Commonly asked questions about autoimmune diseases.

Q I've just been diagnosed with lupus, and my family practitioner is certain she can remain as my primary doctor. Do I need to see a specialist?

A Lupus is a complicated and unpredictable illness, and you should be monitored on an ongoing basis by a well-trained, experienced health care team. Family practice physicians or other primary care providers can serve as a critical part of that team, particularly in areas of the country where there may be a shortage of rheumatologists, the specialists who typically treat lupus. I recommend you consult a rheumatologist and see whether you can put together a team approach, with your primary care doctor directly involved to ensure consistent and comprehensive care.

--Joan T. Merrill, MD

Medical Director, Lupus Foundation of America 

Head, Clinical Pharmacology Research Program

Oklahoma Medical Research Foundation 

Oklahoma City, OK

Q Are there any alternative remedies you recommend for lupus or rheumatoid arthritis?

A If you're interested in supplements or herbs to help your arthritis, you must first realize that none are FDA-approved. As a result, they haven't undergone rigorous scientific studies to assess their benefits or risks. That said, there is some scientific support for some alternative supplements and certain foods in the treatment of rheumatoid arthritis including tumeric, ginger, Boswellia and bromelain (an enzyme from pineapple). Some investigators, including myself, are looking into using concentrated amounts of specific foods to help improve arthritis pain. Make sure you discuss any alternative remedies you're taking with your doctor. Some can interact with medications you may be taking.

Q Why are corticosteroids so often prescribed for autoimmune diseases, and what are their risks?

A Corticosteroids are potent anti-inflammatory medications. They are used for autoimmune conditions like lupus and rheumatoid arthritis because they are effective in dampening the immune response that contributes to the symptoms of these diseases. Unfortunately, while they're very helpful to patients, these medications also have potential side effects including, but not limited to, weight gain, elevated blood sugar levels, osteoporosis and increased risk of infection. It is recommended that these drugs be used at the lowest effective dose for the least amount of time.

--Scott Zashin, MD

Rheumatologist, Clinical Assistant Professor

University of Texas Southwestern Medical School 

Dallas, TX

Author of Arthritis without Pain: The Miracle of TNF Blockers