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Supplement Guide for Systemic Scleroderma

Author: Shelley Ensz. See Types of Scleroderma. Read Disclaimer
The most important thing to know about supplements and scleroderma is that the immune system does not need to be improved in scleroderma, because it is already overactive.
Overview of Scleroderma and Supplements
Herbal Supplements
Antioxidants
Arachidonic and DHA Acids
Calcium Supplements
Cod Liver Oil
Curcumin (Turmeric)
Fish Oil (Omega-3)
Ginseng
Omega-6
Licorice
Lipoic Acid
Probiotics (Acidophilus, Microbes, Yogurt)
Vitamins and Minerals
Quinine

Overview of Scleroderma and Supplements

Systemic scleroderma patients should always consult their doctor(s), especially their scleroderma expert, before using any vitamin or herbal remedies or making any significant changes in their diet. (Also see: Types of Scleroderma and Scleroderma Experts)
In general, most doctors recommend that scleroderma patients follow a normal, well-balanced diet , without the addition of any herbs, vitamins, or minerals. Do not cut out any food groups from your diet, nor go on any "cleansing" diets, since this may accelerate the disease process.
The immune system does not need to be improved in scleroderma, because it is already overactive (and not underactive, as in AIDS.) Doing things that enhance the immune system can actually make scleroderma worse in some cases, as it gives the body more power to attack itself.
Research shows that Raynaud's can cause an abnormal processing of certain vitamins and minerals, leading to worsening scleroderma. So excessive intake of any vitamin is to be avoided. (Also see: Raynaud's)
Many herbs and over-the-counter medications can interact with prescription medications, and many of them make scleroderma symptoms worse. Even simple over-the-counter cold remedies often have ingredients that can trigger Raynaud's or heartburn in systemic scleroderma patients. (Also see: Heartburn)
Don't go on any diets that eliminate food groups, and especially avoid high-protein diets because they are very hard on the kidneys. (Also see: Kidney Involvement)
Scleroderma Symptoms and Treatments Look up each of your scleroderma symptoms here to find other ideas for conventional and natural ways to deal with them. ISN.

Herbal Supplement and Supplement Cautions

PillsFood Allergics Beware: Herbal Products May Contain Surprise Ingredients. New research for the University of Guelph shows that the majority of herbal products on the market contain ingredients that are not listed on their labels. Times Healthland, 10/12/2013. (Also see: Supplements and Scleroderma)
Omega-6 Fats Linked to Increased Risk of Heart Disease. A study shows that not all good fats are the same when it comes to protecting your health. Time Healthland. 02/06/2013.
Are Your Supplements Spiked? On the Doctor Oz Show, Pieter Cohen is a special guest that is exposing the deadly problem of supplements spiked with prescription drugs. CMR, Dr. Oz Show, 01/17/12.
Vitamins and Supplements Linked to Higher Risk of Death in Older Women. If you think you're doing your body good by popping a daily multivitamin or supplementing with extra vitamin C or E, think again. Time Healthland. 10/11/2011.
A Positive Approach to Scleroderma by Dr. Andrew Weil.
Complementary and Alternative Medicine for Scleroderma Excellent information on herbs, vitamins, acupuncture, massage therapy, and biofeedback. Aetna InteliHealth.

Antioxidants

Effects of micronutrient antioxidants (alpha-tocopherol and ascorbic acid) on skin thickening and lung function in patients with early diffuse systemic sclerosis. After 6 months of therapy, patients treated with CyP (intravenous cyclophosphamide) and antioxidants had a significantly lower STPR (skin thickening progression rate), compared to patients treated with CyP only. Lung function parameters remained stable in both subgroups. However, lung diffusing capacity improved slightly, without statistical significance, in patients treated with CyP and antioxidants, and it deteriorated in patients without antioxidants. Predrag Ostojic. (SpringerLink) Rheumatology International. 23 March 2010. (Also see: IV Cytoxan)
Antioxidants: New Kid on the Block for Pain Relief? Researchers found that synthetic antioxidants practically eradicated pain-like behavior in nearly three-quarters of mice with inflamed hind paws. Ohio State University, Research Communications. 11/07/06. (Also See: Pain Management)

Arachidonic and Docosahexaenoic Acids

The essentiality of arachidonic acid (AA) and docosahexaenoic acid (DHA). When dosed appropriately, fish oil-based lipid emulsions contain sufficient essential fatty acid (EFAs) to prevent essential fatty acid deficiency (EFAD). Furthermore, AA and DHA alone may be the true EFAs. Le HD. (PubMed) Prostaglandins Leukot Essent Fatty Acids. 2009 Aug-Sep;81(2-3):165-70.

B Vitamins

Vitamin B12 deficiency may lead to cognitive problems. A growing body of research is drawing a link between low B12 and early cognitive decline, a condition that often leads to dementia. CTV News. 09/26/2011.

Calcium Supplements

Vitamin D and Calcium Supplements May Not Prevent Fractures. For most people, the evidence doesn't support any bone benefit of the popular supplements. Time Healthland 02/26/2013. (Also see: Vitamin D)
Study links calcium pills to heart attacks. Their conclusion was that "increasing calcium intake from diet might not confer significant cardiovascular benefits, while calcium supplements, which might raise (heart disease) risk, should be taken with caution." CBS News, 05/23/12.
Calcium Supplementation Without a Proper Balance of Magnesium Can Increase Risk of Heart Attack, Osteoporosis and Kidney Stones. The effectiveness and benefits of calcium with respect to bone health and the prevention of osteoporosis are enormously impaired in the absence of adequate levels of magnesium in the body. NewsGnom.es. 09/14/2011.

Cod Liver Oil

Cod liver oil (n-3 fatty acids) as an non-steroidal anti-inflammatory (NSAID) drug sparing agent in rheumatoid arthritis. Out of 49 patients 19 in the cod liver oil group and out of 48 patients 5 in the placebo group were able to reduce their daily NSAID requirement by >30%. (PubMed) Rheumatology (Oxford). 2008 Mar 24. (Also see: RA and Pain Management)

Curcumin (Turmeric)

Beneficial role of curcumin in skin diseases. The varied biological properties of curcumin and lack of toxicity even when administered at higher doses makes it attractive to explore its use in various disorders like tumors of skin, colon, duodenum, pancreas, breast and other skin diseases. Thangapazham RL, (PubMed) Adv Exp Med Biol. 2007;595:343-57.

Fish Oil

Fish oil and chemotherapy, the bigger picture. Until much stronger evidence counters both my experience and the existing favorable data. I will continue to recommend fish oil to our patients. As always, I will suggest they use only those fish oils that have been molecularly distilled, while confirming that any and all supplements they take have undergone and passed independent testing. Keith I. Block, MD. 09/26/2011.
Fish oil reduces effectiveness of chemotherapy. Under the influence of cisplatin chemotherapy, the stem cells secrete these fatty acids that induce resistance to a broad spectrum of chemotherapies. Whilst waiting for the results of further research, we currently recommend that these products should not be used whilst people are undergoing chemotherapy. Eurekalert, University Medical Center Utrecht. 09/12/2011.
Fish Oil May Have Positive Effects On Mood, Alcohol Craving, New Study Shows. Omega 3 fatty acids may be beneficial for more than just the heart. Research showed that at a molecular level, there is a potential therapeutic benefit between these dietary supplements, alcohol abuse and psychiatric disorders. Medical News Today. 05/25/2011.

Ginseng

American ginseng may reduce fatigue during cancer treatment. The findings suggest that American Ginseng reduces general and physical cancer-related fatigue over 8 weeks without side effects. Bronx Times. 06/30/12.

Licorice

To date, there has been no scientific evidence on humans or animals that clearly proves that licorice or deglycyrrhizinated licorice (DGL) is effective for various conditions including apthous ulcers/canker sores, atopic dermatitis, peptic ulcer, and heartburn/reflux. Use of licorice or DGL for any condition should be evaluated by a qualified healthcare provider.
Licorice Reduces Cyclosporine, Raises Methotrexate Levels. Janis Kelly, MSK Report, March 2009. (Also see: Cyclosporine and Methotrexate)

Lipoic Acid

Lipoic acid - biological activity and therapeutic potential. Current studies support its use in the ancillary treatment of many diseases, such as diabetes, cardiovascular, neurodegenerative, autoimmune diseases, cancer and AIDS. PubMed. Pharmacol Rep. 2011;63(4):849-58.

Omega-6

Omega fatty acid balance can alter immunity and gene expression. For the past century, changes in the Western diet have altered the consumption of omega-6 fatty acids (w6, found in meat and vegetable oils) compared with omega-3 fatty acids (w3, found in flax and fish oil). Many studies seem to indicate this shift has brought about an increased risk of inflammation (associated with autoimmunity and allergy). EurekAlert! 05/29/09.

Probiotics (Acidophilus, Microbes, Yogurt)

Increase In Allergies: Universite De Montreal Professor Studies How Probiotics Can Help. There is an inverse relationship between the level of hygiene and the incidence of allergies and autoimmune diseases. Although hygiene does reduce our exposure to harmful bacteria it also limits our exposure to beneficial microorganisms. As a result, the bacterial flora of our digestive system isn't as rich and diversified as it used to be. Dr. Delespesse recommends probiotics to enrich our intestinal flora. Medical News Today. 04/15/10.
Bowel Involvement: Acidophilus, Yogurt, and Other Probiotics. Eating 1 to 2 tablespoons a day of live culture acidophilus yogurt may be helpful for combatting bowel involvement with systemic scleroderma, especially small bowel bacterial overgrowth. It may also be particularly helpful when taking antibiotics. ISN. (Also see: Bowel Involvement and Probiotic Supplements on Amazon.)

Vitamins and Minerals

Short-term and long-term consequences and concerns regarding valid assessment of vitamin D deficiency: comparison of recent food supplementation and clinical guidance reports. Healthcare providers should formulate their own opinions with respect to vitamin D as it pertains to the care of their patient. PubMed. Curr Opin Clin Nutr Metab Care. 2011 Sep 19.
Zinc and human health: an update. Zinc has critical effect in homeostasis, immune function, oxidative stress, apoptosis, aging and in chronic diseases, including atherosclerosis, several malignancies, neurological disorders, autoimmune diseases, and Wilson's disease. PubMed. Arch Toxicol. 2011 Nov 10.
Vitamin D warning: Too much can harm your heart. Scientists have long known that low levels of the nutrient can hurt the heart, but new research shows that higher than normal levels can make it beat too fast and out of rhythm, a condition called atrial fibrillation. MSNBC. 11/18/2011. (Also see: Heart Involvement, and Vitamin D)
Calcium Supplements May Increase Risk Of Heart Attacks. An international team of researchers found that taking calcium supplements was linked to a higher risk of heart attack and other cardiovascular events; the authors called for new research to re-assess the role of calcium supplements in the treatment of osteoporosis. Medical News Today. 07/30/10. (Also see: Osteoporosis)
Localized scleroderma and zinc: a pilot study. We conclude that high-dose zinc gluconate can therefore be a valuable alternative treatment for localized scleroderma, with good tolerability, although placebo-controlled studies are necessary to confirm our results. Brocard A. Eur J Dermatol. 2010 Feb 2. (PubMed). (Also see: Localized Scleroderma)
Natural Remedies for Scleroderma. There's little scientific evidence to support the use of alternative medicine in treatment of scleroderma. However, vitamin D and E may be useful for individuals looking to manage this condition. Cathy Wong. About.com: Alternative Medicine. 12/28/09.
Effects of Iron Supplementation and Depletion on Hypoxic Pulmonary Hypertension Two Randomized Controlled Trials. Hypoxia is a major cause of pulmonary hypertension in respiratory disease and at high altitude. Hypoxic pulmonary hypertension may be attenuated by iron supplementation and exacerbated by iron depletion. Thomas G. Smith, MBBS, DPhil. JAMA. 2009;302(13):1444-1450. (Also see: Pulmonary Hypertension and Hypoxia)
Iron homoeostasis in rheumatic disease. Altered iron homoeostasis may represent a purposeful response to inflammation that could have theoretical anti-inflammatory benefits. Physicians should avoid routine iron supplementation in those without depleted iron stores. Joshua F. Baker. Rheumatology. July 23, 2009 (Also see: Anemia)
Dietary Supplement Fact Sheet: Vitamin D. Information about the popular supplement from Office of Dietary Supplements. National Institutes of Health. (Also see: Vitamin D)
How much vitamin D should someone over 55 take? Vitamin D is essential for promoting calcium absorption in the gut, build and preserve bone, helps prevent osteoporosis and helps decrease fracture risk. In addition, vitamin D may help in the prevention or treatment of type 1 diabetes, some cancers, and autoimmune diseases. Dr. Melina Jampolis. CNMHealth.com. 03/20/09. (Also see: Causes of Scleroderma: Vitamin D Deficiency)
Twenty-Five Ways to Spot Quacks and Vitamin Pushers How can food quacks and other vitamin pushers be recognized? Here are 25 signs that should arouse suspicion. QuackWatch.

Quinine

Definition of Quinine. Quinine has been used outside of malaria as a remedy for fever and pain and to treat and prevent leg cramps. Prolonged administration of quinine may produce toxic symptoms such as deafness, disturbances in vision, skin rashes, and digestive upsets. MedicineNet.com
Anti-Malarial Drug: Tryptophan Deficiency May Underlie Quinine Side Effects. Researchers have found that the anti-malarial drug quinine can block a cell's ability to take up the essential amino acid tryptophan, a discovery that may explain many of the adverse side-effects associated with quinine. Once confirmed, these findings would suggest that dietary tryptophan supplements could be a simple and inexpensive way to improve the performance of this important drug. Science News. 07/14/09.
FDA: Don't Use Quinine for Leg Cramps. FDA Cracks Down on Unapproved Quinine Drugs, Cites Problems Including Deaths. WebMD Medical News. 12/12/06.
 
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