Inflammation – A Primer

We all know inflammation: it is the red and painful knee that swells up after we have tripped and fallen on it.  It is the sore, scratchy throat that arises when we are coming down with a cold; it is the sneezes, the drippy nose and itchy eyes that come about after exposure to a very dusty room or a pile of old fall leaves.

Acute inflammation happens when our body is exposed to a stressor, like a fall against hard concrete, a virus or a large amount of an allergenic substance.  It is a natural response of our body to attempt to deal with the stressor.  The response is the same in all cases, in Latin acute inflammation is known as “rubor”, “tumor”, “calor”, “dolor”: redness, swelling, heat & pain.

• Our blood vessels dilate (prostaglandin signaling molecules encourage this) thus allowing blood to arrive at the site of injury (redness);
• Within the blood that arrives at the site of injury are many particles: a significantly increased number of the white blood cells (lymphocytes, neutrophils, eosinophils, basophils, macrophages), platelets, antibodies, and chemical signaling molecules, aka cytokines, to name a few. These arrive at the site of injury and leech out into the tissues to begin their repair work (swelling);
• This increased activity and blood and fluid flow cause increased warmth in the area (heat);
• With all the fluid accumulating in the tissues the tissue integrity is distorted and many of the chemical signaling molecules (prostaglandins, pro-inflammatory cytokines (ILs, TNF), histamine, bradykinin and C-reactive protein to name a few) cause an irritation to the tissues (pain).

A fifth hallmark sign of inflammation that occurs as a result of the above processes is loss of function.  The swelling and pain limit our ability to function and we lose mobility in order for us not to perpetuate the injury.  This is meant to be a rapid and temporary process whereby whatever caused the initial injury is removed (we don’t keep falling/ our body successfully fights the virus/ we get ourselves away from the dusty environment/ etc.), our body can cease its inflammatory response and it can clear away the debris of cellular material that resulted from the repair efforts.

Think of having to tend to something in your home – maybe a leaking tap.  You must bring with you the tools, sealants, perhaps new pipes or valves necessary to fix the leak in the pipe.  In the process, your “repair site” (in this example, perhaps the space around your bathroom sink, where you are tending to the leak) gets messy as you fix what needs attention.  Tools are brought out, set out, used, set back down, etc.  Once you are done with the repair process, everything needs to be put away: back in the tool kit and set back neatly on your utility room shelf, for the next time they are needed.

If we left these useful tools around or didn’t quite fix the leak so kept the tools at the ready, things would be left congested and dangerous.

The site needs to be cleaned up, and so it is with the body.

Chronic inflammation results when we are continually exposed to a stressor to the body and the inflammatory response is perpetuated, and/ or when the body’s capacity to clear away the debris is overwhelmed.  In this case the swelling, pain, redness and heat generally diminish somewhat, in varying degrees depending on the person and the type of inflammation, but these symptoms do not completely resolve.  The loss of function continues and the affected tissues are no longer able to do their jobs.

This is why we are understanding, in the medical world, that all diseases can be linked back to chronic inflammation: from diabetes, cancer, arthritic diseases, cardiovascular disease, autoimmune illness, hormonal dysfunctions all the way to neurodegenerative disorders like Alzheimer’s and dementia.  Whatever tissue is being damaged (pancreas/ insulin receptors to brain cells) loses its function due to ongoing inflammation.

Perhaps you haven’t been diagnosed with one of these conditions – this doesn’t mean inflammation is not at work in your body.  Because disease exists on a spectrum with health, if you are any where outside of the optimal health spectrum for you, you likely have inflammation going on: blood sugar imbalances, frequent infections, allergies, low energy, memory issues, joint/ muscle ache, to name just a few, are all inflammatory conditions.

So what causes chronic inflammation?

This is a loaded question and many things result in the persistent tissue damage that is inflammation.  I often like to think of the “total load” theory in that our body can handle a few insults but the higher the number of insults to the system to less of an ability it will have to mount an appropriate response.  So, this might be due to a chronic infection (bacterial, viral, parasitic, fungal/ yeast/ mold), exposure to detrimental environmental factors (unhealthy air, pollutants, perfumes, molds, solvents, dust, high amounts of pollens/ grasses, etc.).

A significant cause of ongoing chronic inflammation is our diet.  Many of the foods we eat in our modern-day diet stimulate inflammation in the gut wall.  This causes a decrease in integrity of the gut wall which allows many of the pro-inflammatory molecules and allergens to pass through into the blood stream and create more issues.

Another significant cause of ongoing inflammation is poor circulation that is resultant from lack of exercise, a sedentary lifestyle, not engaging in activities (exercise, saunas, getting hot!) that allow us to sweat, avoid exposure to temperature extremes.  The latter point may seem odd but when we are constantly moving from one temperature-controlled environment to another and not having the opportunity to get hot or to get cold and allow our own bodies to thermo-regulate, a process that requires a circulatory system response they lose this ability – use it or lose it!

What can we do about it?

Following an anti-inflammatory diet is key.  You will read many different versions of anti-inflammatory diets if you search for them.  The bottom line is the need to avoid processed foods, sugars, soda pop, refined carbohydrates and minimize non-organic foods (especially meats), alcohol and caffeine.  Refined carbohydrates include breads, muffins, pastas, cookies especially those made from gluten-containing flours (like wheat).  Commercial dairy products promote inflammation and need to be avoided as do hydrogenated fats and processed oils (corn, canola, palm, soy).  Processed meats and artificial sweeteners also need to be eliminated.

And to consume lots of omega-3 fatty acid rich foods like good quality fish, avocado, extra-virgin olive oil, olives, unrefined flax oil, raw walnuts, almonds and raw seeds like hemp, flax, chia, pumpkin, sesame and sunflower.  These help to mitigate the inflammatory response.  Eating high fiber foods like vegetables and whole grains (quinoa, rice, oats) decreases many of the chemical messenger molecules that promote inflammation.  It is also important to ensure that the gut microbiome stays healthy so that means taking probiotics (“good” bacteria), eating prebiotic rich foods (fiber!) and avoiding those foods that feed pathogenic (“bad”) bacteria and yeast and other harmful microorganisms.

Healthy Foods:

• Foods in their fresh, raw, natural state. Locally grown, organic and non-GMO where possible.
• Foods without labels! Produce, whole grains*, eggs, nuts, seeds, good quality meat products.
• *Gluten-free whole grains in moderation: rice, oats, quinoa, buckwheat.
• Fruits and vegetables.
• Wild caught or sustainably farmed seafood; free-run poultry, grass-fed, naturally raised beef and wild game.
• Healthy fats from nuts, seeds, olives, avocado and fish; cold or expresser pressed oils.
• Herbs and spices like turmeric, ginger, oregano, basil.
• Enzyme rich foods like bromelain from pineapple, papain from pineapple.
• Sulfur rich foods like onions, garlic, chives, shallots.

Foods to avoid:

• All wheat, barley, rye and gluten containing grains.
• Commercial dairy milk, yogurt, cheese.
• All forms of sugar and refined flour (including products made with refined gluten-free flours).
• Processed luncheon meats.
• Hydrogenated fats, margarine, processed vegetable oils (corn, canola, palm, soy).
• All fast food, processed food, GMO food.
• Soft drinks, sodas, alcohol**, caffeine**.
• Artificial sweeteners, aspartame, saccharin.

**minimal alcohol (maximum of 5 oz. of wine, preferably red, daily) and caffeine (equivalent to less than 250ml of coffee or black tea per day)

There is some debate about consuming nightshade family vegetables when treating inflammation.  Tomatoes, peppers, eggplant and potatoes all fall into this category.  They contain large amounts of alkaloids that can be irritating to joint tissues in some people.  Being your own detective to determine if these foods impact you is of utmost importance.  In those with significant inflammatory conditions it may be necessary to eliminate eggs, legumes, and grains, in addition to those foods already listed.

Ensuring the cause of the inflammation has been treated is essential – often chronic inflammation needs to be treated with anti-microbial herbs like berberine containing herbs (Goldenseal, Oregon Grape) or high potency garlic or oregano oil should also be considered.  Individualized treatment would create your specific protocol.

You may want to consider supplementation with anti-inflammatory supplements.  Turmeric/ Curcumin packs great anti-inflammatory punch, as do potent anti-inflammatory/ antioxidant combinations like green tea extract and grapeseed, two of my favorites.  Fish oils supplements and the mineral magnesium both provide significant benefit.

Be sure to also get plenty of exercise/ movement to enhance circulation and promote lymphatic drainage.  Sweating, saunas, hot/ cold (contrast) showers, meditation, laughter, play, rest, sleep, and time spent outside in nature are also important remedies for inflammation.    Be kind to yourself and give yourself the gift of incorporating a few of these healthy habits each day!