Lupus is a chronic inflammatory condition. Its main symptoms are fatigue, joint pain and skin rash. Lupus affects many parts of the body, and has unpredictable flares (active disease) and remissions.
Living with lupus can be challenging. Constant fatigue, chronic pain and other symptoms can be devastating in daily life. A flare is characterized by common symptoms that can include fever, painful and swollen joints, extreme fatigue and skin rashes. Knowing what triggers your flare and avoiding that trigger are critical to better managing your condition. Common triggers include exposure to sunlight, emotional stress, smoking, infection, exhaustion, and medications that cause sensitivity to sunlight.
Maintaining an overall healthy lifestyle is an important way to improve your symptoms and reduce the occurrence of flares.
Diet and Nutrition
There is no specific diet for lupus. A balanced diet consisting of carbohydrates, proteins and fats is recommended. One food that should always be avoided is alfalfa. Alfalfa seeds, sprouts and tablets can activate the immune system and increase inflammation due to the amino acid L-Canavanine. Herbal remedies are of unproven benefit and may cause harm. If you are interested, discuss these with your lupus doctor.
Extra vitamins are rarely needed if you eat a balanced diet. Talk to your doctor about taking a daily multivitamin if you are unable to eat a balanced diet or are dieting to lose weight.
Additional considerations regarding diet and nutrition for people with Lupus include:
- People with active disease, fever or a flare may require increased caloric intake.
- Corticosteroids can elevate blood pressure, increase cholesterol and lipids, and cause weight gain. If you are taking steroids, you should limit salt and fat in your diet.
- Corticosteroids cause bones to become fragile, causing or worsening osteoporosis (condition in which bones lose density and become fragile). If you have osteoporosis, you should eat foods rich in calcium such as dark green, leafy vegetables (spinach, broccoli and collard greens), milk, cheese and yogurt. Taking daily calcium supplements with Vitamin D can help support bone growth. Learn about the diet that best supports you, especially if you are on blood thinners, such as Warfarin (Coumadin)
- If you are taking corticosteroids and experiencing swelling due to fluid retention, high blood pressure, or your kidneys are affected, you should lower the amount of salt and sodium-containing foods you eat. In particular, avoid all processed foods.
Sun protection or Ultraviolet (UV) light protection
Exposure to ultraviolet light may exacerbate or induce skin rash and other systemic symptoms, which include joint pain, weakness, fatigue and fever. People with lupus should avoid exposure to direct sunlight, reflected sunlight, and other UV light sources (for example, fluorescent and halogen lights). Use a sun protection factor (SPF) greater than 55 that blocks both UV-A and UV-B rays. Discuss with your doctor medications that can cause photosensitivity and avoiding reactions to sunlight.
Smoking cessation
Smoking has been associated with active disease and increases the risk of heart disease in people with lupus. There is also evidence that smoking decreases the efficacy of Hydroxychloroquine (medicine used to treat lupus).
Moderate use of alcohol
Total avoidance or a moderate use of alcohol is recommended. Alcohol can cause new health problems, decrease the efficacy of certain medications, and worsen existing problems. Alcohol may introduce gastrointestinal side effects caused by NSAIDs (nonsteroidal anti-inflammatory drugs), which may result in an increased risk of ulcers and stomach bleeding.
Incorporating exercise
It can be challenging to exercise when lupus causes fatigue, pain, breathing difficulties and other symptoms. But inactivity can make you feel worse in the long-term from loss of muscle strength. Even a small amount of exercise can be beneficial for your health.
Vaccines
Vaccines containing live virus (measles, mumps, rubella, polio, varicella and smallpox) are not recommended in people for lupus. Those with lupus and taking medicines that suppress immunity, such as prednisone, methotrexate, are especially affected.
People with lupus are recommended to get vaccinated against pneumonia and the flu. Some should also get the shingles vaccine. Talk to your doctor before receiving any kind of vaccine.
Adhering to medication
Studies have shown that people who do not adhere to medication experience high lupus disease activity. It is important that you follow your doctor’s instructions and take all medications as prescribed by your doctor. Let your doctor know if the medications are not working for you, if you experience any side effects, or if your symptoms change after starting a medication.
Pregnancy and birth control
Healthy pregnancy is possible with lupus. However, lupus may raise the risk of certain complications during pregnancy. Work with your doctor and let them know at least 6 months in advance if you are planning a pregnancy. Your doctor may change medications that may be known to cause harm to the baby or mother. Advising your doctor in advance will also allow time for you and your doctor to get your symptoms under control and increase the chances of a healthy pregnancy. On the other hand, if you are not planning for pregnancy, it is important to use birth control to prevent unplanned pregnancy.
Managing stress
Stress can trigger a flare for people with lupus. Keep track of any stressful events or activities, and aim to identify the source of stress.
Some ways to manage stress are:
- Planning around events that cause you stress so you can be prepared and calm.
- Take time to rest and do things that make you happy. You might recharge yourself with music, walking, time in nature, listening to music, meditating or reading.
- Connect with friends and family, especially those who understand how lupus affects you. Time together can be a great stress reliever.
- Make sure to get 7-8 hours of good sleep every night.
- Take care of your mental health and reach out to your doctor if you have mental health problems, such as depression or anxiety. Your doctor can connect you with a specialist or therapist.
Medications to avoid
Certain medications, such as Sulfonamide-containing antibiotics are known to worsen lupus. If there is an acceptable alternative, avoid taking these medications. Make sure that all the doctors you see know you have lupus.
Healthy lifestyle changes and preventive measures can lighten the burden of your illness. Lupus is associated with unpredictable flares during which symptoms can suddenly appear, disappear or change. Because of this, it is especially important to stay on top of your health and make necessary changes that can mitigate your risks and challenges.
“Healing takes courage and we will have courage, even if we have to dig a little to find it.”
Tori Amos
“We must accept finite disappointment, but never lose infinite hope.”
Martin Luther King, Jr
