How to Prevent Lupus & Other Autoimmune Diseases [February 2023 Update]
February 2023 Update: A new study from Harvard doctors from Hahn J et al shows that women who abided by 5 lifestyle changes (maintain normal weight, exercise regularly, not smoking, drink alcohol in small to moderate amounts, and who eat a healthy diet) reduced their risk of developing RA by 13% for each lifestyle that they practiced. That is huge!
This blog post will give advice on how to prevent lupus and other autoimmune diseases. I will first describe the results of a 2021 Harvard research study that showed that vitamin D and omega-3 fatty acid supplements lowered the risk of developing autoimmune disease. Then, I will provide a list of “do’s and don’ts” that can potentially lower the risk of developing lupus. These would be especially helpful for the children and grandchildren of people who have lupus and other autoimmune diseases.
Autoimmune diseases, such as lupus, appear to be genetic in origin. However, most people born with these genes do not get these diseases. Environmental triggers seem to be necessary much of the time for an autoimmune disease to occur. Some of the best evidence for lupus triggers include Epstein Barr virus infection (mononucleosis), ultraviolet light exposure (especially too much sun), and cigarettes. Figuring out how to prevent lupus and other autoimmune diseases by avoiding these triggers could be very important.
Because of this, I have a list of what I recommend that parents should try to teach their children to lower the chances of developing lupus if a parent or other family members have lupus. I have this list in the 1st edition of “The Lupus Encyclopedia.” This list was theoretical and not proven at the time I wrote it. I was pleasantly surprised to hear Dr. Judith James recommend a similar list during her talk in 2019 when she received the Evelyn V. Hess Award from the Lupus Foundation of America.
Even better, we now have a well-done study (prospective, randomized controlled trial) from Harvard that showed people taking vitamin D or omega-3 fatty acid supplementation had a lower risk for developing autoimmune diseases.
Harvard study shows that vitamin D and omega-3 supplements reduce the risk of autoimmune disease
How the study was done
- Name of the study = the VITAL (VITamin D and OmegA-3 TriaL) study
- Close to 26,000 study participants (men and women, middle-aged and older)
- 2011 to 2017
- Subjects took either vitamin D, omega-3 fatty acids, or placebo (“sugar pill”)
- Vitamin D dose = Vit D3 2000 IU daily
- Omega-3 fatty acid (brand not noted) = 1000 mg daily
- They noted how many people developed an autoimmune disease
Results of the VITAL study
- Vitamin D reduced the risk for autoimmune disease by 22%
- Omega-3 fatty acids reduced the risk for autoimmune disease by 18%
- Vitamin D was especially helpful in subjects with a low BMI (body mass index)
- Omega-3 fatty acids were especially helpful in subjects with a family history of autoimmune diseases
Interesting observations of the VITAL study
- Theoretically, it makes sense that avoiding autoimmune disease triggers (in this case, vitamin D deficiency and diets low in omega-3 fatty acids) could be a way on how to prevent lupus and related diseases.
- This large, well-done study showed this with vitamin D and omega-3 fatty acid supplements
- The supplements were not targeted at people starting out with low vitamin D levels or diets low in omega-3 fatty acids
- Could we have seen even greater results if supplementation were targeted at these groups?
- For example, several studies show that vitamin D supplementation can improve lupus disease activity in those who how low levels
- The supplements were used in older individuals.
- Autoimmune diseases commonly occur in younger people than this
- The supplements were not targeted at subjects with a family history of autoimmune disease
- If this had been done, the targeted group would have had a higher chance of having genes predisposing them to autoimmune diseases, such as lupus
- I would love to see this study repeated in younger subjects who have family members (especially parents) and who have vitamin D deficiency and don’t eat very many omega-3 fatty acid rich foods
- Compared to a similar placebo group, there would most likely be even a great chance of showing positive results
How to prevent lupus in people (especially children) with family members with lupus and other autoimmune diseases
The recommendations below come directly from the manuscript submitted to Johns Hopkins University Press for the 2nd edition of The Lupus Encyclopedia. Note, these have not been proven to prevent lupus. However, it makes theoretical sense to avoid these known lupus triggers. This 2021 Harvard study strengthens this recommendation.
This list has had some validation due to this Harvard study by Dr. Costenbader and her group as well as from Dr. Judith James including a similar list in her Hess Award acceptance lecture.
- Abide by uv_light_protection
- Get vaccinated against HPV (preferably at 11-12 years old)
- Floss and brush teeth at least once daily to help prevent periodontal disease
- Have your vitamin D level monitored; take a vitamin D supplement if it is low
- Never smoke cigarettes
- Avoid secondhand smoke
- Avoid sulfa antibiotics (add to allergy list)
- Do not eat alfalfa sprouts or mung bean sprouts
- Consider healthy use of moderate alcohol drinking when old enough (talk to your physician first)
- Eat a diet rich in omega-3 fatty acids (flaxseed, cold-water fish, chia seed, walnuts, etc.)
- Consider eating “resistant starches” regularly (legumes, peas, overnight oats, etc.)
- Avoid occupations and hobbies with exposure to potential lupus triggers (such as silica)
- Ensure adequate dietary intake of selenium (meats and seafood) and zinc (nuts, lentils, fortified breakfast cereals)
- Consider decreasing exposure to phthalates (lipstick, plastics, cosmetics)
- Learn to cope with stress; do daily breathing exercises; practice mindfulness
- Get at least 7 hours of sleep each night
- Avoid the herbal supplement Echinacea
- Avoid exposure to pesticides
- Avoid using hair dyes
Can you identify any triggers that may have triggered your autoimmune disease (such as mononucleosis or a trip to the beach)?
Please COMMENT below.
Author: Donald Thomas, MD
Hahn J, Cook N, Alexander E, Friedman S, Bubes V, Walter J, Kotler G, Lee I, Manson J, Costenbader K. Vitamin D and Marine n-3 Fatty Acid Supplementation and Prevention of Autoimmune Disease in the VITAL Randomized Controlled Trial [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 10). https://acrabstracts.org/abstract/vitamin-d-and-marine-n-3-fatty-acid-supplementation-and-prevention-of-autoimmune-disease-in-the-vital-randomized-controlled-trial/. Accessed December 19, 2021.
Chapter 3 list of journal articles at https://www.lupusencyclopedia.com/references/