Scleroderma is a connective-tissue disease characterized by a thickening and loss of elasticity in the skin, joints, digestive tract (especially in the esophagus), lungs, thyroid, heart, and kidneys. Mild or severe, it can flare up and subside in intensity. There are two forms of the disease: localized to one or two locations or generalized throughout the body.

The most common initial complaint is loss of circulation in toes or fingers (Raynaud’s syndrome), characterized by swelling and a thickening of skin. About 300,000 Americans have scleroderma. Joint pain is an early symptom. As the disease progresses, the skin becomes taut and shiny, with the face becoming masklike.

There may be red blotches on the skin where capillaries have broken. Small calcifications occur under the skin on the fingers. People become malnourished and may need supplemental foods or total parenteral feeding (tube feeding). Scleroderma has definite digestive components in 80 to 100 percent of people and can affect any part of the digestive tract.

In scleroderma, people begin to lose peristalsis. Early in the disease, the esophageal sphincter becomes stiff and loses elasticity, which causes gastric juices to go up into the esophagus and burn the lining, which causes heartburn. Sometimes there is regurgitation back into the mouth.

Eventually, the acids damage the esophagus and may lead to Barrett’s disease, bleeding, or ulceration. It is common to have fungal or candida infections in the esophagus, often called thrush. Because there is loss of peristalsis, the small intestines are prone to bacterial overgrowth.

The bacteria break down bile acids and gut mucosa causing malabsorption of nutrients, which leads to weight loss and diarrhea. The large intestine may develop diverticular pouches. Constipation is common. Late in the disease, the stomach may become involved.

Malabsorption leads to poor movement, dysbiosis, and semiobstructions in the small intestines. Small bowel bacterial overgrowth is common because of a loss of peristaltic function in the intestines. Use of steroid medications increases the likelihood of yeast infections in the digestive tract.

Treatment with antimicrobial medications will cure the infection temporarily but doesn’t change the fact that there is a loss of movement in the area. Small bowel overgrowth must be routinely monitored and treated if an infection is present. There is no single known cause of scleroderma.

It is caused by a combination of genetics and environmental factors. Evidence suggests that prolonged exposure to silica, silicone, and chemical solvents significantly increases the risk of developing scleroderma. (Another possible association is in workers with repetitive hand and arm vibration.)

In some individuals, solvents trigger the illness. An evaluation was made of 178 people with scleroderma, in comparison to 200 controls. People with scleroderma were more likely to have higher concentrations of and levels of exposure to solvents, especially trichloroethylene.

Scleroderma may also be linked to autoimmune disease. In a small study, forty-four women and six men went through extensive testing and examination to see if there was a relationship between their work and autoimmune disease. They had been working for an average of six years in a factory that produced scouring powder with a high silica content.

Thirty-two, or 64 percent, showed symptoms of a systemic illness, six with Sjögren’s syndrome, five with scleroderma, three with systemic lupus, five with a combination syndrome, and thirteen who didn’t fit into any definite pattern of disease.

Seventy-two percent had elevated ANA (antinuclear antibodies), an indicator of autoimmune connective tissue diseases. The conclusion was that workers who are continually exposed to silica have a high probability of developing an autoimmune problem.

The research on breast implants is mixed. Silicone breast implants may also play a role in some women with scleroderma. Twenty-six women with either lupus or scleroderma had breast implants removed. Three had complete remission of at least two years.

If you have breast implants, testing for silicone and chemical antibodies would help you determine if you might benefit from their removal. Some evidence suggests that people with scleroderma have a genetic block of the delta-6-desaturase enzyme. This enzyme system converts fatty acids from linolenic acid to EPA and DHA.

Supplementation with fish oils would circumvent this. There haven’t been a lot of studies using fish oils, but the small amount of literature shows them to be of benefit. Fatty acid testing would be advisable. Antioxidants are beneficial in people with scleroderma. Raynaud’s causes a surge of free radicals that need to be quenched.

Studies have shown that blood levels of vitamin C, vitamin E, selenium, and carotenoids are all lower in people with scleroderma, despite normal levels in their diets. Supplementation with antioxidant nutrients and testing for antioxidant status to see if levels are adequate is advisable.

Specific use of N-acetyl cysteine increases glutathione levels and is also advised. Use of several antioxidant supplements may be necessary for optimal results. Resveratrol, from red grapes, may also be of use. Homocysteine may be elevated in people with scleroderma.

Use of vitamin B6, B12, folic acid, and betaine (TMG) may be useful in normalizing levels. Natural therapies can work along with medical therapies for scleroderma. Infections must be treated, and beneficial flora given. Nutrients that help with collagen maintenance and repair are essential to help prevent loss of elasticity in skin and organs.

Think of vitamin C, quercetin, zinc, glucosamine, and chondroitin. Foods and supplements that help reduce production of arachidonic acid will reduce inflammation and pain. Good-quality oils, fish, nuts, and seeds work in this way. It’s also important to increase circulation and oxygen supply to the tissues. Finally, a nutrient-dense food plan must be developed that works to offset the problems of malnutrition, which are common.

Healing Options

• Treat infections. Small bowel infections, esophageal candida, and other infections are likely to recur. You may be able to keep the infections at bay with use of colloidal silver, grapefruit seed extract, or garlic capsules. Each of these substances has wide antimicrobial properties, low toxicity, and a low incidence of negative side effects. Your doctor may prescribe antibiotics or antifungal medications.

• Try probiotics. Flora supplements containing acidophilus, bifidobacteria, Saccharomyces boulardii, and other beneficial bacteria may help control infections of the intestines. No research has been done on this specifically for scleroderma, but they have been helpful in other cases of small bowel bacterial overgrowth. Take 4 to 6 capsules daily.

• Detoxify. A liver function panel can determine whether your phase I and phase II liver detoxification pathways are working normally. Because the risk of scleroderma increases with solvent exposure, a liver detoxification program may be of significant benefit. In the few people I’ve worked with who have scleroderma, this has proven to be an effective starting point.

• Try DHEA. DHEA is an adrenal hormone that has been found to be beneficial for people with scleroderma, especially in perimenopausal women. Because DHEA is a hormone, I recommend that you have a free DHEA/cortisol saliva test to determine if you actually need supplementation and to monitor your dosage levels. Dosages will vary, depending on your personal needs.

• Try the elimination-provocation diet. Explore the relationship between your scleroderma and food and environmental sensitivities through laboratory testing and the elimination-provocation diet. For best results, work with a nutritionist or physician who is familiar with food sensitivity protocols.

• Make dietary changes. People with scleroderma are often malnourished. So eat at least five servings of fruits and vegetables daily and as many organic and natural foods as possible. You may want to supplement your diet with nutrient-rich protein powder drinks and spirulina or blue-green algae, available at health-food stores. Eliminate nearly all foods that don’t contribute to your nutritional well-being. Make changes gradually.

• Take a multivitamin with minerals. Poor diet, loss of movement in the digestive tract, loss of elasticity of the organs, infections, and medications all contribute to the malabsorption of nutrients. Selenium and vitamin C deficiencies are common in people with scleroderma.

At least seventeen nutrients are essential for formation of bone and cartilage, so it’s important to find a supplement that supports these needs.

Look for a supplement that contains 10,000 IU vitamin A, 800 to 1,000 milligrams calcium, 400 to 500 milligrams magnesium, 400 IU vitamin E, at least 250 milligrams vitamin C, 50 milligrams vitamin B6, 15 to 50 milligrams zinc, 5 to 10 milligrams manganese, 12 milligrams copper, and 200 micrograms selenium in addition to other nutrients. Follow the dosage on the bottle to get nutrients in appropriate amounts.

• Take vitamin C. Vitamin C is vital for formation of cartilage and collagen, which is a fibrous protein that forms strong connective tissue necessary for bone strength. Vitamin C also plays an important role in immune response, helping protect us from diseaseproducing microbes.

Vitamin C also inhibits formation of inflammatory prostaglandins, helping to reduce pain, inflammation, and swelling. If you have candida or bacterial overgrowth, vitamin C can boost your body’s ability to defend itself. Vitamin C is also an antioxidant, needed to counter free radical formation noted in sclerotic conditions. Take 1 to 3 grams daily in an ascorbate or ester form. For best results, do the vitamin C flush.

• Try gamma-linolenic acid (GLA). One gram of evening primrose oil was given to four women with scleroderma three times daily for one year. They experienced a reduction in pain, improved skin texture, and healing of sores; red patches on skin due to broken capillaries were much improved. The researchers suggest that 6 grams daily may be of greater benefit. Take 3 to 6 grams of evening primrose oil, borage oil, or flaxseed oil daily.

• Increase consumption of omega-3 fatty acids and fish oils. Fish oil capsules reduce morning stiffness and joint tenderness. Similar results can be obtained by eating fish high in EPA and DHA—salmon, mackerel, halibut, tuna, sardines, and herring—two to four times a week.

Fish oils increase blood-clotting time and should not be used by people with hemophilia or those who take anticoagulant medicines or aspirin regularly. It’s easier for most people to eat fish two to four times each week. You can also take fish oil capsules, 4 to 10 daily.

• Try licorice. Deglycyrrhized (DGL) licorice helps heal mucous membranes by increasing healing prostaglandins that promote mucus secretion and cell proliferation. Licorice also enhances the blood flow and health of intestinal tract cells. Be sure to use DGL licorice to avoid side effects caused by whole licorice. Chew or swallow 2 tablets three to four times daily.

• Try slippery elm bark. Slippery elm bark has demulcent properties, so it’s gentle and soothing to mucous membranes. It has been a folk remedy for both heartburn and ulcers in European and Native American cultures and was used as a food by Native Americans.

Slippery elm bark can be used in large amounts without harm. Drink as a tea or chew on the bark. To make a tea, simmer 1 teaspoon of slippery elm bark in 2 cups of water for twenty minutes and strain. Sweeten if you wish, and drink freely. You can also purchase slippery elm lozenges at health-food stores and some drugstores.

• Take glutamine. Although I was unable to find any references for use of glutamine to heal the esophagus, it makes theoretical sense. The digestive tract uses glutamine as a fuel source and for healing. It is effective for healing stomach ulcers, irritable bowel syndrome, and ulcerative bowel diseases, and it is likely to be useful in the upper GI tract as well. Begin a one-month trial with 8 grams daily in divided doses. If it’s helpful, continue.

• Try glucosamine. Glucosamine sulfate is used therapeutically to help repair cartilage, reduce swelling and inflammation, and restore joint function. Green-lipped mussels are a rich source of glycosaminoglycans. Use of glucosamine sulfate has no associated side effects. Take 500 milligrams two to four times daily.

• Take ginger. Ginger can provide temporary relief, it has some antiinflammatory properties, and it can help expel gas. Ginger can be used as an ingredient in food or taken as a supplement. To make a tea, take ½ teaspoon of powdered ginger or a few slices of fresh ginger per cup of boiled water. Steep for ten minutes and drink. If you’d like, sweeten it with honey. Cook with ginger and use it freely.

• Try meadowsweet herb. A demulcent, meadowsweet soothes inflamed mucous membranes. To make a tea, take 1 to 2 teaspoons of the dried herb in 1 cup of boiled water. Steep for ten minutes, and sweeten with honey if you like. Drink 3 cups daily.

• Try bromelain. Bromelain is an enzyme from pineapple that acts as an anti-inflammatory in much the same way that evening primrose oil, fish oils, and borage oils do. It interferes with production of arachidonic acid, which reduces inflammation.

It also prevents platelet aggregation and interferes with growth of malignant cells. Bromelain can be taken with meals as a digestive aid, but as an anti-inflammatory it must be taken between meals. Take 500 to 1,000 milligrams two to three times daily between meals.

• Try quercetin. Quercetin is the most effective bioflavonoid in its anti-inflammatory effects. It can be used to reduce pain and inflammatory responses and for control of allergies. Take 500 to 1,000 milligrams two to four times daily.