Anyone who has given even a cursory look at headlines in natural medicine will emerge with the concept that inflammation is a key component in most all chronic degenerative diseases. Indeed, there are a myriad of causes of inflammation affecting many body systems.
Inflammation can generally be divided into two categories; acute and chronic. Acute inflammation is marked by a swelling, redness, and heat following an injury; a response from the body to augment healing to the traumatized area. After some time and rest, the inflammation should subside.
Chronic inflammation is different. Instead of a blazing fire, think about a smoldering bed of ashes. It might not be enough to set off a smoke alarm, but it can still give off plenty of heat and still cause a burn. This reflects one problem with low-grade, chronic inflammation – its effects may register in routine blood work, other times it is silent.
Looking at some of the causes of chronic inflammation, one prominent factor is diet. There are substances which are universal triggers for inflammation, such as the overconsumption of sugar, alcohol, trans fats and any food that causes an immune response in the gut, such as gluten. Certain food sensitivities can also promote inflammation on an individual basis. Over the years I have observed wheat, dairy, nightshade vegetables (tomato, potato, eggplant, peppers), and various other foods that were highly inflammatory to patients struggling with chronic inflammation. When a dietary cause of inflammation is suspected, I carefully note the patient’s hands, especially the back of the hand to assess their progress. There is typically a redness around the knuckles of a patient which will clear as they cease eating their trigger food or foods.
Another well known dietary cause of inflammation is an excess of omega-6 rich vegetable oils and a relative lack of anti-inflammatory omega-3 oils. The primary source of pro-inflammatory omega-6 oils are industrial seed oils such as corn, soy, and canola oil. These oils are replete in processed foods, are often laden with toxic residues from their extraction, and have a high likelihood of being genetically modified. Whereas a normal ratio of omega-3 to omega-6 would be around 1:1, a diet high in processed foods will quickly throw off this balance in favor of a pro-inflammatory state.
Omega-3 rich oils include fish oils and flax seed oil. There is one omega-6 oil that is anti-inflammatory; gamma-linolenic acid (GLA) found in evening primrose oil and black current seed oil. These oils are typically taken as a dietary supplement, but eating fish and avoiding industrial seed oils is typically sufficient to restore balance to this ratio of omega fats.
Another cause of inflammation is overtraining. Exercise induces a beneficial hormetic response whereby our body is enticed to grow stronger to best meet the next stress. The oxidative stress of exercise triggers your body’s innate anti-oxidant system. In this case, the inflammatory response is transient and controlled. If training persisted day in and day out without adequate recovery time, the body may eventually succumb to chronic inflammation, and in its most severe form, muscle breakdown, a condition known as rhabdomyolysis.
Chronic, untreated infections can incite an immune response and engender a low-grade inflammatory response. In some cases this can be very localized, such as an infection of H. pylori and the inflammatory response known as a stomach ulcer. A curious example is the immune reaction to the Demodex mite, found in the skin pores of patients underlying the inflammatory skin disease rosacea.
Environmental toxicity can also be a factor triggering inflammation. The obvious suspects here are known causes of immune reactivity including living in a home with mold or radon, seasonal allergens, bacteria or toxins in drinking water, dirty electricity, and any consumer product that is off-gassing in your environment. The collective burden of these agents can quickly overwhelm the system and result in chronic, low-grade inflammation, especially in the context of a pro-inflammatory diet.
Acute and chronic psychological stress is also known to trigger an inflammatory state as mediated by a messenger molecule called interleukin-6 from the family of proteins known as cytokines. High levels of this pro-inflammatory messenger can also affect our sleep, resulting in a vicious cycle of fatigue, more stress, and potentially musculoskeletal or neurogenic pain.
Emotional stress also has a catabolic effect on the gastrointestinal tract. Perception of stress causes a cascade of changes in the body, increasing levels of a peptide in the gut known as neurotensin and adrenal hormones such as adrenaline and cortisol. These hormones, as well as a host of other signaling molecules, result in a change in the bacterial flora of the gut and a loss of gut integrity (otherwise known as leaky gut syndrome), which dovetail into inflammation both in the gut and throughout the body.
Having examined some of the causes of inflammation, we can explore the effects of chronic inflammation which are varied and complex. At the most fundamental level, inflammatory states cause an increase in free radical production resulting in cellular damage, particularly to the DNA. Because DNA damage underlies abnormal mutation, inflammation can be considered a causative factor (one of many) precipitating the formation of cancer. This process tends to increase as we age but can be exacerbated by a chronic inflammatory state.
That aside, even in an individual who is not predisposed to cancer, the free radicals resultant from inflammation are thought to speed up the aging process, an assertion known as the free radical theory of aging. Its modern moniker is inflammaging. Because joint and muscle pain are also associated with inflammation, aging prematurely in this context includes a loss of mobility – think about a middle-aged individual stressed out, tired, eating poorly, and suffering with joint and muscle pain, often relying on ibuprofen to keep inflammation in check.
Emerging evidence also shows a link between inflammation and an increase in permeability of the blood brain barrier, the protective covering that houses the brain. Inflammation may thus leave us vulnerable to neurodegenerative diseases that increase in incidence as we age.
Diagnosing inflammation can be based upon laboratory science. The two most common markers for inflammation are sedimentation rate and high sensitivity C-reactive protein (CRP). If elevated on a blood panel, you know you are dealing with inflammation that has gotten out of hand. However, the lack of confirming blood work should not preclude diet and lifestyle changes if the clinical picture suggests inflammation.
Any worthwhile treatment for inflammation must center around removing whatever agent or agents that have triggered an immune response. This includes adopting a whole-food, nutrient-dense diet devoid of sugar, alcohol, caffeine, and with careful attention to root out food sensitivities. An abundance of sleep (usually 7-8 hours for most individuals) is also essential. Stress reduction techniques can also turn the tides of chronic inflammation when practiced diligently and regularly.
If a rescue plan from chronic inflammation is needed, herbal remedies and dietary supplements can be a helpful adjunct to diet and lifestyle. Many herbal anti-inflammatories exist, my personal favorites being boswellia and curcumin (turmeric). Boswellia in particular pairs well with a source of omega-3 fats such as fish oil or cod liver oil; fats magnify the potency of the boswellic acids, augmenting its anti-inflammatory effect.