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Dear Pharmacist,

I am suffering with Sjogren's syndrome, it makes my skin, eyes and mouth so terribly dry. Even sex is painful. Do you have any suggestions that may work for me?

--P.W., Santa Rosa, California

Answer: Sjogren’s syndrome or “SS” mainly affects women and occurs, in part, when white blood cells attack the moisture-producing glands. Think dry- dry eyes and mouth, vaginal dryness, dry skin, joint pain, persistent cough or harm to the kidneys, lungs, liver or GI tract can occur. Temporary relief comes from running humidifiers, taking medicine or using natural herbs. Prescriptions of either “pilocarpine” or Evoxac may help dry eyes/mouth as can inexpensive “artificial tear” eye drops. Immunosuppressant drugs calm a hyperactive immune system, in an attempt to balance a see saw immune system that is severely tilted.

The symptoms of SS are mediated by cytokines (very mean compounds) driven by the “NF-kappa B” pathway, and excessive cytokines cause dryness, pain and inflammation. Some of the cytokines are known as “interleukins” and abbreviated as IL and numbered as in IL-1, IL-13 and IL-4 and so forth in the literature. High TNF alpha and prostaglandins are also part of the painful picture of autoimmune dysregulation. Excessive amounts of this stuff causes unspeakable misery but I know ways to reduce these mean compounds. Soon, you will too. I realize this is complicated, but I insist you have some knowledge so you can research yourself and discuss my ideas with your physician.

A healthy immune system rocks like a see-saw, and it remains in balance with it’s two T-helper armies (Th1 and Th2). With SS, it’s dynamic, it changes and sways this way and that way. Often the see-saw is tilted and the Th2 army dominates thus producing a boatload of those mean cytokines mentioned above. Other Th2 dominant conditions include eczema, BPH, Grave’s, cancer, asthma, infections, fibromyalgia, late Lyme’s, lupus and ulcerative colitis. Certain supplements can calm a Th2 dominant condition by strengthening the Th1 army (that’s usually what you want with SS, but not always). Ask your physician for approval, and carefully note your response. If symptoms worsen, stop immediately.

Green tea or EGCG supplements– Reduces many interleukins including IL-1 (associated with skin) and calms inflammation and sensitivity in your eyes and mouth.

Wise Woman Herbals vaginal suppositories– They contain vitamin E, A and the soothing herb calendula. May relieve vaginal dryness.

Omega 3 fish oils- Helps with dry eyes and mouth. Reduces TNF alpha and prostaglandins.

CoQ10 or Ubiquinol- Improves salivary flow.

Herbal mouth rinses- Great but avoid those containing alcohol or witch hazel, which may aggravate oral dryness.

Prickly ash, slippery elm- Taken as tinctures or tea may stimulate saliva production.

Be mindful that some wonderful supplements aggravate Th2 dominance by strengthening that army: Alfalfa, astragalus, echinacea, ginseng, goldenseal, and licorice root. If you’re condition is Th1 dominant, then these are great. A blood test can determine Th1 vs. Th2 dominance.

Suzy Cohen

Suzy Cohen, is known as America’s Pharmacist. She has been a licensed pharmacist for 24 years and is a Functional Medicine practitioner. She’s the author of 6 books, including her most recent Amazon #1 best-seller, “Thyroid Healthy: Lose Weight, Look Beautiful and Live the Life You Imagine.”

She was the host of The Thyroid Summit which broadcast worldwide in June 2014. Suzy has been a syndicated columnist for 19 years reaching 20 million in circulation each week. She is a Huffington Post writer, and also hosts her own syndicated medical minute on TV. Suzy has been featured on The Dr OZ Show 6 times, and has appeared on The View, Good Morning America Health, The Doctors and hundreds of other networks. She is a member of The Institute of Functional Medicine, also the American Academy of Anti-Aging Medicine, The American Pharmacists Association and ILADS, the International Lyme and Associated Diseases Society. You can read free articles and receive your free newsletter by visiting her website,

Books authored by Suzy Cohen include:

  • Thyroid Healthy
  • Headache Free
  • Drug Muggers
  • Diabetes Without Drugs
  • The 24-Hour Pharmacist
  • Eczema: Itchin’ for a Cure (kindle only)
  • Understanding Pancreatitis & Pancreatic Cancer (kindle only)