|Two Problems That People With Scleroderma Face: Malabsorption and Inflammation|
|Tuesday, 26 January 2010 09:17|
According to MotherNature.com, many doctors agree that Scleroderma starts with inflammation, and its progress depends on how much inflammation continues to occur in the body. That's one reason some doctors recommend that patients with any sort of inflammatory disease such as rheumatoid arthritis, lupus or Scleroderma, make sure they are getting optimum amounts of vitamin E, selenium and beta-carotene - a yellow pigment found in dark green, leafy vegetables and in orange and yellow fruits and vegetables.
These nutrients, known as antioxidants, are thought to help to dampen inflammation by neutralizing some of the biochemicals associated with the process.
Inflammation produces unstable molecules called free radicals, which damage a cell by grabbing electrons from healthy molecules in the cell's outer membrane. Antioxidants offer free radicals their own electrons, disarming the free radicals and saving cells from harm.
As yet there hasn't been much in the way of actual scientific study of the use of antioxidants to treat Scleroderma. In one study using laboratory animals, supplemental vitamin E helped prevent calcium deposits in soft tissues, which can be a problem for people with Scleroderma. In another study, three people with Scleroderma who took 800 to 1,200 international units of vitamin E daily had reductions in the stiffness and hardness of their hands, reductions in calcium deposits in soft tissues and, in two of these people, healing of ulcerated fingertips.
And studies of animals with another more common inflammatory disease, lupus, do show that these nutrients can help stop damage from inflammation, says Dr. Sheldon Blau, clinical professor of medicine at the State University of New York at Stony Brook and co-author of Living with Lupus.
He recommends daily intake of 1,000 international units of vitamin E, 25,000 international units of beta-carotene and a multivitamin/mineral supplement that includes 50 micrograms of selenium and 15 milligrams of zinc. (Zinc is used by the body to produce a free radical-quenching enzyme.) Vitamin E in doses exceeding 600 international units daily can cause side effects, so it's a good idea to talk to your doctor about supplementing in this high amount.
Vitamin E and beta-carotene are considered safe, even in fairly large amounts. But if you have Scleroderma, check with your doctor before you take supplements of these or any other nutrients, especially if you have kidney damage or high blood pressure, Dr. Blau cautions.
Perhaps the biggest nutritional problem that people with Scleroderma face is malabsorption. Their intestines absorb less than normal amounts of nutrients from foods because of scarring and bacterial overgrowth. Doctors often recommend treatment with antibiotics to knock out the bad bugs and help restore some absorption. But some people also require liquid nutritional supplements or, in some cases, intravenous nutrition.
But even people who don't require special feeding formulas can benefit from taking a multivitamin/mineral supplement, says Dr. Blau. "These people have an especially hard time absorbing the fat-soluble vitamins A, D, E and K, and they can develop an array of symptoms associated with deficiencies of these nutrients if they do not get adequate amounts," he says.
Dr. Blau says he has seen people with Scleroderma develop softened bones from a lack of vitamin D and hemorrhaging from a lack of vitamin K. That's one reason he urges people with Scleroderma to see a rheumatologist (a doctor who specializes in these sorts of diseases) for their care.
"These symptoms are not a normal course of Scleroderma, and you need to see a doctor who knows what symptoms can be prevented with proper nutrition," he says.
In addition to deficiencies of fat-soluble vitamins, people with Scleroderma are at particular risk for vitamin B12 deficiency, says Dr. Blau. Fatigue, memory loss and abnormal gait can be signs of low B12 levels. Most people with absorption problems require injections of B12 to restore blood levels to normal. Oral doses of 1,000 micrograms a day (well above the Daily Value of 6 micrograms) may maintain normal blood levels in people with only minor absorption problems, he says.
Doctors agree: If you have scleroderma, healthy eating habits can help you function better. Here's what they recommend.
Subtract fat. Chances are you've heard this advice a few times before, as prevention for heart disease and cancer. In the case of a chronic inflammatory condition such as scleroderma, you'll want to cut back on the fat in your diet, especially saturated fat, because fat helps fuel the fire of inflammation. High-fat meals are also harder to absorb than low-fat meals.
To do this, stick to low-fat dairy products, lean meats and reduced-fat salad dressings. "I tell people to eat mostly vegetarian," says Sheldon Paul Blau, M.D., clinical professor of medicine at the State University of New York at Stony Brook and co-author of Living with Lupus.
Fill in with fish. The oil in fatty fish such as mackerel, salmon and tuna actually has a mild anti-inflammatory effect, Dr. Blau says. Some people take fish oil capsules, but since you want to stay low-fat, a better tactic may be to replace high-fat dishes such as macaroni and cheese with broiled fish, he says.
Use yogurt to your advantage. Although antibiotics may be essential to knock out harmful bacteria in your digestive system, these powerful medications also destroy helpful bacteria. Eating plenty of yogurt or taking acidophilus tablets restores these friendly bacteria to the bowel, which helps protect it from a new bout of harmful overgrowth, says Dr. Blau.
Prescriptions for Healing:
Although most doctors do not recommend supplements to people with Scleroderma, some doctors say they've found that certain supplements may help the two biggest problems that people with scleroderma face: malabsorption and inflammation. Here's what they recommend.
Nutrient Daily Amount:
Beta-carotene 25,000 international units
Selenium 50 micrograms
Vitamin B12 1,000 micrograms
Vitamin E 1,000 international units
Zinc 15 milligrams
Plus a multivitamin/mineral supplement containing the Daily Values of all essential vitamins and minerals
If you have Scleroderma and wish to take these nutrients, please discuss it with your doctor first, especially if you have kidney damage or high blood pressure. Vitamin E in doses exceeding 600 international units daily can cause side effects, so it's a good idea to talk to your doctor about supplementing in this high amount. If you are taking anticoagulant drugs, you should not take vitamin E supplements.