In a recent incident report published in the journal Frontiers in Nutrition, The researchers discuss three case studies in which women (ages 40, 54, and 45 years) with Sjögren’s syndrome (SS) and systemic lupus erythematosus (SLE) reported remission of their symptoms after changing their diets to customized plant-based eating patterns. The diet consists mainly of leafy vegetables, omega-3 fatty acids and cruciferous vegetables. While three single case studies are insufficient to establish causality or mechanisms, the success rate of these dietary interventions and their long-term effects (6 and 7 years) mark them as promising future natural interventions against these chronic diseases.
Case series: raw, whole plant-based dietary protocol rapidly reverses symptoms in three women with systemic lupus erythematosus and Sjӧgren syndrome. Image credit: Maja Drazic / Shutterstock
Sjögren’s syndrome, systemic lupus erythematosus and the potential of nutritional interventions
Sjögren’s syndrome (SS) is a chronic autoimmune disease where the moisture-producing glands, especially around the eyes and mouth, are damaged, leading to dry eyes (dry eyes) and xerostomia (dry mouth). SS is often found in association with systemic lupus erythematosus (SLE), another chronic autoimmune condition, although much less studied. Both conditions can be characterized by joint pain, severe swelling, and rashes, the latter of which can be found in a butterfly shape on the cheeks and noses of SLE patients.
Although generally causing discomfort, SLE has been found to be associated with more serious conditions such as nephritis and pleurisy, making its increasing global prevalence alarming. SLE is currently estimated to affect 9.26 out of every 100,000 men and 78.73 out of every 100,000 women, although the reasons for this sex dichotomy remain unknown.
Health behaviors, particularly sleep patterns, physical activity levels, and dietary patterns, are increasingly highlighted for their influence (both positive and negative) on chronic disease. A growing body of literature documents the health benefits of maintaining good eating behaviors and adhering to healthy dietary patterns such as the Mediterranean diet. In particular, research on whole-grain, plant-based (WFPB) diets suggests that these foods are capable of promoting positive weight and cardiometabolic outcomes.
These diets are developed with an emphasis on eating raw foods, including high intakes of cruciferous vegetables, leafy greens, and seeds or oils rich in omega-3 fatty acids, combined with strict avoidance of processed foods, added oils, animal products, and added sugars. Although not formally tested in a scientific context, previous reviews have suggested that healthy vegetarian diets may help prevent or even reverse SS and SLE. Scientific verification of this hypothesis will serve not only to further enhance the stellar reputation of the vegetarian diet, but will form the basis for new research aimed at discovering natural and safe interventions against chronic and debilitating diseases.
About the study
This study summarizes and discusses three case reports involving women with both SLE and SS who, after following a rigorous “Rapid Recovery Program (RRP)” developed by Dr. Brooke Goldner (BG), first author of the study. The women underwent daily monitoring, follow-up and personalized dietary modification for four or six weeks.
“In the recovery protocol, while raw vegetable intake is allowed at will, the minimum daily intake is set as follows: 16 ounces of leafy greens (eg, spinach, kale) and cruciferous vegetables; ½ cup of flaxseed or chia seeds or 3 Tbsp. cold-pressed flaxseed oil and 96–128 oz water. Fruit is recommended at no more than 25% of total dietary intake to ensure that patients can consume the recommended amount of raw vegetables before reaching satiety. Vitamin B12 and vitamin D supplementation is recommended.”
Since the nutritional intervention is intended to be long-term, it allows for the incorporation of a “maintenance period” where consumption of cooked plant foods is permitted after symptoms have subsided. If the maintenance period results in a relapse of the symptom, the RRP is restarted.
“After 6 months of remission, processed vegan foods, foods with sugar or oil, and alcohol are allowed 1-2 times/week (called ‘recreational diet’), while otherwise the maintenance protocol is continued if patients remain asymptomatic.”
The cases themselves are different – the first consists of a 40-year-old woman who was diagnosed with SLE and SS in 2013 during the ninth month of her pregnancy. Her symptoms included extreme photosensitivity, leg pain, and fatigue, for which the clinically recommended intervention was hydroxychloroquine (management of SLE and SS) and aspirin (to prevent blood clots and possible miscarriage). Her RRP program started in April 2017 and lasted four weeks.
The second case is that of a 54-year-old woman who presented with undiagnosed photosensitivity associated with SLE and SS, butterfly rash, itchy scalp, and constant fatigue since 2006. Her SLE progressed to pleurisy in May 2015 and was diagnosed in July of the same year with reported eye inflammation. Her RRP program started in early March 2017.
The latest case is that of a 45-year-old woman who developed symptoms of SLE and SS between 2003 and 2008, but in whom the diseases were not formally diagnosed until her fourth child developed neonatal lupus in late 2008. Between 2008 and 2012, She the case was clinically prescribed levothyroxine, azathioprine and methotrexate, but without symptomatic improvement. Incorporating hydroxychloroquine into her intervention regimen in 2012 helped suppress symptoms.
“In September 2020, due to the extreme stress associated with Covid-19, her symptoms worsened significantly, including extreme fatigue, pain, migraines lasting 4 months, a diagnosis of hyponatremia with hospitalization, and extreme sensitivity to light and eye pain. as it varied from a feeling of ‘someone squeezing my eyes’ to a feeling of sand or grit in the eyes which prevented her from opening both eyes at the same time.’
The third case started the RRP program in June 2021.
Study findings
The findings in the present case report are overwhelmingly positive, with all three cases showing significant and surprisingly rapid remission of symptoms following strict adherence to the RRP intervention. Remission of symptoms was observed to begin as early as day 2 (Case 1), with four weeks representing the longest duration of symptoms after course initiation.
Encouragingly, symptom remission was observed to be long-lasting, with two of three survivors reporting ongoing symptom-free periods of 6 and 7 years, respectively. In all cases, women were able to stop using their prescription drugs in favor of RRP.
These findings highlight the profound implications of nutritional interventions in the treatment of chronic diseases, including SLE and SS. Of particular interest are plant-based diets, rich in natural nutrients, which are just now coming to the forefront of biomedical and clinical research. Such findings inform the general public about optimal dietary choices and form the basis for future research aimed at unlocking the potential of our natural world.
