1. Introduction
A 68-year-old female patient with a known history of Autoimmune Overlap syndrome (Dermatomyositis/SLE), has revisited SLNS Hospital in April 2025 for further evaluation. First referred by epidemiologist in 2022, the patient has shown resilience in managing her complex condition through a combination of allopathic and supportive therapies. Her return to SLNS marks a renewed phase in her healing journey, focusing on reducing medication dependency, improving quality of life, and addressing persistent symptoms such as fatigue, photosensitivity, and gastrointestinal disturbances under naturopathic supervision.
2. Patient Information
NAME: Mrs. XYZ
GENDER: FEMALE
AGE: 68 YEARS
She consulted a Rheumatologist, for her autoimmune-related conditions. The patient’s medical history reveals a chronic and complex case that began in 2017 with severe physical debilitation, rendering her unable to get out of bed. In 2017, she experienced extreme fatigue and weakness. Upon looking into a mirror, she noticed a butterfly-shaped pattern on her face, although there were no apparent rashes. This was a key feature that later contributed to her diagnosis. After consultations and a blood test through Metropolis Labs, the dermatologist in Anna Nagar determined that the patient’s condition was 75% indicative of Dermatomyositis and 25% of Systemic Lupus Erythematosus (SLE). The patient has a long-standing medical history.
In 1985, she was diagnosed with Glaucoma, which has been managed only using eye drops. She also has a cardiac history involving Mitral Valve Prolapse with annular ring formation. Cutaneous calcinosis (calcium deposits in the skin) and elevated SGOT and SGPT liver enzyme levels were also noted. Additionally, she has been diagnosed with IBS (Irritable Bowel Syndrome), for which medications like Rifagut and Lomotil were prescribed. Treatment over the years has included a combination of immunosuppressants, anti-inflammatory medications, and steroids.
Between 2018 and 2019, she was prescribed Prednisolone 2mg, HCQ 200 (hydroxychloroquine), and Azoran. These were aimed at managing inflammation and autoimmunity. During her bout with COVID-19, additional steroids were administered. Occasionally, Ashwagandha supplements were taken to help with sleep. In late 2024, the rheumatologist reinitiated treatment with Metrol 4mg. Following steroid treatment, the patient experienced significant weight gain, rising from 58 kg to 71 kg.
This prompted her to adopt alternate-day fasting for six months, which she has continued along with dietary changes and gym workouts. However, symptoms aggravated due to UV light exposure in the gym, worsening her photosensitivity. She also reported developing a moon face, red to black skin discoloration from sun exposure, and dry skin replacing her previously oily skin. Notably, her knuckles became visibly darker.
In 2024, after experiencing ongoing digestive issues, the patient underwent endoscopy and colonoscopy, revealing gastric erosion and mild Helicobacter pylori (H. pylori) infection. Despite these complications, she has remained diligent in following medical advice from SLNS Nature cure Hospital. Her current treatment regimen focuses on controlling flare-ups and maintaining overall health stability.
3.Naturopathic and Lifestyle Interventions
Yoga and Physiotherapy: Integrated to improve mobility, reduce pain, and enhance well-being through strength, flexibility, and stress management.
Dietary Adjustments: Recommended anti-inflammatory foods, reduced sugar, and increased fiber to improve insulin sensitivity and glucose levels.
Herbal Supplements: Turmeric for inflammation, ginger for pain relief, and Ashwagandha for stress and energy enhancement were suggested.
Lifestyle Changes: Improved sleep hygiene, stress management, and daily physical activity formed the foundation for better health
4.Results and Follow-Up:
| S.No | Biomarker | Before Treatment | After Treatment |
| 1 | FERRITIN | 243 | 149.1 |
| 2 | HBA1C | 5.7 | 5.4 |
| 3 | AVERAGE BLOOD GLUCOSE | 117 | 108 |
| 4 | VITAMIN K | 0.11 | 0.35 |
| 5 | LDL/HDL | 1.3 | 2.6 |
| 6 | CYSTATIN C | 1.47 | 1.38 |
Through personalized naturopathy treatments and lifestyle modifications, a remarkable transformation in key health biomarkers was achieved, reflecting improved well-being and systemic balance. Ferritin levels decreased significantly from 243 to 149.1, indicating reduced inflammation. HBA1C dropped from 5.7 to 5.4, alongside a decline in average blood glucose from 117 to 108, demonstrating better glycemic control. Vitamin K levels rose from 0.11 to 0.35, supporting improved bone and cardiovascular health. The LDL/HDL ratio improved dramatically from 1.3 to 2.6, highlighting better lipid metabolism. Cystatin C levels also decreased from 1.47 to 1.38, signifying enhanced kidney function. These results underscore the power of holistic interventions in achieving sustainable health improvements while promoting natural healing and vitality.
5. Discussion
The introduction of a lifestyle intervention—alternate-day fasting, dietary control, and exercise—helped address metabolic effects but inadvertently worsened symptoms due to UV exposure. Her photo-aggravated rashes, dry skin, and darkening knuckles reflect disease activity and the photosensitive nature of SLE. Her current plan centers on symptom stabilization, flare prevention, gastrointestinal support, and progressive tapering of immunosuppressive medications. Continuous rheumatologic care, nutritional modulation, and careful UV protection remain essential in her long-term management.
6. Conclusion
This case underscores the complexities of managing chronic autoimmune overlap syndromes, where conditions like dermatomyositis and SLE are further complicated by comorbidities such as glaucoma, cardiac anomalies, gastrointestinal disturbances, and steroid-induced side effects. While her journey has been marked by recurrent flare-ups and systemic challenges, she has achieved significant relief from many symptoms and remarkable improvements in biomarkers through integrative approaches and treatment compliance. However, as this is a chronic case, tapering medications will require more time to ensure stability and avoid relapse. Her progress highlights the importance of balancing immunosuppressive therapy with personalized lifestyle adaptations and regular follow-ups. Continued multidisciplinary care, cautious medication tapering, and tailored guidance will remain crucial in maintaining long-term disease control and enhancing her quality of life.