You should see your doctor and he/she should draw lab to see if your markers are elevated.

with me when I am in a flare it is just the symptoms are worse or something changes with the symptoms.

Thank you all. This is very helpful! I would have anticipated it involved hospitalization, so this is good to know! I guess this would mean that I am flaring. I think it will be easier to anticipate the more it happens.

Worsening symptoms (out of the range of the usual daily fluctuations) are the hallmark, and overwhelming exhaustion may even rarely be the only indication that it's time to see your doctor again to be sure there's no evidence of new organ disease.

Well, there is everyday lupus like stiffness and joint pain that goes away as ya move around then there are symptoms that come on fast and furious that linger or even worsen. Every person is different. Sometimes my flares may include fatigue, sweating, fever, chills, stomach upset and muscle weakness.