By Robin Wald


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J'Anna Padmore, a 31-year-old mother of two, swallows down a regimen of prednisone, Plaquenil and Tylenol every morning, along with a handful of vitamins. She lives daily with painful, achy muscles and bones and kidney problems that come and go at whim. Sarah McCormick, 51, suffers from debilitating fatigue, fibromyalgia, arthritis and loss of balance. Jennifer Davis, a 37 year-old database manager, experiences fatigue, arthritis, skin rashes, sun sensitivity and depression. What's the link? All of these women have Systemic Lupus Erythematosis (SLE) or just plain lupus.

Lupus is an inflammatory auto-immune disease that primarily affects women of reproductive age, in which the body's immune system attacks its own organs via "auto-antibodies." Symptoms flare-up and go into remission without warning and range from fatigue, hair loss, skin rashes, depression, cold extremities, arthritis and anemia to life-threatening kidney, heart and lung damage. Lupus is a disease that has no cure. According to JoAnn Quinn, executive director of the Long Island/Queens chapter of the Lupus Foundation of American, lupus affects 1 in 62 women of color - double the rate of one in 123 white women. Black women are at disproportionately high risk, with estimates as high as 1 in every 35 Black women being affected.

Good News and Bad News
The good news: "With early diagnosis, 80-90% of lupus patients live a normal life span," says Quinn, whereas a few decades ago, a lupus diagnosis was a premature death sentence. Lupus can be managed medically to make life with the disease more livable. Corticosteroids, non-steroidal anti-inflammatories, anti-malarial drugs, immuno-suppressive drugs, hormones and chemotherapeutic agents help keep the disease and its symptoms under control and may limit organ damage.

The bad news: Unfortunately, doctors often don't put all the pieces together to accurately diagnose a woman with lupus until many years into the illness, delaying treatment and potentially worsening complications. Once diagnosed, the treatment options aren't anything to jump for joy about either. The medications prescribed for lupus are accompanied by a laundry list of nasty side effects. Extended use of non-steroidal anti-inflammatories like ibuprofen and aspirin may cause liver toxicity, edema and stomach ulcers1. Corticosteroids like prednisone are linked with high cholesterol, heart disease, obesity and bone breakdown (osteonecrosis). Immuno-suppressive therapies increase thrombosis (blood clotting). Plaquenil, an anti-malarial drug, promotes retina damage and hair loss, while chemotherapy drugs like methotrexate cause liver damage and make you downright ill1. To make things worse, Black women have worse disease outcomes than women of other races and often benefit less from common drug therapies than white women.

The really good news -- A healthful diet and lifestyle, nutritional supplements, positive outlook and other safe "alternative" therapies may enable you to reduce your medication dosage, free yourself from some drug use altogether, and enhance your quality of life with lupus. (Caution: consult your doctor before altering doses or discontinuing any prescribed medications.)

1. Diet Dos and Don'ts
Pile your plate high with fresh fruit, vegetables, beans, legumes, whole grains, nuts and seeds - the high fiber, low fat foundation of a healthful diet. Dr. Sam Benjamin, M.D., director of the Center for Complementary and Alternative Medicine at University Hospital at Stony Brook in New York encourages women with lupus to eat as close to a vegetarian diet as possible. A high fat diet decreases immune system response and increases complications associated with lupus, and too much animal protein can stress your kidneys. Also to protect your kidneys: minimize salt, guzzle plenty of water, and lay off the caffeine and soda -- diuretics that cause your kidneys to lose fluid. Learn to curb your sweet tooth since sugar messes with your insulin, raises cholesterol and makes you fat (an unwanted side effect you already battle with if you're on steroids). Sugar, meat and dairy products also triggers inflammation and pain that can worsen arthritic symptoms, along with any foods to which you are allergic.

2. Vitamin E and Antioxidants
400 to 800 I.U. per day of vitamin E (alpha-tocopherol) protects against high cholesterol and heart disease, normalizes B and T cell immune responses and has natural anti-inflammatory effects. Studies in lupus mice show that vitamin E also reduces anti-DNA antibodies, proteinuria (a cause of nephritis), spleen and lymph node enlargement, and extends lupus survival time.

Other antioxidants that guard against tissue damage include selenium, glutathione, beta-carotene, vitamin C and Coenzyme Q10. A Johns Hopkins study found that vitamin E and beta-carotene levels are significantly lower in SLE and rheumatoid arthritis patients than in normal subjects. Dermatological problems and rheumatoid arthritis are also associated with depressed levels of glutathione peroxidase, vitamin C and selenium. Coenzyme Q10 boosts energy production and is especially protective of heart tissue (essential for anyone taking Lipitor). Doses: vitamin C 1-3 grams/day; selenium 200 micrograms/day; beta-carotene10,000 - 25,000 I.U./day); coenzyme Q10 30 mg/day.

3. Healthy Fats
Deep-fried Southern soul food isn't exactly the ideal picture of healthy fat. But salmon, tuna, mackerel, trout, flax seed oil, walnuts, currants and olive oil are. These foods are high in omega 3 and 6 essential fatty acids which lower heart disease, protect against lipid peroxidation and are naturally anti-inflammatory via their production of hormone-like chemical called PG3 prostaglandins. Researchers know that supplementation of EPA/DHA (fish oils), GLA and/or flax seed oil can induce clinical remission of lupus and lower titers of anti-DNA and anti-cardiolipin antibodies.

4. Natural Anti-inflammatories
Natural anti-inflammatories have the same benefits of non-steroidal anti-inflammatories minus the side effects. In addition to vitamin E and essential fatty acids, the spice tumeric is rich in anti-inflammatory curcuminoids, chemicals that inhibit cyclo-oxygenase. Bromelain is a plant enzyme derived from pineapple that aids digestion and reduces inflammation (dose: 500 mg with each meal). Glucosamine sulfate helps reduce arthritic pain and inflammation by regenerating healthy cartilage and joint tissue (dose: 500 - 2,000 mg/day).

5. Other Key Nutrients for Lupus
It's extra important for sisters with lupus to supplement with a good bone-building formula since steroids speed bone loss and minimized sun exposure and dark skin put you at risk of vitamin D deficiency. A suggested daily dose is 1000 mg of calcium and 400 I.U. of vitamin D. A B-complex multi-vitamin (10-100 mg of each B vitamin) boosts energy levels, safeguards normal blood production, and slashes your risk of stroke and heart disease. Folic acid, B12 and B6 (pyridoxal-5-phoshate) pack some serious punch against homocysteine, a chemical that's elevated above normal levels in 51% of SLE patients and seriously increases the risk of stroke.

6. Herb Story
While certain herbal medicines are healing for lupus others can be downright dangerous. Dandelion and parsley nourish the kidneys, nettles is a great iron source to ward off anemia, and Pau D'Arco may provide pain relief. Certain Chinese herbal medicines have immunosuppressive effects that improve clinical symptoms of arthritis, nephritis and skin rashes in lupus patients, while others raise interleukin-2 (IL-2) production. But beware: echinacea, goldenseal and astragalus can send your auto-immune response into a frenzy; ginseng and licorice raise blood pressure; and alfalfa may worsen arthritic pain17. The bottom line: Consult with a trained herbalist or Traditional Chinese Medicine practitioner who knows about lupus before self-prescribing herbs.

7. The Mind/Body/Stress/Energy Connection
"Mind-body medicine is the future of medicine and is the most important factor in healing," Dr. Benjamin expresses. One's outlook on life, optimism or pessimism, belief and stress levels have a huge impact on the immune system's response for healing. "Patient with lupus who are more stressed do worse and have higher antinuclear antibodies," cites Dr. Benjamin. Prayer, meditation, yoga, massage, acupuncture, chiropractic/osteopathic manipulation, homeopathy, chi gong, tai chi, Reiki, guided visual imagery, biofeedback and journal-writing are all practices that can make a huge difference in how lupus patients feel. "I put my stock in prayer and positive thinking," says Sarah who also practices tai chi and Reiki, two energetic healing therapies. "If our belief is strong enough that something will help, it probably will."

8. Relax!
Get plenty of sleep and rest so your body can repair itself. "It's hard to accept the fact that I need to rest and sleep even when I'm feeling OK. But I've learned that overdoing it brings on flares and I need to take care of myself without feeling guilty," explains Jennifer.

9. Exercise
"My attitude is jumpy about staying active and healthy," says J'Anne. She walks on the treadmill and does Tai Bo on days that she's feeling good. "But even when I'm in bed achy, I'll do my arm exercises in bed," she says. Moderate-intensity (a.k.a. don't overdo it!) cardiovascular and strength-training exercise create a healthy heart, strong muscles, upped metabolism and weight loss, lower blood pressure and a natural mood-boosting high.

10. Get the Support You Need
Living with lupus is stressful, and the better you cope, the better your disease outcome according to a Harvard study. Communicate with your health team, family, friends and employers to get the support you need when you're sick. You don't have to be superwoman- get your man, kids and sisters to pitch in with housework and other responsibilities. And take advantage of free local or on-line lupus support groups. "Talking with others who are facing what you are and truly understand what you're going through is great," says Sarah who belongs to Lupus Forum on-line and a support group in Sierra Vista, AZ that she started.

"Complementary medicine does not cure lupus but it can substantially decrease people's dependence on drugs," explains Dr. Benjamin. His advice: Try one thing at a time to figure out what helps you and what doesn't. Find the courage to speak up on your own behalf to demand the care you need. Find doctors who are supportive of your choice to pursue a variety of conventional and alternative therapies that may help you, and who give you the hope and optimism you deserve.

I would also like to add that along with the 1000mgs of calcium and 400 IU's of D, you will need to take at least 500mgs of magnesium to help the calcium and D absorb and the magnesium is a catalyst to all other vitamins and herbs you take. CB