Complaints & connections · borters.ch
Sarcoidosis
Inflammatory nodules, mostly in the lung — many courses heal by themselves.
Also known as: sarcoidosis · Boeck’s disease
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
An inflammatory condition in which small nodules (granulomas) form in the tissue — most often in the lungs and lymph nodes, sometimes also in skin, eyes or other organs. Why the immune system overreacts this way is not fully understood. In many people sarcoidosis is mild and resolves on its own; in others treatment is needed. Common signs are an irritating cough, breathlessness, fatigue or joint complaints. Much of it is treatable and the outlook is often favourable.
As it often resolves on its own, regular monitoring may be enough.
Determine the extent and organs involved to decide the approach.
In more pronounced cases cortisone usually helps; symptoms improve well.
As the eyes can be silently involved, checks are worthwhile.
A threadworm can stay silent in the gut for decades and, under cortisone, biologicals or other immune suppression, flood lung and bloodstream. Anyone who ever went barefoot in the tropics or subtropics is looked for beforehand with a blood test — one effort, and it prevents the worst course this worm has.
In about half of those affected the illness recedes by itself within two years — which is why mild courses without symptoms are only watched at first. Löfgren’s syndrome, with erythema nodosum, joint pain and chest lymph nodes, resolves in more than eighty in a hundred within two years. Cortisone works when organs are involved and is given over six to twenty-four months. The ACE level in blood is too imprecise for the diagnosis.
In about half the illness recedes by itself within two years — which is why mild courses are watched rather than treated. Cortisone works when lung, heart, eyes or nerves are involved; it suppresses the inflammation, it does not cure, and after stopping it returns in some. Treatment runs six to twenty-four months. The ACE level in blood is too imprecise to steer treatment by.
The lung is most commonly affected.
A common, often burdensome non-specific symptom.
Especially in the chest, often found by chance on X-ray.
Can be involved — the eyes should be checked.
The key value. The inflamed tissue itself makes active vitamin D and thereby drives the calcium up — so a well-meant vitamin D supplement can do harm here.
Explains the connection: it is raised while the stored vitamin D can look low. Without this value the situation is read wrongly.
A measure of the inflammatory load over time. It does not make the diagnosis — imaging and a tissue sample do.
A high calcium burdens the kidneys. So both values belong checked together.
Low levels are common in chronic airway illnesses and go along with more infections. Correcting a deficiency is simple; for lung function itself it is no replacement for treatment.
Relaxes the smooth muscle of the airways — which is why it is also given as an infusion in an emergency. For everyday use the tablet replaces no inhaler.
They give rise to messengers that tend to end inflammatory reactions rather than fuel them. Oily sea fish twice a week is the simplest route; capsules are an option but replace no treatment.
Drinking enough keeps the mucus thin and easier to cough up. That is the simplest and most often overlooked lever with sticky sputum.
Needed for steering the defences and for the healing of tissue. A lack is more common with chronic diarrhoea, little meat and pulses, and under cortisone.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
Effective when deficient; effects on sleep and stress plausible but moderate. Too much causes loose stool.
Effects on inflammation and triglycerides established; cardiovascular prevention is mixed. Watch quality and freshness.
The most important point on this page: the inflammatory nodules themselves make the active form of vitamin D — unregulated. A vitamin D supplement can therefore drive calcium dangerously high here. No other condition reverses that recommendation so completely.
Because the calcium comes from elsewhere, this hormone is turned down — it is low although the calcium is high. Exactly that combination separates sarcoidosis from an overactive parathyroid.
The granuloma tissue activates vitamin D itself. Calcium levels can therefore rise and supplementing can harm — unlike almost everywhere else. Here measurement comes before any vitamin D.
Here expressly different from elsewhere: the granuloma tissue activates vitamin D itself and calcium can rise. Measurement precedes any dose — supplementing on suspicion can harm here.