Lupus Awareness Month
A primary care perspective on autoimmune conditions
By Justine Williams Roper / Photos by Kate Treick Photography
Autoimmune diseases affect millions of people worldwide, yet many remain undiagnosed or misunderstood. Among them, lupus stands out as a complex and often intimidating condition, affecting more women than we realize. For Lupus Awareness Month, Davida Wilson, M.D., a primary care physician at Ascension Sacred Heart, discussed the role of primary care in diagnosing and managing autoimmune disorders, including lupus. Wilson has an expansive educational background, graduating from University of South Alabama for medical school as well as completing four years of active duty after her residency in family medicine.
UNDERSTANDING AUTOIMMUNE CONDITIONS
While a broad category that includes many conditions, autoimmune diseases are becoming more well-known.
“There are multiple types of autoimmune disorders,” Wilson explained. “But in a nutshell, an autoimmune disorder is when your body starts attacking some part of itself, thinking it doesn’t belong there.”
The list of autoimmune diseases is extensive and includes conditions such as rheumatoid arthritis, Hashimoto’s thyroiditis, Sjögren’s syndrome, scleroderma and of course, lupus. These conditions can affect various organ systems, resulting in a range of outcomes from mild to severe debilitation.
Lupus, or Systemic lupus erythematosus, causes inflammation and, in some cases, permanent tissue damage, which can be widespread — affecting the skin, joints, heart, lung, kidneys, circulating blood cells, and brain.
RECOGNIZING THE EARLY SIGNS OF LUPUS
For a lot of women, the initial signs of lupus can be very subtle, and because these symptoms are so common, many women endure years of suffering before receiving a diagnosis.
“Fatigue is one of the biggest warning signs, and a lot of times women push that aside because they’re so busy in their lives,” Wilson said.
Other frequent early warning signs are unexplained hair loss and mysterious rashes.
“You should mention to your primary care physician f you have unexplained fatigue, thinning hair or changes in your skin,” she said.
The difficulty of iagnosing lupus is that its symptoms are so variable. A classic “butterfly rash” across the cheeks and nose is often associated with lupus but is not always present, o comprehensive medical evaluation is necessary.
THE ROLE OF PRIMARY CARE
As many people’s first point of contact in the healthcare system, primary care physicians play a critical role in identifying potential autoimmune diseases. Wilson emphasized that diagnosing lupus begins with testing using specific blood panels.
“It’s really simple,” she said. “If a patient comes in complaining of fatigue, hair loss, or unexplained rashes, I order lab tests to rule out underlying conditions. These tests help us determine whether an autoimmune disorder is at play.”
While most autoimmune diseases can be detected through blood markers, a small percentage of cases are “seronegative,” meaning standard blood tests may not reveal the disease despite clear clinical symptoms.
“About 90% of the time, blood work will confirm an autoimmune disorder,” Wilson explained. “For the remaining 10%, clinical evaluation becomes even more crucial.”
NAVIGATING THE REFERRAL PROCESS
Whether an auto-immune condition is suspected or diagnosed, a consult or referral to a rheumatologist is always warranted.
“I essentially hold down the fort until my patient can see a rheumatologist,” Wilson said.
While primary care providers can prescribe basic medications, more advanced treatments require a specialist’s expertise.
“Rheumatologists manage the latest therapies and ensure patients receive the most effective treatment available,” she added.
Even for patients who have been stable on lupus treatment for years, rheumatology follow-up remains essential for maintenance as well as proactive care.
“Autoimmune disorders don’t fade away,” Wilson said. “New medications are constantly being developed, and rheumatologists are the ones who stay up to date on the latest treatment options.”
THE IMPACT ON WOMEN
Shockingly, Lupus is predominantly a women’s disease.
“Only about 12 to 18% of lupus patients are men,” Wilson noted. “We don’t fully understand why, but researchers believe it may be linked to estrogen and progesterone levels.”
This gender disparity extends to many autoimmune diseases, further emphasizing the need for increased awareness and research.
LIFESTYLE MANAGEMENT
Managing lupus and other autoimmune disorders requires more than just medication — it involves lifestyle adjustments as well. Wilson stressed the importance of balance.
“Moderation is key,” she advised. “A dedicated but gentle exercise regimen, such as 30-minute sessions three times a week, can be beneficial. But overexertion can trigger flares.”
Nutrition and stress management also play crucial roles, and Wilson said it’s important to avoid excessive sun exposure, manage workload stress, and maintain a consistent routine to help minimize symptoms.
ADVOCACY & SUPPORTING LOVED ONES
Patient advocacy is of utmost importance on all fronts.
“You know your body better than anyone,” Wilson emphasized. “If something doesn’t feel right, don’t hesitate to seek answers. Even if tests come back normal, a persistent health concern should not be ignored.”
In addition to having good providers, a strong support system is invaluable for those living with autoimmune diseases.
“Having a ‘village’ is crucial,” Wilson said.
Whether it’s friends helping with meals during flares or family members attending doctor’s appointments, community support can make a significant difference.
Many patients struggle with symptoms which can disrupt daily activities and work-life balance.
“People assume that if you have an autoimmune disorder, you can just push through it, but that’s not the reality,” Wilson said. “Some days are manageable, but others are debilitating.”
This is why it is so important to create awareness surrounding lupus so more women are supported on their journeys.
For those supporting someone with lupus, awareness and understanding are key.
“Recognize that bad days will happen,” Wilson said. “It’s not about pushing through — it’s about managing symptoms and allowing for rest when needed.”
Lupus warrior spotlight: Cheryl Etheredge Calhoun
Cheryl Etheredge Calhoun was officially diagnosed with lupus in 2014 after enduring years of unexplained symptoms, including back surgeries, kidney failure and adrenal insufficiency. Like many others, she faced challenges in obtaining a diagnosis, especially as a woman of color navigating the healthcare system. Reflecting on her experience, Calhoun emphasizes the importance of not ignoring symptoms, self-advocacy and using various resources.
“If you feel something isn’t right, you have the right to seek answers and demand the necessary tests,” she said.
Calhoun has found strength in managing lupus with lifestyle changes. She has found that setting boundaries, prioritizing rest and adjusting her diet have been key factors in minimizing flares. Beyond managing her own health, Calhoun has turned her journey into a mission to support others. She founded Smiles Behind Lupus, a nonprofit organization providing care packages to fellow lupus warriors and advocating for greater awareness.
Local and National Resources:
Smiles Behind Lupus
Lupus Strength Circle
Lupus Research Alliance
