Reducing Disease Activity in Systemic Lupus Erythematosus through Adjunctive Naturopathy and Yoga: A Six-Month Case Report with Serial Immunological, Haematological, and Patient-Reported Outcome Monitoring

Abstract

Background: Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease that predominantly affects women of reproductive age. Conventional immunosuppressive therapy controls disease activity but carries substantial adverse effects and rarely addresses the patient's broader physical and psychological well-being. Integrative naturopathic and yoga-based interventions have shown benefit in other autoimmune conditions, yet detailed, protocol-driven documentation of their use in SLE, including serial immunological, haematological and patient-reported outcomes, remains rare in the peer-reviewed literature. This case report was written to help fill that gap.
Case Presentation: A 45-year-old female schoolteacher with a three-year history of SLE (baseline SLEDAI-2K score 14, indicating moderate-to-severe activity) presented with malar rash, polyarthralgia, fatigue, alopecia, oral ulcers and photosensitivity while maintained on stable-dose hydroxychloroquine and a tapering course of prednisolone.
Intervention: The patient was enrolled in a supervised six-month integrative outpatient programme combining naturopathic care (anti-inflammatory diet, hydrotherapy, mud therapy, massage, supervised fasting and targeted supplementation) with a structured daily yoga protocol (modified asana, Nadi Shodhana and Bhramari pranayama, Yoga Nidra and mindfulness meditation). Conventional pharmacotherapy continued throughout under rheumatology co-management.