PT on the Net Research

Lupus


Question:

I need some help with a lupus client. She has been with me since December and has not lost any weight. She weight trains twice a week and does cardio three days a week. Her doctor told her that her muscle enzymes are high, and she needs to back off weight training. She also stopped having her monthly cycles, and he told her this was also due to too much weight training. She is 5'9'' and weighs 231 pounds. She has a body fat percentage of 41. Doesn't she need more lean muscle tissue to help her lose weight? She also has a thyroid issue they have just recently started to control. Any suggestions on workouts etc. would be great!

Answer:

First off, let me give you two definitions so we have a base to work from (www.lupus.org):

  1. What is lupus? - Lupus is a chronic (long-lasting) autoimmune disease in which the immune system, for unknown reasons, becomes hyperactive and attacks normal tissue. This attack results in inflammation and brings about symptoms.
  2. What does autoimmune mean? - Literally, it means immune activity directed against the self. The immune system fights the body itself (Auto=self). In autoimmune diseases, the immune system makes a mistake and reacts to the body's own tissues.

This is a very common disease/dysfunction that we humans have brought upon ourselves. Remember in life, nothing happens by chance but by choice. So, what does that mean? I could sit here and type for hours about lupus, its effects on the body, nutrition, lifestyle, factors contributing to it, mental/emotional well being prior, during, after, etc., but I am not going to. I am going to give you some basic info to give you a base and some direction so you can do some research yourself.

When someone has lupus or any other auto-immune disease, there are a lot of commonalities that you want to focus on. I know we should treat each person as an individual and you should. But when someone has lupus, fibromyalgia, etc (there are distinct differences, but lots of commonalities=auto-immune), the first goal is to reduce the amount of stress in one's life (physical, mental, emotional, spiritual, chemical, EMF, environmental, etc). You can track any disease, dysfunction or injury back to some sort of stress. Stress causes the release of many hormones and also causes inflammation in the body. With an auto-immune disease, the goal is to reduce this.

Any time there is inflammation, there is excess heat in the body that can cause inhibition of organ function and muscular function (visceral-visceral, visceral-somatic, somatic-visceral, somatic-somatic). This can cause many other problems within the body and can be dealt with down the line with some more advanced tools (CHEK NLC 3, Naturopath, Healers, Acupuncturist, etc). When you have inflammation in the body, there is a sympathetic (stress) response that occurs. Certain stress hormones (cortisol and adrenaline) are released, and other hormones are inhibited (estrogen, progesterone, DHEA, melatonin, etc=hormonal imbalances, menstruation problems, decreased concentration, depression, and mood swings). We are meant to handle stress but not 24 hour a day from 20 different directions. When this becomes too much for the body to handle, dysfunctions and diseases start to occur. In the long run, we have an auto-immune response secondary to the overload secondary to the body seeing everything as its enemy.

These hormones are catabolic or break down tissue. So with a client like this, the goal is to get her into a more Parasympathetic (relaxed) state internally and externally in order to assist with the five alarm fire that is going off inside. This will assist with repair and regeneration, allowing the body to feel safe in order to lose weight, etc. There are many ways to do this, and many tools you can use. I will give you some recommendations to try, but at the same time, if you are in doubt, refer out! The goal here is stress reduction, and stress can come from many different directions. If you read some of my other Research Q&A responses, you can learn more about stress.

As I have said, any time there is stress, the adrenal glands release hormones called cortisol. When this goes up, insulin as well is elevated, and the other repair and regeneration hormones go down. So, if a person is “stressed” internally/externally all the time, cortisol/insulin never truly come down (adrenals and pancreas become taxed), and the end result leads to more physiological dysfunctions throughout the entire body's organ and endocrine systems. What usually happens is adrenal fatigue. It is somewhat like running the engine of your car as hard as you can without refilling the gas tank, changing the oil, etc. Eventually, there will be burn out. Symptoms of adrenal “burn out” are fatigue, depression, ups/downs, decreased concentration, altered hormone levels and thyroid dysfunction.

Now why thyroid dysfunction? The hypothalamus, adrenals and pituitary gland are all on the same axis (H-P-A). When there is stress, the hypothalamus is the guy who releases cotrophin releasing factor (CRF), which signals the pituitary to release adrenal corticotrophic hormone (ACTH), which signals the adrenals to release more cortisol. When there is stress to the adrenals, etc., the thyroid (master regulator of metabolism) will slow the body down, thinking that we are under a time of “feast or famine.” It slows things down, burning less calories, holding on to as much as it can hormonally, physically, etc. and not letting go of anything (i.e., fat so it can use it for energy since the body is deficient in so much). Attacking the thyroid can really do some damage, secondary to it being the byproduct of an adrenal problem. To learn more about this, read Adrenal Fatigue: The 21st Century Stress Syndrome by Wilson.

Here is what I would do (if you don’t know how, refer out to a skilled PT, Naturopath, Acupuncturist or CHEK/NLC Practitioner):

  1. You need to put the exercise on the back burner for a while. The goal here is stress reduction. Focus more on energy cultivating exercises or parasympathetic stimulating exercises: Qi Gong, Tai Chi, light yoga, walking outside, stretching, meditating, light swimming, etc.
  2. Focus more on your client's Nutrition and Lifestyle Factors:
    • Metabolic Typing (discovers individuals macro-nutrient ratios: carbs to proteins to fats)
    • Comprehensive Health Appraisal (discovers imbalances in the body’s systems: muscular, hormonal, limbic)
    • Lifestyle Evaluation (discovers what external stressors a client has and how it is effecting their bodies systems, i.e. stress stimulates sympathetic nervous system=poor digestion among other things)
    • Physiological Load and Daily Readiness Assessments (discovers amount of stress in musculoskeletal, hormonal, and limbic systems and what strategies will reduce and bring about a healthy balance)
    • Food and Sleep Diary (establishing eating habits, food intolerances and discovering circadian rhythms)
    • Digestive Health (processed foods, sugar, flour and dehydration, i.e. is your digestive system healthy or do you have a fungal or parasitic infection?)
    • If needed - toxic home/office checklist, gluten and candida questionnaire

Assessing and evaluating the above will give you and your client some answers to where the stressors are coming from and how to approach eliminating them. This should be the first priority of your client's program. If exercise were always the answer, everyone in the world would be healthy. That is why they focus so much on exercise and put less into focusing on prevention, nutrition, lifestyle, etc. That is because most like to think or numb themselves to the fact that it is not their fault that they are dysfunctional. They all believe it is because of lack of exercise, genetics, etc. It is about taking responsibility for one's self. That is health!

Good luck, and feel free to email me or call with questions. I learn from you, as you learn from me.