Systemic lupus erythematosus is a complex chronic autoimmune condition in which the body’s immune system goes awry. Instead of focusing on attacking foreign invaders like viruses and bacteria, the immune system begins attacking the body’s own cells and tissues. This autoimmune struggle results in chronic inflammation, leading to a variety of symptoms that negatively affect the quality of life for people with lupus.
Lupus typically causes an unpredictable up and down journey alternating between times of feeling well, referred to as remission, and times of increased symptoms, referred to as flares. Flares exist on a spectrum from mild to severe and consist of primarily familiar symptoms; although, new symptoms occasionally occur. Lupus flares can also occur without producing any significant symptoms, emphasizing the need for regular follow up with a lupus specialist or primary care provider.
Potential Lupus Flare Triggers
A number of potential lupus flare triggers exist as identified below:
- Not taking medications consistently as prescribed
- Extreme physical fatigue
- Stress: both emotional and physical
- Sunlight and artificial UV light
- Low vitamin D level
- Cigarette smoke: both first-hand and second-hand
- Sulfa/sulfonamide antibiotic: generic name trimethoprim/sulfamethoxazole (TMP/SMX)
- Herbal supplement: Echinacea due to immune boosting nature
- Dietary: alfalfa sprouts and mung bean sprouts due to immune boosting nature
- Weather conditions: heat, humidity, and cold
- Premenstrual/menstrual hormone changes
Primary flare triggers may vary for each individual. A symptom diary provides a helpful method of intentionally recording, reflecting on, and recognizing individual lupus flare trigger characteristics over time. Details to log in a diary include any symptoms experienced along with associated activities, events, exposures, food intake, and alcohol consumption. Discovering trigger patterns allows for proactive lifestyle modifications with a goal of lessening the severity of flares as well as decreasing the frequency of flares.
According to the Lupus Foundation of America, not taking medications consistently as prescribed is one of the most frequent causes of lupus flares. Informing your health care provider of inconsistent medication dosing provides important communication before a decision is made about a change in treatment.
Prioritizing seven to nine hours of sleep per night plays a key role in preventing lupus flares. Adequate sleep supports proper immune system function. Developing a relaxing sleep hygiene routine helps to ensure quality sleep nightly.
Increasing self-awareness about early stress signals like negative emotions and associated physical symptoms helps to identify and reduce stress before a flare occurs. Budgeting time daily for self-care also aids in managing stress and reducing lupus flares. Connecting with a support system of family and friends along with a lupus support group positively contributes to long-term stress management.
The Importance of a Lupus Flare Plan
The Lupus Foundation of America developed a worksheet titled Your Lupus Flare Plan. This worksheet provides talking points for discussion with your lupus specialist or primary care provider to address important questions regarding the management of lupus flares. A clear plan with specific action steps provides a useful tool to reference when flare symptoms occur. A flare plan should aim to treat flares promptly, minimize frequency of flares, and decrease the potential for serious damage to organs. New or worsening symptoms should be reported to your health care provider as soon as they occur so that the treatment plan can be adjusted if necessary. Recognizing lupus flare symptoms at onset and taking proactive steps, as established with your health care provider, serves to reduce the severity and duration of flares as well as the impact on daily life.
Systemic Lupus Erythematosus. NIH National Institute of Arthritis and Musculoskelatal & Skin Diseases.
Lupus. NIH National Library of Medicine, MedlinePlus.
What is a lupus flare? Lupus Foundation of America, National Resource Center on Lupus.
Understanding lupus environmental triggers. Lupus Foundation of America, National Resource Center on Lupus.
Sleep better when you have lupus. Lupus Foundation of America, National Resource Center on Lupus.
Managing Stress When You Have Lupus. Lupus Foundation of America, National Resource Center on Lupus.
Lupus Flares Directly Impact Both Quality of Life and Family Life. Lupus Foundation of America, National Resource Center on Lupus.
Lupus Flare Plan. Lupus Foundation of America.