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The word Paleo means ancient or older. The Paleo diet, as its name states, is a diet based around focusing on foods that have been eaten by humans for thousands of years during their evolution. Foods that existed before the introduction of agriculture. These foods are fresh and free of any added preservatives, mainly consisting of vegetables and meats. Paleo advocates claim that this way of eating can improve all aspects of your health, including your weight, reduction of disease activity and prevention of some chronic diseases like heart disease and type 2 diabetes. The Paleo diet provides that we should be eating what heals and supports our immune system. This diet includes diet the following diet recommendations as shown in the above graphic:

Another recent development is the shift regarding omega-3 fatty acids, which were believed to be beneficial in patients with lupus by decreasing inflammation. “We showed that omega-3 did not affect disease activity, improve endothelial function, or reduce inflammatory markers, though there was evidence that omega-3 may increase [low-density lipoprotein] LDL cholesterol,” said Dr Stojan. “We no longer recommend omega-3 supplementation in lupus patients.”
Patient global assessment (PGA) is one of the most widely used PROs in RA practice and research and is included in several composite scores such as the 28-joint Disease Activity Score (DAS28). PGA is often assessed by a single question with a 0–10 or 0–100 response. The content can vary and relates either to global health (e.g., how is your health overall) or to disease activity (e.g., how active is your arthritis).

The rate of SLE varies between countries, ethnicity, and sex, and changes over time.[95] In the United States, one estimate of the rate of SLE is 53 per 100,000;[95] other estimates range from 322,000 to over 1 million.[96] In Northern Europe the rate is about 40 per 100,000 people.[97] SLE occurs more frequently and with greater severity among those of non-European descent.[96] That rate has been found to be as high as 159 per 100,000 among those of Afro-Caribbean descent.[95] Childhood-onset systemic lupus erythematosus generally presents between the ages of 3 and 15 and is four times more common in girls.[98]
  According to the Mayo Clinic, “People with lupus should eat plenty of fruits, vegetables and whole grains. These foods are rich in vitamins, minerals and essential nutrients that benefit overall health and can help prevent high blood pressure, heart disease, kidney disease, cancer and digestive disorders. Plant-based diets also support a healthy weight because they are naturally low in calories, fat and cholesterol. Fruits and vegetables are particularly high in antioxidants. Antioxidants protect the body by destroying harmful substances that damage cells and tissue and cause heart disease and cancer.” Take a look at our blog, Lupus: the Diet Dilemma for some great tips. While these diets, or eating plans, may have some merit, individual foods should not be the focus. Pay attention to your overall pattern of nutrition. Reducing inflammation is not just about what you eat.  Patients should also know that these diets are never meant to be a replacement for the lupus treatments they may already be taking under the close supervision of a medical professional. Until more research is in on the effectiveness of these diets, be practical by getting enough sleep and exercise, and try to maintain a healthy weight. Back to top
Lupus is diagnosed when a person has several features of the disease (including symptoms, findings on examination, and blood test abnormalities). The American College of Rheumatology has devised criteria to assist doctors in making the correct diagnosis of lupus. A person should have at least four of the following 11 criteria, either at the same time or one after the other, to be classified as having lupus. These criteria include:
The rate of SLE varies between countries, ethnicity, and sex, and changes over time.[95] In the United States, one estimate of the rate of SLE is 53 per 100,000;[95] other estimates range from 322,000 to over 1 million.[96] In Northern Europe the rate is about 40 per 100,000 people.[97] SLE occurs more frequently and with greater severity among those of non-European descent.[96] That rate has been found to be as high as 159 per 100,000 among those of Afro-Caribbean descent.[95] Childhood-onset systemic lupus erythematosus generally presents between the ages of 3 and 15 and is four times more common in girls.[98]
Make sure that you are drinking sufficient liquid, which may include water, coffee, tea, rooibos, fruit juice, cold drinks and moderate quantities of beer or wine. You need three litres or 10 x 300 ml cups of liquid a day in total. This does NOT mean that you should drink all your regular beverages and then add another extra three litres of water. Remember 10 cups/glasses of LIQUID a day are sufficient.

While no single test can determine whether a person has lupus, several laboratory tests may help the doctor confirm a diagnosis, or at least rule out other ailments. The most useful tests identify certain autoantibodies that are often present in the blood of lupus patients. A biopsy of the skin or kidneys may also be ordered if those organs are affected. The doctor will look at the entire picture – medical history, symptoms, and test results – to determine if you have lupus.  Other laboratory tests are used to monitor the progress of the disease once it has been diagnosed.


Everett adds that eating fish for protein is particularly good. Fish — especially salmon, tuna, and mackerel — contain omega-3 fatty acids, which are important because they help fight inflammation, she says. Omega-3s, which are also available as supplements, may decrease your risk for heart disease. This may be especially important for women with lupus because they have at least double the risk of heart disease compared with women who don't have lupus, according to a review of studies published in August 2013 in Seminars in Arthritis and Rheumatism. “Lupus is an independent risk factor for heart disease, so you should maintain a heart-healthy diet that helps fight inflammation and keeps you at a healthy weight," Everett says.
EULAR recommendations for the management of SLE with neuropsychiatric manifestations support the evaluation and treatment of these symptoms in the same way as they are evaluated and treated in patients without SLE; if symptoms persist, management of these symptoms as an extension of SLE should be considered. [83, 61] For example, in patients with neuropsychiatric manifestations that may have an inflammatory etiology, immunosuppressive agents may be considered. [61]
We conducted a systematic evidence-based review of the published literature on systemic lupus erythematosus. After searching several evidence-based databases (Table 1), we reviewed the MEDLINE database using the PubMed search engine. Search terms included “lupus not discoid not review not case” and “lupus and treatment and mortality,” with the following limits: 1996 to present, abstract available, human, and English language. One author reviewed qualifying studies for relevance and method.

Nitrogen in the blood in the form of urea, the metabolic product of the breakdown of amino acids used for energy production. The normal concentration is about 8 to 18 mg/dL. The level of urea in the blood provides a rough estimate of kidney function. Blood urea nitrogen levels may be increased in the presence of dehydration, decreased renal function, upper gastrointestinal bleeding, or treatment with drugs such as steroids or tetracyclines.

Symptoms vary from person to person, but the typical lupus patient is a young woman experiencing fever, swollen lymph nodes (glands), butterfly-shaped rash on her face, arthritis of the fingers, wrists or other small joints, hair loss, chest pain and protein in the urine. Symptoms usually begin in only one or two areas of the body, but more may develop over time. The most common signs and symptoms of lupus are:
Drug-induced lupus erythematosus (DIL) Some drugs can cause lupus, resulting in symptoms such as rash, arthritis, hair loss, and fever. “Once medications are discontinued, the symptoms go away,” says Roberto Caricchio, MD, the interim section chief of rheumatology at Temple University Hospital in Philadelphia and the director of the Temple Lupus Clinic at the Lewis Katz School of Medicine.
If you have osteoporosis or osteopenia, your doctor will most likely recommend that you take calcium and vitamin D supplements in addition to your regular bone medications, since vitamin D helps your body to absorb calcium. It is important that you also try to eat foods rich in calcium, such as milk, light ice cream/frozen yogurt, cottage cheese, pudding, almonds, broccoli, fortified cereal, oranges, yogurt, hard cheese, soybeans and soymilk, navy beans, oysters, sardines, and spinach. These foods will help to keep your bones as healthy and strong as possible.
It is important to understand that osteoporosis has no symptoms. There is no pain in the bones where individuals with osteoporosis would hypothetically feel sore, so it is important to speak with your doctor to have a regular bone mass density test performed. Again, there is a high risk of osteoporosis for people with lupus because of often decreased physical activity, vitamin D deficiency, medication side effects, and the additional risk of kidney disease. Listed below are nutritional tips to follow:
A healthy diet is important in general, but perhaps even more so for the roughly 1 million Americans and 3 million people worldwide who suffer from systemic lupus erythematosus (SLE).1 Because of the multifaceted challenges presented by the disease, consuming adequate amounts of the right nutrients — and limiting others — can help relieve symptoms and improve outcomes.

Dermatomyositis (DM) and polymyositis (PM): While almost all people with lupus have a positive ANA test, only around 30 percent of people with DM and PM do. Many of the physical symptoms are different as well. For instance, people with DM and PM don't have the mouth ulcers, kidney inflammation, arthritis, and blood abnormalities that people with lupus do.
Other drugs used to treat lupus include the antimalarial drug hydroxychloroquine, which modulates the immune system, and belimumab, a targeted drug that is a biologic (meaning it’s made from natural sources). Some chemotherapy drugs and anti-rejection drugs may be used, too, to treat patients with lupus nephritis or other organ problems, says Caricchio.
Patients with SLE should be educated to avoid triggers for flare. Persons with SLE should avoid ultraviolet light and sun exposure to minimize worsening of symptoms from photosensitivity. Diet modification should be based on the disease activity. A balanced diet is important, but patients with SLE and hyperlipidemia, for example, should be placed on a low-fat diet. Many patients with SLE have low levels of vitamin D because of less sun exposure; therefore, these patients should take vitamin D supplements. Exercise is important in SLE patients to avoid rapid muscle loss, bone demineralization, and fatigue. Smoking should also be avoided.
While the genetics of SLE are not very well understood, there is growing evidence for the involvement of specific genes in this complex autoimmune disease. Part of the complexity of this disease is due to the effects of both environment and genetics factors that may contribute to its development.[49] Further compounding our understanding of the etiology of the disease is the involvement of several organ systems.[50] Genetic studies of the rates of disease in families supports the genetic basis of this disease with a heritability of >66%.[51] Identical (monozygotic) twins were found to share susceptibility to the disease at >35% rate compared to fraternal (dizygotic) twins and other full siblings who only showed a 2–5% concordance in shared inheritance.[51]
Patient global assessment (PGA) is one of the most widely used PROs in RA practice and research and is included in several composite scores such as the 28-joint Disease Activity Score (DAS28). PGA is often assessed by a single question with a 0–10 or 0–100 response. The content can vary and relates either to global health (e.g., how is your health overall) or to disease activity (e.g., how active is your arthritis).

While most infants born to mothers who have SLE are healthy, pregnant mothers with SLE should remain under medical care until delivery. Neonatal lupus is rare, but identification of mothers at highest risk for complications allows for prompt treatment before or after birth. In addition, SLE can flare up during pregnancy, and proper treatment can maintain the health of the mother longer. Women pregnant and known to have anti-Ro (SSA) or anti-La antibodies (SSB) often have echocardiograms during the 16th and 30th weeks of pregnancy to monitor the health of the heart and surrounding vasculature.[92]


While SLE can occur in both males and females, it is found far more often in women, and the symptoms associated with each sex are different.[5] Females tend to have a greater number of relapses, a low white blood cell count, more arthritis, Raynaud's phenomenon, and psychiatric symptoms. Males tend to have more seizures, kidney disease, serositis (inflammation of tissues lining the lungs and heart), skin problems, and peripheral neuropathy.[12]
The epicenter of where inflammation begins is considered to be the microbiome. The human microbiome is a very complex ecosystem of trillions of bacteria that perform essential functions like absorbing nutrients, producing hormones, and defending us from microbes and environmental toxins. These bacteria are constantly in flux throughout our lives, adapting to the foods we eat, the quality of our sleep, the amount of bacteria or chemicals we’re exposed to on a daily basis, and the level of emotional stress we deal with.
Neuropsychiatric syndromes can result when SLE affects the central or peripheral nervous system. The American College of Rheumatology defines 19 neuropsychiatric syndromes in systemic lupus erythematosus.[30] The diagnosis of neuropsychiatric syndromes concurrent with SLE (now termed as NPSLE),[31] is one of the most difficult challenges in medicine, because it can involve so many different patterns of symptoms, some of which may be mistaken for signs of infectious disease or stroke.[32]
The NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases (2014) suggests that the symptoms may vary dependent on the type of lupus and the person. Symptoms tend to ‘come and go’, ‘flare’ from mild to severe intensity, and new symptoms of lupus can arise at any stage (NIH, 2014). Better Health Channel (n. d.) state that lupus may even become life-threatening, for example, should it damage major organs such as the kidneys or brain.
No single finding qualifies an individual as having SLE. Instead, the American College of Rheumatology (ACR) has devised certain classification criteria, and four or more of these criteria must be present for a classification of lupus. [The term “classification” is not synonymous with “diagnosis.” “Classification” means that reasonable certainty exists for the diagnosis of lupus for research purposes.] Although, these criteria are currently being updated, they are believed to be about 90% effective. The ACR criteria include malar rash; discoid rash; photosensitivity (development of a rash after sun exposure); oral or nasal ulcers; arthritis of multiple joints; serositis: (inflammation of the lining around the lungs or heart); kidney disease indicated by protein or casts in the urine; neurological disorders such as seizures and psychosis; and blood disorders such as hemolytic anemia, leukopenia, and lymphopenia. Other signs that are common but not included in the classification criteria are hair loss or breaking, especially around the forehead, and Raynaud’s Phenomenon, a two- or three-color change of the fingertips upon cold exposure.
Ms. Everett began by explaining that there is no food that can cause lupus. Lupus is an autoimmune disease, an illness that can affect many body systems. The foods that you eat, however, and the medications you take may have an effect on some of your symptoms. It is also important to understand that there is a link between lupus and osteoporosis and cardiovascular disease. Healthy nutrition can impact on those with these co-occurring diseases. Nutrition (e.g., in the case of osteoporosis, calcium intake) in turn may impact the symptoms and outcomes of these co-occurring illnesses. Here are some key issues and benefits that relate to proper nutrition and people living with lupus;
Granulocytes and monocytes, collectively called myeloid cells, are differentiated descendants from common progenitors derived from hematopoietic stem cells in the bone marrow. Commitment to either lineage of myeloid cells is controlled by distinct transcription factors followed by terminal differentiation in response to specific colony-stimulating factors and release into the circulation. Upon pathogen invasion, myeloid cells are rapidly recruited into local tissues via various chemokine receptors, where they are activated for phagocytosis as well as secretion of inflammatory cytokines, thereby playing major roles in innate immunity.
Heart and Lungs. Heart and lung involvement often is caused by inflammation of the covering of the heart (pericardium) and lungs (pleura). When these structures become inflamed, patients may develop chest pain, irregular heartbeat, and accumulation of fluid around the lungs (pleuritis or pleurisy) and heart (pericarditis). The heart valves and the lung itself can also be affected by lupus, resulting in shortness of breath.
Unfortunately, significant side effects are associated with cyclophosphamide-based regimens, which are the only ones with proven long-term efficacy. An alternative consideration is mycophenolate mofetil, which may be as effective as pulse cyclophosphamide but with less severe adverse effects. In refractory cases (lack of treatment response by 6 months), consider intensifying therapy with mycophenolate mofetil. [61]

The EULAR recommendations indicate that in pregnant women with SLE, prednisolone, azathioprine, hydroxychloroquine (unnecessary discontinuation of hydroxychloroquine during pregnancy may result in lupus flares), and low-dose aspirin may be used. [61] Prednisone, prednisolone, and methylprednisolone are the corticosteroids of choice during pregnancy because of their minimal placental transfer. However, mycophenolate mofetil, cyclophosphamide, and methotrexate are strictly contraindicated. [61]
  According to the Mayo Clinic, “People with lupus should eat plenty of fruits, vegetables and whole grains. These foods are rich in vitamins, minerals and essential nutrients that benefit overall health and can help prevent high blood pressure, heart disease, kidney disease, cancer and digestive disorders. Plant-based diets also support a healthy weight because they are naturally low in calories, fat and cholesterol. Fruits and vegetables are particularly high in antioxidants. Antioxidants protect the body by destroying harmful substances that damage cells and tissue and cause heart disease and cancer.” Take a look at our blog, Lupus: the Diet Dilemma for some great tips. While these diets, or eating plans, may have some merit, individual foods should not be the focus. Pay attention to your overall pattern of nutrition. Reducing inflammation is not just about what you eat.  Patients should also know that these diets are never meant to be a replacement for the lupus treatments they may already be taking under the close supervision of a medical professional. Until more research is in on the effectiveness of these diets, be practical by getting enough sleep and exercise, and try to maintain a healthy weight. Back to top
Women with lupus have a higher risk of miscarriage and preterm labor, says Kaplan. Pregnant women with lupus also have a higher risk of preeclampsia, or high blood pressure, and signs that the kidneys and liver may not be functioning well. (20) If you have lupus and do get pregnant (or if you have lupus and are trying to get pregnant), see a high-risk maternal-fetal medicine specialist who has expertise in how to best handle such pregnancies.

Mercury is toxic to our bodies and can be one piece of the puzzle for those with lupus and other chronic illnesses such as chronic fatigue syndrome, other autoimmune diseases, neurological disorders, and cancer. Mercury overload is far more common than many people think. We’re exposed to mercury in our air and water, the fish we eat, amalgam fillings, cosmetics, and vaccines. I recommend heavy metal testing for all of my patients with autoimmunity, using a pre- and post-DMPS urine challenge test. I also recommend that anyone with mercury amalgam fillings find a biological dentist and have them removed.
Aseptic meningitis is a disease caused by the inflammation of the protective membranes covering the brain and spinal cord known as the meninges. Unlike other forms of meningitis, aseptic meningitis is not caused by infection and cannot be spread person-to-person. Instead it can be caused by lupus, cancers, certain drugs, head injury, and brain surgery, among others. Meningitis is characterized by a sudden onset of fever, headache, and stiff neck. It is often accompanied by other symptoms, such as nausea, vomiting, photophobia (sensitivity to light), and altered mental status (confusion).
Doctors are tasked with interpreting test results, then correlating them with your symptoms and other test results. It's difficult when patients exhibit vague symptoms and clashing test results, but skillful doctors can consider all of these pieces of evidence and eventually determine whether you have lupus or something else entirely. This may take some time along with trial and error.
How an autoimmune disease affects you depends on what part of the body is targeted. If the disease affects the joints, as in rheumatoid arthritis, you might have joint pain, stiffness, and loss of function. If it affects the thyroid, as in Graves’ disease and thyroiditis, it might cause tiredness, weight gain, and muscle aches. If it attacks the skin, as it does in scleroderma/systemic sclerosis, vitiligo, and systemic lupus erythematosus (SLE), it can cause rashes, blisters, and color changes.

A specialized type of dense connective tissue consisting of cells embedded in a ground substance or matrix. The matrix is firm and compact; its proteoglycans can store considerably more sodium than plasma can, which in turn allows cartilage to store water, which in turn helps cartilage withstand pressure or impact. Cartilage is bluish-white or gray and is semiopaque; it has no nerve or blood supply of its own. The cells lie in cavities called lacunae. They may be single or in groups of two, three, or four. Cartilage forms parts of joints in the adult skeleton, such as between vertebral bodies and on the articular surfaces of bones. It also occurs in the costal cartilages of the ribs, in the nasal septum, in the external ear and lining of the eustachian tube, in the wall of the larynx, and in the trachea and bronchi. It forms the major portion of the embryonic skeleton, providing a model in which most bones develop.


Cardiac tamponade is pressure on the heart that occurs when blood or fluid builds up in the space between the heart muscle (myocardium) and the outer covering sac of the heart (pericardium). This prevents the heart ventricles from expanding fully. The excess pressure from the fluid prevents the heart from working properly. As a result, the body does not get enough blood.
Jump up ^ Smyth, Andrew; Guilherme H.M. Oliveira; Brian D. Lahr; Kent R. Bailey; Suzanne M. Norby; Vesna D. Garovic (November 2010). "A Systematic Review and Meta-Analysis of Pregnancy Outcomes in Patients with Systemic Lupus Erythematosus and Lupus Nephritis". Clinical Journal of the American Society of Nephrology. 5 (11): 2060–2068. doi:10.2215/CJN.00240110. PMC 3001786. PMID 20688887. Archived from the original on 2016-01-26.
Not necessarily. The antinuclear antibody (ANA) test is positive in most people who have lupus, but it also may be positive in many people who are healthy or have another autoimmune disease. Therefore, a positive ANA test alone is not adequate for the diagnosis of lupus. There must be at least three additional clinical features from the list of 11 features for the diagnosis to be made.
SLE is regarded as a prototype disease due to the significant overlap in its symptoms with other autoimmune diseases.[49] This means that it is an important area of continued research and study that is utilizing diverse techniques such as GWAS, microarrays, and murine studies.[50] Further genetic studies of multiple ethnic groups and the creation of disease models incorporating environmental influences will help to increase and refine the understanding of specific genes, linkages, as well as the mechanisms underlying the disease.[51]
Drug-induced lupus erythematosus (DIL) Some drugs can cause lupus, resulting in symptoms such as rash, arthritis, hair loss, and fever. “Once medications are discontinued, the symptoms go away,” says Roberto Caricchio, MD, the interim section chief of rheumatology at Temple University Hospital in Philadelphia and the director of the Temple Lupus Clinic at the Lewis Katz School of Medicine.
Maybe. Start by seeing your family doctor and a rheumatologist, a doctor who specializes in the diseases of joints and muscles such as lupus. Depending on your symptoms or whether your organs have been hurt by your lupus, you may need to see other types of doctors. These may include nephrologists, who treat kidney problems, and clinical immunologists, who treat immune system disorders.

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