Lupus is an autoimmune disease that affects around 1.5 million people in the United States. It is a chronic condition where the immune system attacks the healthy cells and tissues in the body by mistake. Like lupus, allergies result from an overactive immune response as well, where the immune system identifies certain foods, drugs or environmental elements as foreign intruders that need to be eliminated. Though some doctors believe that there is only anecdotal evidence that allergies can affect lupus symptoms and increase inflammation, those living with lupus would beg to differ. Ask anyone who has lupus how they feel when they are exposed to an allergen, and they would probably say it was equivalent to being hit by a bus.
Although the jury may still be out in the medical community whether there is a true relationship between allergies and lupus, those suffering would say the verdict is very clear. So let’s break down the usual suspects and how they can affect those living with lupus.
According to the CDC, more than 50 million Americans have some sort of food allergy. Food allergies are most common in babies and children, but can appear (or change) later in life as well. People visit the emergency room roughly 200,000 times a year because of some sort of reaction to a food allergy. Although any food can cause an allergic reaction, 90% of reactions are due to these common foods:
- Tree Nuts
Food allergies occur when your immune system identifies a substance as dangerous and triggers a self-protecting response. The response can range from mild/moderate (stomach cramps, hives, wheezing) to severe (anaphylaxis). Anaphylaxis is a very serious life-threatening reaction that may cause swelling of the throat and tongue and can affect your blood pressure and heart rate. It can come on quickly and cause fatality if not treated in a timely manner and with the appropriate measures.
Those suffering from lupus tend to have sensitivities to alfalfa. Alfalfa contains the amino acid L-canavine, which may be associated with increased levels of inflammation. Other foods that seem to have an adverse reaction with lupus symptoms are the ‘nightshade’ vegetables (potatoes, tomatoes, eggplants and peppers). Keep in mind, foods that may trigger flares can vary greatly from person to person, so unless you feel a food makes your symptoms worse, there is no reason to truly avoid it. Back to top
Drug allergies are the result of your immune system becoming overly sensitive to one or all substances in a particular medication. It usually doesn’t matter if it is in liquid, injectable or pill form. If you develop symptoms such as hives, rash (or itching), difficulty breathing (anaphylaxis), or swelling, you may have a drug allergy.
The most common drug allergies are:
- Antibiotics containing sulfonamides (sulfa drugs)
- Penicillin or other “illin” antibiotics
- Anticonvulsants (commonly known as antiepileptic drugs or as antiseizure drugs)
- NSAIDS such as ibuprofen and aspirin
- Chemotherapy drugs
The interesting thing about drug allergies is that you may not experience an allergic response the first time you take the drug. But, as your body starts to produce antibodies to it, the next time you take the same drug you could develop symptoms. This can make it challenging to diagnose a drug allergy. Penicillin is the only drug that can be diagnosed through a allergy skin test. For all other medications, your doctor may diagnose an allergy by asking questions like:
- How long have you been taking the medication?
- How long after taking it did you experience symptoms?
- What did you experience?
- How long did your symptoms last?
- What other medications are you taking with this one?
After a physical examination, skin test and possible other blood work, your doctor will most likely be able to determine if you have a drug allergy.
With lupus, there seems to be a trend of increased sensitivity to the sulfa antibiotic drugs like Trimethaprim-sulfamethosaxole (Bactrim, Septra). Be wise about over-the-counter supplements as well. Studies have shown that the herb Echinacea (a popular “immune boosting” supplement) may cause lupus flares. It is important to talk to your doctor about his or her thoughts regarding your lupus and drug/supplement reactions. Back to top
Environmental allergies or “indoor/outdoor” allergies are usually responsible for sinus swelling, seasonal and returning allergies, nasal allergies and hay fever. It is estimated that 17.6 million adults and 6.6 million children suffer from hay fever. Allergic rhinitis affects between 10 percent and 30 percent of the population worldwide.
The most common indoor/outdoor allergy triggers are:
- Weed pollen
- Mold spores
- Dust mites
- Rodent Dander
The most common indoor/outdoor irritants are:
- Smoke (cigarette/cigar smoke, fireplaces, woodburning stoves)
- Odors (perfume, hair spray, paint, cleaning products, air freshener, candles)
- Cold air
The best cure is the obvious one – avoidance. If you decrease your exposure to the allergen, you will not have to deal with the symptoms it causes. This is not always easy, particularly if you are sensitive to pollen or other airborne substances.
Those individuals who suffer from lupus affecting the lungs, it is important to very cautious of the irritants like smoke, cold air, exhaust and strong chemicals. If you are a smoker, try to stop. It not only damages the lungs, but it increases lupus disease activity and prevents the drug plaquenil from working properly. Back to top
Spring is upon us, and millions of you will be experiencing seasonal allergies along with flowers blooming and the grass growing. Your best defense is to know your triggers and stay ahead of the curve. Reach out to your primary care if you are experiencing problems which you believe are allergy related. To see how your city ranks on the “allergically challenged” list, visit aafa.org.
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