Systemic Lupus Erythematosus (SLE)
Systemic lupus erythematosus, referred to as SLE or lupus, is a chronic autoimmune disease that causes inflammation, pain and swelling in various parts of the body and can damage many organs of the body.
In addition to affecting the skin and joints, it can affect other organs such as the kidneys, the tissue lining the lungs (pleura), the pericardium around the heart and the brain and often leads to inflammation of the blood vessels (vasculitis). Most patients feel fatigue and have rashes, arthritis (painful and swollen joints) and low-grade fever.
SLE is caused by antibodies produced in response to self-tissue which end up in cells in organs, where they damage those tissues. The cause of lupus is unknown but like other autoimmune diseases, most likely results from a combination of genetics and environmental factors, including chronic viral infections, toxic exposures and certain medications. Lupus usually starts in people in their 20s and 30s, affects women more than men and is more common in some ethnic groups.
Lupus flare-ups vary from mild to severe. Most patients have times when the disease is active, followed by times when the disease is inactive (remission).
Conventional Treatment of SLE
The types of medications used will depend on the severity of your symptoms and how long you’ve had lupus. There is no cure for lupus. The goal of conventional treatment is to decrease your symptoms and poor function.
- NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs) can relieve pain and reduce inflammation. Side effects may include ringing in your ears, stomach irritation, heart problems, liver and kidney damage.
- Steroids. Corticosteroid medications (steroids) reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, edema, weight gain and diabetes.
- Disease-modifying antirheumatic drugs (DMARDs). These drugs can decrease the symptoms of flare-ups and slow the progression of lupus by decreasing the rate of damage to organs and other tissues from the inflammation that occurs but they do this by suppressing the immune system. Side effects vary but may include fatigue, liver damage, bone marrow suppression and severe lung infections.
- Antimalarial drugs. Patients with lupus also may receive an antimalarial medication such as hydroxychloroquine (Plaquenil). These drugs help relieve some lupus symptoms, such as fatigue, rashes, joint pain or mouth sores. They also may help prevent abnormal blood clotting. Side effects include nausea, upset stomach, diarrhea and hair loss.
Functional Medicine Management of SLE
A comprehensive approach to the management of complex conditions such as autoimmune disease must take into consideration many aspects of health, including gut barrier integrity and imbalances of gut flora, liver detoxification capacity and toxic burden, hormone imbalances, energy production capacity, nutrient status and most importantly, immune imbalances which promote autoimmune states. More specifically, Functional Medicine approaches autoimmune disease by identifying the triggers and mediators of the autoimmune attacks, minimizing the self-destructive immune responses and enhancing the body’s ability to recover from flare-ups.
There are 4 areas of management of autoimmune conditions in the Functional Medicine approach:
- Identifying and avoiding the triggers of autoimmune responses
- Modulating the autoimmunity and reducing tissue destruction
- Enhancing and supporting recovery from flare-ups
- Addressing associated conditions that promote autoimmune responses
Identifying and avoiding the triggers of autoimmune responses
Lab testing is a critical first step in identifying the extent of systemic inflammation and ruling out many environmental insults which act as triggers and mediators of autoimmunity, such as chronic infection, heavy metal toxicity and decreased capacity to perform liver detoxification.
Food sensitivities can also promote inflammation and potentially drive autoimmune responses.
Identifying and addressing these issues is critical in autoimmune patients to minimize damage and promote restorative function.
Modulating the autoimmunity and reducing tissue destruction
Functional Medicine addresses diet and lifestyle issues as well as using anti-inflammatory and immune-modulating herbs and nutritional compounds to decrease immune responses to self-tissue.
Identifying the triggers of autoimmunity and modulating the immune response can have powerful long-term positive effects on slowing or stopping tissue destruction and improving quality of life.
Enhancing and supporting recovery from flare-ups
There are a number of natural compounds that help support a faster recovery by breaking down offending triggers, increasing blood flow to target tissue, and dampening the immune response.
Addressing associated conditions that promote autoimmune responses
Intestinal permeability promotes autoimmunity
There is growing evidence that increased intestinal permeability plays a pathogenic role in various autoimmune diseases. Increased intestinal permeability and compromised gut integrity appears to precede AI disease and predisposes to immune activation and chronic inflammation. Assessment and proper restoration of the integrity of the intestinal barrier is crucial in managing autoimmune conditions.
The following nutritional interventions are usually used:
Anti-inflammatory and immune-modulating compounds
Anti-inflammatory and immune-modulating herbs and nutritional compounds to decrease excessive immune responses can very often be helpful.
Nutrients to regenerate the epithelial lining
There are various plant compounds, vitamins and minerals that have been shown to have a restorative effect on a damaged intestinal barrier and a proper selection and regime can be very effective.
Nutrients to decrease food sensitivities
Food sensitivities are very common in people with autoimmune disease. Compounds that have been shown to decrease specific immune responses in the gut related to food sensitivity can be helpful.
There is growing evidence that increased intestinal permeability plays a pathogenic role in various autoimmune diseases. Identifying the existence of intestinal permeability and addressing this condition, leads to a more comprehensive and satisfactory outcome in the autoimmune patient.