Scleroderma (also known as systemic sclerosis) is a chronic autoimmune rheumatic disease affecting the skin and other organs of the body that causes the skin to become thick and hard, causing a buildup of scar tissue, and damage to internal organs such as the heart and blood vessels, lungs, stomach and kidneys. The effects of scleroderma vary widely and range from minor to life-threatening, depending on how widespread the disease is and which parts of the body are affected.
There are two main types of scleroderma:
- Localized scleroderma, which usually affects only the skin, although it can spread to the muscles, joints and bones. It does not affect other organs. Symptoms include discolored patches on the skin (morphea) or streaks or bands of thick, hard skin on the arms and legs (linear scleroderma). Linear scleroderma can also occur on the face and forehead.
- Systemic scleroderma, which is the most serious form of the disease, affects the skin, muscles, joints, blood vessels, lungs, kidneys, heart and other organs.
There are two types of lung disease that patients with scleroderma may develop. The first type is called interstitial lung disease (scarring). The second type of lung disease seen in scleroderma is pulmonary arterial hypertension (high blood pressure in the arteries in the lungs).
The cause of scleroderma is not known. Genetic factors appear to be important in the disease but as in all autoimmune disorders, there are a number of environmental factors that appear to play a role as well. The cause of scleroderma is likely quite complicated. There is no cure for scleroderma but effective conventional treatments for some forms of the disease are available.
Conventional Treatment of Scleroderma
There is no drug that has been clearly proven to stop, or reverse, the key feature of thickening and hardening of the skin. Medications that have proven helpful in treating other autoimmune diseases, such as rheumatoid arthritis and lupus, usually don’t work for people with scleroderma. Doctors focus on decreasing symptoms and preventing further complications with a combination of drugs and self-care.
The following symptoms may be treated as follows:
- Raynaud’s phenomenon is usually treated with drugs such as calcium channel blockers or drugs called PDE-5 inhibitors, such as sildenafil (Viagra®) and tadalafil (Cialis®), which dilate blood vessels to improve circulation.
- Acid reflux is usually treated with antacid drugs, especially PPIs (omeprazole and others).
- Scleroderma kidney disease can be treated with blood pressure medications known as ACE (angiotensin-converting enzyme) inhibitors. These can often control kidney damage if started early.
- Muscle pain and weakness can be treated with anti-inflammatory drugs such as glucocorticoids (prednisone), intravenous immunoglobulin (IVIg), and/or immunosuppressive medications. Physical and occupational therapy may be useful to maintain joint and skin flexibility.
Functional Medicine Management of Scleroderma
A comprehensive approach to the management of complex conditions such as autoimmune disease must take into consideration many aspects of health, including gut barrier integrity and imbalances of gut flora, liver detoxification capacity and toxic burden, hormone imbalances, energy production capacity, nutrient status and most importantly, immune imbalances which promote autoimmune states. More specifically, Functional Medicine approaches autoimmune disease by identifying the triggers and mediators of the autoimmune attacks, minimizing the self-destructive immune responses and enhancing the body’s ability to recover from flare-ups.
There are 4 areas of management of autoimmune conditions in the Functional Medicine approach:
- Identifying and avoiding the triggers of autoimmune responses
- Modulating the autoimmunity and reducing tissue destruction
- Enhancing and supporting recovery from flare-ups
- Addressing associated conditions that promote autoimmune responses
Identifying and avoiding the triggers of autoimmune responses
Lab testing is a critical first step in identifying the extent of systemic inflammation and ruling out many environmental insults which act as triggers and mediators of autoimmunity, such as chronic infection, heavy metal toxicity and decreased capacity to perform liver detoxification.
Food sensitivities can also promote inflammation and potentially drive autoimmune responses.
Identifying and addressing these issues is critical in autoimmune patients to minimize damage and promote restorative function.
Modulating the autoimmunity and reducing tissue destruction
Functional Medicine addresses diet and lifestyle issues as well as using anti-inflammatory and immune-modulating herbs and nutritional compounds to decrease immune responses to self-tissue.
Identifying the triggers of autoimmunity and modulating the immune response can have powerful long-term positive effects on slowing or stopping tissue destruction and improving quality of life.
Enhancing and supporting recovery from flare-ups
There are a number of natural compounds that help support a faster recovery by breaking down offending triggers, increasing blood flow to target tissue, and dampening the immune response.
Addressing associated conditions that promote autoimmune responses
Intestinal permeability promotes autoimmunity
There is growing evidence that increased intestinal permeability plays a pathogenic role in various autoimmune diseases. Increased intestinal permeability and compromised gut integrity appears to precede AI disease and predisposes to immune activation and chronic inflammation. Assessment and proper restoration of the integrity of the intestinal barrier is crucial in managing autoimmune conditions.
The following nutritional interventions are usually used:
Anti-inflammatory and immune-modulating compounds
Anti-inflammatory and immune-modulating herbs and nutritional compounds to decrease excessive immune responses can very often be helpful.
Nutrients to regenerate the epithelial lining
There are various plant compounds, vitamins and minerals that have been shown to have a restorative effect on a damaged intestinal barrier and a proper selection and regime can be very effective.
Nutrients to decrease food sensitivities
Food sensitivities are very common in people with autoimmune disease. Compounds that have been shown to decrease specific immune responses in the gut related to food sensitivity can be helpful.
There is growing evidence that increased intestinal permeability plays a pathogenic role in various autoimmune diseases. Identifying the existence of intestinal permeability and addressing this condition, leads to a more comprehensive and satisfactory outcome in the autoimmune patient.