Sarcoidosis Answers for Physicians, Nurses and Patients

Here at SarcInfo, between 2002 and 2004, we identified the cause of Sarcoidosis, and successfully trialled a curative antimicrobial therapy. During 2005 and 2006 the US FDA designated the antibiotics Clindamycin and Minocycline as Orphan Products in the treatment of Sarcoidosis, and studies are ongoing elsewhere.

For information about this breakthrough, please post your questions at the current study-sites of the Autoimmunity Research Foundation.
 
This archive of the historic study is maintained by volunteers from the Foundation. The material here provides useful background, but most of this site is now out-of-date.

 

** Patient Tutorials **

 Click here to read "WHY DID I GET SARCOIDOSIS? WHY ME? 

  Click here to read "REMISSION IN SARCOIDOSIS"  

 How a Pathologist can see Bacteria causing Sarcoidosis 

"How does Doctor measure my ACE, and my D-metabolites?"

 Weaning from Prednisone

 Protecting your eyes in Sarcoidosis

Vit.D and Calcium in Sarcoidosis

Hypervitaminosis D Symptoms    The SarcInfo F.A.Q.

Medical Abbreviations          CBC Radio Show

Protocol Phase 1-First 3 months

 

** Papers for Physicians **

Antibacterial Therapy induces Remission 

Implications for Autoimmune Disease 
(Here is Fulltext preprint)

Antibacterial mechanisms for ARBs 

Antibiotics in Sarcoidosis- The 1st Year 

Rationale for abx in Sarcoidosis 

1,25-D and Angiotensin II

"New Treatments Emerge.."

Jarisch-Herxheimer in Sarcoidosis

Vit.D and Calcium in Sarcoidosis

Protocol Phase 1-First 3 months

The NIH ACCESS Study finds Sarcoidosis does not go away - Click here to see, and print, the brochure


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 Vioxx Warning & alternative therapies
Author: Karen (---.brsr6.xdsl.nauticom.net)
Date:   10-02-02 07:52

Last winter I was prescribed Vioxx for joint pain. Shortly after I began taking the medication, I developed shortness of breath and heart rythym irregularities. The symptoms felt like an exacerbation of my stage three sarc and I began to have more tests.

The doctor wanted to up my pred from 20mg per day to alleviate my symptoms. I said "no" since my CAT scan and chest x-ray did not show signs of more granulomas. Despite the test results, my symptoms worsened and I began to fear that sarcoid was affecting my heart.

One night in February, I was rushed to the hospital with a severe pain in my abdomen. It felt like someone was taking tweezers and pulling a vein out of my stomach. I passed out in the bathroom. I worried about having a blood clot because of the symptoms over the past month, and my history of deep vein thrombophlebitis. After a lot of studies, they could not determine the cause of my pain.

The next morning, I happened to notice a warning on the prescription information of Vioxx. Shortness of breath and possible blood clots and sudden death are serious side affects of Vioxx and Celebrex (Cox2 inhibitors). I stopped taking the Vioxx immediately and that day felt an immediate improvement in my breathing and heart rythym. Since then, my doctors have indicated on my record: Allergy to Vioxx.

Since then, I have seen numerous warnings on the internet for both Vioxx and Celebrex.

Lesson learned? Don't always assume that all of your breathing problems are sarc related!! Allergies to medications and to the environment can also cause breathing difficulties. Don't allow your doctor to up your prednisone at the first symptom of breathing difficulties.

Please be careful of Vioxx and Celebrex!

Karen

 
 Re: Vioxx
Author: Admin (---.vnnyca.adelphia.net)
Date:   10-02-02 08:04

Karen,
I will go further and say "Don't assume that any of your symptoms are related to your Sarcoid Inflammation".

Many of them are, of course, but many are also due to the drugs that patients have been given. For example, hip failure is absolutely due to prednisone treatment, and not to the sarcoid inflammation.

..Trevor..

 
 natural remedies
Author: sara (---.51.219.151.dslextreme.com)
Date:   10-02-02 09:21

anyone had any luck with herbal supplements? homeopathic remedies? acupuncture and the like?

recently i've been taking beta glucan from yeast and mushrooms and feel better. the pain in my axilla lymph nodes has greatly lessened so I will continue. supposedly this stuff is a natural antibiotic and activates the macrophages to eat the nasty stuff in our cells. "they" say it will not hurt those with auto-immune disorders and can be taken in conjuntion with antibiotics (since i believe my sarc is not an auto immune disorder i am not as worried about stimulating my immune system) its hard to find really clear info on the stuff that's not put out by the supplement companies, but there seems to be alot of anecdotal evidence that it has helped decrease tumors, caused relief for those with lupus and fibromyalgia. the good stuff is pricey and you have to wade through a ton of hype to find out which companies do the extractions right. i am not on any other medications presently so i have to believe this stuff is making the difference. i've only been on it two weeks and will continue for three months (unless i feel worse) to see what happens.

 
 Re: Natural Remdies
Author: Admin (---.vnnyca.adelphia.net)
Date:   10-02-02 09:52

Sara,
In most cases sarcodiosis does not need to be treated aggressively. Some people initially feel that prednisone is curing them, but soon find that it does nothing for most of the symptoms (or the underlying disease). Most patients can learn to cope with their dyspnea and symptoms for at least a few weeks, while tests can be done, Minocin administered, and a better diagnosis obtained.

Therefore, just the action of not taking the plethora of potent drugs that are typically given to Sarc patients will often make them feel better, and a change to a "Natural" product might be given credit for that action.

The biggest problem with the "Natural" products is that they are usually not "natural".
Just like Arsenic (another "Natural" product), they are manufactured into the forms that you buy them, and carry many of the dangers in common with manufactured pharmaceutical drugs.

A bigger problem is that there is no list of ingredients, nor is there any understanding of what the ingredients might do to your body as time goes by. Using the example of arsenic again, just because something is natural does not mean it is good for your body.

All of the "science" that I have seen to back up the claims made for the "natural" products is false. It preys on the limited knowledge of the general public, using long words and sounding very important. Yet the science is actually fiction, and the fantasy in the claims rival that of the best Science Fiction Fantasy authors. Talk about "eating the nasty stuff in your cells" is a good example. You have loads of "nasty stuff" in your cells, and some of it is needed for your body to function properly

With that being said, I personally found that electro-acupuncture was the only way to knock down my migraine pain through all those dim, dark, years when it was ruining my life. I used devices, similar to this one, that I had bought in Japan and Singapore, using two electrodes straddling the nape of the neck, and it worked real well. Pain killers did not work for me, this technology did. I have been unable to figure out why, but it seems to be related to endorphin release. It did relieve the pain, but did nothing for the underlying disease, of course.

It took Minocin to finally knock down the underlying disease. If I were you, I would go for this REAL antibiotic before I would try any fictional "pseudo-antibiotic".

..Trevor..

 
 Re: Natural Remedies
Author: Belinda (---.dsl.rcsntx.swbell.net)
Date:   10-02-02 12:17

Sara,

Since it took a long time for me to get physicians to listen to my complaints and finally diagnose sarcoidosis, I had plenty of time to seek other help. I have personally used acupuncture and food supplements to try to alleviate my symptoms. The problem is in finding a good advisor. It's not likely you will find anyone in a health food store that will understand sarcoidosis. It is best to consult a physician, chiropractor, or nutritionist - one who understands the biochemistry of sarcoidosis. Even professionals may not understand sarcoidosis unless they have read and understand a lot of the sarcoidosis research.

I took beta-glucan on the well-meaning advice of a certified nutritionist. I took it for several months, before and after my diagnosis. It did seem to stop my lymph nodes from throbbing. It did not change how my lungs looked on CT and it didn't put me into remission. (I refused to take prednisone.) I stayed about the same while I was taking beta-glucan. What did help my pain and breathing difficulty at that time was supplemental oxygen, craniosacral therapy and osteopathic manipulation.

I decided to stop taking beta-glucan after I read on my own and understood more about sarcoidosis. I decided I might be doing more harm than good. Beta-glucan activates macrophages to release pro-inflammatory cytokines. People who have sarcoidosis already have an abundance of activated macrophages and pro-inflammatory cytokines. I used the money I was spending on beta-glucan instead to get cranio-sacral therapy from an osteopathic physician. That certainly helped my pain and stiffness.

I used acupuncture for three years, and it provided excellent temporary relief from pain. That was before I finally had a diagnosis, and before I understood how sunlight and vitamin D cause sarcoidosis symptoms to flare. Acupuncture was a gift from heaven when I had "non-bacterial pneumonia" (which, coincidentally, arose at the end of a vacation and more sun) and pain pills didn't work on me.

What has finally helped me get free of pain was first, avoiding sunlight and now, taking low-dose alternate-day antibiotic Minocin as Dr. Mercola uses in treating arthritis. Minocin is the only prescription I am taking.

I hope this helps.
Belinda

 
 Re: Vioxx Warning & alternative therapies
Author: sara (---.51.219.151.dslextreme.com)
Date:   10-02-02 13:58

thanks all for the quick and insightful responses. as we know all sarc cases are different and what works for one doesn't for another. (for instance I work outside and sun has never bothered me) since herbal medicine has been around thousands of years, has been proven effective for millions of people, the fact that most of today's drugs are based on herbs, and the ongoing viral resistance to more and more strains of anitibiotics, i definitely feel it is worth a shot to try a natural cure. As our immune systems are out of balance whose to say what may put them back into "balance" be it cranio-sacrail to faithhealing to minocyn. The "evidence" i have seen on this site and many others does not prove any one "cure" as of yet. My Dr. (Om Sharma a world-renowned sarc specialist) sees no reason not to try natural remedies as long as they don't make you feel worse. We live in a toxic world and i know i am sensitive to many chemicals. At this point, I've decided that adding another foriegn chemical to my body is to be avoided. (i feel some nasty toxin caused my sarc in the first place) so i'm giving the old-fashhioned natural/healthy way a try. My case is minor compared to most, but i was feeling the worst i've ever felt with the sarc two weeks ago and feel much better today so whatever did it, I'm grateful. As an aside, its interesting to me that western medicine is usually considered the "answer" when in fact the resistances of many diseases to antibiotics is caused by over prescription. good luck to all steering your course to wellness!
-s

 
 Re: Vioxx Warning & alternative therapies
Author: Admin (---.vnnyca.adelphia.net)
Date:   10-02-02 14:11

Sara,
IMO, You are very wrong.
All sarc cases are very similar when you understand what causes the disease.

If you have active sarcoid inflammation you will have high levels of 1,25-dihydroxyvitamin-D and be sensitive to sunlight, even if you haven't realized it - get your D-Ratio tested - you may be surprised by the results

Just because remedies have been around for centuries does not mean they are good - how much longer do you expect to live than somebody in the 1800's who only had these "time-tested" remedies available to them?

What you "feel" might have very little to do with the ultimate prognosis for your disease.

Antibiotics are essential tools in the treatment of pulmonary disease.

Finally, please don't invoke the name of Dr Om Sharma to back up your assertions unless you have his permission to do so.

..Trevor..
ps: I understand your anger at the failure of "modern medicine" to "cure" you, but you can only be helped by SarcInfo.com if you listen dispassionately and objectively to the knowledge we all have to share...

 
 Re: Vioxx Warning & alternative therapies
Author: Caroline McGuirl (---.proxy.aol.com)
Date:   10-02-02 15:45

Dear Karen:
I have Sarcoidosis but even so I was on several drugs for Arthritis. I was on Vioxx 50 mg daily and now down to 25 mg. daily.
I was told that Vioxx and Celebrex (which I tried and could not continue with it) are safe.
I did have shortness of breath as one of the first signs of Sarcoidosis and later it was confirmed.
Lately I have been feeling shortness of breath again and started up with Pulmicort inhaler again 2 puffs once a day or 2 puffs twice a day if needed.
I am wondering now about the Vioxx......? I sometimes think I should take all the pills I am on and chuck them.
Tomorrow I skip Vioxx and see how I do.
Caroline McG.

 
 Re: Vioxx Warning & alternative therapies
Author: Caroline (---.win.org)
Date:   10-02-02 18:40

Hi Everyone,
This is very interesting to me as I have been experiencing shortness of breath lately. I have taken Celebrex for over a year but the breathing issue is recent. I had a brocoscopy and CT about two months ago and my lungs have not worsened at all. I think I will skip Celebrex for a while if I can do without and see what happens. I learn SSSOOOoooo much here.
Caroline from MO

 
 Re: Vioxx Warning & alternative therapies
Author: Cher (144.138.225.---)
Date:   10-03-02 09:29

Hey everyone.
I just wanted to put in another perspective. I believe that I am one of the only Sarcoidians on this Phorum to be on opiates (MS CONTEN) & I have also been on Celebrex just as long (2 years). I was initially put on MS CONTEN to alleviate my breathing difficulties whilst in hospital. I have not been able to come off it as each time I have tried my breathlessness increases to almost deathly levels (I end up on O2 for weeks at a time).
I recently had my Celebrex increased to 200mg 2x daily instead of 200mg once daily due to increased swelling of the lymph nodes around my brain. Within 2 days of increasing my Celebrex my dysphasia disappeared, my headaches decreased & I felt much less joint pain. Admittedly I had had a noticeable increase in sun exposure.
I have only yesterday had my Vitamin D levels done & will get the results in two weeks when I return from a work trip. I also haven't been on Minocin yet (yes I know I should have but I can only remember what I write down when I go to my G.P & that was one thing I forgot lol).
So there u go ... yet another lot of medications & a different outcome.
Cheers everyone & stay positive
Cher

 
 Re: Vioxx Warning & alternative therapies
Author: Kathy (65.121.96.---)
Date:   11-10-02 16:23

Trevor -

I have a question for you - and I apologize if you have covered it - I haven't seen it - I am wondering about aspirin.

I am allergic to ALL opiates and NSAIDS, with the grateful exception of ASA. I have taken high dose ASA for 25+ years now (I have a shoulder injury, with an extensive surgical history).

Anway, as much as I hate to ask this, could ASA contribute to my symptoms? It is really the only relief I have available - and I really notice it when it's taken away. I would go off during my prednisone episodes, but my ASA was always preferable.

Thanks for your help!

Kathy

 
 Re: Vioxx Warning & alternative therapies
Author: Admin (---.vnnyca.adelphia.net)
Date:   11-10-02 16:53

Kathy,
This is actually an issue that has interested me quite a bit.

If you take a look at "Aspirin inhibits NF-kappaB and protects from angiotensin II-induced organ damage" you will see that some of the actions of Aspirin are not unlike those of the Angiotensin Receptor Blockers that have worked so well for me over the years.

Like Aspirin, the ARBs also block stimulation of Nuclear Factor kappaB and they also prevent vascular damage that Sarc's high levels of Angiotensin II would otherwise cause.

However, Aspirin has many other actions on your body, and many of them are harmful. By contrast, the ARBs are safe and almost without any side-effects. The ARBs only do one thing - block the receptors of Angiotensin II. One of the safest drugs on the formulary, certainly much safer, and more targetted at Sarc's Angiotensin II, than Aspirin.

If your Blood Pressure will support it (> 125/85, say) have a chat with Doc about trying an Angiotensin Blockade as is described in our latest (complex, doctor's-level) paper "New Treatments Emerge as Sarcoidosis Yields Up its Secrets" (I recall I sent you a copy).

..Trevor..

 
 Re: Vioxx Warning & alternative therapies
Author: Kathy (65.121.96.---)
Date:   11-10-02 17:32

Trevor,

Thanks for your reply! So if aspirin acts as an ACE inhibitor, would that affect my ACE level?

I am also currently on a beta blocker, for my tachycardia - how far is that from an ACE inhibitor? I forwarded your article and information to my doctor, and I see him TOMORROW - I can't wait to see what he thinks!!

Kathy

 
 Re: Vioxx Warning & alternative therapies
Author: Admin (---.vnnyca.adelphia.net)
Date:   11-10-02 18:08

No, No, No.. there is a HUGE difference between an ACE inhibitor and an Angiotensin Receptor Blocker (ARB) (even though most doctors get them confused too).

Lets look at what happens in a sarc patient.
First there is the inflammation (due to excess 1,25-D production stimulated by the bacteria). The Macrophages release ACE (Angiotensin Converting Enzyme) as they mature. The ACE acts on the decapeptide Angiotensin I (which comes from Renin) to create the Octapeptide Angiotensin II. That then binds back at the AT1 receptors on the Macrophages, triggering the Th1 Cytokines, which allow the macrophages to attack and decay the dead and diseased tissue, and which create even more 1,25-D

Angiotensin Receptor Blockers stop the Angiotensin II from binding back into the macrophages. They can block 100% of the angiotensin coming back into the inflammatory cycle. They have no side effects, as they only affect Angiotensin II Receptors (which are primarily in the inflammation).

The ACE Inhibitors are a totally different class of drug, and relatively ineffective at interdicting the inflammatory cycle.

And the Beta Blockers are even less helpful, having virtually no activity in the inflamed tissue.

ARBs have less of an effect on blood pressure than ACE Inhibitors or beta-Blockers.

Summary: My research indicates that a sarc patient should use a high dose of ARBs to effectively block those receptors on the macrophages, right throughout the body (often this does not actually lower the BP very much). Only then should other drugs be added in order to deal with any blood pressure elevation that remains.

..Trevor..
ps: Tachycardia: I have an (unproven) theory that 1,25-D acts on the heart by inducing arrythmia, which can eventually lead to cardiac arrest (many of us can feel our hearts racing after a challenge by 1,25-D). Since we know that Sarc can cause muscle cramps and spasm in the other (voluntary) musles, why not in the involuntary muscles of the heart? You see, the pathologists keep cutting open the hearts of the Sarc patients who have died due to sudden heart failure, and there really is nothing structurally wrong with them that could have led to the failure. Sure - there is visible inflammation, but not enough to cause the heart to fail...

The other tell-tale sign that indicates I am correct is that the implantation of pacemakers helps, but does not totally stop, cardiac arrest due to chronic sarcoidosis...

 
 Re: Vioxx Warning & alternative therapies
Author: Caroline McGuirl (---.proxy.aol.com)
Date:   11-12-02 14:00

Dear Karen:
I was prescribed Vioxx 50 mg daily for over a year and just lately my internist changed the amount from 50 mg. to 25 mg. daily. She said that they found out that 50 mg was too high and caused problems for some. Nice time to tell me. I have Sarcoidosis which she knows about. I do have shortness of breath and have had the symptom for almost 3 years. I have been on and off Pulmicort inhaler for the breathing difficulty from Sarcoidosis.
There are times when I would like to discard all the medications I am on. Now I know why.
Caroline McGuirl

 
 Re: Vioxx Warning & alternative therapies
Author: Admin (---.vnnyca.adelphia.net)
Date:   11-12-02 14:22

Caroline McG,
Your internist is not you.
He/she can listen to what you tell him/her and try to figure out what to do. But only you can observe what happens if you forget to take your Vioxx one day, for example. Only you know why you take a puff of steroid - exactly what threshold level of pain or suffering causes you to do that.

And only you can wean yourself off the drugs that you don't need.

In any case, you had a problem with a high level of 25-D. Have you managed to get that down? Many of your symptoms could well be due to that, you know, and the Vioxx might only be making things worse. I don't know. I am not sitting in your body. You are.

..Trevor..

 
 Re: Vioxx Warning & alternative therapies
Author: Karen (---.brsr6.xdsl.nauticom.net)
Date:   11-12-02 14:26

Hi Caroline,
I know from my experience the Vioxx caused breathing difficulties. It all started the end of last year and I didn't discover the cause until February; three months of shortness of breath, heart rythym irregularities and extreme fatigue from the poor breathing. I assumed my sarc was acting up, but when I discontinued the Vioxx, I noticed immediate improvement (within a day).

Go to Vioxx or Celebrex on MSN search. You will be astounded by all of the warnings.

I would like to think your difficulties are due to Vioxx and not to an exacerbation of your sarc.

I hope you notice improvement after you stop taking it.

Karen

 
 Re: Vioxx Warning & alternative therapies
Author: Caroline McGuirl (---.proxy.aol.com)
Date:   11-13-02 14:44

Dear Karen & Trevor:
I am omitting Vioxx daily .... for a few days. It's worth a try. As far as symptoms, I have so many medical problems all going on at once it is hard to isolate just one. I will give it a try and see if shortness of breath improves.

How often can the blood work be done for Vit. D 3 levels and ACE level.....realistically. There are some tests prohibited by the medical insurance companies if the doctor orders them too frequently. What do you find to be the fair testing? Monthly? Quarterly?
Thanks...
Caroline McGuirl

 
 Re: Vioxx Warning & alternative therapies
Author: Admin (---.vnnyca.adelphia.net)
Date:   11-13-02 17:11

Caroline,
It is not much use measuring 25-D more frequently than once every 2-3 months because it takes that long to change concentrations within the body's fat-storage. 1,25-D changes very rapidly, but it is only measured frequently in a hospital or research situation. Every 2-3 months with the 25-D is as frequently as it is useful.

Note that the 25-D test is less expensive and more common, so since this is the metabolite that you yourself are working on getting down, you might consider just having it measured on its own, and then just assume the D-Ratio is going to remain somewhat constant, estimating your 1,25-D as

1,25-D = 25-D x D-ratio

In your case, with a D-ratio already less than 2, this is a reasonable approximation. For anybody with a D-ratio above 3, I suggest having both D-metabolites measured at once so we can track the progress of the D-ratio (which is a indicator of systemic inflammation).

..Trevor..

 
 Prednisone
Author: J P S Gujral (61.247.229.---)
Date:   09-21-03 23:50

Hi,

I have been detected sarcoid in early 2002 , Intially I had low grade fever , dry cough later pain in legs started , I was put on pred 80 mg and presently now I am on Pred 5mg alternate days. I have been feeling fine besides some fatigue and pain in legs. Last week I have high fever with cough & cold , my doc put me on antibiotic for five days , but still I am running low fever and cough , is it possible that my sarcoid has flared up again. can anyone recomend some preventive tests.

Regards

jps gujral

 
 Re: Vioxx Warning & alternative therapies
Author: Meg (68.190.163.---)
Date:   09-22-03 05:40

JPS,

Welcome to SarcInfo. Yes, it does sound like your sarcoidosis is active again. Of course, it never really went away. The Prednisone merely suppressed your immune system which made you feel better for awhile. But that suppression also allowed the bacteria that cause sarcoidosis to multiply. Now you are feeling the effects.

Please spend some time reading the patient tutorials (especially the FAQs)and physician papers at the top of the page, the links to articles at the bottom of the page and the topic messages (threads), especially those that are starred.

There is also a search feature on the site where you can type in words and find specific intormation. Be sure to click on 'all dates' so you will get the most complete search.

If a phrase is written in bold type in a message, you can click on it to automatically get more information. Then press your back button to return to the text.

You may need a medical dictionary (you can find one online) for some of the papers but I hope you can get the basic idea of Trevor's description of sarcoidosis etiology and treatment. Let us know if you have any specific questions.

Meg

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This is an archive site, membership and posting are no longer allowed.

Historical perspective on Sarcoidosis:


  1. The John's Hopkins Vasculitis Center: Prednisone Side Effects (incl. PHOTOS and PHOTOGRAPHS)
  2. Steroid-Treated patients Have higher risk of Cardiac problems
  3. "Evidence Growing That Inhaled Steroids, Like Steroid Pills, Can Cause Bone Loss"
  4. "Corticosteroids contribute to the prolongation of the disease by delaying resolution"
  5. "No data to suggest that corticosteroid therapy alters long-term disease progression"
  6. Cochrane Review - "Oral and Inhaled Corticosteroids have no discernible effect on lung function"
  7. Prednisone Improves Symptoms but not Lung Function in Sarcodiosis
  8. There is no conclusive evidence that corticosteroids affect the development of irreversible pulmonary damage
  9. Clinical Guideline For Treatment Of Arthritis Pain
  10. Angiotensin II receptor on BALF macrophages from Japanese patients with active sarcoidosis

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