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Do I Have Sjögrens?

If your eyes feel gritty and you need to blink more than you used to, if you need more drinks of water through the day because your mouth feels like a desert, and/or your skin feels dry itchy, burning, cracked; if you feel a profound fatigue most of the time, it’s a possibility. You needn’t have all, or even most of these symptoms; One or more can lead your doctor to a diagnosis. The trouble is that in the early stages, the symptoms come and go and are often non-specific, until later when the disorder becomes acute. Some symptoms of Sjögrens are:

  • Dizziness
  • Tiredness
  • Generally ill with low-grade fever
  • Itching, gritty eyes
  • Difficulty swallowing
  • Loss of sense of taste
  • Severe dental cavities
  • Hoarseness
  • Joint pain or swelling
  • Swollen glands

In spite of the fact that Sjögrens (Sjs) is the cause of suffering for 4 to 5 million Americans, it is not on the tip of all Doctor’s tongues, If your doctor evades your questions and you think that Sjs could be the cause of your troubles, keep looking for a Doctor who has others like you in their practice. Then, the necessary tests to make an objective diagnosis can be performed.  Check out our Resources Page for a list of institutions where you can get more information.  And remember, the earlier you have this checked out by your Doctor, the better.

Below, you can find some of the most recent questions answered by Dr. Carteron, you can find more by searching the menu on the far right. Questions and Answers are organized by topic, or you can ask Dr. Carteron a question by visiting this page.


Rheumatologist Role in Sjogrens

The Sjogren's Syndrome Foundation did an excellent job in partnering with organizations to increase awareness and educate this April Awareness Month. Great Job SSF! http://www.sjogrens.org Read more http://www.the-rheumatologist.org/article/sjogrens-awareness-month-educate-patients-families-caregivers/ dr c  Read More →


Most Common Autoimmune Condition You've never heard of

Thank you to Anna Medaris Miller, journalist for US News and World Report, for bringing a Sjogren person's, Janet Church, life story to a wide audience. Dr Esen Akpek's, Professor of Ophthalmology and researcher at Johns Hopkins, quote "At the end, we are able to diagnose, but by then, patients are irreparably damaged" gave me pause. We all can contribute to the solution. Share your Sjogren's story, support the SSF http://www.sjogrens.org, share resources. I am going to share Dr Akpek's quote with internal medicine residents at my hospital when I talk on Sjogrens this week. Hopefully, less people will be "irreparably damaged" going forward. http://health.usnews.com/health-care/patient-advice/articles/2017-05-04/sjogrens-syndrome-the-most-common-autoimmune-condition-youve-never-heard-of  Read More →


Living with Sjogrens Blog

Follow a Sjogrens Patient who also will become Chairperson for Board of Directors of the Sjogrens Foundation. http://www.sjogrenslife.com   Resource:  SSF http://www.sjogrens.org   dr c  Read More →


Neurological Symptoms in Sjogrens

Several comments and questions have been submitted recently regarding neurological issues in Sjogrens. This resource is a good place to start. https://www.hopkinssjogrens.org/disease-information/sjogrens-syndrome/neurologic-complications/ Also, the Sjogrens Foundation (SSF) is working on Clinical Practice Guidelines for both PNS (peripheral nervous system) and CNS (central nervous system) to guide physicians and other health care team members in managing patients. http://www.sjogrens.org dr c  Read More →


Preventing Tooth Decay in SjogrensConfirm

Confirm your Dentist is aware of Guidelines to help PREVENT dental damage in the setting of Sjogrens...dr c http://info.sjogrens.org/conquering-sjogrens/topic/tooth-decay    Read More →


Neuropathic Pain | SFN (Small Fiber Neuropathy) in Sjogrens Disease

http://docplayer.net/12770054-Clinician-s-corner-small-fiber-neuropathy-and-sjogrens-a-view-from-the-rheumatologist-rheumatologists-are-often-presented-with-patients-with.html   dr c  Read More →


"Brain Fog"

Q:  Hi Dr. Carteron. Thank you for your info. I am being tested for suspected Sjogren's and Autonomoc Dysfunction. Could you please tell me if there is anything that can help with brain fog? A:  I wish....First we need to understand what it is. There are hypotheses, but very little data. One hypothesis is that it is inflammation or immune cytokines that cross into the brain. But a recent study showed a down regulation of suspected cytokines. An other possibility is it is connected to autonomic dysregulation. Other diseases also have a similar symptom. For example, Fibro fog in Fibromyalgia. Track the symptoms. Are there things that make it worse or better. Often sleep problems or stress worsens neurocognitive dysfunction. Exercise, like aquatic or tai chi or walking, and evaluation of your diet and nutrition are a good place to start. If your overall disease is active (inflammation), your team may suggest specific options (i.e. medications) to lower the disease activity. When the disease... Read More →


Frustrations Getting to a Diagnosis

Q:  I have had a positive ANA for years and within the last couple of years have had symptoms including mouth ulcers, joint pain and swelling and skin rashes on my arms and legs. My PCP did a skin biopsy when I had a rash and was indicative of lupus. I also have enthesitis. My most troubling complaint is painful intercourse which has manifested over the last year or so with the other symptoms. Once aroused there is plenty of moisture but the vulva is very painful. Very recently I have started experiencing swelling on one side of my jaw with pain on eating and general swelling of my lymph nodes. I am very frustrated trying to find an exact diagnosis. The rheumatologist refers me to a gynaecologist for the painful intercourse and merely indicates that she doesn't know if it's connected to possible autoimmune disease. My PCP has been most helpful but is not specialised. I feel I need somebody to join all the dots together. I suspect I have lupus and sjogrens although the only other... Read More →


Neurologic Manifestations of Sjs: Dx & Tx by Drs Fox and Birnbaum

http://www.robertfoxmd.com/SjogrensByFox/The_Neurological_Manifeststions_of_Sjögren's_syndrome-Diagnosis_and_Treatment.pdf  Read More →


Uterine Bleeding Probably not Sjs

Q:  Hello Dr. Carteron, I am your patient from some time back. I have had a very satisfying life usually able to manage the flares and avoid them too since your treatment and suggests. About January this year, I developed slight vaginal bleeding daily.I have been using Replens hit and miss and decided dryness was the cause. My Dr. put me on Estrial vaginally. One application and my uterus was tender for 5 days. Bleeding more. Went to OB/GYN had pelvic exam and the pelvic ultrasound both negative. I have been consistent with the use of Luvena moisturizer for 2 months. I still have about a spotting every day. My question is have you seen this or heard of this in an 84 year old Sjogrens patient caused by Sjogrens not CA? Thank you for making my life so so much better. A: Don't think uterine bleeding can be attributed to Sjogren's. Am not a GYN, but probably a uterine biopsy and further investigation is needed...an hopefully has already occurred. Thank you for the update that you have... Read More →