Inflammation is an essential part of our survival package. From an evolutionary perspective, the biggest killer of Homo Sapiens has been infection, with cholera claiming a third of all deaths, ever. The body has to be alert to the possibility of any infection, to all of which it responds with inflammation. However, inflammation is metabolically expensive and inherently destructive. It has to be, in order to kill infections by bacteria, viruses, parasites or whatever. For example, part of the immune defence involves a "scorched earth" policy - tissue immediately around an area of infection is destroyed so there is nothing for the invader to parasitise. The mechanism by which the immune system kills these infections is by firing free radicals at it. However, if it fires too many free radicals, then this "friendly fire" will damage itself. Therefore, for inflammation to be effective it must be switched on, targeted, localised and then switched off. This entails extremely complex immune responses; clearly, there is great potential for things to go wrong.
Inflammation is also involved in the healing process. Where there is damage by trauma, there will be dead cells. Inflammation is necessary to clear away these dead cells and lay down new tissues.
Inflammation is characterised by heat and redness (heat alone is antiseptic), combined with swelling, pain and loss of function which immobilises the area being attacked by the immune system. This is necessary because physical movement will tend to massage the infection to other sites.
If one looks at life from the point of view of the immune system, it has a very difficult balancing act to manage. Too little reaction and we die from infection; too much reaction is metabolically expensive and damaging. If switched on inappropriately, the immune system has the power to kill us within seconds - an example of this being anaphylaxis.
What causes inflammation
- Infection - any acute or chronic infection will result in inflammation
- Tissue damage - eg trauma, burn, fracture, overuse of muscles, ligaments and joints
- Chemicals and toxic insult
- Radiation - eg too much sun-bathing will give us red skin from ultraviolet light!
What controls inflammation
- Vitamin D is anti-inflammatory. This is because sunshine - with all its radiations - causes inflammation in the skin, but locally-produced vitamin D stops this local inflammation and then diffuses to the rest of the body causing a generalised anti-inflammatory effect. The further away from the Equator one lives the greater one's risk of autoimmunity, cancer, allergy and arterial disease.
- Adrenal function - the adrenal gland produces cortisol, DHEA, adrenaline and noradrenaline, all of which have profound effects on the level of immunity. Adrenaline, for example, can switch off anaphylaxis within a few second. Adrenal function can be determined by doing an adrenal stress profile. As we age the adrenal function declines and we are more prone to inflammatory disorders. See CFS and Adrenal gland problems.
- Antioxidant status - the immune system uses free radicals to kill bugs. If these free radicals are not quickly mopped up by the antioxidant system, then they go on to damage normal tissues. See Antioxidants. Poor anti-oxidant status is a disease-amplifying state because any immune activity cannot be switched off. This can be corrected by taking anti-oxidants.
- Cell damage - if there is damage of any sort the immune system will be switched on in order to digest away the damaged cells before they get infected. There are lots of possible causes of cell damages, inflammation being one - which then causes further cell damage; a typical vicious cycle of CFS.
- Essential fatty acids - having good levels of Omega 3 and 6 essential fatty acids feeds into prostaglandins and prostacyclins and leukotrienes which are essential messengers within the immune system. A low fat diet - so beloved of the "cholesterol can be reduced by diet" school of thought - will result in a pro-inflammatory tendency. See Nutritional Supplements. High dose EFAs such as Eskimo Brain sharp oils by Nutri can be most helpful.
- Sugar is directly pro-inflammatory because it raises insulin levels and generates free radicals.
- Toxic load - this is also pro-inflammatory because it causes cell damage and produces free radicals. Eg cigarette smoking, heavy metals, pesticides, volatile organic compounds, surgical implants such as silicones all increase toxic load. If I do fat biopsies almost invariably I find a range of chemicals. These can be eliminated by Detoxification.
- Nitric oxide - a cell-to-cell communicator, is directly pro-inflammatory and drives the OH-NO-OO cycle as described by Martin Pall. Nitric oxide combines with superoxide (a major free radical which is very damaging and mopped up by superoxide dismutase) to form peroxynitirite. This may explain why B12 is so helpful because it scavaneges peroxynitrite directly. These effects result in an up-regulation of the NMDA receptor - this is down regulated by magnesium. See CFS and B12 - rationale for using vitamin B12 and CFS - The Methylation Cycle.
Inflammation is a central part of the ageing process - the more inflammation, the more cell damage and the faster we age.
What switches inflammation on?
Historically, the major cause of inflammation has been infection. Broadly speaking, viruses produce a lymphocyte reaction, bacteria a neutrophil reaction, and parasites an eosinophil reaction. Physical causes include any sort of trauma which could be a fracture, a burn, a wound or ischemia from poor blood supply - all of which can result in tissue death.
For the time-being, modern Western man is ahead of death by infection. However, Western lifestyles are now the major cause of inflammation. See The general approach to maintaining and restoring good health.
Evolution fitted humans to spend their lives living in one place, eating the same local foods throughout their lives, not travelling and meeting unfamiliar bacteria in other countries, nor being invaded by people from abroad. Nowadays, the immune system is brought face to face with new foods it had not experienced whilst it was being programmed in early life, and is assailed by a multiplicity of new bacteria and viruses. Furthermore, modern Western lifestyles bring us into contact with new chemicals including heavy metals, pesticides and volatile organic compounds, all of which upset the normal processes of immune recognition. These are called "adjuvants". One example of this was revealed by a study in Japan which showed how people living in the cities had a higher rate of hay fever than people in the countryside despite pollen counts being very much higher in the countryside. The explanation came from the discovery of diesel particulates in city environments which stick onto grass pollen making it more antigenic.
- Vaccinations are an example of how adjuvants work.
Vaccinations are intended to programme the immune system to recognise pathogenic bacteria and viruses. The body is presented not with the real live bug, but with either a dead form or an attenuated form. In order to wake up the immune system so that it recognises these as a threat (which, in these forms, of course they aren't), adjuvants are added. Many adjuvants are either mercury or aluminium. This is another illustration of how heavy metals can get into the body and may switch on the immune system. Nowadays, children are receiving so many vaccinations that the toxic load of metals may be causing a toxic problem in addition to the problem of immune activation. The "hygiene hypothesis" has much to commend it. Modern life may be "too clean". The immune system needs constant training through stimulation from soil bacteria, gut flora and gut parasites. If it doesn't get this training, it may start to react inappropriately - for example, to foods.
A vital part of the education of the immune system occurs within the first hour of life. The baby is born with a sterile gut which accepts - immunologically speaking - bacteria which are passed through the mother's gut. The baby's gut should be inoculated at birth with its mother's bacteria, and this gut flora should persist for life. Nowadays, with Caesarean sections, sterilisation of bottles and teats, lack of breast feeding, use of antibiotics etc., the baby's immune system may not get this essential initial programming. See Probiotics.
Good digestion is essential for protection against inflammation. Anything which causes a leaky gut will allow large antigenically-interesting molecules to pass from gut to blood-stream and these may switch on allergies. Alcohol, drugs, gastroenteritis, poor digestion of foods, poisoning and so on, can all cause a leaky gut. See Digestive enzymes are necessary to digest food and Fermentation in the gut and CFS.
Any foreign materials implanted in the body may also switch on the immune system. The best example is silicone implants; but surgical implants, especially those containing nickel, can potentially do this. Jewellery and piercing are common causes of metal allergies, often to nickel, but it may be to any other metal. Dental amalgam passes freely into the body and can switch on sensitivity to mercury, nickel and silver.
We then come to the problem of pesticides and volatile organic compounds, all of which are very good at switching on inflammation. These are now ever-present in food, water and polluted air.
The problems of switching on the immune system
If the immune system is switched on then it may become activated against substances entirely inappropriately. This is the basis of allergy, in which reactions to foods, pollens, animal furs, chemicals (MCS) are switched on as well as autoimmunity which can switch on reactions to whole organs in the body (such as autoimmune thyroiditis) or to cell organelles such as anti-DNA antibodies (found in several autoimmune diseases but notably systemic lupus erythematosis).
Indeed it is often impossible to tell the difference between infection, allergy an dauto-immune reactions - the same inflammation is at work - it is just either appropriate or inappropriate.
Herbal treatments which help switch off inflammation
- Devil's Claw
- Curcumin (tumeric)
- Flavonoids, caretonoids
- Probably many others that I do not know of!
Nutritional Supplements which help switch off inflammation
- Vitamin D
- Vitamin B12
- Essential fatty acids
- Anti-oxidant effect: vitamins A, C, E, magnesium, zinc, copper, manganese, selenium, glutathione
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