Complement deficiencies

General: There is currently no cure for complement deficiencies. Instead, patients receive medications called antimicrobials for infections and/or drugs called immunosuppressants for autoimmune disorders. If the complement deficiency develops as a result of another medical condition, such as liver disease, the disorder will be cured once the underlying cause is treated.

Patients should tell their healthcare providers if they are taking any drugs (prescription or over-the-counter), herbs, or supplements because they may interact with treatments. Also, patients should take medications exactly as prescribed by their doctors. If antimicrobials are discontinued too quickly, the infection may return.

Antimicrobials: Antimicrobial medications are used to treat infections commonly associated with complement deficiencies. Antibiotics are used to treat bacterial infections. Antifungals are used to treat fungal infections. Antivirals are used to treat viral infections. Depending on the type and severity of the condition, these drugs may be applied to the skin, injected into a vein, or taken by mouth. The length of treatment and specific dosages also depend on the type and severity of the infection.

Immunosuppressants: Patients who have autoimmune disorders receive immunosuppressants, such as azathioprine (Imuran® or Azasan®). These medications help reduce the immune response against normal body tissue. This treatment helps reduce symptoms of autoimmunity and helps prevent the immune system from damaging organs. The lowest effective dose should be used because immunosuppressants further weaken the body's immune system, making the patient even more vulnerable to infections.

Intravenous immunoglobulin transfusion (IVIG): Intravenous immunoglobulin transfusion (IVIG) has been used to control the autoimmune process and to boost the body's ability to fight disease. IVIG is made of antibodies extracted from pooled blood donations from hundreds to thousands of donors. IVIG, such as Gamimune N®, Gammagard S/D®, or Sandoglobulin®, is typically injected into the patient's vein for about two to four hours a day for two to seven days. The patient usually receives another single dose every 10-21 days or every three to four weeks, depending on the severity of the condition.

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Probiotics: Probiotics are beneficial bacteria that are sometimes called friendly germs. They help maintain a healthy intestine and aid in digestion. They also help keep harmful bacteria and yeasts in the gut under control. Most probiotics come from food sources, especially cultured milk products. Probiotics can be taken as capsules, tablets, beverages, powders, yogurts, and other foods. Limited evidence with day care children suggests supplementation with Lactobacillus GG may reduce the number of sick days, frequency of respiratory tract infections, and frequency of related antibiotic treatments. Fermented milk (with yogurt cultures and L. casei DN-114001) may reduce the duration of winter infections (gastrointestinal and respiratory), as well as average body temperature, in elderly people.

Probiotics are generally considered safe and well tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant.

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Blessed thistle: Blessed thistle leaves, stems, and flowers have traditionally been used in "bitter" tonic drinks and other preparations that are taken by mouth to enhance appetite and digestion. Blessed thistle may also be included in the unproven anti-cancer herbal remedy Essiac®. Laboratory studies report that blessed thistle and some chemicals in blessed thistle may help fight against several types of bacteria, but have no effects on some types. Reliable human study is lacking. Further evidence is necessary in this area before a firm conclusion can be drawn.

Avoid if allergic to blessed thistle, mugwort, bitter weed, blanket flower, chrysanthemum, coltsfoot, daisy, dandelion, dwarf sunflower, goldenrod, marigold, prairie sage, ragweed, echinacea, or any plants of the Asteraceae or Compositae families. Avoid with history of bleeding diseases or gastroesophageal reflux disease (GERD), or if taking drugs for blood thinning, stroke, stomach diseases, or to control stomach acid. Avoid if pregnant or breastfeeding. Stop use two weeks before surgery/dental/diagnostic procedures with bleeding risk and do not use immediately after these procedures.

Cranberry: Cranberries come from small evergreen shrubs with tart, red, edible berries. The berries are used in sauces, jellies, and drinks. Study results of cranberry as an antibacterial in other conditions show conflicting results. Further study is needed before a conclusion can be drawn.

Avoid if allergic to cranberries, blueberries, or other plants of the Vaccinium species. Sweetened cranberry juice can affect blood sugar levels. Use cautiously with history of kidney stones. Avoid more than the amount usually found in foods if pregnant or breastfeeding.

Garlic: The Garlic bulb is made of many cloves wrapped with a paper-thin, white skin. Fresh or dehydrated garlic is used both medicinally and as a spice in foods. Several studies describe the application of garlic to the skin to treat fungal infections, including yeast infections. Use cautiously because garlic can cause severe burns and rash when applied to the skin of sensitive individuals.

Preliminary research suggests potential benefits of oral plus intravenous garlic in the management of cryptococcal meningitis. Further research is needed before a firm conclusion can be made.

Avoid if allergic or hypersensitive to garlic or other members of the Lilaceae(lily) family (such as hyacinth, tulip, onion, leek, or chive). Avoid with history of bleeding problems, asthma, diabetes, low blood pressure, or thyroid disorders. Stop using supplemental garlic two weeks before dental/surgical/diagnostic procedures and avoid using immediately after such procedures to avoid bleeding problems. Avoid in supplemental doses if pregnant or breastfeeding.

Lavender: Lavender is native to the Mediterranean Peninsula, Arabian Peninsula, Russia, and Africa. Today, lavender is cultivated around the world. Oils from the flowers are used in aromatherapy, baked goods, candles, cosmetics, detergents, jellies, massage oils, perfumes, powders, shampoo, soaps, and tea. Early laboratory studies suggest that lavender oils may have antibiotic activity. However, this has not been well tested in animal or human studies.

Avoid if allergic or hypersensitive to lavender. Avoid with a history of seizures, bleeding disorders, eating disorders (anorexia, bulimia), or anemia (low levels of iron). Avoid if pregnant or breastfeeding.

Probiotics: Probiotics are beneficial bacteria that are sometimes called friendly germs. They help maintain a healthy intestine and aid in digestion. They also help keep harmful bacteria and yeasts in the gut under control. Most probiotics come from food sources, especially cultured milk products. Probiotics can be taken as capsules, tablets, beverages, powders, yogurts, and other foods. There is limited evidence that probiotic supplementation may reduce the presence of harmful bacteria in the upper respiratory tract. More studies are needed to establish this relationship and its implications for health.

Probiotics are generally considered safe and well tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant.

Propolis: Bees produce a natural resin called propolis to make their hives. Propolis is made from the buds of conifer and poplar tress, and it is combined with beeswax and other bee secretions. Today, propolis is commonly found in chewing gum, cosmetics, creams, cough drops, and ointments. Laboratory studies report antiviral activity of propolis. It has shown to help fight against viral infections, such as herpes simplex virus types 1 and 2. Preliminary results from poorly designed human studies suggest propolis used on the skin may improve lesions from genital herpes virus infections. However, without better human study, including comparisons to prescription drugs, firm conclusions cannot be drawn.

Animal and laboratory studies suggest activity of propolis in the treatment of various types of infections. Initial human research reports possible benefits against oral/dental bacteria, genital herpes, urine bacteria, intestinal giardia infections, or H. pylori. Additional research is needed before a recommendation can be made.

Avoid if allergic or hypersensitive to propolis, black poplar (Populas nigra), poplar bud, bee stings, bee products, honey, and Balsam of Peru. Severe allergic reactions have been reported. There has been one report of kidney failure with the ingestion of propolis that improved upon discontinuing therapy and deteriorated with re-exposure. Avoid if pregnant or breastfeeding because of the high alcohol content in some products.

Seaweed, kelp, bladderwrack: Bladderwrack (Fucus vesiculosus) is a brown seaweed found along the northern coasts of the Atlantic and Pacific oceans and North and Baltic seas. Another seaweed that grows alongside bladderwrack is Ascophyllum nodosum; itis often combined with bladderwrack in kelp preparations. Laboratory studies suggest antifungal and antibacterial activity of bladderwrack. However, there are no reliable human studies to support use as an antibacterial or antifungal agent.

Avoid if allergic or hypersensitive to Fucus vesiculosus and iodine. Avoid with history of thyroid disease, bleeding, acne, kidney disease, blood clots, nerve disorders, high blood pressure, stroke, or diabetes. Avoid if pregnant or breastfeeding.

Selenium: Selenium is a mineral found in soil, water, and some foods. Preliminary research reports that selenium can be beneficial in the prevention of several types of infection, including recurrence of erysipelas (bacterial skin infection associated with lymphedema) or Mycoplasma pneumonia. Further research is needed to confirm these results before a clear conclusion can be made.

Avoid if allergic or sensitive to products containing selenium. Avoid with history of non-melanoma skin cancer. Selenium is generally regarded as safe for pregnant or breastfeeding women. However, animal research reports that large doses of selenium may lead to birth defects.

Sorrel: Sorrel has been used as a salad green, spring tonic, diarrhea remedy, weak diuretic (to help eliminate water from the body), and a soothing agent for sore noses. In Turkey, it is used to treat anemia and increase appetite. Sorrel is one of the main ingredients in the combination herbal cancer remedy Essiac® and in the European combination herbal sinus remedy Sinupret®. There are no well-conducted published studies that demonstrate sorrel to possess activity against viruses or bacteria that can infect humans. Further research is needed in this area.

Avoid sorrel if allergic to sorrel (Rumex acetosa) or any member of the Rumex genus or Polygonaceae plant family. Avoid large doses of sorrel because there have been reports of toxicity and death, possibly caused by oxalate found in sorrel. Fatal oxalic acid poisoning has been reported from sorrel soup. Be aware that many tinctures contain high levels of alcohol and should be avoided when driving or operating heavy machinery. These sorrel formulations may cause nausea or vomiting when taken with the prescription drugs metronidazole (Flagyl®) or disulfiram (Antabuse®). Avoid if pregnant or breastfeeding.

DNA analysis: Patients who are suspected carriers of complement deficiencies can undergo genetic testing to determine whether they have the mutated gene. Although carriers do not have the disorder, they may pass the mutated gene to their children.

Genetic counseling: Patients who have complement deficiencies may wish to receive genetic counseling. A counselor will provide information and answer questions about the risk of passing the disorder on to the patient's children. Genetic counseling is also available before and after a genetic test is performed.

Good hygiene: Patients can take precautions to avoid contracting infections associated with the disorder. Patients should thoroughly wash their hands with soap and water, especially after close contact with individuals who have contagious infections. Patients should minimize or avoid close contact with individuals who have contagious illnesses.

Vaccines: Patients should talk with their healthcare providers about recommended vaccines to prevent infections. In general, the meningitis, pneumonia, and flu vaccine are recommended.