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Sarcoidosis

Sarcoidosis is a condition in which groups of immune cells form small, inflamed lumps (granulomas) in the body, most often in the lungs and the lymph nodes in the chest. Many people have mild symptoms or none, and it often goes away on its own; others need medicines, and a few develop lasting organ damage. There is no cure, but treatment aims for remission, and regular check-ups — including eye and heart checks — matter even when you feel well.

Call 911 (or your local emergency number) for chest pain or pressure, or for severe or sudden shortness of breath. MedlinePlus lists chest discomfort and shortness of breath among heart attack symptoms and says to call 911 even if you are not sure (MedlinePlus (opens in a new tab)). NHLBI lists sudden shortness of breath or muscle weakness, kidney failure and cardiac arrest as problems that need immediate medical attention in sarcoidosis (NHLBI (opens in a new tab)).

Fainting, heart palpitations or an irregular heartbeat are listed by NHLBI among the symptoms of sarcoidosis (NHLBI (opens in a new tab)). Heart involvement is rare but can be life-threatening (NHLBI (opens in a new tab)); an expert consensus statement describes complications such as heart block, dangerous rhythms, heart failure and sudden cardiac death (PubMed (opens in a new tab)). Do not wait for a routine appointment.

Eye pain, redness, blurred vision, new floaters or sensitivity to light need an eye doctor right away. NHLBI lists these symptoms (NHLBI (opens in a new tab)), and the National Eye Institute says inflammation inside the eye (uveitis) can cause vision loss if it is not treated (National Eye Institute (opens in a new tab)).

New nerve or brain symptoms — seizures, new vision problems, severe headache, dizziness, numbness or tingling — are among the nervous-system problems NHLBI and MedlinePlus list (MedlinePlus (opens in a new tab), NHLBI (opens in a new tab)), and NHLBI says to watch for warning signs that may need emergency care (NHLBI (opens in a new tab)), so tell your doctor right away. In a review of more than 1,000 people with sarcoidosis of the nervous system, the most common problem was a cranial nerve (head-and-face nerve) problem, most often involving the facial and optic nerves (PubMed (opens in a new tab)). But sudden face drooping, arm weakness or slurred speech can also be a stroke — call 911 at once (NHS (opens in a new tab)). See our Stroke guide.

Signs of too much calcium in the blood (hypercalcemia) can occur in sarcoidosis. Mild high calcium is often silent; severe or fast-rising high calcium can cause nausea, vomiting, dehydration, confusion and drowsiness (PubMed (opens in a new tab)). Sarcoidosis can also cause kidney stones (NHS (opens in a new tab)). Get same-day medical care for these symptoms.

Nothing on this page is a reason to delay emergency care. Never wait for a chiropractic, acupuncture or massage appointment, or try an herb or supplement first, if you have any warning sign above.

What is sarcoidosis?

Sarcoidosis develops when groups of immune-system cells form red, swollen (inflamed) lumps called granulomas in various organs (NHLBI (opens in a new tab)). It can affect any organ, but it most often affects the lungs and the lymph nodes in the chest (NHLBI (opens in a new tab)). The NHS calls it a rare condition (NHS (opens in a new tab)). Over time, inflammation may leave permanent scarring in an organ (NHLBI (opens in a new tab)).

The reassuring part: not everyone needs treatment, sometimes the condition goes away on its own, and many people recover with few or no long-term problems (NHLBI (opens in a new tab), NHLBI (opens in a new tab)). The NHS says that for many people symptoms improve without treatment within a few months or years (NHS (opens in a new tab)). The honest part: sometimes scarring (fibrosis) develops in the lungs or other organs and can lead to life-threatening heart or lung problems (NHLBI (opens in a new tab)), and a few people have a long-lasting form called chronic sarcoidosis (NHS (opens in a new tab)). There is no cure; the goal of treatment is remission, meaning the condition is still there but does not cause problems (MedlinePlus (opens in a new tab)).

Who gets it, and why?

The exact cause is not known (NHS (opens in a new tab)). Studies suggest that some immune triggers — symptom-free infections or substances in the environment — can lead to sarcoidosis in certain people, and genes can affect how the immune system reacts (NHLBI (opens in a new tab)). It is not infectious and cannot be passed from person to person (NHS (opens in a new tab)).

  • Age and sex. It can start at any age, and risk rises with age, especially after 55 (NHLBI (opens in a new tab)). The NHS says it usually starts in adults aged 30 to 40, is rare in childhood, and is more common in women (NHS (opens in a new tab)).
  • Ancestry and family. Risk is higher for people of African or Scandinavian descent and for people with a close relative who has it (NHLBI (opens in a new tab)).
  • Environment and work. Living or working near insecticides, mold or other substances that may cause inflammation raises risk; examples include health care, the automotive industry, farming and firefighting (NHLBI (opens in a new tab)).
  • Some medicines. Certain HIV medicines and monoclonal antibodies used for cancer or an overactive immune system can raise the risk (NHLBI (opens in a new tab)).

Where it shows up

Symptoms depend on which organs are involved, so the picture varies widely (NHS (opens in a new tab)). Many people have no symptoms at all and it is found on a chest X-ray done for another reason (NHS (opens in a new tab), NHLBI (opens in a new tab)). General symptoms can include fatigue, weight loss, swollen lymph nodes, depression, fever and night sweats (MedlinePlus (opens in a new tab)).

Löfgren’s syndrome is a classic starting pattern: swollen lymph nodes in the chest (or neck, armpits or groin), the erythema nodosum rash, eye symptoms, joint pain and fever. It is most common in women aged 30 to 40 and usually goes away completely within 2 years (NHLBI (opens in a new tab), MedlinePlus (opens in a new tab)).

How it is diagnosed

There is no single test, and the symptoms resemble many other conditions, which makes sarcoidosis hard to diagnose (MedlinePlus (opens in a new tab)). The American Thoracic Society describes three main criteria: a compatible clinical picture, inflamed tissue lumps (nonnecrotizing granulomas) found in a tissue sample, and the exclusion of other causes of granulomas — so the diagnosis “is never fully secure” (PubMed (opens in a new tab)). NHLBI says diagnosis rests on symptoms, a physical exam, and imaging or a biopsy, after other conditions are ruled out. There are no screening tests to tell who will develop it (NHLBI (opens in a new tab)).

  • Imaging. A chest X-ray looks for granulomas or scarring and helps determine the stage; MRI or ultrasound can look at the heart, eyes and lymph nodes (NHLBI (opens in a new tab)). The NHS adds CT scans of the lungs (NHS (opens in a new tab)). Stages describe where granulomas are and whether there is scarring; stage IV, permanent lung scarring, is the most serious (NHLBI (opens in a new tab)).
  • Biopsy. A tissue sample from the skin, lymph nodes, lungs or another affected organ may confirm the diagnosis, often through a bronchoscopy for lung or chest lymph node samples (NHLBI (opens in a new tab)).
  • Blood tests check blood counts, hormone levels and kidney function (NHLBI (opens in a new tab)). The American Thoracic Society made a strong recommendation for baseline blood calcium testing (PubMed (opens in a new tab)).
  • Organ checks once diagnosed: lung function tests, eye exams, heart tests such as ECG, echocardiography or cardiac MRI, and nerve tests where needed (NHLBI (opens in a new tab)).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

Sarcoidosis: six approaches compared
ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Diagnosis by exam, imaging and often a biopsy, then monitoring. Many people need no treatment. When treatment is needed: corticosteroids first, then other immune-lowering medicines, with treatment of any organ complications, regular eye and heart checks, vaccines and attention to fatigue. Medicare Part B covers medically necessary outpatient therapy: after the Part B deductible you pay 20% of the Medicare-approved amount. Other costs: being researched. Sometimes the condition goes away on its own. Steroids and other immune-lowering medicines can cause side effects and raise infection risk, so you are monitored. Flares are most likely within six months of stopping treatment.
Chiropractic No role in treating sarcoidosis. We found little research on chiropractic care for it. Gentle care for ordinary back or neck pain is a separate question. About $55 to $100 per follow-up visit paying cash, per The Pricer. Medicare covers only spinal adjustments for a subluxation. Joint or bone pain can be part of sarcoidosis, so report it to your doctor first. Long-term steroids can thin bones; ask about avoiding forceful adjustments. Serious side effects from spinal manipulation are very rare.
Acupuncture No role in treating the disease itself. We found little research on acupuncture for sarcoidosis; some people try it for comfort or stress. About $90 to $185 per follow-up visit paying cash, per The Pricer. Medicare covers acupuncture only for chronic low back pain. Done properly it is generally low risk, but immune-lowering medicines make infections more likely: insist on sterile single-use needles and skip sessions when you are ill.
Herbal medicine Mostly a question of safety. No herb or supplement has been shown to treat sarcoidosis. Calcium, vitamin D and vitamin A supplements can raise blood calcium, which is already a risk in this condition. Cost estimate being researched. Use calcium or vitamin D only if your doctor advises it. Tell your doctor and pharmacist about every product; some herbs interact with medicines, and products sold to “boost immunity” are not proven.
Massage therapy Gentle, relaxing massage for stress and sore muscles once your care team agrees. We found little research on massage for sarcoidosis. One national chain: about $70 to $90 a month on a 12-month membership, per The Pricer. Medicare does not cover massage therapy. Risk is low overall; rare serious problems come mainly from vigorous massage. Avoid pressure on tender skin bumps and use a lighter touch if you take long-term steroids.
MBHA Wellness Coach The daily habits that help: staying as active as you can, quitting smoking and avoiding lung irritants, sleep, stress and mood, pacing around fatigue, and keeping appointments and medicines on track. Cost estimate being researched. Supports — never replaces — your medical care. Small trials suggest exercise and mindfulness may ease fatigue, though results are mixed.

Approach 1 of 6

Conventional medicine (AMA)

Sarcoidosis is usually managed by a lung specialist (pulmonologist) or another specialist depending on the organs involved, working with your primary care provider. Treatment depends on your symptoms, which organs are affected and whether those organs are working well (NHLBI (opens in a new tab)). Not everyone needs treatment (NHLBI (opens in a new tab)).

Watchful waiting

If the disease is not getting worse, you may simply be watched to see whether it goes away on its own (NHLBI (opens in a new tab)). The NHS says this monitoring can include regular X-rays, breathing tests and blood tests, and that simple lifestyle changes and over-the-counter painkillers are often all that is needed for flare-up pain (NHS (opens in a new tab)). Even without symptoms, NHLBI says to keep seeing your provider for ongoing care (NHLBI (opens in a new tab)).

Medicines, by class (no doses here — your doctor decides)

  • Corticosteroids (steroids). Prednisone is the most common treatment, taken as pills or given by injection, inhaler, eye drops or skin creams (NHLBI (opens in a new tab)). The NHS says you may start with a higher amount for a short time, then switch to a lower amount for the months or years that follow, with monitoring (NHS (opens in a new tab)). The European Respiratory Society says steroids remain the first choice for symptomatic disease, but prolonged use brings significant toxicity, and steroid-sparing alternatives are available (PubMed (opens in a new tab)). Side effects of pills can include high blood sugar or blood pressure, mood changes, weight gain and appetite; they also raise the risk of cataracts, glaucoma and osteoporosis, and inhaled steroids can cause a hoarse voice or mouth thrush (NHLBI (opens in a new tab)). Because of these, the NHS says steroid tablets are only used when necessary (NHS (opens in a new tab)). A Cochrane review (searches current to 2004, so an older one) found oral steroids improved chest X-ray findings over 3 to 24 months in three studies (the authors urged cautious interpretation), with little evidence of improved lung function and limited data beyond two years (Cochrane review via PubMed (opens in a new tab)).
  • Medicines that lower the immune response. NHLBI lists drugs also used for severe rheumatoid arthritis (methotrexate, azathioprine, leflunomide), whose side effects may include liver damage or blood problems; biologic medicines (monoclonal antibodies such as infliximab, adalimumab, rituximab and golimumab), given by shot or IV, with rare but serious side effects including a life-threatening immune reaction, heart problems, low blood counts or higher risk of certain cancers; and medicines used for malaria (hydroxychloroquine, chloroquine), whose side effects may include eye damage, heart problems and low blood sugar (NHLBI (opens in a new tab)). Immune-lowering medicines can raise the risk of infections (NHLBI (opens in a new tab)). A Cochrane review of these drugs found limited supporting evidence and severe side effects with some (Cochrane review via PubMed (opens in a new tab)). A 2025 trial of 138 people with untreated lung sarcoidosis found a methotrexate-first approach “noninferior” to prednisone for lung capacity at 24 weeks, with different side-effect patterns (PREDMETH trial, NEJM 2025 (opens in a new tab)).
  • Other medicines. A hormone medicine (corticotropin) by shot when prednisone fails or has serious side effects; pentoxifylline, a pill normally used for blood flow; antibiotics for skin sarcoidosis; and colchicine for joint pain (NHLBI (opens in a new tab)).

Treating complications

If untreated, or if treatment does not work, sarcoidosis can cause serious problems (NHLBI (opens in a new tab)). Depending on the organ: inhaled corticosteroids, oxygen therapy and pulmonary rehabilitation for the lungs; treatment for pulmonary hypertension; an implantable cardioverter defibrillator (ICD) to help prevent cardiac arrest, and blood pressure medicines for the heart; lifestyle changes for high calcium; anti-seizure medicines, nerve-pain medicines and physical therapy for the nervous system and muscles; and, for life-threatening lung, heart or liver damage, a transplant (NHLBI (opens in a new tab)).

Flares and long-term follow-up

If you reach remission your doctor may carefully stop medicines, but flares can happen, most often within six months of stopping treatment; the longer you are symptom-free, the less likely a flare is (NHLBI (opens in a new tab)). Some people have sarcoidosis that persists or returns for many years, and tests keep track of it and check for complications (NHLBI (opens in a new tab)). See the sections below on Eye, heart and other check-ups, Infections and vaccines, Fatigue and Calcium and vitamin D. The NHS notes that clinical teams pass information on people with sarcoidosis to a national rare disease register, which helps researchers, and that you can opt out at any time (NHS (opens in a new tab)).

Cost and coverage: Medicare Part B covers medically necessary outpatient physical therapy when your provider certifies you need it; after the Part B deductible you pay 20% of the Medicare-approved amount, with no yearly limit on medically necessary therapy (Medicare.gov (opens in a new tab)). Other costs: being researched.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Chiropractic care has no role in treating sarcoidosis, which is an immune-system condition (NHLBI (opens in a new tab)). We found little research on chiropractic care for sarcoidosis itself. A 2022 systematic review of treatments for sarcoidosis with joint and muscle involvement found no controlled studies of any non-drug treatment; only ten patients in one uncontrolled study had used non-drug treatments, including occupational therapy, chiropractic and acupuncture (PubMed (opens in a new tab)).

  • Joint and bone pain can be sarcoidosis. Joint pain and swelling, bone pain and muscle pain are listed symptoms (NHLBI (opens in a new tab), NHS (opens in a new tab)). Tell your doctor about new or worsening pain rather than assuming it is a back problem.
  • Steroid-thinned bones. Long-term steroid use can cause osteoporosis (NHLBI (opens in a new tab), NHS (opens in a new tab)). Serious side effects from spinal manipulation, including problems of the spine or nerves and strokes involving neck arteries, are very rare, but may be more likely in people with underlying health problems that raise their risk of injury (NCCIH (opens in a new tab)). MBHA suggests avoiding forceful (high-velocity) adjustments if you take long-term steroids or have bone thinning, and asking your doctor first. See our Osteoporosis guide.
  • Tell the chiropractor about your diagnosis, every medicine and every supplement (NCCIH (opens in a new tab)).

Cost and coverage: a self-pay follow-up visit typically costs about $55 to $100, and a first visit about $90 to $200 (The Pricer (opens in a new tab)). Medicare covers only spinal adjustments to correct a subluxation (Medicare.gov (opens in a new tab)).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture does not treat sarcoidosis itself, and we found little research on it for this condition (see the 2022 review above, which found only a small uncontrolled report of its use (PubMed (opens in a new tab))). Some people try it for comfort, stress or aches; that is a personal choice to make alongside your care, not a substitute for it.

  • Infection risk matters more here. Immune-lowering medicines can raise the risk of infections (NHLBI (opens in a new tab)). Acupuncture complications have resulted from nonsterile needles and improper treatment; the FDA requires needles to be sterile and labeled for single use (NCCIH (opens in a new tab)). Ask the practitioner to open a new sterile needle for every session, and MBHA suggests rescheduling if you have a fever or infection.
  • Serious problems from poor technique can include infections, punctured organs and injury to the central nervous system (NCCIH (opens in a new tab)). MBHA suggests that if you have lung scarring or lung symptoms, you ask your doctor before needles are placed near the chest or upper back.

Cost: about $90 to $185 per private follow-up and $125 to $230 for a first private visit, or $50 to $90 at community clinics (The Pricer (opens in a new tab)). Medicare covers acupuncture only for chronic low back pain (Medicare.gov (opens in a new tab)).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

No herb or supplement has been shown to treat sarcoidosis. We found little research on herbal remedies for it; the 2022 review above found no controlled studies of non-drug treatments for the joint and muscle form (PubMed (opens in a new tab)). With sarcoidosis, the question is mostly safety.

  • Calcium, vitamin D and vitamin A. Hypercalcemia has several causes, including granulomatous disease such as sarcoidosis, and supplements such as calcium, vitamin D or vitamin A (PubMed (opens in a new tab)). That means taking them on your own can add to a risk the disease already carries. The NHS says to take calcium or vitamin D only if a doctor advises it (NHS (opens in a new tab)). See Calcium and vitamin D below.
  • “Immune boosters.” NCCIH notes that strong evidence for supplement claims is often lacking, and that a 2022 review found rigorous human studies for only eight of 27 ingredients commonly promoted for immune function, with none strong enough for definite conclusions (NCCIH (opens in a new tab)). NCCIH says there are theoretical reasons to suspect echinacea might interact with immunosuppressants (NCCIH (opens in a new tab)).
  • St. John’s wort can interact dangerously with many medicines, including cyclosporine, which prevents transplant rejection (NCCIH (opens in a new tab)). Check with your doctor and pharmacist before using it or any herbal product alongside your medicines.
  • Hidden ingredients and interactions. Supplements may interact with your medications or pose risks with certain medical problems, and some products (mainly those promoted for weight loss, sexual enhancement and bodybuilding) may contain ingredients not allowed or not listed on the label (NCCIH (opens in a new tab)).

Bring every bottle to your appointments. See our Medication Safety & Interactions guide. Cost: cost estimate being researched.

Approach 5 of 6

Massage therapy

Massage does not treat sarcoidosis, and we found little research on it for this condition. It may still help with stress, muscle tension and general comfort. NCCIH says the risk of harm from massage appears low, though there are rare reports of serious side effects such as a blood clot, nerve injury or bone fracture, some involving vigorous types such as deep tissue massage or people at higher risk of injury (NCCIH (opens in a new tab)).

  • Skin. Sarcoidosis can cause tender, painful skin bumps (NHS (opens in a new tab), NHLBI (opens in a new tab)). MBHA suggests the therapist avoid pressure on them.
  • Bones. Long-term steroids can thin bones (NHLBI (opens in a new tab)). MBHA suggests a lighter touch and no forceful pressure if you take steroids long-term.
  • Swollen glands. Swollen lymph nodes are a common sign (NHLBI (opens in a new tab)); tell your doctor about any new lump or swelling rather than having it massaged.
  • Leg swelling or pain. A blood clot is one of the rare serious side effects NCCIH lists (NCCIH (opens in a new tab)). MBHA suggests not massaging a swollen, painful leg and getting it checked first.

Cost and coverage: one national chain charges about $70 to $90 a month on a 12-month membership (The Pricer (opens in a new tab)). Medicare does not cover massage therapy (Medicare.gov (opens in a new tab)).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

NHLBI says a healthy lifestyle may help you feel better and prevent sarcoidosis from getting worse (NHLBI (opens in a new tab)). An MBHA Wellness Coach can help you build the habits — alongside, never instead of, your medical team.

  • Stay as active as you can. Extreme tiredness can make exercise hard, but physical activity can improve energy and help with shortness of breath and muscle weakness; ask your doctor what level is right for you (NHLBI (opens in a new tab)). Expert consensus suggests considering physical training for symptomatic people, though the best program is still undefined (PubMed (opens in a new tab)). A meta-analysis of five studies (184 people) found pulmonary rehabilitation improved exercise capacity and breathlessness, but not fatigue, quality of life or lung function (PubMed (opens in a new tab)).
  • Quit smoking and avoid lung irritants such as dust, chemicals and secondhand smoke. The National Cancer Institute Smoking Quitline is 1-877-44U-QUIT (NHLBI (opens in a new tab)).
  • Sleep. Experts recommend 7 to 9 hours of sleep for adults (NHLBI (opens in a new tab)). See our Sleep Problems guide.
  • Everyday basics. The NHS lists a balanced diet, a healthy weight, stress reduction, regular exercise and enough sleep as lifestyle measures that may help (NHS (opens in a new tab)).
  • Mood and loneliness. Sarcoidosis may make you feel lonely, anxious or depressed, and tiredness may linger after treatment ends. Counseling (particularly cognitive therapy), a patient support group and family support can help; ask your doctor about antidepressants or other treatments (NHLBI (opens in a new tab)). See our Depression guide.
  • Mind-body practices. In a 99-person trial, 12 weeks of online mindfulness-based cognitive therapy lowered fatigue scores more than the comparison group, and improved anxiety and depression (PubMed (opens in a new tab)). In a small trial of 34 people with stage II lung sarcoidosis, scores for fatigue, breathlessness and quality of life improved after 8 weeks of either telehealth yoga or conventional physiotherapy, each added to standard aerobic training; there was no untreated comparison group (PubMed (opens in a new tab)).
  • Keep a symptom and medicine log for appointments. NHLBI suggests bringing a list of symptoms and telling your provider about work or home exposures to insecticides or mold (NHLBI (opens in a new tab)).

Cost: cost estimate being researched.

Another approach

Eye, heart and other check-ups

Sarcoidosis can quietly affect organs, so check-ups are part of care even when you feel fine. NHLBI says eye exams look for eye damage that can occur without symptoms, and that lung function tests, heart tests (ECG, echocardiography, cardiac MRI) and nerve tests may be used (NHLBI (opens in a new tab)).

  • Eyes. Uveitis is inflammation inside the eye. A dilated eye exam is how eye doctors check for it, and eye drops, pills or injections of steroids are common treatments (National Eye Institute (opens in a new tab)). Because steroids can raise the risk of cataracts and glaucoma, the National Eye Institute says regular eye exams matter if you take them for uveitis (National Eye Institute (opens in a new tab)). NHLBI also lists cataracts and glaucoma as steroid risks and eye damage as a possible side effect of the malaria-type medicines (NHLBI (opens in a new tab)). Ask your doctor how often you need an eye exam. See our Eyes guide.
  • Heart. Cardiac sarcoidosis is uncommon but serious (NHLBI (opens in a new tab)). An ECG and echocardiogram have been recommended as screening for people with biopsy-proven sarcoidosis outside the heart, but in one study of 112 such people, 6 of the 33 with normal results on both tests (about 1 in 5) still had cardiac sarcoidosis on PET and MRI scans (PubMed (opens in a new tab)). So tell your doctor about palpitations, fainting or breathlessness even if earlier heart tests were normal. Fainting has many causes, but heart problems are one of them, so see a provider to find out why (MedlinePlus (opens in a new tab)).
  • Lungs. Lung function tests and imaging track how the lungs are doing (NHLBI (opens in a new tab), NHS (opens in a new tab)).
  • Bones. If you take steroids for a long time, ask about protecting your bones (NHS (opens in a new tab)). See the Calcium and vitamin D section.

Another approach

Infections and vaccines

Immune-lowering medicines can raise the risk of infections (NHLBI (opens in a new tab)). A 2020 review of infection prevention in sarcoidosis says people receiving immunosuppressive medicines are at increased risk of infection, and also notes that low lymphocyte counts are commonly seen in sarcoidosis (PubMed (opens in a new tab)). From that review:

  • New patients should be screened for vaccination status, and appropriate vaccines given before starting immune-lowering therapy.
  • If you are already on immune-lowering medicine, therapy need not be held to give inactivated (“killed”) vaccines. The response may be lower but is still protective.
  • Live vaccines on immune-lowering medicines need careful thought to be sure benefits outweigh risks, and the medicine may have to be held beforehand.
  • Vaccinating household members and close contacts is worth discussing.

The specific vaccine schedule changes over time, so ask your care team what you are due for. Also contact your provider promptly for fever, a new cough or other signs of infection, especially while on immune-lowering medicine.

Another approach

Fatigue

Fatigue is among the general symptoms of sarcoidosis (MedlinePlus (opens in a new tab)), and NHLBI notes you may continue to feel very tired even after treatment ends (NHLBI (opens in a new tab)). Dutch researchers describe it as often reported as the most burdensome symptom and say evidence-based therapies are lacking (PubMed (opens in a new tab)). The European Respiratory Society guideline includes a recommendation on fatigue (PubMed (opens in a new tab)).

  • What has some evidence: exercise training (see the Wellness Coach section), and online mindfulness-based cognitive therapy, which reduced fatigue scores more than the comparison group in a 99-person trial (PubMed (opens in a new tab)). An 18-person randomized trial of supervised exercise in stage 3 and 4 disease reported less fatigue than usual care (PubMed (opens in a new tab)). But a meta-analysis of five rehabilitation studies found no change in fatigue (PubMed (opens in a new tab)), so results are mixed.
  • Medicine: a small, crossover trial of 10 people on sarcoidosis therapy found a stimulant medicine improved fatigue scores (PubMed (opens in a new tab)). That is a doctor’s decision.
  • Ask your doctor what else may be adding to it. Sarcoidosis can bring loneliness, anxiety or depression (NHLBI (opens in a new tab)), and steroids can cause mood changes (NHLBI (opens in a new tab)). See our Chronic Fatigue guide.

Another approach

Calcium and vitamin D

This is the one supplement area where sarcoidosis is different. Granulomatous diseases such as sarcoidosis can cause high blood calcium, as can calcium, vitamin D and vitamin A supplements (PubMed (opens in a new tab)). A 2026 Chest article notes that people with sarcoidosis often need supplementation for bone health, but that it may theoretically raise the risk of high calcium in the blood and urine, and uses four patient scenarios to show how difficult these decisions can be (PubMed (opens in a new tab)).

  • Blood calcium is checked as part of diagnosis (PubMed (opens in a new tab), NHLBI (opens in a new tab)).
  • The NHS says calcium or vitamin D supplements can help reduce the risk of osteoporosis from long-term steroids, but only take them if a doctor advises it, and that people taking steroids may have a higher risk of complications such as kidney stones (NHS (opens in a new tab)).
  • If you have too much calcium in the blood or urine, NHLBI says treatment can include avoiding too much sunlight, drinking plenty of fluids and eating fewer high-calcium foods (NHLBI (opens in a new tab)). Do not change these on your own; your doctor will tell you whether they apply.

Another approach

Pregnancy

Most women with sarcoidosis give birth to healthy babies, but they have a higher risk of certain complications: heavy bleeding after birth, preterm delivery, preeclampsia and blood clots in the lungs or deep veins (NHLBI (opens in a new tab)). If you are pregnant or planning to be, talk with your doctor; get good prenatal care and regular sarcoidosis checkups, and tell your doctor about all your medicines, because some are not safe in pregnancy (NHLBI (opens in a new tab)). See our Pregnancy guide.

Another approach

Questions to ask at your next visit

Member stories

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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