Inflammation

by Qineng Tan, L.Ac., Ph.D. and Xiaomei Cai, L.Ac., Ph.D.

Fever, fatigue, and muscle aches? Swollen lymph nodes, coughing, shortness of breath? Eye pain, or red eyes? These can all be signs of sarcoidosis, an autoimmune disorder. Acupuncture and TCM can help relieve sarcoidosis symptoms.

Sarcoidosis is a complex autoimmune disease characterized by the formation of granulomas—clumps of inflammatory cells—that can affect multiple organs in the body. It most commonly impacts the lungs and lymph nodes, but it can also involve the skin, eyes, heart, musculoskeletal system, and nervous system.

Sarcoidosis typically manifests in young adults, with the highest prevalence observed in individuals in their 20s and 30s, though it can affect people of any age. This condition’s exact cause remains unknown, but researchers believe it results from an overactive immune response to environmental or infectious triggers.

Sarcoidosis can cause serious and even life-threatening complications, especially when it is centered in the lungs. However, the good news is that many cases of sarcoidosis do eventually clear up or go into remission.

Acupuncture, herbs, and other TCM treatments for sarcoidosis can help address underlying issues that contribute to the formation of this autoimmune disorder, as well has help to relieve symptoms. TCM can also help with potential signs of dysautonomia (autonomic nervous system disorders) that can be caused by sarcoidosis.

Types of Sarcoidosis

There are different types of sarcoidosis depending on which organs are affected. 

Pulmonary sarcoidosis, which targets the lungs, is the most common form and can lead to chronic respiratory issues.

Musculoskeletal sarcoidosis may cause joint inflammation (arthritis), muscle pain, or bone lesions, sometimes resulting in long-term complications such as osteoporosis. 

Sarcoidosis can lead to vascular complications that involve inflammation of small, medium, or large blood vessels. These types of sarcoid-related vasculitis are rare but important to recognize, as they may present with overlapping features of other autoimmune or vascular conditions.

Small-vessel vasculitis in sarcoidosis primarily affects the skin. This type of vasculitis might coexist with sarcoidosis and manifests as petechiae (small red or purple spots on the skin), purpuric spots (purple “blood spots” under the skin, due to broken blood vessels), or infiltrative erythema (raised rash, like welts on skin). 

Medium-vessel sarcoid vasculitis often involves pulmonary lymphatic capillaries and may present with systemic symptoms, including fever, arthritis, and cutaneous manifestations (skin rash or lesions). 

Sarcoidosis symptoms can vary widely but may include persistent fatigue, fever, shortness of breath, coughing, swollen lymph nodes, and joint pain. Because of its wide range of manifestations, sarcoidosis can be difficult to diagnose and often requires imaging tests, biopsies, and bloodwork.

New Diagnostic Methods for Sarcoidosis

Diagnosing sarcoidosis remains a complex challenge for clinicians because there is no single definitive test for the disease. The diagnosis is often made by combining a thorough clinical evaluation, imaging studies, laboratory tests, and biopsy results. However, emerging research has identified new biomarkers that may help streamline the diagnostic process.

One promising development involves the discovery of type 1 innate lymphoid cells (ILC1) as a potential biomarker for sarcoidosis. A study led by researchers at the University of Pennsylvania compared skin samples from sarcoidosis patients to those with granulomas caused by other conditions. They found that levels of ILC1 were significantly higher in sarcoidosis-affected tissues. This trend was also observed in lung granulomas and even in the bloodstream, where sarcoidosis patients showed a 12-fold increase in circulating ILC1 levels compared to healthy individuals.

Sarcoidosis Treatment

The main goals of treatment for sarcoidosis are managing symptoms, reducing the risk of organ damage, and improving the patient’s quality of life. In some cases, sarcoidosis may go into remission, meaning that the condition is no longer causing complications. 

Patients with mild or no symptoms might not require treatment, just monitoring. When treatment is necessary, Western medicine focuses on reducing inflammation and suppressing the overactive immune system. These treatments can be highly effective but often come with potential risks and side effects.

Prednisone is usually the first-line treatment for sarcoidosis. This steroid  medication suppresses the immune system and reduces inflammation, which can help to improve symptoms and prevent organ damage. However, long-term use of prednisone may lead to significant side effects, such as weight gain, bone loss, high blood sugar, and an increased risk of infection. For this reason, corticosteroid doses are typically tapered once symptoms improve, or alternative medications may be introduced to minimize steroid use.

Methotrexate, a drug commonly used for severe rheumatoid arthritis, is another option for managing sarcoidosis. It is particularly effective in patients with significant organ involvement, such as lung, skin, or joint manifestations. Methotrexate helps to suppress the immune system and can be used in combination with corticosteroids to reduce the need for higher steroid doses.

Drugs such as hydroxychloroquine, which are typically used to treat malaria, can be effective for sarcoidosis that primarily affects the skin or joints. These medications may also be helpful for managing chronic fatigue and muscle pain associated with the condition.

Tumor necrosis factor (TNF) inhibitors, like infliximab or adalimumab, are biologic medications that help reduce inflammation. These drugs are often used in patients with severe sarcoidosis, particularly when other treatments have not been effective. TNF inhibitors can be administered intravenously or as an injection under the skin.

Corticotropin is a medication that stimulates the adrenal glands to produce natural steroid hormones. It can be injected under the skin to help manage inflammation and reduce immune system activity, offering an alternative to synthetic corticosteroids.

Acupuncture and other TCM treatments can be helpful for clearing inflammation and relieving symptoms related to sarcoidosis, as well as helping to manage the side effects that may be caused by other medications.

Can Acupuncture Help Sarcoidosis?

In TCM, sarcoidosis is viewed as a condition arising from underlying imbalances in the body. These imbalances are often associated with heat, phlegm, and stagnation of Qi and blood. Granulomas, for example, may be interpreted as accumulations of dampness and phlegm obstructing the free flow of Qi and blood. Furthermore, the systemic inflammation seen in sarcoidosis can be attributed to excessive heat in the body. TCM practitioners focus on identifying the root causes of these imbalances and tailoring treatments to the individual’s unique presentation.

Acupuncture treatments for sarcoidosis aim to reduce inflammation, support the immune system, and restore balance within the body. By stimulating specific acupuncture points, practitioners can promote the smooth flow of Qi and blood, reduce stagnation, and clear heat and dampness. This can help alleviate symptoms such as shortness of breath, fatigue, and joint pain, which are commonly experienced by those with sarcoidosis.

Research has shown that acupuncture can help modulate the immune system, reduce stress, and improve quality of life for people with chronic inflammatory conditions. For sarcoidosis patients, regular acupuncture sessions may not only provide symptom relief but also address the underlying imbalances contributing to the disease.

Chinese Medicine diagnosis is different from Western medicine diagnosis. An acupuncture practitioner will look carefully at each individual patient’s specific symptoms, medical history, and foundational constitution to discover the underlying causes of their particular presentation of disease. 

In the case of sarcoidosis, possible TCM diagnoses might be: 

•  Lung Qi Deficiency – presents with symptoms like shortness of breath, weak lung sounds, throat rattling, spontaneous sweating, feeling cold, pale complexion, weak voice. Treatment will seek to tonify Lung Qi to strengthen respiratory function possibly with the inclusion of moxibustion treatment.

• Lung Yin Deficiency – symptoms: breathlessness, night sweats, 5-center heat (warmth in palms, soles, and chest), dry throat, non-productive cough, malar flush, red skin lesions. Treatment goals include nourishing Lung Yin and clearing  heat.

• Lung Qi Stagnation – symptoms: chest congestion/blockage, difficulty breathing, emotional grief or melancholy, trouble letting go of the past, and constipation. Treatment will help improve circulation of Lung Qi to relieve stagnation and promote emotional well-being.

• Phlegm in the Lungs- symptoms: Chronic phlegm retention contributing to fibrous tissue and scarring, which can parallel conditions such as chronic bronchitis. There may also be phlegm-related symptoms like congestion or rattling breath. Treatment will seek to nourish Lung Qi, transform phlegm, and circulate Qi to reduce stagnation.

These differential diagnoses reflect the diverse ways in which TCM approaches pulmonary dysfunctions and can be used to tailor treatments for individuals with sarcoidosis, ensuring that the root causes and symptoms are addressed holistically.

Acupuncture for Sarcoidosis Near Me in West Los Angeles

If you or someone you know is suffering with sarcoidosis, or perhaps has some of the symptoms mentioned above, but has not been able to get adequate diagnosis or treatment for their condition, it may be appropriate to seek care from a qualified TCM doctor. Dr. Tan and Dr. Cai at Art of Wellness in Los Angeles, just east of Santa Monica, have over 35 years of experience helping people with all types of autoimmune disorders, skin conditions, respiratory problems, and musculoskeletal pain. We can help you find relief and better health.

*This article is for education from the perspective of Traditional Chinese Medicine only. The education provided by this article is not approved by FDA to diagnose, prevent, treat and cure human diseases. It should not stop you from consulting with your physician for your medical conditions. Traditional Chinese Medicine is based on Qi, which is an invisible force that usually cannot be observed by modern science. Because science focuses on testing ideas about the natural world with evidence obtained through observation, these aspects of acupuncture can’t be studied by science. Therefore acupuncture and Chinese herbs are often not supported by double-blind, randomized trials, and they are considered alternative medicine therapies in the United States.