- What Is Sarcoidosis?
- Types of Sarcoidosis
- Sarcoidosis Causes To Be Aware Of
- Sarcoidosis Symptoms You Must Watch Out For
- Sarcoidosis Diagnosis: How to Identify if You Have This Illness
- Effective Sarcoidosis Treatments to Try
- Strategies to Help Prevent Sarcoidosis
- Sarcoidosis Diet: Foods to Eat and What to Avoid
- Frequently Asked Questions About Sarcoidosis
Sarcoidosis was first identified a century ago by two dermatologists, Englishman Dr. Jonathan Hutchinson and Norwegian Dr. Caesar Boeck. Both men were separately studying a similar condition, and because of this, sarcoidosis was previously called Hutchinson's disease or Boeck's disease.
Eventually, Boeck combined the Greek words "sark" and "oid" (which collectively translates to "flesh-like"), in reference to eruptions that appear on patients' skin, to form the disease's name.1 Sarcoidosis is defined as a rare condition characterized by the appearance of red, swollen tissue called granulomas.2
Sarcoidosis is an autoimmune disease, similar to rheumatoid arthritis and lupus, wherein patients develop granulomas in some organs. The body parts usually targeted by this disease include:3,4,5
Nose or sinuses
Sarcoidosis can develop in three phases:6
• Phase 1: Inflammation occurs.
• Phase 2: Granulomas begin to develop in the affected area. When your body's immune system detects foreign substances that it cannot discard, it signals granuloma development so it can separate these substanc es from the rest of the system.
• Phase 3: Tissue or organ scarring, or fibrosis, manifests. Sarcoidosis with extensive fibrosis, especially in a vital organ, may be fatal.
In some cases, sarcoidosis develops chronologically in the affected organ's tissues. However, some patients may undergo all of these phases all at once. Oftentimes, these granulomas may disappear on their own in two to three years, even without the patient noticing their existence. Unfortunately, if the granulomas still remain and worsen, there is a possibility of irreversible fibrosis.
People between 20 and 40 years of age are most prone to develop sarcoidosis, although symptoms of this disease can appear at any age. However, sarcoidosis rarely appears in children.7 It tends to affect women more than men, and causes less than 1 percent of hospital admissions in the U.S., according to American Thoracic Society8 There is also a genetic link to this disease, as it may show up in a person with a family history of sarcoidosis.9
A higher risk for sarcoidosis development has been seen in people of African descent compared to other ethnic groups. They are also prone to having more severe forms of the disease, which reappear and trigger lung problems.10,11 Approximately 36 out of every 100,000 African-Americans may be affected with sarcoidosis, whereas only 11 per 100,000 Caucasian-Americans will develop this disorder.12
Determining the exact number of people affected by this condition in the U.S. is quite difficult, since sarcoidosis is typically confused with other illnesses or isn't fully diagnosed.13 A 2012 Respiratory Medicine article echoes this sentiment, as sarcoidosis prevalence in the U.S. is virtually unknown. Estimates range widely from 1 to 40 per 100,000 people.14
What sets sarcoidosis apart from other autoimmune diseases15 is that it can target almost any organ in your body.16 Two of the most common types are:17
• Pulmonary sarcoidosis: It's characterized by the appearance of granulomas in the lungs.18 Around 90 percent of reported sarcoidosis cases are pulmonary.19
• Cardiac sarcoidosis: Patients develop granulomas composed of white blood cells in the heart muscle and can be dangerous if left untreated. These granulomas can inhibit the heart's electrical system, possibly causing irregular heartbeats or even heart failure.20
Sarcoidosis cases can also be classified as either acute or chronic:
• Acute sarcoidosis: These cases resolve on their own within a few months or years. Patients may notice that common sarcoidosis symptoms may improve on their own even without treatment, especially if they weren't diagnosed with severe forms of this disease.
• Chronic sarcoidosis: This occurs when a patient experiences worsened symptoms to the extent that the condition severely impacts their daily routine. Patients also notice multiple granulomas within an organ.21
Researchers are still trying to fully determine the causes of sarcoidosis . Initial research, however, has given clues that environmental and hereditary factors can predispose a person to this disease.22 Furthermore, reports have also highlighted that bacteria, viruses, dust or chemicals can prompt sarcoidosis.23
Because it's an autoimmune disease, sarcoidosis usually begins when there is a disruption in the normal functions of the immune system, prompting it to attack tissues and organs. Typically, if the body detects an unfamiliar substance, white blood cells are released into the bloodstream to look for the cause and eradicate it from the body. Once the substance is dealt with, this reaction dies down. If a patient has sarcoidosis, however, the inflammation remains and promotes granuloma development,24 and potentially impairs proper function of an organ.25
The severity of sarcoidosis depends on the location and the inflammation in an area.26 While prognosis is difficult to estimate, the Foundation for Sarcoidosis Research highlights around 60 percent of sarcoidosis patients can heal from this disease, and notice that granulomas can go away within two to five years27 without needing additional treatment.28 However, if you notice any of sarcoidosis' initial symptoms, have yourself checked immediately, as there are long-term problems that can arise because of this disease, namely:29
Permanent lung scarring and breathing difficulties among people with untreated pulmonary sarcoidosis
Eye inflammation that may lead to blindness
Cataracts and glaucoma (although these are rare)
Kidney failure as this disease may interfere with the body's handling of calcium
Abnormal heart rhythms and other heart problems that may lead to death
Central nervous system issues, especially when granulomas develop in the brain and spinal cord
Facial nerve inflammation that could cause facial paralysis
The sarcoidosis symptoms that develop in a patient depend on the affected organs. However, there are common hallmarks that can appear in almost anyone:
Shortness of breath
A persistent cough
Tender and red bumps on skin
Swollen lymph nodes
Almost 90 percent of sarcoidosis patients experience symptoms in the lungs, while 25 percent notice it on their skin. Meanwhile, some may have it on the eyes or lymph nodes. Here are other organ-specific indicators to watch out for:30,31
• Shortness of breath
• Persistent dry cough
• Chest pain and discomfort (uncommon)
• Warm, tender and red-purple bumps or patches on the skin, typically on the ankles or shins
• Sores or lesions on the nose, cheeks and ears
• Skin that's either darker or lighter
• Rashes on the upper body
• Nodules (growths under the skin) around scars or tattoos
• Blurred vision
• Eye pain
• Severe redness
• Sensitivity to light
• Red or sore eyes
• Tender and swollen glands in the face, neck, armpits or groin
• Tiredness and a feeling of being unwell
• Painful joints
• Abnormal heart rhythm
• Blocked or stuffy nose
• Bone pain
• Kidney stones
Because of its tendency to affect any of the body's organs, sarcoidosis can be quite tricky to spot. In some cases, people may not even experience indicators at all, and may only discover they have the disease when they undergo an X-ray for another health concern.32
To determine if a patient has sarcoidosis or not, he or she may need to undergo certain diagnostic tests, depending on the organ/s affected.33 Doctors can also inquire about your medical history and ask questions regarding:34
• A family history of sarcoidosis
• Working at any job/s that may increase your sarcoidosis risk
• Potential exposure to inhaled beryllium (a metal used to make aircrafts and weapons)
• Possible contact with organic dust from birds or hay
Afterward, your physician will look for symptoms35 and possibly recommend any of these tests, depending on the organ/s where initial indicators were spotted:36,37,38,39
Physical exam: This checks for skin lesions, swelling (in lymph nodes), and heart and lung function.
Chest X-ray: This can give information about the lungs, bronchi and mediastinum (area that separates the lungs, found in the middle of the chest), particularly their size, shape and location.
Computerized tomography (CT) scan: Produces highly detailed images of your lung/s to assist with a diagnosis, as well as show current state of the disease and determine a treatment plan.
Pulmonary function tests: The patient breathes into a special machine so their lung volume and ability to move air in and out can be observed.
Bronchoscopy: The interior portion of your lungs, particularly the bronchi, is checked by inserting a long, thin and flexible tube with a light source and a camera on one end.
Lung biopsy: A small lung tissue, fluid or cell sample will be inspected under a microscope.
Other biopsies: Tissue samples may be taken from the lymph nodes, skin and other body parts to be examined.
Positron emission tomography (PET) or magnetic resonance imaging (MRI) scans: These tests may be ideal for patients with symptoms that manifest in the heart or the central nervous system.
Eye exam: If eye problems are potentially triggered by sarcoidosis, this may be recommended.
Blood test: This checks liver and kidney function, carbon dioxide and oxygen quantities in the blood, and presence of other infections and diseases.
Electrocardiogram (EKG or ECG): By examining the heart's electrical activity, heartbeat irregularities may be spotted.
Purified protein derivative: Although this is more often utilized to help determine a tuberculosis (TB) exposure or infection, a purified protein derivative may be advised since sarcoidosis can be confused with TB. If the test comes back negative or non-reactive, then a person may have sarcoidosis.
Unfortunately, no known cure for sarcoidosis has been determined. However, this disease can resolve on its own within a few months or years, possibly even without treatment, since the condition can go away on its own.40
Most sarcoidosis patients are initially prescribed prednisolone tablets. It's important to note that high doses of prednisolone, a known steroid, are linked to side effects like weight gain, mood swings, osteoporosis and a higher risk for complications like kidney stones.41 Other medicines to avoid include:42
• Corticosteroids: Oral and inhaled corticosteroids have been linked to high blood pressure levels, mood, memory and behavior problems, oral thrush, weight gain, development of acne and red skin lesions, and higher blood sugar levels, to name a few.43
• Hydroxychloroquine (plaquenil): Hydroxychloroquine is prominently used for malaria treatment and prevention. Malaria occurs once parasites enter your system through a mosquito bite and interfere with proper body function — a far cry from the nature of sarcoidosis.44 This drug may cause headaches, nausea, vomiting, stomach pain, appetite loss, muscle weakness, and signs of an allergic reaction like rashes and breathing difficulties.45
• Immune system-suppressing drugs like methotrexate (Trexall) and azathioprine (Azasan or Imuran): Both of these medicines are linked to harmful complications. For instance, methotrexate can induce dizziness, headaches, reduced appetite, blurred visions, seizures or confusion. There are also life-threatening side effects such as a decrease in the amount of bone marrow-produced blood cells. Damage to the liver, lungs or lining of the mouth, stomach or intestines; and a higher lymphoma risk is also possible.
Meanwhile, azathioprine may cause nausea, vomiting, diarrhea, muscle pain, fever and weakness. People who take this drug in high doses may be more predisposed to skin cancer, lymphoma or hepatosplenic T-cell lymphoma (usually among teenage or young adult males) and reduced amounts of blood cells in the bone marrow.46,47
• Tumor necrosis factor-alpha (TNF-alpha) inhibitors These medicines may cause localized rash with burning or itching (injection site reactions). TNF-alpha inhibitors have also been linked to an increased risk of infections, skin cancer or lymphoma.48
Treating sarcoidosis doesn't mean you have to depend on risky treatments. Instead, opt for natural methods to ease pain and help relieve the disease. Some examples include:49
• Turmeric (Curcuma longa) extract: This is an anti-inflammatory spice with many known health benefits. Be sure to consult a physician first before taking turmeric supplements, because these can interact with other medicines and raise your bleeding risk.
• Bromelain: These enzymes, which may come from pineapples or papayas, are known to help reduce inflammation.50,51
• Probiotic supplement containing the Lactobacillus acidophilus strain: A high-quality probiotic supplement may increase the number of good bacteria in your gut, which can help improve your overall well-being.
While the ultimate cause of sarcoidosis hasn't been determined yet, genetics, bacterial or viral infections, and chemical and exposure are known to play a role in the onset of this disease.52 The good news is there are techniques that could help lower your risk for some possible causes and, ultimately, for sarcoidosis itself.
Cigarette smoking is dangerous, particularly for someone afflicted with sarcoidosis,53 as it may exacerbate breathlessness, further injure breathing tubes and cause bronchitis or emphysema. Plus, smoking worsens any type of lung disease.54 It's best to quit this habit by enacting the following health practices:
• Exercise frequently: Not only is exercise beneficial in helping you quit smoking, it may help you prevent sarcoidosis and other diseases as well. In a 2011 Nicotine and Tobacco Research article, smokers who underwent resistance training were able to quit this bad habit and improve their physical health.55 Other notable workouts to try include high-intensity interval exercises like Peak Fitness, core-strengthening exercises, stretching and regular non-exercise movement.
• Look for a healthy emotional outlet: Meditation, relaxation techniques and the Emotional Freedom Techniques (EFT) are excellent strategies. By resolving emotional blockages in your system, you can maintain balance in your mind and body, stop the addiction, and avoid nicotine cravings.
To counteract any cravings that may occur, try forecasting when the urge to smoke will strike and ensure that you have healthier alternatives and distractions at hand.
Try following these tips as well to prevent sarcoidosis from affecting you or your loved ones:
• Avoid prolonged exposure to dust, chemicals, fumes and toxic gases: Any of these substances can harm your lungs and predispose you to a higher sarcoidosis risk, or worsen existing sarcoidosis.56
• Get adequate sleep: Sleep problems are common in people with autoimmune disorders like sarcoidosis.57,58 By maintaining a consistent sleep cycle, you are able to help reduce your risk for brain damage59,60 and related disorders like Alzheimer's disease,61 and impaired immune function,62 to name quite a few. Aim for around seven to nine hours of shuteye nightly.
• Wash your hands properly: Since sarcoidosis can be caused by a viral or bacterial infection,63 proper handwashing before and after eating or preparing food, as well as after using the bathroom may help mitigate the spread of these agents.
Implementing a healthy diet is an absolute must when dealing with sarcoidosis. Here are reminders on some foods that are best to eat if you have this disease, as well as items you should stay away from:64
|Foods to Eat||Foods to Avoid|
Antioxidant-rich fruits and vegetables: Increasing your antioxidant intake may boost your body's defenses against free radicals that may trigger autoimmune diseases like sarcoidosis. Some foods you can try are cherries, blueberries, tomatoes, squash and bell peppers.65
Refined carbohydrates: Foods such as white bread and pasta are low in fiber and other nutrients, and have been linked to overeating,66 and a higher risk for obesity,67,68 heart disease69 and Type 2 diabetes.70
Healthy oils: Coconut oil is a vital source of healthy omega-3 fatty acids (particularly medium-chain fatty acids or MCFAs) that can play a role in improving conditions of people with brain disorders,71,72 and even help prevent Alzheimer's disease.73
Plus, lauric acid found in coconut oil transforms into monolaurin that may eliminate fungi, bacteria and viruses from the body. If you have high-quality olive oil at home, drizzle this cold over salads, but not for cooking. Your best bet for this purpose is still coconut oil.
Trans fat-loaded processed foods: These foods not only have a low nutritional value, but are also loaded with harmful sugars, high-fructose corn syrup, artificial ingredients and processed vegetable oils that may negatively impact your health.74,75
It's best to avoid these foods, which include cookies, biscuits, cakes, fast foods, doughnuts and margarine.
High-quality, filtered water: Water is important for optimal body function, since it helps circulate your blood, regulate body temperature, remove waste and promote detoxification, and improve your metabolism. Ideally, aim to drink at least six to eight glasses of water daily.
Alcoholic beverages: Doing so may lead to inflammation that'll reduce white blood cells' effectivity and hinder the healing process.76
Omega-3 rich seafood: Sardines, anchovies, wild-caught Alaskan salmon or Menhaden77 (a herring variety that's usually low in contaminants) are good examples of omega-3-loaded seafood that may help reduce inflammation .
Coffee: Excessive caffeine intake if you have sarcoidosis is known to exacerbate fatigue.78
Aside from the aforementioned foods, improving your health will be attainable if your diet is composed of these foods, whether you have sarcoidosis or not:
• Unrestricted amounts of organic, fresh and low net-carb vegetables
• Moderate portions of high-quality protein from organically raised, grass-fed or pastured animals
Q: What does sarcoidosis look like?
A: Patients with sarcoidosis commonly develop granulomas in certain organs. According to WebMD, these are abnormal lumps or nodules that are mainly composed of inflamed tissue.79 Granulomas are as tiny as grains of sugar or sand, but they can grow larger and form clusters, causing a variety of large and small lumps to manifest.80
Q: How do you get sarcoidosis?
A: Sarcoidosis occurs when a patient's immune system malfunctions and signals the body to attack various tissues and organs. This eventually leads to widespread granuloma-causing inflammation. However, what ultimately causes this "malfunction" in the body is still unknown, although some researchers have proposed that sarcoidosis may arise because of bacteria, viruses, dust or chemicals that can trigger disease-related genes, as well other as environmental and hereditary factors.81,82
Q: Is sarcoidosis hereditary?
A: Initially, it's said that people with a family history of sarcoidosis are more likely to have the disease.83 However, more research is needed to fully establish this link.84
Q: What are the common symptoms of sarcoidosis?
A: Sarcoidosis symptoms may be different from person to person. The indicators that may appear usually depend on the organs affected, such as the lungs, skin or eyes. If you or someone you know experiences swollen lymph nodes, tender and red bumps on the skin, shortness of breath, persistent coughs, fever and weight loss, consult a physician immediately since these are the most common signs of sarcoidosis.85,86
Q: How is sarcoidosis diagnosed, and what tests are needed to know if you have sarcoidosis?
A: Diagnosing sarcoidosis involves multiple steps. Your physician will likely inquire about your medical history, especially if you've had a family history of the disease or were exposed to some substances that may cause sarcoidosis. Checking for other sarcoidosis symptoms and lung and heart function may be done too.87
Afterward, your physician will recommend testing on organs where initial indicators were spotted. Examples include a chest X-ray, computerized tomography (CT) scan, positron emission tomography (PET) scan or magnetic resonance imaging (MRI), blood tests, eye exam and pulmonary function tests.88
Q: Are there natural treatments for sarcoidosis?
A: Yes. Turmeric, bromelain and high-quality probiotic supplements are notable natural remedies for sarcoidosis.89
Q: How can you prevent sarcoidosis from affecting you?
A: Sarcoidosis prevention begins with avoiding or stopping smoking, since this may negatively affect proper lung function, cause breathlessness that may worsen breathing tube injuries, and lead to development of bronchitis or emphysema. Smoking exacerbates any lung disease, and it's known that one of sarcoidosis' main targets are your lungs. Other prevention techniques that may help combat this disease include:90,91
• Avoiding prolonged exposure to dust, chemicals, fumes and toxic gases
• Drinking six to eight glasses of high-quality, filtered water daily92
• Getting adequate sleep93
• Washing your hands properly94