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Lupus

Nutritional influences on Lupus

07/07/2000

Question:

I have SLE, diagnosed early 1999. I am a phsically active person who keeps fit(condition allowing), maintains a healthy diet and generally I look after myself. I take Prednesilone 15mg/day, Plaquenil 200mg/day and 1/2 Asprin a day (due to the anticoagulant/anticardiolipin antibodies present). At this stage I have had no thrombotic problems. In a paper by Melvyn R. Werbach MD I read that the amino acids "phenylalanine" and "tyrosine" appear to aggrivate the disease, with both of these aa`s being present in beef and dairy products. I do not eat a lot of red meat as I source Iron elsewhere. However over the last year since starting on steroids I have increased my Dairy intake significantly, as I am concerned about reducing bone density mass with long term steroid use. My questions are: What do you know about the relation of Lupus and these aa`s? If these studies are correct, do Calcium supplements provide enough and work well enough in maintaining good bone health? I would appreciate any comments, thanks.

Answer:

There is no well-defined relationship between nutrition and flares of SLE. Most of the studies that have examined this relationship have been performed in mice that are genetically susceptible to develop lupus that is quite similar, but not identical, to human disease. In these mice, fasting or low fat diet improves disease. Feeding certain fish oil and omega 3 fatty acids suppress disease in these mice. However, studies in patients are not conclusive. In certain diseases that are similar to SLE in some respects such as rheumatoid arthritis, certain diets such as meat products seemed to worsen disease in some patients. This is a long answer for `I don`t know`. In general, I tend to recommend my patients eat good balanced healthy diet, eat lots of fruits and vegetables, and less of meat and fatty fried meals. Smoking has been suggested to increase some antibodies such as antinuclear antibodies that you have, and also some symptoms of lupus. I have not seen the particular paper by Melvyn R Werbach that you mention. I have also not come across any such definitive study that explores the role of these amino acids. You may also contact your local or national Lupus Foundation of America or Arthritis Foundation support group office. They have information brochure on all kinds of issues related to this disease.

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Response by:

Ram Raj   Singh, MD Ram Raj Singh, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati