Last week, a couple (both are my clients), walked into my clinic and the husband wanted to know if there was any definitive test for 'mental power' as he put it. On probing a bit deeper he said he felt his mental abilities had declined somewhat but that he wasn't very sure of it. I knew he was suffering from diabetes and more recently also had blood pressure problems.

Hi everyone!

I'm Deborah Susan, a dietician and personal trainer specializing in nutrition and physical fitness for diabetics. I've written several dozen blogs covering various aspects of diabetes including symptoms, monitoring, explaining glycaemic index, carbohydrate counting, and correlation between body weight, lifestyle and diabetes and so on. This week I shall write about the possible link between diabetes, blood pressure and mental decline.

Over time, all of us undergo changes in our diabetes mental abilities. Up to 50 or so, research seems to indicate that healthy individuals get smarter. Between 50 and 60 our body maintains the status and post 60 years of age, it begins to decline gradually and then more rapidly as we age. In some individuals however, the decline might begin sooner than expected.

When this couple visited me, I decided to dig up all research papers on the subject. Here are my conclusions:

Studies have indicated that high blood pressure when combined with diabetes in middle aged people can trigger a decline in mental function earlier than expected. However, in none of the papers was there any conclusive evidence presented that high blood pressure, type 2 diabetes and hypertension had anything to do with mental decline. The presence of these two medical complications along with mental decline was assumed to be reason enough to link all three.

The most detailed study was conducted by physicians from the Mayo Clinic, Rochester, Minnesota Researchers. They studied close to 11,000 people between the ages 47 and 60 over a six-year period. Tests were taken at the start and end of the six year period and found that people who had high blood pressure and diabetes at the start of the six year period fared worse in the mental tests at the end of the six year period.

While I do not dispute the findings, I personally feel it is too early to jump to conclusions. The mere presence of diabetes and high blood is not conclusive. More similar research will have to be conducted before we can acknowledge the link. However, I do agree that something in bodies of those suffering from diabetes and high blood, seems to point towards a decline in cognitive function. So if you are already a diabetic and also have high blood pressure then you need to ensure you keep both under control because irrespective of whether or not it leads to a decline in cognitive function, untreated diseases will lead to a decline in your happiness and well-being.

About the author:


is there a definitive test for lupus

23 thoughts on “Is There A Definitive Test For Lupus

  1. gapper1964

    Can you still have Lupus if ANA test came back negative?
    I have several symptoms of Lupus but the ANA came back negative. Don’t know what else it could be. I don’t have an appointment with the specialist until next month.

    1. Corrie W

      Yes, you can. My ANA test is alternately positive or negative. and I have Lupus and fibromyalgia. Go to Mayo Clinic’s site. They have information on which of the other blood tests taken in combination point to a firm Lupus (SLE) diagnosis. Pay particular attention to your rheumatoid factor results.

      Remember: there is no definitive blood test for lupus per se; a combination of results from several types of blood tests combine to point to the diagnosis. There are many people with Lupus who have never had a positive ANA!

  2. akivas_wifey04

    Is a primary diagnosis a definitive diagnosis based on results of tests and examinations?
    I was looking on my insurance website under my personal medical summary and noticed that under one my many primary diagnosis — one is Multiple Sclerosis. I have currently been undergoing numerous neurological exams hoping to get some clarity out of my current condition. My primary care physician stated he was worried I could have MS or Lupus and referred me to a Neurologist. After $17,000 worth of medical bills and no known diagnosis, I wonder if it has been diagnosed MS. I must state that all my other diagnoses state specific disorders or illnesses. Is a primary diagnosis a definitive diagnosis based on results of tests and examinations? Or is it just a doctor’s offices’ way of getting paid for tests administered?

    1. mirror

      The working diagnosis or primary can become a definitive diagnosis when there exist positive test that nails the diagnosis.

      MS is a diagnosis of exclusion, rather than a positive lab test or imaging.

      If the Neurologist has not put MS down as a definitive diagnosis it is still in the process of being ruled out.

      The fat lady has not sung.

  3. jam1968

    Can you have an ANA with a nucleolar pattern with Lupus? ?
    My doctor says lupus but some labs and symptons point to scleroderma. My ana has always been nucleolar pattern. I have some skin changes, terrible itching, joint pain, extreme fatigue and abdomen bloating. Just want to make sure it’s the right diagnosis and that I’m not taking meds that I don’t need.

    1. mgunnycappo

      An ANA test isn’t definitive. It basically shows the potential for an auto immune disease…any auto immune disease. Yes their are certain patterns (ie. homogeneous) that are more specific to Lupus but really that is a small part of the diagnosis. You need additional blood tests such as a DS-antiDNA test, an Anti-SM, Anti-Ro, etc to help aid in the diagnosis. I’m sure that they also tested you for RA. The doctor will use symptoms and history along with blood work to help come to a diagnosis. Unfortunately there is no specific test for Lupus. Basically the doctor just keeps narrowing it down. If any of the tests above are positive (except the ANA) then you most likely have Lupus. But if they are negative you could still have Lupus as only a small percentage of people actually test positive.

  4. Hedy

    Why is it hard for a doctor to detect that someone has Lupus?
    I am an african american female hair is coming out in the top of my head, have noticed the butterfly around both eyes, nose and cheeks area, discoloration on both arms, excess weight gain, ana positive, excess portein in urine etc.

    1. mgunnycappo

      It is difficult because there is no definitive blood test for Lupus. ANA is only an indicator of an auto immune disease…not specifically for Lupus. A DS-DNA test is a much better indicator. If this is positive then you most likely have Lupus. However, many people with Lupus do not test positive for this test.

      Protein in your urine along with the malar (butterfly) rash and your positive ANA tests are a good indicator that Lupus is a possibility.

      Hopefully your doctor has had your blood taken for a battery of tests that will help find out what is wrong with you.

      But to answer your question. Lupus is a very complex disease that affects people differently. Without a specific Lupus blood test it is up to the doctor to use what is available to come to a diagnosis.

    1. mgnysgtcappo

      not at all. You can definately have a negative ANA and still have Lupus. Unfortuantely, there is no definitive test for Lupus. Doctors use a battery of tests and symptoms to diagnose it. Conversely, a positive ANA test also doesn’t confirm Lupus as any one of a number of auto immune diseases can cause a positive ANA.

      It can be a very difficult disease to diagnose for this reason.

  5. Louise Whitehill

    Can I ask my GP for further blood tests?
    I suffer from depression and anxiety. I also suffer from a chronic, debilitating tiredness that’s ruining my life and getting worse. My GP pins it on my depression/anxiety. Normal bloods came back ok, but I’m certain there’s something underlying. Can I ask for further blood tests i.e. to check for lupus? The GP says they won’t do further investigations but I’m wondering if I am entitled to ask for this and how to go about it?

  6. errands24

    Does anyone know about multiple sclerosis?
    If MS can be detected thru blood tests? I’ve been experiencing limb numbness, difficulty swallowing, dizziness etc. My doctor tested me for auto-immune diseases such as Lyme disease. But a family member was diagnosed with MS a few years ago. Can it only be diagnosed with MRI and spinal tap?

    1. Tarkarri

      There are no specific tests for multiple sclerosis. Ultimately, the diagnosis relies on ruling out other conditions that might produce similar symptoms. Your doctor may base a multiple sclerosis diagnosis on the following:

      Blood tests
      Analysis of your blood can help rule out some infectious or inflammatory diseases that have symptoms similar to multiple sclerosis.

      Spinal tap (lumbar puncture)
      In this procedure, a doctor or nurse removes a small sample of cerebrospinal fluid from within your spinal canal for laboratory analysis. This sample can show abnormalities associated with multiple sclerosis, such as abnormal levels of white blood cells or proteins. This procedure can also help rule out viral infections and other conditions that can cause neurological symptoms similar to those of multiple sclerosis.

      This test uses a powerful magnetic field and radio waves to produce detailed images of internal organs. MRI can reveal lesions, indicative of the myelin loss caused by multiple sclerosis, on your brain and spinal cord. However, these types of lesions can also be caused by other conditions, such as lupus or Lyme disease, so the presence of these lesions isn’t definitive proof that you have multiple sclerosis.

      During an MRI test, you lie on a movable table that slides into a large, tube-shaped machine, which makes loud tapping or banging noises during the scans. Most MRIs take at least an hour. While the test is painless, some people feel claustrophobic inside the machine. Your doctor can arrange for a sedative if necessary.

      You may also receive an intravenous dye that may help highlight “active” lesions. This helps doctors know whether your disease is in an active phase, even if no symptoms are present. Newer MRI techniques can provide even greater detail about the degree of nerve fiber injury or permanent myelin loss and recovery.

      Evoked potential test
      This test measures the electrical signals sent by your brain in response to stimuli. An evoked potential test may use visual stimuli or electrical stimuli, in which short electrical impulses are applied to your legs or arms.

    1. Eden*

      Although the definitive cause of MS is unknown, a growing number of scientific studies suggest that nutrition may be a very important factor. Nutrition oriented health care practitioners have noticed that early MS can be helped by optimizing nutritional status with respect to essential fatty acids, amino acids, minerals such as zinc, selenium and magnesium and B vitamins, especially vitamin B12 and folic acid.

      In my practice, I have noted tremendous subjective improvements in many M.S. patients after a series of vitamin B 12 and folic acid injections. Not only did all these patients have greater energy after vitamin B 12 and folic acid treatments, but, objectively, there were improvements in nerve conduction studies done by neurologists. Spontaneous remission? Not likely because both vitamins have been demonstrated to improve nerve cell function. It is indeed possible that some cases of M.S. are really B vitamin deficiencies in disguise.

      Most cases of MS (over 80% according to one 25 year study) improve on a low saturated fat diet (Swank diet for MS). Researchers have also reported that symptoms improve when food intolerances (allergies) are eliminated. In my experience, the commonest hidden food allergies appear to be wheat, milk, eggs, yeast and corn. Testing and treatment of these allergies may unlock the door to recovery for many M.S. sufferers.

      Supplements which are very effective in both prevention and treatment of M.S. include fish oil (omega-3-EPA) and evening primrose oil capsules. Dosages depend on the severity of the illness and the patient’s tolerance for these supplements. Alternatives include flaxseed oil, edible linseed oil, oil of borage and black currant oil. Vitamin E and other antioxidants (vitamin A, beta carotene, B complex vitamins, vitamin C, zinc, selenium, pycnogenol and others) are also beneficial.

      Hypersensitivity to toxic heavy metals such as mercury can produce all the symptoms of MS. So can Lyme Disease. Testing for these two possibilities is certainly worth while. Some dentists have advocated the replacement of all mercury dental fillings with non-metal fillings as a therapy for MS. Although the testimonials that support the replacement of the common mercury filling in MS patients are legion, it is still a highly controversial topic. In my practice, I have had at least a dozen M.S. victims improve drastically after replacement of mercury dental fillings. Unfortunately, an equal number have had no change in their health status as a result of this sort of treatment. Hair mineral analysis and urine tests can screen for excess body burdens of mercury as well as other toxic heavy metals that may interfere with the immune system. High levels can usually be offset by supplementation with vitamin C, selenium, garlic, cysteine, methionine and other high sulfur containing compounds. If you are one of these people with a mouthful of dental hardware, get yourself a copy of “Eliminating Poison in Your Mouth” by Klaus Kaufmann and find a dentist familiar with the mercury problem.

      There is a recently published book on DHEA by Dr. Neecie Moore (Bountiful Health, Boundless Energy, Brilliant Youth: The Facts about DHEA) which is well documented and easy to read. One can also get a great deal of information on DHEA from the Life Extension Foundation (see below).

      DHEA has been used successfully in the treatment of many autoimmune disorders including multiple sclerosis, Lupus and fibromyalgia. DHEA regulates the immune system and maintains the metabolic and structural integrity of the nervous system. DHEA has been shown to be antiviral and has benefited conditions as serious as HIV infection and AIDS.

      One 1990 study by Roberts indicated that M.S. victims had low DHEA levels which were improved by DHEA administration. It was also noted that the majority of these patients had discernible improvement in their daily quality of life including increased energy levels, better dexterity, greater limb strength, decreased sensations of numbness, more power in the lower limbs and even an increase in libido. Another 1990 study by Calabrese concluded that DHEA helped to improve the fatigue so often associated with M.S. In Canada and the U.S., DHEA is available only on a doctor’s prescription. Natural precursors to DHEA can be found in wild yam but studies do not indicate that this is equivalent to the pure hormone.

      Some authors also believe that MS can be benefited by anti-candida treatment. This too is controversial. In situations where all else has failed and the patient is in the early stages of the disease, trial therapy with a yeast-free diet and natural antifungal remedies may be warranted. For more information on treatment of food allergies, yeast-free diets and candida therapy, see my book, “The Joy of Health.”

      Finally, European and South American doctors have reported successful results with the use of ozone therapy. So, as you can see, there are plenty of reasons to adopt a more positive, hopeful attitude in dealing with this serious disease.

  7. julie

    What kind of Neurological symptoms do you have with Lupus?
    I’m being tested for lupus after being sick for 2 yrs and I have tons of neurological symptoms just wondering if these are common symptoms for lupus. here are my symptoms.
    Burning stinging headaches, dizzy, lightheaded,vertigo, seizure type incidents, sharp shooting pains in head, also get weard sensations on my body like warm water pouring on me. Any info will be appreciated. If you have any neurological symptoms from Lupus pleas list them for me. Thanks!

    1. Linda R

      Some lupus patients have neurological symptoms, some do not. Lupus symptoms vary widely from patient to patient.

      Headaches could be caused by lupus or by Raynaud’s phenomenon or other things. Many lupus patients have Raynaud’s, a condition in which stress or cool temperatures cause the nerves to tell the blood vessels to clamp down and restrict blood flow, usually to hands and feet, but can also cause headaches.

      Lightheadedness can be caused by a number of things as well. Lupus patient are often anemic, When you are anemica, there is not enough available oxygen in your blood, which could account for light headedness or dizziness.

      Vertigo usually has to do with the inner ear. Lupus can cause inflammation anywhere, including the inner ear.

      I am not sure what you mean my “seizure type” incidents. Do you lose consciousness? Do you convulse? Some lupus patients do have seizures. But seizures can be caused by many other things.

      Lupus patients with antiphospholipid antibody syndrome (sticky blood) which causes clots may have TIAs or ministrokes. This could account for your head pain and seizure type incidents. Ask to have your blood tested for this.

      As for the weird sensations, please find a clearer way to describe that as well. If you tell the doctor that you have “seizure type incidents” and “weird sensations on your body” you are not helping the doctor get to the root cause of your problem. If these weird sensations are painful, you could have neuropathy which sometimes comes with lupus, or diabtetes, or multiple sclerosis, or other things.

      As a patient your job is to give the doctor the best and clearest information possible. It is the doctor’s job to connect the dots. A diagnosis of lupus is made based on family history, your medical history, a wide variety of lab tests and after everything else is ruled out. There is no definitive lab test for lupus.

      To do your job, keep a symptom journal including
      1. a clear description of the symptom
      2. when it started
      3. how often it happens
      4. how long it lasts
      5. what makes it feel better
      6. what makes it feel worse
      7. to what degree does it interfere with your activities of daily living

      Then create a concise summary and bring a copy for your doc and a copy for you.

    1. mar

      Not at all, the WBC (white blood cell count) is the measure of the leukocytes cells per microliter of blood. The normal range varies between 4,500 to 10,000. It is slightly more elevated for younger children. An elevated WBC may be due to:

      1) Infection
      2) Inflamation (reumathoid arthritis, Lupus, etc.)
      3) Response to trauma, burns, Miocardial infarction, etc.
      4) Leukemia, and leukemoid reactions (usually with values greater than 50,000 leukocytes)

      a leukemoid reaction does not indicate malignancy and it is transient.

      Also, there are different kinds of white blood cells, such as:

      lymphocites (20 to 45%), basophils (1%), eosinophils (1 to 6%) and neutrophil (40 to 75%), monocyte (2 to 6%) and macrophages.

      Each of them plays different roles against infection. Neutrophils are usually elevated in response to a bacterial infection, while lymphocites in response to viral infections and eosinophiles in allergies or parasitic infections.

      Anyway, a laboratory result almost NEVER gives you a definitive diagnosis, and this needs to be correlated with your history. In some cases of leukemia is found after an incidental laboratory finding and your Physician will decide if he needs further testing (like bone marrow aspirate) etc.

      I hope this helps you! 🙂

  8. amanda g

    How likely is it that I have lupus?
    I tested positive for ANA. I ave inflamation in my lungs. I also had n unexplained rash that came on and off for a week on various parts of my body.

    When the doctor was explaining to me in dr lingo…lol he mentioned lupus about times I go to a specialist in about a month. let me know what you think. Thanks

    1. Linda R

      Lupus is tricky to diagnose. You can help the doctor by keeping track of your symptoms, when they started, how long they last, what makes them feel better, what makes them feel worse, and to what degree they interfere with your normal activities of daily living. Let the doctor connect the dots.

      10 million Americans have a positive ANA
      1.5 million Americans have lupus
      5% of people with lupus have a negative ANA

      The ANA is not a definitive test.

      One thing I can tell you is that if you stress out over whether or not you have lupus, whatever you have will get worse. That is what stress does. Thinking causes feelings. Feelings cause physical reactions.

      Worrying about it will not change a thing. What it will do is waste time that you can never get back. Even when you see this doc it may take time to come to a diagnosis. Your symptoms match many diseases. All you can do is wait.

      Lupus is a serious autoimmune disease. Diet alone cannot treat it, although diet is an important part of self management. 40% of us get lupus kidney disease, and I am one of them. That requires strong immunosuppressant drugs to come under control. If I relied on flax seeds I would be on dialysis or dead by now, instead of happily working at four jobs and writing and speaking. It is not natural to get lupus. Lupus cannot be controlled by simply “natural” means. Hemlock and arsenic are natural too!!!

  9. Mary

    Can Lupus affect the brain and be confused for MS?
    I was diagnosed with Lupus and now they are seeing Dysmyelination in my MRI, and I have symptoms that can be seen in both Lupus and MS. But I never read anything about Lupus affecting the brain and causing dysmyelination….was I not diagnosed right?

    1. pobrecita

      It is possible. There are certain diseases out there that are often misdiagnosed for one another…MS, Lupus, Lyme Disease. People I know with these diseases were tested over and over and diagnosed and misdiagnosed…an endless cycle. Ask for repeat blood tests, even though the tests are not definitive, something could have changed to give you a clearer answer. Ask for the tests to be repeated often.

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