2 posts tagged “dietary recommendations”

Lupus and vitamin D deficiency – get the lowdown

Posted March 8th, 2018 by

Vitamin D is nicknamed “the sunshine vitamin” because catching some rays on bare skin triggers your body to produce it naturally.

But what if lupus-related sun sensitivity (not to mention the winter weather) restricts your sun exposure? Take a peek at some key info on vitamin D deficiency, plus learn some dietary sources of this important nutrient.

What are the effects of limited sunlight?

Vitamin D deficiency is a common health issue in general, and reduced exposure to sunlight is one of the main factors. Researchers estimate that almost 50% of the world’s population – across all ethnicities and age groups – have a vitamin D deficiency. When the sun’s rays hit bare skin, it signals the body to produce its own vitamin D.

Getting vitamin D via sunshine can be especially tricky for some people with lupus who are taking steps to limit sun exposure or protect the skin with sunscreen and clothing. Ultraviolet (UV) light from the sun or artificial light sources can make lupus worse in 40 to 70% of people with the condition, according to Lupus.org. Sunlight may exacerbate skin disease or skin-related symptoms in people with lupus, such as the “butterfly” rash, discoid lesions and photosensitivity.

Not everyone with lupus is affected by skin problems or sun sensitivity, so completely avoiding sunlight may not always be necessary. Talk with your doctor about sun safety and healthy levels of sunlight, in your case, as well as other factors in vitamin D deficiency (such as darker skin, kidney problems and obesity) and other good sources of vitamin D (read on!).

Why is vitamin D important?

Vitamin D plays an important role for all people. Here are just a few of the health benefits for the general population:

  • Helps the intestine absorb calcium
  • Supports bone health and helps prevent osteoporosis
  • Helps with muscle movement and nerve function
  • Supports immune function and reduction of inflammation

For those with lupus, vitamin D is also vital because:

  • Low levels of vitamin D may increase the risk of kidney complications or kidney failure
  • Some initial research shows that vitamin D may play a role in controlling lupus symptoms and bolstering kidney function (but more research is needed on the role of vitamin D in lupus treatment)

What are some other sources of vitamin D?

Talk with your doctor about testing your blood level of vitamin D and the best sources of this nutrient for you. For the general population, good sources of vitamin D beyond sun exposure include:

  • Foods that contain it naturally, such as the flesh of fatty fish like salmon, mackerel and tuna (small amounts are also found in beef liver, cheese, egg yolks and mushrooms)
  • Foods fortified with vitamin D, such as milk, yogurt and cereal (fortified foods provide most of the vitamin D in the American diet)
  • Oral vitamin D2 or D3 supplements, taken as directed by a doctor, usually in the case of vitamin D deficiency. Talk with your provider before taking a new supplement.

The most common test for vitamin D deficiency is called 25-Hydroxyvitamin D (or ’25-OH Vit D’).

How do you get your vitamin D? Add a comment or join PatientsLikeMe today to talk about this topic with 10,000+ members living with lupus.

Share this post on Twitter and help spread the word.


Taking Psoriasis Treatment to the Next Level: An Interview with Dermatologist Dr. Jerry Bagel

Posted February 11th, 2013 by

Board-Certified Dermatologist Dr. Jerry Bagel, MD

A nationally recognized psoriasis expert, Dr. Jerry Bagel, MD, has been an investigator on more than 45 clinical trials seeking new treatments for psoriasis and other skin conditions.  In addition to treating patients at his private dermatology practice in East Windsor, New Jersey, Dr. Bagel serves as Senior Attending Physician at the Princeton University Medical Center and Director of the Psoriasis Treatment Center of Central New Jersey.   He is also a three-term member of the National Psoriasis Foundation’s Medical Advisory Board.  What investigational treatment for psoriasis is he currently studying?  And what does he wish more psoriasis patients knew?  Check out our insightful interview below.

1. What led you to focus your research on psoriasis?

I started studying psoriasis when I was resident at Columbia-Presbyterian in 1982-1985. At that time I would spend six months on in-patient service with 30 hospitalized psoriatic patients who would stay in for treatment for a month.   And I realized the burden of disease – the psychological, emotional and physical impact of this disease on people.

So when I opened up my private practice in 1985, I decided that psoriasis treatment and care of psoriasis patients would be a major part of my professional career and so I started seeing a lot people with psoriasis.  I started doing research in 1992 and then just kept working with pharmaceutical companies and developing our own protocols for research into the treatment of psoriasis, trying to find better treatments, safer treatments, more effective treatments.

2. Tell us about some of your most recent clinical trial findings.

The most recent clinical trial I’m doing as of today is IL-17 receptor antibodies with Amgen that is remarkable, using subcutaneous injections once every other week.   People are getting clear within 2-4 weeks, so it’s really a quite effective treatment.  I mean, obviously we don’t know [everything yet], but so far it’s been good at our facility, and the data I’ve read about it seems to be pretty good.  So I think it could take the treatment of psoriasis to another level in the sense that over half the people will probably clear and probably 85% will have a very effective level of clearing.  So it’s going to take it to another level of clearing given what existed before.

3. Speaking of what existed before, what current treatments are most effective in your experience?

Well, we still use phototherapy, but people have to come in three times a week for about 12 weeks. It works about 75% of the time, but people only stay clear for about six months maybe 75% of the time.  So in the end it only works well for about 50% of the people.  But it’s totally safe, so therefore the benefit ratio is high.  We also do all the biologic agents, like Enbrel and Humira and Stelara, and they’re quite effective treatments.

In fact, Enbrel and Humira are FDA-approved for the treatment of psoriatic arthritis as well – and up to 25% of people with psoriasis have psoriatic arthritis.  So it helps the arthritic component of psoriasis as well.   So we do use the biologics, although sometimes we have to tweak them with some systemic therapies.   Sometimes we use cyclosporine, sometimes we use methotrexate.  But the treatment of psoriasis today is certainly a lot better than it was say 10 years ago.

4. Do you have any dietary recommendations for psoriasis patients?

I think diet helps, but I don’t think diet necessarily clears psoriasis for very many people, if any.  But we know that psoriasis is associated with the metabolic syndrome, and many patients are obese and have diabetes, which are inflammatory triggers.  I think patients that eat a low-inflammatory diet – with more fish like mackerel, salmon or anchovies, and less red meat – tend to be better.  Staying away from fatty foods like animal fats, and eating more vegetable fats like nuts, tends to be helpful.  Also, I do think that weight loss tends to help people with psoriasis.  The other culprit is alcohol.  Alcohol is not good for people with psoriasis.

5. What is something you wish more psoriasis patients knew?

I wish more psoriasis patients knew that there are physicians providing effective care for psoriasis.  For instance, today I had a young woman who was 23 years old.  She came into my office with psoriasis covering about 20% of her body.  She’d been to three dermatologists before me, and two of them told her there was nothing they could do about it, and she should learn to live with it.  So I wish there was more education for people with psoriasis to know there are dermatologists or psoriasis caregivers who are interested in the treatment of psoriasis – and a better way of connecting people with psoriasis with the physicians interested in treating psoriasis.