Diet and Alzheimer’s Disease

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What weighs a mere four pounds and has a workload that demands 20 percent of all the oxygen inhaled?  Answer:  the human brain.

As technology opens the door to the unique metabolic functions of the brain, scientists are investigating the nutrients required to keep mentally sharp over the decades.

With dementia rising at an alarming rate — along with obesity, diabetes, heart disease, and other ailments — let’s eat with purpose, using sound, nutrition-related science applicable to the brain and the rest of the body.

Starting with the belief that what we eat plays a significant role in determining who gets dementia, Martha Clare Morris, Ph.D. and colleagues developed the MIND Diet as an intervention against the most common cause of neurodegeneration:  Alzheimer’s disease.

The work of Morris and her colleagues is based on research completed at Rush Medical University in Chicago, Illinois.  The term “MIND” is an acronym for Mediterranean-DASH Intervention for Neurodegenerative Delay.

The DASH diet plan is based on research sponsored by the U.S. National Institutes of Health.  The plan was developed to lower blood pressure without the use of medication.

The Mediterranean and DASH diets are models of healthy eating for the body.  The Morris team chose foods that improve brain function significantly and also added to overall body wellness.

Adherence to the MIND diet may lower the risk of Alzheimer’s disease by as much as 53%, offering more protection for the brain than any other dietary regimen.

The MIND cuisine lists 10 brain-healthy food groups (green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil, and wine).  The plan limits consumption of five brain-unhealthy food groups (red meats, butter/stick margarine, cheese, pastries/sweets, and fried or fast food).

The plan suggests a minimum of three servings of whole grains, a salad, and one other vegetable every day — along with a glass of wine.  For snacks, add a variety of nuts.  Berries are the only fruits recommended.

Specifically, blueberries are noted as the powerful protectors of the brain.  Strawberries are a second choice for good cognitive function.

Use Google and enter the term “MIND Diet” for daily guidelines and recipes of a cuisine designed to maximize brain function while providing healthy foods for the rest of the body as well.


Dr. Laura Pawlak (Ph.D., R.D. emerita) is a world-renown biochemist and dietitian emerita.  She is the author of many scientific publications and has written such best-selling books as “The Hungry Brain,” “Life Without Diets,” and “Stop Gaining Weight.”  On the subjects of nutrition and brain science, she gives talks internationally.

 

Mood and Food

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What you eat can affect your risk of the most common mood disorder in the United States:  depression.

Mental health begins with lifestyle:  nutritious food; regular exercise; sufficient sleep; and coping skills.

The chemical components of food impact one’s state of mind throughout the day — that is, after every meal and snack.  A long period of time without nourishment (fasting) activates survival emotions throughout the brain.  Food, or the lack of it, thus alters both feelings and thoughts.

A significant part of the treatment program for patients with depression is a brain-healthy diet prescription designed by what may be termed a nutritional psychiatrist.  Clearly, changing one’s eating habits requires more time and energy than swallowing a pill.  However, research in mental health has appeared, showing the flaws of prescribing quick-fix medications — in the absence of healthy habits.

A recent study published in BioMed Central Medicine tested the effect of prescribing both a modified Mediterranean Diet and medication to treat patients with clinical depression.  Thirty-three percent of the patients given medication plus a modified Mediterranean Diet plan achieved remission in 12 weeks.  However, eight percent of the patients prescribed medication only reached remission in the same period of time. (Study by S. Reddy, January, 2017)  This mood-enhancing cuisine is highly concentrated in brain-protective foods:  fruits; vegetables; legumes; whole grains; raw, unsalted nuts; low-fat, unsweetened dairy foods; olive oil; and fish.

The positive effects of nutrition intervention reported in this study have encouraged psychiatrists to prioritize this diet prescription for all patients diagnosed with depression.  The modified Mediterranean food plan may help prevent the incidence of depression in persons at high risk, aid patients who reject medication, and may block the progression from mild depression to serious depression.

Regardless of one’s family history, the brain can slip into an imbalanced state that alters mood and mind-power. The wise statement, “You become what you eat,” applies to everyone.  The original Mediterranean cuisine has already scored high ratings against brain atrophy, pain, and all age-related diseases.  The Mind Diet, another modified format of the Mediterranean Diet, reduces the risk of Alzheimer’s disease.

Cook, eat, and share mood-enhancing meals.  It’s a challenge that delivers great rewards for the brain — sharper thinking and happier moments.
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Dr. Laura Pawlak (Ph.D., R.D. emerita) is a world-renown biochemist and dietitian emerita.  She is the author of many scientific publications and has written such best-selling books as “The Hungry Brain,” “Life Without Diets,” and “Stop Gaining Weight.”  On the subjects of nutrition and brain science, she gives talks internationally.

Influenza

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By Raj Hullon, M.D., J.D.

The flu is a contagious infection that affects the nose, throat, and lungs.  Onset is more abrupt compared to the common cold.  Symptoms can range from mild to severe, even leading to life-threatening complications.  Nausea, vomiting, and diarrhea are more common in children than in adults.  Other flu symptoms include:

  • fever (usually high).
  • extreme fatigue.
  • dry cough.
  • sore throat.
  • nasal congestion or runny nose.
  • muscle aches.
  • impaired sense of taste and smell.
  • loss of appetite.

Although flu-related morbidity and mortality vary from year to year, the CDC estimates that between five and 20 percent of Americans contract flu in a given year and that 200,000 people are hospitalized for treatment of flu-related complications.  Approximately 36,000 deaths a year result from flu-related causes in the United States (cdc.gov).

Seasonal flu refers to any of the combinations of influenza viruses that circulate throughout the world each year.  The flu season in the United States can begin as early as October and run through March.  The Center for Disease Control (CDC) tracks circulating flu viruses and related disease activity all year and, between October and May, provides weekly influenza updates at http://www.cdc.gov/flu/weekly/fluactivitysurv.htm.   Pandemic flu refers to a global outbreak of flu that can overwhelm the health care system.  The cause is most likely a strain of influenza virus that is new or that has not circulated recently enough for large portions of affected populations to have built up gradual immunity to it.  Therefore, healthy individuals are at risk for complications following infection during a pandemic flu outbreak.  Seasonal flu, however, usually leads to fewer complications in healthy adults.  During the 1918 pandemic, for example, the estimated deaths from the disease and disease-related complications reached 20 to 40 million individuals globally. Fortunately, pandemic flu outbreaks are rare.  There were only three pandemic outbreaks in the 20th century while seasonal flu is annual and peaks in January or February.

Cold Symptoms and Prevention

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By Ben Hayes, MD, PhD, FAAD

Cold symptoms generally emerge between one and three days after a cold virus enters the body.  The symptoms resolve in a week — with or without medication. One cold in four lasts up to 14 days; this most often occurs in children, the elderly, and people who are in poor health. Smokers often have more severe, extended cold symptoms than nonsmokers.

Fewer than five percent of colds lead to such complications as bronchitis, middle ear infection, or sinusitis accompanied by a prolonged cough, but between 5 and 15 percent of children who have colds develop acute ear infection when bacteria or viruses infiltrate the space behind the eardrum. A cold can produce wheezing, even in children who do not have asthma, and symptoms of asthma, bronchitis, and emphysema can be exacerbated for many weeks. Symptoms that persist for more than two weeks or that recur might be more allergy than infection-related.

Post-infectious cough, which usually produces phlegm, may disrupt sleep and persist for weeks or months following a cold. This complication has been associated with asthma-like symptoms and can be treated with asthma medications prescribed by a physician.  Medical attention is indicated if symptoms progress to:

  • ear pain.
  • high fever.
  • a cough that worsens as other symptoms abate.
  • a flare-up of asthma or of another chronic lung problem.
  • significantly swollen glands.
  • strep throat.

Babies can have between five to seven colds during their first two years of life. This enhanced susceptibility results both from immature immune systems and from exposure to older children who are often careless abut washing their hands or covering coughs and sneezes. Nasal congestion and runny nose are the most common symptoms of colds in babies. Treatment consists of breathing moist air and drinking plenty of fluids. Medical attention is indicated at the first sign of a cold in infants less than three months of age because of a heightened risk for pneumonia, coup, and other complications.

Physician evaluation is also necessary if a baby of any age:

  • has an uncomplicated cold, the symptoms of which last for more than seven days.
  • does not wet a diaper properly.
  • refuses to nurse or accept fluids.
  • coughs up blood-tinged sputum or coughs hard enough to cause vomiting or changes in skin color.
  • has trouble breathing.
  • has bluish-tinted lips or mouth.
  • has a temperature higher than 102°F for one day.
  • has a temperature higher than 101°F for more than three days.
  • shows signs of having ear pain.
  • has reddened eyes or yellow eye discharge.
  • has a cough or thick green nasal discharge for more than a week
  • has any other symptoms that concern parents and/or caregivers

Prevention

Common sense plays an important part in preventing the common cold. Absolute avoidance of cold viruses is virtually impossible to achieve, but experts advise keeping a healthy distance from anyone who is ill. The actions the human body takes to clear infection are the same actions that spread the infection to others. Sneezing, for example, is a response to irritation of the nose and mouth. Sneezing as well as a runny nose is the body’s attempt to expel cold viruses before they can invade the nasal passages more deeply. Unfortunately, a sneeze sends infectious particles hurtling through the air at a speed of more than 100 miles an hour.

Simply being in the company of someone who has a cold can contaminate the hands of another person. Touching one’s eyes, nose, or mouth can transfer the infection. It is imperative to wash hands thoroughly after touching someone who has a cold or something that has been touched by someone who has a cold. Playthings touched by a child who has a cold should be washed before being put away. Cleaning surfaces with antiviral disinfectant may help prevent the spread of infection, and increasing interior humidity can reduce susceptibility.

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Arthritis and Diet

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older-black-woman-rubbing-her-hands-arthritisThere are more than 100 different types of arthritis, and, therefore, no single diet will work for every person with arthritis.  However, studies have found that green tea, green leafy vegetables, dried plums, and kiwi fruit are all vitamin-rich and have powerful antioxidant properties.  Diets which include large quantities of fruits and cruciferous vegetables have been shown to have a beneficial effect on preventing the development of rheumatoid arthritis.  In addition, it is clear that carrying extra weight can put significant stress on the joints, and even a small reduction in weight can have an effect on the severity of arthritis symptoms.  Studies have shown that losing weight can significantly ameliorate the effects of osteoarthritis.  Significant weight gain prior to age 35 — as well as excessive alcohol consumption — has been linked to the development of gout.

Other contributing factors are certain foods and nutritional supplements (vitamins, minerals, and omega-3 fatty acids) which may play a role in preventing and reducing symptoms in some types of arthritis, such as gout, osteoporosis, osteoarthritis, rheumatoid arthritis (RA), and reactive arthritis.  Fish oil, particularly when ingested in conjunction with a diet low in arachidonic acid, reduces inflammation in some patients with rheumatoid arthritis.   Regular intake of fish has been shown to have a beneficial effect.  Consumption of excessive dietary fat, however, appears to exacerbate arthritis symptoms.

WEIGHT LOSS AND THE ARTHRITIS PATIENT

Weight loss for overweight arthritis patients is very important for several reasons.  First, as mentioned previously, loss of even a few pounds can significantly reduce stress on weight-bearing joints.   Research demonstrates that exercise and combined weight loss — as well as exercise regimens — result in decreased pain and disability and increased performance levels in patients with osteoarthritis.  Biomechanical data suggest that exercise in combination with diet may also result in improved gait when compared with exercise alone. Secondly, patients of all ages who have arthritis are much healthier, have an improved sense of well-being, and are less likely to suffer arthritis-related depression when they follow a nutritious, well-balanced diet.  The Arthritis Foundation recommends following a balanced diet that includes plenty of fruit, vegetables, and whole-grain products, while limiting consumption of sugar, salt, and saturated fat (i.e., a diet low in fat, high in fiber, and low in sugar).

By Mary O’Brien, MD

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Celebrate the Brain

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fondue-709713_640Thanksgiving and the many holidays that follow are joyful times to be with family and friends.  Holiday cheer, a positive emotion, can also provide the brain with healthful hormones and neurochemicals that improve brain function.

Family traditions boost enjoyment of holiday gatherings.  In a recent series of studies in the Journal of the Association for Consumer Research, subjects described the customs they followed — along with those of their families — during holidays.  These activities were rated as enjoyable, personal experiences that enhanced bondings with family members.  In fact, simply recalling past traditions can put a warm glow on holiday gatherings and support creative thinking.

Memories of childhood or lost loved ones often surface at celebrations.  The bittersweet feeling of nostalgia can elevate mood and mental outlook.  A recent study published in the journal, Emotion, reported that nostalgia boosts a sense of connection to the past, creating a social web that extends across people and time.  This “self-continuity” energizes the brain.  So, pull out an old photo album and spend some time revisiting your past this season.

When listing New Year’s resolutions, resolve to keep friendships alive throughout the year.  The benefits of supportive relationships are numerous.  Research published online in the Journal of Epidemiology and Community Health (2016), stated that individuals who have greater levels of social support enjoy better psychological health and mental functioning.  The reduction of chronic stress and the stimulation associated with meaningful social interaction are strongly linked to improved resilience and reduced risk of anxiety and depression.  There is also a lower likelihood of cognitive decline.

The highlight of any holiday is food, often deeply entwined with tradition, but possibly devoid of brain-healthy choices.  Compromises that allow both brain-healthy and traditionally-happy fare, including desserts, can solve this dilemma.  First, shift the spotlight from rich food to lighter fare by serving salad as the first course.  Go heavy on the greens, colored veggies, and crunchy bits of apples or pears.  Second, make a healthy vegetable side dish the co-star of the main course.  Third, regarding the turkey, think outside the bread box with offerings such as wild-rice stuffing, augmented with vegetables and dried cranberries.  Lastly, the first bite of dessert, thoughtfully consumed, always gets rated as the best.

Enjoy the fabulous taste of that bite!  Then, empower your mind with oxygen — by taking a mindful walk — to complete the celebration of your brain.


Dr. Laura Pawlak (Ph.D., R.D. emerita) is a world-renown biochemist and dietitian emerita.  She is the author of many scientific publications and has written such best-selling books as “The Hungry Brain,” “Life Without Diets,” and “Stop Gaining Weight.”  On the subjects of nutrition and brain science, she gives talks internationally.

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What Is Gluten?

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By Annell St. Charles, Ph.D., R.D.

Gluten is the general name given to the proteins found in certain grain products — including wheat and its derivatives (wheat berries, durum, emmer, semolina, spelt, farina, faro, graham, and einkorn wheat), rye, barley, triticale (a hybrid of wheat and rye), malt, brewer’s yeast, and wheat starch (Celiac Disease Foundation, 2014).  Apparently, the hybridization that led to the production of modern bread wheat enabled the creation of a product with high amounts of the gluten complex, making modern bread wheat the worst gluten offender.

Gluten plays a significant role in nourishing plant embryos during germination.  In addition, as the name implies, “glu-ten” acts as a type of glue that holds food together, affects the elasticity of dough made from these grains, and gives shape and a chewy texture to products (such as bread) that are made from the dough.  It is also used as an additive in foods that have low-protein levels or no protein at all.  When it is used in vegetarian recipes (lacking any animal products), it helps to increase the firmness of the texture of the finished product in order to replicate that found in meats and other animal foods.

Gluten is actually made up of two different proteins, gliadin (prolamin) and glutelin, which are attached to starch in the endosperm of the grain.  Because the starch is water-soluble but the gluten isn’t, gluten can be obtained by dissolving away the starch with cold water.  (Salty cold water works best).  When gluten enters the digestive system, the proteins are broken down into smaller units called peptide chains, which are made up of amino acids.  Apparently, these peptide chains are the source of gluten sensitivity in some people, resulting in an array of symptoms, potentially contributing to more serious conditions such as celiac disease.  Whereas glutelin is water-soluble, gliadin is alcohol-soluble.  Gliadin is considered the most toxic.  Among the problematic disorders related to gluten, approximately six percent may be due to non-celiac gluten sensitivity, 10 percent may be the result of wheat allergy, and only one percent would be celiac disease.  However, despite its lower occurrence, celiac disease is considered the most serious of the bunch.

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Neck Pain: An Introduction

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Rear view of a young man holding her neck in pain, isolated on white background, monochrome photo with red as a symbol for the hardening

By Raj Hullon, MD

Almost everyone has experienced neck pain of some sort during his or her lifetime — and for good reason.  One of the most common causes of such pain is poor posture.  Simple activities such as reading, especially in bed — or sleeping on a pillow that may either be too low or too high — can cause neck pain.  Other activities that can cause neck pain include bending over a desk for hours, maintaining poor posture while watching TV, and positioning a computer monitor either too high or too low.  The key is always to maintain the neck as close to a neutral position as possible.

The best medical care, however, begins with a crucial question:  What is the most serious problem this could be?  Neck pain can be referred from multiple anatomical structures as a result of developmental processes in the embryonic stage.  Serious cardiovascular, neurologic, infectious, or neoplastic etiologies must be considered before attention is focused on common musculoskeletal disorders.

Chronic neck pain is prevalent in Western societies, with about 15 percent of women and 10 percent of men suffering from it at any given time.  People with physically demanding jobs requiring neck flexion and awkward lifting are at high risk of developing chronic neck pain.  It is also common among health care professionals, particularly affecting nurses who are constantly involved in handling tasks that involve reaching, lifting, and pulling.  Dental professionals who work long hours bending over their patients also suffer from neck pain because of postural demands.

The pain is often muscular or ligamentous in origin and is usually self-limited although the pain can be persistent.  Pain is transmitted through nerve endings in the various ligaments and muscles of the neck, vertebral joints, and the outer layer of the intervertebral discs.  When these structures are irritated, strained, or inflamed, pain is felt in the back of the neck, may spread toward the shoulders, and is commonly felt between the shoulder blades.

The natural healing processes result in improvement in almost all cases.  In fact, the pain from serious neck injuries such as fractures, dislocations, and most cervical spine surgeries often resolves after a few weeks or months.  There is usually little if any correlation between neck pain and the degenerative changes that are commonly seen on X-rays.

Neck strain or sprain is the most common type of injury to motor vehicle occupants treated in U.S. hospital emergency departments.  Whiplash injuries can be serious in certain situations.  Severe damage to the spinal cord can be fatal.

Sports and athletics are also common sources of injury to the neck region and should be a particular concern for the younger adult population.

Another common offender is carrying unbalanced loads, such as a heavy briefcase, luggage, or a shopping bag. A careful history is often required to identify such factors as playing a role in neck and shoulder pain.

 

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Binge Eating Disorder

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fat-foods-binge-eatingBy Nikita Katz, MD, PhD

Binge eating disorder is an illness that resembles bulimia nervosa.  Like bulimia, the disorder is characterized by episodes of uncontrolled eating or binging—occurring, on average, at least once a week for three months, according to DSM-5.  However, binge eating disorder differs from bulimia because its sufferers do not purge their bodies of excess food.

Individuals with binge eating disorder feel that they lose control of themselves when eating. While they commonly eat fewer meals than people without eating disorders.  When they do eat, they eat rapidly, consuming large quantities of food and do not stop until they are uncomfortably full.  When binging, they typically do so alone because they feel embarrassed by how much they are eating, and they tend to feel disgusted with themselves, depressed, or very guilty afterward.  Usually, they have more difficulty losing weight and keeping it off than do people with other serious weight problems. Most people with the disorder are obese and have a history of weight fluctuations.

Binge eating disorder is found in about two percent of the general population—more often in women than men.  Recent research shows that binge eating disorder occurs in about 30 percent of people participating in medically supervised weight-control programs.

Because people with binge eating disorder are usually overweight, they are prone to the serious medical problems associated with obesity, such as high cholesterol, high blood pressure, and diabetes. Obese individuals also have a higher risk for gallbladder disease, heart disease, and some types of cancer. Research at the National Institutes of Health and elsewhere has shown that individuals with binge eating disorder have high rates of co-occurring psychiatric illnesses, especially depression.

Cognitive behavioral therapy and interpersonal therapy are the treatments found to produce the greatest degree of remission in patients with binge eating disorder.  Also, there can be improvements in specific eating-disorder psychopathology, associated psychiatric problems such as depression and psychosocial functioning.

Epidemiology of Eating Disorders

Estimates of the incidence or prevalence of eating disorders vary depending on the sampling and assessment methods.

  • Eating disorders have generally been recognized as affecting a narrow population of Caucasian adolescent or adult young women from developed Western countries.  In recent years, data are steadily accumulating to document that:
  • The prevalence of anorexia nervosa and bulimia nervosa in children and younger adolescents is unknown.
  • Approximately 0.5–1 percent of adolescents suffer from anorexia nervosa and 1–5 percent suffer from bulimia nervosa. Female college students are at highest risk of the latter.
  • An estimated 85 percent of eating disorders have their onset during adolescence.
  • Estimates of the lifetime prevalence of bulimia nervosa among women have ranged from 1.1 to 4.2 percent. Some studies suggest that the prevalence of bulimia nervosa in the United States may have decreased slightly in recent years.
  • The reported lifetime prevalence of anorexia nervosa among women has ranged from 0.5 percent for narrowly defined to 4 percent for more broadly defined anorexia nervosa.
  • Estimates of the male-female prevalence ratio range from 1:5 to 1:10 (although 19-30 percent of younger patient populations with anorexia nervosa are male).
  • An estimated five million Americans suffer from eating disorders at any given time, including approximately 5 percent of women and <1 percent of men with either anorexia nervosa, bulimia nervosa, or binge eating disorder.
    • eating disorders have become more common in pre-pubertal children and women in middle and late adulthood in such countries
    • ethnic and racial minority groups in these countries are vulnerable to eating disorders, and
    • there is nothing uniquely “Western” about eating disorders, which are a global health problem.

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About Systemic Lupus Erythematosus (SLE)

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bhmkclteeodsgq5wrqwaSystemic lupus erythematosus (SLE) is an autoimmune disease that can cause damage to the heart, lungs, kidneys, joints, skin, brain, and blood vessels.   It is characterized by flare-ups, and symptoms, ranging from mild to severe, including extreme fatigue, chest pain, anemia, swelling in legs and near the eyes, painful joints, fever, skin rashes, hair loss, and kidney problems.

At least 1.5 million Americans suffer from lupus.  The ratio of female to male is 9:1 according to the Lupus Foundation of America.   African-American women are far more likely to be affected than are Caucasian women.   Recent research points to a strong genetic role, but environmental and hormonal factors seem to be involved in lupus as well.

Diagnosis can be difficult and may be delayed because the onset of symptoms is hard for patients to pinpoint and because the wide variety of symptoms overlap with many other conditions.  To diagnose lupus, the clinician takes a careful history, performs a physical exam, and orders anti-nuclear antibodies and other laboratory tests.

Although lupus can be life-threatening, some 80 to 90 percent of sufferers can expect to live a normal lifespan if they are carefully monitored and treated.

Management of lupus is directed at preventing flare-ups, treating symptoms, and preventing or slowing damage to organs.  According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the principal medications include:

  • NSAIDs to reduce inflammation.
  • Anti-malarials such as hydroxychloroquine (Plaquenil®) to prevent flare-ups.
  • Corticosteroids such as prednisone (Deltasone®), hydrocortisone, methylprednisolone (Medrol®), and dexamethasone (Decadron®, Hexadrol®) to reduce inflammation.
  • Immunosuppressive agents such as cyclophosphamide (Cytoxan®) and mycophenolate mofetil (CellCept®) to inhibit an overactive immune system.  Belimumab (Benlysta®) is a B-lymphocyte stimulator protein inhibitor that was approved by FDA 2011 for patients with lupus who are receiving other standard therapies.  It may reduce the number of abnormal B cells thought to be a problem in lupus.
  • Methotrexate (Folex®, Mexate®, Rheumatrex®), a disease-modifying antirheumatic drug, may be used to help control the disease in some patients.

Other treatments may include hormonal therapies such as dehydroepiandrosterone (DHEA) and intravenous immunoglobulin, which may be useful for controlling lupus when other treatments haven’t worked.

A variety of self-care and complementary approaches can be useful, including exercise, diet, the avoidance of sun exposure, and skin protection.  Patients are advised to recognize early signs of a flare-up and get immediate medical attention.

Findings from prospective human studies have strengthened the evidence of a connection between lupus and vitamin D status.  There is evidence that increased vitamin D levels (via supplementation) may help reduce inflammation.  A reasonable dose would be 2000 IU of vitamin D3 on a daily basis.  Vitamin D levels are easily checked.

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