Fasting and Lupus: What You Should Know

Lupus is an autoimmune disorder that can affect various organs and tissues, including the joints, skin, kidneys, and brain. 

Fasting has been increasingly investigated for its role in supporting more balanced immune responses and may offer potential benefits for individuals with lupus. 

Discover the connection between lupus and fasting, and learn when caloric restriction may be helpful–and when it should be avoided.

What is lupus?

Lupus is an autoimmune disease, meaning the body’s immune cells mistakenly attack its own tissues, leading to chronic inflammation that can affect multiple organs.

There are several types of lupus, each distinguished by the specific tissues or organs affected. These variations are believed to be influenced by genetic susceptibility, environmental triggers, and specific immune responses, which influence how lupus develops and presents in each individual.

The most common types of lupus include systemic lupus erythematosus, the most serious form that typically affects multiple organs, and cutaneous lupus erythematosus, characterized by skin inflammation.

Drug-induced lupus is typically a milder form that can develop in response to certain medications, including immunomodulating and cardiovascular drugs. 

Lupus is a lifelong condition that typically follows a pattern of flare-ups and remissions, with periods of increased disease activity alternating with asymptomatic periods.

While lupus patients can display a wide range of symptoms depending on which organs are affected, most report fatigue and extreme tiredness, joint pains, poor mental health, and skin rashes. 

According to a report published by the Centers for Disease Control (CDC), lupus is significantly more common in women than in men, indicating potential hormonal influences. 

In addition, factors such as stress, estrogen imbalances, certain infections, and smoking can contribute to lupus flares, as they can trigger the immune system to produce autoantibodies that attack the body’s own tissues.

Watch the video below to discover the beneficial effects of fasting for lupus. 

Potential benefits of fasting for lupus

Fasting, especially prolonged fasting protocols such as 24-, 48-, or 72-hour fasts, may offer potential benefits for individuals with autoimmunity-related conditions such as lupus.  

Extended periods of caloric restriction trigger a complex cascade of metabolic and hormonal changes that activate autophagy, a process in which cells recycle damaged organelles and proteins.

Autophagy is active in most of the body’s tissues, including immune cells such as T cells, B cells, and macrophages. By clearing out dysfunctional or aged immune cells, autophagy can help reset the immune system, decrease inflammation, and support a more balanced immune response.

A study published in the Journal of Immunology investigated the potential effects of fasting in the progression and management of lupus. 

The authors summarize, “Fasting is beneficial in the prevention and amelioration of the clinical manifestations of autoimmune diseases, including systemic lupus erythematosus (SLE).”

In addition to prolonged fasting, intermittent fasting, characterized by alternating periods of fasting and time-restricted eating windows, has also been studied for lupus management.  

Evidence published in Autoimmunity Reviews found that intermittent fasting is associated with improved inflammatory markers and has beneficial effects on the gut microbiota, which plays a key role in regulating immune functions and inflammatory balance.

These findings suggest that both prolonged and intermittent fasting routines could support immune balance and help reduce inflammation in those with lupus. 

Potential concerns with fasting and lupus

While fasting may benefit individuals with autoimmune diseases, it’s crucial to be aware of the potential adverse effects of caloric restriction in those affected by lupus. 

It is essential to consult a healthcare provider specialized in lupus before starting any fasting regimen, as individual responses can vary, making careful medical supervision critical.

Here are four concerns of fasting and lupus. 

1. Energy demands

Severe fatigue is among the most common lupus symptoms and can be exacerbated by fasting, especially fasting periods beyond 24 hours.  

Reduced calorie and nutrient intake can limit the body’s ability to produce energy and slow recovery, which can worsen fatigue and make daily activities more difficult.

2. Fluid and electrolyte needs

The metabolic effects of fasting can temporarily increase fluid and mineral loss, increasing the risk of dehydration and contributing to electrolyte imbalances. 

If fluids and essential electrolyte minerals such as potassium, sodium, and magnesium aren’t adequately replenished, kidney function may be strained, and lupus-related symptoms such as fatigue, muscle weakness, and brain fog can worsen.

3. Medication timing 

The majority of lupus patients take medications to manage symptoms, including corticosteroids and immunosuppressant drugs. 

Fasting can interfere with the absorption and effectiveness of these medications, especially those that need to be taken with food, making careful planning with a healthcare provider essential.

4. Kidney function 

Those diagnosed with lupus nephritis, characterized by kidney inflammation and impaired renal function, are at increased risk of dehydration and electrolyte imbalances and are advised to avoid both intermittent and prolonged fasting.

Tips for fasting if you have lupus 

Discussing fasting with a healthcare professional, following a healthy diet, focusing on hydration, and carefully listening to your body can help maximize the benefits of fasting while minimizing potential health risks. 

Here are three tips for fasting if you have lupus. 

1. Start slow and monitor how the body responds 

“Some individuals may notice significant improvements in lupus-related symptoms when fasting,” explains Dr. Berg. “However, others may experience increased fatigue, dizziness, or other symptoms, highlighting the importance of slow implementation and self-monitoring.”

It’s recommended to start with shorter intermittent fasting schedules, such as 16:8, which involves fasting for 16 hours followed by an 8-hour window during which two meals are typically consumed.

If tolerated, slowly extend intermittent fasting to an 18:6 or 20:4 schedule and only incorporate 24-hour fasts or longer under professional supervision, and if overall well-being remains stable.

2. Prioritize a nutrient-focused diet

To ensure that the body’s energy and nutrient demands are met during the eating window, it’s essential to follow a nutrient-dense diet by prioritizing minimally processed whole foods. 

Adopting an anti-inflammatory diet can support the body’s ability to regulate immune responses and manage inflammation, making it a particularly beneficial strategy for individuals with lupus.

Research published in Food Science and Nutrition found that regular inclusion of fatty fish, olive oil, nuts, seeds, and antioxidant-rich foods is associated with improved inflammatory markers and overall better well-being in lupus patients. 

Dietary antioxidants, including vitamins A, C, and E, as well as selenium and zinc, help strengthen the body’s ability to combat oxidative stress, which is a main driver of immune dysregulation and tissue damage. 

Some of the best dietary sources of antioxidants include:

• Leafy green vegetables
• Cruciferous vegetables
• Extra virgin olive oil 
• Seeds
• Nuts
• Berries
• Lemons and limes
• Herbs and spices
• Black coffee
• Green tea
• Unsweetened dark chocolate 

3. Stay hydrated and replenish minerals  

Because fasting can increase the risk of dehydration and electrolyte deficiencies, especially in those with lupus, it’s crucial to consume enough water and replenish electrolytes before, during, and after a fast. 

Adding Himalayan pink sea salt, a natural source of electrolytes, to water is a simple but effective strategy to support fluid and mineral balance during fasting.

In addition, consuming plenty of electrolyte-rich foods such as leafy green vegetables, avocado, oily fish, pumpkin seeds, and bone broth, or making a homemade electrolyte drink, during eating windows can help minimize the risk of fasting-related electrolyte imbalances.

FAQ

Sources

1. https://www.cdc.gov/lupus/signs-symptoms/index.html 
2. https://pmc.ncbi.nlm.nih.gov/articles/PMC3288569/ 
3. https://www.sciencedirect.com/science/article/abs/pii/S1568997223001428 
4. https://pmc.ncbi.nlm.nih.gov/articles/PMC12399882/