Lupus/SLE


Lupus is an autoimmune disease which can lead to inflammation and damage to the skin, joints, brain, kidneys, and other organs, and is one of the more dangerous categories of autoimmune disease.

 
  • Overview
  • Action Plan
  • Ask The Doctor
  • Read & Watch
  • Success Stories
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Overview


It is unclear what the actual prevalence of lupus is, but it has been estimated that in the U.S. it is approximately 161,000 to 322,000, or 0.1% of the population.1 Most of those diagnosed with lupus are young women.

Common symptoms of lupus may include:

  • joint and muscle pain
  • fatigue
  • low-grade fever
  • rashes
  • chest pain
  • hair loss
  • anemia
  • mouth sores
  • swollen lymph nodes
  • skin sensitivity to light

If lupus goes uncontrolled, severe consequences can occur including organ damage and death. Persons with lupus have a higher risk of blood clots, kidney failure, heart disease, and stroke.

Little is known about what exactly causes lupus in individuals, but investigators believe it is a combination of genetic and environmental factors such as diet, toxin exposures, and intestinal bacteria imbalance.

 
References
  1. Helmick CG, Felson DT, Lawrence RC, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part I. I 2008, 58:15-25.

Action Plan


Diet

  • Hundreds of my patients over the last 25 years, have made dramatic recoveries from autoimmune diseases, including rheumatoid arthritis, lupus, connective tissue disease and psoriasis via a Nutritarian diet. Many have achieved complete recoveries and no longer require any medications.  A vegan, gluten-free diet has shown to be quite helpful for many with autoimmune diseases.1,2  
  • Identify specific or general triggers to the disease to reduce or remove (which may be individual to each person). Many with lupus will find they are sensitive to gluten, processed foods such as added sugars, animal products, alfalfa, and figs. Other foods are less common triggers, such as certain nuts, soy, nightshades, or corn, for example.
  • Vitamins, minerals carotenoids, flavonoids, fiber, and other phytochemicals have anti-inflammatory effects that could help to normalize the immune response and reduce symptoms.3-5 Maximize the intake of immune-system-regulating, anti-inflammatory foods such as green vegetables, mushrooms, onions, squashes, parsnips, turnips and rutabaga, which have low allergic or reaction potential.  Eat both raw and cooked cruciferous vegetables every day. 
  • Fruit intake may need to be reduced to low or moderate amounts.
  • Anti-inflammatory spices such as turmeric, ginger, cayenne pepper, cloves, garlic, and cinnamon should be used in seasoning dishes.6-9  
  • Talk to your doctor before and after making changes to your diet and supplement regimen if you have a chronic disease or if you are taking any medication, as medication and/or unique dietary modifications may be necessary.  Medication reduction should be monitored by a physician.
  • Meal plan: Autoimmune Reversal

Supplements

  • Dr. Fuhrman’s general supplement protocol for adults (see Vitamin Advisor for details) includes:

  • Additional Supplements:
    • Probiotics: Research has suggested that healthy bacteria in our intestines may be protective and help to keep a normal functioning immune system. Lupus has been associated with alterations in the gut microbiome.10  Eating a fiber-rich diet helps to build up healthy gut bacteria over time, and supplemental probiotics may also be helpful.11-14 Ask your doctor to discuss if taking probiotics is right for you.
    • Omega-3 DHA and EPA: Trials on omega-3 supplementation in patients with lupus have reported reduced disease activity.15 High doses may be necessary to experience a difference in symptoms.16 If considering higher doses of omega-3 supplementation, please discuss this with your doctor first as it is not appropriate for everyone
    • Immune Biotect provides assorted immune-supporting mushroom phytochemicals that are not normally consumed in the diet, plus astragalus, elderberry and other berry extracts. Consult your physician if you are on medication.
    • Anti-inflammatory botanicals: Turmeric, green tea, and grape seed. Curcumin (from turmeric) has potent anti-inflammatory effects in laboratory studies, and in human trials, curcumin supplementation decreased inflammatory biomarkers and oxidative stress.17-21 In addition to curcumin, turmeric contains several other anti-inflammatory phytochemicals.9 Grape seed phytochemicals called proanthocyanidins also have anti-inflammatory effects. In human trials, grape seed extract has been reported to reduce inflammatory markers.22-25 Green tea phytochemicals have inhibitory effects on the T cells that mediate some autoimmune diseases, which may help protect against autoimmunity.26, 27 In human supplementation studies, green tea extracts reduced the inflammatory marker TNF-alpha.28 
    • Ultra Cell Biotect provides absorption-enhanced curcumin and green tea extract plus turmeric, grape seed extract, and black turmeric extract to help neutralize free radicals and promote cellular health. Consult your physician if you are on medication. 

For supplement recommendations personalized to you, your health condition and goals, visit the Personalized Vitamin Advisor and answer a few questions. 

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Other Considerations

Supervised, periodic water fasting can be used as an adjunct treatment for autoimmune conditions. I have documented remission of autoimmune diseases following supervised fasting in a published series of case reports.29 Additional studies have found that fasting (followed by a vegetarian diet) reduces pain in rheumatoid arthritis patients.30, 31 Continuing to follow a Nutritarian diet after completing the fast is essential for sustaining the benefits of the fast. Fasting puts the body into a repair mode, facilitating the elimination of damaged molecules, reducing inflammation, and resetting the immune system.32, 33

Find additional help

ONLINE: All members of DrFuhrman.com can search the Ask the Doctor archives for discussions on this topic. Platinum and Diamond members can connect with Dr. Fuhrman by posting questions in the forum. Not a member? Join now.

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References
  1. Hafstrom I, Ringertz B, Spangberg A, et al. A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford) 2001, 40:1175-1179.
  2. Alwarith J, Kahleova H, Rembert E, et al. Nutrition Interventions in Rheumatoid Arthritis: The Potential Use of Plant-Based Diets. A Review. Front Nutr 2019, 6:141.
  3. Yahfoufi N, Alsadi N, Jambi M, Matar C. The Immunomodulatory and Anti-Inflammatory Role of Polyphenols. Nutrients 2018, 10.
  4. Gioia C, Lucchino B, Tarsitano MG, et al. Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations? Nutrients 2020, 12.
  5. McAlindon TE, Gulin J, Chen T, et al. Indole-3-carbinol in women with SLE: effect on estrogen metabolism and disease activity. Lupus 2001, 10:779-783.
  6. Mazidi M, Gao HK, Rezaie P, Ferns GA. The effect of ginger supplementation on serum C-reactive protein, lipid profile and glycaemia: a systematic review and meta-analysis. Food Nutr Res 2016, 60:32613.
  7. Zhu C, Yan H, Zheng Y, et al. Impact of Cinnamon Supplementation on cardiometabolic Biomarkers of Inflammation and Oxidative Stress: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Complement Ther Med 2020, 53:102517.
  8. Singh S, Aggarwal BB. Activation of transcription factor NF-kappa B is suppressed by curcumin (diferuloylmethane) [corrected]. J Biol Chem 1995, 270:24995-25000.
  9. Aggarwal BB, Yuan W, Li S, Gupta SC. Curcumin-free turmeric exhibits anti-inflammatory and anticancer activities: Identification of novel components of turmeric. Mol Nutr Food Res 2013, 57:1529-1542.
  10. Lopez P, de Paz B, Rodriguez-Carrio J, et al. Th17 responses and natural IgM antibodies are related to gut microbiota composition in systemic lupus erythematosus patients. Sci Rep 2016, 6:24072.
  11. Mohammed AT, Khattab M, Ahmed AM, et al. The therapeutic effect of probiotics on rheumatoid arthritis: a systematic review and meta-analysis of randomized control trials. Clin Rheumatol 2017, 36:2697-2707.
  12. Kouchaki E, Tamtaji OR, Salami M, et al. Clinical and metabolic response to probiotic supplementation in patients with multiple sclerosis: A randomized, double-blind, placebo-controlled trial. Clin Nutr 2017, 36:1245-1249.
  13. Tankou SK, Regev K, Healy BC, et al. A probiotic modulates the microbiome and immunity in multiple sclerosis. Ann Neurol 2018, 83:1147-1161.
  14. Tamtaji OR, Kouchaki E, Salami M, et al. The Effects of Probiotic Supplementation on Gene Expression Related to Inflammation, Insulin, and Lipids in Patients With Multiple Sclerosis: A Randomized, Double-Blind, Placebo-Controlled Trial. J Am Coll Nutr 2017, 36:660-665.
  15. Duarte-Garcia A, Myasoedova E, Karmacharya P, et al. Effect of omega-3 fatty acids on systemic lupus erythematosus disease activity: A systematic review and meta-analysis. Autoimmun Rev 2020, 19:102688.
  16. Proudman SM, James MJ, Spargo LD, et al. Fish oil in recent onset rheumatoid arthritis: a randomised, double-blind controlled trial within algorithm-based drug use. Ann Rheum Dis 2013.
  17. Mirzabeigi P, Mohammadpour AH, Salarifar M, et al. The Effect of Curcumin on some of Traditional and Non-traditional Cardiovascular Risk Factors: A Pilot Randomized, Double-blind, Placebo-controlled Trial. Iran J Pharm Res 2015, 14:479-486.
  18. Panahi Y, Alishiri GH, Parvin S, Sahebkar A. Mitigation of Systemic Oxidative Stress by Curcuminoids in Osteoarthritis: Results of a Randomized Controlled Trial. J Diet Suppl 2016, 13:209-220.
  19. Panahi Y, Hosseini MS, Khalili N, et al. Antioxidant and anti-inflammatory effects of curcuminoid-piperine combination in subjects with metabolic syndrome: A randomized controlled trial and an updated meta-analysis. Clin Nutr 2015, 34:1101-1108.
  20. Shehzad A, Lee YS. Molecular mechanisms of curcumin action: signal transduction. Biofactors 2013, 39:27-36.
  21. Panahi Y, Khalili N, Sahebi E, et al. Antioxidant effects of curcuminoids in patients with type 2 diabetes mellitus: a randomized controlled trial. Inflammopharmacology 2017, 25:25-31.
  22. Belcaro G, Ledda A, Hu S, et al. Grape seed procyanidins in pre- and mild hypertension: a registry study. Evid Based Complement Alternat Med 2013, 2013:313142.
  23. Irandoost P, Ebrahimi-Mameghani M, Pirouzpanah S. Does grape seed oil improve inflammation and insulin resistance in overweight or obese women? Int J Food Sci Nutr 2013, 64:706-710.
  24. Razavi SM, Gholamin S, Eskandari A, et al. Red grape seed extract improves lipid profiles and decreases oxidized low-density lipoprotein in patients with mild hyperlipidemia. J Med Food 2013, 16:255-258.
  25. Kar P, Laight D, Rooprai HK, et al. Effects of grape seed extract in Type 2 diabetic subjects at high cardiovascular risk: a double blind randomized placebo controlled trial examining metabolic markers, vascular tone, inflammation, oxidative stress and insulin sensitivity. Diabet Med 2009, 26:526-531.
  26. Wu D, Lewis ED, Pae M, Meydani SN. Nutritional Modulation of Immune Function: Analysis of Evidence, Mechanisms, and Clinical Relevance. Front Immunol 2018, 9:3160.
  27. Wu D, Wang J, Pae M, Meydani SN. Green tea EGCG, T cells, and T cell-mediated autoimmune diseases. Mol Aspects Med 2012, 33:107-118.
  28. Haghighatdoost F, Hariri M. The effect of green tea on inflammatory mediators: A systematic review and meta-analysis of randomized clinical trials. Phytother Res 2019, 33:2274-2287.
  29. Fuhrman J, Sarter B, Calabro DJ. Brief case reports of medically supervised, water-only fasting associated with remission of autoimmune disease. Altern Ther Health Med 2002, 8:112, 110-111.
  30. Muller H, de Toledo FW, Resch KL. Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol 2001, 30:1-10.
  31. Smedslund G, Byfuglien MG, Olsen SU, Hagen KB. Effectiveness and safety of dietary interventions for rheumatoid arthritis: a systematic review of randomized controlled trials. J Am Diet Assoc 2010, 110:727-735.
  32. Longo VD, Mattson MP. Fasting: molecular mechanisms and clinical applications. Cell Metab 2014, 19:181-192.
  33. Cheng CW, Adams GB, Perin L, et al. Prolonged Fasting Reduces IGF-1/PKA to Promote Hematopoietic-Stem-Cell-Based Regeneration and Reverse Immunosuppression. Cell Stem Cell 2014, 14:810-823.

Ask The Doctor


The following are sample questions from the Ask the Doctor Community Platinum and higher members can post their health questions directly to Dr. Fuhrman. (All members can browse questions and answers.)

Q.

For someone who has lupus nephritis, what are the food restrictions? I heard that a certain amount of protein can damage the kidneys even more. Are there foods that can help the kidneys? Thanks.

A.

Did you read my book, Super Immunity? The diet and supplement protocol in the book is what I want you to do. The main point for lupus nephritis is no animal products, salt or oil, in other words, a strict vegan diet. You can eat brown and wild rice and vegetables, mushrooms, squash, and greens, with a small amount of fruit and a limited amount of nuts, seeds, and beans to keep protein fairly low. You can eat a half cup of beans with each meal, you can eat one ounce of seeds and nuts with each meal, and you can eat up to two fresh fruits with each meal. You should not have animal products at all until you are better.

 
Q.

I have been following your autoimmune protocol for lupus nephritis for a little over a month now, and I still don’t see any improvement. When should I start feeling better and have no more protein in the urine? I also eliminated wheat, oil, and salt. Will I ever be able to eat any type of animal product in the future?

A.

It takes at least 3 months to get the micronutrient load built up in your tissues, but it might take even longer to see results. Your immune system and disease process can’t just reverse itself in a few weeks. Your condition is serious enough that you should avoid animal products for a long time now, until we see things are significantly improved.

I have seen some very severely ill patients with this condition get well. I often begin to see improvement after the first 3-4 months, but I have seen lupus patients take a few years to get well, making slow progress.