Sarcoidosis is a condition characterized by the presence of granulomas
- small beadlike patches of inflamed cells
- that often appear in the lungs and adjacent lymph
nodes. Sarcoidosis can also affect other tissues of the body including the
muscles, eyes, and skin. While most individuals with sarcoidosis have no
symptoms at all, sarcoidosis can cause long-term organ damage, such as the
abnormal formation of fiber-like scar tissue in the lung. This actually distorts
the structure of the lungs and can interfere with breathing. Those who have a
variation of the condition, called Lofgren's syndrome, may have symptoms that
include swollen lymph nodes, fever, painful, reddened nodules, and joint pain.
Lofgren's syndrome is found more frequently in persons of Scandinavian, Irish,
and Puerto Rican descent and it generally tends to clear up on its own within
one to two years. The prevalence of sarcoidosis is higher in Blacks than Whites
in the United States; about 36 in 100,000 Black Americans and 11 in 100,000
White Americans have the condition.
Signs and Symptoms
Many individuals with sarcoidosis have no symptoms at all.
Some individuals with pulmonary (lung) sarcoidosis may experience the
following signs and symptoms:
Fatigue and weakness
Shortness of breath or chest pain
Enlarged lymph nodes around the lungs
When sarcoidosis affects areas of the body other than the lungs, symptoms can
Enlarged lymph nodes
Red-purple inflamed areas on the legs
Swelling and pain in the ankles and knees
Infections of the eye, including conjunctivitis
Enlarged or inflamed liver
Although the precise cause of sarcoidosis is unknown, some scientists
speculate that an exaggerated defense reaction against some event or substance
perceived as a threat by the immune system may trigger the condition. Other
researchers have proposed that the condition may be inherited, caused by an
infection, or caused by inhaled allergens or toxins found in the environment.
The National Heart, Lung, and Blood Institute is currently conducting a study to
determine the cause of the condition.
Sarcoidosis is found throughout the world within almost all races and ages
and in both sexes, however it is most common among the
Individuals of Scandinavian, Irish, African, or Puerto Rican descent
Individuals in their 30s or 40s
Although many individuals with sarcoidosis experience no symptoms of the
condition, the following tests may help a physician diagnose the
Chest X ray
CT scan, MRI, or other imaging tests
About half of all individuals with sarcoidosis recover spontaneously and do
not need treatment. For those who do not recover spontaneously, symptom relief
and prevention of complications are often provided by medications such as
corticosteroids, which reduce swelling, rashes, pain, fever and lung problems.
lifestyle changes, including a diet low
in calcium or avoidance of vitamin D and sunlight, may help control some of the
complications of the condition, such as kidney stones or other damage. While
complementary therapies for sarcoidosis have not been well studied, anecdotal
reports suggest that melatonin and homeopathy may provide symptom
relief and improve general well-being.
Eating a diet low in calcium and vitamin D may relieve or help prevent two of
the complications of sarcoidosis, hypercalcemia (an abormally high amount of
calicium in the blood) and kidney disease. A physician can provide advice on how
to cut calcium out of the diet.
Avoiding sunlight, which is converted to vitamin D by the body, is also
Quitting smoking can ease lung symptoms.
Corticosteroids such as prednisone, prescribed by a physician, are the most
effective medications for reducing inflammation associated with sarcoidosis.
Oral corticosteroids can have some serious side effects if taken in high doses
for long periods, including high blood pressure, diabetes, peptic ulcers,
tuberculosis, or hirsutism (excessive hair growth). If an individual is at risk
for these problems, a physician will likely advise regular check-ups and
Other medications for sarcoidosis can include:
Methotrexate - for severe sarcoidosis; may
cause liver damage
Antimalarial drugs such as hydroxychloroquine
- for disfiguration of the skin; may be toxic to the
Surgery and Other Procedures
Surgery, such as a lung or heart transplant, is only necessary in extreme
Nutrition and Dietary Supplements
Melatonin: For individuals with chronic sarcoidosis who do not respond
to corticosteroids, preliminary studies suggest that the brain hormone melatonin
may be an effective alternative. In one study, individuals with sarcoidosis who
did not respond to corticosteroid therapy experienced the following improvements
after taking 20 mg of melatonin per day for 4 to 12 months:
Decreased lymph node swelling
Normalization of blood tests (indicate improvement in the
Once the melatonin supplements were discontinued, however, these improvements
disappeared. More extensive research will help better determine the value of
using this supplement for sarcoidosis.
A few case reports suggest that homeopathic remedies may improve the general
well-being of individuals with sarcoidosis. An experienced homeopath can
prescribe a regimen for treating sarcoidosis that is designed specifically for
each individual. The primary remedies used by individuals who reported
improvements in their symptoms include:
Other homeopathic remedies that have been used clinically for the condition
are as follows:
Sarcoidosis does not affect fertility. Symptoms may improve in up to 65% of
pregnant women who once had the condition, while 5% may experience worsening of
symptoms. Postpartum symptom flare-ups may also occur within the first 6 months.
Pregnant women with sarcoidosis should avoid exposure to X rays and toxic
medications such as methotrexate.
Prognosis and Complications
Complications from sarcoidosis usually occur in only the most serious cases,
and can include heart, kidney, and lung damage. Ulcers, diabetes, high blood
pressure, and infections, such as tuberculosis, may result from long-term use of
The prognosis for most individuals with sarcoidosis is good. Only 15% of
those with sarcoidosis experience symptoms that progressively worsen and 5%
develop severe lung problems, which increases the risk of death. Almost half of
all individuals with sarcoidosis spontaneously improve without any therapy, and
treatments used today, such as coritcosteroids, are often successful in helping
to ease the inflammation associated with the
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Review Date: March 2001
Reviewed By: Participants in the review process include: Constance Grauds, RPh, President,
Association of Natural Medicine Pharmacists, San Rafael, CA; Jacqueline A. Hart,
MD, Department of Internal Medicine, Newton-Wellesley Hospital, Harvard
University and Senior Medical Editor Integrative Medicine, Boston, MA; Lonnie
Lee, MD, Internal Medicine, Silver Springs, MD; Leonard Wisneski, MD, FACP,
George Washington University, Rockville,
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