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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Could Smoking Cause Swelling In Foot While Having Sjogren S, R.A., And Lupus?

I have Sjogren s, R.A., and Lupus. I have swelling everywhere, but in my left foot it is severe. I have low BP but have put on a lot of weight since they started me on steroids. From my lower shin down, there is almost no feeling. The swelling worsens throughout the day, to the point I can t fit a shoe on my foot. The top of my foot is the most swollen. The swelling is worse all on my left side, but the foot is just horrible. They have run test after test trying to determine the cause, with no success. I am on gabapentin, plaquenil, prednisone, methotrexate, tramadol, Tylenol 3, and furosemide. I have a very high white cell count, and very low lymphocyte count. I see random doctors at a free clinic that is attached to a med school. The latest doctor today looked at my foot, said well it must be from your smoking, ordered one full panel blood lab, and sent me home. I do still smoke, but maybe 3-5 cigarettes a day. Could the smoking actually cause the swelling and stabbing pain that runs up my legs into my hips and back? The pain is severe enough that it greatly limits my mobility.
Thu, 6 Aug 2015
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Addiction Medicine Specialist 's  Response
Yes.
Just without an exam I cannot say why. 1) blood backs up into the legs to cause edema. This can be due to heart/lung/liver/kidney problems but in autoimmune disease can be from damaged vessels (uncommon even in autoimmune disease) OR... just not having a lot of normal protein in the vessels to hold in the fluid (very very common; perhaps the majority of those with RA).

Any cause of edema adds up with all other causes. So... smoking and lung disease causes increased fluid backing up behind the lungs and more edema. So... smoking can cause vasoconstriction and cause less fluid able to get back from the legs. So.. smoking can cause heart problems and fluid accumulation. Cannot say which may be occurring in your case.
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Could Smoking Cause Swelling In Foot While Having Sjogren S, R.A., And Lupus?

Yes. Just without an exam I cannot say why. 1) blood backs up into the legs to cause edema. This can be due to heart/lung/liver/kidney problems but in autoimmune disease can be from damaged vessels (uncommon even in autoimmune disease) OR... just not having a lot of normal protein in the vessels to hold in the fluid (very very common; perhaps the majority of those with RA). Any cause of edema adds up with all other causes. So... smoking and lung disease causes increased fluid backing up behind the lungs and more edema. So... smoking can cause vasoconstriction and cause less fluid able to get back from the legs. So.. smoking can cause heart problems and fluid accumulation. Cannot say which may be occurring in your case.