Q: I am a 50-year-old woman who has had lupus for a few years. Because of the condition, I started to suffer from infections behind my ears and in between my fingers. What can I do to help improve my health, and reduce the occurrence of these infections?
A: Systemic lupus erythematosus, often referred to as lupus, is an autoimmune disease that can affect any part of the body.
The immune system attacks the body's cells and tissues, resulting in inflammation and tissue damage. It most often harms the heart, joints, skin, lungs, blood vessels, liver, kidneys and the nervous system.
Common initial and chronic complaints include joint pain, fever, malaise, muscle pain and fatigue.
More than 90 per cent of the patients will suffer from joint and muscle pain, particularly on the small joints of the hands and wrists.
In traditional Chinese medicine (TCM), this disorder is likely caused by problems with the kidneys, liver and spleen. It could also be traced to a yin (element responsible for cooling organs) deficiency and heat toxin.
Blood-related issues, such as a blood deficiency, heat and poor circulation, may also be to blame.
Lupus could also be aggravated by external pathogens like wind, heat, dryness and fire.
In TCM, the kidneys are the congenital foundation of the body.
Kidney yin and yang (element responsible for heating organs) is the root of yin and yang for all the other organs.
For instance, kidney yin moistens and nourishes the whole body, while kidney yang provides warmth to the body's organs and tissues.
They both restrict and depend on each other in order to maintain a dynamic physiological balance.
If this balance is disrupted, pathological changes of hyperactivity or hypoactivity of kidney yin and yang will occur.
When one's kidney yin is deficient, internal heat will be created in the body. For lupus sufferers, this can trigger joint pain, chronic low fever, feverish sensations in the palms and soles, a malar rash (butterfly-shaped rash on the face), sensitivity to sunlight, thirst and a flushed face.
The above are often seen in people who are in the early stages of the disease.
Another scenario is when external pathogens, such as wind, heat, dryness and fire, invade the body. These pathogens can combine with one's internal heat to create what is known as heat toxin.
One would suffer a lupus flare-up with high fever of above 38 deg C, a flushed face, malar rash, joint and muscle pain, as well as red rashes on the hands and legs. One may also have a low white blood cell and platelet count, or fluid may accumulate in the heart. This is often seen in lupus patients who are at the acute outbreak period.
The problem with internal heat is that, when allowed to accumulate in the body for a prolonged period of time, it dries up one's blood and creates blood stasis.
This blocks the body's meridians (channels through which qi travels) and gives rise to lupus symptoms of joint pain in all four limbs, joint stiffness in the morning and Raynaud's phenomenon - a condition where one's fingers turn white or blue when cold.
The patient may also have swollen hands with red rashes, as well as purplish spots on the legs. This is often seen in lupus patients with arthritis and a low blood count.
Similarly, when heat toxin builds up in the body over time, it can enter the blood and turn into "blood heat".
This blood heat will weaken one's circulation, prompting a lupus flare-up with the following symptoms: purplish spots and swelling on the hands and legs; ulcers on the fingers and toes which, if severe, can dry out; and a branch-like pattern of green discolouration on the thighs.
This is often seen in lupus sufferers with inflammation of the blood capillaries or ulcers on the hands and legs.
Finally, when the regular functions of the kidneys, liver and spleen are disrupted, problems can occur too.
In TCM, the kidneys manufacture blood. The liver stores it, and also oversees the health of ligaments and tendons in the joints. Meanwhile, the spleen governs the muscles around the joints, and converts nutrients into qi (vital energy) and blood.
When these organs grow weak, a lower volume of blood will be produced. This leads to a blood deficiency which can trigger symptoms in lupus patients. Some of them include a flushed face, thirst for cold beverages, bruises on the skin, lack of strength and aching in the legs, nose bleeds and heavy periods in women.
Do note that a lack of kidney yang can, in turn, affect spleen yang. The lupus patient may then suffer from a pale complexion, fear of cold, hot flushes, low urine volume and lower back pain, among other discomforts.
Chinese herbal medicine, acupuncture, moxibustion and cupping therapy can help to improve your condition by strengthening the organs and dispelling pathogens that cause your lupus to flare up.
Herbs to get rid of internal heat and boost yin levels - which can then reduce the frequency of your infections - are gypsum, figwort root, baical skullcap root and coix seed.
To reduce inflammation, take pronghorn, honeysuckle flower, tree peony bark and red peony root.
Blood circulation can be improved with the help of szechwan lovage rhizome, medicinal cyatula root and kadsura pepper stem.
To address blood heat, take honeysuckle stem, pagodatree flower and lotus rhizome node.
Rehmannia root, ginat knotweed rhizome and yerbadetajo herb are used to dispel heat created by blood deficiency.
Finally, boost your kidney and spleen yang with milkvetch root, largehead atractylodes rhizome, eucommia bark, dodder seed and white mulberry root-bark. These will help to reduce lupus flare-ups.
Besides herbs, try to take light and easily digested meals, as these can increase your yin levels and dispel heat.
Examples include porridge with lily bulb, white fungus soup and bittergourd. Avoid raw, spicy, barbecued and oily food. Stay away from coffee and alcohol too.
Your room should be quiet, clean and well-ventilated. Sleep in a position where you can avoid any wind directly blowing on you. For joint pain, you can do some stretching exercises or light massage to enhance your qi and blood circulation.
Also, guard yourself against sun exposure by wearing long-sleeved shirts, a hat and sunglasses.
MS LIM LAY BENG,
traditional Chinese medicine practitioner at YS Healthcare TCM Clinic at The Adelphi
This article was first published on Mar 5, 2015.
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