Inflammation 101
What is inflammation?
Inflammation is part of the body’s inherent immune response. When your body senses damage to its cells, it releases chemicals into the bloodstream or the damaged tissue that trigger a protective response from your immune system. This causes more blood to flow to the area, which can lead to visible redness and heat. It can also cause the tissues to give up fluid causing swelling. The stimulation of nerves in the area can give rise to temporary pain.
There are two types:
Acute – this is short term in nature, lasting from a few hours to a few weeks. It usually occurs because of an external injury. This kind of inflammation is a good thing – it is the body’s natural defence against damaged cells, viruses, bacteria. Without inflammation, wounds would become septic and even minor infections would spread and become deadly. Acute inflammation is not the same as infection although the two are often confused. Inflammation is the body’s response to infection. However, inflammation can also happen without an infection.
Chronic – this can last for months or years. The inflammatory response is on-going, leaving your body in a constant state of alert and trying to defend itself, thus overwhelming your immune system. It will only go when you address the underlying cause. Often there are few, if any, signs or symptoms.
What does inflammation cause?
While acute inflammation is necessary and beneficial, chronic inflammation has an unequivocal detrimental impact on your health.
It plays a significant role in many serious health conditions, including metabolic syndrome, heart disease, non-alcoholic fatty liver disease, type 2 diabetes, cancer, Alzheimer’s, arthritis, ulcerative colitis (-itis is a suffix meaning ‘inflammation’), osteoporosis, lupus and asthma. According to Dr Nasha Winters, chronic inflammation is considered a main precursor for cancer development, contributing to at least 25% of cases. It is also one of the main drivers behind the two most deadly aspects of cancer: growth and spread.
Inflammation is one of the most important biological factors associated with mental health disorders. The link with bipolar was made back in 1981, and with depression in 1991, with research showing that inflammation may be a factor in about one third of people who suffer from depression. This is, or soon will be, the subject of a separate article.
On a less severe level, inflammation also causes memory loss, compromised digestive function, loss of muscle tone, weight gain, accelerated skin aging and joint pain.
What causes chronic inflammation?
Chronic inflammation is a sign of an overtaxed body. It is caused by an excessive stress load on your body, which can be due to a combination of reasons of a physical, emotional or chemical nature. As a result, your body ends up trying to constantly defend itself. It can’t differentiate between a poor diet and grief over the loss of a friend, or stress in your workplace or a badly damaged toe.
Let’s look at the principal causes.
1) Inflammatory diet:
An inflammatory diet, low in nutrients, high in processed foods, is one of the main causes of chronic inflammation. Such foods include sugar, refined carbs, trans fats (found in fast and processed foods), omega-6 fatty acids (think vegetable and seed oils), MSG, grains, gluten, casein (one of two main proteins in diary), aspartame and alcohol. Foods that you are sensitive or allergic to will also be causing it. Meanwhile our diet is so often devoid of the healthy omega-3 fats found in foods such as cold-water fish, olive oil, walnuts and dark greens and woefully low in antioxidants (basically nothing like enough veggies). The standard Western diet, sadly, is the primary cause of chronic inflammation, heart disease and cancer.
2) Blood sugar imbalance:
Eating too much sugar and refined carbs leads to high blood sugar levels. This causes the over production of inflammatory cytokines which in turn leads to insulin resistance and further elevated blood sugar, forming a vicious cycle.
3) Leaky Gut:
A healthy gut works like a cheese cloth, allowing only nutrients through into the bloodstream, but keeping larger food particles and bad bacteria, yeast and parasites out. But in a leaky gut, the tight junctions in the lining of your gut are loosened, so that undigested particles, microbes and toxins can get through. Your immune system treats them as foreign invaders and mounts a response – causing inflammation and food sensitivities. Leaky gut is caused by inflammatory foods, toxins, infections, medications and stress. It is characterized by gas, bloating, constipation, indigestion and other digestive issues. However, it can also lead to more serious health issues, including autoimmune diseases (1).
4) Chronic Stress
This plays a huge role in chronic inflammation. Emotional stress can lead to poor eating habits, less exercise, bad sleep, more alcohol, all of which increase the risk of inflammation. Inflammation is now increasingly being recognized as a cause of depression (2). Chronic stress also puts your body in a state of permanent fight-or-flight mode that gives rise to digestive disorders (3) and anxiety. These in turn fuel the cycle of inflammation and emotional health issues.
5) Poor sleep habits
Sleep is the time when your body does a ton of stuff, broadly around recovery and healing. Bad sleep can result in low-grade inflammation, as well as high blood pressure, obesity, diabetes that are also all linked to chronic inflammation (4). Getting good quality sleep in essential for your health and wellbeing.
6) Environmental toxins
These are everywhere – in the food you eat, the air you breathe, the water you drink, and the cleaning and personal care products you use every day in your home. Long term exposure to such toxins can result in increased chronic inflammation. As you cant completely eliminate them, do you best to lower your toxic load by buying organic if you can and buying natural products – and then pay attention to other factors such as diet and lifestyle.
Diagnosing inflammation
There are a number of useful biomarkers for inflammation:
Hs CRP – High sensitivity C-Reactive Protein. It measures a protein (CRP) produced in your liver that indicates inflammation levels in your body. This is the key test for inflammation.
Clinical range: 0 – 5 mg/l,
Optimal range: 0 – 1 mg/l. Ideally 0.01 mg/l
HbA1c – Hemoglobin A1c. This measures your average blood sugar over the past 3 months. As blood sugar imbalance is one of the main causes of inflammation, I have included it.
Clinical range: 4.8 – 5.6.
Optimal range: 4.5 – 5.2
Homocysteine. Common amino acid in blood that you get mostly from eating meat. It’s a good marker for cardiovascular issues and for indicating inflammation.
Clinical range: 5.5 – 16 umol/l,
Optimal range: 6 – 8 umol/l
ESR. The ‘erythrocyte sedimentation rate’ refers to the rate at which your red blood cells in anticoagulated whole blood go down in a standardized tube over a period of one hour! A high sedimentation rate indicates high levels of inflammation in the body.
Clinical range: 0 – 20 mm/hr, although men under 50 should be a bit lower and women over 50 could be up to 30 mm/hr.
Optimal range: < 10 mm/hr
LDH – Lactate Dehydrogenase. An enzyme involved in energy production, present in all cells of body. Elevated LDH indicates some form of acute or chronic tissue damage and is considered an inflammatory marker. It is an accurate indicator of lung infections or respiratory failure.
Clinical range: 135 – 225 IU/L
Optimal range: 140 – 180 IU/L
TNF Alpha – Tumor Necrosis Factor – Alpha.
Range: < 8.1 pg/ml
IL6 – Interleukin 6.
Range: < 7 pg/ml
Treating inflammation conventionally
Conventional treatment usually involves over the counter medications called ‘non-steroidal anti-inflammatory drugs’ (NSAIDs) like ibuprofen and aspirin. (Acetaminophen ‘Paracetamol’ does not relieve inflammation). Aspirin was the first, and now there are over fifty. These work by interrupting the formation of cyclooxygenase-2 (COX-2), the enzyme associated with inflammation and pain. The problem is that NSAIDs (also known as ‘COX-2 inhibitors’) don’t discriminate between COX-1 and COX-2. Both are blocked. COX-1 is critical for maintaining the integrity of the gut lining, and regular use of these medications therefore leads to Leaky Gut syndrome. NSAIDs also upset the delicate balance of microbes in the gut. Long term use can result in stomach ulcers and kidney and liver toxicity. They account for thousands of deaths a year, and many hospitalisations due to liver and kidney damage or intestinal bleeding (5) (6)
Corticosteroids, such as cortisone and hydrocortisone are often prescribed for chronic inflammation for conditions such as rheumatoid arthritis, cancer and asthma. However their use interferes with the metabolism of vitamin D, zinc, folic acid, B6 and B12, essentially halting methylation while causing immune and epigenetic problems. You may get reduced inflammation in the short term, but long term use of these drugs can cause more harm than good. On a long-term basis (more than 3 months) the side effects include osteoporosis, high blood pressure, diabetes, weight gain, cataracts, muscle weakness, thinning of the skin, bruising easily and greater vulnerability to infection (7)
I would opt for natural remedies if at all possible.
Treating inflammation naturally
1) Eat an anti-inflammatory diet
avoid the foods mentioned above, and also all processed foods.
move towards a Mediterranean or Paleo diet, comprising of plenty of fruit and vegetables such as green leafy veg
eat meat from a clean source (no chemicals or meat additives)
eat an abundance of omega-3 foods such as wild-caught fish, mackerel, salmon, seabass, herring, sardines, and cod liver oil
think “nutrient-dense” in respect to everything you eat (sorry, but liver is top of the list!)
2) Add herbs into your diet
Turmeric. One of the most potent anti-inflammatory herbs. It has been highly researched - there are literally thousands of studies on its efficacy. The secret of this herb lies in its active compound Curcumin, a powerful antioxidant known for its numerous medicinal properties. One of its top benefits is its ability to lower inflammation – just as well as ibruprofen but without the side effects. It has been found to possess an unprecedented amount of anticancer activities via its effect on many biological pathways, and an anti-proliferation effect in multiple cancers. It has also shown itself to be effective in those with ulcerative colitis (8), diabetes (9), osteoarthritis (10) and lupus (11)
Ginger. Similar to turmeric in that they are both rhizomes, ginger is a powerful anti-inflammatory herb that has been used in China and India for 5000 years. Its most important active compound is Gingerol, providing its ability to raise antioxidant levels and reduce inflammation. A study found that patients who were given 2g of ginger experienced a significant reduction in colon inflammation markers compared to the placebo group. (12) Other studies showed it as effective in lowering inflammation in osteoarthritis (13), exercise-induced muscle pain (14), and inflammation linked to obesity and metabolic syndrome (15).
Boswellia (Frankincense). This is a potent herbal extract from the Indian Boswellia Serrata tree. Is has been used for centuries as an anti-inflammatory herb by Asian and African cultures to treat conditions including chronic inflammation. Research has shown it to be effective in reducing inflammation in osteoarthritis and rheumatoid arthritis (16). It may also inhibit cancer growth (17). Boswellia is particularly beneficial when used in combination with curcumin – they can be used safely together and synergise to reduce inflammation (18). Place a couple of drops of a high-quality, therapeutic-grade oil under the tongue, or add a couple of drops to a homemade salad-dressing
White Willow Bark and Meadowsweet. These herbs bon contain salicin, which has a very similar chemistry to aspirin (acetylsalicylic acid). Salicin also has the same fever-reducing, anti-inflammatory, and pain-relieving properties as aspirin. However, in contrast with synthetic aspirin, will bark doesn’t damage the mucose membrane that lines the stomach.
Conclusion
Listen up. Chronic inflammation is the root cause of many chronic diseases, and hugely increases your risk of early death (19). Inflammation prevents your body’s ability to function at a cellular level, which is why it contributes to so many conditions. While there are certainly other factors to consider, mitigating inflammation delivers the body into a healing state, from which many health challenges can be overcome.
Inflammation is rampant. It is caused, to put it bluntly, by our modern lifestyle. Inflammatory diet, stress, poor sleep, gut dysbiosis and environmental toxins all cause inflammation on their own. However, when combined, they are an explosive mixture. Unfortunately the modern medicine, drug-centred approach comes with side effects that include the risk of developing cancer.
Testing for inflammation is a no-brainer, helping to uncover the root causes of your problems or allowing you to stop them ever occurring. You should absolutely go do it.