Systemic lupus erythematosus (SLE)
is "...an inflammatory connective tissue disorder of unknown
etiology occurring predominantly in young women, but also in children:
90% of cases occur in women," so sayeth the Merck
Manual. It is a very complex
disease. It may start suddenly with fever, like an acute infection,
or may come on slowly for months and years. Any organ can be affected.
Most patients complain of joint symptoms from intermittent arthralgia
to acute polyarthritis. Characteristic is a flush on the cheeks,
a butterfly-shaped area of reddening, but other lesions may occur
anywhere. There may be a general reddening of the skin and rashes
of various types. Forty percent of patients are sensitive to sun.
Other tissues involved include the brain (with mental changes),
the kidneys, the lymph glands, the lungs, and others. Over the past
20 years, treatment has improved substantially. Over ten percent
survive more than ten years. Treatment includes corticosteroids,
nonsteroidal anti-inflammatory drugs, and antibiotics against infections.
I first became interested in the late 1970's, when I was asked to
see a woman with severe lupus from which she was dying. Because
of the prominence of joint pain, arthritis, and because I was, by
then, familiar with the use of niacin for treating arthritis, I
thought it might help her as well. I started her on niacin, I think
about 500 mg t.i.d. I cannot remember what else I gave her, but
since it has been my habit to always combine niacin with ascorbic
acid, I probably also gave her the same amount of ascorbic acid.
To my amazement, she was normal in about a week. Her lesions healed,
her arthritic pain eased, and her depression was less troublesome.
I was convinced I had found an answer for this dreadful disease,
then considered uniformly fatal. However, several months later,
she was back in hospital, and this time she no longer responded
to any vitamin regimen. Within a few weeks, she died. This showed
me that there was to be no simple vitamin treatment to this very
complicated disease or syndrome.
In 1972, Henrietta Aladjem published The
Sun is My Enemy. Here is
how this book is described on the cover. "When Henrietta Aladjem
experienced her first symptoms of systemic lupus erythematosus in
1953, she did not know that the dizziness, headaches, and nausea
were only the beginning of a grueling, 15-year battle with a mysterious
disease." Lupus primarily strikes young women. There are 17
to 19 female cases of it for every male case. In Canada, 5,000 women
die of lupus each year. Not only can it be a vicious disease, but
also an elusive one. Twenty years ago, little was known about lupus.
Ms. Aladjem, fortunate to have the resources of the Harvard Medical
School near her home, consulted many doctors before lupus was diagnosed.
These doctors subjected her to endless testing and a series of wonder
drugs, which, often enough, worsened her condition. She even went
to Switzerland in search of a cure. Nothing helped. Ms. Aladjem
feared that she would succumb to an early, painful death, as some
lupus victims do.
A few years later, by chance, she heard of a Bulgarian doctor who
had been successful in treating lupus. She went to Bulgaria, located
an old professor who had been using injections of nicotinic acid
for this disease. She was started on the program and advised to
continue it back in Boston. The doctors in Cambridge were skeptical
– previously nicotinic acid had only been used to treat pellagra,
and they doubted that it could have any effect on lupus. In fact,
they equated the Bulgarian remedy with "any harmless potion."
But at the same time, they realized that their own methods had failed
and that any experiment was worth a try. Finally, Ms. Aladjem became
the first lupus patient in the United States to be treated with
nicotinic acid. In a few months, her symptoms disappeared, and she
became strong enough to play tennis. Even her severe kidney damage
began to repair itself. The doctors were totally surprised and are
still by no means convinced that it was not a spontaneous remission!
The Sun Is My Enemy
is the only published first-hand account of a case of lupus I have
seen. This account is very important, not only to doctors and medical
students. Its importance goes far beyond that. Ms. Aladjem's story
makes each and every one of us a little stronger. We learn once
again what the refusal to admit defeat can do for every individual
A few years after reading her book I had lunch with Ms. Aladjam
in New York, and heard what had happened and her activities from
then on. She had helped organize a lupus society in New York, and
was actively promoting further research and newer treatments for
lupus. Later, I was in contact with an organization in the Midwest,
kept alive by the dedicated zeal of a victim of lupus who had also
recovered on vitamins, including nicotinic acid. Unfortunately,
the medical profession ignored these very important first leads,
and even today, I doubt there are any internists who are familiar
with the potential benefit from nicotinic acid in treating patients
C.M. Born 1930 - In September 1987, she complained of a variety
of symptoms coming on for a long time but worse over the past four
years. She had difficulty swallowing, had changes in her skin on
her hands, fingers, legs, and ankles. She also suffered bowel spasms
and constipation. At times, her hands and feet would turn white
and purple and become very painful. She also suffered a lot of fatigue.
Many years earlier, she had a right lobectomy, probably scarred
from old tuberculosis. She had had three mastoid operations, had
suffered pneumonia many times for which she was given antibiotics,
and had suffered from frequent colds. One year before I saw her,
she eliminated all dairy products and felt somewhat better after
that. She was on penicillamine, which had decreased her zinc levels
to the point her sense of taste was poor. Her blood copper was 133,
her zinc was 87, giving her a high ratio of 1.5 She was then taking
vitamin A 25,000 IU, B complex 50 1 OD, a calcium and magnesium
preparation twice daily, vitamin E 1200 IU. I added to that ascorbic
acid 12 g, vitamin K 5 mg, pyridoxine 250 mg b.i.d., niacin 500
mg t.i.d., and zinc sulfate 220 mg.
Two months later, she reported she had a flu shot early in November.
This was followed by the development of ulcers in her mouth, cleared
by mycostatin. Her lupus was quiescent. After four months, her toenails
began to come back, she had no further hemorrhages in her skin,
she had lost 25 pounds, and had had no colds. Her mood was good.
April 1992: her nails were still healing, she still had difficulty
swallowing, and had three small ulcers in her gastrointestinal tract.
She decided to discontinue naprosyn. One month later, she was better,
sleeping well, and swallowing easier. One year later, she still
had good and bad days and had been in hospital four times. She had
to have her esophagus stretched. She had been depressed in the fall,
but this was alleviated by small doses of an antidepressant drug.
D.R. Born 1971 - Lupus was diagnosed in December 1987, and I saw
her the following May 1988. As an infant, she suffered colic for
several months. This was followed by constant colds and ear infections,
and pneumonia when she was 2.5 years old. She suffered permanent
hearing loss and has needed a hearing aid. At age five, she was
found positive for nuclear antibody factor. On aspirin, she went
into remission but two years later, required more. Her knee had
become swollen. At age 12, both knees flared up. During the year
before she saw me, she was very tired. In October, she developed
pain in her fingers, elbows, shoulders, feet, and ankles and a churning
feeling in her stomach. Eventually she ran a high fever for ten
days and had to be admitted to hospital. She was started on prednisone
90 mg daily but needed only 10 mg when I saw her. Her kidney was
involved, and her liver was enlarged. She also had the butterfly
rash on her face. At times, she was depressed.
I advised her to eliminate sugar, dairy products, and the grains.
To this, I added niacin 500 mg t.i.d., ascorbic acid 1 g t.i.d.,
evening primrose oil three capsules daily, in addition to the Centrum
she had been taking before. One month later, she was better. She
had not eliminated the grains. Her hair was not falling out as fast,
and new hair was coming in. She still had her rash, but her mood
was better. After two months, her rash was worse. She had had a
flare-up and had to increase the prednisone to 20 mg. I doubled
her niacin. All her hair was coming back.
After three months, her rash began to leave her, and she had more
energy. She was now taking 30 mg prednisone. June 1993: she told
me she had a kidney transplant in December 1991 and had been well
since then. She was on prednisone 15 mg every second day. She was
taking only Centrum daily. Her mood was good, and she stated she
These two cases illustrate how the orthomolecular approach has been
helpful but has to be combined with standard treatment, usually
prednisone. Nutrition and supplements used alone have not gotten
my patients well nor maintained them. They have been subject to
recurrent episodes, often precipitated by virus infections such
as the flu. However, the vitamins and diet have been helpful in
alleviating depression and fatigue, and I think it has decreased
the frequency of the episodes. Unfortunately, I have not seen the
very early cases. I think this approach would work even better with
A. Hoffer, MD, PhD, FRCP(C)
Suite 3 - 2727 Quadra Street
Victoria, British Columbia V8T 4E5
See Hoffer's Home Page:
At Member's Mall, Health & Medicine, Hoffer on Schizophrenia
1. Aladjem H. The Sun is My Enemy.
Englewood Cliffs, NJ: Prentice-Hall, Inc.; 1972.
2. These were cortisone and ACTH, introduced in the early 1950s
with great fanfare and given to almost every disease then known.
They were supposed to be very effective against the arthritides
but eventually were shown to be no better than aspirin. The first
recorded double-blind experiments were conducted in England testing
these hormones against aspirin. Prednisone is a more modern derivative
of the corticosteroids.