Interview with Dr. Donald Thomas-lupus and Sjogren’s Syndrome

Comprehensive, yet easily understandable, this interview with Dr. Donald Thomas, M.D. discusses 27 secrets to living a better life with lupus and other and other autoimmune diseases. His book, “The Lupus Encyclopedia” needs to be in the library of every lupus patient.

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ASK THE EXPERTS-teleconference


Lupus can affect the heart. What? Lupus is a disease of the immune system not the heart; the heart isn’t a ‘card-carrying member’ of the immune system! Well, short of writing out the answer, which I’ll do in another post and have done before, (go to WHAT IS LUPUS>HOW DOES LUPUS EFFECT ME>CARDIOPULMONARY in the navigation bar.

The North Carolina Chapter of the Lupus Foundation of American is sponsoring a teleconference on this very subject on Tuesday February 24, 2015 from 7-8PM EST. All information for registration and information about the program can be found here or by clicking the image. There is no charge for these informational teleconference.



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Just a few symptoms    aneiainlupus     chestpaininlupus     feverinlupus     lupusfatigue

These are common to many autoimmune diseases: joint pain,  anemia caused by disruption of the bone marrow which produces red blood cells, chest pain, fevers and  debilitating fatigue. What causes these symptoms? First, it needs to be known that not every rash is a tell-tale sign of lupus, nor is every instance of chest pain caused by lupus.

Here are some symptoms you may see, however:

  • Extreme fatigue
  • Purple or cold fingertips and toes
  • Sun sensitivity
  • Hair loss, mainly on the scalp
  • Low blood count
  • Red rash or color change on the face, across the cheek or bridge of nose
  • Unexplained fever for several days
  • Chest pain
  • Protein in the urine
  • Painful or swollen joints
  • Oral or nose sores
  • Depression, trouble thinking, and/or memory problems or other cognitive problems

In the same token, not every symptom named above is noted in every one of us. We each have a case of lupus that is individual, unique-but somehow, I don’t feel lucky!

What follows, is a partial list of symptoms and some of the reasons that you might develop them. Keep in mind that lupus is a disease of the immune system and inflammatory in nature.

Many people with lupus also have Sjogren’s syndrome, and the two conditions together can cause a dry mouth that can become so severe that the delicate tissue in the mouth ulcerate> mouth sores.  Medications to treat lupus can also be quite drying.

Anemia might be caused by a folic acid deficiency or a vitamin B-12 deficiency and there is discussion that anemia results from antibodies against components of the blood.

Hair loss, or alopecia, may be caused in part from exposure to the sun.

Vasculitis literally really refers to an inflammation of the blood vessels. This inflammation causes  leaking of blood from the vessels (which happens often near the ankles) to the tissues. Often what we see are discolorations in the skin, called petechiae.

These are just a few of the symptoms that present with lupus, but during the course of their disease,  not every symptom is present and some not mentioned ARE present.

The debilitating fatigue which can be from lupus is often caused by coexisting anemia. This isn’t always the case, but sometime a partial explanation.

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Magnesium Deficiency

Several weeks ago, I learned of the importance of magnesium in our diets when I had an extreme muscle cramping/twitching issue. Our bodies don’t manufacture magnesium; but it is essential for many bodily functions. It is used by the bones (approximately, half of the magnesium in the body is found in the bones). Magnesium also helps to control neuromuscular activities of the heart and helps to keep the heart beating regularly. It has many functions.
The video that follows, albeit 10 minutes long, explains the importance of magnesium in our bodies. Not only does Dr. Osborne explain the importance of an adequate amount of magnesium in our bodies, but he spends a good deal of time explaining the signs and symptoms of magnesium deficiency and why they ‘happen:’
To recap: some causes of magnesium deficiency
  • long-term stress
  • diuretics
  • diet
some manifestations of magnesium deficiency:
  • depression (treated with SSRI). (But SSRIs can result in other deficiencies which can cause depression!)
  • vasoconstriction which can cause high blood pressure and migraines
  • bone loss so hormone replacement like estrogen is prescribed (However, estrogens can cause further magnesium deficiency.)
  • muscle spasm, resulting in pain so we take NSAIDs.
  • increases thickness of blood (sludgy blood) so we are at an increased risk of stroke
We have to in treat the CAUSES of magnesium defieiency; not the SYMPTOMS
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While writing another post, I came across this video, which, in 3 or so minutes speaks volumes about a lot about this disease:

 Support those who know no relief from this disease that can strike any place in their bodies:

You can help those ‘who don’t look sick’ and click the blue button below to be taken to the website of the

Lupus Foundation of America

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Some symptoms of lupus and their causes

Lupus causes many symptoms, but here are a few. Again, this list isn’t all-inclusive. How can you figure out what causes a symptom? Often all you need to do is consider the powerful inflammatory action that lupus causes, or the ending ‘itis:’ inflammation

  • The malar rash (butterfly rash) is often the first thing that comes to mind when talking of the symptoms of lupus; but not everyone with lupus gets it. When the immune system mounts it attack on the skin (cutaneous lupus), the attack is either acute or chronic. If the attack is acute, (acute meaning it comes rapidly and ‘goes’ rapidly), you might see the classic “butterfly” rash. It is often referred to by doctors as ‘malar’ because of the location on the face where it occupies. Many also refer to it as the “butterfly rash” because it’s redness involves the bridge of the nose and the cheekbones, looking like the the body and wings of a butterfly.
  • fatigue: The precise cause of lupus-related fatigue isn’t known, but disease activity, pain, age, and medicines can contribute to fatigue caused by lupus. Lupus compromises your sleep and too little sleep or poor-quality sleep can result in flares of your symptoms. During these flares, you’re likely to be depressed that there is more pain and other symptoms seem worse. 
  • chest pain. The lung is lined by a membrane, the pleura. Inflammation of the pleura results in the pleura rubbing rubbing up against the lung causing pain. This pain is usually a pain on inspiration (when you breathe in), a pain which may mimic the chest pain of a heart attack. This pain should never be taken lightly and should be reported to your doctor immediately. Most people who have/or had lupus, have had an instance of this inflammation.
  • If the membrane surrounding and protecting the heart (pericardium) becomes inflamed, pericarditis can result. Symptoms of pericarditis often resemble those of a heart attack because there may be sharp, stabbing pain as the heart rubs agains the pericardium. There can also be a fast heart rate or a dry cough or shortness of breath. This should not be ignored.
  • chest pain: Another source of chest pain is called costochondritis. I was privileged (?) to have costochondritis once and it felt like I’d been kicked in the chest: by a horse! Costochondritis is an inflammation of the cartilage that connects a rib to the sternum. Recurring episodes of costochondritis often lead doctors to make a more thorough exam and a diagnosis of lupus follows.
  • shortness of breath in lupus can be caused by several things, too. If there is pleuritis (inflammation of the pleura, or pleuritis) pain of lupus is caused by pleuritic chest pain, the person might guard against the pain, by not taking deep breaths. Taking shallow breaths results in not getting enough air in the lungs; therefore shortness of breath.
  • headache. The most common type of headache in lupus is the tension or muscle tension headache which will usually ‘go away on its own’ or with over-the-counter analgesics. Lupus also causes migraine headaches which are much more prevalent in lupus sufferers than non-lupus sufferers. However, another kind of headache is more rare, but much more serious and indicative of a life-threatening complication., meningitis. It is due to inflammation of the meninges (membranes which encase the brain). Your physician should be aware of a headache that you have.

These are just a few symptoms of lupus, but for brevity’s sake, I didn’t discuss them all. I’ll discuss others in another post.

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Inflammation, lupus and the lungs

lungsheartdiaphragmLupus affects the lungs in numerous ways and I’ll only detail a few. However, before going into any detail, it is worth mentioning that the lungs and the heart are a pretty intricate duo. They march to the ‘beat’ of the heart, but the lungs have a lot to ‘say’ about how our body functions. Remember the old ditty, “You can’t have one without the other…” The very simple image to the left adds on one more body part, often forgotten, to make a trio out of this important duo, the diaphragm. However, suffice it to say, that whenever there is lupus involvement in respiration, THINK INFLAMMATION.

The image shows the red heart tucked in between the pink left and right lobes of the lung; the brown/tan organ on which the lungs appear to rest is the diaphragm. I won’t address the diaphragm much except to say that the it acts much like a set of bellows: the muscle that powers the lungs to expand and contract so that ‘in goes the good air and out goes the bad.’

The inflammation caused by lupus can affect the lungs in numerous ways; but mainly by:

  • causing inflammation of the lining of the lung
  • causing inflammation of the lung itself
  • causing inflammation of the blood vessels within the lungs
  • it can affect the diaphragm.


  • Inflammation of the lining of the lung (pleura) usually called pleuritis (‘itis’-inflammation) which results in pain called pleuritic chest pain or pleurisy. A hallmark of pleurisy is pain when you breathe in (inhalation).


  • Inflammation of the lung tissue itself is often called interstitial lung disease (ILD). Examples of ILD include pulmonary fibrosis, interstitial pneumonitis, and sarcoidosis and their symptoms often include shortness of breath.
  • Inflammation of the soft tissue (cartilage) between the ribs often results. When the ribs expand during inhalation, pain is the result. This is called costochondritis and is often a recurring ailment in lupus patients. Again this is a cause of pain in the chest; ANY chest pain should be evaluated by a health care professional. This pain can also mimic that of a heart attack or pleurisy so your doctor must conduct a thorough physical exam.

Those are two examples of conditions resulting from inflammation of structures in the lung.

If vasculitis is of a small blood vessel, it can break and blue dots can be seen on the skin from the breakage. If vasculitis effects a larger blood vessel, it may be noticed as a larger node near the surface of the skinIf the inside of a blood vessel becomes inflamed, there can be a decrease in blood flow that results in less oxygen getting through.

INFLAMMATION OF THE DIAPHRAGM: Lupus can affect diaphragm because of repeated inflammation the diaphragm can lose it’s ability to generate the pressures needed to expand and contract. On rare occasion this results in “Shrinking Lung Syndrome” (SLS). On x-ray or a high-resolution CT scan, the lungs look clear. This condition is rare, but can be serious because the lungs themselves are not muscular and are only powered by the diaphragm. No diaphragm, no air exchange.

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