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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.

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 →

Numb Cold Feet

Q: Hi, the toes of my feet are numb, and especially bothersome at night because they feel cold.  Is there anything I can do for myself, massage? soaking? pills?  Will the feeling ever come back and more important could it lead to gangarine.  Im 73 and I think Ive had Sjogrens for 30 years or more. thank you so much. A:  Numbness in the feet could be a symptom of Neuropathy or decrease blood flow (circulation). The "cold" feeling suggests decreased circulation (peripheral vascular disease, Raynaud's...blood vessel spasm). An exercise program (walking) may help form additional blood vessels and improve circulation. Improved blood flow (oxygen) to the small nerves...could lead to less numbness. Soaking feet in warm water, perhaps with Epsom salts (Mg#) might help. As you describe it, doubtful gangrene would develop. Your physician, upon exam, would be able to assess this. dr c  Read More →

Treatment Guidelines for Sjogrens: Biologics, Fatigue, Joint/Muscle Pain/Inflammation

First Treatment Guidelines for Sjogren's Disease. Use of biologics, management of Fatigue, and treatment of musculoskeletal disease. Supported by Sjogren's Syndrome Foundation http://www.sjogrens.org http://rheumatologic treatment guidelines sjogrens disease Share with your treating physician's. dr c  Read More →

Pleural effusion Chilblains Sjogrens

Dr. Carteron, My question is regarding pleural effusions and Sjogren's. My earliest symptoms began with shortness of breath, fatigue, chronic sinusitis, rashes, low grade temps, muscle and joint pain, dry eyes, & brain fog. I had 1000 cc's of fluid drained from my right lung. The same lung same location was drained again about five years later but less fluid was removed. I have another pleural effusion at the present time that can only be seen on CT scan or sonogram, this one is on the same lung but different location. I have gone through many lung/breathing tests some of which were done at Mayo in Rochester. I have seen three different Pulmonologists who all say this is caused by an autoimmune condition, the first even said he was sure it was Lupus. They all say my tests show a mild case of asthma until the most recent test and the doctor said it was inconclusive for asthma so maybe it is the beginning of COPD. I have had a hard time getting treatment from Rheumatologists,... Read More →

Internal Tremors and Buzzing with Sjogrens

Q:  Hello.  Thank You So Much for your presentation and information at the SS conference.  It was my first time attending.  I learned so much and met some amazing people.  I'm in a fight for my life as are most Sjogrens' patients. But, I am so limited due to my insurance coverage; luckily I do have coverage,but I have very few choices of who I can see.  My Doctor cannot explain why I experience internal tremors, particularly at night.  I have a buzzing sensation throughout my body after consuming dairy, sugar, breads, anything with preservatives, basically just about everything. Please help. A:  Buzzing and tremors suggest something "neurological". Foods or additives perhaps suggest "allergic" type of trigger. A Neurologist, especially if they have experience with Sjogrens may be able to shed additional light on your symptoms. An elimination type diet might be an option to try to calm things down. It is not unusual to notice more of these types of symptoms at night, similar... Read More →

Challenges of Get'in a Diagnosis

Q:  I am currently in the process of differential diagnosis for an autoimmune disorder, but nobody seems to be able to help me.  My rheumatologist wants me to get diagnostic information from an eye doctor, dentist, and radiologists, while those doctors want me to get a diagnosis from a rheumatologist!  Further, my rheumatologists won't help me manage symptoms without more information and suggested that in 10-12 years (I am in my late 20s) I may have a clear-cut enough case to treat.  I am looking for a new rheumatologist who is more interested, and less afraid of my relatively young age, but that could take months.  My current symptoms suggest Sjogrens (e.g. extreme dry mouth, chronic dry eye that has worsened with onset of systemic symptoms, positive ANA+SSB, with joint pain/radiological findings, etc).  I've started calling general dentists but I can tell I am not asking the right questions.  Do you have any suggestions for what kinds of questions I should ask to find... Read More →