A painful and potentially life-threatening illness, lupus occurs when your immune system turns renegade and attacks your body’s own tissues, causing inflammation and damage. The skin, kidneys, blood vessels, eyes, lungs, nerves, joints—just about any part of the body—can be involved. At the same time, your immune system sometimes ignores its normal duties of fighting infection, so you end up being prone to all sorts of illnesses. The exact causes of lupus aren’t known for sure, but research has shown that genetic and environmental factors are involved. There is no cure. Conventional treatment generally involves controlling the symptoms with drugs, including anti-inflammatories such as ibuprofen, analgesics such as acetaminophen, and corticosteroids (hormones) such as prednisone. Some people are also treated with immune suppressants—that is, medications that suppress the action of the immune system.
Alternative practitioners believe that their treatments can reduce inflammation, increase the body’s production of certain hormones, and strengthen immunity. Naturopathic doctors may also treat what they think are possible underlying causes of lupus. They believe that diseases of this kind, called autoimmune diseases, may be associated with digestion problems, food allergies, and weakness of the adrenal glands.
A naturopathic doctor will usually do tests to determine if any of these underlying problems exist, says Jody Noé, N.D., a naturopathic doctor at the Brattleboro Naturopathic Clinic in Vermont. Once the possible causes are identified, there are a number of alternative treatments that may help.
"It’s important to try to figure out the cause of this disorder," she says, "and to work out a treatment plan based on each person’s symptoms." Supplements often play a role in alternative treatments, but you should get your doctor’s approval before taking supplements to treat lupus. You’ll also need to consult a holistic physician or naturopath to determine the dosages best suited to you.
Knocking Out Free Radicals
When inflammation occurs, the body produces more free radicals, the unstable molecules that can harm cells. One of the first lines of defense that a naturopathic doctor uses against inflammation is extra amounts of nutrients that neutralize the radicals. These nutrients, called antioxidants, are vitamins E and C, beta-carotene, and selenium. They also include zinc, which has antioxidant activity, and phytochemicals such as bioflavonoids, which are found in plants and herbs, Dr. Noé says.
Dr. Noé recommends that her patients take a mixture of antioxidant nutrients daily with food. She suggests 1,000 to 3,000 milligrams of vitamin C in divided doses, 400 to 600 international units (IU) of vitamin E, 200 to 400 micrograms of selenium, and 15 to 30 milligrams of zinc in the form of zinc picolinate or citrate.
She also recommends 1 to 2 milligrams a day of copper and 5 to 15 milligrams of manganese. Both help the body make its own antioxidants. These trace minerals should be taken only in these recommended doses to avoid getting toxic amounts.
Essential Fatty Acids Fight Inflammation
You can reduce levels of inflammation-generating biochemicals in your body by changing the kinds of fats you eat, Dr. Noé says. Meat and other animal products provide your body with something called arachidonic acid, which is used to make pro-inflammatory biochemicals. On the other hand, fish oils, which contain eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and certain plant oils, which contain gamma-linolenic acid (GLA), follow a biochemical pathway that reduces production of these biochemicals.
In studies of animals that spontaneously develop a lupuslike syndrome, diets high in fish oil reduced inflammation and improved kidney function and immunity. In human studies, results have been inconclusive, perhaps because the studies were not long enough or because people started taking fish oil too late in the course of the disease. Still, a study from India showed that people had lower levels of free radicals in their blood when they were taking fish oil than they did prior to taking it.
One study found that people with the most common type of lupus showed a reduction of free radical chemical "markers" and increased amounts of antioxidants in their blood after undergoing therapy with the omega-3 fatty acids EPA and DHA. Researchers surmise that fish oil, which is high in omega-3’s, might be helpful for people with lupus.
"In my practice, I’ve seen that most people with an autoimmune disease benefit from getting essential fatty acids," Dr. Noé says. "These oils are good for everyone with chronic inflammation."
Dr. Noé recommends that people with lupus take 1,000 to 1,500 milligrams a day of EPA and 500 to 700 milligrams of DHA. She also recommends 500 to 1,000 milligrams of GLA from evening primrose, borage, or black currant oil. Since borage oil is the most potent and most economical, some specialists feel that it may be your best buy. These supplements are all available at health food stores. You can take them for as long as you like, but it is best to take them with food, says Dr. Noé.
DHEA—And What Sex Has to Do with It
Lupus is influenced by hormone fluctuations in the body. In some people, an imbalance of the estrogenic (female) and androgenic (male) hormones can make lupus symptoms worse. While scientists don’t quite understand why this happens, they do have some clues, says Philip Mease, M.D., a rheumatologist at Minor and James Medical Center and clinical associate professor of medicine at the University of Washington Medical School, both in Seattle. Lupus may first appear during pregnancy, for instance, when there are changes in the hormone balance, according to Dr. Mease.
Animal studies also indicate a link between the balance of male and female hormones and lupus. Female mice with lupus tend to have more severe symptoms than male mice, according to Dr. Mease. Scientists found that the female mice’s symptoms improved considerably when they were given male hormones.
In two studies at Stanford University Medical Center, researchers looked closely at the effect of DHEA to find out whether it could be helpful in treating lupus. DHEA—short for dehydroepiandrosterone—is a hormone that sets off a chain reaction when it arrives in certain tissues. At the end of that chain reaction, the body produces sex hormones, either testosterone (in male organs) or estrogen (in female organs). Thus, when taken as a supplement, DHEA leads to increased production of sex hormones.
The Hormone in Action
One study of DHEA involved 28 women who had mild to moderate lupus. Most of the participants were already taking doses of prednisone, a corticosteroid drug, to relieve their symptoms. Fourteen of the women were given pills that contained 200 milligrams of DHEA. The other 14 took pills that looked exactly the same but were inactive (placebos). At the end of a three-month trial period, the women who were receiving DHEA showed a marked improvement and were able to reduce their dosages of the prednisone. Women in the placebo group showed little improvement.
In another study, 10 women with lupus were given 200 milligrams of DHEA for three to six months. Three of the women had protein in their urine, which is a sign of kidney damage resulting from lupus. At the end of the trial period, 8 of the 10 women felt that their overall well-being had improved, and those with signs of kidney damage had less protein in their urine, indicating that they were getting some protection.
Some pharmacies can make up either a tincture or capsule of DHEA, Dr. Mease says. If you can get the tincture, take it as drops under the tongue as directed by your pharmacist, he says. "My experience has been that the DHEA made by pharmacists is more effective than the capsules you’d get at a health food store."
Whatever you do, work with your doctor if you want to take DHEA, especially if your goal is to reduce your corticosteroid dosage, Dr. Mease advises.
"People who need to take corticosteroid drugs, namely prednisone, to control their symptoms can usually reduce their drug dosage if they take DHEA," Dr. Mease says. Being able to reduce the dosage of steroid drugs is a benefit because these drugs cause bone loss, suppress immunity, and have other side effects, he adds.
Plugging a Leaky Gut
Some alternative doctors and practitioners who have studied cases of autoimmune diseases, especially certain types of arthritis, believe that these conditions might be associated with a special kind of intestinal problem. They call the condition increased permeability or, more commonly, leaky gut.
The theory proposes that if the walls of the intestines are leaky, molecules derived from incompletely digested foods or from bacteria are able to seep through the intestinal lining and get into the bloodstream. There, they set off an immune response that can result in immune cells going haywire, ultimately triggering attacks on the body’s own cells. Whether or not this happens in some cases of lupus isn’t certain, says Dr. Noé.
Tests are available that some experts claim can detect a leaky gut. Dr. Noé says that she orders certain blood, urine, and saliva tests, for instance, to reveal if someone is having an immune reaction that could cause lupus.
Enzymes to the Rescue
In addition to eliminating foods identified as contributing to the problem, such as wheat gluten, corn, and dairy products, Dr. Noé recommends nutritional supplements that nourish and rebuild the intestinal lining and restore good bacteria to the bowel. If there are enough good bacteria there, they will crowd out the bad types that can contribute to digestive problems.
"I also may recommend enzymes that help break down food for proper digestion if tests suggest that someone’s pancreas is not producing enough for normal digestion," she says. The following supplements are among those that Dr. Noé recommends.
- 500 to 750 milligrams of the amino acid glutamine
- 100 to 300 milligrams of gamma-oryzanol, a component of rice bran oil
- 50 to 150 milligrams of l-butyrate
- 50 to 100 milligrams of fructooligosaccharides (FOS), naturally occurring sugars that promote the growth of friendly bacteria in the intestines
She suggests taking all of these two or three times a day between meals. She notes that these substances are safe to take on a continuous basis as long as you remain under a doctor’s supervision while taking them.
All of these supplements except FOS are broken-down forms of amino acids, fats, or sugars that can be absorbed directly by the intestinal cells, bypassing digestion. FOS are used as food for intestinal bacteria in order to promote more friendly flora. Although there are no studies to show that supplements are effective for lupus, some alternative doctors use them in an attempt to decrease intestinal permeability.
To restore friendly bacteria and improve digestion, Dr. Noé suggests the following supplements.
- One or two capsules two or three times a day of a product that contains various forms of lactobacillus and other so-called friendly bacteria—Lactobacillus acidophilus, L. rhamnosus, L. casei, L. plantarum, Bifidobacterium bifidum, B. longum, and B. breve—with two to five billion active organisms in each capsule. (If you can’t find some of these bacteria in supplements at a health food store, you may need to ask a naturopathic or holistic doctor to get them for you.)
- 500 to 1,000 milligrams of 10X U.S.P. of digestive enzymes. (10X U.S.P. is a measure of strength and is listed on the bottle.)
- A mixture of other enzymes derived from plants, including 12,500 to 18,000 U.S.P. of protease, 2,675 U.S.P. of lipase, 12,000 to 27,000 U.S.P. of amylase, and 175 CU(2) of cellulase.
Dr. Noé says that these supplements are safe to take on a continuous basis as long as you get your doctor’s approval to take them and remain under medical supervision.
Indian Spice Eases Aches
Turmeric, an Indian spice used in traditional Ayurvedic medicine, contains an anti-inflammatory and antioxidant compound called curcumin that might be helpful for people with conditions, such as lupus, that involve inflammation, says Andrew Rubman, N.D., director of the Southbury Clinic for Traditional Medicine in Connecticut and consultant to the Office of Complementary and Alternative Medicine at the National Institutes of Health.
"In animals, curcumin has excellent anti-inflammatory and antioxidant effects, without any toxicity," Dr. Rubman says. When curcumin is present, the body is much less likely to form the compounds that are instrumental in causing inflammation, he explains. "Plus," he adds, "it may stimulate the body’s own anti-inflammatory mechanisms by interacting with the adrenal glands and preventing the breakdown of cortisone in the body." Although research with humans is still sketchy, preliminary studies suggest that curcumin does have some benefits.
In one study, 1,200 milligrams a day of curcumin relieved morning stiffness and joint swelling in people with rheumatoid arthritis, which, like lupus, is an autoimmune disease. With curcumin supplementation, people with rheumatoid arthritis also found that they could walk faster. Moreover, the supplements didn’t seem to cause any side effects.
Although no studies have established a similar connection between curcumin and lupus, Dr. Rubman observes that "lupus has enough in common with rheumatoid arthritis to make me believe that it is worth a try." It can be used initially to bring inflammation under control. "If it is going to work for you, you should feel less sensitive and have fewer aches within 24 to 48 hours," he says. You can also use it if you feel that a flare-up is coming on, he notes.
The recommended dosage of curcumin for treatment of rheumatoid arthritis is 400 to 600 milligrams three times a day, with or without food. Dr. Rubman advises using the same dosage range for lupus. If you don’t notice some relief within 10 days, stop taking it. It is safe to take indefinitely, but for best results, he recommends seeking the advice of a naturopathic doctor.
Enzyme Adds Anti-Inflammatory Action
To enhance absorption of curcumin, supplement manufacturers sometimes mix it with the natural enzyme bromelain, Dr. Rubman says.
In addition to its ability to enhance absorption, bromelain has been shown to have anti-inflammatory action of its own and is frequently used for inflammatory conditions like lupus. "Bromelain can activate compounds that break down fibrin," says Dr. Rubman. Fibrin is a tissue that blocks off areas of inflammation, interrupting blood flow. The results are inadequate tissue drainage and swelling, Dr. Rubman says. Bromelain also blocks the production of certain compounds that increase swelling and cause pain when tissues are inflamed.
If you take bromelain separately, the usual dosage is 400 to 600 milligrams three times a day, says Dr. Rubman. He advises taking it at the same time that you take curcumin, and you should take them on an empty stomach. If you take bromelain with food, it will be enlisted for digestion rather than being absorbed by your body.
You can find special mixtures of bromelain and curcumin at some health food stores or obtain them from a naturopathic doctor. They’re premixed in a ratio designed to reduce inflammation.
