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Supplements That Worsen Lupus & 6 That Help [March 2025 Update]

posted in Complementary Alternative Medicine on January 4, 2025 by

Donald Thomas, MD

Updated March 22, 2025

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Lupus is an autoimmune disease where the immune system is overactive. This post discusses a 2024 research study showing that some herbal supplements for lupus can worsen lupus. Patients should not take substances that are “immunostimulatory” and “boost” or “support” the immune system. The last thing you want to do is make the immune system more active by taking supplements that worsen lupus.

The proper way to treat lupus is to use the safest treatments available that calm down the immune system enough to control lupus without causing any side effects. To see the latest (2025) ways we should treat lupus, see my blog post:  https://www.lupusencyclopedia.com/treatment-of-lupus

This article discusses supplements that can flare autoimmune diseases like lupus. To make them easier to find, this article highlights unsafe supplements in bold red font.

I also list supplements that may help autoimmune diseases like lupus. These healthy supplements are highlighted in green font.

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NOTE: Johns Hopkins University Press, publisher of The Lupus Encyclopedia, is a nonprofit publisher. If you purchase JHUP books, like The Lupus Encyclopedia, you support projects like Project MUSE.

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2024 Study Shows Supplements That Increase Lupus Flares

For many years, we have known that patients taking echinacea supplements or eating a lot of alfalfa or mung bean sprouts can get lupus flares. Now, we can confidently add other immune system-boosting supplements to the list. Studies in the laboratory and in animals previously demonstrated that supplements promoted as “boosting” or “supporting” the immune system increase immune system activity. Now, a large study demonstrated that these supplements actually do cause flares in autoimmune disease patients.

The Supplement Study

Lupus experts at the Veterans Affairs Medical Center, Philadelphia, Pennsylvania, followed 673 patients with lupus and dermatomyositis (another autoimmune disease). All patients had autoimmune skin (cutaneous) disease. Here are the findings:

  • 1 out of every 3 patients took herbal supplements (showing that many patients are taking supplements that can make lupus worse)
  • Younger patients were almost twice as likely to take herbal supplements for lupus than older patients
  • Hispanic patients were more likely to take herbal supplements (58% Hispanics took herbs while only 30% of Whites did)
  • Flares with the herbal supplements for lupus occurred as often in men as women (no sex differences in flares)
  • Turmeric (curcumin) did not cause flares. One patient noted disease improvement on it. The study was not designed to see if any supplements improved lupus.
  • Garlic was NOT reported to cause lupus flares. There is no evidence that garlic consumed in moderation is bad for lupus, though some websites (to include Johns Hopkins) continue to list garlic. Garlic was actually included in an anti-inflammatory diet shown to help autoimmune disease.

Herbs That Increase Lupus Flares

The percentage in parentheses after the name of the herbal supplement shows the percentage of lupus patients who flared when taking the supplement. These are listed in order starting with the herbs that caused the most lupus flares.

I have included links for each herb that supports its immunostimulatory effects (click on the name of the herb):

  • Elderberry (50% of lupus patients flared on elderberry)
  • Ashwagandha (25%)
  • Echinacea (20%)
  • Spirulina (20%)
  • Alfalfa (18%)
  • Chlorella (17%)
  • Other (as a group; fewer patients took these): moringa, Zyflamend (blend of 10 herbs), herbal teas, green drinks, immune-system boosting supplements, and protein powders (18% of lupus patients taking any of these supplements flared).
  • The authors did not list the ingredients of the green drinks, herbal teas, or protein powders. I suspect that most of these are probably safe. I would recommend to my patients that they avoid drinks, teas, and powders that contain any of the immune system-boosting herbs mentioned in this article and any concoction that states “boost” or “support” on the label.
  • This study specifically studied cutaneous lupus. However, lupus primarily affects the skin as a major organ, with a pathogenesis similar to that in other organs, such as high levels of type 1 interferon.

Additional Supplements to Avoid

Doctors Grace Hile (University of Michigan) and Victoria Werth (University of Pennsylvania) are dermatologists specializing in autoimmune diseases like lupus and dermatomyositis. In their 2025 article about type 1 interferons in lupus and dermatomyositis, they also recommend avoiding the following immune system-boosting supplements:

List of Supplements That May Help Lupus

The following supplements have shown promise for reducing lupus disease activity and help lupus include:

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How Bad Are Supplements that Boost the Immune System?

Dr. Michelle Petri, Director of the Johns Hopkins Lupus Center, reported that they had a series of SLE patients who were taking daily Echinacea and had severe flares. Two patients required the chemotherapy agent cyclophosphamide. The autoimmune skin expert, Dr. Victoria Werth, reported many patients flaring from taking these supplements. Many of the articles above, highlighted in red, are from Dr. Werth’s clinic.

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For more in-depth information on Supplements That Worsen Lupus & 6 That Help [March 2025 Update]:

Read more in The Lupus Encyclopedia, edition 2

Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia

If you enjoy the information from The Lupus Encyclopedia, please click the “SUPPORT” button at the top of the page to learn how you can help. 

What are your comments and opinions?

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29 Comments

  1. Thank you for sharing this information, it is really helpful to lupusnpatients like me. I’m curious, the last item seems to be a very broad category, it says protein powder. There are a LOT of protein powder with a host of different ingredients in them. Did this study break down that category any further?

    • SJ: I totally agree. The same goes for the green drinks and herbal teas. I wish they had included the ingredients in the associated drinks, so we would have more information. I suspect that protein powders, green drinks and herbal teas are safe if they do not contain immunostimulatory herbal products. I’ll amend the post with this comment.

      Thanks for commenting,

      Donald Thomas, MD

  2. Thanks for this site, my mom was just recently diagnosed with lupus.

      • Doc’s right on! Making the changes is really key. I’ve found the NAC especially helpful (with oregano oil & black seed oil… doesn’t come in one supplement, unfortunately.) I’m 58 y/o female, 5’2″ 110# and take only 100 HCQ daily.

  3. Thanks for this? So this does not translate to SLE patients?

  4. Thanks for this!***

  5. This is quite interesting, as I have both Lupus Nephritis AND was diagnosed with Dermatomyositis in July 2024. I am curious though – what about gut health supplements, which would include part of the anti inflammatory diet? By default that is supposed to help your immune system as well.

  6. Thank you for sharing. Is Isa big problem that not enough information is givne about supplements. I am a nurse, that works at a pharmacy and have lupus…I wonder is it because we don’t know enough or are we bad at communicating the information to patients and consumers? 20 years ago I was on exchange in Thailand, and they were researching in herbal medicin and western medicin and how they worked together.

    • Karina: the US is finally catching on. The NIH now has an entire department dedicated to integrative medicine research.

      Donald Thomas, MD

  7. This is quite helpful for other autoimmune diseases too. I, too, wished they’d included more detail for the herbal teas & protein powders. I have autoimmune cirrhosis so green tea extracts are off my menu. The helpful supplements really do help. My liver doc does caution about turmeric & contaminants & suggests using fresh. Not always reasonable!

    • LUPUS SLE treatment

  8. Dr. Thomas, what are your thoughts about SLE patients (w/o any history of kidney involvement) supplementing with creatine monohydrate? I take 5 mg daily and have noticed both strength and cognitive benefits. I stop the creatine a week or two before getting labs done for rheumatology appt and so far no problems with creatinine levels or kidney markers.
    Thank you for all of the valuable info you share on your website.

    • I am also a lupus patient and started taking creatine monohydrate 5mg daily yesterday. I have the same question and concern.

    • Julie and Dechen: I just saw your question. I actually do recommend creatine to my patients with sarcopenia (low muscle mass). The American College of Sports Medicine, along with the Academy of Nutrition and Dietetics and Dietitians of Canada, recognizes creatine as the most widely used and effective performer enhancer. Studies show it can help with muscle strength, fatigue, and even cognition. 3-5 gm a day is recommended.

      People with reduced kidney function, eGFR, should not take it.

      It should be safe in SLE.

      Donald Thomas, MD

  9. This is very helpful. My daughter has been battling lupus for the last several years. I just learned about mornings and was hopeful about it for her. I appreciate the caution and hope there is more research in this area.

  10. Hello I am Ashlie, I have lupus since 2021. I just found out, does moringa leaves really trigger/flare up lupus? I thought that moringa leaves can boost the immune system so I steam and drink it every night. and i think the moringa leaves help me to have a good sleep at night, and also helps me to relax my stomach because i have a heartburn and ulcer.

    • Ashlie: I would avoid it. Melatonin is safer and has been hypothesized as a possible help for autoimmune disorders (theoretically only). In lupus, the immune system is already overactive (boosted), anything that boosts the immune system (all the herbs mentioned) can make it worse. Though there were not a large number of patients on moringa in the study, it was still associated with flares.

      Instead of “boosting” or “supporting” the immune system, we want to calm it down and balance it out to reduce lupus disease activity.

      Glad you asked.

      Donald Thomas, MD

  11. Thank you a lot for sharing, I am teaching myself in this area because of my female dog, she was diagnose with lupus sle, polyarthritis. From the time i respect and avoid all those supplements, it is very much better,
    specially spirulina and alfaalfa is in almost all dog food, so better to cook each day fresh and avoid it,
    and i each day give my doggie natural sunscreen (coconut oil, to avoid UV), it is quite challenging because of fur, but we already learn how to do it correctly,
    into food I add mostly high D3 (without k2, as this could also lead to flare up), green tea, ginger, sardine oil and curcumin. Coriolus is real miracle. However, It seems, the flares are connected to the period.
    Could you please advice if there was any study made based on female period and how to protect naturally before period to avoid flare up? For example by dogs to avoid false pregnancy the chasteberry is used, unfortunately this one leads to flare up.

    to Ashlie: unfortunately with Moringa we do not have good experience, so I agree with Mr Thomas to rather use something else. We very much like Valerian.

    Thank you

    • Petra: Thanks for your comments. That is interesting as we see the same in women with SLE. It is very common to flare around the time of their period, related to the female hormone fluctuations. Estrogen increases immune system activity.

      Donald Thomas, MD

  12. Any data on oil of Oregon being helpful or harmful if you have lupus?

    • Kim: I am unaware of any studies on oil or Oregano in humans. Supposedly it has immunomodulatory properties, antibacterial, and anti-inflammatory effects in animal studies. From that information alone, it probably is safe (but not sure)

      Donald Thomas, MD

  13. Thank you Dr. Thomas for sharing this information! I’d love to hear your thoughts on mushrooms when it comes to culinary use. I really enjoy the umami flavors of varieties like lion’s mane, shiitake, and matsutake, but I’m a bit concerned about their immune-boosting properties. Do you think it’s safe to enjoy mushrooms in general, or would it be better to avoid them altogether? Are there particular species I should be more cautious about? Thank you!

  14. Hi–What are your thoughts on a sleep aid for lupus patients. It seems like many over the counter supplements have melatonin and ashwaganda. Are they OK? Years ago (over 20) my doc said no to melatonin so I thought I’d get an update. Thanks, Laura

  15. What are your thought on collagen and bone broth for SLE. Thanks

    • Kia: To my knowledge, these have not been studied. Nor is there evidence of harm. Therefore, I would tell a patient: “it is probably safe for you to take it, but there is no evidence of these helping lupus patients.”

      Donald Thomas MD

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