Scleroderma

a human hand

Scleroderma is an autoimmune condition whereby the body’s immune system reacts against its own tissues causing a tightening nerve and blood disease. Scleroderma is characterized by fibrosis and a symmetric thickening and tightening of the skin of the fingers and the skin that is proximal to the metacarpophalangeal or metatarsophalangeal joints. The thickening of skin is believed to be due to an overproduction of connective tissue. Other changes may occur and affect the face, neck, trunk (thorax and abdomen) and other extremities. The disease may start with a swelling of the hands and thickening of fingers. Arthritis, digestive and respiratory problems may ensue. 

The symptoms of the disease can vary greatly among patients, and the illness takes two forms.  Systemic scleroderma can ravage not only the skin but also the internal organs including the heart, lungs and kidneys.  It can be life threatening. The milder form is labeled localized scleroderma and can limited to patches of thickened or discolored skin, while internal organs are spared.

The systemic form of the disease affects many organ systems. Although it is most obvious in the skin, the gastrointestinal tract, the respiratory and genitourinary systems are frequently involved. The symptoms result from progressive tissue fibrosis and occlusion of the microvasculature by causing excessive production of collagen. These continued vascular alterations affect the small arteries and capillaries. The structural defects caused continual occlusion that eventually leads to a collapse. Next, the tight junctions become altered and are no longer functional.

There are new treatment options for the sufferer of this affliction, and more may be coming in the future.  Some newer treatments like stem cell transplants may show great promise now and in the years to come. Intravenous immune globulin treatments have shown success in a number of patients, but the cost can be over $30,000 each and insurance does not cover it.

CAUSES

As with any autoimmune condition, the real ideology of the disease is unknown. Scleroderma can occur when collagen, a connective tissue protein, is overproduced. The most suspected causes are environmental toxins, allergies, and possible nutrient deficiencies.

The exact etiology of scleroderma is unknown, however the following pathogenic mechanisms have been proposed: endothelial cell injury, immune system derangement and fibroblast activation. 

Environmental factors must also be recognized as a possible etiology for scleroderma. Chemicals and xenoestrogens are pervasive in our environment. Certain toxic solvents (trichloroethylene, epoxy resins, benzene, and carbon tetrachloride) have been implicated. The human herpes virus 5 has been proposed as an accelerating factor in scleroderma, but evidence of its involvement is inconclusive.

DIET

It is recommended that testing for food allergies be implemented with any treatment protocol. Avoiding or decreasing foods that may be sensitive/allergic in nature to the patient decreases the self-destructive mode of the immune system. It appears that specific foods may trigger counterproductive immune responses in some individuals. 

The most common food allergens/sensitivities are: dairy products, wheat, citrus, sugar, soy and nuts. Food reactions are different for each individual. See the Elimination Diet for better responses to specific food allergies. From a dietary perspective, try and eliminate white flour, sugar products, tobacco smoke, sweets, chocolate, soda, greasy foods, coffee, harsh detergents, antibiotics, and irritating agents. It is advisable to do a liver and bowel detoxification two to four times a year.

Pathological changes in the gastrointestinal tract in scleroderma patients can result in reduced colonic motility.  This affliction can cause severe abdominal pain. Thus, marked increase in dietary fiber should be undertaken cautiously and introduced gradually.

It may be advisable to instruct the patient to avoid mega doses of vitamin C (more than 1,000 mg daily). There is evidence to show that high doses of vitamin C stimulate collagen formation and may enhance deposition.

SUPPLEMENT PROTOCOL

  1. VITAMIN E and other ANTIOXIDANTS
    Deficiencies of antioxidant vitamins and nutrients are common in patients with this disease. VITAMIN E has a strong anti-oxidant effect on toxins and heavy metals and stabilizes cell membranes. Large doses of vitamin E help to prevent the tissue hardening typical of this illness and overall, improved the skin in most patients. VITAMIN C with BIOFLAVONOIDS acts against inflammatory processes, decreases free radical damage, and is necessary for the health of connective tissue. Dosage: Vitamin E 200-1,200 IU daily; Vitamin C 500-2,000 mg daily.
  2. OMEGA 3, 6 FATTY ACIDS  (PRIMROSE OIL and FISH OIL)
    Research has demonstrated that fish and flaxseed oil inhibits arachidonic acid- which plays a key role in autoimmune diseases. The overlap of Sjogren’s Disease, and overlapping condition with scleroderma, has been argued to be a lack of adequate synthesis of prostaglandin E1, a potent anti-inflammatory hormone like fatty acid. GLA is an essential fatty acid that is converted to the precursor for PE1. EVENING PRIMROSE OIL contains a high concentration of GLA. Dosage: 1-3 grams daily. 
  3. VITAMIN D3
    Vitamin D3 is 3-9 times more potent than vitamin D2. Recent studies have shown the effectiveness of orally administered vitamin D as a treatment for scleroderma.  Oral administration with 1,25-dihydroxycholecalciferal (Calcitriol) treatments improves skin manifestations, but is expensive compared to vitamin D3. Dosage: Up to 4,000 IU daily for 2-5 months is a safe level.
  4. CALCIUM and SILICA
    These are two minerals critical for bone and collagen development. Dosage: Calcium 1,000-1,500 mg daily; Silica 1,000 mg daily. 
  5. N-ACETYLCYSTEINE (NAC)
    One study showed that patients with Raynaud’s phenomenon secondary to scleroderma were successfully treated with IV infusions of NAC.  Dosage: 15 mg per kg of body weight, only under direction of a qualified practitioner.                                                                                                                       
  6. B-COMPLEX
    The B vitamins are critical for the rejuvenation of cell formation and the production of energy in the body. It is recommended to take higher doses of B1, B2, B3, B6, B12, biotin, folate, and pantothenic acid. Dosage: 50-200 mg daily. 
  7. COX-2 INHIBITING HERB
    These herbs have anti-inflammatory effects and can be effective in treating the pain and arthralgias often suffered by patients with scleroderma. The most effective COX-2 herbs include BOSWELLA, CURCUMIN (Turmeric), BROMELAIN, GINGER, and WHITE WILLOW BARK. These herbs may inhibit the formation of leukotrienes (inflammatory mediators in the body) which causes inflammation and free radical damage in the body. Dosage: See packages or advice from a qualified health practitioner. 
  8. OREGON GRAPE (BERERIS)
    This herb has a cooling and drying affect on the skin, and is effective in treating various skin conditions, including scleroderma. Dosage: As directed. 

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