Sarcoidosis Supportive Care Protocol
Primary Stack
Core supplements with strongest evidenceAnti-inflammatory; may help modulate immune response
Supporting Studies (1)
Anti-inflammatory; antioxidant; may help with granulomatous inflammation
Supporting Studies (1)
Supporting Stack
Additional supplements for enhanced resultsMay need RESTRICTION - sarcoidosis often causes hypercalcemia
Supporting Studies (1)
CAUTION - sarcoid granulomas can activate vitamin D, causing hypercalcemia
Supporting Studies (1)
Antioxidant; supports cellular energy; may help with fatigue
Supporting Studies (1)
How This Protocol Works
Simple Explanation
Sarcoidosis is an inflammatory disease where clusters of immune cells (granulomas) form in various organs, most commonly the lungs and lymph nodes. The cause is unknown.
COMMON SYMPTOMS:
ORGANS AFFECTED:
CRITICAL: Sarcoidosis requires medical monitoring and treatment when indicated. This protocol is SUPPORTIVE ONLY.
MEDICAL TREATMENTS:
IMPORTANT WARNINGS:
* Anti-inflammatory supplements may provide modest support.
* CAUTION with vitamin D and calcium - can worsen hypercalcemia.
* Fatigue management is important for quality of life.
Expected timeline: Many patients have spontaneous remission within 2-5 years. Chronic sarcoidosis requires ongoing management.
Clinical Perspective
Sarcoidosis: Multisystem granulomatous disease of unknown etiology. Diagnosis: compatible clinical/radiographic findings + non-caseating granulomas + exclusion of other causes. Lofgren syndrome (erythema nodosum, bilateral hilar adenopathy, arthralgias) has good prognosis.
CRITICAL: Treatment when indicated - symptomatic, progressive pulmonary, cardiac, neurologic, eye involvement requiring systemic treatment. Corticosteroids first-line. AVOID vitamin D and calcium supplementation - 1-alpha hydroxylase in granulomas activates vitamin D causing hypercalcemia/hypercalciuria. Check calcium before any supplementation. Anti-inflammatory supplements have limited evidence but may be reasonable adjuncts.
* Omega-3 (C-grade): Anti-inflammatory. Systematic review: (PMID: 27840029). 2-4g EPA+DHA daily.
* Curcumin (C-grade): Anti-inflammatory. Review: (PMID: 27213821). 1000-2000mg daily.
* Calcium (SPECIAL): CAUTION - avoid unless deficient AND no hypercalcemia.
* Vitamin D (SPECIAL): CAUTION - only if truly deficient without hypercalcemia.
* CoQ10 (C-grade): Fatigue support. Review: (PMID: 24268541). 100-200mg daily.
Assessment targets: Symptoms, PFTs, imaging, calcium/vitamin D levels, organ-specific monitoring.
Protocol notes: Vitamin D paradox: patients often have LOW 25-OH-D but ELEVATED 1,25-OH-D (active form) from granulomas; don't supplement based on 25-OH-D alone. Calcium: check serum calcium and 24h urine calcium; restrict if elevated. Treatment indications: progressive pulmonary, cardiac, CNS, eye threatening sight, hypercalcemia, disfiguring skin. Prednisone: start 20-40mg/d; taper slowly over months. Steroid-sparing: methotrexate, azathioprine, mycophenolate. Infliximab: for refractory. Fatigue: can persist even when disease controlled; address sleep, depression. Exercise: helps fatigue; pulmonary rehab if pulmonary involvement. Cardiac: screen with ECG; consider MRI/PET if suspected. Spontaneous remission: 50-70% within 2-5 years, especially Lofgren syndrome.