Tag: Complications Of Sjogren’s Syndrome

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.

Sjogren’s Syndrome

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

“यत् कूणितं दारुणरुक्षवर्त्म विलोकने चाविलदर्शनं यत् |
सुदारुणं यत् प्रतिबोधने च शुष्कक्षिपाकोपहतं तदक्षि ||“
(Sushruta samhita, Uttartantra 6/26)

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

“वातपित्तातुरं घर्षतोदभेदोपदेहवत् | रूक्षदारुणवर्त्माक्षि कृच्छृोन्मीलनिमीलनम् ||
विकूणनविशुष्कत्वशीतेच्छाशूलपाकवत् | उक्त्त: शुष्काक्षिपाकोअयं-”
(Astanga Hridayam, Uttara sthana 15/16, 17)

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.
“शुष्कक्षिपाके हविष्: पनमक्ष्णोश्च तर्पणम् |
घृतेन जीवनीयेन नस्यं तैलेन वाअणुना ||
परिषेको हिताश्चात्र पय: कोष्णं ससैन्धवम् |
सर्पिर्युक्त्तं स्तन्यपिष्टमञ्जनं च महौषधम् ||“
(Astanga Hridayam, Uttara sthana 16/28, 29)

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


Sjögrens Syndromes Care Pack

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.

The Most Effective Treatment For Sjogren’s Syndrome

Sjogren’s syndrome is an autoimmune disease that affects the glands that secrete fluids such as tears and saliva. These glands are the lacrimal glands and salivary glands respectively. This leads to dryness of the eyes and mouth or lips.

Sjogren's

Types of Sjogren’s syndrome

There are two types of Sjogren’s syndrome i.e. primary or secondary

Primary Sjogren’s Syndrome: This condition develops on its own, not as a complication of any other disease. This condition is more dangerous.

Secondary Sjogren’s Syndrome: This condition occurs as a result of another disease, such as lupus or rheumatoid arthritis.

People are more prone to have Sjogren’s Syndrome

Sjogren’s syndrome can affect people of all ages, although it usually occurs in adults older than 40 years. Also, women are at a greater risk of developing the condition than men.

The body organs affected by Sjogren’s syndrome

Sjogren’s syndrome attacks the lacrimal glands and salivary glands resulting in reduced production of tears and saliva which leads to dryness of the eyes and dryness of mouth or lips respectively. It can also gradually influence other parts of the body such as the liver, kidneys, lungs, nerves, skin, thyroid, and joints.

Causes of Sjogren’s Syndrome

The exact cause of developing Sjogren’s syndrome is not specifically known, but the possible cause of this disease is the abnormal functioning of the immune system. When the immune system mistakenly attacks the body’s healthy cells and tissues. That’s why it is known as an autoimmune disorder. This syndrome can also be associated with other autoimmune diseases like lupus or rheumatoid arthritis. Other factors that may cause Sjogren’s syndrome are a genetic, environmental and bacterial or viral infection. Because women are more likely to be affected, so menopause is also considered a cause in women.

Complications of Sjogren’s Syndrome

Sjogren’s syndrome usually affects the eyes and mouth and gradually affects other organs of the body including the liver, thyroid, lungs, and kidneys, etc.

The most common complications include eyes and mouth:

  1. Photophobia, blurred vision and corneal damage.
  2. Dental cavities: Due to less production of saliva and dryness of the mouth.
  3. Fungal or yeast infections in the mouth like oral thrush

Few common complications related to other organs:

1. Lungs: It can cause bronchitis, pneumonia or other dilemmas in the lungs.

2. Liver: It can cause liver cirrhosis and hepatitis.

4. Kidneys: It leads to difficulties with kidney function

5. Lymph Nodes: Some people with Sjogren’s syndrome are at risk of developing lymphoma (lymph nodes cancer)

6. Nerves: It can develop peripheral neuropathy which includes numbness, itching and tingling in the hands and feet.

Symptoms of Sjogren’s Syndrome

The main symptoms of Sjogren’s syndrome develop due to inflammation and swelling of the salivary glands and lacrimal glands which are shown by dry mouth and dry eyes respectively.

Symptoms associated with dry mouth are:

  1. Decaying Of Teeth
  2. Gum Disease
  3. Persistent Dry Cough
  4. Difficulty In Speaking And Eating
  5. Impaired Voice
  6. Oral Thrush

Symptoms associated with dry eyes are:

  1. Burning Sensation In The Eyes
  2. Mucus Discharge From Eyes
  3. Itching In Eyes
  4. Gritty Sensation
  5. Swollen Eyelids
  6. Photophobia

Other symptoms

  1. Arthritic Pain
  2. Continued Fatigue
  3. Dry Skin
  4. Skin Rashes
  5. Dryness In Vagina

shloka

(Reference: Ashtangahridraya, Sutrasthana, chapter 1, shloka 12)

This shloka explains: Vata is dry, cold, light, rough, minute and mobile. All these symptoms are associated with Sjogren’s syndrome and even the patient becomes restless.

Ayurvedic aspect for Sjogren’s syndrome

According to Ayurveda, the cause of the disease is the agitation of the three doshas or the Oja and doshas i.e. Vata, Pitta, and Kapha of the body. These doshas control and supervise the functioning of body organs. Among these tridoshas, Vata and Kapha are more active. The disturbed Vata causes dryness and Kapha causes low saliva production.

Beneficial Herbs for Sjogren’s syndrome

Ayurveda provides many herbs which helps to maintain balance in tridosha of the body, especially pacifies the Vata and Kapha dosha. These herbs are the following:

  1. Shalaki
  2. Curcumin
  3. Grape Seed
  4. Wheat Grass
  5. Spirulina
  6. Green Tea
  7. Amla

1. Shalaki: It contains Boswellic acids, which provide anti-inflammatory action.

2. Curcumin: It has antimicrobial, anti-inflammatory, and anti-oxidant properties.

3. Wheat Grass: It is a natural antioxidant (3) and helps to remove toxins from the blood and liver.

4. Grape Seed: It is a great source of vitamin C. It improves the functioning of the immune system. It possesses an antioxidant property that helps to eliminate harmful toxins from the liver and blood.

5. Spirulina: It has anti-inflammatory activities and packed with vitamins and nutrients which helps to increase the immunity of the body.

6. Green Tea: Green tea comprises antioxidants known as polyphenols which increase the body’s ability to combat free radicals and also stimulate the immune system.

7. Amla: It is also a great source of vitamin C and antioxidants which improves immunity power and works against infections.

These are used to formulate various herbal formulation. Planet Ayurveda gives very effective herbal remedies by adding the best quality of the herbs for Sjogren’s syndrome.

Ayurvedic products for Sjogren’s syndrome by Planet Ayurveda

The products offered by Planet Ayurveda are the following:

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

Herbs for Sjogren's Syndrome
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Product description

1. GREEN ESSENTIALS CAPSULES

These capsules are made of many herbs such as Green Tea (Camellia sinensis), Grape Seed (Vitis vinifera), Wheat Grass (Triticulumaestivum), Amla (Emblica Officinalis), Chlorella (Chlorella Vulgaris), Alfalfa (Medicago sativa), and Spirulina (Spirulinaplatensis). These herbs help in strengthening the immune system, removal of toxins from the blood and liver, fight free radicals, infections, and promote the energy level of the body. These capsules increase the production of blood and repair tissue. Due to the presence of these herbs, green essentials capsules become rich in vitamins, minerals, and iron. It also prevents dryness.

Dosage: 1-2 capsules twice daily post meals, with lukewarm water.

2. BOSWELLIA CURCUMIN CAPSULES

Boswellia-Curcumin capsules contain two herbs such as shallaki (Boswellia serrata) and turmeric (Curcuma longa). These two herbs make these capsules strong Vata pacifying herbal remedy. These capsules of Planet Ayurveda helps to combat the antibodies which cause Sjogren’s syndrome. Shalaki comprises Boswellia acids, which is responsible for its anti-inflammatory action. Curcumin possesses anti-inflammatory and anti-oxidant properties. Its antimicrobial action plays a very important role in Sjogren’s syndrome.

Dosage: 1 to 2 capsules twice daily post meals with lukewarm water.

3. ASHWAGANDHA CAPSULES

The pure extract of Ashwagandha (Withania somnifera) herb is used to make these Ashwagandha Capsules. These capsules are known to show satisfying effects in treating SjogrenSyndromeThis herb pacifies tridoshas in the body especially Vata dosha. It is a great adaptogenic due to which it is very effective to manage stress. It has an anti-inflammatory property and provides comfort from insensitivity and tingling sensation. It also helps to improve the immune system, so prevent the immunosuppressive action of the body. Along with these properties, it improves blood quality. Ashwagandha enhances blood production by increasing bone marrow cellularity and also improves the quality of the blood.

Dosage: 1 to 2 capsules twice daily after meals with lukewarm water or milk.

4. SHILAJIT CAPSULES

The herb Shilajit (Asphaltum) of the best quality is added to prepare Shilajit Capsules. These capsules are a great natural remedy for Sjogren’s syndrome. It helps to improve immunity and makes the patient’s body able to combat fatigue, weakness, tiredness. It possesses restorative, rejuvenating, adaptogenic and anti-inflammatory properties. This herb also helps in cleansing and detoxification of the body. The shilajit capsules pacify the Vata dosha.

Dosage: 1 -2 Capsules once or twice daily with plain water or milk post meals.

  • For adults: 1 capsule twice daily post meals
  • For children: 1 capsule once daily

5. YOUTH RESTORA CAPSULES

The best quality herbs included in these capsules are Grape Seed (Vitis vinifera), Bhumi Amalaki (Phyllanthusniruri), Green Tea (Camellia sinensis), and Colostrum of Cow (Bovine colostrum). These capsules improve and increase metabolism. It also eliminates free radicals from the body.
Youth Restora capsules pacify the worsened Vatadosha. Therefore, this herbal remedy is good for Sjogren’s syndrome.

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

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3361921/
  2. https://www.ncbi.nlm.nih.gov/pubmed/17569207
  3. https://www.functionalfoodscenter.net/files/47516971.pdf
  4. https://www.ncbi.nlm.nih.gov/pubmed/18384090
  5. https://www.ncbi.nlm.nih.gov/pubmed/21317655