What is Lupus?
Lupus or Systemic Lupus Erythematosus (SLE) is an autoimmune disease. This means that the body cannot tell the difference between foreign pathogens, invading from the outside and its healthy tissues. The body creates what are known as auto-antibodies (auto means self and anti means against: against self). These auto-antibodies damage and destroy, causing problems in tissues and organs throughout the whole body.
Lupus is a complex and unpredictable disease. The most common symptoms include inflammation and pain, rash, especially on the face, wrists and hands and fatigue. However, symptoms vary widely from person to person and can change over time. You may have an extended period of relatively mild symptoms followed by a flare-up where they suddenly become much more severe.
It is critical for patients to monitor their symptoms and report any changes to their healthcare team, even if the seem minor, temporary and unrelated. Any changes in symptoms could be a sign of organ damage and need to be investigated further.
How is Lupus Diagnosed?
Lupus is diagnosed based on a combination of current symptoms, laboratory test results, medical history and the medical history of close family members including grandparents, parents, brothers and sisters, aunts, uncles and cousins.
What Causes Lupus?
The cause of lupus is unknown. Many (but not all) scientists believe that it develops in response to a combination of factors both inside and outside the body, including hormones, genetics, and environment.
Lupus is more common among women of childbearing age, and it often develops in response to hormonal changes such as puberty, childbirth, and menopause. It is also more common in people with African, Caribbean and Asian backgrounds than in those of European descent.
One important factor thought to play a role in the development of lupus is exposure to ultraviolet light. Too much time in the sun often causes a worsening of symptoms and should be avoided.
Other factors that may play a part in the development of SLE are infections and smoking.
How do you Treat Lupus?
Lupus is currently incurable. However, there are several treatment options available to help manage symptoms and improve your quality of life.
- Medications such as corticosteroids and anti-inflammatories can be used to reduce swelling and pain.
- Immunosuppressant drugs can be used to suppress the body’s immune response and lessen the production of auto-antibodies.
- Hydroxychloroquine is a drug traditionally used to treat malaria, but it has also been used successfully to reduce some of the symptoms of SLE.
Of course, all drugs have side-effects, and these can range from mild stomach upsets with anti-inflammatories to an increased risk of severe infections with immunosuppressants.
What causes Lupus in TCM?
According to Traditional Chinese Medicine (TCM), the disease is caused by an imbalance in any one or more of the following systems:
Yin and Yang
Yin and yang are the two complementary and opposing forces of nature which are also reflected within the human body. When yin and yang are in harmony, the body is healthy, but if one or the other becomes excessive or deficient, then disease occurs.
The Five Elements
The five elements are wood, fire, earth, metal and water. These five elements of nature are also present within the body and are related by two complex cycles, one of generation and one of control. A disease occurring in one of the elements can have a negative, knock-on effect on any of the others via these two cycles.
In Chinese medicine, there are twelve major organs. These are divided into six pairs with one yin and one yang organ in each pair. Each pair of organs is also associated with one of the five elements and emotion, and this association defines their functions and relationships with one another.
Each organ has its own meridian, an invisible channel on the body which can be affected by a disease in its respective organ. The acupuncture points are located along these meridians and are a way of treating the internal organs directly using the surface of the body.
The Vital Substances
In Traditional Chinese Medicine, there are five vital substances. These are body fluids (including saliva, tears and the synovial fluid which lubricates your joints), blood, essence, qi (vital energy) and shen (which roughly translates as spirit or mind). These vital substances should be plentiful and flow freely throughout the body. Any deficiency or blockage can result in stagnation and disease.
The Eight Parameters
In Chinese medicine, the disease can be further classified into eight parameters. These are yin or yang, hot or cold, internal or external and excess or deficiency. So according to organ, vital substance, and the eight parameters, we might call a disease something like “Liver yang excess” or “Spleen qi deficiency” and so on.
There can be many causes of the disease, and the causes as well as symptoms vary from patient to patient.
To understand how many possible combinations and causes of the disease there are in Chinese medicine, we can use the following equation:
“from n choose r” or “combinations of n things, taken r at a time.”
For the five elements – from the 5 elements I select 2 imbalanced organs, (I cannot pick the same one twice).
I want to choose 2 imbalanced organs out of 5 to form a diagnosis e.g. Liver excess / Spleen deficiency.
So from 5 choices, you get a possible 20 combinations: 5*4 = 20
The Eight Parameters
For the eight parameters –
I need to choose one parameter from each opposite pair to make a diagnosis such as, “internal heat due to Yin deficiency”.
So, I need to choose 1 from each pair, 4 times 2*2*2*2= 16
Therefore there are at least 320 possible diagnostic combinations (20*16)
This explains how in a complex disease like Lupus, two patients with the same diagnosis from a western point of view can have different symptoms and be treated very differently within the framework of Chinese medicine.
Common Symptoms of Lupus from a TCM Point of View:
- Extreme fatigue (Qi or Blood Deficiency)
- Fever higher than 100ºF (excess yang)
- Muscle pain (Qi or Blood stagnation)
- Skin sensitivity or rash after sun exposure (yin deficiency)
- Rash around nose, skin disorders (excess yang)
- Decrease in red and white blood cells as well as platelets (yin deficiency)
- Headaches (excess yang)
- Memory loss (deficiency)
- Hair loss (yin deficiency)
- Pain, stiffness and swollen joints (yin deficiency)
- Kidney disorders (excess yang)
- Inflammation of other organs (excess yang)
- Difficulty breathing (yin deficiency)
- Depression (stagnation)
Each one of these symptoms may be treated with acupuncture.
In Chinese medicine, we view disease like a tree. The symptoms can be seen on the leaves, but the cause of the disease is coming from deep within the roots. By treating the roots as well as the leaves, the whole tree becomes healthy, and the symptoms disappear.
So how do we make a diagnosis in TCM?
It all starts when you walk into the clinic.
During your consultation, I will ask where the discomfort is and the trigger of the symptoms. I will ask about your sleeping patterns, allergies, BM, childhood health, family history and assess your symptoms from A to Z, from head to toe, and from morning to night. This will help me to build up a detailed picture of how your body is functioning and to find out which meridians and organs we need to work on.
Treatment includes acupuncture, herbs, bodywork, adjustments to nutrition and lifestyle changes.
Acupuncture points commonly used for Lupus symptoms:
CV 3 : This is an intersection point of three different meridians – the Spleen, Kidney, and Liver. It is known to be a powerful point in acupuncture and acupressure.
Kidney 3 : This is the Kidney revival point; it’s between your medial anklebone and the Achilles tendon. It helps to tonify Kidney energy and restore yin and yang.
Lung 9 : When excess yang is causing aggravation of Lupus symptoms, this is the point to stimulate to calm the excess yang.
Bladder 20 : This point is commonly used for conditions such as diarrhea, vomiting, jaundice, anorexia, backache, and swelling. It can also be used with cupping.
Bladder 23 : This point is used to relieve dizziness, lower back pain, asthma, diarrhea, blurred vision, and urination problems.
Stomach 36 : This point is called ‘Leg Three Miles’; It can be found just below the knee at the joint between the femur and the tibia. This is to tonify Blood and Qi and improve circulation.
Chinese Formula Commonly Used for Lupus symptoms:
Zhi Bo Di Huang Wan: to enrich yin, nourish the essence and reduce fire deficiency.
Liu Wei Di Huang Wan: Enriches yin and nourish the essence.
Jia Wei Xiao Yao San: to help liver Qi stagnation and tonify your spleen and to nourish your yin and blood.
Yin Qiao San: to disperse wind-heat and relieve toxicity.
Gan Lu Yin: nourish yin fluid and clear heat
To avoid organ damage, it is important for you to be aware of your symptoms, even if they seem insignificant, temporary, or unrelated to their other symptoms and report them to your healthcare provider. Acupuncture and Chinese medicine can help to reduce your daily complaints and prevent further deterioration of your condition.
Traditional Chinese Medicine is a flexible and individualized treatment which aims to relieve the symptoms of the disease by treating its cause. It is, therefore, a very suitable method for treating illnesses which are difficult to diagnose and treat with western medicine such as lupus.
Resources and Further Reading:
Acupuncture for systemic lupus erythematosus: a pilot RCT feasibility and safety study. Lupus, Dec. 2008; 17 (12): 1108-16.
Semin Arthritis Rheum. 2016 Apr;45(5):596-603. doi: 10.1016/j.semarthrit.2015.09.006.
Greco, C.M., et al. Acupuncture for systemic lupus erythematosus: a pilot RCT feasibility and safety study. Lupus, Dec. 2008; 17 (12): 1108-16.