Lupus Care and Management

Lupus is an autoimmune disorder characterized by systemic inflammation that can cause damage to the skin, blood, joints, kidneys, brain, heart, and lungs. There are several types of lupus including cutaneous (skin) lupus erythematous, drug-induced lupus, and neonatal lupus, but the most common is systemic lupus erythematosus, or SLE. Caring for and managing lupus can be complex and involve a number of different modalities, conventional and holistic. (Source)

In this article, we’ll explore how to care for and manage SLE through conventional and holistic approaches. Understanding how to care for yourself or a loved one, getting to the root causes, and being educated on how to prevent and manage symptoms are all important in supporting overall health with lupus. Let’s discover together how to weave conventional and holistic styles of medicine together to create an individualized approach to lupus treatment.

Conventional Treatment

Managing lupus conventionally can be done with a number of different medications that target specific symptoms. The symptoms you experience are bound to ebb and flow with flare-ups occurring then subsiding, and altering medications may be an option to meet your needs with lupus. Conventional medications may be helpful for managing symptoms, but they also carry the risk of side effects. The following medications are conventional treatments for lupus. 

NSAIDs

Nonsteroidal anti-inflammatory drugs, or NSAIDS for short, are a common over-the-counter option for lupus. Drugs in this category include naproxen sodium (Aleve), and ibuprofen (Advil and Motrin). Just as the name suggests, these medications work by reducing inflammatory symptoms associated with lupus, such as pain, fever, and swelling. If over-the-counter options are not strong enough to tackle symptoms, prescription NSAIDs are another option. Side effects of NSAIDS may include bleeding in the stomach, kidney problems, and an increased risk of cardiovascular issues. (Source)

Antimalarial drugs

Lupus is an autoimmune disease, and antimalarial drugs such as hydroxychloroquine (Plaquenil) are used to manage lupus flares by changing how the immune system responds to disease. By reducing rashes, pain in the muscles and joints, inflammation in the heart and lungs, fatigue, and fever, these drugs can also prevent lupus from spreading to major organs such as the kidneys, brain, and spinal cord. Antimalarial drugs can upset the stomach and long-term use may damage the retina, although this risk is low. (Source, Source)

Corticosteroids

Inflammation is a large part of lupus, but common steroid treatments such as prednisone and methylprednisolone, prescribed as intramuscular injections and topical medications, may help reduce inflammatory symptoms of swelling, pain, warmth, and tenderness. Corticosteroids may work quickly, but possible side effects are many and may include bruising, weight gain, bone thinning, high blood pressure, an increased susceptibility to infection, and risk of developing diabetes. High dosages and use of corticosteroids for an extended period of time increase the overall risk of experiencing these negative side effects. (Source, Source)

Immunosuppressants

Suppressing the immune system so it does not attack the body’s own tissues is an option for treating lupus, and immunosuppressants do just that. This category of drugs includes azathioprine (Imuran or Azasan), mycophenolate (Cellcept), methotrexate (Trexall and Xatmep), cyclosporine (Sandimmune, Neoral, Gengraf), leflunomide (Arava). Treating lupus with immunosuppressants may be necessary for more severe cases but may carry serious risks such as infertility, infection, liver damage, and cancer. (Source)

Biologics

Biologics, which are made from biological materials and are given via injection, may help reduce systemic symptoms associated with lupus. Studies have shown that not all biologics are effective in treating lupus symptoms, but they are being used more and more to decrease corticosteroid use and reduce the risk of developing the serious side effects that accompany long-term steroid use. Side effects of biologics may include nausea, diarrhea, and infections. In some cases depression may be worsened with the use of biologics, but the risk is considered low. (Source, Source)

Nutrition

Consuming a nutrient-rich diet of colorful and diverse whole foods can offer foundational support on your lupus journey. You may be able to reduce inflammatory symptoms and flare-ups, slow progression and disease activity, and manage your overall health with dietary modifications. These modifications involve avoiding foods that may trigger symptoms while prioritizing foods that reduce inflammation, balance blood sugar, and protect gut health. 

Anti-Inflammatory Foods

Understanding the role of inflammation in lupus is crucial, as it arises from the immune system mistakenly attacking its own healthy tissues, leading to excessive inflammation and the subsequent symptoms. Consuming a diverse array of fresh and colorful fruits and vegetables, healthy proteins such as fish, and fats like olive oil, may help reduce overall inflammation to manage lupus symptoms more effectively. It’s also important to avoid foods that may increase inflammation and disease progression, such as processed and fried foods high in fat and sugar. (Source)

Blood Sugar

Balanced blood sugar is important in managing inflammation. The typical Standard American Diet (SAD) in Western culture is high in processed foods that contain poor carbohydrate and fat sources with little protein, all factors that can spike blood sugar and cause inflammation. To avoid blood sugar highs and lows, prioritize foods that are nutrient-dense with a low glycemic index such as:

• broccoli
• leafy greens
• peppers
• apples
• lemons
• pears
• beans and legumes

(Source)

Gut Health

The gut microbiome is made up of varied organisms such as fungi, bacteria, and viruses. These organisms either contribute to a healthy immune system or take away from it. Research has shown that an imbalance in the gut microbiome known as dysbiosis, with higher levels of harmful bacteria and lower levels of beneficial microbes, is common in those with lupus. 

The gastrointestinal tract is home to the largest number of immune cells in the body, and poor gut health means poor immunity. Antibiotics, stress, inflammatory foods, and even some SLE medications can cause an imbalance in gut microbes. This dysbiosis can trigger gut inflammation that spreads throughout the body, causing uncomfortable symptoms. Good gut health can be supported with a steady diet of anti-inflammatory foods, good sleep, stress management, and reduced use of antibiotics. (Source)

Foods To Avoid

When managing lupus or any autoimmune condition, it’s essential to be mindful of foods and supplements that stimulate the immune system, as they can exacerbate symptoms. Though alfalfa sprouts, garlic, and echinacea are three generally healthy substances, they should be avoided with lupus due to their immune-stimulating properties. Small amounts aren’t likely to be harmful, but it’s best to avoid cooking and preparing foods with these ingredients. (Source)

Supplementation

Supplements can be great additions to an already nutrient-dense diet and healthy lifestyle, but it can be tough to sort through all the information out there. Working with a knowledgeable nutritional therapy practitioner could be exactly what you need to help manage lupus symptoms and flares with supplementation. The following supplements have been researched and proven effective in reducing inflammation in lupus.

Vitamin D

Research has shown vitamin D is essential for healthy immune function, and low levels of this critical nutrient have been linked to higher inflammation and disease activity in lupus. Vitamin D can be found in foods such as eggs and fatty fish, but many diets don’t provide enough vitamin D to support healthy inflammation levels and immune health, so supplementation may be necessary. Your vitamin D levels can be monitored through a simple blood test and it’s important to have your levels checked regularly. A health care professional can help you determine how much vitamin D you should take. (Source)

Omega-3 Fatty Acids

Inflammation is a major factor in autoimmune disorders in general, and omega-3 fatty acids may help to reduce overall inflammation in the body. Research has shown that consuming omega-3s could reduce the risk of cardiovascular disease, which is one of the leading causes of death in those with lupus. (Source)

Vitamin C

Reducing overall stress can be helpful in managing inflammation, and this is where vitamin C supplementation can play a part in your lupus care plan. Oxidative stress, which increases internal inflammation, can be greatly reduced with vitamin C supplementation. Foods high in vitamin C include broccoli, oranges, tangerine, and papaya. Studies have found that vitamin E also helps reduce inflammation, and vitamins C and E have increased anti-inflammatory effects when taken together. (Source)

Probiotics

Gut health plays a key role in autoimmune disease symptoms and progression, and probiotic supplementation can be a good addition for managing lupus. The gut microbiota can be altered with specific probiotic strains to increase beneficial bacteria while decreasing harmful bacteria. The use of targeted probiotics may be helpful in regulating immune system response and strengthening the gut microbiome overall to achieve better health with lupus. (Source)

Lifestyle

Living with a chronic disease like lupus can be challenging. While shifting lifestyle habits alone cannot cure lupus, habit changes can support your body to manage and reduce symptoms while preventing flare-ups. The following lifestyle factors, when consistently included in a regular routine, can improve quality of life with lupus. 

Sun Protection

Too much time in the sun can trigger symptoms for many people with lupus. Avoiding the sun between 10:00 a.m. and 4:00 p.m., the brightest and hottest hours of the day, could be an option. If it’s not possible to avoid sun exposure during this time, wear protective clothing with long sleeves and UV protection, utilize sunscreen that is 50 SPF or higher, and wear a hat. (Source)

Photosensitivity in lupus can occur with exposure to artificial lights, too. Although household and work site lights don’t emit high amounts of UV radiation, spending a lot of time indoors can add up to significant exposure. UV exposure from artificial lights, especially fluorescent bulbs, may be just as much of a trigger for those who are extra sensitive to light, and protective clothing may need to be worn indoors to prevent lupus symptoms and flare-ups. (Source, Source)

Mindful Movement

Exercising with lupus can be supportive on many levels, benefitting overall physical, social, and emotional health. Regular movement can balance inflammatory hormones to improve stiffness and range of motion, as well as regulate body composition. Lupus can weaken the heart, lungs, bones, and joints, but regular exercise can strengthen these crucial body parts. Regularly moving the body has also been shown to improve mental health by reducing fatigue, lifting mood and self-esteem, and managing stress. Low impact exercises such as yoga, walking, swimming, Pilates, tai chi, cycling, and water aerobics allow those with lupus to safely and comfortably engage in physical activity without compromising joint and bone health. (Source)

Sleep Hygiene

Your body needs sleep to recharge and refuel, repair and recover, conserve energy and storage, and maintain proper brain function. Sleep may seem like a simple process, but that isn’t always the case with lupus. Fatigue is one of the top symptoms of lupus and may be due in part to sleep disturbances caused by pain, mood disorders, and unmanaged stress. Some medications increase restlessness and agitation and may contribute to poor sleep as well. It’s possible to improve sleep hygiene by aiming for 7 to 9 hours per night, sticking to a consistent bedtime routine and schedule, reducing stress in daily life, getting regular exercise, and limiting or avoiding alcohol. (Source, Source, Source)

Stress Management

Living with a disease like lupus can affect stress by triggering symptoms or worsening what you are already dealing with. Learn to recognize triggers by noticing how you feel and the physical side effects you experience such as headaches, sleeping issues, or symptoms that may flare with stress. A constant state of stress can weaken the immune system and increase inflammation, and identifying triggers and navigating around or through them is crucial for managing overall stress. Consider working with a mental health therapist to create healthy boundaries and learn stress management techniques. (Source)

Make stress management a priority by practicing one or more relaxation techniques daily such as meditation, breathwork, yoga, or journaling. In addition, following a healthy sleep schedule, eating anti-inflammatory foods, and moving your body can all improve your quality of life with lupus. It’s essential to prioritize self-care and practice healthy coping mechanisms to help manage stress regularly and effectively, so it doesn’t become a chronic issue. (Source)

Prevent Flare-Ups

As with any autoimmune disease, a key piece in managing your condition is preventing flare-ups from occurring. Supporting your body with a solid foundation of consistently good nutrition, great rest, stress management, and appropriate exercise can reduce and prevent flare-ups by reducing disease triggers. It’s normal for symptoms to come and go with lupus, but noticing when symptoms start to creep up and understanding why it happens can help prevent these flare-ups from occurring time and again.

Lack of sleep can have a negative effect on mental health and elevate stress levels, undermining the protective benefits that rest provides. Reducing stress, both internally and externally, through mindful dietary choices, nurturing relationships, and physical activity, can help prevent frequent lupus flare-ups. Engaging in low-impact exercises tailored for individuals with lupus has been demonstrated to alleviate stress, thereby enhancing sleep quality. Better sleep, in turn, boosts mood and mental well-being, improving resilience against stress. Adopting healthy lifestyle practices is key to minimizing lupus flare-ups and promoting overall health. (Source) 

Recommended Care Team for Lupus

Managing and caring for yourself or a loved one with lupus requires a team that is knowledgeable and supportive in creating a comprehensive plan of individualized care to improve quality of life. Although the composition of the lupus care team will be unique to you or someone you love, the following may be integral members of that team. 

Primary Care Provider

Your primary care provider is likely to be the first point of contact once unusual symptoms begin. The primary provider may be responsible for diagnosing and monitoring symptoms and your overall condition, as well as offering support and recommendations for prescription medications to manage lupus and any coexisting health issues. 

Rheumatologist

A rheumatologist is a specialist in inflammatory diseases of the joints, muscles, and bones, making them an integral part of your lupus care team. They have specialized knowledge and experience in managing conditions like lupus and can collaborate with other providers as well to provide the care you need to manage your condition well.

Nutritionist or Dietitian

Proper nutrition is crucial for managing lupus. A nutritionist or registered dietitian can help manage your condition by providing individualized dietary advice that takes into account your specific needs and preferences, as well as identifying and targeting any nutrient deficiencies that may be contributing to the symptoms you are experiencing. 

Naturopath or Functional Medicine Doctor

Naturopathic medicine and functional medicine are two approaches to health care that focus on treating the root cause of health issues rather than just managing symptoms. In recent years these practices have become more popular, especially for people with autoimmune diseases. They focus on using food as a type of medicine and encouraging good health habits to help control the immune system and make life better for those with lupus. (Source)

Mental Health Practitioner

Living with a chronic condition such as lupus can take a toll on your mental health and make it difficult to manage stress. It’s essential to have access to a mental health professional, such as a therapist or psychologist, who can help you cope with the emotional and psychological challenges that may come with managing a chronic illness.

WellTheory’s Perspective and Approach

At WellTheory, we approach chronic illness and autoimmune disease by assessing the individual needs of each member within our community. With high-quality nutritional therapy and lifestyle approaches, we prioritize filling in the gaps in our members’ healing journeys to optimize whole-body health and well-being. This method of collaborative care empowers our members to lead their own health journeys, while our care team guides them in how they can effectively manage their condition.

WellTheory can provide one-on-one support and guidance to help you manage and thrive with lupus. At WellTheory, we offer functional lab testing that can serve as a valuable tool in your arsenal to provide more insight into the root causes of your symptoms while identifying nutritional deficiencies and imbalances. Lab testing supports our food-first approach and helps us understand your unique needs, so we can tailor and personalize our approach to your autoimmune condition. Bridge conventional medicine and holistic practices in the management of your autoimmune condition with a WellTheory membership. 

The Bottom Line

Utilizing a combination of conventional and holistic approaches can help manage lupus symptoms effectively. Along with any medications your health care provider may recommend, consuming anti-inflammatory foods and supplements, getting good rest, and avoiding dietary and environmental factors that trigger symptoms and flare-ups can help reduce SLE inflammation. It is possible to support your body daily with the resources it needs to thrive and improve quality of life with lupus long-term. Your lupus care plan is unique to you, and at WellTheory we approach every member as the individual they are. Let us help you and yours support and manage chronic disease like SLE with a solid foundation of dietary and lifestyle habits to optimize long term health success.