Finding the Cause of Inflammation to Stop the Disease Process

By Dr. Susan Tanner, MD

In our previous article about inflammation, we discussed at length what inflammation is, how it can present, and the cascade of issues that can arise throughout the body when inflammation is prolonged and is left untreated. Now, let’s look at how we can determine what caused the inflammation and the ways we can detect its origin.

With every patient that I treat, the first order of business is to obtain a very detailed environmental and medical history. I prefer doing this on a timeline, beginning even before birth, if possible, because a mom’s health and nutrition, as well as any complications during her pregnancy, influence the future health of her baby. Many people do not realize that their personal toxic or body load actually began accumulating BEFORE birth while they were in the womb. The timeline approach helps to divide the patient’s health history by decade, giving us a good organizational starting point. I ask my patients to include every place lived, illnesses, surgeries, major stressors, medications, and more. By mapping out the details, we can often detect a causal relationship between some of these factors and a change in the patient’s health. One of my mentors in Environmental Medicine told me, “Every patient has a story. If you ask enough of the right questions, they will tell you what is wrong with them.” I have found this statement to be amazingly true.

Testing for Inflammation

Once we have the history down, then we look at testing. There are blood tests for inflammatory markers relating to previous or current infections. These infections may be viral, fungal, or bacterial. These may include an Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), Antistreptolysin O Titer (ASO), and Transforming Growth Factor Beta-1 (TGF Beta-1), to name a few. I will briefly break each test down to give you a simplistic idea of what these tests are measuring and looking for. Remember, though, this list is not complete and is just an overview:

  • Erythrocyte Sedimentation Rate (ESR) – Not a standalone diagnostic, but one that can help measure the progress of inflammation in the body. It measures the rate at which red blood cells fall to the bottom of the tube or form sediment. A high or elevated sedimentation rate would correlate with more disease activity while a low sedimentation rate would suggest that the disease is less active.
  • C-reactive protein (CRP) – This measures CRP, a protein made by the liver. High levels indicate inflammation. It is commonly used to diagnose acute infection or inflammation as CRP is released into the blood immediately when trauma occurs, but high CRP levels can also indicate signs of a flare-up of chronic inflammatory disease.
  • ASO titer – Test used to measure ASO and anti-DNase B, the most common of several antibodies that are produced by the body’s immune system in response to a strep infection. An elevated titer of antibody (positive ASO) or an ASO titer that is rising means that it is likely that the person tested has had a recent strep infection. ASO titers that are initially high and then decline suggest that an infection has occurred and may be resolving.
  • TGF Beta-1 – A superfamily of cytokines involved in the maintenance of tissue and cellular homeostasis, also an innate immune system regulator. Often, TGF Beta-1 levels are elevated in patients with autoimmunity and chronic inflammation.

If any test results are abnormal, then that may lead down a number of other paths. If mold exposure is evident in the patient’s history, then looking for the resultant inflammation in respiratory passages (nose, throat) should be pursued. If a chronic virus such as Epstein Barr is present, then helping the immune system adjust to this virus without overreacting is the goal. There are many other possibilities, of course, but the point is, a detailed history is a must to get to the cause.

Inflammation and Genetics

Genetic susceptibility is another consideration. If autoimmune disorders run in a family, then all efforts must be made to decrease the “switch” be it environmental or infectious, that allows these pro-inflammatory genes to express themselves. Remember, epigenetics is the kicker here: Our genes load the gun, but our behaviors, environments, toxic load, etc. pull the trigger, so to speak. Just because the gene is there does NOT mean that it will be expressed. There is a LOT we can do to put our bodies at an advantage to overcome genetic predispositions and to heal. Thus, a detailed family history can be very revealing for this purpose as well.

The Sometimes Overlooked Dental Component to Inflammation

One area that may be easily overlooked is a dental component. For example, I have had patients present with diffuse joint pain, swelling, rashes, and fatigue. They may have been diagnosed with an inflammatory type of arthritis. But why did it suddenly occur? A very important part of history is to see what dental procedures have been done. One particular area of concern has to do with root canals. When the “canal” is opened in the tooth to remove a dead or infected nerve, this exposes the root of the tooth to air. Once opened, adequate sterilization of this area is almost impossible to do. A study done by Drs. Robert Kulacz, DDS, and Thomas Levy, MD, cardiologist, and authors of The Toxic Tooth, found that 100 percent of extracted teeth with root canals were positive for infection. The act of chewing pulses this infection into the lymphatic system of the body, disseminating bacteria throughout the body. I realize this is a very controversial area of discussion, and while I understand the need for root canals, when they can be avoided, it is best. And if a root-canaled tooth shows evidence of infection, especially when the root of the tooth extends into the sinus cavity, then it should be removed.   These teeth are not usually painful so detection can be tough! Dr. Levy’s articles and research correlating root canals with heart disease and thoracic and breast cancer are compelling and interesting read.

Toxic Exposures

Inflammation can also be resultant from toxic exposures. We have discussed mold exposure and the various ways it can impact the body, but so can chemicals and other toxins, including pesticides, herbicides, and cleaning solutions. Another area of great concern that is being discussed quite a bit in news media is vaping. Vaping solutions are laden with chemicals that, over time, I think we will find to be every bit as harmful, if not worse, than the cigarettes they were meant to replace. Because these substances are inhaled into the lungs, their ability to stimulate an inflammatory response is huge!

Hormones and Inflammation

Certain hormonal reactions can feed into the inflammation cascade as well, especially that of insulin and blood sugar. Some foods elicit the release of more insulin into the bloodstream and secondary by-products that are, by their nature, very inflammatory to tissues and organs. As the functionality of these organ tissues is compromised, then their operation, in turn, may create more inflammation!

There have been diets and books termed, “The Anti-Inflammatory Diet,” etc., and many of these are quite good as giving some very basic information about what to eat and what to avoid in order to quell inflammation. To that effect, certain foods are also considered “pro-inflammatory.” These are typically those of large molecular structures, such as gluten and casein. This group can also include foods that contain certain compounds that affect SOME people in an inflammatory way, such as tomatoes and peppers. However, I do think that much of this must be quite individualized, one person’s cure can be another’s poison. That said, avoidance of refined foods, artificial colorings, preservatives, and pesticide-laden produce is best, as ingestion of any of these ingredients simply increases the body load. Junk food, alcohol, and high-sugar content foods and sodas are ALL proinflammatory. Is it really any wonder that the occurrence of depression, ADD/ADHD, and other brain and cognitive disorders is at an all-time high with the American diet being what it is? We are eating foods that are counterproductive to our ability to function properly.

Summing It Up

The mechanism of inflammation accelerates aging, disease, and pain. Anything we can do to decrease it should prolong life and vibrancy. Antioxidant supplements, including Vitamin C, glutathione, Lipoic acid, Beta Carotene, and others do help in calming inflammation, but there are specific uses and doses for various conditions. Identifying the cause is the main thing. Once the cause is identified, the patient can avoid it, treat the inflammation, and finally allow their body to heal. In future articles, we will discuss avoiding environmental causes, like mold, inflammation, and treating inflammation specifically.