Disease Activity And Fatigue
Fatigue and arthritis go hand in hand for many people with arthritis. The main culprits are the inflammatory disease process and the accompanying chronic pain.
- Inflammation. If you have an autoimmune disease, your immune system attacks your body and inflammation is the result. The body undergoes stress as it tries to cope with the release of inflammatory cytokines in the blood. That can cause fatigue, especially when disease activity is high or low-grade inflammation remains for a long time.
- Chronic Pain. The pain-fatigue connection can be a vicious circle. Dealing with arthritis pain for months at a time over many years can wear you down. It can affect your sleep habits, which adds to your exhaustion. Being fatigued, in turn, can worsen pain and make it more difficult to manage.
How To Work With Your Doctor To Understand Fatigue
While fatigue is a common experience, Dr. Berman believes both patients and healthcare professionals do not know enough about how to manage fatigue well.
Dr. Berman said doctors generally do not do a good job addressing their lupus patients concern about fatigue because many other important medical issues seem to take priority during each appointment. One way to make sure they are addressed is to talk about it at the beginning of the appointment. Here are some of the questions she asks her patients to get an idea of what to discuss with your doctor:
Dr. Berman said its important to help your doctor prioritize during your visits. She suggested writing down the top one or two issues you want to talk to your doctor about and bringing them up in the beginning of your visit, so it can focus the appointment.
In summary, there are several ways your doctor can help you manage your fatigue. The first is to look for and treat any other medical conditions that may be contributing to it. Secondly, it is important to examine your current medications and the possibility that one of them is contributing to fatigue . In addition, if you are suffering from insomnia, your doctor may want to prescribe a sleep agent. Some doctors may add an activating medicine, such as Wellbutrin or Provigil, to improve your ability to function with fatigue. In some situations getting more exercise may be beneficial as well. Again, talk to your doctor about your individual case of lupus and fatigue.
How Are The Inflammatory Myopathies Diagnosed
How are the inflammatory myopathies diagnosed?Diagnosis is based on medical history, results of a physical examination that includes tests of muscle strength, and blood samples that show elevated levels of various muscle enzymes and autoantibodies. Diagnostic tools include:
- electromyography to record the electrical activity generated by muscles during contraction and at rest
- ultrasound to look for muscle inflammation
- magnetic resonance imaging to reveal abnormal muscle anatomy.
A biopsy sample of muscle tissue should be examined for signs of chronic inflammation, muscle fiber death, vascular deformities, or other changes specific to the diagnosis of a particular type of inflammatory myopathy. A skin biopsy can show changes in the skin associated with dermatomyositis.
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The Difference Between Rheumatoid Arthritis And Osteoarthritis
Like RA, people with osteoarthritis can experience painful and stiff joints that make moving around difficult.
People with OA may have joint swelling after extended activity, but OA doesnt cause significant enough inflammatory reaction to result in redness of the affected joints.
Unlike RA, OA isnt an autoimmune disease. Its related to the natural wear and tear of the joints as you age, or it can develop as a result of trauma.
OA is most often seen in older adults. However, it can sometimes be seen in younger adults who overuse a particular joint such as tennis players and other athletes or those whove experienced a severe injury.
RA is an autoimmune disease. The joint damage from RA isnt caused by normal wear and tear. Its caused by your body attacking itself.
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Autoimmune Disease: Why Is My Immune System Attacking Itself
Autoimmune disease affects 23.5 million Americans, and nearly 80 percent of those are women. If you’re one of the millions of women affected by this group of diseases, which includes lupus, rheumatoid arthritis and thyroid disease, you may be wondering why your immune system is attacking itself.
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Neurovascular Unit And Vasohemodynamics
Diagram of the neurovascular unit in modulating vasohemodynamics. The neurovascular unit at the level of the cerebral microvasculature including the arterioles and capillaries is comprised of endothelial cells, smooth muscle, astrocytes, neurons, pericytes, and is modulated by surrounding microglia and perivascular macrophages. Additionally, alterations in metabolism and inflammation can modulate astrocyte end-feet to modulate cerebral blood flow . The neurovascular unit modulates blood flow throughout the brain and is regulated by energy needs of the surrounding cells and the vasoconstrictive, such as catecholamines and dopamine, and vasodilative factors, such as IL-1, TNF-, and adenosine, that are released by these cells. Pro-inflammatory molecules tend to be vasodilative, reduce vascular resistance, and increase cerebral CBF, while monoamines released by neurons have both vasodilative and vasoconstrictive properties, which can influence blood flow. Vasoconstrictive substances typically increase vascular resistance and reduce CBF.
Symptoms Of Autoimmune Myositis
) and may include vomiting of blood, black and tarry stools, and severe abdominal pain, sometimes with a hole , which causes a release of gastrointestinal contents and can lead to sepsis ⦠read more ) in the lining of the bowel.
Skin changes occur in people who have dermatomyositis. Rashes tend to appear at the same time as muscle weakness and other symptoms. A dusky or purplish rash can appear on the face with reddish purple swelling around the eyes. The rash may also be raised and scaly and may appear almost anywhere on the body but is especially common on the knuckles, elbows, knees, outer part of upper thighs, and parts of the hands and feet. The area around the nails may redden or thicken. When the rash fades, brownish pigmentation, scarring, shriveling, or pale depigmented patches may develop on the skin. The rash on the scalp may look like psoriasis and be intensely itchy. Sun sensitivity and sores on the skin occur as well. Bumps composed of calcium may develop under the skin or in muscle, particularly in children. Raised, reddish bumps may appear on the large knuckles and sometimes on the small knuckles.
Sometimes these characteristic skin changes occur in people who do not have muscle weakness and inflammation. In this case, the disorder is called amyopathic dermatomyositis.
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Autoimmune Disease Risk Factors
Researchers dont know what causes autoimmune disease, but several theories point to an overactive immune system attacking the body after an infection or injury. We do know that certain risk factors increase the chances of developing autoimmune disorders, including:
- Genetics: Certain disorders such as lupus and multiple sclerosis tend to run in families. Having a relative with autoimmune disease increases your risk, but it doesnt mean you will develop a disease for certain, says Orbai.
- Weight: Being overweight or obese raises your risk of developing rheumatoid arthritis or psoriatic arthritis. This could be because more weight puts greater stress on the joints or because fat tissue makes substances that encourage inflammation.
- Smoking: Research has linked smoking to a number of autoimmune diseases, including lupus, rheumatoid arthritis, hyperthyroidism and MS.
- Certain medications: Certain blood pressure medications or antibiotics can trigger drug-induced lupus, which is often a more benign form of lupus, Orbai says. Our myositis center also discovered that specific medications used to lower cholesterol, called statins, can trigger statin-induced myopathy. Myopathy is a rare autoimmune disease that causes muscle weakness. Before starting or stopping any medications, however, make sure to talk to your doctor.
Get Enough Rest To Prevent Fatigue
Most people do best with at least seven to eight hours of sleep each night. If you have lupus you may need even more sleep.
âItâs important to develop good sleeping habits,â says Jolly. âIt can really make the difference in getting a good nightâs sleep.â
- Take time to relax before bedtime. A warm shower or bath can help.
- Avoid alcohol and food or drinks that contain caffeine after dinnertime.
- Donât watch TV right before bedtime because it can be distracting. Read a book instead.
If there are times when you know you wonât get a full nightâs sleep, you may need to plan to make it up the next day.
âI canât go out on a work night like other people my age. If I donât get at least eight hours of sleep, Iâm useless the next day,â says Brown. âSo if thereâs something I want to do in the evening, I have to plan for it by setting aside time to sleep the next day.â
Even with a full nightâs sleep you may need to take several rest periods throughout your day. âSome people may need to plan short periods of rest after each activity,â says Jolly. âThis gives your body time to catch up and can make a big difference in how you feel.â
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How Would You Describe Fatigue Associated With Pots
People with POTS experience fatigue differently. Many describe it as feeling beyond exhausted. Its as if your energy is completely depleted. The fatigue is probably hundreds of times worse than your worst flu. People with POTS may also have trouble concentrating and thinking straight. Doing simple tasks may feel like youve just run a marathon.
This fatigue might come and go, hitting you without warning daily, weekly or less frequently. For some people, extreme fatigue lasts for days. Others may experience periodic attacks. It can come on at any moment even if you just woke up. And there is no amount of sleep or coffee that can make it go away.
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Experiment With Complementary Wellness Approaches To Help Fight Fatigue
Aromatherapy is one example of an complementary remedy that may be used in addition to traditional treatment. It uses the essential oils from plants and other sources to lessen the effects of stress and promote well-being. The oil is usually diluted and either rubbed into your skin or inhaled. Some laboratory studies performed on animals suggest that essential oils can be effective in promoting energy. Essential oils, such as those made from geranium, lavender, and cedarwood, may send chemical messages to your brain that improve your mood and help you to feel more relaxed and energized.
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Stages Of Autoimmune Disease
There are three stages in the progression of an autoimmune disease. Stage one is the silent autoimmune disease, during which time antibodies may become elevated, however, the target organ shows no symptoms or loss of function. Stage two is known as Autoimmune Reactivity, characterized by elevated antibody levels and the some symptoms present as well as mild loss of function. However, in stage two, no severe impairment of tissue associated with the disease occurs. Stage three is what most doctors would identify as an autoimmune disease, at which point labs, imaging, and special studies are able to identify significant loss of function along with elevated antibodies and significant signs and symptoms of the disease.
Conventional medicine usually catches immune dysfunction in the advanced stage when its already too late. For example, Addisons disease is only diagnosed when 90% of adrenal function has been affected. At this point, its very difficult to regain function. However, its encouraging to know that you can identify your problem well in advance of stage three of an autoimmune disease if youre alert and listen carefully to your bodys signals. If the signs are caught early, your body will have the opportunity to rebuild itself under the right guidance.
Much Remains To Be Learned
For the most part, we still do not know what causes an autoimmune disease. That is, we do not know the specific factors that initiate the process ultimately leading to an autoimmune disease.
Since the official acceptance in the mid 1950s that the immune system can attack the very own body of an individual , several different theories have been proposed to explain the induction of an autoimmune disease.
Each theory is supported by experimental data and some clinical evidence, but none has the ability to explain the entire clinical picture in a satisfactory manner. Indeed, minimal change in the diagnosis and management of patients with autoimmune diseases has resulted from these theories of causation.
Quite interestingly, it also remains unknown why in autoimmune diseases the autoreactive lymphocytes become specific for a particular antigenic target, as opposed to other possible targets . For example, in patients with type 1 diabetes mellitus, why is the insulin-producing beta cells of the endocrine pancreas targeted by the patients immune system rather than the nearby glucagon-producing alpha cells?
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Fatigue Gerd Itchy Skin Brain Fog Are You Experiencing Autoimmune Disease Symptoms
Last weekend I was able to attend a wonderful seminar on auto-immune disease and its relation specifically to stress. As someone who has suffered with auto-immune response to stress for the last 12 years this just boosted my belief that it is one of the most serious and substantial causes of inflammation and chronic disease that we have today. For me it was diagnosed in the form of Hashimotos or Auto-immune Thyroiditis.
What is auto-immune disease? Autoimmune conditions are connected by one central biochemical process: A runaway immune response also known as systemic inflammation that results in your body attacking its own tissues. We are facing an epidemic of allergic , asthmatic , and autoimmune disorders . Autoimmune diseases include rheumatoid arthritis, lupus, multiple sclerosis, psoriasis, celiac disease, thyroid disease, and the many other hard-to-classify syndromes in the 21st century.
Your immune system is your defense against invaders. It is your internal army and has to clearly distinguish friend from foe to know you from others. Autoimmunity occurs when your immune system gets confused and your own tissues get caught unrecognized and then are under attack.
Vagus Nerve And Cns Inflammation
Two mechanisms whereby peripheral inflammation can enhance CNS inflammation are through leaky areas in the blood-brain-barrier and the vagus nerve . The vagus nerve, the tenth cranial nerve, is the longest nerve in the autonomic nervous system. This nerve has parasympathetic control of numerous organs that are involved in respirationincluding the lungs, heart, and diaphragmto mediate oxygen demand , which could contribute to fatigue. The vagal nerve afferents tend to relay pro-inflammatory responses cells from organs in the periphery to the CNS . These vagal efferents tend to induce anti-inflammatory responses in peripheral tissue from CNS signals.
The DMN and NTS are major sources of efferent motor vagal input. Longer preganglionic cholinergic neurons communicate with postganglionic neurons in closer proximity and within tissues of the viscera to induce anti-inflammatory signals . Acetylcholine released from neurons interacts with muscarinic acetylcholine receptors and utilizes the DMN, NTS, nucleus ambiguus , and the vagal efferent nerve to alter heart rate, gluconeogenesis, and bronchial constriction . Consequently, these physiological effects could potentially affect fatigue-like behaviors.
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Fighting Lupus Fatigue And Boosting Energy
Fatigue is one of the most common symptoms of lupus. In fact, most people with lupus have fatigue at some point in their illness.
âWhen lupus hit, it was like running into a wall at 80 mph,â says Ann S. Utterback, PhD, a broadcast voice specialist in Virginia who was diagnosed with lupus in 2006. âI had been very active my whole life, and the fatigue just knocked me flat. Most days I have about four good hours.â
Experts arenât certain what causes the fatigue of lupus. In some patients it may be caused by fibromyalgia, a syndrome of widespread muscle pain and fatigue. About one-third of people with lupus have fibromyalgia. In other cases, the fatigue can be caused by another condition, such as anemia or depression. Fatigue can also be a side effect of medication.
If fatigue hinders you, there are ways you can try to increase your energy with lupus. This article offers five key ways to cope with fatigue and boost your energy levels.
Autoimmune Condition Progression As A Cause Of Adrenal Fatigue
Although there is no clear cause of an autoimmune disease, upon examining the etiology of the disease, many factors clearly come into play. As mentioned earlier, factors include genetic predisposition and an array of environmental factors ranging from stress and infections to immune system issues. Often overlooked, and seldom considered, is the role of our adrenal glands.
The adrenal glands are located just above the kidneys and control the production and release of the hormone cortisol. During physical or emotional stress, the hypothalamus acts on the anterior lobe of the pituitary gland causing it to secrete certain hormones and trigger numerous hormone pathways, including the adrenocorticotropic hormone pathway, which signals to the adrenals to produce cortisol. After a sufficient amount of cortisol is produced, cortisol act on the hypothalamus to turn off the pathway. However, if the amount of cortisol produced is not sufficient, the pathway is not turned off and the upstream hormone ratios become out of balance. This puts pressure on the adrenal glands and upstream glands such as the anterior pituitary gland, which regulates many other hormone pathways including the thyroid hormone response, as well as the hormone responses controlling bone growth and sexual development. Hormonal imbalances and unusual cortisol to other hormone ratios have been associated with the incidence of autoimmune conditions including SLS and Hashimotos thyroiditis.
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