Systemic lupus erythematosus (SLE) is a chronic, inflammatory, autoimmune disorder characterized by unpredictable exacerbation, remissions, and immunologic manifestations. SLE targets women disproportionately; about 1-2 million Americans are affected, with women between the ages of 15 and 45 accounting for 90 percent of the sufferers. Lupus is a generally manageable but potentially dangerous autoimmune disorder that occurs when a person’s defense system does not recognize the difference between a foreign invader and body cells. Initial symptoms appear as painful swelling of the joints and a sudden fever, but other organs and/or tissues can be involved including the heart, kidneys, brain, lungs, and blood. Patients with SLE have a continual risk of clinical exacerbations; and more than half these patients will develop severe organ damage in various combinations.
Lupus is dubbed the “disease of a thousand faces” because it touches every person differently and is involved in one or more organ systems. It affects some women mildly with symptoms like sore joints, fatigue and rashes. In other women, lupus damages their vital organs, leads to neurological disorders, and leaves them in constant pain. The possibility exists that this condition may be related to an estrogen or hormonal imbalance specific to women.
People living with a chronic autoimmune disease like lupus have nutritional requirements well beyond those of the general public. This disease places an excessive demand on the entire body by interfering with the body’s ability to assimilate basic nutrients. Add to that the fact that lupus patients frequently have gastrointestinal upset and distress, variable appetites, and irritable bowel problems.
Recent studies are finding that the sugar substitute ASPARTAME may be directly linked to the increased incidence of lupus. Aspartame (Equal and Nutra-sweet) can be a toxic chemical and should be eliminated from your diet.
Begin by eliminating and desensitizing all possible FOOD ALLERGIES. Food allergies consistently appear in many autoimmune disorders. The most common food allergens to avoid are GLUTEN GRAINS and DAIRY PRODUCTS. These may have to be eliminated almost permanently. Make sure to hydrate the body well, with 6-8 glasses of filtered, fresh water daily. It may be critically important to decrease ACIDIC FOODS as much as possible (especially cola, alcohol, caffeine, red meat, and refined sugar.)
Attempt to reduce animal fat, red meat, poultry, junk food, and saturated fats. Eat more whole foods, including whole grains (not wheat), green and yellow vegetables, fruits, legumes, and organic nuts. Eating more cold-water and deep-sea fish has healthy benefits, but avoid shellfish. Avoid alfalfa sprouts since they can produce arginine which produces a lupus-like effect. A macrobiotic diet composed of alkaline foods like mineral-rich vegetables is most helpful.
Get more rest and relaxation, quit smoking, reduce stress, and exercise to tolerance (somatics, yoga, walking, tai chi). A heavy-metal detoxification may be helpful.
Environmental pollution and heavy industrialization are linked. Avoid toxins, household solvents, lead, nickel, cadmium, and aluminum. Because the HEAVY METAL pollutant mercury contributes to autoimmune disorders, detoxification may stabilize an individual with SLE.
Drug-induced lupus erythematosus is a syndrome that is associated SLE and is associated with symptoms such as fever, malaise, arthritis, and/or rash. This condition usually appears in white Caucasians, and usually resolves itself in weeks or months after discontinuation of the offending drug. See below for drugs that may induce SLE symptoms.
Most people with SLE have mild to moderate thrombocytopenia. This condition occurs when low blood platelet counts result because of failure in the bone marrow. As platelet counts falls, bruising, nosebleeds and tiny red bleeding points in the skin called petechiae occurs.
Most physicians will prescribe the drug Plaquenil (hydroxychloroquine sulfate), a malaria medicine that works to suppress SLE. When taking Plaquenil you should monitor your cholesterol levels (may increase), your liver enzymes (may increase), and possible cardiovascular problems. They also prescribe prednisone (a steroid), non-steroidal anti-inflammatory drugs (Ibuprofen, naproxen, aspirin), and immunosuppressants drugs (Methotrexate, Immune globulin IV, and Cyclosporin). These drugs must be closely monitored for possible serious side effects.
- Osteoporosis/Arthritis (swollen and achy joints)
Besides occurring as a side-effect of steroid use, osteoporosis can appear as a direct result of lupus. Arthritis and arthralgia (achy joints) occurs 90% of the time.
- Kidney function
Nearly 50% of lupus patients have significant renal disease and can suffer kidney failure. Maintain a low protein diet and adequate water intake.
Pain can manifest many ways in lupus patients, including headaches, nephritis, chronic achiness and skin inflammation. Approximately 90% of lupus patients have some form of musculoskeletal symptoms in the hands, wrists, knees and shoulders. Take magnesium in adequate doses. Try natural pain killers that raise endorphins; melatonin, tyrosine, and diphenylalanine can elevate brain endorphin levels.
- Skin lesions and inflammation
SLE commonly causes skin lesions and rash. The malar “butterfly” rash on the cheek and nose is a classic symptom. Other rash-like symptoms include alopecia (hair loss), photosensitivity, Raynaud’s phenomenon, itching, redness and vasculitis. Supplementing with essential fatty acids and perilla have decreased inflammation.
- Chronic fatigue and/or weakness
These are considered “constitutional” problems, such as severe fatigue, exhaustion, fever, weight loss, and an increased proneness to infection (low immunity). Supplementing with B-complex and ginseng may be helpful.
Hematologic problems such as anemia, leucopenia, and thrombocytopenia are serious clinical symptoms of SLE. Check levels of iron and pernicious anemia (low vitamin B12). B12 injections are helpful. Low levels of white blood cells are of extreme concern to lupus patients.
Some of the common cardiac ailments include pericarditis, endocarditis, and myocarditis. These conditions may exacerbate conditions such as atherosclerosis and inflammation of the heart. Supplementing with CoQ-10 is advised.
The most common involvements are pleuritis and inflammation of the membrane surrounding the lungs. In severe cases some sufferers can develop pulmonary hypertension and parenchymal disease.
- Neurologic problems (seizures, psychosis), gastrointestinal problems, fever, and ulcers in the mouth and nose
RELEVANT LAB TESTS
- Antinuclear antibody test (ANA TEST). This tests the presence of antibodies that attack the patient’s own cells.
- Gastric Acid Analysis
- DHEA, testosterone and hormonal tests (saliva)
- ELISA food allergy testing
DRUGS THAT MAY INDUCE OR CAUSE LUPUS
These include Hydralazine, Methyldopa (Aldomet), Tegretol, Phenothiazines (Thorazine), Quinidine, Sulfasalazine.
DRUGS THAT MAY EXACERBATE LUPUS
These include antibiotics, oral contraceptives, oral diabetic drugs, aspartame, cimetidine (Tagamet), and sulfa-based drugs (Bactrim).
- POTENT MULTIPLE VITAMIN/MINERAL FORMULA WITH EXTRA ANTIOXIDANTS
Like any auto-immune condition, extra antioxidant supplementation is deemed critical to enhance the immune system. This is needed in higher doses of antioxidants to decrease free radical damage, detoxify the liver, boost the immune system, and protect against nutrient deficiencies. Supplement with quality antioxidants containing VITAMIN C, QUERCETIN, VITAMIN E, VITAMIN A, GREEN TEA, SELENIUM, L-GLUTATHIONE, ALPHA LIPOIC ACID and GINKGO. Dosage: See a qualified practitioner.
- DEHYDROEPIANDROSTERONE (DHEA) MAGNESIUM, CALCIUM and VITAMIN D
The FDA has recently approved an expanded indication for DHEA, allowing its use for the prevention of loss of bone mineral density in patients with SLE who are receiving corticosteroid therapy. DHEA will help to boost autoimmune function and decrease disease activity. DHEA use can help alleviate symptoms and reduce the need for the steroid prednisone. Dosage: 10-100 mg daily for women; 15-100 mg a day for men. See a qualified practitioner before supplementing with DHEA.
- CALCIUM AND MAGNESIUM
These will help offset bone loss, relax muscles, and compensate for some of the side effects of oral steroids. Dosage: Calcium 1,000-1,500 mg daily; Magnesium 500-600 mg daily; Vitamin D 300-600 mcg daily. Magnesium can decrease pain.
In higher doses, B-complex will support the spleen, an organ critical in surviving lupus. Supplementation with B-complex may become more effective when combined with extra VITAMIN B6 and FOLIC ACID. Dosage: 50-150 mg daily.
- PEPSIN (HYDROCHLORIC ACID) and ENZYMES
Supplementing with pepsin (a natural plant source of hydrochloric acid) if the patient shows symptoms of being hypochlorhydric (low HCL), may help to relieve gastro-intestinal symptoms. Low stomach acid will inevitably induce skin reaction like acne rosacae. Other PANCREATIC ENZYMES are helpful for pain management, digestion, and the reduction of prostaglandins (inflammatory mediators in the body). Dosage: 1-2 tabs 10-15 before each meal.
- PLANT STEROLS
These can aid immunity, regulate cortisol and reduce inflammation. They can naturally enhance DHEA and protect the stomach from excessive steroid and non-steroidal drug usage. Dosage: 2 capsules 3 times daily for 1 week, then 3 daily thereafter.
- GLUCOSAMINE (with CHONDROITIN)
Supplementing with glucosamine with chondroitin can help relieve arthritis-like symptoms. These nutrients also are helpful for healthy skin, bones and connective tissue. Dosage: 1,000-1,500 mg of glucosamine daily, with 1/2 dose of chondroitin.
- FREE AMINO ACIDS
Amino acids such as L-CYSTEINE, L-METHIONINE, and L-LYSINE assist in cellular protection and preservation. Important for skin formation and white blood cell activity. Amino acids may aid in preventing viruses that lead to painful mouth sores. Dosage: 500-1,00O mg each daily. Take on an empty stomach, with water or juice but not with milk.
- ESSENTIAL FATTY ACIDS (FLAX SEED OIL)
These will decrease inflammation, increase mood and energy, help to lubricate joints, and slow the onset of autoimmunity. Dosage: 1,000-4,000 mg daily of omega 3 and 6 EFAs. Take 15ml of flaxseed oil twice a day.
- N-ACETYLCYSTEINE (NAC)
This is an amino acid that can convert metabolites capable of stimulating glutathione synthesis which can detoxify heavy metals from the liver. NAC may help to prevent a skin eruption called lupus erythematous. Dosage: 200-800 mg daily.
- MILK THISTLE
This is an important herb used to detoxify the liver and increase liver integrity. Milk thistle also increases glutathione, an important antioxidant. Many patients are placed on the drug Plaquenil, which may increase liver enzymes, so taking milk thistle can help protect the liver. Dosage: 1-3 capsules daily.
Zinc (plus copper) aids in normalizing immune function and protects the skin and organs and promotes healing. Dosage: 30-60 mg a day. Balance with 2-3 mg of copper.
- VITAMIN B12
Injections of 1000mcg weekly, bi-weekly or monthly can help energy levels and improve wellness.
Astragalus is an “adaptogenic” herb that is excellent in supporting healthy immune function. Dosage: As directed.
- PYCNOGENOL or GRAPE SEED EXTRACT (OPCs)
These are potent antioxidants that can be of benefit in reducing pain and inflammation. The OPCs have also been attributed to initiating T-lymphocyte activation and a lowered erythrocyte sedimentation rate. Dosage: 100-200 mg a day.
- PROBIOTIC THERAPY
Many lupus patients have irritable bowel and dysbiosis (an imbalance in bowel flora). Acidophilus and bifidus can regulate bowel flora and protect against imbalances. Dosage: 1-2 capsules 3 times a day in between eating.
- RAW THYMUS GLANDULAR
Glandulars may help enhance thymus and spleen immune function. Take as directed by a qualified health practitioner.
- MYCO-IMMUNE MUSHROOMS
These have been used for thousands of years in China and Japan. They are potent immune enhancers, antioxidants, and free-radical scavengers. Types include cordyceps, Reishi, Shiitake, and Maitake. Dosage: As directed.
This potent antioxidant may help increase energy and reduce free radical exposure. Also, because gum and heart disease are linked to lupus, the use of this supplement is wise. Dosage: 60-200 mg daily.
This hormone may play a significant role in the body’s autoimmune system. There is a relationship between high estrogen levels and low testosterone levels. Check saliva; if levels are low, then supplement with 5-10 mg a day for females and 50-100 mg a day for males.
- SAM-e and MSM
Supplement with SAM-e for depression and pain management, along with MSM. Dosage: See a qualified practitioner.
- BEE PROPOLIS or BEE VENOM
These natural products have been used effectively for autoimmune disorders. Dosage: See a qualified practitioner.
Brady, J. Living Easier Despite Lupus. Energy Times, June 2005. 15(6): 56.
Disease Prevention and Treatment. 3rd ed. Hollywood (FL): Life Extension Media. 2000.
Farnsworth K. The Mystery of Lupus. Alive Magazine #205, July 1999. Pp. 42-45.
Gaby AR, Wright JV. Lupus Erythematosis, Systemic. Lecture Series 1996.
Gromm R. Recovery from Fibromyalgia. Alive Magazine #216, August 2000. Pp. 32-3.
Howard, CH, Mayhew, SL. The Pharmacist’s Role in the Treatment of SLE. U.S. Pharmacist, May 2006. 31(5): 39-48.
Hsu-Leblanc E. Getting Beyond Lupus. Taste for Life, September 2002. Pp 49-51.
Lahita, R. Lupus in Men. Lupus Foundation of America brochure, 2001.
LaValle JB. System Lupus Erythematosus: Immunity Enigma. Natural Pharmacy, 2000. 4(1): 22-6.
Oligoric Proanthocyanidins (OPCs) monograph, Alternative Medicine Review, Nov. 2003. 8(4): 442-447.
Rona Z, Ghosh S. Living Successfully with Lupus. Alive Magazine #244, December 2003. Pp. 60-61.
Sanderoff B, Plant Fats Facts. Natural Pharmacy, 2001.5(1):10-11.
Up Next: Irritable Bowel Syndrome (Leaky Gut)