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8 common lupus symptoms, explained

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This autoimmune disease can cause damage to your major organs. So knowing the early warning signs — and starting treatment as soon as possible — is vital for long-term health.
Written by Jessica Migala
Updated on June 13, 2022

We rely on our immune system to defend our body against diseases and infections. When you scrape your knee or encounter the flu virus, your immune cell soldiers rush out to squash foreign invaders. But sometimes those soldiers misfire. Instead, they mistakenly attack healthy cells, tissues and organs.

When that happens, it’s called an autoimmune disease. There are more than 100 different autoimmune diseases, including rheumatoid arthritis, celiac disease and Type 1 diabetes. But one of the most unpredictable ones is lupus. With lupus, nearly any organ system in the body can be attacked. And that leads to a wide range of symptoms and complications, which makes it difficult to diagnose.

According to the Lupus Foundation of America, at least 5 million people around the world have lupus. About 9 out of 10 people living with lupus are women, and the disease doesn’t affect all races equally either. In fact, women of color are 2 to 3 times more likely to have lupus than white women. (Here are 5 racial inequalities that persist in health care — and what you can do about them.)

Like other autoimmune conditions, lupus is thought to run in families. But anyone can develop the condition and experts aren’t sure what causes it.

What we do know: Lupus is not a cookie-cutter disease. No 2 people will have the same experience. Symptoms can range from mild to severe. They can come and go (called flares) or stick around for good. On top of that, some symptoms, such as fatigue, are nonspecific. That means they aren’t unique to lupus and can be easily chalked up to lifestyle factors such as stress.

Lupus can have serious effects on your health, including damage to your heart, kidneys and lungs. So knowing the warning signs is vital. “Overall, if patients are diagnosed early and follow treatment, they usually live long, healthy lives,” says Hanni Menn-Josephy, MD. She’s an attending physician at Boston Medical Center who specializes in autoimmune kidney diseases.

Your task: Stay vigilant for these 8 symptoms — and reach out to your doctor with any concerns.

(There’s no cure for lupus, but there are medications that can help. Be sure to show your pharmacist this free discount card each time you fill a prescription. You could save up to 80%.)

Lupus warning sign #1: Joint pain, stiffness and swelling

For a lot of people, joint pain has nothing to do with an autoimmune disease. Maybe your elbow is sore from practicing your golf swing too many times. Or you wake up to a fever and full-body aches from a viral infection (such as the flu).

That said, with lupus, pain and swelling strikes small joints symmetrically, says Dr. Menn-Josephy. For instance, you may have swelling in both hands that’s more severe in the morning after you wake up but lessens as the day goes on and you move around. “If you have morning stiffness, where you feel as if you can’t move right for the first 30 minutes after you wake up, it’s a strong sign you have inflammatory pain that requires diagnosis and treatment,” she says. It may not be lupus, but you should still seek help.

Recommended reading: 5 ways to treat stiff and achy joints.

Lupus warning sign #2: The butterfly rash

The most well-known symptom of lupus is a “butterfly rash.” Called a malar rash, it’s a red rash that spans the bridge of the nose and cheeks.

According to the Johns Hopkins Lupus Center, about half of people with lupus experience this rash. But it could also be a sign of another skin condition. Possibilities include a skin infection or rosacea (a skin disease that can cause redness, swelling and acne-like breakouts on the nose and cheeks).

Dr. Menn-Josephy notes that a malar rash typically doesn’t itch. But it can be a bit painful — especially when you’re in the sun. “We tell patients to avoid the sun as much as possible and to use SPF 50 when going out,” she says.

In addition to the benefits to your skin, practicing sun-safe habits also decreases the risk of lupus flares that affect other parts of the body. Check out our favorite SPF products here.

Lupus warning sign #3: Hair loss

Though medications, infections and stress can cause hair loss, it can also be a symptom of lupus, according to the Centers for Disease Control and Prevention. If you’re seeing more hair than usual washing down the shower drain every day, or if you notice bald spots, consult a dermatologist.

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Lupus warning sign #4: Mouth sores

Did you bite the side of your cheek or burn your mouth on a hot slice of pizza? In that case, a mouth sore is probably not related to lupus. But if you’re getting them often and can’t identify the cause, mention it to your doctor. “Patients don’t often mention oral ulcers until we ask them, but we find that this is a very common symptom of lupus,” says Dr. Menn-Josephy.

Lupus warning sign #5: Fatigue

We all have reasons to be dog tired these days, whether it’s because of long hours at a job or with your kids (or both). But if your fatigue is lupus-related, there will be strong clues, says Dr. Menn-Josephy.

One top clue? You have extreme fatigue that doesn’t go away, no matter how much you sleep. It may be hard for you to go about your normal routine or even complete simple tasks.

Lupus warning sign #6: Changes to your urine

According to the Lupus Foundation of America, many people with lupus have issues with their kidneys. It can cause a type of kidney disease called lupus nephritis, in which inflammation stops the kidneys from working their best. When that happens, your kidneys can’t filter waste or control your blood pressure as effectively.

Most people don’t recognize the symptoms of kidney disease until the condition is quite advanced, says Dr. Menn-Josephy. That said, if you notice blood in your urine or if your pee is foamy or has a soap-like appearance, see your doctor.

Lupus warning sign #7: Chest pain

Lupus can cause inflammation in the membranes around the heart and lungs. And that can cause pain or discomfort in your chest. You may also feel short of breath when climbing the stairs or walking, or have pain when breathing heavily. “If you take a deep breath, you might feel a stabbing pain,” says Dr. Menn-Josephy.

But there are many other causes of chest pain, too, from heart attacks to pneumonia. If discomfort in your chest is your only complaint, it’s not likely to be related to lupus. People who have lupus will typically have other symptoms along with chest pain, says Dr. Menn-Josephy. But all chest pain should be treated seriously, so seek medical care ASAP.

Recommended reading: 5 heart attack symptoms women shouldn’t ignore.

Lupus warning sign #8: Cognitive troubles

Lupus can also affect your nervous system (your body’s command center). That can prompt symptoms such as confusion, memory problems and difficulty concentrating. Brain fog can also make it hard to function and take care of day-to-day tasks. Symptoms can also include seizures or a stroke, which are severe and require immediate care.

Diagnosing your symptoms isn’t up to you. (After all, the last thing any of us needs is extra stress.) Use this list to stay informed, but bring any concerning symptoms to your health care team. Even if it doesn’t turn out to be lupus, the sooner you get treated, the better off you’ll be.

If you’re battling lupus or another condition, we want to help you save money on your prescription medications. Use our free mobile app to find the best prices near you.

Additional sources
Lupus statistics: Lupus Foundation of America
Background on malar rash and lupus: Johns Hopkins Lupus Center
Hair loss as a symptom of lupus: Centers for Disease Control and Prevention
Lupus and the kidneys: Lupus Foundation of America