Alternatives to Prednisone for Lupus

If you’re taking prednisone for lupus and looking for natural alternatives, I understand completely. Prednisone causes more side effects than almost any other drug, and I experienced many of them myself. To give you real answers instead of guesses, I went to the Natural Medicines Database, an evidence-based resource that ranks natural treatments by effectiveness for specific conditions, and pulled together what the research actually shows for systemic lupus erythematosus, also known as SLE or simply lupus.

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TL;DR: Quick Summary

Three natural substances show potential for supporting lupus management: flaxseed, which has enough evidence to be rated possibly effective for kidney function, plus ALA (an omega-3 fatty acid) and DHEA, both of which show promise but lack sufficient high-quality evidence to be formally rated. None of these replace prednisone when it’s medically necessary, but if you do need to stay on it, replenishing the nutrients it depletes can make a meaningful difference in how you feel day to day.

What the Natural Medicines Database Says About Lupus

The Natural Medicines Database reviews scientific studies and ranks natural treatments on a scale that ranges from likely not effective all the way up to effective, similar in rigor to how the FDA evaluates pharmaceutical drugs. I went through everything available on lupus to find out what actually has support behind it. Here’s what I found, starting with the best news first.

Flaxseed: The One With Real Evidence

Flaxseed is currently the only natural substitute for prednisone in lupus that has enough evidence to earn a possibly effective rating. That means the studies behind it are good quality, there just isn’t yet enough volume of research to call it a slam dunk.

Oral flaxseed may help improve kidney function in people with SLE
Available as whole seeds or ground into flax meal
Can be added to smoothies, baked goods, or other foods without noticeably changing the taste
Can also work as an egg substitute when soaked in water for about five minutes
I personally use Bob’s Red Mill Golden Flax because it blends in seamlessly and doesn’t affect flavor

ALA (Alpha-Linolenic Acid): Promising but Not Yet Proven

ALA is one of the omega-3 fatty acids commonly found in fish oil supplements. Studies have looked at its effect on lupus, but there isn’t yet enough high-quality evidence to officially rate it as effective or ineffective.

Considered one of the anti-inflammatory omega-3s
Found in fish oil supplements as well as fatty fish
Fish oil in general has been linked to brain health benefits and may help prevent cognitive decline
Good sources include mackerel, salmon, and other fatty fish

Fish oil is something I recommend broadly, not just for lupus, since the anti-inflammatory and cognitive benefits are relevant for almost everyone.

DHEA: A Steroid Hormone With Mixed Results

DHEA is a steroid hormone in the same cascade as prednisone in the body, which makes it an intriguing candidate. Unfortunately, the research so far shows only modest symptom improvement, not enough to confidently call it an effective substitute.

May offer some benefit, but evidence is inconsistent
Supplement quality varies significantly across brands
Some DHEA products on the market have been found contaminated with testosterone or other undisclosed ingredients
If you choose to try DHEA, sourcing a high-quality, third-party tested product matters

If Prednisone Is Still Necessary for Your Lupus

For many people with lupus, none of these natural substitutes are enough on their own, and prednisone remains a necessary part of treatment. When I had to take it for nine months, I learned firsthand that a lot of the misery comes from what prednisone steals from your body, not just the drug itself. It depletes:

Calcium and vitamin D, contributing to bone loss and osteoporosis risk
Chromium, which affects hunger, cravings, weight gain, and blood sugar regulation
Magnesium, leading to muscle cramps and feeling generally unwell
Melatonin, disrupting sleep quality

Replenishing these nutrients while you’re on prednisone can make a real difference in how you feel, even if the underlying condition still requires the medication.

Supporting Your Body While You Take Prednisone

Lupus doesn’t have the same depth of possibly effective ratings that some other autoimmune conditions do, and I wanted to be honest about that rather than overpromise. That’s what led me to build the Lupus Support Pack, a single morning packet built as educational and nutritional support, not as a treatment or cure for lupus or any other condition.

It combines three things, taken together each morning alongside your prednisone dose:

DHEA (10mg), the same steroid hormone covered above, sourced and third-party tested since supplement quality varies so much across brands in this category
BodyBio Balance Oil, an omega 6 and 3 blend that includes linolenic acid, the same type of compound behind the flaxseed research discussed above, though at a different amount than the higher-dose ground flaxseed used in the kidney-function study, so I think of it as general essential fatty acid support rather than a direct stand-in for that specific study
An essential multivitamin, a broad-spectrum foundation of core vitamins and minerals to round things out alongside the two more targeted ingredients

I built it as one AM packet since all three pieces are meant to be taken together, alongside your prednisone if you’re still on it. It’s the nutritional support I wish I’d had, meant to sit alongside whatever your doctor has you on, not replace it. And because DHEA is a hormone, it’s worth talking to your doctor before starting it, especially if you have a hormone-sensitive condition or take other hormone-related medications.

Get Lupus Support Pack here →

Frequently Asked Questions

Is flaxseed an effective natural substitute for prednisone in lupus?

Flaxseed is currently the best-supported natural option for lupus, with evidence suggesting it may improve kidney function in people with SLE. It’s rated possibly effective, meaning the evidence is promising but not yet extensive.

Can fish oil help with lupus symptoms?

Fish oil, which contains ALA, shows some promise for lupus but doesn’t yet have enough high-quality evidence to be formally rated as effective. It’s still a broadly beneficial supplement for inflammation and brain health.

Is DHEA a good substitute for prednisone in lupus?

DHEA has shown only modest improvement in symptoms in studies so far. If you try it, look for a high-quality, third-party tested product, since contamination with other steroid hormones has been documented in some supplements.

Can I stop taking prednisone and rely on natural substitutes instead?

This decision should always be made with your doctor. These natural options may offer supportive benefits, but they are not established replacements for prednisone in managing lupus.

Why does prednisone cause so many side effects in people with lupus?

Prednisone depletes key nutrients including calcium, vitamin D, chromium, magnesium, and melatonin, which contributes to many of the side effects associated with long-term use.

How does Nutranize Zone fit into a lupus treatment plan?

Nutranize Zone is designed as nutritional support to be taken alongside prednisone, helping replenish depleted nutrients. It does not treat, cure, or prevent lupus and is not a substitute for your doctor’s care.

Disclaimer: Nutranize Zone does not diagnose, treat, cure, or prevent any disease. It is not a substitute for medical care or your doctor’s guidance.

References:
Clark WF, Kortas C, Heidenheim AP, Garland J, Spanner E, Parbtani A. Flaxseed in lupus nephritis: a two-year nonplacebo-controlled crossover study. J Am Coll Nutr. 2001 Apr;20(2 Suppl):143-8. doi: 10.1080/07315724.2001.10719026. PMID: 11349937.
National Institutes of Health, Office of Dietary Supplements. (2022). Omega-3 Fatty Acids: Fact Sheet for Consumers. Updated July 18, 2022. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/
Skare TL, Hauz E, de Carvalho JF. Dehydroepiandrosterone (DHEA) Supplementation in Rheumatic Diseases: A Systematic Review. Mediterr J Rheumatol. 2023 Aug 25;34(3):292-301. doi: 10.31138/mjr.20230825.dd. PMID: 37941864; PMCID: PMC10628885.
Crosbie, D., Black, C., McIntyre, L., Royle, P., & Thomas, S. (2007). Dehydroepiandrosterone for systemic lupus erythematosus. Cochrane Database of Systematic Reviews, (4), CD005114. https://doi.org/10.1002/14651858.CD005114.pub2