Lupus

Systemic lupus erythematosus (lupus or SLE for short) is an autoimmune disease that primarily affects women of childbearing age. Its cause is unknown, but is believed to involve both genetic inheritance and factors in the environment. Whatever the cause, individuals with SLE develop antibodies against substances in their own bodies, including DNA. These antibodies cause widespread damage and are believed to be primarily responsible for the many symptoms of this disease.

SLE may begin with such symptoms as fatigue, weight loss, fever, malaise, and loss of appetite. Other common early symptoms include muscle pain, joint pain, and facial rash. As SLE progresses, symptoms may develop in virtually every part of the body. Kidney damage is one of the most devastating effects of SLE, but many other serious problems may develop as well, including seizures, mental impairment, anemia, and inflammation of the heart, blood vessels, eyes, and digestive tract.

Conventional treatment for SLE revolves around anti-inflammatory drugs. In mild cases, taking nonsteroidal anti-inflammatory drugs (NSAIDs) may help; more severe forms of SLE require long-term use of corticosteroid anti-inflammatory drugs such as prednisone. The side effects of these medications can be quite serious themselves. So-called cytotoxic agents (azathioprine, cyclophosphamide, and chlorambucil) might also be helpful, but they have many side effects as well.

Close physician supervision is always required with lupus due to the risk of complications in so many organs.

Principal Proposed Treatments for Lupus:

Increasing evidence tells us that the hormone dehydroepiandrosterone (DHEA) may be helpful for the treatment of lupus, when used as a part of a comprehensive, physician-directed treatment approach.

DHEA

Dehydroepiandrosterone (DHEA), a hormone produced by the adrenal glands, is the most abundant steroid hormone found in the bloodstream. Your body uses DHEA as the starting material for making the sex hormones testosterone and estrogen. DHEA has been tried as a treatment for a variety of medical conditions, including osteoporosis, but it is showing its greatest promise in the treatment of SLE.

What Is the Scientific Evidence for DHEA?

A 12-month double-blind placebo-controlled trial of 381 women with mild or moderate lupus evaluated the effects of DHEA at a dose of 200 mg daily. Although many participants in both groups improved (the power of placebo is amazing!), DHEA was more effective than placebo, reducing many symptoms of the disease. Similarly positive results were seen in earlier small studies.

Even if DHEA is not strong enough to completely control symptoms of SLE on its own, it might allow a reduction in dosage of the more dangerous standard medications. In addition, it might directly help offset some of the side effects of corticosteroid treatment, such as accelerated osteoporosis. (Calcium, vitamin D, and ipriflavone might also help prevent corticosteroid-induced osteoporosis.)

For more information, including dosage and safety issues, see the full DHEA article.

Other Proposed Treatments for Lupus:

Flaxseed contains lignans and alpha-linolenic acid, substances with a wide variety of effects in the body. In particular, flaxseed may antagonize the activity of a substance called platelet-activating factor (PAF) that plays a role in SLE kidney disease (lupus nephritis). Preliminary evidence suggests that flaxseed might help prevent or treat lupus nephritis.

Fish oil contains omega-3 fatty acids, which have some anti-inflammatory effects. Fish oil has been found useful in rheumatoid arthritis, a disease related to SLE. The results of a small double-blind crossover trial suggest that fish oil might be useful for SLE as well, but more study is needed. Current evidence suggests that fish oil is specifically not effective for lupus nephritis.

Other treatments sometimes recommended for SLE include beta-carotene, magnesium, selenium, vitamin B3, vitamin B12, vitamin E,pantothenic acid, and food allergen identification and avoidance. However, there is no real evidence as yet that these treatments work for lupus.

Alfalfa: An Herb to Avoid

The herb alfalfa contains a substance called L-canavanine, which can worsen SLE or bring it out of remission. Individuals with SLE should avoid alfalfa entirely.