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NMU 116 – Herbs Flarring Up Autoimmune Dis

Nutrition / Natural Medicine Update No 116 (January 14, 2019)

with Dr. James Meschino


Topic: Herbal Supplements Linked to Flare-up of Autoimmune Disease

Source: Archives Dermatology (2004); Journal Gastroenterology Medicine & Research (2018)


You probably know that certain natural supplements and various foods can modulate immune function, which is normally a good thing. For example, medical mushrooms such as reishi, shitake, maitake mushrooms and their extracts, taken as supplements or powdered blends, can act as biological response modulators. This means that if the immune system is weak they can boost its function, but if the immune system is overactive, then they show the potential to calm it down. One of the unanswered questions that have been around for a while is whether immune-modulating foods and supplements are a good idea for a person who has an autoimmune disease, like rheumatoid arthritis or lupus. In autoimmune disease, the immune system is already overactive and attacking the body’s own normal tissues, such as the joints, the lungs, the kidneys, the liver, etc., producing inflammation and a decline in a joint and/or organ function that can be life-threatening in some cases. Boosting immune function in these cases seems counter-productive when the immune system is already overactive. However, there are very few reports of dietary supplements or immune-modulating foods triggering or aggravating autoimmune diseases in these cases.

In 2004 three case reports surfaced that potentially linked the intake of certain immune-stimulating herbal supplements with flare-ups of existing autoimmune conditions. In one report the popular immune-stimulating supplement known as Echinacea was linked to a flare-up of a rare autoimmune condition known as pemphigus Vulgaris, whereby the body produces antibodies that cause blistering on the skin and mucous membranes (which can include the mouth, throat, nose, eyes, genitals, lungs). In another case of pemphigus Vulgaris, a flare-up was linked to the ingestion of the algae Spirulina platensis. The ingestion of another type of algae (Aphanizomenon flos-aquae) preceded the flare-up of dermatomyositis, another autoimmune disease that is characterized by a distinctive skin rash, muscle weakness, and inflammatory myopathy, or inflamed muscles. In 2018, a review published in the journal Gastroenterology Medicine and Research linked the development of autoimmune hepatitis (causing liver inflammation and damage) to the intake of a few rarely encountered herbal agents (Angeline, Kath edulis -evergreen shrub, high levels of ephedra), some of which have been known to induce liver injury. In my own clinical experience, I encountered a patient whose autoimmune condition flared-up shortly after she began taking an Astragalus supplement. Astragalus is a known immune-stimulating herb.

I think the take-home message from these case reports is that individuals with known autoimmune conditions need to exercise caution when considering ingesting supplements or foods that have known immune-stimulating properties. At the outset of a cold, many people gobble up Echinacea supplements, for instance, to help get their immune system to fight off the virus. For most of us, this may be a prudent strategy, but for 20% of the population who have an autoimmune disease (1:5 Americans), it may have the potential to trigger a flare-up of their condition.

The sobering aspect of all of this is that over the last 20 years or so there have been very few reports of immune-modulating herbs or foods actually triggering or exacerbating an autoimmune condition. So, that’s quite encouraging if you are a supplement user. These reports are indeed very rare, but I think we should be aware of them.

As always, I’ve included the references in the text below.


1. 3 Case Reports: Arch Dermatol June 2004:


2. Autoimmune hepatitis (Journal of Gastroenterology Medicine & Research 2018):

Eat Smart, Live Well, Look Great,

Dr. Meschino

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