Inflammation, Inflammation, Inflammation!
First, I hope you all read that like Jan from the Brady Bunch says “Marsha, Marsha, Marsha!” Because that is how I really feel like the term “inflammation” gets tossed around. Everybody talks about inflammation these days. “Don’t eat this because it will cause inflammation”, “do this because it is anti-inflammatory”, “inflammation is bad for your health”, “poor gut health leads to inflammation”, etc etc etc! Well, I want to take a little bit of time to talk about what inflammation really is and help you understand, truly, the repercussions of chronic inflammation. This really is the root cause, catalyst, and driver of so many terrible conditions like obesity, heart disease, diabetes, and metabolic syndrome-and those are only the result of CHRONIC inflammation. There are also a whole lot of awful conditions that result when you have subtle, acute inflammation, such as skin conditions, migraines, brain fog, fatigue, joint pain, and more. However, we NEED inflammation, too. Without it, we could not fight off foreign invadors, pathogens, or heal in an appropriate, timely manner. This will be the first of a few posts on inflammation because there really is so much to cover. I want you guys to understand this and understand how to prevent and limit it. So, for starters, let’s review the basic physiology of what triggers an inflammatory reaction and the two main immune systems that react. Then we will get into how to prevent and decrease your level of exposure to inflammation.
Your body has an innate defense system and an adaptive immune system as your two main defense mechanisms. Your innate defense system is composed of nonspecific defense mechanisms that are activated immediately or within hours of a foreign invader, or “antigen”, appearance in the body. Barriers like skin, chemicals in the blood, and immune system cells that attack foreign cells in the body are all part of the innate defense system and are activated by the chemical properties of that antigen (1). Antigens can be harmless, like grass pollen, or rather harmful, like pathogens such as the flu virus.
Your adaptive immune system refers to antigen-specific immune responses, and would respond to the latter. This is the system that “recognizes” foreign invaders after initial exposure, and develops antibodies and other defenses to battle them when faced again (much of the rationale behind vaccines). As you can imagine, these are both vital processes for our bodies to go through to battle invaders and remain healthy. However, as part of the defense, they provoke inflammatory responses, which can be life-saving, but when over-activated can be very harmful.
The Inflammatory Response
There are two main types of inflammation in your body: acute and chronic (also known as systemic). Acute inflammation arises after, say, you get a cut on your skin or you sprain your ankle (pop quiz-what immune system reacts?). You start to get some redness around the area, swelling, warmth, and pain-usually due to increased pressure on surrounding nervous tissue from the swelling. Proteins called cytokines act as “emergency signals” that call out to your body’s immune cells, hormones, and nutrients to come in and heal, causing much of the aforementioned symptoms. Additionally, arteries dilate, blood flow increases, and capillaries become more permeable so that white blood cells, hormones and nutrients can move into the spaces between cells. These “healers” ingest germs, dead or damaged cells, and other foreign materials to help; hormones called prostaglandins create blood clots and trigger pain and fever to help the process (2). There are all sorts of immune cells that are called out to “battle”, of which I won’t go into much detail here, but it is important to know that although necessary, it is not good to have these cells around regularly.
Here are some examples of diseases, conditions, and situations that can result in acute inflammation:
- Acute bronchitis
- Infected ingrown toenail
- Sore throat from a cold or flu
- A scratch/cut on the skin
- Exercise (especially intense training)
- Acute appendicitis
- Acute dermatitis
- Acute tonsillitis
- Acute infective meningitis
- Acute sinusitis
- Twisted or sprained ankle
Chronic inflammation is a little bit different than acute. The chronic immune response is not quite so intense short-term and poses high risk to tissues in the long-term. In contrast to acute inflammation, we don’t really ever NEED chronic inflammation. It isn’t necessary for any type of healing process. In fact, it is actually quite damaging long-term. Think about a stressful situation at work or in life. Say you have a big presentation coming up and you’re rather anxious about it. That feeling is not pleasant. I REALLY don’t like being anxious or stressed out. Now imagine being that stressed out on a regular basis.
Every day having that kind of stress.
I actually would not be surprised if some of you can actually relate to that because of crazy busy lives and jobs, but hopefully MOST of you do not find that type of intense stress prevalent in your daily lives. That kind of persistent stress doesn’t seem sustainable, right? You would be exhausted, your brain and body not functioning fully, probably having weird hunger signaling, and overall pretty miserable. With chronic inflammation, that is exactly what’s happening inside of you. Your body is on high alert all the time, either because you are constantly exposing yourself to problematic invaders, you have an autoimmune condition, or your body lacks the efficiency of clearing out inflammatory cells. EVERYBODY has some level of inflammation going on on a regular basis in their bodies considering we are never fully “safe” from external toxins or invaders, but the poison is in the dose. It is important to know how you may be provoking inflammation in your own body and understand ways to decrease.
What causes chronic inflammation?
Oh boy. This is a big, complex answer, but I will do my best to summarize. So, we now understand there must be some sort of irritant that your body is constantly battling and thus constantly producing and sending out the troops (those immune cells) to respond. Having these cells circulating your system regularly without resolving the issues damages your cells and tissues and can lead to some serious repurcussions. Sometimes the result can be somewhat minor like a skin rash or some minor achy joints, and other times it can be quite serious like an autoimmune condition, severe joint pain, poor recovery, HPA axis dysregulation (sometimes referred to as adrenal fatigue), type II diabetes, heart disease, asthma, and many more. Here is a list of some general causes followed by more specific triggers of inflammation.
Examples of what can lead to chronic inflammation (5):
- Failure to eliminate whatever was causing an acute inflammation
- An autoimmune response to a self antigen – the immune system attacks healthy tissue, mistaking it (them) for harmful pathogens
- A chronic irritant of low intensity that persists.
- Causative agent- non-degradable pathogens that cause persistent inflammation, infection with some types of viruses, persistent foreign bodies, overactive immune system reactions
Triggers of the Immune Response and Inflammation (4):
- Oxidative stress (reactive oxygen species, especially oxidized lipids-remember my post on those unhealthy oils that are in EVERYTHING?? This is why they aren’t good…)
- Psychological stress
- Food and environmental allergens
- Viral infections
- Nutrient deficient/poor diet (e.g. diet high in refined sugar/grains, processed animal products, high alcohol intake, the “Standard American Diet”)
- Intestinal hyper-permeability (also known as leaky gut-largely due to that chronic intake of the SAD diet)
- Pathogen-associated molecular patterns (PAMPs) – PAMPs are molecules that trigger an immune response by activating toll-like receptors. Toll-like receptors are transmembrane proteins expressed by cells of the innate immune system and the antigen presenting cell. Once activated, the toll-like receptors signal the pathways of the inflammatory response, namely nuclear factor kappa B (NF-kB)
- Environmental toxins (check out my last blog)
- Blood sugar dysregulation
I find that with many of my clients, the issue isn’t necessarily that they are consciously choosing to be inflamed on a regular basis, but they don’t even know that they have this inflammation. It is very similar to clients that come In and say they “feel pretty good” when I ask how their energy is, and after putting them on a specified, healthier meal plan, they come back saying they had NO IDEA how good they COULD feel when we first met. Same thing with inflammation. There are tons of subtle clues that a person has inflammation, which varies from person to person, but once you can figure eout your main triggers and eliminate/decrease them, you will likely find alleviation of symptoms you hardly knew you even had.
These symptoms could include:
- Skin rashes, acne
- Brain fog
- Poor sleep
- Thin hair and nails
- Poor digestion
- Loose stools/constipation
- Mood swings
- Energy slumps
- Poor recovery from workouts
- Poor energy during workouts
- Weight gain/retention
That’s just to name a few…
So how can you keep this inflammation at bay? Well, in addition to checking out the list of triggers and causes and analyzing where you may be at risk there, make sure you get good sleep, practice good stress management, optimize your diet, and get moving more! Probably the first time you’ve heard those recommendations, right? If you want an edge on more anti-inflammatory treatments, you can try:
- Vitamin D
- Alpha Lipoic Acid
- Green Tea Extract
- Omega 3’s in fish oil or other fatty wild fish/seafood, particularly (and most importantly) EPA and DHA
Per usual, MAKE SURE you check with your doctor or healthcare professional before diving in to any supplement or treatment protocols.
Next week: How oxidative stress causes inflammation, the relationship of inflammation to diabetes and obesity, and inflammation and Altzeimer’s.
In TWO weeks: the ins and outs of autoimmunity and how to know if you are at risk
Thanks guys! Let me know if you have questions or requests for further blog posts J
Therese Martinez, MS, RD, CPT