Systemic Lupus Erythematosus

The Brain Therapeutics Medical Clinic

From LET’S LIVE Personalized Regenerative Medicine
Magazine David A. Steenblock M.S., D.O., H.MD
By David Steenblock, D.O. 26381 Crown Valley Parkway, Ste. 130, Mission Viejo, CA 92691
March 1982

Fighting The Big Red Wolf Of

Things You Can Do
Diseases Naturally
Right Now:
WOULD YOU BELIEVE that use of aspirin, and in severe B-cell is “hyper” and ready to
the big, bad wolf is still in cases – cortisone. make antibodies in great
Increase Sulfur- pursuit of grown up Red Riding The immune system is the quantities, there is a good
containing amino Hoods? key to understanding the possibility that the B-cell will
acids: cysteine and Lupus comes from the Latin cause(s) of lupus. The begin to make antibodies
methionine “fox wolf”, while immune system includes those against some of those injured
erythematosus means “red”. cells of your body involved or dead body cells. If that
RAST & Cytotoxic This red wolf primarily attacks with attacking bacteria, happens, the beginning of an
Tests women between the ages of 20 viruses, foreign proteins (e.g., autoimmune disease is in the
and 40, but may occur between ragweed), and cancer. There making! Auto refers to “self”
Avoid Caffeine childhood and old age in both are three main types of and the disease is thus an
sexes. The name is derived “immune cells” and all immune attack directed against
Avoid Alcohol from the characteristic red face circulate in the blood and body your own normal body cells.
rash and the skin changes, fluids. These include the B- The T-lymphocytes are of
Tryptophan-poor diet which may resemble the bite of lymphocytes, the T- great importance to all of us
a wolf. lymphocytes, and the since they protect the body
Thera-Comp Diet The disease can produce a macrophages. from viruses and help with the
number of problems for the The B-lymphocyte is a bone body’s surveillance against
Evening Primrose victim, including fever, marrow derived cell and is cancer. Besides those
Oil arthritis, anemia, kidney responsible for the production important functions they help
dysfunction, and heart, lung, of antibodies. Antibodies are regulate the B-cells. A certain
Vitamin C nerve and gastrointestinal specific proteins produced by type of T-cell called a
inflammations. The disease these cells to fight off foreign suppressor cell appears to not
Vitamin A comes and goes and the person invaders. If for any reason be functioning well in lupus.
may be totally healthy for years these B-cells become more The suppressor cell’s job is to
Biotin, B1, B5, B6, and then have a return of the excited than they should be, suppress the activity of the B-
Niacin problem. The severity ranges they will produce more cell. If the suppressor cells are
from a very mild illness with antibodies than normal; and not functioning correctly, they
Zinc little effect on the person to an diseases such as lupus, will not suppress the B-cells,
acute, severe disease afflicting allergies, rheumatoid arthritis, which in turn will tend to
L-Glutamine many organs simultaneously. scleroderma, etc., may occur begin to make too many
The disease seems to be since all of these diseases have antibodies.
activated by infections, the common property of Macrophages are another
sunlight, surgery, pregnancy, having too many antibodies type of cell that is involved
physical or emotional stresses present! At times of stress, with immune regulation. The
and certain drugs. injury, infection, sunburn, and macrophage is a phagocytic
Treatment for lupus has possibly menstruation, the cell (phago = to get, cyte =
varied somewhat over the years blood will contain injured and cell) and is responsible for
but most authorities now freshly killed antibody cells picking up foreign proteins
recommend bed rest for days due to any of these harmful that enter into the body and
when the disease is active, the factors. If at the same time the delivering these to the B and
T-cells. All three types of
cells (B,T and macrophages)
work together in mustering the
correct attack against whatever
foreign invader is present. The
headquarters for their
interaction and planning of the
body’s attack is the thymus
gland, which is a gland that is
present in the neck close to the
thyroid.
It appears that for correct
function and balance of the
immune system, the thymus
gland has to work correctly.
The thymus gland is large in
the child, reaches its peak at
the time of puberty and
gradually diminishes in size
and function as we get older.
In lupus the thymus gland has
been shown to be abnormal in
appearance1 and have a
premature loss of thymus
hormones.2
These deficiencies of
thymus function are very
important since if the thymus
gland doesn’t work properly,
the suppressor T-cells will not
work properly and hyper-
reactivity of B-cells will result,
setting the stage for the
development of lupus.
Dr. Jerry Daniels and his
colleagues at the University of
Texas Medical Branch in
Galveston have given thymus
hormone to patients with
systemic lupus and have found
evidence that it will correct
certain immune imbalances.
They are currently doing a
randomized study to see if
thymus hormone will help.
Since the disease tends to run
in families, a genetic tendency
may be responsible for many
of the thymus gland
abnormalities, however the
thymus gland also can be
injured by a number of things.
In childhood, if not enough
protein or calories are present
the thymus gland will not
develop properly. Lack of
vitamins, minerals, and
Page 2
essential fatty acids in a
growing child can injure the
immune system’s regulating
ability – possibly for life.
Beside having adequate
levels of protein and calories
in the diet it has been shown
that vitamin B-5, B-6, and B-
12, vitamin C, zinc, biotin,
iron, selenium, essential fatty
acids, vitamin A and folic
acid3 are essential for proper
immune system development.
Vitamin B-6 deficiency, for
example, causes decreased
thymus hormone while a
vitamin A deficiency decreases
the actual number of T-cells in
the blood. During an active
flare of the disease the number
of circulating T-cells is
diminished in the blood while
the number of auto-antibodies
is increased. Since anything
which will diminish the
activity of T-suppressor cells
will lead to hyper-reactivity of
the B-cells the importance of
adequate vitamin A and other
nutrients in optimizing
immune regulation is clear.
The main essential fatty acid
in food is linoleic acid and this
is present primarily in
vegetable oils. Once taken
into the body linoleic acid is
converted into gamma-
linolenic acid and then into
prostaglandin E-1.
Prostaglandin E-1 (PGE-1) has
many beneficial attributes and
a deficiency of this has been
linked with a great variety of
illnesses. The highest
concentration of PGE-1 in the
body is found in the thymus!
PGE-1 has an effect very
similar to thymus hormone in
producing growth and
development of T-cells. A
deficiency of PGE-1 occurs
with dietary lack of vegetable
oil or when a certain enzyme
(delta-6-desaturase) is not
working in the body, which
normally converts linoleic acid
into PGE-1. Hydrogenation of
vegetable fats (as in some
margarines) converts a portion
of cis-linoleic acid into trans-
linoleic acid, which cannot be
used by the body to make
PGE-1. Saturated fats,
cholesterol, and sugar will
inhibit the function of the
delta-6-desaturase enzyme and
lead to deficiencies of PGE-1.
Deficiencies of vitamin B-6,
vitamin C, zinc, magnesium
and niacin have all been shown
to impair the enzyme and
result in decreased tissue
levels of PGE-1.
In 1982 there were no
studies on PGE-1 levels in
lupus, but many studies have
been conducted since then. In
one 1995 study, rats treated
with the antiinflammatory
prostaglandins (PGE-1) had a
prolonged survival rate and
amelioration of kidney
disease4 associated with lupus,
suggesting that there is,
indeed, a deficiency of these
beneficial prostaglandins in
lupus sufferers. A related
disease (scleroderma) has been
treated with some success by
giving evening primrose oil
orally. This oil has a high
concentration of gamma-
linoleic acid and will increase
the body’s levels of PGE-1
since it can sidestep the
blocked delta-6-desaturase
enzyme.
Most people with lupus tend
to be women (nine to one) and
more depressed and anxious
than people with other types of
chronic illnesses. Women are
most often afflicted with the
problem in their childbearing
years (20 to 40), and these are
the years of greatest stress.
Society’s and her own
expectations of herself are best
exemplified by the saying “A
woman is expected to act like
a lady, think like a man, and
work like a dog.” Stress in
excess can precipitate disease
in anyone. During the
childbearing years a woman
has to take care of her
children, husband, the house,
the checkbook, the groceries,
and the babysitters while
working at her own job,
menstruating monthly, and
always being rushed.
Combine all these with the
overwhelming feeling of
being on a treadmill for
which you receive little
reward (lack of job
satisfaction) and you have a
person who is under
tremendous stress. Add a
virus, injury, sunburn, poor
diet, surgery, pregnancy,
lack of sleep, poor life
habits, etc., and the “spring
will have been wound too
tight” causing disease to
appear. Is it any wonder that
the main treatment for lupus
is rest?
Excessive stress activates
the adrenal glands to
produce adrenaline and
cortisone. Cortisone has an
inhibitory effect on
suppressor T-cells while
adrenaline activates the B-
cells to make more
antibodies.
Stress also causes a decrease
in serum zinc as does
estrogen and pregnancy.
The white spots seen in the
fingernails of people under
great stress are indicative of
this deficiency. Zinc
deficiency causes a loss of
lymphocyte function and
especially of the of the
thymus gland cells and the
T-lymphocytes.5 This lack of
zinc may be one of the
reasons why women are so
much more susceptible to
lupus than men. Addition of
zinc to the diet increases the
size of the thymus,6
improves the immune
system, and facilitates the
formation of prostaglandin
E-1 from the essential fatty
acids. 7
 Stress can produce stomach
and intestinal spasms or
irritability. This irritability of
the gastrointestinal tract causes
the release of histamine and
serotonin into the circulation.
These substances directly
inhibit the function of
suppressor T cells. These
observations would indicate
that treatment of lupus should
be directed at least in part
toward inhibition of the
production of adrenaline,
serotonin and histamine since
that will tend to correct the
immune imbalance.
Adrenaline is produced by
both adrenal glands and nerve
tissue in response to something
perceived as dangerous to you.
This produces the well known
“fight or flight” bodily
responses including the
liberation of stored sugar
(glycogen) from the liver so
that there is enough sugar for
the muscles to use if we need
to run fast to get away from the
perceived danger. If you
substitute the word anxiety for
danger here, you can appreciate
that chronic anxieties will keep
your adrenaline pumping hour
after hour, day after day. This
constant bombardment of
adrenaline on the liver causes
the eventual depletion of the
liver’s stored sugar reserves.
When the blood sugar starts to
fall a few hours after eating,
there is little stored sugar in the
liver to be put back in the
bloodstream. Hypoglycemia
symptoms then begin to
appear. Some of the symptoms
of hypoglycemia are due to the
release of more adrenaline
since the body perceives the
low blood sugar as another
stress. This causes even more
loss of the liver stores of sugar
leading to more and more
problems.
Adrenaline itself has a direct
stimulating effect on the B-
cells and this further
stimulation of the B-cells will
aggravate allergies and in the
case of lupus will worsen the
condition. Oftentimes a simple
change in diet with avoidance
of all sugars, sweet foods and
high carbohydrate foods will
improve the allergic state!
To counteract the excesses
of adrenaline there are a
number of tricks that can be
employed. Raising the intake
of the sulfur-containing amino
acids (Cysteine and
methionine) works by
increasing the detoxification
system of the liver.
Vitamin B-1 (thiamine) is
normally the fastest vitamin to
be destroyed in the body with a
“half life” of 20 minutes.
Vitamin B-1 is also used up
faster by the body when there
is increased sugar or
carbohydrates in the diet or
when there is more stress and
adrenaline in the system. The
body must receive adequate
levels of vitamin B-1 in order
to counteract these increased
demands to help normalize the
metabolism.
Vigorous physical activity is
also capable of reducing
adrenaline levels and is usually
quite helpful at reducing stress
levels; but in lupus it is not
recommended unless advised
by your physician.
Food allergies can be of
great importance in lupus as
well as other chronic diseases.
Patients with lupus have indeed
been shown to have more food
allergies than most people.8
Food allergies are difficult to
diagnose and there is a
continual controversy over
what tests to use if any. In my
experience I have found that
the use of both RAST and
cytotoxic tests give the most
accurate results and help the
patient the most. If only one or
the other is used, often a
serious allergy will be missed.
This will hamper the healing
process since eating that one
food may well produce a
tremendous stress on the body
and worsening of the condition.
Caffeine tends to further
stimulate the action of
adrenaline in the body and
therefore should be avoided
(coffee, tea, chocolate, soda
pop, etc).
Alcohol also must be
avoided in all forms since it
tends to release adrenaline in
the body and also injures the
liver, further worsening the
problem of hypoglycemia. By
interfering with the liver,
spleen, bone marrow and
lymph node’s phagocytosis
actions, alcohol also allows
foreign proteins to circulate
longer in the body, which tends
to produce more allergies.
Alcohol also damages small
blood vessels (venules) and
makes them “leaky” which
allows fluid from the blood to
escape into the tissues. Once
in the tissues this “edema”
fluid causes the breakdown of a
type of cell called a mast cell,
which then liberates its stores
of histamine. Histamine
aggravates all allergies by
causing more leakiness of the
small blood vessels (giving the
clinical symptoms of water
retention, runny nose, welling
of tissues and weeping mucous
membranes) and by inhibiting
the suppressor T-cells. 9
Stress induced adrenaline
paralyzes the intestine and
interferes with digestion. As
food passes into the paralyzed
bowel the food will “sit” in one
place until such time as the
amount of food is great enough
to physically irritate the bowel
and then the bowel will
contract spasmodically. This
combination of paralysis and
spasm results in the clinical
picture of constipation,
diarrhea, or alternating bouts of
each, which is called the
irritable bowel syndrome.
Since 40 percent of the
normal population suffers
from this condition more or
less, the likelihood is that
people with lupus may well
have the problem also.
If the irritable bowel
syndrome is present certain
changes occur in the bowel.
First, the pH gradually
changes from the optimum
of six to an undesirable
eight or nine. These
changes occur because the
decreased peristalsis allows
the food to putrefy and
ferment. This allows an
overgrowth of harmful
anaerobic bacteria and these
cause the formation of
harmful, toxic, metabolic
poisons to be formed from
bile salts, foodstuffs, and
the bacteria themselves.10
These substances decrease
the liver’s ability to
detoxify foreign proteins
and other poisonous
material.
Tryptophan is an
essential amino acid, which
is present in dairy products,
nuts and bananas. Once
eaten and absorbed
tryptophan is converted into
serotonin, and 95 percent of
the body’s content of
serotonin is contained in the
bowel wall. When the
bowel contracts
spasmodically, this
serotonin can be released
into the blood. Serotonin is
thought to be inactivated by
a liver enzyme system,
which also inactivates
adrenaline and related
compounds. If the liver has
been injured by alcohol,
toxic material from the
bowel, stress, or has lost its
stores of sugar (glycogen)
as in hypoglycemia; this
adrenaline and serotonin
inactivating enzyme system
will become overloaded and
the blood concentrations of
Page 3
serotonin and adrenaline will
rise. Injection of adrenaline
and serotonin into human
volunteers causes severely
constricted skin blood
vessels to the point of
cyanosis.11 Serotonin and
adrenaline are both powerful
blood vessel contractors.
Elevated levels of serotonin
have been demonstrated in
patients with irritable bowel
syndrome.12
The irritable bowel
syndrome is most often due
to nervous tension or food
allergies both of which
produce excessive levels of
adrenaline. This
combination of elevated
adrenaline and serotonin
levels is probably the reason
people will have cold hands
when they suffer from
constipation.
From the above you could
be led to believe that patients
with lupus have elevated
levels of serotonin but in fact
they have decreased levels!
Apparently these people
have a decreased ability to
convert tryptophan into
serotonin in the body due to
malfunction of various
enzymes. The mechanism
for this enzyme inhibition is
not clear but a case can be
made for tryptophan
metabolites as a generalized
poison to the body. Injection
of adrenaline into human
volunteers causes large
increases in plasma free
tryptophan.12 Stress releases
nonesterified free fatty acids
from fat and these
substances raise the levels of
tryptophan. Lack of proper
nutrition (proteins-calories-
vitamins) also can raise
blood levels of tryptophan.
Tryptophan breakdown
products have carcinogenic
properties13 causing
leukemia and tumors in
mice. When tryptophan is
Page 4
exposed to sunlight (UV) in
the presence of oxygen as
found in and around the
capillaries of the skin, a
number of poisonous and
carcinogenic compounds
may be formed. One of the
most serious is hydrogen
peroxide. If any of these
compounds come into close
contact with a cell, that cell’s
vital structures may be
chemically altered to the
point that the body no longer
recognizes that cell as
normal. These changes
could then result in the
development of auto-
antibodies. 14
In summary, a person may
develop lupus from the
complex interactions of
stress, injury, anxiety,
sunlight, diet, genetics,
viruses, etc., all of which
raise tryptophan levels either
directly or by inactivation of
the enzymes that degrade or
convert tryptophan into
serotonin. The excess
tryptophan is partially broken
down to form protein
damaging chemicals
especially in areas of the
skin, which are sun exposed
and where the circulation is
slowed due to blood vessel
constriction. The same
factors of stress, excess
adrenaline, poor nutrition,
injuries, etc., also create an
imbalanced immune system
that is over-reactive in terms
of seeking out foreign
proteins to destroy.
Treatments of lupus should
take all of these factors into
account.
From a dietary point of
view the worse the disease is,
the more rigid and strict the
diet must be. As the disease
improves dietary controls can
begin to be relaxed. In lupus
the use of a diet that is
deficient in tryptophan and
related compounds is
important as illustrated by
antagonizes the effects of
the increased survival of
tryptophan, serotonin, and
animals with lupus on such a
histamine. 16
diet.15 Removal of saturated In severe cases the use of
fats, chocolates, cholesterol,
plasmapheresis is producing
dairy products, wheat, nuts,
beneficial results by actually
pineapple, bananas, sugar,
removing the excess
sweet foods, alcoholic
quantities of antibodies.17
beverages, caffeine-
The immune system is then
containing drinks and all
suppressed with cortisone to
foods one is allergic to is of
prevent further antibody
great importance when the
production. Perhaps the
disease is active. The only
addition of the concepts of
possible way of following
stress reduction, a specific
such a diet is with the help
diet for each person,
of a computer-selected
nutritional supplements and
recipe program such as
rest will be of additional
offered by THERA-COMP
benefit and we can chase that
P.O. Box 6083, Santa Ana,
old red wolf away once and
CA 92706. They are
for all!
working on an on-line
therapeutic dietary program
that eliminates foods you are
allergic to,
or which may aggravate
some physical problems.
Thera-Comp will prepare a
14-day diet, which excludes REFERENCES
whatever foods you wish to
exclude. Thera-Comp then
tries
to construct your diet so that
none of the remaining foods 1. Arch. Intern. Med. 124: 60-63,
1969.
is repeated more than once
2. J. Urol. Nephrol. (Paris) 78:994,
in four days. When this
1972.
service is ready, the 3. JAMA 245(1): 53-58, 1981.
complete diet can be sent to 4. Clin Immunol Immunopathol. 1995
you by priority mail, or by e- May:75(2):125-30
mail. The cost will be 5. Lancet, 7917, 1973.
$12.95. 6. Lancet, 8047, 1977.
Taking daily supplements 7. Med. Hyp. 7: 1211, 1981.
of evening primrose oil, 8. J. Allergy Clin. Immunol. 50: 18-
30, 1972.
vitamin E (non-wheat
9. Amer. J. Med. 71: 100-104, 1981.
derived), vitamin C,
10. “Colon Cancer, Part 1,” Let’s
methionine, cysteine, Live, November 1981, 11-14.
vitamin A, biotin, Vitamin 11. Trans. Ass. Amer Physicians 79:
B1, B5, B6, niacin and zinc 54-63, 1957.
will help correct the 12. Ann. Intern. Med. 59: 164, 1963.
underlying biochemical 13. Clin. Sci. and Mol. Med. 53: 227-
abnormalities. 232, 1977.
L-glutamine may be 14. J. Cancer Res. Clin. Oncol, 96:
163-168, 1980.
helpful since it has been
15. Science 191: 468-469, 1976.
shown recently to have a
16. Agents and Actions 11, 3: 243-
marked anti-inflammatory 249.
action comparable to 17. Dubois, Lupus Erythematosus, 2nd
phenylbutazone – a cortisone Ed., 121.
type of drug. L-glutamine