatologist matters.^{2, 3, 4}

How our care fits alongside your rheumatologist

Avicenna Functional Medicine does not replace your rheumatologist or the treatment they prescribe. Our role is to add to your care, not to take its place.

In a functional medicine visit, we look at factors that may contribute, such as gut health, nutrition, environmental exposures, sleep, stress and immune regulation, alongside the care you already receive. Stress can trigger a flare, and poor sleep is common in people with lupus. Some people try special diets or nutritional supplements, but research has not clearly shown whether they help lupus. Our aim is to understand the whole picture of your health and to support your overall wellbeing.^{1, 2, 5}

Please do not stop or change any prescribed medication without talking to the doctor who prescribed it. Some over-the-counter products and herbs can interact with prescription medicines, so check with your rheumatologist before starting anything new.²

What to expect at Avicenna

All visits are by telehealth, for patients located in Florida and Texas. We are a cash-pay practice, and we accept HSA and FSA. Care usually follows these steps:

• A free, 30-minute discovery call to talk about your health and whether our approach is a good fit for you
• A full intake visit with our health coach, under clinician supervision, covering your history, symptoms, current treatment and goals
• Testing chosen for you, where it is likely to be useful
• A personalized plan, with follow-up visits to review how you are doing and adjust the plan as needed

When to get urgent care

Contact your rheumatologist promptly if you notice signs of a flare, such as more tiredness, joint pain or swelling, a rash, fever, stomach pain or headache. Also tell them about changes in your urine or new swelling in your hands or feet, which can be signs of kidney problems, and about any medication side effects.^{2, 3, 4}

Telehealth visits with our team are not for emergencies. Call 911 right away if you have warning signs of a medical emergency, such as:⁶

• Chest pain or pressure that lasts two minutes or more⁶
• Trouble breathing or shortness of breath⁶
• Sudden confusion, unusual behavior or trouble waking up⁶
• Fainting or passing out⁶
• Sudden dizziness, weakness or changes in vision⁶
• Being unable to speak⁶
• Severe belly pain, or sudden severe pain anywhere in the body⁶
• Coughing up or vomiting blood⁶
• Thoughts of suicide or of harming someone else (you can also call or text 988)^{6, 7}