Johns Hopkins Lupus Center Reviews: 2025 Sunspots & Milder Lupus?

Johns Hopkins Lupus Center Reviews: Could sunspots in 2025 lead to milder lupus?

Largest sunspot in 2014 picture by NASA may predict lupus flares

2014 photo by NASA showing an 80,000 mile long sun spot (the length of 10 Earths side by side). Photo source Wikipedia Commons and NASA, Greenbelt, MD
Johns Hopkins Lupus Center reviews of sunspot patterns: lupus disease activity varies with sunspot cycles

– The Johns Hopkins Lupus Center reviews many ways that lupus is affected by the environment. It appears that the pattern of sunspot formation may be one of them.
– Previous research in Germany suggested health changes related to magnetic storms and sunspots (specifically while studying heart attacks by Halberg F, et al.)
– The Lupus Clinic at Johns Hopkins compared disease activity in their center from 1996 to 2020 and compared it to solar cycles, sunspots, and geometric disturbances.
– They found that increased sunspots (called solar maximum in the solar cycle) was followed by lower disease activity on average in their patients.
– Increased geomagnetic activity was also associated with lower disease activity.
– This is another study suggesting how important our environment is regarding lupus. 

When will there be milder lupus activity as predicted by sunspots?

– Of course, this is all hypothetical, and this research needs to be reproduced.
– If it is correct, our most recent time of fewer sunspots was DEC 2019 (the least solar activity in 100 years)
– NASA predicts that solar maximum will occur in July 2025 with 115 sunspots (179 is the average)
– The previous solar maximum was in APR 2014 with 114 sunspots. Since Dr. Stojan’s research included that sun cycle, this upcoming cycle should be similar.

– Therefore, SLE patients may look forward to the Fall and Winter, Northern Hemisphere (this was a Northern Hemisphere study) of 2025 as a period of having milder lupus attacks.

Note… this is all very interesting, but I would not put my money on it until further research is done


 Don Thomas, MD, author of “The Lupus Encyclopedia” and “The Lupus Secrets

Stojan G, Giammarino F, Petri M. Systemic lupus Erythematosus and geomagnetic disturbances: a time series analysis. Environ Health. 2021 Mar 16;20(1):28. doi: 10.1186/s12940-021-00692-4. PMID: 33722240; PMCID: PMC7962208.

Halberg F, Cornélissen G, Otsuka K, Watanabe Y, Katinas GS, Burioka N, Delyukov A, Gorgo Y, Zhao Z, Weydahl A, Sothern RB, Siegelova J, Fiser B, Dusek J, Syutkina EV, Perfetto F, Tarquini R, Singh RB, Rhees B, Lofstrom D, Lofstrom P, Johnson PW, Schwartzkopff O, the International BIOCOS Study Group. Cross-spectrally coherent ~10.5- and 21-year biological and physical cycles, magnetic storms and myocardial infarctions*. Neuro Endocrinol Lett. 2000;21(3):233-258. PMID: 11455355.

NASA: What Will Solar Cycle 25 Look Like?

Good Advice on Lupus and Bactrim [per sulfa antibiotic research]

Lupus and Bactrim: List sulfa antibiotics (like Bactrim) in your allergy list if you have lupus

Lupus patients are more likely to have allergies to antibiotics (plus, lupus and Bactrim are a bad combination)

While lupus and Bactrim are a bad combination, many systemic lupus erythematosus (SLE) patients also report numerous drug allergies. However, studies do not show an increased amount of allergies than non-lupus patients (other than antibiotics).

Lupus and antibiotics treatment:

SLE patients have higher rates of allergies and intolerances to penicillins, cephalosporins, sulfonamides, and the antibiotic erythromycin. The most important antibiotic intolerance is that of sulfonamide (often called “sulfa”) antibiotics. This most commonly refers to the antibiotic trimethoprim-sulfamethoxazole (Bactrim and Septra).

Sulfur versus sulfonamides versus other sulfa drugs and lupus

The element called sulfur exists in all of us, so none of us are allergic to sulfur. Many different molecules contain sulfur to include sulfates, sulfites, and sulfonamides. Lupus patients have an increased risk of antibiotic sulfonamides (specifically Bactrim, trimethoprim-sulfamethoxazole) flaring their lupus. Sulfonamide antibiotics are very different than sulfates, sulfites, and others. These are safe for lupus patients to take. There are some non-antibiotic sulfonamides (furosemide, hydrochlorothiazide, acetazolamide, sulfonylureas used for diabetes, and celecoxib). However, these do not appear to increase lupus flares and are safe for lupus patients to take (unless they just happen to have an allergy to that particular drug).

Sulfa antibiotics can cause significant lupus flares (list is as an allergy!)

Around one-third of lupus (SLE) patients have reactions to Bactrim, and it can cause lupus flares as well. These reactions are more common in Caucasians, those with low lymphocyte counts (lymphopenia), and anti-SSA positive patients. Still, they can occur in any lupus patient. They especially can cause flares of fever, sun-sensitive rashes, and low blood cell counts. Sometimes these flares can be severe. There are so many other antibiotics now available that sulfonamide antibiotics can usually be avoided in SLE patients.

I, and most lupus experts, recommend that all lupus patients always carry an up-to-date medication list (similar to the first image, above) and that it also includes an allergy list that includes “sulfa antibiotics.” This can protect you if you ever get sick and end up in the emergency room where it can be hard to remember to tell your entire medical history. While lupus patients are more likely to be intolerant of the antibiotics penicillin, cephalosporins, and erythromycin, these do not typically cause lupus flares, and the vast majority of SLE patients tolerate them well. Therefore, they do not need to be avoided in lupus patients who are not allergic to them.

Patient Question: “Can you take amoxicillin if you have lupus?”

“Yes!” The good news is that we have dozens of other safe antibiotics that lupus patients can take.  Lupus and antibiotics treatment should not be complicated. As long as you list “sulfa antibiotics” on your drug intolerance list and show it to doctors, they can come up with safe alternatives. Although lupus and Bactrim are a bad idea, lupus patients can take many other medications safely.

The Lupus Secrets

Learn and abide by the Lupus Secrets to live a healthier, longer life with SLE
This is my first blog post (as I stated I’d do in my 1st post) with one of my Lupus Secrets. It is such an important one! I will discuss the other “Secrets” in my blog in the future. 


Background of “The Lupus Secrets“:

A long time ago, I realized that most patients and most physicians were not familiar with all the important things that lupus patients can do themselves that improve their health and lives. So, I made a list and called them “The Lupus Secrets” that addresses these important things. I called them “The Lupus Secrets” not because I wanted them to be a secret, but because they appeared to be a secret since most people (and doctors) did not know about all of them.

I regularly update this list as our knowledge of lupus improves. The Lupus Secrets list is given to all my patients, and encourage them to follow it. Most of my SLE patients are in remission or low disease activity, and I care for many people with SLE. My patients’ utilization of “The Lupus Secrets” is an important tool in achieving this goal. Please download a copy. Each recommendation has medical literature to back it up (check out the references below for this “Secret”), though each varies in the strength of evidence. 


Don Thomas, MD
​Author of The Lupus Encyclopedia

Picture showing a bunch of people holding a sign in the shape of a cloud that says comment on lupus medication list and lupus sulfa allergy

What is your experience with sulfa antibiotics? Have you had any difficulties with your lupus and antibiotics treatment?

​Please click “Comments” 

Lupus Flare After Flu Shot? Question of the Day Here

Do Flu Shots Cause Lupus Flares? Lupus flare after flu shot?

Question of the day: Dr. Thomas, I have lupus and was told by another lupus patient that she gets a flare when she gets a flu shot. Do flu shots cause lupus flares?  – JP
ANSWER: “No and Yes; in that order”

Fortunately, the vast majority of systemic lupus erythematosus (SLE) patients do not get a flare after getting the flu shot. A recent study showed that only 32 SLE patients out of 1966 (1.6%) who got the flu shot (influenza vaccine) had flares from their SLE, and all were mild. I have never had a patient get a severe flare from the flu shot over 30 years. I had one severe flare from Pneumovax, though.

Now the really interesting thing about this study is as follows… it would be very easy to conclude “the flu shot must cause flares in 1.6% of SLE patients.” However, that is not true. Imagine studying 1966 SLE patients even for just a very short period of time. I find it amazing that only 32 out of 1966 would flare. You’d expect more of them to flare during the study period simply because that is what lupus likes to do.

Compared to healthy controls, they responded very well to the vaccine as far as it protecting them from the flu.

It is flu season. Please get your flu shot. Especially with COVID-19, we do not want a one-two punch!

NOTE: The Centers for Disease Control recommends getting the flu shot BEFORE the end of October.

(Many people misinterpret this as they should get it in October). Their only warning about this is that elderly vaccine recipients may have the vaccine response be a little weaker at the end of the flu season if they get it in July or August. Otherwise, it is best to get it as soon as it is available to help decrease community spread.

Please SHARE my post with others.

Click the COMMENTS button above regarding your experience with the flu shot when you have lupus. Would love to hear from people who have had no problems at all and those who have.

– by Don Thomas, MD, FACP, FACR