Some people who have been diagnosed with systemic lupus erythematosus (SLE) may really be suffering from an intolerance to the gluten in their diet, reports the Annals of the Rheumatic Diseases (2004;63:1501â€“3). In the study, three patients who had been treated for SLE for years no longer experienced symptoms or abnormal laboratory tests and were able to discontinue their SLE medications after removing gluten from their diet.
SLE is a serious and sometimes fatal autoimmune disease in which the bodyâ€™s immune system attacks its own tissues. The word â€œlupusâ€ is Latin for â€œwolf,â€ and â€œerythematosusâ€ means â€œredness.â€ Together these terms refer to the reddened lesions resembling a wolf bite that appear on the face of people with SLE. Common manifestations of SLE include fever, weight loss, arthritis, nervous-system problems, and, in some cases, heart and kidney damage. Drug treatment for SLE includes prednisone (a steroid drug similar to cortisone) and other powerful medicines that suppress the immune system. These drugs may reduce the damage caused by SLE, but they do not cure the disease or even, in many cases, adequately control it. In addition, drugs used to treat SLE can cause side effects such as osteoporosis, cataracts, or increased susceptibility to infection.
A few research studies have suggested that food allergy is a contributing factor in some cases of SLE, but most doctors do not consider allergy when evaluating SLE patients. The new study presents case reports of three patients previously diagnosed with SLE who were found to have antibodies in their blood against gliadin, a protein present in gluten-containing foods (primarily wheat, oats, barley, and rye). Based on that finding, as well as other tests results, the patients were advised to try a gluten-free diet, which resulted in marked improvement in each case.
Doctors frequently equate gluten intolerance with celiac disease, an intestinal disorder in which ingestion of gluten leads to diarrhea, weight loss, abdominal pain, and other problems. The authors of the new study point out, however, that gluten sensitivity can affect many different parts of the body besides the intestines and that some people who become ill from eating gluten do not have celiac disease. For that reason, testing negative for celiac disease does not necessarily rule out gluten sensitivity. The authors suggest that a blood test for antigliadin antibodies can be used to identify gluten intolerance, regardless of whether or not a person has celiac disease.
The results of this study must be considered preliminary and should be confirmed by additional research. Even if confirmed, the findings do not suggest that all, or even most, cases of SLE are caused or aggravated by gluten or other foods. Nevertheless, the study opens a potentially successful new approach to treating a common and difficult-to-treat disease. Recent studies have shown that most people with gluten intolerance (at least those with celiac disease) can safely include oats in their diet, as long as they avoid the other three grains.
Alan R. Gaby, MD, an expert in nutritional therapies, testified to the White House Commission on CAM upon request in December 2001. Dr. Gaby served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Three Rivers Press, 1999), the Aâ€“Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Three Rivers Press, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patientâ€™s Book of Natural Healing (Prima, 1999). A former professor at Bastyr University of Natural Health Sciences, in Kenmore, WA, where he served as the Endowed Professor of Nutrition, Dr. Gaby is the Chief Medical Editor for Healthnotes, Inc.