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Wednesday, December 11, 2013
Will diet/exercise change reduce SLE symptoms
I`m 23 years old and was diagnosed with SLE when I was 16, due to the fact that I met several criteria, including a positive ANA and anti-Sm test. Until now, my symptoms generally were minor-- fevers, fatigue, muscle aches, and insomnia. I take 10mg prednisone daily. Today I was diagnosed with my first "complication" of sorts-- strange bruise-like speckles on my legs that were identified as erythema nodosum. This has scared me a bit, and I wonder two things: First, are there any foods/ingredients I should include or exclude from my diet in order to prevent future flares like the one I have now? Second, what is the best type of exercise recommended for lupus patients that is not too strenuous for a fatigued person like me? Basically, I would like to know if I can make any changes in diet or exercise in order to prevent future erythema nodosa and reduce my other SLE symptoms as well. I plan on asking my rheumatologist these questions, but I would like an answer from you as sort of a second opinion. Thank you in advance!
There is no well-defined relationship between diet 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 a good 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. The other things that you may do to prevent flares is avoid intense sun exposure, may wear long-sleeved clothing and large brimmed hats, and going outdoors only during early morning or evening hours. If you have to go out in sun, liberally use sunscreens. You may also like to modify your work area/desk a little bit - avoid sunlight from the window or even overhead fluorescent light, if you are photosenstive. Many patients who have lupus are prone to getting more infections. So, if you have an unexplained fever, you need to call your Doctor. You may also try to avoid situations that can expose you to infections. Pregnancy and birth control issues are also very important, and need to be discussed with your lupus Doctor. 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.
Ram Raj Singh, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati