Diet and nutrition with lupus
There is no special diet for lupus, despite numerous claims on the Internet, and in various books and other publications. In general, you should try to eat a nutritious, well-balanced, and varied diet that contains plenty of fresh fruits and vegetables, whole grains and moderate amounts of meats, poultry, and fish.
One food for people with lupus to avoid is alfalfa. Alfalfa tablets have been associated with reports of a lupus-like syndrome or lupus flares. The lupus-like effects may include muscle pain, fatigue, abnormal blood test results, changes in how the immune system functions, and kidney problems. These reactions may be due to the amino acid L-canavanine (found in alfalfa seeds and sprouts, but not in leaves), which can activate the immune system and increase inflammation.
If you plan to add herbs, dietary supplements, or vitamins to your diet, you should discuss your decision with your lupus doctor first. This is especially important as herbs or supplements may interact with medicines used to treat lupus. Herbs or supplements should never be used to replace medicines prescribed to control symptoms of lupus or medication side effects.
You may have to cut back or eliminate certain items from your diet because of the medications you are taking, or because of the damage that lupus has done to certain parts of your body.
Guidance on alcohol use with lupus
Moderate use of alcohol is usually not a problem for people with lupus, but alcohol can lower the effectiveness of some medications, cause new health problems, and/or can make existing problems worse. For example, non-steroidal anti-inflammatory drugs -- such as aspirin, ibuprofen (Motrin®), naproxen (Naprosyn®), and celecoxib (Celebrex®) -- can cause ulcers and bleeding in the stomach and intestines at any time during treatment; the chance of developing an ulcer or internal bleeding increases with alcohol use. Also, anticoagulant medicines such as warfarin (Coumadin®) and the chemotherapy drug, methotrexate, may not be as effective if you are drinking alcohol.
Dietary considerations for corticosteroid use
Corticosteroids can elevate blood pressure and the levels of cholesterol and lipids in the blood. If you are taking steroids, you should limit the fat and salt in your diet as both can contribute to these conditions.
Corticosteroids also can cause or worsen osteoporosis, a disease in which bones become fragile and more likely to break. If you have osteoporosis, you should eat foods rich in calcium every day to help with bone growth. Examples are dark green, leafy vegetables (spinach, broccoli, collard greens), milk, cheese, and yogurt or calcium supplements that contain Vitamin D.
If you are experiencing fluid retention that causes swelling (edema), you should lower the amount of salt and sodium-containing foods you eat; in particular, processed foods should be avoided.
Read more about managing steroid-related weight gain.
Common dietary questions
Should people with lupus stop eating red meat?
There’s no scientific evidence that avoiding red meat will have an effect on lupus. If you have kidney disease, red meat can give you more protein than your kidneys can handle. If you have high cholesterol or high triglyceride levels, red meat can raise these further. On the other hand, if you have inflammation in your body you need more protein than when you’re healthy. So the bottom line is to eat a well-balanced diet. If you’re not sure how much you should be eating, ask your doctor to refer you to a Registered Dietitian for a consultation.
Should a person with lupus be on a gluten-free diet?
If you also have celiac disease, a gluten-free diet is critical. Otherwise, there is no evidence that gluten worsens or improves inflammation in any other autoimmune disease such as lupus. If you haven’t been tested for celiac disease, there is a blood test that can be done to detect it.
Are vegetarian or vegan diets okay for people with lupus?
Vegetarian or vegan diets are okay, but you need to take a multivitamin that includes vitamin B12, as this vitamin can only be obtained through animal products. Otherwise you might develop anemia and nerve damage. Also, it’s important to mix your sources of protein so that you get complete proteins – for example rice and beans, or corn and wheat. Animal proteins, dairy, and eggs are complete proteins, but vegetable proteins are generally low in one or more amino acids, which makes them inadequate as sole sources of protein.