Systemic lupus erythematosus (also known as SLE, or just lupus) is an autoimmune disease that primarily affects women of childbearing age. Its cause is unknown, but is believed to involve both genetic inheritance and factors in the environment. Whatever the cause, people with SLE develop antibodies against substances in their own bodies, including their DNA. These antibodies cause widespread damage and are believed to be primarily responsible for the many symptoms of this disease.
SLE may begin with such symptoms as fatigue, weight loss, fever, malaise, and loss of appetite. Other common early symptoms include muscle pain, joint pain, and facial rash. As SLE progresses, symptoms may develop in virtually every part of the body. Kidney damage is one of the most devastating effects of SLE, but many other serious problems may develop as well, including seizures, mental impairment, anemia, and inflammation of the heart, blood vessels, eyes, and digestive tract.
Conventional treatment for SLE revolves around a variety of anti-inflammatory drugs. In mild cases, taking nonsteroidal anti-inflammatory drugs (NSAIDs) may help; more severe forms of SLE require long-term use of corticosteroid anti-inflammatory drugs such as prednisone. The side effects of these medications can be quite serious themselves. So-called cytotoxic agents (azathioprine, cyclophosphamide, and chlorambucil) might also be helpful, but they have many side effects as well.
Close physician supervision is always required with lupus due to the risk of complications in so many organs.
A meaningful body of evidence tells us that the hormone dehydroepiandrosterone (DHEA) may be helpful for the treatment of lupus, when used as a part of a comprehensive, physician-directed treatment approach.
DHEA is the most abundant steroid hormone found in the bloodstream. Your body uses DHEA as the starting material for making the sex hormones testosterone and estrogen. DHEA has been tried as a treatment for a variety of medical conditions, including osteoporosis, but it is showing its greatest promise in the treatment of SLE.
A 12-month, double-blind, placebo-controlled trial of 381 women with mild or moderate lupus evaluated the effects of DHEA at a dose of 200 mg daily.1 Although many participants in both groups improved (the power of placebo is often amazing), DHEA was more effective than placebo, reducing many symptoms of the disease.
Similarly, in a double-blind, placebo-controlled study of 120 women with SLE, use of DHEA at a dose of 200 mg daily significantly decreased symptoms and reduced the frequency of disease flare-ups.18
A smaller study found equivocal evidence that a lower dose of DHEA (30 mg daily for women over 45, and 20 mg daily for women 45) might also work.20
Positive results were also seen in earlier, smaller studies.2,3
A 2007 review of all published studies concluded that use of DHEA may meaningfully improve quality of life in the short term for people with lupus, but that it probably does not alter the long-term course of the disease.21
For more information, including dosage and safety issues, see the full DHEA article.
Flaxseed contains lignans and alpha-linolenic acid, substances with a wide variety of effects in the body. In particular, flaxseed may antagonize the activity of a substance called platelet-activating factor (PAF) that plays a role in SLE kidney disease (lupus nephritis). Preliminary evidence suggests that flaxseed might help prevent or treat lupus nephritis.11,12
Fish oil contains omega-3 fatty acids, which have some anti-inflammatory effects. Fish oil has been found useful in rheumatoid arthritis, a disease related to SLE. The results of two small double-blind studies suggest that fish oil might be useful for SLE as well.13,19 However, current evidence suggests that fish oil is not effective for lupus nephritis.14,15
Other treatments sometimes recommended for SLE include beta-carotene, cordyceps, magnesium, selenium, vitamin B3, vitamin B12, vitamin E, pantothenic acid, and food allergen identification and avoidance. However, there is no meaningful evidence as yet that these treatments work for lupus.
Various herbs and supplements may interact adversely with drugs used to treat lupus. For more information on this potential risk, see the individual drug article in the Drug Interactions section of this database.
1. Mease PJ, Merrill JT, Lahita R, et al. GL701 (prasterone, dehydroepiandrosterone) improves or stabilizes disease activity in systemic lupus erythematosus. Presented at: The Endocrine Society’s 82nd Annual Meeting; Toronto, Canada; June 21-24, 2000.
2. van Vollenhoven RF, Morabito LM, Engleman EG, et al. Treatment of systemic lupus erythematosus with dehydroepiandrosterone: 50 patients treated up to 12 months. J Rheumatol. 1998;25:285-289.
3. van Vollenhoven RF, Park JL, Genovese MC, et al. A double-blind, placebo-controlled, clinical trial of dehydroepiandrosterone in severe systemic lupus erythematosus. Lupus. 1999;8:181-187.
4. Robinzon B, Cutulo M. Should dehydroepiandrosterone replacement therapy be provided with glucocorticoids? Rheumatology (Oxford). 1999;38:488-495.
5. van Vollenhoven RF, Park JL, Genovese MC, et al. A double-blind, placebo-controlled, clinical trial of dehydroepiandrosterone in severe systemic lupus erythematosus. Lupus. 1999;8:181-187.
11. Hall AV, Parbtani A, Clark WF, et al. Abrogation of MRL/lpr lupus nephritis by dietary flaxseed. Am J Kidney Dis. 1993;22:326-332.
12. Clark WF, Parbtani A, Huff MW, et al. Flaxseed: a potential treatment for lupus nephritis. Kidney Int. 1995;48:475-480.
13. Walton AJE, Snaith MJ, Locniskar M, et al. Dietary fish oil and the severity of symptoms in patients with systemic lupus erythematosus. Ann Rheum Dis. 1991;50:463-466.
14. Clark WF, Parbtani A, Naylor CD, et al. Fish oil in lupus nephritis: clinical findings and methodological implications. Kidney Int. 1993;44:75-86.
15. Clark WF, Parbtani A. Omega-3 fatty acid supplementation in clinical and experimental lupus nephritis. Am J Kidney Dis. 1994;23:644-647.
16. Roberts JL, Hayashi JA. Exacerbation of SLE associated with alfalfa ingestion [letter]. N Engl J Med. 1983;308:1361.
17. Malinow MR, Bardana EJ, Pirofsky B, et al. Systemic lupus erythematosus-like syndrome in monkeys fed alfalfa sprouts: role of a nonprotein amino acid. Science. 1982;216:415-417.
18. Chang DM, Lan JL, Lin HY, et al. Dehydroepiandrosterone treatment of women with mild-to-moderate systemic lupus erythematosus: A multicenter randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2002;46:2924-2927.
19. Duffy EM, Meenagh GK, McMillan SA, et al. The clinical effect of dietary supplementation with omega-3 fish oils and/or copper in systemic lupus erythematosus. J Rheumatol. 2004;31:1551.
20. Nordmark G, Bengtsson C, Larsson A, et al. Effects of dehydroepiandrosterone supplement on health-related quality of life in glucocorticoid treated female patients with systemic lupus erythematosus. Autoimmunity. 2005;38:531-40.
21. Crosbie D, Black C, McIntyre L, et al. Dehydroepiandrosterone for systemic lupus erythematosus. Cochrane Database Syst Rev. 2007;CD005114.
Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 12/15/2015
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