ABSTRACT

Sarcoidosis is a multisystem disease which causes non caseating (inflammatory) granulomas in the affected organ. Sarcoidosis can affect lungs, eyes, lymph nodes, Liver and other organs. As we all know, the liver is a very important organ for our body that helps in detoxification. Also the liver secretes bile which is helpful in digestion of fats. Hepatic sarcoidosis may lead to liver cirrhosis in later stages if left untreated.

INTRODUCTION

Sarcoidosis is a rare chronic inflammatory disease that can affect multiple organs in the body most commonly the lungs but sometimes in the liver also. In sarcoidosis no caseating granulomas form in an organ causing inflammation and damage. Abnormal collections of inflammatory cells that form lumps are called granulomata. Liver sarcoidosis is very rare rather than lung sarcoidosis or lymph sarcoidosis. Cause of sarcoidosis is unknown till now. Some say that it is our own immune system that starts the infection. Sarcoidosis may resolve within years without any treatment or in some patients it may persist for a long time. Liver is an important metabolic organ in the human body that sits under the rib cage on the right side. Liver helps in detoxification and digestion. Liver has 4 lobes: right, left, quadate, quadrate. Apart from metabolism, the liver has a very important digestive role as it secretes biles which is helpful in digestion of fat. Patients of liver sarcoidosis may feel pain in the right hypochondriac regions (right upper flank of abdomen). Liver cirrhosis, portal hypertension are the main complications of liver sarcoidosis.

CAUSES

The exact cause of sarcoidosis is unknown till now but still some factors for autoimmune disorders are as follows

• Genetic mutations
• Environmental factors
• Immunological response

SYMPTOMS

Some common symptoms as follows

• Abdominal pain (right upper flank of abdomen)
• Itchy skin
• Fever
• Weight loss
• Hepatomegaly
• Jaundice
• Edema in face
• Ascites
• Dark urine
• Portal hypertension

INVESTIGATIONS

• Ct- Scan, MRI’s, USG - Shows hepatomegaly, multiple hypointense multiple nodules in liver.
• Blood Tests - CBC(complete blood count), LFT (liver function test). High level of alkaline phosphatase
• LIVER BIOPSY - Can be done for confirmation of  the nature of the nodules (benign or metastatic).

AYURVEDIC OVERVIEW OF HEPATIC SARCOIDOSIS

Hepatic sarcoidosis do not have any direct correlation in Ayurvedic classical texts but according to features and symptoms of the disease we can say that there will be vitiation of all three doshas (Vatta, Pitta, Kapha – kinetic, thermal, potential energies), involvement of "dhatus" {supporting structures of body i.e - RAS(plasma), RAKTA(blood), MAMSA(muscle), MEDA(fat), ASTHI(bone), MAJJA(bone marrow), SHUKRA(reproductive system)}, there will also be condition of "AMA formation", low immunity and low digestion. These all conditions along with genetic causes together will result in this condition of hepatic sarcoidosis.

This condition is an immune response of the body i.e due to disposition of genes the immune system of the body starts to fight against itself causing sarcoidosis. First there is vitiation of kapha dosha which affects the lymph and lymph nodes after that there is involvement of pitta dosha. As pitta dosha starts involving kapha, it gets vitiated and moves to the liver deteriorating it after all this vata dosha comes into action and dries off the kapha dosha. Then there is formation of "Ama '' which results in inflammation and collection of toxins due to "low ojas" (decreased immunity) and "low agni' (decreased digestion) resulting in formation of multiple granulomas in the liver. So in short we can say that the causes will lead to the above mentioned conditions- vitiated doshas (vatta, pitta, kapha) will move to the liver through blood/lymph and will reside in the micro channels of the organ then will hamper the normal functioning. This will lead to the formation of "AMA" (free radicals or toxins) in the liver; these toxins in turn vitiate dhatus (supporting structures of liver) and cause granulomas. So in Ayurveda as we treat liver sarcoidosis we mainly focus on treating the root cause i.e balancing of all 3 doshas, ama pachana(detoxification), boosting agni and immunity.

SINGLE HERBS USED IN THIS CONDITION

• Haritaki (Terminallia chebula)
• Adrak / ginger (Zingiber officinale)
• Pepper (Piper nigrum)
• Pippali (Piper longum)
• Fennel (Foeniculum vulgare)
• Guggul (Commiphora mukul)
• Chitrak (Plumbago zeylanica)
• Hing (Ferula asafoetida)
• Ajwain (Trachyspermum ammi)
• Mustard (Brassica nigra)
• Dalchini (Cinnamomum verum)
• Kalmegh (Andrographis paniculata)
• Bhumi amla (Phyllanthus niruri)
• Kanchnaar (Bauhinia variegata)
• Tulsi (Ocimum sanctum)
• Haridra (Curcumin)

SOME CLASSICAL AYURVEDIC FORMULATIONS

• Ajmodadi churna
• Chitrakadi vati
• Sanjeevani vati
• Mahashankh vati
• Arogyavardhini vati
• Lavangadi vati
• Vridhivadhika vati
• Kanchanar guggulu
• Triphala guggulu
• Kaishore guggulu
• Haridra khand
• Tulsi ghan vati
• Guluchyadi kashayam
• kalmeghasav
• Amalkadi rasayan

HERBAL REMEDIES FOR HEPATIC SARCOIDOSIS BY PLANET AYURVEDA

Planet Ayurveda is a manufacturer of Ayurvedic medicines derived entirely from plants. This medicine does not contain chemicals, additives or preservatives. All products are GMP certified and 100% vegan. Planet Ayurveda provides herbal remedies for Liver Sarcoidosis:

PRODUCTS LIST

1. Kanchnaar Guggul
2. Boswellia Curcumin
3. Liver Detox Capsule
4. Phyllanthus Niruri
5. Kalmegh Ghan Vati
6. Yakrit Plihantak Churna

Herbal Remedies For Hepatic Sarcoidosis

PRODUCTS DESCRIPTION

1. Kanchnaar Guggul

It is a classical ayurvedic formulation given in cancer and cancerous growth and has antioxidant properties that can be given in fibroids, cysts, tumours, goitre, etc. Contains kanchanar twak (Bauhinia variegata) which has potent anticancer effects and is a good hepatoprotective agent. Guggul (commiphora mukul) pacifies vatta dosha hence is very helpful in managing inflammation and pain conditions. Shunthi (Zingiber officinale) is a very potent detoxifier and also increases digestion, Pippali (Piper longum) is a very good kapha pacifier, maricha (piper nigrum) besides being a detoxifier also stimulates organs etc.

Dosage - 2 tablets twice daily.

2. Boswellia Curcumin

It is the most effective herbal formulation of Planet Ayurveda for inflammatory conditions. It has similar efficacy to corticosteroids. Contains Shallaki (Boswellia serrata), Haridra (Curcuma longa). Boswellia balances the vatta dosha (kinetic energy) and reduces the inflammation in sarcoidosis. Curcumin balances all 3 doshas hence subsiding the symptoms (pain, itching, inflammation etc) in sarcoidosis.

Dosage - 1-2 capsules twice a day.

3. Liver Detox Capsule

Herbal formulation from planet ayurveda helps detoxification of liver. Contains herbs that stimulate liver functions. Constituents- kalmegh (Andrographis paniculata), kutaki (picrorhiza kurroa), punarnava (Boerhavia diffusa), makoy (Solanum nigrum) etc.. Kalmegh, kutaki, makoy all act have hepatoprotective effects & are good liver stimulants hence managing its functions while punarnava has a very good rejuvenating effect. Also this formulation balances all three doshas (vatt, pitt, kapha)

Dosage - 1 capsules twice a day.

4. Phyllanthus Niruri

It is a single herbal capsule that includes Bhumi Amla (Phyllanthus niruri). It helps to manage liver diseases by balancing the vitiated kapha and pitta dosha (potential and thermal energy). Bhumi Amla has hepatoprotective, antioxidant and antiviral activities that help treat liver disease and reverse liver damage.

Dosage -1 capsule twice daily.

5. Kalmegh Ghan Vati

It is widely used in liver diseases due to its hepatoprotective properties.This herbal medicine contains Kalmegh (Andrographis paniculata) which balances the pitta dosha (thermal energy) in liver as well as in blood. It has antioxidant and anti-inflammatory properties and is a goood liver stimulant. It also removes toxins from the body and it also improves digestion.

Dosage - 2 Tablets twice daily.

6. Yakrit Plihantak Churna

It is a churna containing Bhumyamalaki (Phyllanthus niruri), Bhringraj (Eclipta alba), Kalmegh (Andrographis paniculata) etc. Bhringa is a powerful liver tonic and acts as a great rejuvenator, used also for the treatment of hepatitis and liver cirrhosis as it balances the vatta dosha whereas kalmegh, bhumi amla act as good liver stimulants as the balances kapha and pitta imbalance and have hepatoprotective effects.

Dosage - 1 teaspoon twice daily.

CONCLUSION

Hepatic sarcoidosis is a granulomatous disease of unknown aetiology. Around 70% of patients have non-caseating granulomas on liver biopsy; 20–40% of patients have hepatomegaly or elevated liver enzymes. Most of the cases with liver involvement are asymptomatic. It is a multisystem disease of unknown aetiology. Histological evidence of non-caseating granulomas in the liver represents the main finding. So with conservative treatment and proper ayurvedic approach we can get very good results in patients of liver sarcoidosis. Few things like the concept of AMA pachana, agni and tridosha balance has to be kept in mind. Only then one can get better results in patients of autoimmune disorders. For online consultation or any queries contact us at www.PlanetAyurveda.com