Lupus

Lupus: How to successfully manage the disease and prevent the distressing flare up of symptoms

Lupus is an autoimmune disease – causing the body’s immune system to attack its own tissues – which affects around 25,000 people in the UK, a staggering 90 per cent of whom are women.

The disease is thought to result from genetic defects, which cause abnormal activity in the immune system’s B-cells and T-cells. The vast majority of lupus cases are systemic lupus erythematosus, or SLE. This form of the disease attacks the connective tissue which provides strength to joints, tendons, ligaments, blood vessels, skin, nerves and vital organs. Symptoms can range from mild to severe and often change over time, making this a difficult disease to diagnose. The classic sign of the disease is a red “butterfly rash” across the cheeks and nose. However, this is not always present.

The commonest symptom of SLE is inflamed, painful joints, but many patients also suffer from chronic fatigue, mouth ulcers, unexplained fever, and sensitivity to sunlight. The inflammation typically flares up periodically, with periods of remission in between.

If you are suffering from any of these symptoms it’s important that you see your doctor and request a blood test to detect specific antibodies. Particularly as SLE can cause blood and kidney disorders, in addition to inflammation of the lungs, as it progresses. The conventional treatment ranges from simple painkillers to steroid drugs and even anti-malaria drugs. However, taking steroids long term carries a significant risk of weight gain, high blood pressure and heart disease, so doctors will usually try to limit their use to treating acute flare-ups of symptoms only.

Fortunately, researchers have recently discovered a number of natural supplements that can help sufferers to better manage this disease and so reduce their reliance on dangerous drugs.

The hormone connection that points to a potent herbal remedy

Because SLE is mainly a disease that affects women, some researchers have primarily concentrated on studying possible links with female sex hormones. Research has shown that SLE sufferers generally have high levels of the female hormone oestrogen and reduced levels of testosterone (Altern Med Res 2001; 6(5): 1018-1028). One form of oestrogen, called oestradiol, is linked to inflammation and autoimmune disease since it binds onto receptors on the immune system’s B-cells and T-cells, increasing their activity (J Clin Invest 2002; 109(12): 1625-1633).

The hormone dehydroepiandrosterone (DHEA) has been used with success in treating SLE. DHEA is converted in the body to either testosterone or a weak form of oestrogen called oestrone. In a double-blind, placebo-controlled clinical trial, DHEA reduced disease flare-ups in women with SLE and reduced the need for steroid drug use (Ann Rheum Dis 2004; 63(12): 1623-1626).

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But there is a catch. DHEA is only available on prescription in the UK and can cause side effects of acne, unwanted hair growth and breast tenderness.

Because NHR is committed to bringing you information about safe, natural products that are free of side effects, we can’t recommend the use of prescription DHEA for SLE at the present time. However, there is a way in which you can safely increase your body’s own levels of DHEA. The herb Tribulus terrestris contains an active ingredient called protodioscin, which is chemically very similar to DHEA and is converted to DHEA in the body (J Alt Complement Med 2003; 9(2): 257-265). The recommended dosage is 500mg a day of 5:1 standardised extract.

Fish oils have a dual action – they reduce inflammation and protect your kidneys

Because inflammation is a central feature of SLE, natural anti-inflammatory supplements can help considerably. The essential fatty acids in fish oil – eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – suppress abnormal B-cell and T-cell activity and reduce the production of inflammatory substances called cytokines and interleukins. This effect was seen in a clinical trial in which 12 SLE patients received 180mg EPA and 120mg DHA daily (Kidney Int 1989; 36: 653-660).

Kidney inflammation (lupus nephritis) is a common symptom of SLE and a recent study involving sufferers with this condition found that EPA not only controlled inflammation but also reduced “oxidative stress” from free radical damage (In Vivo 2005; 19(5): 879-882).

According to animal studies, fish oils boost the kidneys’ levels of beneficial antioxidants – in a particular catalase, glutathione peroxidase and superoxide dismutase (Biochem Biophys Res Commun 1994; 200: 893-898). The recommended dosage of fish oil for SLE patients is 240mg of EPA and 160mg of DHA, taken three times a day.

Vitamins A and D help calm an over-active immune system

Vitamin A is a powerful anti-oxidant that the body needs to maintain the health of skin and joints. But it also has immune stimulating properties and is often deficient in patients suffering from SLE (Rheumatol Int 2002; 22(6): 238-243). In a small study involving ten women with SLE, two weeks’ supplementation with vitamin A resulted in a more normal and beneficial immune response (J Clin Lab Immunol 1988; 26: 33-35).

Take 1,500mcg (5,000 IU) of vitamin A each day plus 15mg (25,000 IU) of beta-carotene. Beta-carotene is a powerful antioxidant in its own right and is also converted into vitamin A as the body requires it. Talk to your doctor before using vitamin A if you’re taking retinoid drugs (used to treat acne and psoriasis), as vitamin A is chemically very similar to retinoid drugs, and taking both could lead to an overdose, resulting in damage to the liver and spleen.

SLE sufferers may also lack vitamin D, partly because sensitivity to sunlight means that they do not build up the vitamin in their skin from sun exposure. This means that they are also at risk of low bone density and osteoporosis. As well as vitamin D’s well-known role in building strong bones, recent research has discovered that it has profound effects on the immune system, including damping down over-active T-cells (Curr Drug Targets Inflamm Allergy 2004; 3(4): 377-393).

In addition, animal studies have shown that vitamin D, combined with sufficient calcium intake, can prevent or dramatically suppress autoimmune diseases such as lupus (FASEB J 2001; 15(14): 2579-2585).

The optimum dose of vitamin D is 30mcg (1200 IU) a day, but check with your doctor first if you’re taking heart medication, as Vitamin D acts like a hormone in the body and affects the contraction of heart muscle cells so the two combined could cause abnormal heart beats (arrhythmia).

20.09.2007

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