Vitamins and Supplements for Lupus

Medically Reviewed by Melinda Ratini, MS, DO on March 08, 2022
5 min read

If you already have a drug treatment plan for lupus, it’s natural to wonder what else you can do to feel better. Could certain vitamins and supplements help? Researchers are studying how they might ease symptoms of autoimmune conditions or stop them altogether. Vitamin D and fish oil are at the top of the list.

Talk to your doctor before adding any vitamins or supplements to your daily routine. Some might change how your medication works or trigger a flare. They’ll let you know what’s safe.

Along with calcium, you need vitamin D to build strong bones. But vitamin D also affects how your immune system works. It plays a role in controlling certain types of inflammation, including the kind that leads to autoimmune conditions.

It’s common for people with lupus to have low levels of vitamin D. That’s partly because sunshine can trigger a flare, and ultraviolet (UV) rays are the biggest source of vitamin D. Other reasons might include:

  • You take certain medications, including corticosteroids
  • You have darker skin
  • You have a hard time absorbing vitamin D
  • Your kidneys can’t convert vitamin D

It’s unclear how vitamin D levels affect the disease course in someone who has lupus. But researchers are studying the possible benefits of adding a supplement.

Here’s what some of the latest science shows:

Researchers gave a group of 31 people with lupus vitamin D3 supplements for a year. Those with a vitamin D deficiency took 8,000 international units (IU) daily for 8 weeks, followed by 2,000 IU daily. Those with a vitamin D insufficiency took 8,000 IU daily for 4 weeks, followed by 2,000 IU daily.

After 1 year, researchers found:

  • Less disease activity
  • Lower levels of fatigue

In another study, a group of older adults added 2,000 IU per day of vitamin D. After 5 years, those who took the supplement, alone or with fish oil, were 22% less likely to develop an autoimmune disease compared to the group that didn’t take either supplement.

Those who took fish oil, with or without vitamin D, were 15% less likely to develop an autoimmune condition.

Fish oil is high in omega-3 fatty acids. That includes DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid). These are heart-healthy fats that you can’t make on your own. You have to get them from outside sources like food or supplements.

You can’t cure lupus with fish oil. But there’s growing evidence that a diet high in DHA and EPA might lessen inflammation in people with an autoimmune disease and those without. Studies offer conflicting results, but some researchers found that fish oil might:

  • Reduce lupus flares
  • Boost your quality of life
  • Lessen fatigue

Omega-3 fatty acids found in fish oil might also improve blood flow and blood vessel health. That may:

  • Lower your risk of heart disease
  • Regulate heart rhythm
  • Lower blood pressure
  • Improve triglycerides levels
  • Prevent blood clots

Fish oil might quiet an overactive immune system. But experts aren’t sure if very high doses could also affect your ability to fight off germs. More research is needed to know the long-term risks and benefits for people with lupus.

You can safely add more omega-3 fatty acids to your diet. The best way is through fatty fish. The American Heart Association recommends at least two servings a week of fish such as mackerel, wild salmon, or tuna.

That’s something you should ask your doctor. But it’s generally considered safe for people ages 9 and older to take up to 4,000 IU per day of vitamin D. The amount you need depends on your current levels. Too much vitamin D can be harmful. Your doctor can run a blood test to find out how much is safe for you.

Whether you have lupus or not, there isn’t a recommendation on how much fish oil you should take. And experts don’t agree whether supplements are needed at all. But if you have a history of heart disease, your doctor might suggest 1 gram of fish oil a day with both EPA and DHA. Most studies on lupus looked at the benefits of less than 3 grams per day, though some looked at higher doses.

Talk to your doctor if you want to take more than 3 grams of fish oil a day. Large amounts of omega-3 fatty acids might raise your chances of unwanted side effects, including increased bleeding.

Keep in mind that vitamins and supplements aren’t regulated the same way as medicine. There’s no way to know if you’re getting the product described on the label. But if you buy fish oil, make sure it’s purified to get rid of mercury and other heavy metals.

These are natural or man-made molecules. They include vitamins and minerals found in foods or supplements.

Antioxidants like selenium and vitamin C can help protect against free radicals. Those are molecules that can damage your cells in a process called oxidation. Studies show people with lupus might have higher levels of “oxidative stress.”

There’s not much research on the benefits of antioxidant supplements for people with autoimmune conditions. In general, they aren’t known to prevent chronic conditions. Health experts agree it’s best to get antioxidants from healthy foods, including fruits, vegetables, and whole grains.

Talk to your doctor before you take any antioxidant supplements. They might change how your medication works. High doses of some vitamins and minerals might be harmful. Be extra careful with vitamin E, vitamin A, and beta-carotene.

Visit the website of the National Center for Complementary and Integrative Health for more safety information.

Some herbal supplements are thought to have immune-stimulating properties. It’s common for people to try these products when they have a cold or other illness. But some herbs might trigger a flare if you have an autoimmune condition like lupus.

Talk to your doctor before you take any dietary supplements. Some that are associated with lupus-like flares include the following:

  • Echinacea
  • Spirulina
  • Alfalfa tablets
  • Garlic

Show Sources

SOURCES:

BMJ: “Vitamin D and marine omega 3 fatty acid supplementation and incident autoimmune disease: VITAL randomized controlled trial.”

Lupus Foundation of America: “Diet and nutrition with lupus,” “The Expert Series: Diet and lupus,” “Lupus nutrition FAQs.”

Autoimmunity Highlights: “Role of vitamin D deficiency in systemic lupus erythematosus incidence and aggravation.”

Bulletin of the NYU Hospital for Joint Diseases: “Vitamin D in Lupus: New Kid on the Block?”

BMC Rheumatology: “Vitamin D supplementation in systemic lupus erythematosus: relationship to disease activity, fatigue and the interferon signature gene expression.”

Journal of Clinical Rheumatology: “Omega-3 Fatty Acids in Rheumatic Diseases - A Critical Review.”

Toxicologic Pathology: “Lupus, Silica, and Dietary Omega-3 Fatty Acid Interventions.”

Frontiers in Immunology: “Immunomodulatory Effects of Diet and Nutrients in Systemic Lupus Erythematosus (SLE): A Systematic Review,” “Requisite Omega-3 HUFA Biomarker Thresholds for Preventing Murine Lupus Flaring.”

Nutrition Journal: “Placebo-controlled randomized clinical trial of fish oil’s impact on fatigue, quality of life, and disease activity in Systemic Lupus Erythematosus.”

Cleveland Clinic: “Omega-3 Fatty Acids.”

American Heart Association: “Fish and Omega-3 Fatty Acids.”

Mayo Clinic: “Vitamin D.”

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