Systemic Lupus Erythematosus (SLE)

Compiled by John G. Connor, M.Ac., L.Ac., Edited by Barbara Connor, M.Ac., L.Ac.

TABLE OF CONTENTS
Introduction
Overview of Systemic Lupus Erythematosus (SLE)
Useful Nutrients and Herbs
Dietary Recommendations
Herbs and Foods To Avoid
Lifestyle Recommendations
References

INTRODUCTION

· Barbara and I see many patients with autoimmune conditions and get very good results treating them with a combination of acupuncturecraniosacral therapy, Chinese herbs, nutritional supplements and dietary recommendations.  By combining acupuncture with craniosacral therapy we are able to effect energetic and physiological mobilization, fluid exchange, improved delivery of nutrients and removal of metabolic waste products in the affected areas which helps your body to heal naturally.  The addition of specific herbs and supplements helps reduce the inflammation and rebuild damaged tissues without the harmful side effects of drugs.  The following article has been written to give you a better understanding of systemic lupus erythematosus and how we treat it.

OVERVIEW OF SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)
· Systemic lupus erythematosus, or SLE, is a multisystem autoimmune disorder without a known cure.  It is estimated to affect nearly 1 million Americans, primarily affecting women and arising mainly between the ages of 20-40.  The systemic disease includes production of antinuclear antibodies (ANA; mainly targeting the nucleic acid guanosine), generation of circulating immune complexes and activation of the complement system. (Dharmananda, 2001)

· SLE causes a characteristic rash accompanied by inflammation of connective tissue, particularly joints, throughout the body.  Kidney, lung and vascular damage are potential problems resulting from SLE.  The cause of SLE is unknown.  However, one theory ties the cause of SLE to a type of immune reaction known as Type III.  It is based on the fact that Type III (immune complex) reactions involve antigens, antibodies (IgA or IgM) and complement. When certain ratios of antigen to antibody occur, the complexes are small and escape phagocytosis. The complexes become trapped in the basement membrane under the endothelium of blood vessels, activate complement and cause an inflammation. Type III reactions include systemic lupus erythematosus (SLE), glomerulonephritis, and rheumatoid arthritis.

· According to Paul Pitchford, lupus is a direct result of excessive leukotrienes, which are released in the body by arachidonic acid.  Arachidonic acid causes production of PGE2 type prostaglandins–an excess of which can produce pain and inflammation and encourage blood to clot.  Leukotrienes act beneficially to heal wounds and injuries but in excess are thought to provoke breast lumps and inflammation.

· Antioxidant levels have been reported to be low in people with SLE. (Comstock et al, 1997)

· Free radicals are thought to promote SLE. (Nagata et al, 1995)

USEFUL NUTRIENTS AND HERBS

· Flaxseed has been investigated for the treatment or prevention of lupus nephritis with some promising results in preliminary animal trials. (Hall et al, 1993; Clark et al, 1995)

· A growing number of reports indicate that anti-inflammatory actions of fish oil (FO) are beneficial against systemic lupus erythematosus (SLE). (Halade et al 2013) Supplementation with EPA and DHA (omega-3 fatty acids found in fish oils) has prevented autoimmune lupus in animal research. (Kelley et al, 1985)  Caution:  If you do decide to try fish oil make sure you get one in which the mercury levels have been tested and they are shown to be low enough to be safe for long term consumption.

·  In a double-blind study, 20 grams of fish oil daily combined with a low fat diet led to improvement in 14 of 17 people with SLE in 12 weeks. (Walton et al, 1991)  Smaller amounts of fish oil have led to only temporary improvement in other double blind research.

·  Useful Chinese herbs include ching-hao, rehmannia, moutan and chin-chiu.  Ching-hao is reported to improve T-cell activities by promoting the suppressor cells (T-cells) so as to reduce the hyperactivation of the T-4 cells that promote the autoantibody production.  Chin-chiu is thought to provide a powerful anti-inflammatory action, thereby lowering the required dosage of prednisone (if it is being used).  (Dharmananda, 2001)

·  Another Chinese herb that has been shown to be beneficial in treating lupus is Tripterygium wilfordi.  It acts by suppressing immunity and acting as an anti-inflammatory agent. Because of potential side effects consult a health care practitioner experienced in Chinese herbal medicine before using this herb.  (Werbach & Murray, 1994) 

·  Consuming spirulina micro-algae, evening primrose oil, black currant oil and borage oil which are high in gamma-linolenic acid (GLA) can be helpful.  According to Paul Pitchford these foods are effective against inflammatory and auto-immune conditions.  Other sources of GLA include linoleic acid-rich foods such as nuts, seeds, grains, legumes, most vegetables and fruits.

DIETARY RECOMMENDATIONS
· There is an isolated case of someone with SLE improving significantly after the introduction of a vegetarian diet. (Shigemasa et al, 1992)
· In Japan, women who frequently ate fatty meats, such as beef and pork, were reported to be at higher risk for SLE compared with women eating little of these foods. (Minami et al, 1993)
· Consuming fewer calories, less fat, and foods low in phenylalanine and tyrosine (prevalent in high protein foods, such as meat and dairy) might be helpful. (Corman, 1985)

HERBS AND FOODS TO AVOID
· Avoid alfalfa seeds and sprouts because they contain the amino acid L-canavanine, which provokes a lupus-like condition in monkeys and possibly humans. (Roberts & Hayashi, 1983)
· Avoid the nightshade vegetables (peppers, eggplant, tomatoes, white potatoes).  These foods contain a substance called solanine, which can contribute to inflammation and pain.
· Get your iron from food sources, not supplements, as taking iron in supplements may contribute to pain, swelling and joint destruction.
· Use caution if taking immune enhancing herbs such as garlic, echinacea, Panax ginseng, andrographis and eleutherococcus.  These herbs could theoretically increase autoimmunity.
·    Avoid foods which are high in arachidonic acid such as animal meats, dairy, eggs, peanuts and nori seaweed.

LIFESTYLE RECOMMENDATIONS
·   Get plenty of rest and regular moderate exercise.
·   Avoid strong sunlight and use protection from the sun.  Go out in the sun only when absolutely necessary.
·   Avoid large groups of people and those with colds or other viral infections. 
·   Triggers for flare-ups include emotional distress and ultraviolet light exposure; infections may also serve as triggers.  . . .  Avoid using birth control pills as they may also cause lupus to flare up.
·   In preliminary research smoking has been linked to significantly increased risk of developing SLE. (Hardy et al, 1998)

REFERENCES
Balch, James F, M.D. & Balch, Phyllis A, C.N.C, Prescription for Nutritional Healing New York: Avery Publishing Group. 1997
Bratman, Steven, MD & Andrea M. Girman, MD MPH, Mosby’s Handbook of Herbs and Supplements and their Therapeutic Uses, St Louis: Mosby, 2003
Dharmananda, Subhuti, Ph.D., “A Bag of Pearls” Institute for Traditional Medicine, Portland, OR: 2002
Dharmananda, Subhuti, Ph.D., “Treatment of Systemic Lupus Erythematosis (SLE) with Chinese Herbs”, Institute for Traditional Medicine, Portland, OR: August 2001
Kirschmann, Gayla, J, Kirschmann, John D, Nutrition Almanac, New York: McGraw- Hill, 1996
Lininger, Schuyler W., Jr., DC, The Natural Pharmacy, Rocklin, CA: Healthnotes, Inc. 1999
Patavino, Tom, MS, DC & David M. Brady, DC, CCN, ND “Natural Medicine and Nutritional Therapy as an Alternative Treatment in Systemic Lupus Erythematosus” Alternative Medicine Review, Vol.6, No. 5, p. 460-471
Pitchford, Paul, Healing with Whole Foods, Berkeley: North Atlantic Books, 1993: 131-134
Werbach, Melvyn R., MD, Nutritional Influences on Illness, Tarzana, CA Third Line Press, 1996

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Compassionate Acupuncture and Healing Arts, providing craniosacral acupuncture, herbal and nutritional medicine in Durham, North Carolina. Phone number 919-309-7753.

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