Why Lupus Patients Feel More Fatigue in Cold Weather in Vietnam

As winter approaches in Vietnam, concerns are rising over the exacerbation of symptoms like fatigue and joint pain experienced by patients with Systemic Lupus Erythematosus (Lupus). A 40-year-old man from Lam Dong province, who has lived with lupus for three years, questions whether the worsening of his condition with decreasing temperatures is a disease flare-up or merely a response to the weather. According to experts, while lupus is a chronic autoimmune disease and cold weather is not the direct cause, it is an environmental factor that can make symptoms more pronounced, particularly joint pain and fatigue. In healthy individuals, the body constricts peripheral blood vessels to limit heat loss when temperatures drop. However, in lupus patients, this reaction is more intense due to a sensitive vascular and immune system. Reduced blood flow to the skin, muscles, and joints can temporarily cause stiffness, pain, and difficulty in movement, especially in the morning or after prolonged inactivity. Beyond temperature, changes in atmospheric pressure during seasonal transitions can also make the tissues around the joints more sensitive, increasing pain perception even if the inflammation level doesn't change significantly. Furthermore, low temperatures heighten the sensitivity of pain receptors, leading many patients to feel pain more acutely on cold days. In addition to joint pain, lupus patients are more prone to vascular issues in cold weather. Raynaud's phenomenon affects 25-60% of patients. This condition involves the constriction of blood vessels in the fingers and toes when exposed to cold or stress, causing the digits to turn white, then blue, and finally red as blood flow returns. Patients often experience numbness, burning, or pain in their extremities. In some cases, chilblain lupus erythematosus may appear as red-purple papules or plaques on the fingers, toes, nose, or earlobes after exposure to cold, damp environments. These lesions can persist for weeks and cause pain, itching, or burning if not treated properly. Approximately 25% of lupus patients have cryoglobulins, temperature-sensitive proteins. When exposed to cold, these proteins can precipitate in blood vessels, increasing the risk of small vessel inflammation and, in some instances, leading to purpura or skin ulcers. Fatigue experienced in cold weather is also a very common issue for lupus patients. It's not solely due to joint pain discouraging movement, but also linked to chronic inflammation caused by an overactive immune system. As temperatures drop, the body expends more energy to maintain core temperature. However, patients often suffer from poor sleep due to pain, lack of activity, and sometimes anemia or medication side effects. This confluence of factors makes feelings of lethargy and exhaustion more pronounced. If symptoms only slightly increase with weather changes and improve with warming or rest, there's no need for excessive worry. However, if patients experience severe joint pain, swelling in multiple joints, prolonged fever, new rashes, shortness of breath, leg swelling, or other unusual signs, they should seek medical attention for evaluation of disease activity and possible treatment adjustments. To mitigate symptoms, lupus patients should keep their bodies warm, especially their hands and feet, using gloves, socks, or layered clothing. Maintaining gentle physical activity like walking, stretching, or daily joint exercises can improve circulation, reduce stiffness, and prevent muscle weakness from inactivity. It is advisable to use warm compresses or soak hands and feet in warm water to relieve pain and improve blood flow. Patients should continue taking their prescribed medications, attend regular check-ups, and avoid self-adjusting or stopping medication based on weather-induced symptom changes.