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| *Women health>>>Lupus |
Has anyone try hemp seed. for fatigue.it was recommend to me. for my systemic lupus? |
Has anyone try hemp seed. for fatigue.it was recommend to me. for my systemic lupus? Start with this, I have never heard anything about hemp seed; sounds like quack practice. mcc_md@yahoo.com for further info. TREATMENT OF SLE 鈥?Although there is no "cure" for SLE, a variety of general and specific treatments and strategies to reduce symptoms, limit damage to vital organs, and reduce the risk of recurrence are available. General treatment considerations 鈥?Although specific drugs are used for particular organs, a number of general issues are applicable to every person with SLE. Diet and nutrition, exercise, and preventive measures including immunizations, avoiding certain medications, and issues related to pregnancy are among the most important general issues for patients with SLE. (See "Overview of the therapy and prognosis of systemic lupus erythematosus in adults"). Diet and nutrition 鈥?It is not well known what the effect of dietary modification is in SLE. One study reported that frequent intake of meat was associated with more active and progressive disease. In contrast, dietary fish oil has been reported to be beneficial. These findings await confirmation, however, and at present we do not recommend fish oil supplements in the treatment of SLE. A conservative approach is a balanced diet consisting of carbohydrates, proteins, and fats. However, the diet should be modified based upon disease activity and the response to therapy: Patients with active inflammatory disease and fever may require an increase in caloric intake. Corticosteroids (prednisone and others) enhance appetite, resulting in potentially significant weight gain. Hunger can be somewhat lessened by the ingestion of water, antacids, histamine H2 blockers (eg, zantac), and/or proton-pump inhibitors (eg, prilosec). If weight gain is significant, however, patients should follow a low calorie diet. Significant increases in blood levels of fat and cholesterol may occur (hyperlipidemia). Patients with hyperlipidemia should be encouraged to eat a low fat diet. A lipid-lowering agent should be considered if cholesterol levels remain high despite a change in diet. Vitamins are rarely needed with a balanced diet. However, a daily multivitamin should be taken by patients who are not able to obtain an adequate diet or who are dieting to lose weight. Patients on long term steroids and postmenopausal women should take 400 to 800 units of Vitamin D plus 1000 to 1500 mg of calcium per day to minimize the degree of bone loss. It is important to note that herbal supplements are of unproven benefit, and may even cause harm. Exercise 鈥?Inactivity produced by acute illness causes a rapid loss of muscle mass and stamina. As a result, fatigue may follow even after the illness subsides. This can usually be treated with graded exercise. In selected cases that do not respond to regular exercise, relief of fatigue can sometimes be obtained with prednisone or antimalarials (hydroxychloroquine or chloroquine). Immunizations 鈥?Influenza vaccine is safe and effective; pneumococcal vaccine is also safe but fewer antibodies are created in people with SLE than in those without the disease. People whose immune systems are weakened should not receive live vaccines. The efficacy and safety of hepatitis B vaccination has not been determined. Avoiding certain medications 鈥?Sulfonamides and penicillin (but not the synthetic penicillins) may cause exacerbations of SLE and should therefore be avoided. In contrast, medications that cause drug-induced lupus, such as procainamide, hydralazine, and isoniazid do not cause exacerbations of SLE and may be used if otherwise needed. Pregnancy and contraception 鈥?Pregnancy should be avoided during active disease (especially in women who have significant organ impairment) due to the high risk of miscarriage. Women with SLE should not become pregnant until the disease has been controlled adequately for at least six months. Oral contraceptives containing high dose estrogens can cause exacerbations of SLE, but this complication rarely occurs with the low dose estrogen or progesterone containing compounds that are currently in use. Certain patients (eg, those with migraine headaches, Raynaud syndrome) probably should not be treated with oral contraceptives. Intrauterine devices should also be avoided due to the increased risk of infection. Pregnant patients with active SLE are generally managed with corticosteroids. Other drugs used during pregnancy include NSAIDs and hydroxychloroquine (probably safe). Cyclophosphamide and methotrexate are contraindicated; however, azathioprine can be cautiously used. Women with SLE who have experienced repeated miscarriages or have had problems with blood clots should be screened for antibodies in the blood (antiphospholipid antibodies). If such antibodies are present, some type of blood thinning treatment (anticoagulation) may be necessary. Treatment of specific organ involvement 鈥?A number of medications are commonly used in the treatment of SLE, including nonsteroidal anti-inflammatory drugs (NSAIDs), antimalarials (primarily hydroxychloroquine and chloroquine), corticosteroids, and immunosuppressive agents (primarily cyclophosphamide and azathioprine). What follows is a general overview of which drugs are preferred for particular problems related to SLE. NSAIDs are generally effective for joint pain due to arthritis for, and mild inflammation of, the linings of the body cavities. Antimalarials are most useful for skin manifestations and for arthritis that does not adequately respond to NSAIDs. Systemic corticosteroids, used alone or in combination with immunosuppressive agents, are reserved for patients with significant organ involvement, particularly when the kidneys, blood, lungs, or central nervous system disease is affected. A number of other therapeutic approaches have been tried or are under investigation in SLE. These include intravenous immune globulin, DHEA, thalidomide, bromocriptine, zileuton, cyclosporine, anti-CD40, LJP 394, anti-C5 complement mAb, anti-IL-10, mycophenolate mofetil, and stem cell transplantation. PROGNOSIS 鈥?SLE can run a varied clinical course, ranging from a relatively benign illness to a rapidly progressive disease with severe organ failure and death. Most patients experience periods of relapse and remissions, which may be associated with the use of high dose steroids during the treatment of severe flares. (See "Overview of the therapy and prognosis of systemic lupus erythematosus in adults"). Survival 鈥?The survival rate in SLE has dramatically increased over the last several decades from approximately 40 percent at five years in the 1950s to approximately 90 percent at 10 years at the present time. The improvement in patient survival is probably due to multiple factors. These include increased disease recognition with more sensitive diagnostic tests, earlier diagnosis or treatment, the inclusion of milder cases, and increasingly judicious therapy and prompt treatment of complications. Many patients go into remission and thus require no treatment. In a study of 667 patients, approximately 25 percent had treatment-free remission lasting for at least a year. Remission occurred in 50 percent of those with disease over 18 years duration, and in 75 percent of those with disease over 30 years duration. Remission was also seen in some patients who had had severe renal disease. Causes of death 鈥?The major cause of death in the first few years of illness is active disease (eg, central nervous system, renal, or cardiovascular disease), while deaths after many years of disease are either caused by the illness or treatment complications (including infection and coronary disease). Prognostic factors 鈥?The likelihood of survival can be ranked on the basis of organ involvement. Those with only skin and/or joint disease have the best prognosis. Those with central nervous system and/or renal disease have the poorest survival. The number of American College of Rheumatology criteria for SLE is also correlated with survival; patients with higher numbers of criteria, on average, have shorter survival than those with fewer criteria. Poor prognostic factors 鈥?Poorer survival in patients with SLE is also associated with the presence of the following patient specific characteristics: Hypertension Male sex Young age Older age Black race, which may primarily reflect low socioeconomic status Poor socioeconomic status Presence of antiphospholipid antibodies Side-effects of treatment 鈥?Despite the reduction in long-term mortality, patients with SLE are still at risk for significant illness due both to active disease and the side effects of drugs such as corticosteroids and cytotoxic agents. As examples, use of steroids can lead to generalized thinning of the bones (osteoporosis) or localized damage to the bones of the hip and knee (avascular necrosis). (See "Prevention and treatment of glucocorticoid-induced osteoporosis"). Steroids can also cause fatigue, memory difficulties, and difficulty concentrating. Side-effects become particularly important problems as patients live longer with their illness. THE IMPORTANCE OF CLINICAL TRIALS 鈥?Researchers are continually conducting clinical trials of lupus treatments to find better ways of treating the disease. A clinical trial is a carefully controlled way to study the effectiveness of new treatments or new combinations of known therapies. For more information about clinical trials, visit http://clinicaltrials.gov/ WHERE TO GET MORE INFORMATION 鈥?Your healthcare provider is the best source of information for questions and concerns related to your medical problem. Because no two patients are exactly alike and recommendations can vary from one person to another, it is important to seek guidance from a provider who is familiar with your individual situation. |
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