Medical Treatment for LUPUS…the good, the bad and the ugly…

<strong>Medical Treatments for Lupus</strong>

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Let me state right off from the start that I DO NOT believe in Pharmaceuticals…I am posting this piece, so you will see what is available out there, for you…and I want you to pay special attention to what the WARNINGS are.

And even though the STEROIDS that they suggest, are not the same as athletes are taking…the result are worse for Lupus persons…because we are very reactive to any drugs!

I have had steroids…and they make you feel so wonderful…like you can go out dancing all night again [something, I truly miss, horribly]…but do not be disillusioned…they are harmful.  I will not allow them in my person again.  No matter how low my immune system goes.  They are poison.

So…with that said…here you go…I will always print the other side so you can make an intelligent decision.  I pray that it will be the right one!

~The Baby Boomer Queen~
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<strong>Steroids</strong>

Tissue inflammation is the major cause of Lupus symptoms.  While the body naturally produces cortisone to decrease inflammation, it may not be solely effective in reducing the inflammation in Lupus patients.  Therefore, synthetic steroids are used to decrease the swelling, warmth, tenderness, and pain in lupus patients.

<strong>Corticosteroids are a commonly prescribed medication.   </strong>

Corticosteroids are produced by the outer part of the adrenal gland, and they differ from the anabolic steroids that weightlifters use illegally to increase their strength and size. 

The most commonly used corticosteroid is Prednisone, while others used include hydrocortisone, methylprednisolone (Medrol), and dexamethasone (Decadron).  They usually relieve symptoms right away.  Corticosteroids can be helpful in serious cases of inflammation like pleurisy, pericarditis, or organ threatening disease, but they do have some serious side effects. 

While steroids are remarkably effective at decreasing Lupus symptoms, they come with numerous side effects.   Common side effects include acne, the development of a moon-shaped face, and increased appetite.  The increase in appetite can also cause weight gain.  

They can redistribute fat and lead to more fragile skin.  The psychological effects of steroids include irritability, agitation, euphoria, and depression.   Also, insomnia can set in.   There is a higher susceptibility of getting an infection and the possibility of aggravating any diabetes, glaucoma, high blood pressure, and high cholesterol. 

However, it should be noted that steroids do not cause cancer.  

Long-term use of steroids can result in some serious conditions. <strong>

 Avascular necrosis of the bone is usually associated with high doses of prednisone taken over a long time period.  The disease usually occurs in the hip, and it is very painful.  Relief usually comes in the form of a core bone biopsy or joint replacement.  

<em>Osteoporosis </em>is another common result of long-term steroid use, but it can usually be prevented with calcium, vitamin D, hormones, calcitonin, biphosphonates, and certain hormones.

</strong><strong>Cataracts, and muscle weakness are also caused by long-term use.  Plus, there is a relationship between premature arteriosclerosis and long-term steroid use.   It is due to these potential side effects that steroids need to be used with great care and under a physician’s watchful eye.</strong>

<strong>Immunosuppressives</strong>

The fourth class of drugs used to treat Lupus are known as Immunosuppressives.  As the name implies, Immunosuppressives are used to suppress or inhibit an over-active immune system. 

Immunosuppressives are normally used in transplant patients to prevent the body from rejecting the transplanted organ.   Immunosuppressives are often used in patients with more serious systemic lupus.  Doctors consider using immunosuppressives when major organs like the kidneys are affected, severe muscle inflammation is present, or there is intractable arthritis.  Immunosuppressives can also be helpful in decreasing the amount of steroids needed to treat inflammation, saving patients who are susceptible to more severe side effects from added discomfort.

There are several immunosuppressives available in the treatment of Lupus, though five are the most commonly used:   azanthioprine (Imuran®), cycolphosphamide (Cytoxan®), methotrexate (Rheumatrex®), cyclosporine (Neoral®), and mycophenolate mofetil (CellCept®).  They each work in different ways, but all immunosuppressives function to decrease or prevent an immune response. 

<strong>Azanthioprine (Imuran): </strong>

For Lupus patients, azathioprine is one of the most often prescribed immunosuppressives.   It is also an antimetabolite, meaning it blocks metabolic steps in immune cell, thus helping to control the underlying processes in a disease.  It also has fewer side effects than other Lupus drugs.

<strong>Cyclophosphamide (Cytoxan):</strong>

Cyclophosphamide is an alkylating agent and a very strong drug.  It is usually only used in Lupus patients that have kidney or other organ threatening disease.   Cycolphosphamide goes after autoantibody producing cells.  This activity suppresses the immune response and decreases disease activity.   <strong>However, its use can produce severe side effects.</strong>

<strong>Methotrexate (Rheumatrex):</strong>

Methotrexate was first used as a treatment for cancer and then used to treat rheumatoid arthritis.  It is also an antimetabolite and often used for Lupus arthritis.   There is some concern about <strong>toxicity</strong>, so doctors will have to <strong>do regular CBC and liver function tests.</strong>

<strong>Cyclosporine (Neoral):</strong>

Cyclosporine is commonly used to threat rheumatic diseases, and it is an antimetabolite.

<strong>Mycophenolate mofetil (CellCept): </strong>

Mycophenolate mofetil is a strong immunosuppressive and is sometimes used in place of cyclophosphamide in patients that have kidney involvement.  It functions by preventing the replication of T and B-lymphocytes.

<strong>Some of the side effects associated with immunosuppressives include an increased risk of infection and bone marrow suppression.   Also malignancies can develop from their use.  Some patients experience alopecia, nausea, vomiting, esophagitis, hematuria, thrombocytopenia, and leukopenia.  With high doses, pulmonary fibrosis can develop.  Side effects like amenorrhea and impotence reverse themselves with the discontinuation of the medication.</strong>

<strong>DHEA</strong>

DHEA is one of the new hopes in medicinal treatment of lupus symptoms, but it comes with <strong>cautious optimism</strong>.  DHEA (dehydroepiandrosterone) is a steroid hormone that occurs naturally in all mammals.  It is an androgen produced by the adrenal glands, and is used to make other hormones like testosterone and estrogen.

DHEA has not been without its controversy.   <strong>In 1980 the supplement was banned by the FDA after the FDA declared DHEA was a drug (by declaring it a drug the law required it be tested for safety and efficacy by the FDA)</strong>.   However, Canada and the U.K. have banned over-the-counter sales of DHEA altogether. 

Basically DHEA is used in Lupus patients to decrease dosages of steroids, because it helps to relieve pain, inflammation, and fatigue.   Much of the documented research has been done by Genelabs with most of the participants reporting that they felt better.   While the researchers <strong>do not know</strong> the mechanism by which DHEA affects Lupus, they do know that women with Lupus have lower DHEA levels.  They also know that DHEA increases testosterone and estrogen levels.

The side effects of DHEA <strong>have not been fully studied</strong>.   However there is concern that <strong>it may influence certain types of cancers </strong>that are directly related to hormones (i.e. breast, ovarian, uterine, and prostate cancer).   In men it can increase aggression, but upon decrease of dosage this problem can go away.  Also, a too-high dosage of DHEA can cause facial hair growth and a deepening of the voice in women.
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{{{SOUNDS LIKE STERIODS TO ME!!!}}}
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Thank you Freedom from Lupus
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Though I am not a Doctor or someone who has a degree from Harvard, I do not have to be a rocket scientist to see the warning signs of Pharmaceutical usage.

I am a Lupus survivor and am grateful for every day here in earth.
Pain and depression or not, it beats the alternative!

I chose the non-pharmaceutical life.

Please read my other posts to see how I cope with Lupus.

Smiles, world peace and wellness,
~The Baby Boomer Queen~ 

~ by thebabyboomerqueen on July 25, 2007.

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