Lymph system disease

Category: Illness or disabilities

Type

Involuntary

Introduction and description

The lymph system is an extensive network of vessels that resemble veins, but which are not either arteries or veins. 

Along with these larger organs are numerous little sacs called lymph nodes.  This network of conduits called lymphatic vessels carry the lymph unidirectionally towards the heart.

There are between five and six hundred lymph nodes in the human body, many of which are grouped in clusters in different regions as in the underarm and abdominal areas. Lymph node clusters are commonly found at the base of limbs (groin, armpits) and in the neck, where lymph is collected from regions of the body likely to sustain pathogen contamination from injuries.

The lymph system is a closed system.  Fluid enters through the walls of lymphatic vessels, which can stretch to hold more fluid as necessary.  The lymphatic system has no heart to pump lymph round the body.  Lymphatic vessels can contract, but the circulation of lymph depends mainly on external pressure, lymph is squeezed along vessels by the pressure associated with breathing, intestinal movements and the movements of skeletal muscles.

Names, names, names

In examining diseases of the lymph system it makes no sense to separate the various connecting organs, despite the fact that many medical textbooks do. 

The lymph system is a system and as such if one part goes wrong it affects all the other parts. 

The numerous names given to the various symptom combinations of disease of the lymph system also simply confuse the issue, names like Lymphadenopathy, which refers to  enlarged lymph nodes; Lymphedema which is the swelling caused by the accumulation of lymph; Lymphangiomatosis which describes cysts or lesions on lymphatic vessels.  Then we have Lymphoma which refers to a tumour -  leukemias and lymphomas are now considered to be tumors of the same type. They are called "leukemia" when in the blood or marrow and "lymphoma" when in lymphatic tissue.

Lymphangiosarcoma is a malignant soft tissue tumor, whereas lymphangioma is a benign tumor. Lymphangioleiomyomatosis is another sort of  benign tumor.  And so it goes on. 

Purpose of the system

There are four main but inter-related purposes of the lymph system.  In order to understand these it may help to read the description in the Science section that describes the Immune system.

Defence against disease

Functionally the lymph system plays a key part in our defences against disease:

• The lymph nodes produce and store the white blood cells called lymphocytes and also  filter out foreign particles, bacteria and dead tissue before these enter the blood stream

• The adenoids and the tonsils - are our first line of defence against pathogens that enter through the nose and mouth.  They both contain antigen producing cells, so to remove these organs is madness - utter madness.  All sorts of infections - ear, nose and throat - can result if these are damaged or removed...

• The spleen stores an emergency supply of blood as well as being a store of white blood cells.  The spleen also makes antibodies and removes antibody-coated pathogens.

• 

   
  Bone marrow is responsible for both the creation of T cells and the production and maturation of B cells. From the bone marrow, B cells immediately join the blood system and travel to secondary lymphoid organs in search of pathogens. T cells, on the other hand, travel from the bone marrow to the thymus, where they are allowed to develop further. Mature T cells join B cells in search of pathogens.
  
  
• The appendix  - supplies a back up store of bacteria for the Intestine.  The Intestine is totally dependent upon its flora both to function and to provide a first line of defence against pathogens, as such those without an appendix are at some risk. "When we get a severe gut infection such as cholera ....., the beneficial bacteria in our gut are depleted. The appendix allows them to be restored"

... an interesting finding.  It is worth noting that the appendix has 'substantial lymphatic tissue', as such it may have more roles, not yet discovered.

Route of repair and signalling

The lacteals into which fatty acids are absorbed in the small intestine are small branches of the lymphatic system and also the main route by which cholesterol makes its way into the blood. The enriched lymph originating in the lymphatics of the small intestine is called chyle.

Cholesterol is an essential structural component of animal cell membranes, and the raw material for the manufacture of Vitamin D.  Without cholesterol we may become infertile, our sex drive may lower, and we will be Vitamin D deficient.  The lymphatic system also transports substances such as fatty acids, and some enzymes.  Both cholesterol and fatty acids are cell repair substances, thus the lymph system is the major route by which repair substances can get to cells after attack.

Immune system signalling

The lymph system appears to be a pathway for certain hormones which act as immune system regulators.  Hormones can thus act as immunomodulators, altering the sensitivity of the immune system. For example, female sex hormones are known immunostimulators.   By contrast, male sex hormones such as testosterone seem to be immunosuppressive.   Other hormones appear to regulate the immune system as well, most notably prolactin and growth hormone.   It is unclear from research which hormones are to be found in the lymph system, but there is enough evidence that hormones are present.  The key question remaining is which hormones.  

It has been shown that hormones and related substances are present in the lymph draining from the ovary, testis, adrenal and thyroid (Daniel, Gale & Pratt, 1963).  In addition, insulin is present in the lymph of the thoracic duct (Daniel & Henderson, 1966).  As such the lymph sytem may be a very major supplier of hormones to the body in addition to the blood circulatory system.

Removal and transport of interstitial fluid

Mammalian cells are bathed in a fluid called tissue fluid.  This fluid forms the immediate environment of the cells, it is the source of water, oxygen and nutrients.  It also receives excretory substances from the cells.  The chemical composition, temperature and pH of the tissue fluid are very important to the cells.  If the conditions are unsuitable, a cell may not function efficiently or it may even die.  

Most tissue fluid is recycled via the blood circulatory system.  Blood at the arterial end of a capilary is under high pressure and this pressure is sufficient to force water and nutrients into the spaces between cells.  Blood pressure at the venous end of the capillaries is much lower and the reverse process takes place as water, salts and waste products flow back into the capillary.  

But not all tissue fluid circulates back into the venous ends of capillaries.  Some of its drains into the lymphatic system.

Symptoms

I think it should be apparent from the section on the purposes of the lymph system, that any problems with the system is going to affect every part of the body causing anything from infertility to heart disease. 

But there are immediate symptoms which tell you that something is wrong with your lymph system.

When the lymph system becomes damaged or blocked or is being attacked by a pathogen, a number of symptoms may become immediately evident.

Swelling and tenderness - If a pathogen attacks the body the lymph system firstly produces white blood cells often very rapidly and these then become active engulfing bacteria or viruses and secreting antibodies to kill them.  The accumulation of white blood cells and dead or engulfed pathogens can cause the lymph nodes to become swollen and tender.  The adenoid, for example, also known as a pharyngeal tonsil or nasopharyngeal tonsil, is a mass of lymphatic tissue situated posterior to the nasal cavity, in the roof of the nasopharynx, where the nose blends into the throat. 

An enlarged adenoid can become nearly the size of a ping pong ball and completely block airflow through the nasal passages. Even if the enlarged adenoid is not substantial enough to physically block the back of the nose, it can obstruct airflow enough so that breathing through the nose requires an uncomfortable amount of work, and inhalation occurs instead through an open mouth. The enlarged adenoid can also obstruct the nasal airway enough to affect the voice without actually stopping nasal airflow altogether.

Oedema - Lymph vessels can be blocked by a number of pathogens or by damage.  This can result in a build up of lymph and tissue fluid which can cause oedema or it can become much worse causing massive swelling of tissues. 

The effect of blocked lymph vessels can be seen in people suffering from elephantiasis.  In this case the blocking agent is a parasite called Wucheria bancrofti which most commonly affects the legs.

White urine - Chyluria - also called chylous urine, is a medical condition involving the presence of chyle in the urine stream, which results in urine appearing milky white.  It is caused by a blockage in the lymph system.  Once the lymph channels are blocked, one may open into the kidney hilum or ureter or sometimes into the bladder and chyle can leak into the urinary tract resulting in milky white urine. Blood sometimes mixes with the urine resulting in haemato-chyluria.

 Skin eruptions and disease - one of symptoms which is often missed, because the connection between it and the lymph system is not understood, is psoriasis.  Where the lymph system is damaged or blocked via surgery or a pathogen, inflammation will occur followed by weeping of the lymph fluid out of the area via the skin.  Eczema can follow a similar pattern and for the same reasons.

A number of skin diseases may follow the same pattern - the lymph system may be blocked by pathogens or the lymph nodes may be swollen as a result and acne, spots, pimples and bumps may then appear. 

 

Fungal infections, nail pitting and ridging - A person with a damaged lymph system is in effect immunocompromised in those areas to which the lymph cannot reach and fungal infection often occurs on the skin and in the nails.  Trichosporon for example,  is a genus of anamorphic fungi. All species of Trichosporon are yeasts. Most are typically isolated from soil, but several species occur as a natural part of the skin microbiota of humans and other animals. 

In effect, the fall may have damaged her lymph system and with a damaged lymph system, infection set in.  You can see that in the cases of elephantiasis shown above there is not just swelling, but fungal infection as well.

Causes

The main causes of the diseases of the lymph system are as follows

Parasites

A number of parasites are known causes of lymph system diseases, but one of the most vicious cause what is called Lymphatic filariasis - Filariasis (or philariasis) - a parasitic disease caused by an infection with roundworms of the Filarioidea type. These are spread by blood-feeding black flies and mosquitoes.

Bacteria infection

Bacterial infection of any sort can result in swelling of the lymph nodes closest to the infection.  Thus a swollen lymph node in these cases is itself a symptom of a series infiltration of a pathogen.

For example; Cat-scratch disease (CSD) is a bacterial infection spread by cats. The disease spreads when an infected cat licks a person's open wound, or bites or scratches a person hard enough to break the surface of the skin. About three to 14 days after the skin is broken, a mild infection can occur at the site of the scratch or bite. The infected area may appear swollen and red with round, raised lesions and can have pus.  Later, the person's lymph nodes closest to the original scratch or bite can become swollen, tender, or painful.

But many other bacteria are implicated

Viruses

Again, because the lymph system is a part of the immune response to a pathogen, swelling or tenderness in an area in which lymph nodes are present could indicate a virus.  Interestingly any number of viruses have been implicated in this when the person not only did not know they were infected with a virus, but where the virus reappears from an infection that could have been caught many years ago.  This serves to emphasise the fact that many viruses are not defeated by the immune system but simply lie low waiting for a time of stress and low immunity to strike again.  For example:

 Vaccines

For the reasons stated above, any vaccine which uses live attenuated viruses [or bacteria] may be the cause of lymph system disease, not only at the time of vaccination but later, in those cases where the virus is not entirely eliminated at the time of vaccination.

Pharmaceuticals

An increasingly large number of pharmaceuticals cause lymph system disease.  The following links take you to the eHealthme website where a full list of the pharmaceuticals that have caused various forms of lymph system disease are shown along with the number of Adverse Health reports for each pharmaceutical.

• Lymphadenoid goiter - LINK
• Lymphatic obstruction - LINK
• Lymphedema - LINK
• Lymph nodes swollen - LINK
• Lymph node tuberculosis - LINK
• Lymphoblastic lymphoma - LINK
• Lymphocytic lymphoma - LINK
• Lymphoma - LINK
• Lymphoma non Hodgkin's - LINK

 The following table shows all the disease of the lymph system caused by one statin.  [Avorstatin].  The information comes from eHealthme and was correct as at May 2015.  The table also gives us a good idea of the number of names for the various symptoms of lymph system disease and thus why it is so difficult to see trends or diagnose correctly, but it is also indicative of the effects many pharmaceuticals have in causing widespread lymph system disease.

Lymphadenitis Lymphadenocyst Lymphadenoid Goiter Lymphadenopathy Lymphangiectasia Lymphangioleiomyomatosis Lymphangioma Lymphangiopathy Lymphangiosarcoma Lymphangiosis Carcinomatosa Lymphangitis Lymphatic Disorder Lymphatic Duct Injury Lymphatic Duct Rupture Lymphatic Fistula Lymphatic Obstruction Lymphatic System Neoplasm Lymphedema Lymph Follicular Hypertrophy Lymph Gland Infection Lymph Node Abscess Lymph Node Calcification Lymph Node Cancer Metastatic Lymph Node Fibrosis Lymph Node Infection

Lymph Node Pain Lymph Node Palpable Lymph Nodes Scan Abnormal Lymph Nodes - Swollen Lymph Node Tuberculosis Lymphoblast Count Increased Lymphoblastic Lymphoma Lymphoblastosis Lymphocele Lymphocyte Count Abnormal Lymphocyte Count Decreased Lymphocyte Count Increased Lymphocyte Morphology Abnormal Lymphocyte Percentage Abnormal Lymphocyte Percentage Decreased Lymphocyte Percentage Increased Lymphocyte Stimulation Test Positive Lymphocyte Transformation Test Positive Lymphocytic Dermatitis Lymphocytic Hypophysitis

Lymphocytic Infiltration Lymphocytic Leukaemia Lymphocytic Lymphoma Lymphocytic Thyroiditis Lymphocytopenia Neonatal Lymphocytosis Lymphocytotoxic Antibody Positive Lymphoedema Lymphogranuloma Inguinale Lymphogranuloma Venereum Lymphohistiocytosis Lymphoid Hyperplasia Lymphoid Hypertrophy Lymphoid Tissue Hyperplasia Lymphoma Lymphomatoid Papulosis Lymphoma Transformation Lymphopathia Venereum Lymphopenia Lymphoplasia Lymphoplasmacytoid Lymphoma/immunocytoma Lymphoproliferative Disorder Lymphorrhoea

 Surgery and other physical damage

Unwise removal of key lymph system organs - the adenoids, the appendix and the tonsils, for example - as well as surgery on the spleen and thymus may all have serious long term consequences.  What is less obvious is that surgery to other parts of the body may also cause blockage of the system or malfunction.

The lymph system nodes and drainage channels are interwoven with numerous organs of the body, muscles and fascia.  There are between five and six hundred lymph nodes in the human body, and surgery can easily result in damage, blockage and disruption.  Surgery which has apparently been successful in repairing one organ may result in damage to the lymph system which has much greater long term consequences.

It is worth noting that this is not uncommon.  Plastic surgery in general has a record of producing lymphedema, there are a number of papers on PubMed - not of what caused the damage, but of suggested ways of repairing it by lymph node transfer using microsurgery [not always successfully].

 Inherited genes and gene mutation

An increasing number of genes are being implicated in malformation of the lymph system.  Although gene damage is known, what caused the gene damage is less well researched although Toxins including Nanoparticles are frequently mentioned as being candidates:

some more research results - note the number of diseases caused by lymph system malfunction

 Treatment

The first step is to find the cause and address this.  Boosting the immune system is clearly not going to have much effect, because this is the immune system, so this may be one area of severe difficulty when it comes to treating the problem.  The second step is to alleviate the symptoms and in this a number of options exist.

We saw that the lymph system is a closed system, it has no heart to pump lymph round the body.  The circulation of lymph depends on the pressure associated with breathing, intestinal movements and the movements of skeletal muscles.

The principle benign treatments for any forms of blockage are thus going to depend on exercises that increase the breathing, or exercise the intestines and exercise the muscles. 

Exercising and keeping fit

One of the first lines of treatment is Exercising and keeping fit.

Controlled breathing

Another key treatment is likely to be Controlled breathing.  All of the following are likely to be useful as they affect the lungs and the intestines:

• Belly breathing - 
• The bellows breathing technique 
• Dharana Darshan  
• Reverse breathing 
• Ocean breath also called Ujjayi pranayama. 
• Sahita yoga 
• Circular breathing 
• Embryonic breathing - used in Qigong. 

 Massage

Another useful treatment is Massage of the affected area - Stimulation of trigger points using acupressure or just general targeted massage.  Acupuncture may also be helpful for the same reason, but in general the pressure methods are likely to be more effective.  There are, theoretically machines that can also be used if you are unable to get to a person - people are more effective at massage.

 Warmth and warm baths

Both warmth, because it opens and expands the body's systems and puts less stress on the immune system and hot baths or Turkish baths are likely to be of help.  Similarly saunas may also bring some relief.

A Summary

In creating this description it became apparent that the seriousness of this disease to human health is simply completely underestimated.  The immune system is our first line of defence against pathogens and the lymph system forms a key part of the immune system.  Simply put, if this system does not work we die.  We can die of any number of diseases, but we will die because we no longer have any defences against disease.

There also appears to be little recognition of just how many people are affected by lymph system problems.  If we take just parasite induced lymph system disease we find the following

This is twice the population of the UK.

Permanent damage to this system or gene mutations may result in a very large number of diseases immediately or later in life and yet the problem does not appear to have been recognised - it should be!

References and further reading

Acta Virol. 1960 Jul;4:233-40. The role of the lymphatic system in experimental infection with tick-borne encephalitis. I. The tick-borne encephalitis virus in the lymph and blood of experimentally infected sheep.  MALKOVA D. PMID: 13856112

Scientific American - Your Appendix could save your life By Rob Dunn | January 2, 2012

Lymphedema chronicles - this is a very important website for those with lymph system problems or those who suspect this is what they have.  It has a series of case histories of people who have lymphedema principally from surgery, - plastic surgery, surgery for breast and other cancer, and surgery for other sorts of repair work that went very wrong.

Related observations

Healing observations

• Antifilarial Lead Molecules Isolated from Trachyspermum ammi 027879
• Carum copticum L.: A Herbal Medicine with Various Pharmacological Effects - Antiparasitic activities 027883
• Causes Of Chronic Non-Infectious Diarrhoea In Infants Less Than 6 Months Of Age: Rarely Recognized Entities 027332
• Current status of after-care cures in oncologic patients 016653
• Devil's Claw-a review of the ethnobotany, phytochemistry and biological activity of Harpagophytum procumbens 016804
• Diagnosis and treatment of primary lymphedema. Consensus document of the International Union of Phlebology (IUP)-2013 016657
• Dr Duke's list of Biological activities of Coumarin 018558
• Influence of manual lymphatic drainage on health-related quality of life and symptoms of chronic venous insufficiency: a randomized controlled trial 016655
• Lymphatic pump treatment repeatedly enhances the lymphatic and immune systems 016656
• Lymphedema after breast or gynecological cancer: use and effectiveness of mainstream and complementary therapies 016654
• Mrs Grieve on Fenugreek 016791
• Patent literature on mosquito repellent inventions which contain plant essential oils--a review 016774
• Self care integrative treatment demonstrated in rural community setting improves health related quality of life of lymphatic filariasis patients in endemic villages 016652
• Yoga management of breast cancer-related lymphoedema: a randomised controlled pilot-trial 016651

Hallucination

• A case of Castleman's disease with a variable neuropsychiatric symptomatology 016650
• CNS Diseases and Uveitis 027568
• Creutzfeldt-Jakob disease - hallucinations and visions 016647
• Hallucinations from enlarged hilar lymph nodes and a tumour 016649
• Isoniazid-induced visual hallucinosis in Lymph node tuberculosis 016648
• Louis XVII of France hears celestial music as he dies 027857
• Torisel hallucinations 006926
• West Nile Virus Central Nervous System Infection in Patients Treated With Rituximab: Implications for Diagnosis and Prognosis, With a Review of Literature 027567

In time

Synaesthesia, Pure or enhanced perception, Inter composer communication, Vision, Dream, Perception recall, Exploring group perception

• Creutzfeldt-Jakob disease - hallucinations and visions 016647
• Thomas, Elizabeth and Phyllis come to visit 021618

Dying

• Louis XVII of France hears celestial music as he dies 027857
• Thomas, Elizabeth and Phyllis come to visit 021618

Other observations

• Molecular confirmation of Bacillus Calmette Guerin vaccine related adverse events among Saudi Arabian children 016556
• The lymph system and skin diseases - background info 016703