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  Lupus, SLE (Systemic Lupus Erythromatosis) / Risk  
 
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Systemic Lupus Erythematosus (SLE) is a chronic, potentially fatal autoimmune disease characterized by exacerbations and remissions with many clinical manifestations, and may mimic infectious mononucleosis, lymphoma or other systemic disease. SLE is a complex disorder resulting from the production of antibodies that attack the DNA and proteins within healthy cells and the generation of circulating immune complexes. The complications from this involve multiple organs and are potentially life-threatening. The hallmark of the disease is recurrent, widespread, and diverse vascular lesions. The idea that lupus is generally a fatal disease is one of the gravest misconceptions about this illness. In fact, the prognosis of lupus is much better today than ever before. It is true that medical science has not yet developed a method for curing lupus and some people do die from the disease. However, with current methods of therapy, deaths from lupus are uncommon, and 80-90% of people with lupus live more than 10 years after diagnosis.

There is clinical involvement of the joints, skin, kidney, brain, and membranes of the lung, heart and gastrointestinal tract. The symptoms are often vague, can be mild or severe and are often unrelated to lab tests. A patient can have many lupus symptoms in a lifetime. Women and non-Caucasians are disproportionately affected and SLE is most common in women of child-bearing age although it has been reported in all ages. The incidence is about 1 in 200 people in America.

Among children, SLE occurs three times more commonly in females than in males. In the 60% of SLE patients who experience onset between puberty and the fourth decade of life, the female to male ratio is 9:1. The disorder is three times more common in African American blacks than American Caucasians. SLE is also more common in Asians.

The cause of SLE remains unknown. A genetic predisposition, sex hormones, and environmental trigger(s) are strongly implicated in this disordered immune response. One of many suspected factors is a genetic mutation that disrupts the body's waste disposal mechanism in cells. The health status of a patient with SLE is related not only to disease activity, but also to the damage that results from recurrent episodes of disease flareups.

A tentative diagnosis can be made through examining a patient's medical history and performing a physical exam and screening tests (positive ANA). Once SLE is suspected, additional tests are valuable to confirm or rule it out. These include anti-double stranded DNA, anti-RNP, anti-Sm, anti-Ro, anti-La, C3, and C4. 30-70% of patients with SLE will be anti-DNA positive. 30% of patients with SLE will be anti-Sm positive. The presence of anti-double stranded DNA antibodies and low complement levels strongly suggests the diagnosis of lupus and identifies the patient at increase risk of kidney damage.

Treatment
The majority of lupus symptoms are due to inflammation and so the treatment is aimed at reducing that inflammation. There are four families of medications used in the treatment of lupus - Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, antimalarials, and cytotoxic drugs.

The treatment of infections in lupus patients is basically the same as for other patients. To prevent possible infections, patients at high risk of infection often benefit from taking antibiotics before dental treatment or surgical procedures. In general, individuals with lupus should avoid exposure to people with colds or other infections.
 

 
 

Signs, symptoms & indicators of Lupus, SLE (Systemic Lupus Erythromatosis) / Risk:
 
 
Lab Values - Cells  Elevated ESR or High ESR

Lab Values - Chemistries

  (Mildly/highly) elevated ANA levels

Counter-indicators:
  Normal ANA levels
 Any value less than 40 is considered a normal ANA level and called a negative test result. Normal levels of ANA virtually rule out active SLE. [Med Clin North Am 81(1): pp.113-28, Jan. 1997]

Symptoms - Environment

  Regular photosensitive rash
 Approximately 80% of patients with SLE have dermatological manifestations during the course of their illness. The acute skin eruption manifests itself as a photosensitive rash which often has a butterfly appearance and involves the bridge of the nose and cheeks. A feature of this rash is a sparing of the crease seen on the sides of the mouth when smiling. Photosensitivity is less common in patients of color but occurs in 50% of all patients with SLE.

Symptoms - General

  Constant fatigue
  Minor/major fatigue for over 3 months or major fatigue for over 12 months
 Prolonged or extreme fatigue is reported by 81% of lupus patients.

  Fatigue on light exertion
 90% of patients with SLE experience fatigue.

Symptoms - Head - Eyes/Ocular

  (High) sensitivity to bright light
 Sun or light sensitivity (photosensitivity) is experienced by 30% of sufferers.

Symptoms - Head - Mouth/Oral

  Aphthous ulcers
 Mouth or nose ulcers have been reported by between 12 and 30% of lupus patients, depending on the study. They most often occur in the mouth on the hard or soft palate but may also be found on the nasal septum.

Symptoms - Immune System

  History of infections
 Lupus patients have abnormalities in their immune systems that predispose them to develop infections.

  Postviral syndrome
 Infections in lupus patients tend to last longer and require a longer course of treatment with antibiotics than infections in people who do not have lupus.

Symptoms - Metabolic

  Having a moderate/having a slight/having a high fever
  Frequent/occasional unexplained fevers
 A less common but more serious constitutional feature of SLE is persistent fever.

  Unexplained fevers that hit hard or unexplained high fevers
 Fever of more than 100F (38C) is reported by 90% of lupus patients.

Symptoms - Muscular

  Tender muscles
 Muscle pains are a common symptom of SLE. Less common is actual muscle inflammation which occurs occasionally during the course of SLE.

Symptoms - Nervous

  Numb/tingling/burning extremities
 Connective tissue disorders such as systemic lupus erythematosus can cause peripheral neuropathy and lead to paresthesia. Paresthesia caused by peripheral neuropathy may be accompanied by pain.

Symptoms - Respiratory

  Chest pain when breathing or chest pain when breathing out or chest pain when breathing in
 Pain in the chest on deep breathing (pleurisy) is experienced by some 45% of lupus patients.

  (Frequent) sore throats
 Sore throat or pain on taking a deep breath may occur with a flare of lupus.

Symptoms - Skeletal

  Joint pain/swelling/stiffness
 Most patients with SLE have musculoskeletal symptoms. The typical clinical manifestations are arthralgia, reported by 95% of patients, and arthritis (swollen joints) by 90%. The joints most commonly involved are the index finger, wrist and knees. Lupus is rarely accompanied by actual joint erosion.

Symptoms - Skin - Conditions

  Rashes
 Skin rashes are reported by 74% of lupus sufferers.
 
 

Conditions that suggest Lupus, SLE (Systemic Lupus Erythromatosis) / Risk:
 
 
Autoimmune  Chronic Thyroiditis
 Approximately 10% of lupus patients have thyroid antibodies, and autoimmune thyroiditis occasionally coexists with SLE.

  Gluten Sensitivity / Celiac Disease

Circulation

  Anemia, Hemolytic
 Anemia as a result of chronic inflammation is a characteristic but not especially common feature of active SLE.

  Pericarditis
 Sometimes pericarditis may be a secondary symptom of lupus (systemic lupus erythematosus).

  Vasculitis
 In the vasculitis caused by lupus, the antigens causing the immune complexes are often not known. In some cases, the complexes contain DNA and anti-DNA antigens, or Ro (also called SS-A) and anti-Ro antigens. Another antibody, ANCA (anti-neutrophil cytoplasm antibody), can cause vasculitis in some individuals.

  Raynaud's Phenomenon
 Raynaudís phenomenon has been observed in 17-30% of patients with SLE, depending on the study.

  Bruising Susceptibility
  Atherosclerosis
 There is an increased incidence of atherosclerotic heart disease amongst patients with SLE.

Infections

  Cystitis, Bacterial Bladder Infection
 Infections of the urinary tract are common in lupus patients.

  Shingles (Herpes Zoster)
 Lupus patients are at an unusually high risk for contracting herpes zoster.

Inflammation

  Episcleritis

Lab Values

  Low Platelet Count
 Lupus is suggested if thrombocytopenia (a low platelet count of under 100,000 platelets per cubic millimeter) is detected in the absence of drugs that are known to induce it.

  Monocytes Elevated
  Low White Count
 Active lupus and an infection may share many symptoms. Further, infection can induce a lupus flare or be difficult to distinguish from a lupus flare. A low white blood cell count is suggestive of active lupus (although certain viruses can also give a low white count) while a high count suggests infection.

  Elevated Triglycerides

Metabolic

  Headaches, Migraine/Tension
 Vascular or migraine headaches occur in 10% of lupus patients.

Nervous System

  Seizure Disorder
 Seizures have been found to complicate the course in between 15-25% of patients with lupus, depending on the study quoted.

Nutrients

  EFA (Essential Fatty Acid) Type 3 Requirement
 There is a possible defect in the metabolism of essential fatty acids (EFAs) in systemic lupus erythematosus (SLE). In order to verify this possibility, doctors in one study measured the plasma levels of various EFAs and their metabolites in SLE. These results showed that amongst SLE patients the concentrations of Omega-6 and Omega-3 oils or metabolites were low. Even small doses of fish oils (which contain EPA and DHA) have been shown to help.

Organ Health

  Kidney Weakness / Disease
 Diverse kidney problems can arise from the deposition of circulating immune complexes in the kidneys. Lupus, being an auto-immune disease, causes the immune system to attack the body's own tissues. The commonly affected organs/tissues are skin, joints, nervous system and kidneys.

Respiratory

  Bronchitis, Acute
 Infections of the respiratory tract are common in lupus patients.

Skin-Hair-Nails

  Female Hair Loss
 Alopecia occurs in 27 to 50% of patients. Typically manifested as reversible hair thinning during periods of disease activity, it is demonstrated by the ease with which hair can be plucked from the scalp and the development of "lupus hairs" (i.e. short strands at the scalp line). Following an acute attack of SLE, usually with fever, patients may experience much generalized hair loss. This results from a period of arrested hair growth during the acute episode.

Symptoms - Immune System

  Lupus

Counter-indicators:
  Absence of lupus

Uro-Genital

  Vaginitis/Vaginal Infection
 Lupus patients are at an unusually high risk for contracting candida (yeast) infections.

  Susceptibility To Miscarriages
 The miscarriage rate in SLE patients is much higher than that of the general population. Although most women who suffer recurrent miscarriages do not have clinical signs of SLE, many exhibit autoimmune phenomena which is similar to that seen in SLE patients.
 
 

Risk factors for Lupus, SLE (Systemic Lupus Erythromatosis) / Risk:
 
 
Autoimmune  Autoimmune Tendency

Hormones

  Low Adrenal Function / Adrenal Insufficiency
 Lupus is one of the auto-immune diseases caused by a hyperactive ("hypervigilant") immune system that attacks a person's own protein as if it were foreign matter. One reason for this is poor adrenal function. Adrenal steroids modulate (slow down) the immune system: when there is not enough of these steroids the immune system goes berserk.

  Low DHEA Level
 Low blood levels of the hormone DHEA have been associated with more severe symptoms in people with SLE. Preliminary trials have suggested that 50 to 200mg per day DHEA improved symptoms in people with SLE. One double-blind trial of women with mild to moderate SLE found that 200mg of DHEA per day improved symptoms and allowed a greater decrease in prednisone use, but a similar trial in women with severe SLE found only insignificant benefits.

If the levels of DHEA-sulfate is less than 100ng/ml, consider supplementing first with oral DHEA. The dosage is 10 to 25mg in the morning and afternoon. For more severe disease, consider increasing the DHEA to 50mg twice daily with an upper limit of 300mg twice daily. The only side effects maybe facial hair and acne. These are much less severe if spirolactone, 50mg is prescribed one to three tablets twice daily. Some note improvement of acne with the herb Saw Palmetto 120mg twice daily also.

  Low HGH (Human Growth Hormone)
 Human growth hormone levels should be tested. Normal levels are greater than 200 MIU/ml but levels below 100 mIU/ml have been seen in many SLE patients.

  Low Testosterone Level, Female
 Findings in animal and human studies point to a defect in testosterone production in the affected female who suffers from lupus. Until we are able to change the genetic makeup of these individuals, the most promising therapy might be anabolic therapy with DHEA, testosterone and human growth hormone replacement. [Lupus Erythematosis (SLE) by Edward M. Lichten, M.D.]

Lab Values - Chemistries

  (Highly) elevated CRP level
 The concentration of C-reactive protein (CRP) in the sera of patients with systemic lupus erythematosus (SLE) was higher when the disease was active than when it was inactive, but was only markedly raised in patients suffering from identifiable microbial infection. CRP levels greater than 60mg/ml suggest the presence of intercurrent infection and may therefore be a valuable aid to the differential diagnosis of fever in SLE. [Annals of the Rheumatic Diseases. 39(1): pp.50-2, Feb. 1980]

Lab Values - Scans

  Having white matter lesions

Counter-indicators:
  Absence of white matter lesions

Personal Background

  Latin / Hispanic/African ethnicity
 It is not known why, but lupus occurs more often in certain ethnic groups. The incidence in Caucasians is approx. 1:1000. In African-Americans, the incidence is approx. 1:250.

Symptoms - Head - Mouth/Oral

  History of aphthous ulcers
 Mouth or nose ulcers have been reported by between 12 and 30% of lupus patients, depending on the study. They most often occur in the mouth on the hard or soft palate but may also be found on the nasal septum.

Symptoms - Immune System

  History of lupus
  History of postviral syndrome
 Infections in lupus patients tend to last longer and require a longer course of treatment with antibiotics than infections in people who do not have lupus.

  History of shingles
 Lupus patients are at an unusually high risk for contracting herpes zoster.

Symptoms - Metabolic

  Recent unexplained weight loss

Symptoms - Mind - General

  History of seizures
 Seizures have been found to complicate the course in between 15-25% of patients with lupus, depending on the study quoted.

Symptoms - Muscular

  History of tender muscles
 Muscle pains are a common symptom of SLE. Less common is actual muscle inflammation which occurs occasionally during the course of SLE.
 
 

Lupus, SLE (Systemic Lupus Erythromatosis) / Risk suggests the following may be present:
 
 
Autoimmune  Autoimmune Tendency

Circulation

  Atherosclerosis
 There is an increased incidence of atherosclerotic heart disease amongst patients with SLE.

Hormones

  Low Adrenal Function / Adrenal Insufficiency
 Lupus is one of the auto-immune diseases caused by a hyperactive ("hypervigilant") immune system that attacks a person's own protein as if it were foreign matter. One reason for this is poor adrenal function. Adrenal steroids modulate (slow down) the immune system: when there is not enough of these steroids the immune system goes berserk.

  Low HGH (Human Growth Hormone)
 Human growth hormone levels should be tested. Normal levels are greater than 200 MIU/ml but levels below 100 mIU/ml have been seen in many SLE patients.

  Low Testosterone Level, Female
 Findings in animal and human studies point to a defect in testosterone production in the affected female who suffers from lupus. Until we are able to change the genetic makeup of these individuals, the most promising therapy might be anabolic therapy with DHEA, testosterone and human growth hormone replacement. [Lupus Erythematosis (SLE) by Edward M. Lichten, M.D.]

  Low DHEA Level
 Low blood levels of the hormone DHEA have been associated with more severe symptoms in people with SLE. Preliminary trials have suggested that 50 to 200mg per day DHEA improved symptoms in people with SLE. One double-blind trial of women with mild to moderate SLE found that 200mg of DHEA per day improved symptoms and allowed a greater decrease in prednisone use, but a similar trial in women with severe SLE found only insignificant benefits.

If the levels of DHEA-sulfate is less than 100ng/ml, consider supplementing first with oral DHEA. The dosage is 10 to 25mg in the morning and afternoon. For more severe disease, consider increasing the DHEA to 50mg twice daily with an upper limit of 300mg twice daily. The only side effects maybe facial hair and acne. These are much less severe if spirolactone, 50mg is prescribed one to three tablets twice daily. Some note improvement of acne with the herb Saw Palmetto 120mg twice daily also.

Immunity

  Immune System Imbalance (TH2 Dominance)

Infections

  Yeast / Candida
 Lupus patients are at an unusually high risk for contracting candida (yeast) infections.

  Mycoplasma Infection
 
 

Lupus, SLE (Systemic Lupus Erythromatosis) / Risk can lead to:
 
 
Circulation  Anemia, Hemolytic
 Anemia as a result of chronic inflammation is a characteristic but not especially common feature of active SLE.

Inflammation

  Episcleritis

Lab Values

  Low White Count
 Active lupus and an infection may share many symptoms. Further, infection can induce a lupus flare or be difficult to distinguish from a lupus flare. A low white blood cell count is suggestive of active lupus (although certain viruses can also give a low white count) while a high count suggests infection.

Metabolic

  Headaches, Migraine/Tension
 Vascular or migraine headaches occur in 10% of lupus patients.

Organ Health

  Kidney Weakness / Disease
 Diverse kidney problems can arise from the deposition of circulating immune complexes in the kidneys. Lupus, being an auto-immune disease, causes the immune system to attack the body's own tissues. The commonly affected organs/tissues are skin, joints, nervous system and kidneys.
 
 

Lupus, SLE (Systemic Lupus Erythromatosis) / Risk could instead be:
 
 
Infections  Lyme Disease
 Lyme arthritis is often mistaken clinically for systemic lupus erythematosus.

Organ Health

  Retinitis Pigmentosa
 Systemic Lupus Erythematosus (SLE) is an autoimmune disease sometimes misdiagnosed as retinitis pigmentosa. [Am J Ophthalmol, 1996 Dec, 122:6, pp.903-5 Abstract]
 
 

Recommendations for Lupus, SLE (Systemic Lupus Erythromatosis) / Risk:
 
 
Amino Acid / ProteinNot recommended:
  Tryptophan / 5 HTP
 Some doctors caution against the use of tryptophan in patients with SLE. Because of abnormal tryptophan metabolism and the possibility of promoting auto-antibody production SLE patients should avoid supplementation with tryptophan or 5HTP unless determined to be tolerated by any particular patient.

Animal-based

  Thymic Factors
 Through his clinical experiences with thymic supplementation, Dr. Burgstiner said he observed 12 cases of systemic lupus go into remission. Some of the patients were using as many as 22 different drugs and are now diagnosed as asymptomatic.

  Urine Therapy
  Cetyl-myristoleate
 Some authors and practitioners believe that cetyl myristoleate may have the ability to normalize hyper-immune responses, thus producing the favorable results in such autoimmune conditions such as rheumatoid arthritis and systemic lupus erythematosus. However, it seems to function more effectively as a lubricant and an anti-inflammatory.

Botanical, Chinese

  Lei Gong Teng (Tripterygium wilfordii Hook F)
 In patients with lupus nephritis unresponsive to prednisone and other immunosuppressive drugs, combined administration of prednisone and TP (polyglycoside extract of Tripterygium wilfordii Hook F) resulted in reduction or even complete disappearance of protien in the urine in 40-50% of cases. Many side effects, however, have been reported. [Chin Med J (Taipei) 1996; 57: S35]

Diet

  Vegetarian/Vegan Diet
 Animal-based proteins (beef and milk) seem to be the prime offenders in aggravating the symptoms of Lupus. However, certain plant-based proteins appear also to be. These include soy beans, corn, spinach and carrots. [Scandinavian Journal of Gastroenterology 1982;17: pp.417-24]

Alfalfa sprouts and legumes, to a lesser extent, should also be avoided as the constituent L-canavanine causes SLE-like diseases in primates. [Acta Medica Scandinavica 1984;216: pp. 67-274] Peas and lima beans are alright to eat in this regard.

lupus flare-ups have also been reported after the ingestion of large amounts of foods containing psoralens (celery, celery salt, parsnips and figs).

  Therapeutic Fasting
  Gluten-free Diet
 A one-month trial period of avoiding dairy products and foods containing gluten/gliadin should indicate whether there is going to be any change in symptoms or lab values in individual patients. If there are improvements then these foods will need to be avoided on a permanent basis.

  Dairy Products Avoidance
  Raw Food Diet
 Some people with Lupus have reported much improvement, even testing negative for Lupus, after being on a raw food diet for many months.

Digestion

  Bromelain
 If there is kidney involvement, bromelain can be added as a cleansing agent. Flax oil or fish oil along with bromelain between meals is a good natural anti-inflammatory combination.

Drug

  LDN - Low Dose Naltrexone
  Conventional Drugs / Information
 Hydroxychloroquine (Plaquenil) is one of a number of drugs, like chloroquine or quinacrine, which have been used for many years in the treatment of malaria. It was discovered that these drugs often are helpful in the treatment of various rheumatic diseases, particularly systemic lupus erythematosus (SLE) and rheumatoid arthritis. Although chloroquine is sometimes used, the preferred antimalarial drug is hydroxychloroquine due to its greater safety. These can be used in combination also, sometimes with better success.

Environmental

  Chemical Avoidance
 Hair dyes contain high levels of hydrazines and other similar chemicals that are absorbed through the scalp, thus increasing the risk of contracting Lupus. [Am J Med 1983;75: pp.365-70] Hydrazines are also present in mushrooms, some food dyes, tobacco smoke and some cooked foods, especially meats.

Extract

  Diindolylmethane DIM / Indole 3 Carbinol IC3
 There is an acceleration of the testosterone to estradiol conversion by an increase in aromatase activity in healthy SLE patients when compared to controls. Interestingly, "among SLE patients the aromatase activity varied inversely with the disease activity. Patients with SLE had decreased androgen and increased estrogen levels. Aromatase activity in SLE patients had significant direct correlation with estrogen levels. These data suggest that abnormal regulation of aromatase activity may partially explain the abnormalities of estrogen synthesis in SLE." These patients are relatively testosterone deficient. [Lupus 1992;1(3): pp.191-5] Aromatase blockers like DIM (diindolylmethane) and Chrysin can be considered. Diindolylmethane (DIM) is a stable indole found in cruciferous vegetables

  Plant Sterols / Sterolins (Phytosterols)
 It is thought that the condition results from the uncontrolled activity of specific cells of the immune system leading to the production of auto-antibodies. It is these auto-antibodies that destroy healthy cells and organs. The body is literally attacking itself. Research indicates that the trigger for this attack may be caused by a virus or by an increase in stress.

Sterols and sterolins, by balancing the immune system, target the specific cells (the T cells) that can inhibit the formation of antibodies. These plant fats also increase the secretion of immune factors that activate killer cells to seek out and destroy the virus.

The link between stress and autoimmune disorders lies with the balance between cortisol (the stress hormone) and DHEA. An increase in stress leads to an increase in cortisol and a decrease in DHEA. High levels of cortisol cause immune cells to make more factors that lead to the production of autoantibodies. A balance between cortisol and DHEA is essential for optimum immune function.

Research has shown that sterols and sterolins lower cortisol levels in the body and normalize DHEA thus achieving a balance between these two hormones.

Hormone

  DHEA
 One hundred-twenty women with active SLE were randomly given 200mg per day of DHEA or placebo for 6 months. During the study, 18.3% of the patients in the DHEA group experienced a flare-up of their disease, compared with 33.9% of those in the placebo group. The incidence of disease flare-ups was 46% lower in the DHEA group than in the placebo group. No serious side effects were seen, but DHEA treatment increased testosterone levels and increased the incidence of acne.

In other conditions, DHEA is typically administered in much lower doses. But, it has not been demonstrated that lower doses will provide any benefit in SLE. [Arthritis Rheum 2002;46: pp.2924-2927]

Lab Tests/Rule-Outs

  Tests, General Diagnostic
 Diagnosing lupus can be a difficult and slow process. It may take months or even years for doctors to piece together the symptoms to diagnose this complex disease accurately.

No single test can determine whether a person has lupus, but several laboratory tests may help the doctor to make a diagnosis. The most useful tests identify certain autoantibodies often present in the blood of people with lupus. For example, the antinuclear antibody (ANA) test is commonly used to look for autoantibodies that react against components of the nucleus, or "command center," of the patientís own cells.

Most people with lupus test positive for ANA; however, there are a number of other causes of a positive ANA besides lupus, including infections, other rheumatic or immune diseases, and occasionally as a finding in normal healthy adults. The ANA test simply provides another clue for the doctor to consider in making a diagnosis.

In addition, there are blood tests for individual types of autoantibodies that are more specific to people with lupus, although not all people with lupus test positive for these and not all people with these antibodies have lupus. These antibodies include anti-DNA, anti-Sm, anti-RNP, anti-Ro (SSA), and anti-La (SSB). The doctor may use these antibody tests to help make a diagnosis of lupus.

  Hydrochloric Acid (Trial)
 Stomach acid levels are generally lower in patients with autoimmune diseases. Inadequate digestion can add to the immune system malfunction.

  Test for DHEA
 DHEA is almost always low in patients with autoimmune conditions such as SLE.

One of the first medical publications to report the beneficial effects of anabolic steroids on Lupus erythematosis was performed at Stanford University Medical Center under the direction of JL McGuire, M.D. He reported in 1995 that DHEA, an over-the-counter hormone, was able to decrease proteinuria and fatigue symptoms in female lupus patients. [J Rheumatology 1998:25(12): pp.2352-6] In a follow-up study in by his associate van Vollenhoven [J Rheumatology 1998;25(2): pp.285-9], they confirmed the beneficial effects of DHEA in both premenopausal and menopausal women followed for one year.

Van Vollenhoven reported that "the weakly androgenic adrenal steroid dehydro- epiandrosterone (DHEA) raised not only DHEA and DHEA-S levels, but also the level of testosterone. His patients showed a decrease in disease activity measured by the SLE Disease Activity Index score, patient global assessment and physician global assessment over the entire year. Other than mild acne, there were no complaints.

Mineral

  MSM (Methyl Sulfonyl Methane)
 "MSM has been shown to be clinically helpful in lupus and may be beneficial in other autoimmune disorders as well." [Stanley W. Jacob, M.D.] However, some Lupus patients have reported an intolerance to MSM, so caution is advised. Please discontinue use if any negative reaction occurs.

  Calcium-2AEP
  Colloidal Silver

Nutrient

  TMG (Tri-methyl-glycine) / SAMe
  Essential Fatty Acids
 Flax seed oil and/or fish oil have been shown to reduce the severity of the disease in animal studies. One tablespoon flax seed oil bid is recommended.

Vitamins

  Vitamin B6 (Pyridoxine)
 Vitamin B6 at a dosage of 500mg tid causes some patients to feel better. Side effects such as pain, numbness and weakness in the limbs are a possibility at this dose. If found to be beneficial, supplementation may need to be long term or permanent.

  Vitamin D
 See the link between Autoimmune Tendency and Vitamin D.
 
 


KEY
Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Strongly counter-indicative
Very strongly or absolutely counter-indicative
May do some good
Likely to help
Highly recommended
May have adverse consequences







GLOSSARY

Acne:  A chronic skin disorder due to inflammation of hair follicles and sebaceous glands (secretion glands in the skin).

Acute:  An illness or symptom of sudden onset, which generally has a short duration.

Alopecia:  Loss of hair.

Anabolic:  Anabolic compounds: Allow the conversion of nutritive material into complex living matter in the constructive metabolism.

Anemia:  A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.

Antibody:  A type of serum protein (globulin) synthesized by white blood cells of the lymphoid type in response to an antigenic (foreign substance) stimulus. Antibodies are complex substances formed to neutralize or destroy these antigens in the blood. Antibody activity normally fights infection but can be damaging in allergies and a group of diseases that are called autoimmune diseases.

Antigen:  A substance, usually protein or protein-sugar complex in nature, which, being foreign to the bloodstream or tissues of an animal, stimulates the formation of specific blood serum antibodies and white blood cell activity. Re-exposure to similar antigen will reactivate the white blood cells and antibody programmed against this specific antigen.

Anti-inflammatory:  Reducing inflammation by acting on body mechanisms, without directly acting on the cause of inflammation, e.g., glucocorticoids, aspirin.

Arthralgia:  Severe throbbing or stabbing pain along a nerve in one or more joints.

Arthritis:  Inflammation of a joint, usually accompanied by pain, swelling, and stiffness, and resulting from infection, trauma, degenerative changes, metabolic disturbances, or other causes. It occurs in various forms, such as bacterial arthritis, osteoarthritis, or rheumatoid arthritis. Osteoarthritis, the most common form, is characterized by a gradual loss of cartilage and often an overgrowth of bone at the joints.

Autoimmune Disease:  One of a large group of diseases in which the immune system turns against the body's own cells, tissues and organs, leading to chronic and often deadly conditions. Examples include multiple sclerosis, rheumatoid arthritis, systemic lupus, Bright's disease and diabetes.

Candidiasis:  Infection of the skin or mucous membrane with any species of candida, usually Candida albicans. The infection is usually localized to the skin, nails, mouth, vagina, bronchi, or lungs, but may invade the bloodstream. It is a common inhabitant of the GI tract, only becoming a problem when it multiplies excessively and invades local tissues. Growth is encouraged by a weakened immune system, as in AIDS, or with the prolonged administration of antibiotics. Vaginal symptoms include itching in the genital area, pain when urinating, and a thick odorless vaginal discharge.

Chronic:  Usually Chronic illness: Illness extending over a long period of time.

CRP:  C-reactive protein. A sensitive measure of inflammation in the body.

Cytoplasm:  The inner substance of a cell contained within the cell membrane other than the nucleus.

Cytotoxic:  A compound that produces a toxic effect on cells.

DHA:  Docosahexanoic Acid. A metabolite of the omega-3 fatty acid alpha-linolenic acid.

DHEA:  Dehydroepiandrosterone (DHEA) is a steroid produced by the adrenal glands and is the most abundant one found in humans. DHEA may be transformed into testosterone, estrogen or other steroids. It is found in the body as DHEA or in the sulfated form known as DHEA-S. One form is converted into the other as needed.

DNA:  Deoxyribonucleic acid, the large molecule that is the main carrier of genetic information in cells. DNA is found mainly in the chromosomes of cells.

EPA:  Environmental Protection Agency. Also: Eicosapentanoic Acid. A metabolite of the omega-3 fatty acid alpha-linolenic acid.

Essential Fatty Acid:  (EFA): A substance that the human body cannot manufacture and therefore must be supplied in the diet.

Gastrointestinal:  Pertaining to the stomach, small and large intestines, colon, rectum, liver, pancreas, and gallbladder.

Herbs:  Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with one teaspoon herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Tinctures may be used singly or in combination as noted. The high doses of single herbs suggested may be best taken as dried extracts (in capsules), although tinctures (60 drops four times per day) and teas (4 to 6 cups per day) may also be used.

Hormones:  Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.

Immune System:  A complex that protects the body from disease organisms and other foreign bodies. The system includes the humoral immune response and the cell-mediated response. The immune system also protects the body from invasion by making local barriers and inflammation.

Lymphoma:  Any tumor of the lymphatic tissues.

Metabolism:  The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.

Metabolite:  Any product (foodstuff, intermediate, waste product) of metabolism.

Migraine:  Not just a headache, but a disorder affecting the whole body, characterized by clearly defined attacks lasting from about 4 to 72 hours, separated by headache-free periods; progresses through five distinct phases. Prodrome: experienced by about 50% of migraineurs and starting up to 24 hours before the headache - changes in mood, sensory perception, food craving, excessive yawning, or speech or memory problems. Aura: experienced by about 15% and starting within an hour before the headache - disruption of vision (flashing lights, shimmering zigzag lines, blind spot) or sensation (numbness or 'pins and needles' around the lips or hand), or difficulty speaking. Headache: usually pulsating and occurring on one side of the head, it may occur on both sides of the head and alternate from side to side. Muscles in the neck and scalp may be tender; there may be nausea and the desire not to eat, move, see or hear. Resolution: the headache disappears and the body returns to normal. Resolution may occur over several hours during sleep or rest; an intense emotional experience or vomiting may also end the headache. Postdrome: After the headache stops, the sufferer feels drained, fatigued and tired. Muscles ache, emotions are volatile and thinking is slow.

Milligram:  (mg): 1/1,000 of a gram by weight.

Millimeter:  (mm): A metric unit of length equaling one thousandth of a meter, or one tenth of a centimeter. There are 25.4 millimeters in one inch.

Mononucleosis:  An acute, infectious disease caused by the herpes virus, Epstein-Barr virus, with fever and inflamed swelling of the lymph nodes around the neck, under the arms, and in the groin.

Nervous System:  A system in the body that is comprised of the brain, spinal cord, nerves, ganglia and parts of the receptor organs that receive and interpret stimuli and transmit impulses to effector organs.

Neuropathy:  A group of symptoms caused by abnormalities in motor or sensory nerves. Symptoms include tingling or numbness in hands or feet followed by gradual, progressive muscular weakness.

ng:  Nanogram: 0.000000001 or a billionth of a gram.

NSAID:  Non-steroidal anti-inflammatory drug.

Paresthesia:  A skin sensation, such as burning, prickling, itching, or tingling, with no apparent physical cause.

Protein:  Compounds composed of hydrogen, oxygen, and nitrogen present in the body and in foods that form complex combinations of amino acids. Protein is essential for life and is used for growth and repair. Foods that supply the body with protein include animal products, grains, legumes, and vegetables. Proteins from animal sources contain the essential amino acids. Proteins are changed to amino acids in the body.

Seizure:  While there are over 40 types of seizure, most are classed as either partial seizures which occur when the excessive electrical activity in the brain is limited to one area or generalized seizures which occur when the excessive electrical activity in the brain encompasses the entire organ. Although there is a wide range of signs, they mainly include such things as falling to the ground; muscle stiffening; jerking and twitching; loss of consciousness; an empty stare; rapid chewing/blinking/breathing. Usually lasting from between a couple of seconds and several minutes, recovery may be immediate or take up to several days.

Shingles:  A severe infection caused by the Varicella-Zoster virus (VZV), affecting mainly adults. It causes painful skin blisters that follow the underlying route of brain or spinal nerves infected by the virus. Also know as herpes zoster.

Steroid:  Any of a large number of hormonal substances with a similar basic chemical structure containing a 17-carbon 14-ring system and including the sterols and various hormones and glycosides.

Testosterone:  The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In men, the testicles continue to produce testosterone throughout life, though there is some decline with age. A naturally occurring androgenic hormone.

Thrombocytopenia:  Condition of abnormally small number of platelets circulating in the blood, characterized by inability to properly clot blood and easy bruising.

Thyroid:  Thyroid Gland: An organ with many veins. It is at the front of the neck. It is essential to normal body growth in infancy and childhood. It releases thyroid hormones - iodine-containing compounds that increase the rate of metabolism, affect body temperature, regulate protein, fat, and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor.

Ulcer:  Lesion on the skin or mucous membrane.

Vasculitis:  Inflammation and necrosis of blood vessels, including arteries, veins and capillaries. The damage may be due to infectious agents, mechanical trauma, radiation or toxins; often no specific causative factor is identified. It involves immune mechanisms such as deposition of circulating immune complexes and direct attack by circulating antibodies

Virus:  Any of a vast group of minute structures composed of a protein coat and a core of DNA and/or RNA that reproduces in the cells of the infected host. Capable of infecting all animals and plants, causing devastating disease in immunocompromised individuals. Viruses are not affected by antibiotics, and are completely dependent upon the cells of the infected host for the ability to reproduce.

White Blood Cell:  (WBC): A blood cell that does not contain hemoglobin: a blood corpuscle responsible for maintaining the body's immune surveillance system against invasion by foreign substances such as viruses or bacteria. White cells become specifically programmed against foreign invaders and work to inactivate and rid the body of a foreign substance. Also known as a leukocyte.

Yeast:  A single-cell organism that may cause infection in the mouth, vagina, gastrointestinal tract, and any or all bodily parts. Common yeast infections include candidiasis and thrush.