Lifestyle choices, like diet and sleep hygiene, can significantly support your health, including your immune system. But for a lupus patient, simply having a healthy diet is not a complete answer to feeling well.
Anti-inflammatory diets are frequently touted for their benefits. However, such broad wellness advice is generally geared toward people who are already well. Those struggling with incurable autoimmune diseases, like lupus, require personalized solutions.
If you're looking for a list of food rules for lupus, this is not it. Evidence-based wellness tips are important to consider. But focusing on nutrient-dense, whole foods alone may not help keep inflammation down and energy levels up.
Many people have already found that following a popular anti-inflammatory diet can actually increase lupus symptoms and make you feel worse. As autoimmune disease-focused health coaches, we recommend trigger identification and confirmed self-evidence to determine what's "good" and "bad" for each person.
Remember, your body's response to a particular food will not necessarily be the same as another person's response. Importantly, you can have symptoms after consuming a "healthy" food item. So, even if it can feel counterintuitive, following a diet considered to be healthy may not work for you.
Here, we'll discuss some popular dietary tips for lupus symptom management and explore why they shouldn't be considered one-size-fits-all solutions. You're likely faced with many food choices each day. Understanding what works for your particular body is vital to optimizing your health.
Listen to and trust your body. You know yourself best.
Common Dietary Recommendations for Lupus Patients
Eat Nutrient-Rich Food
Skipping breakfast or eating a meal primarily of carbs in the morning might leave you feeling fatigued. Instead, consider a high-protein breakfast to curb sleepiness and eventual food cravings. Protein is an essential macronutrient that helps regulate metabolism and prevent the breakdown of muscles.
Even those on a low-to-moderate protein diet must eat adequate amounts of protein to maintain energy and repair tissues. Plus, the quality of the protein source matters. When buying meat or fish, consider those labeled grass-fed, organic, pasture-raised, and wild. These items may be easier to tolerate and carry fewer contaminants (which can be triggers too).
Plant-based sources of proteins can be more cost-sensitive. These include lentils, chickpeas, beans, organic soy, mushroom meat, nuts, and seeds. Some studies have shown that eating plant-based foods generally helps inflammation.
However, even a protein source like lentils, which are healthy for most people, can be behind immune dysfunction in some. It is vital when you are introducing new foods to pay attention to how you feel eating them. Even foods generally regarded as healthy lead to flare-ups in some lupus patients.
Eat Lots of Veggies
You may have heard the phrase, "eat the rainbow." Incorporating colorful whole foods and vegetables — what could go wrong? Eating several servings of antioxidant-rich, vibrant vegetables can help ensure a diversity of vitamins, minerals, and phytonutrients to support your immune system. But, details are critical.
Not every vegetable may be anti-inflammatory for a lupus patient. In fact, some vegetables negatively alter the gut microbiome of some lupus patients. This alteration may further activate an already overactive immune system, causing symptom flares and debilitating pain.
Avoiding vegetables is not a long-term solution. It's crucial to seek support to identify which vegetables are healthful for you and which cause symptom aggravation.
Incorporate Omega-3 Fatty Acids
Consuming more foods high in omega-3 fatty acids is generally considered beneficial for lupus patients with anti-inflammatory and energy-boosting benefits. Foods high in omega-3 fatty acids include salmon, sardines, walnuts, flax seeds, pumpkin seeds, and hemp seeds. Indeed, some research supports omega-3 fatty acids for people with lupus.
However, keep in mind that seeds, fish, and nuts can be unknown allergens or sensitivities, leading to symptoms in a person with a hypervigilant immune system. No matter how healthy sardines and Brazil nuts may be for some, their effects can be dire if you’re allergic to them. Lupus patients need to avoid their known allergens and intolerances.
Eat Whole Foods
Processed foods are inflammatory, particularly for sensitive immune systems. They are often full of sugar, artificial sweeteners, and common food allergens. Opt instead for whole foods. Think fresh fruits, vegetables, whole grains, and home-cooked meals.
When possible, choose organic foods. If organic options are not available, select the "clean 15" and limit the "dirty dozen" to reduce your chemical exposure. The Environmental Working Group creates these lists annually to reflect the levels of pesticides and chemicals in foods.
Again, this is a general recommendation. Eating non-organic celery would be healthier for someone than eating an organic version of their trigger food, like lettuce (yes, we have worked with people triggered by lettuce). Mymee clients have also been triggered by a non-organic version of a food but can eat the organic without issue.
Remember, each person is unique, and with the susceptible immune system that characterizes lupus, identifying your specific triggers can be the difference between "just barely managing" and thriving.
Optimize Your Gut Health Through Food
Optimizing your digestive system can help improve your immune system. If you do try general digestion-enhancing tips, introduce them one at a time. This slow approach to all new food introductions may reduce your potential for adverse reactions and readily help home in on problematic foods. Also, consider tracking your symptoms or energy level so you can readily distinguish between improvements and setbacks.
Incorporate Foods High in Probiotics
Apple cider vinegar, fermented vegetables (like sauerkraut), non-dairy kefir, and kimchi are each high in probiotics. While these items can provide immune-supportive nutrients, they may also cause digestive upset, gas, and bloating.
Some lupus patients are histamine-intolerant, meaning they are sensitive to dietary histamines. For patients with histamine intolerance, foods high in probiotics may lead to digestive upset. Headache, sinus congestion, and menstrual irregularities are also possible.
Eat Diverse Plant Foods
Foods like onions, asparagus, seeds, lentils, and apples help maintain adequate fiber in your diet. However, in lupus patients with small intestinal bacterial overgrowth (SIBO), these foods containing high FODMAPs may cause digestive discomfort.
Avoid Known Food Triggers
If items in your diet regularly lead to heartburn or other digestive imbalances, it's safe to say that you should consider them a trigger and avoid them. However, knowing which foods are causing symptoms is often difficult.
Gluten and nightshades are among the more common dietary triggers for lupus symptoms. However, not all people with lupus react negatively to incorporating them into their diet. In fact, removing them can lead to negative results depending on the person. As with other recommendations for diet, eliminating gluten and nightshades will not work across the board.
It's often recommended for people with lupus and other autoimmune diseases to try removing nightshades from their diets for symptom relief. Nightshades are a group of foods that include tomatoes, white potatoes, eggplant, peppers, paprika, and cayenne pepper.
While nightshades are a relatively common dietary trigger, they are not triggers for everyone. They are well tolerated by many people, including some people with lupus. Furthermore, eliminating nightshades may unintentionally lead to symptoms for people who do not have an issue with nightshades.
For example, if you avoid nightshades and opt instead for carrots and celery but have an unknown sensitivity to foods in the Apiaceae family (like carrots and celery), your symptoms would worsen. So, in that case, avoiding nightshades wouldn't be the best for you.
Removing gluten is frequently given as advice for a wide range of health-related concerns. Of course, people with celiac disease must avoid gluten for their health. But is removing gluten best for people with lupus? It might help, but it is entirely dependent on the individual.
Non-celiac gluten sensitivity (NCGS) does occur in lupus patients. People with NCGS often have symptoms of fatigue, joint pain, constipation, neuropathy, and brain fog. Some literature finds that over 50% of individuals with autoimmune diseases experience a reduction in their symptoms by following a gluten-free diet.
Removing gluten from your diet can be tricky for several reasons. Most people know that bread and pasta contain gluten, but gluten is often in less obvious foods like soy sauce, salad dressings, processed lunch meats, and even vitamins and medication.
In addition, NCGS may not be your only sensitivity. As an example, many gluten-free products contain potato starch. For one Mymee client with lupus, her symptoms were triggered by potato starch. So, for her, making the substitution of gluten-free bread ended up making her symptoms worse.
Finally, when eliminating gluten, people often make up for the treats they're missing with highly processed, gluten-free products. If you don't truly have a gluten sensitivity, this swap would be more counterproductive and might cause a symptom flare-up.
Though it's well-intentioned, removing gluten from the diet is not suitable for everyone with lupus.
Maintaining hydration is critical to help your body repair itself and fight inflammation. A lack of hydration can be behind symptoms like joint pain, constipation, headaches, and fatigue. Additionally, finding the right balance of water intake and electrolytes is significant for those with kidney-related conditions.
Here are some common tips for staying hydrated with lupus – and why some won't work for everyone:
Count Your Glasses of Water
A good rule of thumb is to aim for half of your body weight in ounces. So, if you weigh 150 pounds, aim to drink 75 ounces of water daily. If you aren't sensitive to lemon or other citruses, squeezing a flavorful fruit into your water can help when plain water isn't your choice of drink. Plus, this offers additional electrolyte and detox support.
Electrolyte drops and powders can be a convenient way to add depleted minerals to your diet. However, some contain potential triggers, like caffeine or natural or artificial sweeteners. And, for people with kidney issues, some products may be dangerously high in certain minerals like potassium. Add a pinch of unbleached sea salt to your water for low-cost, natural electrolytes.
Drink Herbal Teas
While teas like lemon balm, ginger, and holy basil can be tasty options, they would not be best suited for people with allergic reactions or sensitivities to the ingredients. For others, black tea can trigger symptoms.
Limit High Sodium Foods
It is generally best to avoid packaged foods, fast foods, and cured and processed foods. However, knowing ingredients and brands can help determine what's best. For example, some cured meats that are lower in sodium also contain beneficial probiotics.
Reduce or Eliminate Stimulants
Coffee, soda, diet soda, energy drinks, and alcohol should not be overconsumed. Not only are they partially dehydrating, but they can also interfere with sleep and trigger inflammation. These beverages may also contain sugar, artificial sweeteners, and other allergens like pesticides, mold, and contaminants, which can trigger some.
Keep in mind that personalized recommendations are always better than general information. For example, not all alcohol is made with the same ingredients. Also, caffeine has been shown to enhance focus and reaction time during times of restricted sleep, which may go a long way in helping your day. We advocate swapping out your favorite vices only when they are hindering your health.
Address Nutrient Deficiencies
In addition to eating a low-nutrient diet, common lupus medications and stress can trigger nutrient deficiencies. Mymee's lupus clients commonly have iron, vitamin B12, magnesium, and vitamin D deficiencies. Each can lead to symptoms like fatigue, muscle aches, numbness, tingling, and mood disturbances.
Maintaining an optimal vitamin D level is particularly important when you have lupus. Vitamin D can help to minimize disease activity and keep you healthy. If you avoid sunlight because it triggers your lupus, you are at greater risk for vitamin D deficiency. And yet, repleting vitamin D (or any other vitamins or minerals) isn't always straightforward.
Supplement formulations often contain allergens like corn, potato, gluten, or soy. For some, even a tiny amount of these ingredients can trigger lupus symptoms. We frequently uncover these lesser-known triggers for our clients.
In many cases, it may be appropriate to use supplements under your practitioner's supervision. For the best results, consider working with a naturopathic or functional medicine doctor to identify what kind of supplements, at what doses, and which brands are most appropriate for your body.
Mymee's recommendations are under the supervision of a licensed naturopathic doctor and a board-certified rheumatologist. Along with your health coach, these health care professionals guide program supplement recommendations and help you experience symptom relief as soon as possible.
The "Best Diet Plan for Lupus" Doesn't Exist
There is no one-size-fits-all diet for people with lupus. However, there is a diet that would work best for your individual needs, and finding it can be life-changing. Just as having lupus is not your fault, having little or no success with broadly recommended diets is undoubtedly not an indication of failure.
Every person responds differently to food and environmental factors. You can identify the unique pieces of your diet and surroundings triggering your lupus symptoms to flare. Mymee offers tailored lupus plans to methodically determine your triggers rather than sweeping dietary recommendations.
If you're interested in an individualized approach to understanding your lupus symptoms, you may benefit from working with Mymee.