Ten Advances In The Fight Against Lupus

The Centers for Disease Control and Prevention in Atlanta tells us that there are about 160,000 confirmed and 330,000 "possible" cases of lupus, as defined by its severest symptoms, in the United States alone. ("Lupus" is the common term for the disease known as systemic lupus erythematosus, or SLE.) The Lupus Foundation of America estimates that as many as 1.5 million Americans have some symptoms caused by the disease, with certain ethnic groups affected disproportionately.

Lupus strikes 10 to 11 times more women than men, and it is most likely to strike during a woman's reproductive years. Men who carry two copies of the X chromosome, who are XXY rather than XY, are also especially susceptible to developing the disease. The course of the disease varies greatly from person to person, but it is not unusual for lupus to be benign for many years until it rapidly and unexpectedly progresses to a fatal condition.

Lupus makes living difficult, but scientists have a better understanding of the disease than ever before. Five surprising facts about lupus have emerged in recent scientific studies.

1. Lupus seems to be triggered by staph infections.

Staph, which is short for Staphylococcus aureus, is a common bacterium on the skin and on the mucous membranes of the nose and throat. Most staph infections are benign, and it is only when the natural population of bacteria on the skin or in the mucous membranes becomes unbalanced that staph infections cause symptoms.

Four researchers at the Mayo Clinic in Rochester, Minnesota have found that women who have lupus tend to have had greater exposure to staph bacteria. They believe that the staph bacterium, which has specialized defenses against white blood cells, sends the immune system on a "wild goose chase," eluding the action of those white blood cells. The overactive white blood cells may trigger a lupus attack, suggesting that one way to avoid exacerbations of lupus might be to be especially careful to avoid staph infections.

2. Exposure to radioactive materials may increase the risk of lupus.

Women who live near uranium processing plants, two reports have found, are at greater risk for developing lupus. At least one unpublished report has suggested that exposure to radon, a radioactive gas that accumulates in basements in much of the eastern United States, may also increase the risk of lupus. Avoiding uranium dust and making sure basements are well ventilated potentially reduces the rate of relapse in the disease.

3. Good cholesterol may go bad in Black women who have lupus.

Lupus often causes kidney disease, and it is especially likely to cause kidney disease in women of African descent. Researchers have noticed that Black women who get lupus tend to have an unusual form of "good" HDL cholesterol that activates the immune system. In Africa, this kind of cholesterol activates the immune system to fight certain fly-born parasites. In America and in the UK, however, this kind of cholesterol causes damage to the kidneys. This doesn't mean that it's a good idea to avoid raising your HDL cholesterol, but it make sure the doctor knows about any family history of lupus, or that you have lupus, before prescribing any cholesterol-altering or statin drug.

4. Stimulating the immune system in lupus is not necessarily a good thing.

Scientists have found that a defect in the normal process of "cellular suicide," or apoptosis, of certain kind of white blood cells increases the severity of lupus. When white blood cells don't die at the times and in the numbers the body needs to keep their numbers constant, they can become hyperactive and damage joint and kidney tissues.

5. How much sun you get may influence how long you will live with lupus.

Our skin makes vitamin D in response to the UV-B rays of sunlight, and vitamin D helps regulate the immune system. Getting too much sun so that the skin makes too much vitamin D, however, may be a major risk factor in the progression of lupus. Researchers have found that people who have lupus who live in sunny climates die sooner than people who have lupus who live in northerly, cloudier, colder climates, possibly because of excessive exposure to the sun leading to excessive production of vitamin D. Don't take high doses of vitamin D, and limit your exposure to the sun to 20 minutes per day if you have lupus.

Five Natural Approaches To Lupus Management

No natural remedy cures lupus, but that natural approaches to lupus management may slow the progression of the disease and make it far easier to manage. Here are five suggestions for natural approaches to lupus management that are based on scientific evidence.

1. Elimination diets often relieve lupus symptoms.

An elimination diet is nothing more than removing a particular food from your diet to see if your symptoms improve. It's not unusual for people who have lupus to report improvement or sometimes remission from symptoms when they give up dairy products, or they adopt a vegan or vegetarian diet, or they avoid foods prepared with chemical additives. It can take a very long time to find out which foods should be eliminated for best results, but occasionally the results of elimination diets almost bring about remission.

A word of caution about diets for lupus, however, is in order. Lupus is a disease that remits and relapses. Symptoms naturally get better and worse no matter what lupus sufferers do, as white blood cells die and are replaced. It's natural for the good results of an elimination diet to fade with time--but if you stick to what you know works for you, you will eventually get better again, and the long-term trajectory of your disease will be for fewer symptoms.

Don't give up a diet that works when you relapse. And be forewarned that the diet that works for you may not be the same as the diet that works for someone else.

2. Omega-3 essential fatty acids relieve the symptoms lupus-related kidney disease, but all omega-3 essential fatty acids are not equally effective.

The two most commonly consumed omega-3 essential fatty acids are docosahexaenoic acid, better known as DHA, and eicosapentaenoic acid, better known as EPA. Both DHA and EPA are found in fish oil, while neither is found in flaxseed oil, and only DHA is found in microalgae.

Scientists at the University of Texas Health Science Center in San Antonio have found that it's the DHA, not the EPA, that makes the difference in kidney health in lupus. If you take fish oil, get a brand that is DHA-enriched, or take the much more expensive microalgae oil in the highest dose you can afford.

3. Of all the herbs investigated for the treatment of lupus, the Ayurvedic herb ashwagandha seems to hold the most promise.

Ashwagandha (Withania somnifera, so named for the plants more common use as a sleeping aid) seems to "tone down" the immune system so that lupus does not progess as rapidly. Although the herb has been used for thousands of years and is generally accepted as safe, it is not a cure for lupus. It may only extend the time users of symptom-free and reduce the severity of symptoms when they occur.

4. Calcium is the nutrient most often missing in the diets of women who have lupus.

Nutritional surveys have found that most women who have lupus are calcium-deficient. The solution to a calcium deficiency is not necessarily to take calcium supplements, however. 

The body cannot absorb more than 400 mg of calcium at a time; taking a supplement that provides 1,000 mg per dose will only result in an increased tendency to constipation.

5. Exercise reduces joint inflammation in women who have lupus.

A study at the David Geffen School of Medicine at the University of California at Los Angeles found that women with lupus who don't get any exercise at all tend to have more joint pain and joint inflammation, and higher levels of a kind of HDL cholesterol that is associated with deteriorating joints, than women who get at least mild exercise on a regular basis. The level of exercise that seems to make a difference is 225 METS per week. This is the equivalent of walking at a moderate pace 15 minutes a day, 5 days a week.