Ayurvedic Treatment of Sjogren’s Syndrome with Herbal Remedies

ABSTRACT

Sjogren’s syndrome is an autoimmune disorder of chronic nature. In this condition, the moisture producing glands do not function properly which leads to oral and ocular dryness. It is associated with other autoimmune diseases like Rheumatoid Arthritis, Lupus, Inflammatory Myositis, etc. It can be primary or secondary. Primary Sjogren’s syndrome is characterized by Keratoconjunctivitis sicca, Xerostomia and Secondary Sjogren’s syndrome is characterized by RA, Scleroderma, Vasculitis (extraglandular manifestations). Primary Sjogren’s is more common in females and has a female to male ratio of around 9:1. It usually strikes after menopause. Symptomatic treatment of this syndrome is available like use of lubricants and steroids. However, the Ayurvedic approach is targeted more at the root cause. This article will hint at the symptoms, types, causes and line of management of Sjogren’s syndrome according to both Modern and Ayurveda aspects.

INTRODUCTION

This systemic disease is named after the Swedish ophthalmologist, Henrik Sjögren, who introduced the term ‘Keratoconjunctivitis sicca’ for dryness of eyes. In Sjogren’s syndrome, the immune system attacks the exocrine glands that produce saliva and tears due to which the moisture decreases and mouth and eyes become dry. The attack is not just limited to eyes and mouth, other organs like skin, kidney, liver, lungs or nervous system can also be affected by this condition. It has two age peaks with the first in the 20s and the second in the 50s. Primary Sjogren’s affects 0.1 to 0.6% of the adult female population. Both the innate (monocytes) and the adaptive immune system (T/B-cells) are involved in the initiation of this disease. People often complain of a sandy or gritty feeling in their eyes, especially in the morning.

SIGNS AND SYMPTOMS

Mouth

• Dryness of mouth (xerostomia)
• Burning and cracking of the tongue
• Trouble swallowing
• Difficulty speaking
• Swollen parotid glands
• Increased dental cavities

Eyes

• Photosensitivity
• Itching and redness in eyes.
• Decreased tear output
• Feeling of a foreign body presence in the eyes

Other Symptoms

• Chronic dry cough due to decreased mucous section in the upper and lower respiratory tract
• Esophageal dryness due to decreased mucous secretion in the GI Tract.
• Vaginal Dryness
• Joint and muscle pain
• Fatigue
• Low-grade fever
• Trouble while sleeping
• Brain fog

TYPES OF SJOGREN’S SYNDROME

There are two types of Sjogren’s syndrome

1. Primary Sjogren’s syndrome : It develops on its own and is not the consequence of another disease.

2. Secondary Sjogren’s syndrome : It is triggered by other conditions like rheumatoid arthritis or other auto-immune conditions.

CAUSES

Sjogren’s syndrome is an autoimmune disease when instead of protecting your body the immune system damages it by mistake. It is still not known what makes your immune system attack your glands and cause Sjogren’s syndrome. It may be caused due to the influence of genetic or environmental factors like viral infection.

DIAGNOSIS

Diagnosis is done based on the questions asked by your physician, examination of the body and conduction of any of the following tests

• 80 percent of people with Secondary Sjogren’s test positive for antinuclear antibodies (ANA).
• Rheumatoid factor is positive in the majority of people with Secondary Sjogren’s.
• Protein levels will be elevated in 80% of Secondary Sjogren’s patients.
• Schirmer’s test
• Rose-Bengal staining test
• Saliva flow Test
• Erythrocyte sedimentation rate (ESR) – High
• Hb – Low
• Albumin – Low
• USG
• Salivary gland biopsy of the lip or parotid gland.

RISK FACTORS

• Genetic Predisposition : 10% people with Sjogren’s syndrome have a blood relative with the same condition. Some genes like HLA-B8 and HLA-DR3 are found more frequently in people with Primary Sjogren’s.
• Gender : It is more common in females
• Age : It is usually diagnosed in people more than 40 years old.
• Auto-immune conditions : This condition usually occurs in pairs. Half of the population with Sjogren’s syndrome has another auto-immune condition especially of rheumatoid nature.

COMPLICATIONS

• Eye problems like corneal damage.
• Lymphomas (Cancerous tumors)
• Affected kidney function
• Abnormal liver function
• Fungal infections in the mouth
• Yeast infections
• Dental caries
• Neurological problems due to weakened nervous systems.

LINE OF TREATMENT

There is no cure for Sjogren’s syndrome, however, symptomatic treatment is suggested

• Medications like NSAIDs (non steroidal anti-inflammatory drugs) for pain, corticosteroids and immunosuppressants.
• Saliva produces medications for dry mouth.
• Lubricants for private areas.
• Some people may require hormone therapy.
• Eye drops for eye lubricants.

AYURVEDA ASPECT

In Ayurveda Primary and Secondary Sjogren’s syndrome can be understood through the concept of swatantra (independent) and partantra (dependent) vyadhi (disease). Primary Sjogren’s is due to direct causative factors and can be correlated with Sushka Akshipak. Whereas Secondary Sjogren’s is associated with other autoimmune disorders, it can be included under the presented conditions like Aamvata, Vatarakta etc. Acharya Sushruta has mentioned about Shushka akshipak in Sushruta Samhita, Uttartantra, 6th chapter

Above shloka states that the disease in which the eye-lids become dry and hard and remain always closed, the vision becomes cloudy and hazy, and it becomes very painful to open the eye-lids, is called the Shushk akshipaka.

According to Acharya Vaaghbhat

The above shloka states that in sushka akshipak, Vata and Pitta are the main doshas asserting their dominance. The eyes experience pain as if scrubbed, needle-pricking pain, etc, eyelids become dry and hard, difficulty in opening and closing of eyelids. Eyes become dry and usually stay closed. In such a scenario, the patient experiences a need for cooling foods. Such disease in which eyes become dry and painful is called Shushk akshipak.

CAUSATIVE FACTORS OF SHUSHKA AKSHIPAK

• Over-eating of cold, heavy and unctuous food.
• Intake of viruddha ahaar (contraindicatory food) such as milk and salty food together leads to the production of Ama (toxic form of undigested food).
• Regular intake of dry and hot potency food, emotional factors like anger, grief, anxiety, withholding natural urges like urine, sneezing etc. can cause the vitiation of udakavaha srotas (channels of transportation of water in the body).

ORIGIN OF DISEASE

Virudha ahar and vihar (contraindicatory diet and lifestyle) lead to agnimandhya (diminished digestive fire) that causes dosha imbalance and production of ama in the body. Aggravation of Vata Dosha along with Pitta and Kapha causes udakavaha srotodushti due to which dryness of mouth and eyes occurs. It then causes rasa and rakta dhatu dushti (vitiation of circulatory fluids and blood) in the eyes. This is the course of development of Shushka akshipaka.

DOSHA INVOLVED

Tridoshaj with Vata predominance

TREATMENT

The line of treatment of Sjogren ’s syndrome is as follows

• Nidana Parivarjan (Dietary Changes)
• In case of Ama in the body like rheumatoid cases, deepana-pachana treatment is given.
• Nasya, Shirodhara, Akshi tarpan.
• Vamana (emesis) / Virechana (purgation)
• Shaman Chiktsa for vitiated Doshas (Medicine Treatment)
• In case of excessive dryness, Sneha Pradhan (unctuous) treatment is given.

Various types of treatments are stated like intake of ghee, local eye therapy called Tarpana Kriya Kalpa with ghrita of Jeewaniyagan aushadh, anutail nasya, parishek (pouring of liquid) on eyes with milk mixed with rock salt. Anjana (collyrium) made from the paste of dry ginger, cow’s ghee along with human milk.

JOURNEY OF CARRIE ANN INABA WITH SJOGREN’S SYNDROME

Carrie Ann Inaba suffered from Sjogren’s syndrome but she didn’t know it for years. Due to her eyes being constantly dry she went to her doctor which for some reason yielded no result. Many years later she woke up one morning with a lump in her neck. Being scared of cancer she immediately contacted a specialist. She was then referred to a rheumatologist and was diagnosed with Sjorgren’s. She also suffers from fibromyalgia, lupus and rheumatoid arthritis. Carrie wasn’t a fan of medicines that is why she waited for six months after her diagnosis to take medication for her condition. Now she is glad she did the right thing. She says her decision turned out to be the biggest blessing for her. She describes her secret to cope with multiple chronic conditions that is taking proper nutrition. She starts her day with a protein shake, performs various Sjogren-friendly exercises. It listens to what her body needs instead of following a mass routine of high intensity workouts and heavy diets. She is the Sjogren’s syndrome Foundation’s National Awareness Ambassador and Spokesperson. She is committed to increase awareness about Sjogren’s and help raise funds for the research and treatment of this disease.

HERBAL REMEDIES FOR SJOGREN’S SYNDROME BY PLANET AYURVEDA

Planet Ayurveda is a GMP certified company that offers a wide variety of herbal supplements and wellness products formulated using traditional Ayurvedic principles and potent herbs. Planet Ayurveda offers an effective combination of herbal remedies for Sjogren’s syndrome. These remedies focus on relieving the symptoms of the diseases in order to enhance quality of life

1. Ashwagandha Capsules
2. Shilajit Capsules
3. Boswellia Curcumin
4. Green Essentials
5. Youth Restora

Product Description

1. Ashwagandha Capsules

These capsules contain the standardized extract of a potent herb called Ashwagandha (Withania somnifera). It helps to reduce the intensity of the flare-ups caused by this condition. It helps reduce fatigue in the body and stress in the mind. Ashwagandha possesses anti-inflammatory and immunomodulatory properties.

Dosage : 1-2 capsules twice a day with plain water after meals.

2. Shilajit Capsules

Each Shilajit Capsules contains 500mg of standardized extract of raw Shilajit (Asphaltum punjabianum). These capsules have pain-relieving and anti-inflammatory properties. They will help purify the blood and strengthen the immune system which helps reduce immune attack on the glands. The rejuvenating properties will help in recovering from this disease. They are useful in depression and mental fatigue arising from chronicity of a disease as they help strengthen the nervous system.

Dosage : 1-2 capsules twice a day with plain water after meals.

3. Boswellia Curcumin

Boswellia CurcuminBoswellia Curcumin contain shallaki (Boswellia serrata) and Curcumin (Curcuma Longa). Curcumin reduces the oxidative stress that causes dry eyes. It will provide a strong immune support to the body. Boswellia will reduce dryness of eyes and mouth by pacifying Vata and Pitta Dosha. It will facilitate movement of eye balls which is quite difficult and painful in dry eyes. These capsules also have anti-inflammatory action useful in complications. These capsules are extremely beneficial in rheumatoid conditions that are usually associated with Sjogren’s syndrome.

Dosage : 1-2 capsules twice daily with plain water after meals.

4. Green Essentials

Green Essentials contain extracts of Grape Seed (Vitis vinifera), Wheat Grass (Triticulum aestivum), Spirulina (Spirulina platensis), Alfalfa (Medicago sativa), Green Tea (Camellia sinensis), Amla (Emblica Officinalis) and Chlorella (Chlorella vulgaris). This combination is a nutritional supplement that eliminates toxins from the body and acts as an immune booster. It effectively provides relief in Sjogren’s symptoms by acting on its root cause.

Dosage : 1-2 capsules twice a day with plain water after meals.

5. Youth Restora

This herbal preparation contains Bhumi amla (Phyllanthus niruri), Grape seeds (Vitis vinifera), Green tea (Camelia sinensis) and Cow colostrum (Bovine colostrums). This highly nutritive composition will Pacify Vata Dosha and help induce secretions from glands.

Dosage : 1-2 capsules twice daily with plain water after meals.

CONCLUSION

Sjogren’s syndrome is the third-most common rheumatic autoimmune disorder. There is no cure for this condition. However, Ayurveda can play a significant role in the management of its symptoms and associated diseases. This will help the patient’s overall health and improve quality of life. The herbal remedies by Planet Ayurveda mentioned in this article adhere to the principles of Ayurveda thus helping the patients affected with this chronic condition.