Lifestyle Modifications in Lupus: What’s the Evidence? Margy Holyst, M.D.

 Chronic disease  Active participant in health care  Improve sense of well being  Quality of life Why Lifestyle Modifications?

 Social wellbeing  Emotional wellbeing  Financial wellbeing Quality of Life

 Catch all title  Licensed professionals or certified instructors  High usage Complementary and Alternative Medicine

 Ancient practice  Part of Traditional Chinese Medicine  Different forms Acupuncture

 Chronic pain  Low back  OA of the knee  fibromyalgia Acupuncture

 Very little in medical literature for lupus  Pilot study  Potential benefit without risk Acupuncture

 Not been formally studied in lupus  Studied in RA  Form of yoga  Iyengar yoga  Hatha yoga  unspecified  Tailored to RA Yoga and Meditation

 Improved  Energy  Mood with decrease depression  Relaxation  Range of motion & balance  Coping, self-efficacy  Pain Yoga

 Breathing and meditation  With or without yoga  Stress management tool Yoga and Meditation

 OA and low back pain  Reduces pain  Increases range of motion  Improves coordination Chiropractic Care

 No studies in SLE or related autoimmune diseases  Theory  Restore normal motion  Return of alignment  Prevent undue stress on joint(s) Chiropractic Care

 No studies in SLE  One study in RA with benefit  Case study  Improvement in pain, fatigue, ROM, quality of life Therapeutic Massage

 Effective in OA of knee and low back pain  Decreases pain and improves function in osteoarthritis of the knee  Decreases pain and increases ROM in back pain  Benefit in timed coupling with chiropractic care Therapeutic Massage

 Depression common  As high as 45%  Anxiety common  As high as 37% Taking Care of You

 Counseling  Stress management  Groups focused on  Education  Coping strategies Taking Care of You

 Herbal supplements are medically active  Studies done primarily in Asia  Purity  Quality  Single ingredients Herbal Supplements

 Licensed practitioner  Quality  Safety  Tell all your providers about all of your supplements Herbal Supplements

 Proper nutrition is important  Copious amounts of information  No studies  Avoid foods that make you feel ill Nutrition

 Find what works for you  Be an informed consumer  Websites  Resources from Wellness Series What is a Person to Do?