Sarcoidosis treatment, diet, food, review of cause and natural, alternative therapy by Ray Sahelian, M.D. see a list of hundreds of health and nutrition topics
December 6 2014

Sarcoidosis is a systemic granulomatous disease of unknown cause characterized by the formation of noncaseating granulomas. Sarcoidosis primarily involves inflammation that produces tiny lumps of cells in various organs. The lumps are called granulomas because they look like grains of sugar or sand. They are very small and can be seen only with a microscope. These tiny granulomas, over time, enlarge and join each other. If many granulomas form in an organ, they can affect how the organ works. This leads to the symptoms and diagnosis of sarcoidosis. Any organ can be affected, but most often sarcoidosis affects the lungs and lymph nodes.
   Sarcoidosis is thought by most scientists to be a disorder of the immune system, where the body's natural defense system malfunctions.

Cause of sarcoidosis
This medical disease may be linked to seasonal, environmental and genetic factors. Another cause may be infection, due to mycobacterial or other infections. Some drugs may be another cause.
   Is pollution or exposure to dust and particles another cause? There is an increased incidence of sarcoidosis or "sarcoid-like" granulomatous pulmonary disease among Fire Department of New York rescue workers since the World Trade Center disaster. On September 11, 2001, the attack and collapse of the World Trade Center in New York City released large amounts of airborne particulate matter and combustion byproducts.. Since then, an increased risk of granulomatous pneumonitis and cardiopulmonary sarcoidosis in workers exposed to dust have been reported.

Diet
In some cases sarcoidosis has been associated with celiac disease, such as a reaction to certain protein chains commonly referred to as glutens found in some cereal grains.

Natural supplements, herbs, vitamins
I was diagnosed with sarcoidosis 5 years ago and am having some neuro symptoms now and lung symptoms have started to return. I ran across this piece of news out of Johns Hopkins about amyloids being very high in sarcoidosis cells. In light of their discovery wouldn’t it be safe to say that looking at curcumin treatment for inflammation would make sense? I also have Alzheimer’s (early onset) in my family.
   It's difficult to say since we are not aware of much research in this area. Perhaps the use of anti-oxidants and natural anti-inflammatory supplements could be of benefit.

Clin Nutr. 2011.Quercetin reduces markers of oxidative stress and inflammation in sarcoidosis.
A double-blind intervention study has been conducted with two groups of non-smoking, un-treated sarcoidosis patients, matched for age and gender. One group was given 4 x 500 mg quercetin orally within 24 h, the other one placebo. Plasma malondialdehyde levels were used as marker of oxidative damage, plasma ratios of TNFα/IL-10 and IL-8/IL-10 as pro-inflammatory markers. Quercetin supplementation improved the antioxidant defense, indicated by the increased total plasma antioxidant capacity. Moreover, supplementation also reduced markers of oxidative stress and inflammation in the blood of sarcoidosis patients.

Respir Med. 2009. Antioxidant status associated with inflammation in sarcoidosis: a potential role for antioxidants. Department of Pharmacology and Toxicology, Maastricht University, The Netherlands.
Enhanced production of reactive oxygen species (ROS), capable of reducing endogenous defense levels and enhancing inflammation, is suggested to play a role in sarcoidosis. Antioxidant supplementation might offer protection against such ROS-mediated damage. Non-smoking sarcoidosis patients and healthy controls matched for age, gender and dietary behavior were enrolled. Measurements included assessment of total plasma antioxidant capacity, vitamin C, uric acid, glutathione, basal and LPS-induced levels of tumor necrosis factor alpha (TNFalpha), interleukin (IL)-8 and -10 as well as the effect of quercetin on these levels. Compared to their controls, the sarcoidosis patients displayed significantly lower total plasma antioxidant capacity, decreased levels of vitamin C, uric acid and glutathione and increased levels of basal TNFalpha and IL-8. Quercetin significantly decreased ex vivo LPS-induced TNFalpha- and IL-8 production in a concentration-dependent manner in both groups. Our results regarding the effect of quercetin on cytokine production imply that sarcoidosis patients might benefit from antioxidant supplementation not only by empowering the relatively low protection against ROS but also by reducing inflammation.

I would be grateful if I may have your thoughts on serrapeptase as a potential cure for sarcoidosis which has (so far) affected my lungs - I have lost over 60pct of lung capacity, aged 45, and very keen to find ways to push this condition into remission.... My doctors are telling me that there are no known 'cures' for my condition and cortico-steroids can assist in relieving the inflamatory symptoms, but clearly are not a long term solution... I have recently come across the "aden protocol" on the internet, which is promoting serrapeptase as a potential cure for this condition. Do you agree with this? What sort of dosage would you suggest?
   I have not seen any studies regarding this form of treatment so I do not know if this nutritional supplement would be effective.

I read an article you wrote about amyloid deposition and supplements that counteract this problem. I have sarcoidosis stage 3 which means I am beginning to have amyloid deposits in my lungs and in my liver. I am strong and healthy otherwise. I hike once a week on difficult hikes although sometimes my lungs like to spasm at high altitudes. I see you gave a list of supplements, but in my experience, i have wasted a lot of money on my own guesswork. Is it possible you have made suggestions to another patient, and would it be possible that I could see those suggestions or prescriptions? This way you are not prescribing to me and have no liability. I can just use it as educational material.
  A. I am still waiting for more research in this area.

Vitamin D
Q. I have followed you for years and would like to know if you have any new info on sarcoid and vitamin D. My daughter has lung sarcoidosis and was diagnosed 10 years ago. Should individuals with this condition avoid vitamin D completely?
   A. I have not seen enough data to have a strong opinion on this topic, but it seems for the moment that taking additional amounts through pills should be avoided due to potential hypercalcemia. Normal sun exposure seems to be acceptable.

Sarcoidosis treatment
The is no overall medical consensus regarding the treatment of this condition. Corticosteroids remain the cornerstone of therapy, but immunosuppressive, cytotoxic, and immunomodulatory agents have emerged as potential treatment options for patients failing or experiencing side effects from corticosteroids. Methotrexate has been evaluated, and there have been studies with leflunomide, azathioprine, antimalarial and antimicrobial agents, and tumor necrosis factor-alpha inhibitors.
   Patients with sarcoidosis are at risk for osteoporosis caused by glucocorticoid therapy.

Q. I have recently been diagnosed with pulmonary sarcoidosis stage 4 and am on a regiment of Prednisone and Plaquenil. Are you familiar with the Aden Dietary Protocol? Does Quercetin interfere with Plaquenil and or Prednisone.
   A. I am not very familiar with the Aden dietary protocol. I have not seen any studies regarding the interactions of these medications with quercetin.

Outlook for a patient
The progression varies among different patients, ranging from self-limited acute disease to a chronic debilitating disease that may result in death. Spontaneous remissions occur in about two thirds of patients, but 10-30% of patients have a more chronic or progressive course. Sarcoidosis often goes away on its own without treatment — usually within two to three years.

Depression
More than half of people with sarcoidosis have depression. Depression can affect one's work, school studies, sleep, and even appetite. Depression is treatable. Medications and/or talk therapy are often helpful.

Gastrointestinal sarcoidosis
Gastrointestinal  tract involvement is rare.

Cardiac sarcoidosis
Cardiac involvement is a rare and potentially life-threatening complication. Infliximab may be considered as an alternative first-line therapy in sarcoidosis with serious organ involvement.

Drug cause of sarcoidosis
Etanercept therapy may trigger it. Interferon could also be a drug induced cause.

J Am Acad Dermatol. 2013. Cutaneous and pulmonary sarcoidosis-like reaction associated with ipilimumab.

Sarcoidosis natural treatment emails
Q. Do you know how to treat neuro sarcoidosis?
   A. I am not familiar with neurosarcoidosis treatment.

I found this site as I was searching the UNM in Albuquerque regarding the use of chlorambucil for sarcoidosis patients that are advanced in the disease and steroids are not an option. I am taking large doses of Benicar to help control the inflammation but my kidneys are in chronic renal failure. I am 54 and 3 years ago had a thyroidectomy and they found the sarcoidosis had destroyed it. Since then we have found it is very advanced. We tried steroids and I was not able to take it without severe adverse effects. I suffer from fevers and chilling, partial complex seizures, chronic pulmonary restrictive disease and i'm on 02, pain in all my bones, weak, lethargy, depression.
    Sorry, I am not familiar with this therapy and I do not have a contact source.

I am 38 yrs old. I was recently diagnosed with sarcoidosis and they currently have me taking Mycophenolate 500 MG Tablet (Cellcept). I would like to know if you know of any other alternative than the medication I am currently taking. I want to live a healthier life without taking medication that may cause me to get cancer.