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Well, maybe I’ll just have one.
Stop and think seriously about this before having the bartender pour you a lemon drop. While you might not have thought twice about enjoying a drink before you were diagnosed with lupus, since diagnosis it is a whole new ballgame. The morning after a night out in the past may have left you with a raging headache and craving Wendy’s – and more often than not, you felt better after dipping your French fries into your Frostee. Now that you know you have lupus, the morning after having one too many may mean a painful and exhausting lupus flare that could last for days, something that hangover food cannot cure.
Alcohol intake itself (responsibly and in moderation) is not necessarily bad and may even have health benefits. A 2017 study by researchers from Harvard Medical School determined that the ethanol and antioxidants found in alcohol can actually “suppress systemic inflammation and decrease the synthesis of pro-inflammatory cytokines such as tumor necrosis factor (TNF), interleukin (IL)-6, and IL-8… “Moderately drinking alcohol has also been “associated with reduced cardiovascular disease and rheumatoid arthritis risk.” The same study also notes that the intake of wine in a group of women the researchers studied “significantly reduced SLE risk.” It is important to note, however, that at the time of the study, the participants did not have lupus.
Unfortunately the ability to drink alcohol when you have lupus is not always cut-and-dried and may not have benefits. It is important to mention that your ability to drink alcohol may also change from time-to-time depending on your symptoms and medications. In this article, we’ll take a look at how you can balance common sense, medical advice, your symptoms, and your personal relationships all while still having a good time. Drinking 101 – An Alcohol Primer
Using common sense and sound judgement around drinking is sometimes easier said than done especially when you are excited about the party and get caught up in the moment. Taking a step back, however, and considering the compromising position drinking alcohol may easily put you in bears worth mentioning here – think of it as a refresher course for anyone who is considering drinking: Do not drink if you are pregnant or planning on becoming pregnant. If you are predisposed to alcoholism – don’t drink! Always drink in moderation – limit your alcohol intake to two servings a day or less for men and one for women. A serving is typically 12 ounces of beer, 8 ounces of malt liquor, 5 ounces of wine, 3-4 ounces of fortified wines such as port or sherry, 2.5 ounces of 24% alcohol liqueur, or 1.5 ounces of 80-proof liquor. Do not drink and drive. Always chose a designated driver if going out in a group or opt for public transportation, taxis, Uber, or Lyft. Avoid prescription drug interactions. Always follow the advice of your healthcare practitioner or pharmacists and never assume – ask whether or not you can safely drink when taking your meds. Stop drinking at least two hours before bedtime – remember, contrary to belief, alcohol acts as a stimulant. Keep hydrated. If you are drinking, make sure to have a glass of water nearby. Try to avoid drinking on an empty stomach. Make sure to eat something filling before you start drinking and have munchies on-hand throughout the event.
You may be rolling your eyes at this point, but let this serve as an important refresher of the do’s and don’ts of drinking. I personally did not know for years that alcohol is actually a stimulant (that explains the poor sleep quality and outrageous dreams I often experience after a night out), and I did not know what a serving of alcohol looked like – especially for a woman – until just now. Avoiding a Cocktail for Disaster – Drug Interactions with Alcohol When You Have Lupus
As someone with lupus, you may be taking medications for symptom control or for other lupus-related conditions. The side effects from the medications listed below may be exacerbated by drinking alcohol and could include gastrointestinal upset, ulcers, increases in blood sugar levels, and changes in blood pressure. More specifically, the following medications – though not an inclusive list – may have the following adverse effects when consumed with alcohol: Methotrexate – a form of chemotherapy typically taken once a week that has been known to cause cirrhosis of the liver in extreme cases. Drinking alcohol may increase the risk of occurrence. Prednisone (Fosamax, Boniva) – since this steroid can increase blood sugar levels, drinking alcohol may further increase the chances of developing type 2 diabetes. Alcohol can also suppress your immune system making your more susceptible to whatever bugs are going around. Hydroxychloroquine ( Plaquenil ), quinacrine (Atabrine), and chloroquine (Aaralen) – all are antimalarial drugs prescribed to treat symptoms such as inflammation and skin rashes. Side effects may include retinal damage, gastrointestinal discomfort, and skin rashes. You should always speak to your doctor and pharmacist before you plan on drinking if you take an antimalarial. While drinking in moderation may be okay, side effects may occur that may be further exacerbated while drinking alcohol. Non-steroidal anti-inflammatory drugs (NSAIDs) – often referred to by their brand names of Motrin, Aleve, Midol, and Advil, NSAIDs already may predispose individuals to gastrointestinal bleeding and kidney damage and drinking alcohol may increase those risks. One thing we may overlook is that NSAIDs also cause relaxation, which decreases alertness, and drinking alcohol may exacerbate this effect. Acetaminophen – also known as Tylenol, acetaminophen taken with alcohol may increase your risk for liver damage. Antidepressants – drinking alcohol while taking antidepressants may intensify any potential side effects from the medication – it can also make you feel like your meds aren’t working. I made the mistake of drinking once while taking a selective serotonin reuptake inhibitor (SSRI) for anxiety – and ironically had the worst panic attack of my life that night. Mixing alcohol with certain antidepressants such as monoamine oxidase inhibitors (MAOIs) may also cause spikes in blood pressure. Opioids – recognized by their brand names such as Vicodin, Percocet, and OxyContin, mixing these painkillers with alcohol can have devastating consequences. Opioids can cause drowsiness, dizziness, impaired motor function, confusion, low blood pressure, etc. and consuming alcohol will intensify these effects.
If you are confused or doubtful as to whether even the smallest amounts of medications can negatively interact with the smallest amounts of alcohol, always make it a best practice first to talk to your pharmacist and/or healthcare practitioner. Your health and your life are worth more than a whiskey sour.
Do not forget – you may be able to drink in moderation. This is why it is so important to speak with a trusted healthcare practitioner and/or your pharmacist – it’s worth it to find out if you are able to nurse even one favorite drink throughout the evening! Celebrate Good Times – One Ginger Ale at a Time
If it turns out that having a glass of bubbly is out of the question, you can still participate in the celebratory toasts and have fun. Ask the host or bartender to make you a mocktail – you can still get the cute umbrella and pieces of fruit without dialing it all the way back to a Shirley Temple. Sparkling cider or ginger ale are also great subs for champagne. Sipping on sparkling water can look chic and fancy. Bring a bottle or two with you and others may appreciate not feeling the pressure to over-indulge – you may serve as their role model! Confidently say “no thanks” when offered the strong stuff – tell your host you want to be able to enjoy yourself as much as possible and you can’t if you’re down for the count before sunset. Let them know that drinking while taking your meds can have adverse effects – it should mean more to your host to be able to enjoy your company rather than contribute to a lupus flare the next morning. Set a time limit – stay for a while and if the party gets too raucous or the temptation to drink too great, leave. Always remember to thank your host for inviting you and reciprocate the invitation – ask your host and others to join you for brunch or tea soon to catch up on life and what happened at the party after you left – there’s always a good story or two to share! In Conclusion
As much as people may try to convince you – or themselves – that you cannot have fun without the rum, we all know better. While having lupus does not always mean drinking is completely off limits, it does mean you have to delicately balance how you feel with common sense and medical advice. If you are able to drink, you should know yourself well-enough to know that while drinking one mojito may leave you with a glow, having one more for the road may mean waking up with inflammatory joint pain. If you aren’t able to drink, be grateful that you are feeling well enough to at least attend the party and hang out with your friends. It’s all give-and-take: giving up a drink or two tonight while still having fun may mean a symptom-free tomorrow.
References Barbhaiya, M., Chang, S., Costenbeder, K., Karlson, E., Lu, B., Malspeis, S., & Sparks, J. (2017). Influence of alcohol consumption on the risk of systemic lupus erythematosus among women n the nurses’ health study cohorts. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5140763/pdf/nihms793878.pdf Burtchell, J. (2016). Should I avoid alcohol? What to know when taking prednisone. Retrieved from: https://www.healthline.com/health/should-i-avoid-alcohol-prednisone-questions-answered#effects Chloroquine (oral route). (n.d.). Retrieved from: https://www.mayoclinic.org/drugs-supplements/chloroquine-oral-route/description/drg-20062834 Gabrielle, S. (2018). When lupus and alcohol meet at a party. Retrieved from: https://lupusnewstoday.com/2018/07/19/lupus-alcohol-meet-night-partying/ Hall-Flavin, D. (n.d.). Why is it bad to mix antidepressants and alcohol? Retrieved from: https://www.mayoclinic.org/diseases-conditions/depression/expert-answers/antidepressants-and-alcohol/faq-20058231 Hydroxychloroquine (oral route). (n.d.). Retrieved from: https://www.mayoclinic.org/drugs-supplements/hydroxychloroquine-oral-route/before-using/drg-20064216 Is it safe to drink alcohol while drinking acetaminophen? (2016). Retrieved from: https://www.healthline.com/health/pain-relief/acetaminophen-alcohol Pietrangelo, A. (2016). Effects of using ibuprofen with alcohol. Retrieved from: https://www.healthline.com/health/pain-relief/ibuprofen-alcohol The effects of mixing opioids and alcohol. (2018). Retrieved from: https://www.alcohol.org/mixing-with/opioids/ Thinking about drinking? Read this first. (2018). Retrieved from: https://www.lupus.org/resources/thinking-about-drinking-read-this-first Thomas, D. E. (2014). The lupus encyclopedia: A comprehensive guide for patients and families. Baltimore, MD: Johns Hopkins University Press. Treating lupus with antimalarial drugs. (n.d.). Retrieved from: https://www.hopkinslupus.org/lupus-treatment/lupus-medications/antimalarial-drugs/
Article written by: Liz Heintz
Liz Heintz is a copywriter and creative writer who received her BA in Communications, Advocacy, and Relational Communications from Marylhurst University in Lake Oswego, Oregon. She most recently worked for several years in the healthcare industry. A native of San Francisco, California, Liz now calls the beautiful Pacific Northwest home.
All images unless otherwise noted are property of and were created by Kaleidoscope Fighting Lupus. To use one of these images, please contact us at firstname.lastname@example.org for written permission; image credit and link-back must be given to Kaleidoscope Fighting Lupus.
All resources provided by us are for informational purposes only and should be used as a guide or for supplemental information, not to replace the advice of a medical professional. The personal views expressed here do not necessarily encompass the views of the organization, but the information has been vetted as a relevant resource. We encourage you to be your strongest advocate and always contact your healthcare practitioner with any specific questions or concerns. Hey, like this post? Why not share it with a buddy? Tweet Article by : Elizabeth Heintz
Liz Heintz is a technical and creative writer who received her BA in Communications, Advocacy, and Relational Communications from Marylhurst University in Lake Oswego, Oregon. She most recently worked for several years in the healthcare industry. A native of San Francisco, California, Liz now calls the beautiful Pacific Northwest home. Popular Posts
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Anosmia is the inability to perceive odor or a lack of functioning olfaction—the loss of the sense of smell. Anosmia may be temporary, but some forms such as from an accident, can be permanent. Anosmia is due to a number of factors, including an inflammation of the nasal mucosa, blockage of nasal passages or a destruction of one temporal lobe. Inflammation is due to chronic mucosa changes in the paranasal sinus lining and the middle and superior turbinates.
When anosmia is caused by inflammatory changes in the nasal passageways, it is treated simply by reducing inflammation. It can be caused by chronic meningitis and neurosyphilis that would increase intracranial pressure over a long period of time, and in some cases by ciliopathy including ciliopathy due to primary ciliary dyskinesia (Kartagener syndrome, Afzelius’ syndrome or Siewert’s syndrome).
Many patients may experience unilateral anosmia, often as a result of minor head trauma. This type of anosmia is normally only detected if both of the nostrils are tested separately. Using this method of testing each nostril separately will often show a reduced or even completely absent sense of smell in either one nostril or both, something which is often not revealed if both nostrils are simultaneously tested.
A related term, hyposmia, refers to a decreased ability to smell, while hyperosmia refers to an increased ability to smell. Some people may be anosmic for one particular odor. This is known as “specific anosmia”. The absence of the sense of smell from birth is called congenital anosmia.
Anosmia can have a number of harmful effects. Patients with sudden onset anosmia may find food less appetizing, though congenital anosmics rarely complain about this, and none report a loss in weight. Loss of smell can also be dangerous because it hinders the detection of gas leaks, fire, and spoiled food. The common view of anosmia as trivial can make it more difficult for a patient to receive the same types of medical aid as someone who has lost other senses, such as hearing or sight.
Losing an established and sentimental smell memory (e.g. the smell of grass, of the grandparents’ attic, of a particular book, of loved ones, or of oneself) has been known to cause feelings of depression.
Loss of olfaction may lead to the loss of libido, though this usually does not apply to congenital anosmics.
Often people who have congenital anosmia report that they pretended to be able to smell as children because they thought that smelling was something that older/mature people could do, or did not understand the concept of smelling but did not want to appear different from others. When children get older, they often realize and report to their parents that they do not actually possess a sense of smell, often to the surprise of their parents.
A study done on patients suffering from anosmia found that when testing both nostrils, there was no anosmia revealed; however, when testing each nostril individually, tests showed that the sense of smell was usually affected in only one of the nostrils as opposed to both. This demonstrated that unilateral anosmia is not uncommon in anosmia patients.
A temporary loss of smell can be caused by a blocked nose or infection. In contrast, a permanent loss of smell may be caused by death of olfactory receptor neurons in the nose or by brain injury in which there is damage to the olfactory nerve or damage to brain areas that process smell (see olfactory system). The lack of the sense of smell at birth, usually due to genetic factors, is referred to as congenital anosmia. Family members of the patient suffering from congenital anosmia are often found with similar histories; this suggests that the anosmia may follow an autosomal dominant pattern. Anosmia may very occasionally be an early sign of a degenerative brain disease such as Parkinson’s disease and Alzheimer’s disease.
Another specific cause of permanent loss could be from damage to olfactory receptor neurons because of use of certain types of nasal spray; i.e., those that cause vasoconstriction of the nasal microcirculation. To avoid such damage and the subsequent risk of loss of smell, vasoconstricting nasal sprays should be used only when absolutely necessary and then for only a short amount of time. Non-vasoconstricting sprays, such as those used to treat allergy-related congestion, are safe to use for prescribed periods of time. Anosmia can also be caused by nasal polyps. These polyps are found in people with allergies, histories of sinusitis & family history. Individuals with cystic fibrosis often develop nasal polyps.
Amiodarone is a drug used in the treatment of arrhythmias of the heart. A clinical study performed demonstrated that the use of this drug induced anosmia in some patients. Although rare, there was a case in which a 66-year-old male was treated with Amiodarone for ventricular tachycardia. After the use of the drug he began experiencing olfactory disturbance, however after decreasing the dosage of Amiodarone, the severity of the anosmia decreased accordingly hence correlating the use of Amiodarone to the development of anosmia.
Anosmia can be diagnosed by doctors by using acetylcysteine tests. Doctors will begin with a detailed elicitation of history. Then the doctor will ask for any related injuries in relation to anosmia which could include upper respiratory infections or head injury. Psychophysical Assessment of order and taste identification can be used to identify anosmia. A nervous system examination is performed to see if the cranial nerves are damaged. The diagnosis as well as the degree of impairment can now be tested much more efficiently and effectively than ever before thanks to “smell testing kits” that have been made available as well as screening tests which use materials that most clinics would readily have. Occasionally, after accidents, there is a change in a patient’s sense of smell. Particular smells that were present before are no longer present. On occasion, after head traumas, there are patients who have unilateral anosmia. The sense of smell should be tested individually in each nostril.
Many cases of congenital anosmia remain unreported and undiagnosed. Since the disorder is present from birth the individual may have little or no understanding of the sense of smell, hence is unaware of the deficit. It may also lead to reduction of appetite.
Though anosmia caused by brain damage cannot be treated, anosmia caused by inflammatory changes in the mucosa may be treated with glucocorticoids. Reduction of inflammation through the use of oral glucocorticoids such as prednisone, followed by long term topical glucocorticoid nasal spray, would easily and safely treat the anosmia. A prednisone regimen is adjusted based on the degree of the thickness of mucosa, the discharge of oedema and the presence or absence of nasal polyps. However, the treatment is not permanent and may have to be repeated after a short while. Together with medication, pressure of the upper area of the nose must be mitigated through aeration and drainage.
Anosmia caused by a nasal polyp may be treated by steroidal treatment or removal of the polyp.
Although very early in development, gene therapy has restored a sense of smell in mice with congenital anosmia when caused by ciliopathy. In this case a genetic condition had affected cilia in their bodies which normally enabled them to detect air-borne chemicals, and an adenovirus was used to implant a working version of the IFT88 gene into defective cells in the nose, which restored the cilia and allowed a sense of smell.
On June 16, 2009, the US Food and Drug Administration sent a warning letter to Matrixx Initiatives, manufacturer of an over-the-counter nasal spray for the common cold, Zicam. The FDA cited complaints that the product caused anosmia. The manufacturer strongly denies these allegations, but has recalled the product and has stopped selling it.
Matrixx had received more than 800 reports of Zicam users who were losing their sense of smell but did not provide those reports to the FDA.
Thanks for your understanding. No, none of those symptoms. I did bang the top of my head on the side mirror of my car while getting up from bending down 3 months ago, but there was no bump, no bleeding and no pain after the first day. My head pressure/pain began a week or so later. I went to ENT who looked up my nose and saw some inflammation and treated me with antibiotic Augmentum, plus prednisone 7-day treatment. By that point I had symptoms of a cold virus/ or something very close to it. They went away a week later. I’ve been suffering from these residual sensations in my front head since the end of September. ENT prescribed aother round of Prednisone in late October, which helped, but only temporarily. Thus, the CT that was done over the weekend. As for the Internist, I saw her this morning. She darkedened the room and put a light in my eyes, she made me close my eyes and touch my nose with my finger, she made me walk step in front of step like a tigt-rope walker. I passed with flying colors. But because I complained of the pressure in forehead above and behind eye sockets, she wants me to run and get a CT tomorrow. Like I said, I’ve had so much CT radiation already, I’d like to avoid another. I read online that 1 out of every 2,000 people who gets one develops cancer. That’s rather high if true. Perhaps what I’m suffering is just chronic inflammation from repeated sinus issues (I still have a deviated septum which showed up on the CT as having some thickening mucus around it).
INCHEON, South Korea & JERUSALEM–(BUSINESS WIRE)–Celltrion, Inc. (KRX:068270) and Teva Pharmaceutical Industries Ltd. (NYSE and TASE: TEVA) today announced that the U.S. Food and Drug Administration (FDA) has approved TRUXIMA® (rituximab-abbs), a monoclonal…
Her doctors thought the young woman had a virus commonly seen in children. But when she only got worse, one doctor looked elsewhere.
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