Sjögren's flares (worsening symptoms) are triggered by factors like overexertion, stress, infections, certain medications, hormonal changes (estrogen), environmental factors (dryness, allergens), and sometimes even an imbalanced gut microbiome, leading to increased dryness, fatigue, and pain as the immune system attacks moisture-producing glands. Managing these triggers through adequate rest, stress reduction, hygiene, and avoiding irritants helps control flares.
Doctors typically use steroids to treat flare-ups, when symptoms such as joint pain and rashes come on suddenly. Steroids such as prednisone or methylprednisolone are taken by mouth, and your doctor determines the dosage based on the severity of your symptoms.
In Sjögren's disease, this type of arthritis usually affects the fingers, wrists and ankles. The shoulders, hips and knees may also be painful.
It has been reported that more than 400 drugs can exacerbate the dryness symptoms of Sjögren's syndrome, including antihypertensives, diuretics, antidepressants, antiparkinson drugs, antipsychotics, antihistamines, centrally acting analgesics, and anticholinergics [6], [13], [14], [15].
Inflammation can cause pneumonia, bronchitis or other problems in your lungs; lead to problems with kidney function; and cause hepatitis or cirrhosis in your liver. Lymph nodes. A small percentage of people with Sjogren's syndrome develop cancer of the lymph nodes (lymphoma).
Dry mouth.
Nipocalimab is the first and only investigational therapy granted U.S. FDA breakthrough therapy designation for the treatment of adults living with moderate-to-severe Sjögren's disease [news release]. Johnson & Johnson. 2024 Nov 11. U.S. Food and Drug Administration Safety and Innovation Act ().
Vitamin D, also known as the “sunshine vitamin,” is crucial for individuals with Sjogren's Syndrome as it regulates the immune system and reduces inflammation. Vitamin D deficiency was shown to increase the risk of autoimmune disease by 22%.
However, widely used herbs — including spirulina, elderberry, ashwagandha, chlorella, echinacea, and alfalfa — possess immunostimulatory properties that can worsen autoimmune symptoms, posing risks to patients with conditions like DM and CLE.
Sjögren's patients should avoid mouthwashes and rinses that contain alcohol or witch hazel. These ingredients can aggravate oral dryness and burning. Chew sugar-free gum or suck on hard diabetic or sugar-free candies to help increase saliva.
In addition to dryness, Sjögren's syndrome can cause other symptoms, including: Joint pain. Muscle pain or weakness.
If scaly, dry skin is present, utilizing moisturizers with lactic acid, urea, or salicylic acid can be used. Examples include: AmLactin®, CeraVe® SA, and Eucerin® Roughness Relief.
Sjögren's disease can cause numbness or burning of the face, called “trigeminal neuralgia.” Pain in the back of the throat, which may worsen while swallowing, is called “glossopharyngeal neuralgia.” Patients with trigeminal or glossopharyngeal neuralgia can have agonizing mouth and facial pain.
Turmeric may also help improve digestion, which is often affected in people with Sjogren's syndrome. The anti-inflammatory and antioxidant properties of turmeric can help reduce inflammation in the digestive system, leading to improved digestion and reduced symptoms of Sjogren's syndrome.
Examples of important herbs in the management of autoimmune conditions:
Start with five minutes of aerobic exercise daily (e.g. walking, biking, running, elliptical, treadmill) and increase the duration by an additional two-to-three minutes each month up to a maximum of 25 minutes daily.
Green tea
Green tea is a great supportive herb for autoimmune conditions as it contains catechins, notably epigallocatechin gallate (EGCG), with strong anti-inflammatory properties. Studies suggest green tea may help reduce inflammation and improve immune function, potentially benefiting autoimmune diseases.
Ways diet can help improve your condition
Turmeric and curcumin extracts improved clinical and/or laboratory outcomes in ulcerative colitis, rheumatoid arthritis, oral lichen planus, Crohn's disease, multiple sclerosis, systemic lupus erythematosus, and psoriasis, with a greater clinical effect in psoriasis, ulcerative colitis, and rheumatoid arthritis.
Some people with Sjögren's have a related autoimmune condition (pernicious anemia) that impairs vitamin B12 absorption. This can be tested by your physician. Routine B12 supplementation is not necessary unless one adheres to a strict vegan diet.
B12 deficiency can trigger specific food cravings, most notably for meat, fish, or eggs, as the body seeks animal-based sources to replenish the vitamin, especially in those on vegetarian/vegan diets or older adults. While cravings for sugary or salty foods can also signal general B-vitamin issues, the distinct urge for protein-rich animal products is a key indicator, but professional testing is crucial for confirmation.
VITAMIN A. This vitamin helps keep mucous membranes healthy. It prevents dry mouth and helps your mouth heal quickly. What to eat: For strong gums and teeth, load up on fish, egg yolks and liver.
Nuts, leafy greens, fatty fish, avocados, olive oil, whole grains, and foods prepared with turmeric, garlic, or ginger have proven to benefit some individuals. To alleviate symptoms, some patients avoid red meat, alcohol, smoking, processed or fried foods, and refined grains as well as safflower, corn, and canola oils.
Nipocalimab is the only investigational treatment to be granted Breakthrough Therapy Designation by the U.S. Food and Drug Administration (FDA) for SjD (November 2024). It also received Fast Track Designation by the U.S. FDA earlier this year in April 2025.
Immunosuppressant drugs: These are stronger than Plaquenil and actually decrease (or suppress) immune system activity rather than just calm it down. These medicines are called immunosuppressants. They include methotrexate, mycophenolate mofetil, azathioprine, and cyclophosphamide.