Lupus

lupus

Butterfly rash typical of lupus

What is Lupus?

Systemic lupus erythematosus (SLE) is an autoimmune disease that affects the body’s connective tissues. SLE, like all auto-immune conditions, occurs when the body produces abnormal antibodies that attack normal body tissue as if it were a foreign invader. The immune system normally accepts its own tissues, and protects the body by producing antibodies or proteins that attach to and destroy foreign invaders, such as bacteria or viruses. In people with lupus, the immune system, for yet undiscovered reasons, produces antibodies that target the body’s own healthy cells, which can lead to tissue damage, organ failure, disability or death. Lupus primarily affects women – approximately 1 in 700 women between the ages of 15 and 64 are affected by lupus. And why the picture with the pills? Because pills are the doctor’s solution – just medicate.

What Causes Lupus?

While the exact cause of lupus is not fully understood, a combination of defective genes and environmental factors are believed to cause lupus disease activity. SLE imposes multiple complications on an affected person, their family, and the health care provider who tries to control its manifestations. To complicate matters even further, SLE is often misdiagnosed or overlooked by health care providers.

The 3 Types Of Lupus

Did you know that there are different kinds of lupus? There are many kinds of “mixed” auto-immune diseases, and with lupus this is certainly a fact. Here are the three main kinds of lupus.

Discoid or Cutaneous Lupus

Is described as usually being limited to the skin and may, or may not, present with a positive anti-nuclear antibody (ANA) test. Its symptoms include mucosal ulcerations of the nose, mouth and vagina, a “butterfly” rash, loss of hair, thick scarring lesions, skin pigmentation changes, hives and welts, and Raynaud’s phenomena (colour changes in the fingertips which can make them red, white, or blue as a response to stress and temperature change.

Systemic Lupus

This form of lupus can involve any system of the body, including the joints and other connective tissue, as well as major organs, including the heart, lungs, kidneys and brain. When lupus progresses and begins to involve one or multiple systems of the body, it achieves the diagnosis of SLE, systemic lupus erythematosus.

Drug-Induced Lupus

Generally caused by extensive use of certain medications. Its symptoms are similar to systemic lupus but usually go away when the medications are discontinued. Anticonvulsant drugs, such as Tegretol (carbamazepine) have been particularly found to induce lupus-like symptoms in some patients.
Pharmaceutical solution: steroids

Conventional Medical approach Of Lupus With Drug Therapy

SLE has proven to be quite a difficult disease to understand and an even harder one to control with drug-based medicine. Conventional medicine typically utilises a treatment approach similar to other autoimmune diseases, targeting the disease by the use of corticosteroids and/or non-steroidal anti-inflammatory drugs (NSAIDS). Prednisone, probably the most widely used corticosteroid, aims to suppress the resultant inflammatory response that accompanies SLE and many other autoimmune conditions. Steroids like prednisone are commonly to both suppress the aggressive autoimmune response and stabilise the resultant inflammation. NSAIDS are readily prescribed to “back-up” the corticosteroids. Anti-malarial drugs, like hydroxychloroquine, are frequently used to calm the manifestations of SLE. Finally, drugs toxic to cells like methotrexate, azathioprine, and cyclophosphamide are used with the rationale of reducing steroid dosage.

Variable results are obtained from these conventional approaches and side effects often must be weighed against the manifestations of SLE. Prednisone has been found to cause a huge variety of side effects, particularly when used long-term. The extensive damage done to the gastrointestinal system caused by the excessive use of NSAIDS is well documented in the medical literature. Toxic pharmaceutical drugs often fail to achieve remission and cause significant side effects such as hepatitis, nausea, vomiting, bone marrow depression, pancreatitis, skin rashes, fevers, inflamed mouth, and delayed healing to name a few.

Natural Lupus Management Plan

Alternatives to conventional drug based therapy treatments are becoming increasingly popular due to the inability to find a cure for SLE, along with a growing desire for a treatment plan which carries a lower risk of adverse side effects. Have you looked at some of the potential causes of your SLE? Yes – auto-immune disease does not happen by chance. Something made your immune system “turn” on itself. Do you have a root canal or dental problem? Your teeth may be a hidden hazard, and I have given up counting how many patients I have seen with dental issues resulting in an auto immune disorder like Lupus, rheumatoid arthritis, Hashimoto’s thyroiditis and many more chronic conditions for which doctors claim there is “no cure” and no cause is ever sought. Any unresolved stresses or are you heading for being “burned out”? Dig deep enough and you can piece together the reason/s why auto immunity develops in 99% of cases. A good start is a detox followed by the Adrenal Fatigue Program.

Adrenal Gland Treatment

This is one of my main treatments of choice. It makes sense to ensure your adrenal glands are working well, after all – they produce cortisol – the body’s main anti-inflammatory hormone.Many patients I have seen in the clinic presenting with an auto-immune disease need:
1 – Digestive work
2 – Detoxification
3 – Adrenal gland rejuvenation

DHEA

One alternative therapy gaining acceptance overseas is the use of DHEA, a hormone made by the adrenal glands. DHEA is a natural hormone that is made by your adrenal glands, and the most abundant hormone made by the adrenal glands is DHEA. After DHEA is made by these glands it goes into the bloodstream, and from then on it travels all over the body and goes into your cells, where it is converted into male hormones known as androgens, or female hormones, known as oestrogens. Whether DHEA gets converted predominantly into androgens or oestrogens depends on many factors, such as your medical condition, age and sex.

From the many studies that have been done so far, it seems that DHEA helps fight disease by boosting your immune function, improves mood and energy (many people say they have an increased sense of well being), boosts your sex drive and influences longevity. DHEA has been shown to reduce the risk of heart disease in men, help SLE, rheumatoid arthritis, and multiple sclerosis as well as diabetes and certain forms of cancer. The physiological role of DHEA is not fully understood, but certain findings in America suggest it may play an instrumental role in helping those with SLE. DHEA levels are quite low in the serum of SLE patients. DHEA is currently unavailable in NZ, but can be had by mail-order (internet, USA) for those who desire to try it. I would recommend that you work in conjunction with your health-care professional with knowledge in this area, rather than self-prescribe.

DHEA was found to have various immuno-regulatory effects, when administered at a dose of 200 mg/day for three months to 28 females with SLE, the result was a good reduction in prednisone dosage, a lower occurrence of flare-ups, better sense of well being, and a decrease in activity of the disease based on the SLE symptoms index. The same findings were not present with the placebo group, with the condition of
the patients either staying the same or deteriorating. The treatment was well tolerated with a very low toxicity profile; however, side effects of acne and mild hirsutism (excessive or abnormal distribution of hair) occurred in a small number of patients. Topical steroid treatment was beneficial in most cases and no patient dropped out of the study due to the very mild side effects.

In another study, SLE patients were randomly divided into a DHEA or placebo group for six months. All patients continued their corticosteroids and immunosuppressive drugs. The researchers found that the placebo group demonstrated loss of bone density of the lumbar-sacral spine, probably due to the effects of corticosteroid therapy. The test group received 200 mg/day of DHEA for six months and maintained bone density throughout the course of the study. This suggests DHEA may counteract bone damage caused by corticosteroids. Although benefits were apparent, DHEA therapy was not without drawbacks. 62% of the pre-menopausal woman in the study developed acne as a side effect, and a smaller group had mild cases of hirsutism. DHEA can be used alongside pharmaceutical drugs effectively, but one must find a practitioner with the skill and knowledge to integrate conventional and natural medicines.

Flax Seed Oil

The role of essential fatty acids and dietary oils has been extensively examined in SLE using various human studies. Flaxseed oil has been shown to have a positive effect on the antibody profile of SLE patients. Flaxseed oil was shown to have a positive effective in lupus patients with nephritis (kidney inflammation). About a tablespoon per day seems to be the most beneficial dosage. One to two tablespoons per day also demonstrated the ability to lower total cholesterol by 11 percent and LDL (bad) cholesterol by 12 percent. Various studies suggest that, although flaxseed may not prevent the inevitable manifestations of the disease, it prolonged the onset of damage from and increased the life span of those with chronic SLE. My favourite brand I recommend is Wahi Bush, one of the best available in NZ.

Vitamins A & D

Supplementation with fat-soluble vitamins A and D may be well indicated for patients with SLE. A possible explanation for the decreased vitamin D levels may be linked to the lack of sunlight exposure in most SLE patients due to their increased sensitivity to sunlight. The presence of a known deficiency in SLE suggests vitamin D may be well indicated in SLE. Supplementation of vitamin A showed a beneficial immune responses in women who participated in one particular study. Leave the prescribing of these singular vitamins (especially high dose) to the experts, it is best not to self prescribe here. You may like to try small amounts of Cod liver oil, a rich source of the vitamins A & D.

Antioxidants

Free radical damage plays a significant role in the development of SLE. Several studies suggest antioxidant supplementation may well improve the disease status of SLE patients. Researchers have found that the antioxidant vitamins A and E, and beta carotene were lower in patients with SLE, as well as rheumatoid arthritis. Selenium was found to increase one important aspect (killer cell activity)of the immune system in two different SLE studies.

Dietary Considerations

Food allergies and sensitivities have been shown to have an adverse impact on rheumatoid arthritis, which is similar in many ways to SLE in both treatment and flare-up activity. The discovery and elimination of possible food triggers has prove to be beneficial and has made a difference to many of my rheumatoid arthritis patients, as well as those with SLE. Diet may well play a significant role in the course of SLE. An interesting note is the use of alfalfa seeds in the diet of animals with SLE exacerbated some symptoms. Researchers have concluded that the amino acid L-canavanine was the key constituent in unsprouted alfalfa that causes the exacerbation of SLE signs and symptoms. L-canavanine is found in many legumes including soybean, alfalfa, and clover, as well as onions. However, cooking and high temperatures apparently destroy the lupus-eliciting effects without decreasing the lipid-lowering properties found in the foods.

Conclusions

SLE has proven to be a difficult disease to manage because so little is known about its cause. Finding an appropriate treatment (that actually works with minimal side effects) creates difficulty for your health care provider. What is known is that SLE can affect any organ system in the body and each and every patient’s response is unique. Drugs can be beneficial to some patients and of little help and devastating long-term to others. In addition, side effects often outweigh benefits and create complications of their own. DHEA, may be a viable alternative as it has demonstrated the ability to reduce disease activity and decrease prednisone necessity. However, long-term safety and appropriate dosage has not been established to date. Antioxidant and omega-3 fatty acid supplementation have been shown to reduce free radical damage and inflammation, improve immuno-regulation, and decrease heart and kidney disease risk. I would also recommend testing for food allergies for all SLE patients. Despite the inability to find a cure for SLE, research suggests alternative methods may benefit those who fail to respond to conventional drug-based therapies or who wish to offset the potential side effects of conventional medicines. It is up to the you and your health care professional to explore all your treatment options, both conventional and alternative. With good quality nutritional and medical support, along with a positive outlook, SLE patients can expect lead to lead relatively normal and productive lives for many years to come.

References

Wallace DJ. The Lupus Book: A Guide for Patients and Their Families. New York: Oxford University Press; 1995:6-12, 66.
Rahman P, Humphrey-Murto S, Gladman DD, Urowitz MB. Cytotoxic therapy in systemic lupus erythematosus. Experience from a single center. Medicine (Baltimore) 1997;76:432-437.
Wise CM, Vuyyuru S, Roberts WN. Methotrexate in nonrenal lupus and undifferentiated connective tissue disease, a review of 36 patients. J Rheumatol 1996; 23:1005-1010.
Van Vollenhoven RF. Dehydroepiandrosterone in systemic lupus erythematosus. Rheum Dis Clin North Am 2000;26:349-362.
Formiga F, Moga I, Nolla JM, et al. The association of dehydroepiandrosterone sulphate levels with bone mineral density in systemic lupus erythematosus. Clin Exp Rheumatol 1997;15:387-392.
Clark WF, Parbtani A, Huff M, et al. Omega-3 fatty acid dietary supplementation in systemic lupus erythematosus. Kidney Int 1989;36:653-660.
Clark WF, Parbtani A, Huff MW, et al. Flaxseed: a potential treatment for lupus nephritis. Kidney Int 1995;48:475-480.
Muller K, Kriegbaum NJ, Baslund B, et al. Vitamin D3 metabolism in patients with rheumatic diseases: low serum levels of 25-hydroxyvitamin D3 in patients with systemic lupus erythematosus. Clin Rheumatol 1995;14:397-400.
Panush RS. Food induced allergic arthritis: clinical and serologic studies. J Rheumatol 1990;17:291-294.

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