Lupus is an autoimmune disease that causes swelling (inflammation) and a wide variety of symptoms. Lupus affects everyone differently. Some people have a few mild symptoms, and others have more severe symptoms.

Symptoms usually start in early adulthood, anywhere from the teen years into the 30s. People with lupus generally experience flare-ups of symptoms followed by periods of remission. That’s why early symptoms are easy to dismiss.

Because early symptoms are similar to those of other conditions, having them doesn’t necessarily mean you have lupus. Early symptoms can include:

  • fatigue
  • fever
  • hair loss
  • rash
  • pulmonary problems
  • kidney problems
  • swollen joints
  • gastrointestinal problems
  • thyroid problems
  • dry mouth and eyes

Learn more: Visualize the effects of lupus on the body.

Up to 90% of people with lupus experience some level of fatigue. An afternoon nap does the trick for some people, but sleeping too much during the day can lead to insomnia at night. It may be difficult, but if you can remain active and stick to a daily routine, you may be able to keep your energy levels up.

Speak with your doctor if you’re living with fatigue that interrupts your everyday life. Some causes of fatigue can be treated.

One of the early symptoms of lupus is a low grade fever for no apparent reason. Because it may hover somewhere between 98.5˚F (36.9˚C) and 101˚F (38.3˚C), you might not think to see a doctor. People with lupus may experience this type of fever off and on.

A low grade fever could be a symptom of inflammation, infection, or imminent flare-up. If you have recurrent, low grade fevers, make an appointment with your doctor.

Thinning hair is often one of the first symptoms of lupus. Hair loss is the result of inflammation of the skin and scalp. Some people with lupus lose hair by the clump. More often, hair thins out slowly. Some people also have thinning of the beard, eyebrows, eyelashes, and other body hair. Lupus can cause hair to feel brittle, break easily, and look a bit ragged, earning it the name “lupus hair.”

Lupus treatment usually results in renewed hair growth. But hair loss in those areas may be permanent if you develop lesions on your scalp.

One of the most visible symptoms of lupus is a butterfly-shaped rash that appears over the bridge of the nose and on both cheeks. About 30 percent of people with lupus have this rash. It can occur suddenly or appear after exposure to sunlight. Sometimes the rash appears just before a flare-up.

Lupus can also cause non-itchy lesions in other areas of the body. Rarely, lupus can cause hives. Many people with lupus are sensitive to the sun or artificial lighting. Some experience discoloration in the fingers and toes.

Inflammation of the pulmonary system is another possible symptom of lupus. The lungs become inflamed, and the swelling can extend to lung blood vessels. The diaphragm may also be affected. These conditions can all lead to chest pain when you try to breathe in. This condition is often referred to as pleuritic chest pain.

Over time, breathing issues from lupus can shrink lung size. Ongoing chest pain and shortness of breath characterize this condition. It’s sometimes called vanishing (or shrinking lung syndrome). The diaphragmatic muscles are so weak they appear to move up in CT scan images, according to the Lupus Foundation of America.

People with lupus can develop a kidney inflammation called nephritis. Inflammation makes it harder for the kidneys to filter toxins and waste from the blood. According to the Lupus Foundation of America, nephritis usually begins within 5 years of the start of lupus.

Symptoms include:

Early symptoms may go unnoticed. After diagnosis, monitoring of kidney function is recommended. Untreated lupus nephritis can lead to end stage renal disease (ESRD).

Inflammation can cause pain, stiffness, and visible swelling in your joints, particularly in the morning. It may be mild at first and gradually become more obvious. Like other symptoms of lupus, joint problems can come and go.

If over-the-counter (OTC) pain medications don’t help, talk with your doctor. There may be better treatment options. But your doctor must determine if your joint problems are caused by lupus or another condition, such as arthritis.

Some people with lupus experience occasional heartburn, acid reflux, or other gastrointestinal problems. Mild symptoms can be treated with OTC antacids.

If you have frequent bouts of acid reflux or heartburn, try cutting down on the size of your meals, and avoid beverages containing caffeine. Also, don’t lie down right after a meal. If symptoms continue, see your doctor to rule out other conditions.

It’s not uncommon for people with lupus to develop autoimmune thyroid disease. The thyroid helps control your metabolism. A poorly functioning thyroid can affect vital organs like your brain, heart, kidneys, and liver. It can also result in weight gain or weight loss. Other symptoms include dry skin and hair, and moodiness.

When a thyroid is underactive, the condition is known as hypothyroidism. Hyperthyroidism is caused by an overactive thyroid. Treatments to get your metabolism back on track are available.

If you have lupus, you may experience dry mouth. Your eyes may feel gritty and dry, too. That’s because some people with lupus develop Sjögren’s syndrome, another autoimmune disorder. Sjögren’s causes the glands responsible for tears and saliva to malfunction, and lymphocytes can accumulate in the glands. In some cases, lupus and Sjögren’s may also cause dryness of the vagina and skin.

The list of potential symptoms of lupus is lengthy. Other symptoms include oral ulcers, enlarged lymph nodes, muscle pain, chest pain, osteoporosis, and depression. Rare symptoms include anemia, dizziness, and seizures.

Symptoms vary depending on the person. While new symptoms can appear, others often disappear. Speak with your doctor if you notice any of these symptoms so you can seek diagnosis and treatment.