Common forms of treatment for sarcoidosis include prednisone, immunosuppressive drugs, and eye drops. Treatment methods vary -- not only from patient to patient, but also depending on the organ that is affected. Regardless of the treatment used, they all have the same goals: improve organ function, relieve symptoms, and shrink granulomas.
The goals of sarcoidosis treatment are to:
- Improve how the organs affected by sarcoidosis work
- Relieve sarcoidosis symptoms
- Shrink the granulomas.
Treatment for sarcoidosis may shrink the granulomas and even cause them to disappear, but this may take many months. If scars have formed, treatment may not help, and you may have ongoing symptoms.
Your treatment options will depend on:
- What symptoms you have
- How severe your symptoms are
- Whether any of your vital organs (for example, your lungs, eyes, heart, or brain) are affected
- How the organ is affected.
Some organs must be treated, regardless of your symptoms. Others may not need to be treated. Usually, if you don't have symptoms, you probably don't need treatment, and you will likely recover eventually.
The main sarcoidosis treatment is prednisone. Prednisone is a corticosteroid, or anti-inflammatory, drug. Sometimes, it is used with other medicines for sarcoidosis. Sometimes, other corticosteroids are used.
Prednisone almost always relieves symptoms of inflammation. If a symptom doesn't improve with prednisone treatment within a couple of months, consult your physician.
Prednisone is usually given for many months, sometimes for a year or more. Low doses of prednisone can often relieve symptoms without causing major side effects. When used at high doses, however, prednisone does have a risk of serious side effects, including:
- Weight gain.
- High blood pressure.
- Mood swings (depression).
- Difficulty sleeping at night.
- Thinning of bones (osteoporosis) and skin.
- Adrenal gland insufficiency, which occurs when the adrenal glands don't make enough of certain hormones. This requires treatment by an endocrinologist, a doctor who specializes in the diagnosis and treatment of the endocrine glands. The endocrine glands include your adrenal and pituitary glands.
- Aseptic or avascular necrosis of the hip, which is the development of cysts and hardened, dead tissue in the hip.
Your doctor can usually help you manage these side effects.
When it is time to stop taking prednisone, you should cut back slowly, with your doctor's help. This will help prevent flare-ups of sarcoidosis and allow your body to adjust to life without the medicine. You may also want to see an endocrinologist to make sure that your endocrine glands are producing enough hormones. The endocrinologist may prescribe certain hormones for you to take until your endocrine glands are working well again.