Sjogren's disease affects between 1 and 4 million people in the United States, according to the National Institute of Dental and Craniofacial Research. Women are nine times more likely to develop it than men, and most patients are older than 50 when they are first diagnosed.
That overlap with normal aging is a big reason the disease is often missed for years.
Sjogren's is an autoimmune condition in which the immune system attacks the glands that make tears and saliva. Left unchecked, it can also damage the kidneys, lungs, liver and blood vessels, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) explains.
Eight symptoms show up again and again. Here they are, in the order NIH lists them.
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The two hallmark signs
Dry eyes are usually the first clue. NIAMS describes eyes that burn, itch or feel as if they have sand in them.
Dry mouth is the second cardinal sign. According to NIAMS, the mouth may feel chalky, and swallowing, speaking and tasting can all become harder. Less saliva also raises the risk of cavities and tooth loss.
Fatigue and joint pain
Fatigue is the third common sign, and it can be constant rather than tied to activity. A fourth is joint pain, often in the hands, wrists and knees.
Both symptoms are frequently written off as normal wear and tear or early osteoarthritis, which is one reason a rheumatology referral gets delayed.
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Skin, cough and swallowing
The fifth warning sign is the skin. NIAMS lists dry skin and skin rashes among the disease's regular manifestations, and NIDCR notes rashes on the hands or feet.
A sixth sign is a persistent, unexplained dry cough. NIAMS attributes it to dryness of the nasal passages and throat.
The seventh sign, difficulty swallowing, follows directly from a lack of saliva. Food may feel as if it sticks going down.
Brain fog and numbness
The eighth cluster is neurological. NIAMS lists poor concentration and memory problems, often called brain fog, along with numbness, tingling and weakness in the extremities. Trouble sleeping is another frequent complaint.
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Sjogren's also raises the risk of a type of cancer called lymphoma, which is why NIH treats early recognition as clinically important.
When to see a doctor
A rheumatologist, described by NIAMS as a specialist in autoimmune diseases, typically leads the workup. Blood tests can identify the antibodies present in most people with Sjogren's, most often anti-SSA/Ro and anti-SSB/La alongside antinuclear antibodies (ANA).
An ophthalmologist or dentist may also run tear-production and salivary tests to complete the picture.
If dryness of the eyes and mouth has become a daily fixture, especially alongside fatigue, joint pain or brain fog, ask your primary care doctor for a referral to a rheumatologist.
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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.