One main type of lupus, cutaneous lupus erythematosus, is limited to skin symptoms, including a rash and lesions. That means people with cutaneous lupus, which does not progress and become systemic lupus erythematosus, only experience skin symptoms. People with cutaneous lupus most commonly develop a discoid rash. It appears as round, raised, red patches and can cause scarring, Dr. Caricchio explains. “It’s often confined to small areas above the neck, such as the ears and scalp,” he says. The rash usually does not itch or cause discomfort.
In recent years, mycophenolate mofetil (CellCept) has been used as an effective medication for lupus, particularly when it is associated with kidney disease. CellCept has been helpful in reversing active lupus kidney disease (lupus renal disease) and in maintaining remission after it is established. Its lower side-effect profile has advantage over traditional immune-suppression medications.
“I have given up sugar (except natural sugars), all soft drinks, pasta, chocolate, takeaways, and most processed foods/snacks. I have experienced a marked difference in energy levels and severity of flares, plus I have lost almost three stone in a year. I eat a simple diet, increase fruits/veg and I have found it has also helped with my stomach issues.”

Systemic lupus erythematosus (SLE) is a complex multisystemic autoimmune disease resulting, oftentimes, in irreversible damage, diminished quality of life and reduced life expectancy.1–3 Genetic and environmental factors play important roles in its pathogenesis.4–8 Disease manifestations and severity vary according to the patients’ racial/ethnic background and socioeconomic status (SES).1 9 10 Data from Grupo Latino Americano de Estudio del Lupus (GLADEL), Lupus in Minorities: Nature vs Nurture (LUMINA) and the Lupus Family Registry and Repository cohorts have demonstrated that Latin American and North American Mestizo patients (mixed Amerindian and European ancestry), African descendants and Native Americans develop lupus earlier11 12 although diagnostic delays may occur.1 They also experience more severe disease, have higher disease activity levels,1 accrue more organ damage2 and have higher mortality rates,1 succumbing mainly to disease activity and/or infections.1 3 13–15


Conventional lupus treatment usually involves a combination of medications used to control symptoms, along with lifestyle changes — like dietary improvements and appropriate exercise. It’s not uncommon for lupus patients to be prescribed numerous daily medications, including corticosteroid drugs, NSAID pain relievers, thyroid medications and even synthetic hormone replacement drugs. Even when taking these drugs, it’s still considered essential to eat an anti-inflammatory lupus diet in order to manage the root causes of lupus, along with reducing its symptoms.
Anemia is common in children with SLE[20] and develops in about 50% of cases.[21] Low platelet and white blood cell counts may be due to the disease or a side effect of pharmacological treatment. People with SLE may have an association with antiphospholipid antibody syndrome[22] (a thrombotic disorder), wherein autoantibodies to phospholipids are present in their serum. Abnormalities associated with antiphospholipid antibody syndrome include a paradoxical prolonged partial thromboplastin time (which usually occurs in hemorrhagic disorders) and a positive test for antiphospholipid antibodies; the combination of such findings have earned the term "lupus anticoagulant-positive". Another autoantibody finding in SLE is the anti-cardiolipin antibody, which can cause a false positive test for syphilis.[citation needed]
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;
Collagen is the major insoluble fibrous protein in the extracellular matrix and in connective tissue. In fact, it is the single most abundant protein in the animal kingdom. There are at least 16 types of collagen, but 80 – 90 percent of the collagen in the body consists of types I, II, and III. These collagen molecules pack together to form long thin fibrils of similar structure. Type IV, in contrast, forms a two-dimensional reticulum; several other types associate with fibril-type collagens, linking them to each other or to other matrix components. At one time it was thought that all collagens were secreted by fibroblasts in connective tissue, but we now know that numerous epithelial cells make certain types of collagens. The various collagens and the structures they form all serve the same purpose, to help tissues withstand stretching.
We encourage you to reach out to friends, family, and join support groups to share your feelings and fears.  Also, remember to be your own best advocate in your journey with lupus, take great notes, and bring a support person with you to each visit to help remind you of the doctor’s advice and information. We are always here for you, please join our online community and share your story or ask us any questions you may have! Back to top

“There’s no specific diet for lupus, but the Mediterranean-style diet comes close to what’s most ideal," says Sotiria Everett, RD, a clinical assistant professor in the department of family, population, and preventive medicine at Stony Brook School of Medicine in New York. "You want to eat a diet that’s low in fat and sugar and has lots of fruits and vegetables. You should get some of your protein from fish and eat lots of beans and legumes because they’re high in fiber, vitamin B, and iron."


Blood clots are more common in people with lupus. Clots often occur in the legs (called deep venous thrombosis or DVT) and lungs (called pulmonary embolus or PE) and occasionally in the brain (stroke). Blood clots that develop in lupus patients may be associated with the production of antiphospholipid (APL) antibodies. These antibodies are abnormal proteins that may increase the tendency of the blood to clot. Blood can be tested for these antibodies.
A general, imprecise, colloquial, and somewhat old-fashioned term for acute and chronic conditions marked by inflammation, muscle soreness and stiffness, and pain in joints and associated structures. It includes inflammatory arthritis (infectious, rheumatoid, gouty), arthritis due to rheumatic fever or trauma, degenerative joint disease, neurogenic arthropathy, hydroarthrosis, myositis, bursitis, and fibromyalgia.
Many types of wild seafood provide omega-3 fats that help reduce inflammation levels. The best choices are wild salmon, sardines, mackerel, halibut, trout and anchovies. Aim to consume these omega-3 foods about two to three times weekly, or consider supplementing. Just be sure to buy “wild-caught” to reduce intake of things like heavy metals found in farm-raised fish, plus limit intake of fish high in mercury.
Anyone can have lupus. More than 90 percent of people living with lupus are women between the ages of 15 and 45. African-American, Hispanic, Asian and Native American women are at greater risk of developing lupus than white women. In particular, African-American women are three times more likely to get lupus than white women. Men, who make up 10 percent of lupus patients, often develop the disease before puberty and after the age of 50. 
Once remission is achieved, start maintenance therapy with azathioprine or mycophenolate mofetil (ie, use less potent agents relative to long-term cyclophosphamide). The ALMS maintenance trial also found that mycophenolate mofetil was superior to azathioprine in the maintenance of the renal response to treatment and in the prevention of relapse in patients with lupus nephritis. [134] In the MAINTAIN trial, there was a trend toward fewer renal flares in patients receiving mycophenolate mofetil than in those receiving azathioprine [135] ; however, these results did not reach statistical significance.

To unravel which people with positive ANA tests actually have lupus, additional blood work can be done. Doctors look for other potentially troublesome antibodies, so they will test for anti-double-stranded DNA and anti-Smith antibodies. These tests are less likely to be positive unless a patient truly has lupus. However, a person who has negative test results could still have lupus, even though this is not so in the case of ANA tests.
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.
Research has demonstrated evidence that a key enzyme's failure to dispose of dying cells may contribute the development of systemic lupus erythematosus. The enzyme, DNase1, normally eliminates what is called "garbage DNA" and other cellular debris by chopping them into tiny fragments for easier disposal. Researchers turned off the DNase1 gene in mice. The mice appeared healthy at birth, but after six to eight months, the majority of mice without DNase1 showed signs of systemic lupus erythematosus. Thus, a genetic mutation in a gene that could disrupt the body's cellular waste disposal may be involved in the initiation of systemic lupus erythematosus.
Inflammation of the pleurae known as pleurisy can rarely give rise to shrinking lung syndrome.[25] SLE can cause pleuritic pain and also give rise to shrinking lung syndrome, involving a reduced lung volume.[26] Other associated lung conditions include pneumonitis, chronic diffuse interstitial lung disease, pulmonary hypertension, pulmonary emboli, and pulmonary hemorrhage.

Your primary care doctor should coordinate care between your different health care providers and treat other problems as they come up. Your doctor will develop a treatment plan to fit your needs. You and your doctor should review the plan often to be sure it is working. You should report new symptoms to your doctor right away so that your treatment plan can be changed if needed.

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;


While there is no specific lupus diet, scientists have found that low-dose diet supplementation with omega-3 fish oils could help patients with lupus by decreasing inflammation and disease activity and possibly decreasing heart-disease risk. It is generally recommended that patients with lupus eat a balanced diet that includes plant-based foods and lean sources of protein.

I recommend having your MTHFR genes tested, as this genetic mutation can impact how you detoxify mercury and other heavy metals. There are multiple options for heavy metal testing, however I’ve found the DMPS “challenge” test to be the gold standard. To assess whether someone is being exposed to mycotoxins, I use the test from Real Time Lab. If either heavy metals or mycotoxins are an issue for you, work on minimizing your exposure to these toxins, and be sure to support your detox pathways while you work to flush them out.
The gene is the basic physical unit of inheritance. Genes are passed from parents to offspring and contain the information needed to specify traits. Genes are arranged, one after another, on structures called chromosomes. A chromosome contains a single, long DNA molecule, only a portion of which corresponds to a single gene. Humans have approximately 20,000 genes arranged on their chromosomes.

Other medicines. You may need other medicines to treat illnesses or diseases that are linked to your lupus — such as high blood pressure or osteoporosis. Many people with lupus are also at risk for blood clots, which can cause a stroke or heart attack. Your doctor may prescribe anticoagulants (“blood thinners”), such as warfarin or heparin, to prevent your blood from clotting too easily. You cannot take warfarin during pregnancy.


Kaposi observed that lupus assumed two forms: the skin lesions (now known as discoid lupus) and a more aggravated form that affected not only the skin but also caused fever, arthritis, and other systemic disorders in people.[112] The latter also presented a rash confined to the face, appearing on the cheeks and across the bridge of the nose; he called this the "butterfly rash". Kaposi also observed those patients who developed the "butterfly rash" (or malar rash) often were afflicted with another disease such as tuberculosis, anemia, or chlorisis which often caused death.[110] Kaposi was one of the first people to recognize what is now termed systemic lupus erythematosus in his documentation of the remitting and relapsing nature of the disease and the relationship of skin and systemic manifestations during disease activity.[113]
SLE can also flare during or after pregnancy. Whether flares of SLE are more frequent during pregnancy is controversial. The flares do not seem to be exceedingly more serious than those in nonpregnant patients, although pregnancy outcomes are generally more likely to be complicated. Increased rates of hypertension during pregnancy, premature delivery, unplanned cesarean delivery, postpartum hemorrhage, and maternal venous thromboembolism are all more frequent in women with SLE.
The ACR Quality of Care statement [147] recommends annual cardiovascular disease risk assessment; some researchers suggest that the cardiovascular risk for SLE is similar to that for diabetes mellitus. The 10-year coronary event rate is 13-15% in patients with active SLE, which is comparable to the 10-year event rate of 18.8% in patients with known coronary artery disease. [148] African American patients with SLE may be particularly vulnerable to premature cardiovascular disease and related death. [149]
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.
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:
Genetic factors increase the tendency of developing autoimmune diseases, and autoimmune diseases such as lupus, rheumatoid arthritis, and autoimmune thyroid disorders are more common among relatives of people with lupus than the general population. Moreover, it is possible to have more than one autoimmune disease in the same individual. Therefore, "overlap" syndromes of lupus and rheumatoid arthritis, or lupus and scleroderma, etc., can occur.
There is a wide range of diets advertised to help you lose weight quickly or control various chronic diseases, such as lupus. Many people claim to be experts in nutrition yet have limited knowledge and offer no protection to the public. You should be wary of unqualified practitioners who may be offering unproven techniques to diagnose and treat nutritional problems.

SLE is undoubtedly a potentially serious illness with involvement of numerous organ systems. However, it is important to recognize that most people with SLE lead full, active, and healthy lives. Periodic increases in disease activity (flares) can usually be managed by varying medications. Since ultraviolet light can precipitate and worsen flares, people with systemic lupus should avoid sun exposure. Sunscreens and clothing covering the extremities can be helpful. Abruptly stopping medications, especially corticosteroids, can also cause flares and should be avoided. People with SLE are at increased risk of infections as SLE-related complications, especially if they are taking corticosteroids or immunosuppressive medications. Therefore, any unexpected fever should be reported to medical professionals and evaluated.


Neonatal lupus is a rare form of temporary lupus affecting a fetus or newborn. It's not true lupus: It occurs when the mother’s autoantibodies are passed to her child in utero. These autoantibodies can affect the skin, heart, and blood of the baby. Fortunately, infants born with neonatal lupus are not at an increased risk of developing SLE later in life.

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