The Case:  Miranda is 42 She was experiencing rashes on her face and chest, joint pain, and fatigue. A dermatologist prescribed antihistamines and a Physical therapist gave her exercises for the joint pain.  There was no explanation or treatment for the fatigue. Miranda’s doctor responded to her condition the way many do - by ruling out the obvious (in this case, arthritis) and then treating the symptoms. More blood tests revealed the presence of ANA or anti nuclear antibody. This indicated that it could be Lupus but it could also not be Lupus. After months of waiting to see her rheumatologist the Lupus diagnosis was confirmed. But, her health mystery still hadn’t been solved because the root cause was still unknown.   The Investigation An estimated 5 million people worldwide have Lupus, and about 1.5 million of them are in the United States. Dr. Tiffany Caplan is a chiropractic physician and a Certified Functional Medicine Practitioner who specializes in treating Lupus patients. She, along with her husband Dr. Brent Caplan founded the Central Coast Center for Integrative Health in Ventura California and wrote the book “The Lupus Solution”. On this episode of Health Mysteries Solved, Dr. Tiffany shares her knowledge in relation to Miranda’s case.    What is Lupus? Lupus is an autoimmune disease that affects an estimated 5 million people around the world, although Dr. Tiffany feels this is an underestimation because the disease is very difficult to diagnose.  Lupus is more likely to affect women (90 percent of all Lupus patients are female) and it is usually diagnosed during their childbearing years. Because Lupus is so hard to diagnose, it can be years of dealing with symptoms before a patient gets a diagnosis.   Common Symptoms of Lupus The most common (and telltale) symptom is a butterfly-shaped rash on the face. While not all patients present with this rash, when someone does have it, it is a good indication of Lupus. Other symptoms may include fatigue, pain (joint-pain, body-aches, general achiness), stomach pain and/or nausea, headaches, photo-sensitvity, mouth ulcers, and/or acne. Lupus can sometimes occur in conjunction with other autoimmune diseases like Hashimoto’s, Sjorgren’s, or Raynaud’s disease, which means that symptoms associated with these diseases can also be symptoms of Lupus.    The Difficulty of Diagnosing Lupus Lupus is a systemic autoimmune disease so it can attack different parts of the body, in different ways, at different times which makes it hard to connect the dots. There are 11 different criteria that are considered in diagnosing Lupus but not all of these need to be satisfied for it to be Lupus. Other diagnoses (like Hashimoto’s or kidney disease) might come first and end the search for the real cause as symptoms are lumped into that single diagnosis. Typically, it takes about seven years for someone to be diagnosed with Lupus.    How Lupus is Diagnosed In addition to considering the clinical criteria (symptoms), there are a variety of lab tests that can help confirm a Lupus diagnosis. A DNA test could reveal an anti-double-stranded DNA marker which is present in about 80% of Lupus patients. A positive test for anti-Smith antibody and various antiphospholipid antibodies that are present in about 30% of lupus patients that can also be indicators. Doctors may also test the function of the immune system function by looking at complement c3 and complement c4 levels through blood tests.   Treating Lupus Traditionally Most conventional doctors will deal with Lupus by prescribing immunosuppressants (since the immune system is overactive). They may also prescribe medication to treat the other symptoms such as antidepressants, pain medication, and/or sleep medication. However, a functional medicine approach to treating lupus doesn’t focus on treating the symptoms but rather getting to the root cause.    The Root Cause of Lupus Each patient is going to be different, but the most common root causes of Lupus