There is a lot of talk about inflammation with the rise of COVID-19 due to this viral infection being highly inflammatory. But is all inflammation bad? The two main functions of the immune system are to defend and repair so let’s talk about inflammation as a whole…
Types of Inflammation:
There are two types of inflammation, acute and chronic. Acute inflammation is necessary and useful when we come into contact with an invader to our bodies. Temporary invaders can be viruses, bacteria, toxins, trauma. A healthy immune system is detective and defensive and will be able to detect invaders and defend against them. The immune system is internally regulated, meaning the minute it is turned on its also in the process of being turned off. Fibroblasts and anti-inflammartory cytokines are involved in turning off the immune system. A healthy immune system can immediately fight and then repair damage. In an unhealthy immune system we see progression of disease and an inflammatory cascade that is not turned off leading to tissue and organ destruction. A healthy immune system is also tolerant and does not attack itself in the form of autoimmune disease.
An immune system that is constantly triggered brings about chronic inflammation. Advanced glycation end products from foods such as donuts, sticky buns, and foods high in sugar have a molecular structure that looks like a foriegn invader triggering an immune response. Toxins (organic chemicals and heavy metals) and free radicals also turn on the inflammatory cascade. When these elements are constantly present in the body there will constantly be a low lying level of inflammation eventually leading to tissue and organ dysfunction, eventually.
Conditions associated with high levels of inflammation in the body:
Vascular disease (hypertension/hypertriglyceridemia)
And many more!
Western medicine approach to treatment for acute and chronic inflammation:
There are many drugs for acute and chronic inflammation as this is a billion dollar industry with pharmaceutical companies working to develop new drugs everyday to address the inflammatory cascade. Some examples are non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen, motrin, advil, aleve and steroids, inhaled and oral. There are also drugs to called immune biologics that suppress the immune system and at the same time leaving the body more open for infections. These drugs are used in conditions like autoimmune disease. In an unhealthy immune system, the repair does not occur and these medications are needed and necessary to treat the downstream effect of chronic inflammation and prevent tissue and organ destruction. But keep in mind these medications are not treating the cause of the inflammation.
What induces inflammation in the body:
Elevated blood sugar
Lipopolysaccharide (endotoxin released from pathogenic gut bacteria)
Cytokines (inflammatory mediator)
Certain Hormones and growth factors
Hypoxia (low oxygen levels)
What is the functional medicine approach:
Inflammation regulation is a foundational concept for functional medicine. Inflammation is where dysfunction starts. Functional medicine focuses on treating the cause of inflammation not the downstream effect. For example, interleukin 17 (proinflammatory mediator) is found to be elevated in psoriasis patients. A functional medicine approach would ask “what is the cause of increased IL-17?” Is it toxins, diet, gut dysfunction, impaired detoxification, etc etc.
A functional medicine practitioner will focus on diet as number one because “food is thy medicine and medicine is thy food.” Hippocrates. The long term presence of inflammatory mediators are found in obese individuals and promote insulin resistance, lead to increased gut permeability and alter hormone function.
Some natural treatments for inflammation:
Whole foods, plant based diet!!! Eat real food!!
Quercetin: Quercetin is a mast cell stabilizer known to decrease histamine and other inflammatory mediators. Equally as good as prescription drug cromolyn. Found in red onions, tea, berries, apple skin, tomatoes.
Bromelain: Found in pineapple, aloe, polyphenols. Inhibits overproduction of bradykinin (inflammatory mediator). Signs of overproduction of bradykinin are extreme muscle pain after working out and the life-threatening condition of angioedema.
Eicosanoids (EPA)/docosahexaenoic acid (DHA) (Omega 3 fatty acids): EPA produces resolvins, which resolve inflammation and DHA produces protectins. Eicosanoids are essential fatty acids and needed in our diets and stored in our cell membrane. They are generally anti-inflammatory, if from omega 3 fats such as fish, wild game meat, nuts (walnuts), chia seed, flaxseed, enriched eggs. They also influence nerve transduction and lower triglycerides.
Arachonidonic acid (omega 6 fatty acids): Found in borage, black currant, sunflower, safflower, peanut, red meat, dairy products. More inflammatory and should be consumed in limited quantities but do produce some anti-inflammatory effects in the right ratio to omega 3 fatty acids.
DGLA (omega 6): found in breast milk and is anti-inflammatory.
Curcumin: Primarily absorbed in the gut. Natural anti-inflammatory.
Antioxidants: Free radicals are are being made all the time in our body. Glutathione, vitamin E and vitamin C are examples of anti-oxidants. A diet with limited plant-based, antioxidants does not provide the internal, innate protective mechanism our body uses to fight against invaders. We have to give our body the nutrients it needs to thrive!
Calorie restriction and fasting: This turns off part of the inflammatory cascade and promotes apoptosis, or programmed cell death, where unhealthy cells can die and be removed from the body.
Vitamin D: Antimicrobial peptides are stimulated by vitamin D. Vitamin D is importan
t for many physiological processes in our body and is sometimes though of
as more of a hormone than a vitamin.
In summary, acute inflammation is necessary and needed to our survival. It is chronic inflammation that causes chronic disease presentation.