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Living With Lupus Blog: The Lupus Encyclopedia – Q & A Video

Dr. Donald Thomas Answers Lupus Patients’ Questions on His Living With Lupus Blog: The Lupus Encyclopedia

Watch this YouTube video — patients’ important questions are answered about living with lupus

Dr. Donald Thomas’ Lupus Encyclopedia is a practical “living with lupus blog.” This presentation (link below) is published on YouTube by lupus warrior Kelli Roseta of “More Than Lupus
Moderator and questions are asked by lupus warrior Molly McCabe
Lupus questions about “The Lupus Secrets” and living with lupus are answered by Don Thomas, MD

Topics include:

Hydroxychloroquine (Plaquenil) dosing, safety, how to avoid eye problems
Belimumab (Benlysta) safety and helpfulness for lupus
How long does it take for Benlysta to work?
Which lupus patients are the best candidates for Benlysta treatment
Genetics and epigenetics that can predispose people to getting lupus
Why lupus occurs more often in people of color (African descent, Hispanic, Asian, indigenous peoples)
The treatment of lupus and rheumatoid arthritis overlap, also called rhupus
What is the significance of an antinuclear antibody (ANA) test becoming negative in a lupus patient?
How to ensure that new doctors believe your diagnosis of systemic lupus made by a previous doctor
The use of hormone replacement therapy (estrogen, progesterone) in women after menopause
Steroid usage in lupus. Should it be stopped?

For more in-depth information on living with lupus:

Read chapters 29 and 44 of The Lupus Encyclopedia, edition 2

Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia

If you enjoy the information from The Lupus Encyclopedia, please click the “SUPPORT” button at the top of the page to learn how you can help. 

What are your comments and opinions?

If you have lupus, what has your experience been? What do you recommend for other patients?

Do you have any questions to ask Dr. Thomas?

Please click on “Leave a Comment” above to comment.

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Don Thomas, MD, author of “The Lupus Encyclopedia” and brought to you by Kelli Roseta of “More Than Lupus” and author of “My Special Butterfly”

Dr. Thomas is on the Speakers’ Bureau of GlaxoSmithKline for belimumab (Benlysta). He mentions this in his answers as well in the video


  1. Thank you for this very interesting talk. I’m curious – when you say Benlysta may be a good option for those with high anti ds-dna and low complements, what lab ranges do you have in mind for “high” and “low?” What about anti ds-dna = 17, C3 = 65, C4 = 11? For context, my main lupus complaint is pervasive exhaustion (and yes, I do follow the lupus secrets). Would it be reasonable to discuss adding Benlysta with my doctors, or will they think I’m crazy and should leave well enough alone? A year after diagnosis and starting hydroxychloroquine, I’m still trying to find the line between too whiny/paranoid and too complacent. I’m not sure what would qualify as remission, but I don’t feel like this is it.

  2. ARW:
    PLEASE do not think you are being “whiny!” Fatigue from SLE is a horrible problem that greatly interferes with quality of life. It is real. You should constantly search for ways to help it (better treatment of your SLE, getting good quality sleep, eating well, exercising regularly, etc.) I have had numerous patients develop significantly better energy levels after successful treatment with Benlysta (belimumab).
    Having a high anti-dsDNA and low C3 or C4 indicates that their is significant immune system activity with systemic lupus. In medical terms, we know that there is activation of the complement pathway. B-cells are the cells that produce anti-ds DNA and are directly involved in the immune system’s activity with complement activation.
    The studies show that those patients with these abnormalities (it does not matter how abnormal) are most likely to respond to Benlysta. If I had lupus and if hydroxychloroquine did not have me in remission, knowing what I know, I’d ask my provider if I could try Benlysta, especially if I had these lab values.
    Good luck and thanks for reading my posts and commenting.

    • Thanks for the response. In the past when I have asked whether further treatment is warranted, the answer has been “we don’t treat these labs, they just tell us that we need to watch you closely for effects that would need to be treated” (e.g., elevated ESR/CRP or blood/protein in the urine). So it seems like adding a biologic would be a stretch, especially since they are incredibly expensive. But, I can certainly throw it out for discussion.

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