Supplements and Lupus

Many people take supplements to add essential nutrients to their diet, hoping for potential health benefits.

People often try to add nutrients to their diet by taking them as supplements, separately from their food. Supplements can take the form of specially-formulated gummies, capsules of ground medicinal herbs or spices, or hard tablets.  In theory, they can help people make sure that they are taking in enough nutrients, or some sort of substance with health benefits. However, supplements are not always absorbed properly by the body and it is generally considered best to take in most nutrients through one’s diet. This is because nutrients often interact with each other when eaten together in their natural form, and that interaction itself may provide benefits to us in ways we don’t fully understand. Some supplements are, however, worth a second look.

Antioxidants

Antioxidants such as vitamin C, vitamin E, selenium, beta-carotene, lycopene, lutein, and zeaxanthin, protect cells from damage from oxidation. Oxidation is a chemical process that occurs in the body, when free radicals – unstable molecules – try to stabilize themselves by stealing electrons from some other molecule. This destabilizes that molecule in turn, and not only is it unable to do its job, but it needs to steal another electron to stabilize itself. This causes damage to many parts of your cells, even to the DNA! This is one of the weapons of the immune system, usually used against bacteria and virus-infected cells to kill them. But in autoimmune diseases like lupus, it is turned against the body. Antioxidants, on the other hand, have one or more electrons they can donate for free to these poor, unstable molecules, bringing them back to working order and preventing damage.

There is a lot of research that supports the idea that antioxidants are essential for health, and can even help prevent or reduce the symptoms of chronic disease. It is highly recommended that you take in antioxidants through your diet, but fortunately, antioxidants are one of the easiest nutrients to find! Foods rich in antioxidants include many fruits and vegetables (especially red, orange, or yellow fruits,) fresh fruit juices, and flours (especially buckwheat, millet, and barley.) These also have other nutrients that people with lupus need. But what about supplements?

There are a lot of antioxidant supplements out there, especially Vitamin C, also known as ascorbic acid, marketed to people with lupus. These can lead to very high intakes.

High doses of vitamin C might have many benefits for people with lupus, but it is not without harm. Some people have serious allergic reactions to citrus, an easy dietary source of vitamin C, and others have severe reactions to vitamin C supplements. Some other antioxidant supplements have undergone processing that causes them to have molecules that encourage oxidation damage, which are the opposite of antioxidants.

In short, the answer is that supplements (or IV antioxidants,) can be very useful for people with lupus, but should be monitored. It’s a good idea to make sure you are getting plenty of antioxidants through your diet anyway, which may interact with other vitamins and nutrients in the fruits and vegetables for better health effects.

Turmeric and Lupus

Turmeric is a bright orange root related to ginger that is dried, ground into powder, and used in many Indian and Middle Eastern foods. Curcurmin, a chemical compound found in turmeric (about 3.14% of ground turmeric,) has anti-inflammatory effects. To make sure they are getting curcurmin into their systems, some people take turmeric supplements in the form of capsules containing the ground powder. It isn’t a bad idea: In studies, using just the powdered turmeric as a supplement reduced proteinuria, hematuria, and systolic blood pressure in people with lupus. Like other supplements, the studies were inconclusive, and some people with lupus report that it made pre-existing heart problems worse (although it was not reported to have other side effects.) It can also be taken as an herbal tea.

Omega 3 Fatty Acids and Lupus

Fish oil is extracted from oily fish like salmon (or from krill and some algae,) as well as vegetables and oils like mustardseed oil and walnut oil, that is rich in ecosapentaenoic acid (EPA) and docosaheaenoic acid (DHA.) These are also known as Omega-3 fatty acids, and many of the diets that are good for lupus also have sources of these oils. Omega-3 fatty acids are important for people with lupus because they are turned into eicosanoids, which signal the immune system to turn itself down. These oils are anti-inflammatory, and some people try to make sure they take in enough omega-3 fatty acids by taking supplements.

Fish oil supplements have minor side effects,  typically to do with the fish oil itself, which can upset the stomach and cause “fishy breath.” Some people have more intense reactions, such as rashes and nosebleeds, though these are uncommon.

While many people take fish oil pills without issue, it is generally considered to be better to take in Omega-3 fatty acids as food and eating a high amount of foods rich in EPA and DHA. You can read more about Omega-3 fatty acids, here.

CBD, Food, and Lupus

Cannabidiol, or CBD oil, is an extract from the cannabis and hemp plants. It can be ingested as a supplement pill, as part of an edible, or added to foods. CBD does not cause a “high” and is being studied as a way to reduce symptoms of pain, reduced appetite, and inflammation in chronic diseases. CBD can have interactions with medications, or even trigger flares. It is also difficult to control the dosage when it is added to food. Ingest with care!

Probiotics and Lupus

Our gut is full of bacteria that help digest food, break down vitamins, produce vitamins, and even help regulate the immune system. This is called the “gut microbiome” and the bacteria involved are often referred to as “good bacteria.”

Probiotics are an infusion of “good bacteria” into the gut, usually by eating foods that are rich in these types of bacteria, but sometimes by ingesting supplement tablets designed to protect the bacteria from being digested. Probiotics can be potentially helpful for people with lupus, even potentially reducing inflammation in the kidneys. Lupus also may involve damage to the gut wall, which infusions of good bacteria may help to heal.

Foods that have probiotics include ferment foods like yogurt, miso (the main component of miso soup,) tempeh (fermented tofu,) and many pickles. Many of these fermented foods are also very healthy foods, a good addition to a balanced diet, and compatible with other non-inflammatory diets.

Calcium and Lupus

Calcium is important for both bone health and neurological function, and it gets more difficult to take in and use calcium as we get older. People with lupus are at higher risk for osteoporosis (bone weakness,) and should try to make sure they are getting enough calcium in their diet, which is important for bone health. Dairy foods, dark leafy greens, and broccoli are good sources of calcium, though there are also “fortified” foods that add calcium. Many people take calcium supplements to make sure that they are getting enough calcium, especially if they do not or cannot eat dairy.

Bone Broth and Lupus

Bone broth is a liquid made by boiling bones and connective tissue from cows, chicken, or fish with a bit of vinegar. It has a high concentration of collagen. Which is important for strengthening and protecting the bones, skin, hair, and joints of people. Bone broth also has some calcium, magnesium, phosphorus, iron, vitamin A, vitamin K, zinc, selenium, and manganese. Depending on how the bone broth is made and what ingredients go into it, it may have varying amounts of these nutrients. However, it’s not a bad idea for people with lupus to add bone broth to their diets.

Green Tea and Lupus

Green tea is a variety of tea where the tea is not withered or oxidized as it dries, maintaining much of the original chemical composition of the tea leaf (Camellia sinensis.) It has an active chemical, called EGCG which helps regulate the immune system, and L-theanine, which helps reduce stress. Drinking green tea is known to help with inflammation as well. Warm tea is very comforting and can help with congestion, but not everyone likes the taste of tea (or the caffeine). For people who don’t want to drink green tea, powdered green tea leaves (similarly to matcha powder,) can also be put into capsules and swallowed as a supplement. It is unknown if this has the same effects, but it is an available alternative!

Vitamin D

Vitamin D refers to the building block of a very important hormone that regulates the immune system, kidney function, nerve function, cell function, and bone health. One of the forms of Vitamin D is produced in the skin as a response to ultraviolet light (as from sunlight). But it can also be in the diet as oily fish, liver, egg yolks, and certain types of mushrooms. There are some foods that are fortified with vitamin D as well. 

Many people with lupus have a vitamin D deficiency, especially due to

• fatigue
• weather sensitivity
• photosensitivity 

that can be symptoms of lupus. And – though changing supplements or treatment plans should always be discussed with a doctor – it might not be a bad idea to take supplements or make sure that vitamin D-rich foods are present in your diet.

A Lupus Warrior’s Takeaway

The main concern with supplements is that they are not always well regulated. They can be contaminated with mis-identified herbs, heavy metals, and unknown chemicals. We also do not know much about the potential negative side effects of many supplements. Or even the true benefits of many supplements. Some supplements might also interact with lupus medications in unexpected ways. It’s important to talk to your doctor or treatment team about any major changes to your diet, including supplements.

However, for many people, their benefits, overall, outweighs the risk.